BKM Public Health and Community Medicine

Epidemiological features and climatological effects on future malaria control in Indonesia

Anwar Rovik, Ayu Rahayu, Oktaviani Naulita Turnip, Edwin Widyanto Daniwijaya — Tue, 25 Nov 2025 00:00:00 +0700

Purpose: Malaria is a leading cause of death worldwide, including in Indonesia. Climate change should be considered when addressing malaria control in Indonesia. This study examined the relationship between climatological parameters (temperature, wind speed, humidity, and rainfall) and malaria cases in Indonesia from 2006 to 2015.

Methods: Data on climatological parameters were obtained from Indonesia's 2022 statistics, while malaria case data were taken from the annual report of Indonesia's Ministry of Health. Results were presented using maps, diagrams, and graphs. The associations between climatological parameters and malaria cases were analyzed annually using GraphPad Prism 9 software.

Results: Between 2006 and 2015, the API fluctuated each year. Papua province had the highest malaria incidence in Indonesia (25.5%). A significant decline in malaria cases was observed outside Papua province, whereas cases in Papua tended to increase annually. During this period, annual temperature ranged from 23.39°C to 28.44°C, wind speed from 1.01 m/s to 17.54 m/s, relative humidity from 70.85% to 85.84%, and rainfall from 99.74 to 3,838.2 mm3.

Conclusion: From 2006 to 2015, annual temperature, rainfall, and relative humidity showed weak positive correlations with the API, whereas annual wind speed showed a negative correlation.

Effectiveness of netboard-based learning management system (LMS) nutrition education on nutritional intake of pregnant women

Sunarto Kadir, Suardi, Lia Indrawati — Thu, 27 Nov 2025 00:00:00 +0700

Purpose: Analyzing the effect of nutrition education through a Netboard-based Learning Management System (LMS) on the nutritional intake of pregnant women in the working area of the Kota Tengah Community Health Center, Gorontalo Province.

Methods: This study employed a quasi‑experimental design with pre‑test and post‑test measures. This study was conducted with two groups: an experimental group that received nutrition education through a Netboard-based LMS, and a control group that received education through conventional methods. The sample consisted of 40 second‑trimester pregnant women in the catchment area of the Kota Tengah Community Health Center, assigned to the experimental group (n=20) and the control group (n=20). Data were collected using a 3 × 24‑hour food recall form that covered indicators of macronutrient and micronutrient intake, as well as dietary patterns. The data were analyzed using an Independent Samples t‑test.

Results: The results showed that Netboard‑based LMS nutrition education had a significant effect on pregnant women's dietary intake. The analysis yielded a significance value of 0.000 (< 0.05), with the experimental group demonstrating higher mean scores than the control group.

Conclusion: Netboard-based LMS nutrition education effectively enhances the nutritional intake of pregnant women. Notably, 95% of participants in the experimental group achieved a 'good' intake classification post-intervention, compared to only 5% in the control group. This suggests that the digital platform is a promising tool for nutrition education in maternal health settings.

Integrating the role of community and mobile health in preventing risk factors for cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials

Thu, 27 Nov 2025 00:00:00 +0700

Purpose: Cardiovascular disease (CVD) continues to be the primary cause of global morbidity and mortality, predominantly attributable to modifiable risk factors such as unhealthy diets, physical inactivity, and so on. While behavioral interventions are critical, the effective implementation of prevention strategies is often hindered by resource limitations. The integration of community-based strategies with mobile health (mHealth) technologies presents a promising approach for scalable, personalized risk mitigation. This review evaluates the efficacy of community-integrated mHealth inter- ventions in reducing CVD risk factors.

Methods: We searched multiple databases for randomized controlled trials (RCTs) published over the last 10 years. Fourteen RCTs (n = 9,862 participants) met inclusion criteria, with interventions combining mHealth tools and community components. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and meta-analyses were conducted using RevMan 5.4.

Results: mHealth and community have demonstrated considerable efficacy in diminishing various cardiovascular risk factors. The primary mechanisms include enhanced adherence to a healthy lifestyle, continuous monitoring, and improved access to health-related information. The results of the meta-analysis are directly proportional to the findings, which significantly reduce the risk factors for heart disease: healthy dietary patterns (p < 0.0001), physical activity (p = 0.04), BMI (p = 0.002), systolic blood pressure (p = 0.002), and diastolic blood pressure (p = 0.02). However, total cholesterol and fasting blood sugar did not have significant results, namely (p=0.23) and (p=0.77).

Conclusion: Community-integrated mHealth is an effective strategy for addressing CVD risk factors.

Estimated cost of diabetic wound care in primary healthcare facilities using the time-driven activity-based costing method

Sun, 30 Nov 2025 00:00:00 +0700

Purpose: This study aimed to estimate the unit cost of diabetic wound care services in primary healthcare facilities (FKTPs) using the Time-Driven Activity-Based Costing (TDABC) method and to quantify the potential cost savings from reallocating cases from secondary (FKRTL) to primary care facilities.

Methods: A micro-costing analysis was conducted across 40 FKTPs in Indonesia using a standardized five-step TDABC framework, covering personnel, facility, medical supplies, and overhead costs. Descriptive and nonparametric statistical methods, including the trimmed mean, geometric mean, and interquartile range, were applied to derive cost estimates, and simulations with 15% and 35% case shifting from FKRTL to FKTP were performed. Non-parametric methods (Kruskal–Wallis and Mann–Whitney U) were applied because the cost data were not normally distributed.

Results: The estimated unit cost per diabetic wound-care visit ranged from IDR 67,121 (best-case scenario) to IDR 77,189 (realistic scenario). Cost-shifting simulations projected potential savings of up to IDR 28.15 billion in the 35% scenario.

Conclusion: Strengthening diabetic wound-care services at the primary care level may enhance system-wide efficiency and reduce avoidable expenditures within the National Health Insurance (JKN) scheme, supporting the adoption of more cost-effective service delivery models in Indonesia.

Effectiveness of digital gaming intervention in enhancing adolescents’ knowledge and attitudes toward sexual and reproductive health: a systematic review

Reztika Cahyani, Etty Rekawati, Sigit Mulyono, Widyatuti — Sun, 30 Nov 2025 00:00:00 +0700

Purpose: Adolescents often lack adequate sexual knowledge, leading to risky behaviors. Traditional sexual health education is usually less effective in enhancing the motivation and engagement of students. Digital gaming interventions offer a promising alternative in the digital era, providing interactive, engaging, and safe learning experiences. This systematic review aims to analyze the effectiveness of digital games in enhancing adolescents’ knowledge and attitudes toward sexual and reproductive health education.

Methods: This systematic review followed the PRISMA guidelines and employed the Joanna Briggs Institute (JBI) critical appraisal. A literature search across ClinicalKey, Cochrane, EBSCO, ScienceDirect, and Scopus identified studies published between 2015 and 2025. The inclusion criteria were original, quantitative studies in English that were freely accessible and focused on digital gaming interventions in adolescent reproductive health. Conventional games or unrelated topics were excluded. Four authors independently screened and reviewed the studies, yielding nine articles for analysis.

Results: Nine studies with 6,969 adolescents (aged 11–24) from six countries were included. Digital game interventions significantly improved SRH knowledge and attitudes, with effects ranging from modest (6.27% gain; β = 0.05–0.08) to numerous (η² = 0.80). The small number of studies, design heterogeneity, and cultural differences limit the evidence.

Conclusion: Digital gaming intervention improves adolescents’ SRH knowledge and attitudes across contraception, STI prevention, and healthy relationships. However, the limited number of studies, design heterogeneity, and cultural variations restrict generalizability. Future rigorous studies and integration into schools and community programs are recommended. Registered in PROSPERO, ID CRD4202511 68048.