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All Journal Sriwijaya Journal of Ophthalmology Sriwijaya Journal of Obstetrics and Gynecology
Annisa Annisa
Department of Health Sciences, Baloi Medical Center, Batam, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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Peer-Led Nutritional Education Plus Iron-Folic Acid for Adolescent Iron-Deficiency Anemia: A Cluster Randomized Controlled Trial in Indonesia Indri Yani Septiana; Annisa Annisa
Sriwijaya Journal of Obstetrics and Gynecology Vol. 3 No. 2 (2025): Sriwijaya Journal of Obstetrics & Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v3i2.279

Abstract

Introduction: Iron-deficiency anemia affects roughly one-third of adolescent girls and, by entering reproductive life with depleted iron stores, propagates intergenerational maternal risk. Standard weekly iron-folic acid (IFA) supplementation is undermined by poor adherence. We evaluated whether adding a peer-led nutritional-education program to IFA improves hematologic and psychosocial outcomes more than IFA alone. Methods: In a single-blind, parallel-group cluster randomized controlled trial in urban Palembang, Indonesia, 16 school clusters were randomized 1:1 to peer-led education plus weekly IFA (60 mg iron, 2.8 mg folic acid) or IFA alone. We enrolled 320 post-menarcheal girls aged 13–17 years with baseline hemoglobin 8.0–11.9 g/dL. Co-primary outcomes were hemoglobin and serum ferritin; the secondary outcome was the WHO-5 Well-Being Index, assessed at baseline, 3 and 6 months. Generalized linear mixed models with cluster random intercepts (intention-to-treat) were used. Results: At 6 months the intervention produced adjusted mean differences of +1.42 g/dL hemoglobin (95% CI 1.05–1.79; Cohen's d 2.11), +13.5 µg/L ferritin (10.2–16.8; d 2.75) and +23.4 WHO-5 points (19.8–27.0; d 3.14), all p<0.001. Anemia resolved in 89.3% versus 33.1% (RR 2.70, 95% CI 2.13–3.42; NNT 2). Adherence was higher with the intervention (92.5% vs 74.3%; OR 4.25). The multivariable model discriminated resolution well (AUC 0.89, 0.85–0.93). No severe adverse events occurred. Conclusion: A peer-led nutritional-education program markedly enhanced the efficacy of standard IFA, normalizing hemoglobin, replenishing iron stores and improving psychosocial well-being in anemic adolescent girls. This low-cost, scalable, school-based strategy is a promising preconception reproductive-health intervention for Indonesia and similar settings.
Machine Learning Prediction of Binocular Vision Recovery in Accommodative Esotropia: A Prospective Multicenter Study Karina Chandra; Pham Uyen; Annisa Annisa
Sriwijaya Journal of Ophthalmology Vol. 8 No. 2 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i2.139

Abstract

Introduction: Accommodative esotropia is the most common childhood convergent strabismus, yet predicting binocular vision recovery after treatment remains challenging. This study developed and validated machine learning (ML) models to predict binocular vision recovery using baseline clinical parameters. Methods: This prospective multicenter study enrolled 156 patients (aged 2–12 years) with accommodative esotropia across three private hospitals in Indonesia. The unit of analysis was patients. Baseline binocular vision parameters were used to train four ML models (gradient boosting, random forest, neural network, logistic regression) with 5-fold stratified cross-validation. Treatment success was defined as stereoacuity ≤100 arc seconds at 12 months. Model performance was evaluated using AUC-ROC and SHAP feature importance. Results: Treatment success was achieved in 104 patients (66.7%). Gradient boosting achieved the highest AUC of 0.903 (95% CI: 0.854–0.952; sensitivity 0.875; specificity 0.827). The strongest predictors were baseline stereoacuity ≤400 arc seconds (OR = 4.15; p < 0.001), deviation angle ≤20 PD (OR = 3.42; p < 0.001), and Worth 4-dot fusion (OR = 3.21; p = 0.001). Conclusion: ML models accurately predicted binocular vision recovery in accommodative esotropia, identifying clinically interpretable predictors that may optimize treatment selection in pediatric strabismus management.
Co-Authors Indri Yani Septiana Karina Chandra Pham Uyen