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Factors Influencing Mortality Among HIV Patients Utami, Dian Margi; Pakki, Irfansyah Baharuddin; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Abstract

Background : The World Health Organization reported that global coverage of antiretroviral therapy (ART) reached 77% in 2024; however, mortality among people living with HIV remains relatively high. Various clinical, immunological, and social factors influence treatment success and patient survival outcomes. Objective : This study aims to narratively analyze the factors associated with mortality among HIV patients receiving ART. Research Methods/ Implementation Methods : This narrative review identified relevant literature published between January 2020 and June 2025 through four electronic databases: PubMed, Scopus, Google Scholar, and ScienceDirect. The search used combinations of keywords and Boolean operators (“AND,” “OR”): “HIV” OR “Human Immunodeficiency Virus” AND “mortality” OR “death” AND “antiretroviral therapy” OR “ART” AND “survival analysis” OR “Cox regression” OR “Kaplan–Meier” AND “cohort study.” Only peer-reviewed, full-text articles in English were included. Eligible studies employed prospective or retrospective cohort designs, involved adult HIV patients receiving ART, and reported mortality outcomes analyzed using Kaplan–Meier or Cox proportional hazards models. Review articles, case reports, and studies without relevant survival or mortality data were excluded. A total of 12 studies met the inclusion criteria, primarily conducted in Sub-Saharan Africa, the Caribbean, and Latin America. Results : Mortality rates ranged from 4.2 to 11.7 per 100 person-years, with a 5-year survival rate of 81.7–88.5%. Approximately 60–70% of deaths occurred within the first year of therapy. The most consistent mortality risk factors included CD4 count <200 cells/μL (AHR 2.3–6.6), severe anemia or hemoglobin <10 g/dL (AHR 2.2–5.2), WHO clinical stage III/IV (AHR 4.3–15.0), poor functional status (bedridden/ambulatory) (AHR 3.0–9.5), tuberculosis co-infection (AHR 1.9–4.1), and poor ART adherence (AHR 3.3–9.6). Sociodemographic factors such as being unmarried, low education, and poverty also increased mortality risk (AHR 1.6–3.7). Conversely, good ART adherence, cotrimoxazole prophylaxis (CPT) use, adequate nutritional status (BMI ≥18.5 kg/m²), and CD4 ≥200 cells/μL were significant protective factors. Conclusion/Lesson Learned : Mortality among adult HIV patients in developing countries remains high, particularly within the first year of ART and among individuals with low immunity, anemia, or tuberculosis co-infection. Strengthening anemia and TB screening, optimizing ART adherence, and early identification of patients with low CD4 counts should be prioritized to reduce mortality rates.
Diet, Knowledge and Hypertension : a Correlation Study for Elderly with Hypertension Husna, Gusti Nurul; Pakki, Irfan Baharuddin; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Healthy dietary behavior is one of the key factors in maintaining nutritional status and preventing degenerative diseases, particularly among the elderly population. Hypertension is one of the most prevalent chronic health problems experienced by older adults. The prevalence of hypertension in the elderly tends to increase with age and is mostly associated with unhealthy lifestyle behaviors, especially dietary patterns that do not follow the principles of a hypertension diet. Objective : to analyze the correlation between knowledge and healthy lifestyle patterns in elderly people with hypertension Research Methods/ Implementation Methods : This study employed a cross-sectional design. The sample consisted of 100 respondents aged 60–65 years selected using purposive sampling in the Bengkuring Public Health Center. Data were collected through questionnaires covering respondent characteristics, knowledge level, and dietary behavior. The data were analyzed using the Spearman correlation test with a significance level of 0.05. Results : The results showed that out of the five dietary behavior components observed, only one component showed a significant correlation between knowledge and lifestyle behavior related to caffeine and smoking consumption, with a p-value of 0.011 (<0.05). Elderly individuals who possess better knowledge regarding the effects of caffeine and smoking on hypertension tend to be more cautious in consuming these substances. Cigarettes and caffeine are known to increase sympathetic nervous system activity and elevate blood pressure. Conclusion/Lesson Learned : Knowledge have an important yet limited role in shaping healthy lifestyle behaviors among elderly individuals with hypertension.
Effectiveness and Safety of Dengue Vaccines in School-Aged Children in Endemic Areas: A Narrative Review Kurniasih, Hefi; Pakki, Irfansyah Baharuddin; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Dengue fever remains one of the most significant mosquito-borne viral diseases, particularly in tropical and subtropical regions such as Indonesia. The increasing incidence among school-aged children highlights the urgent need for effective and sustainable prevention strategies. Vaccination has emerged as a crucial intervention to reduce dengue burden, with two main vaccines —TAK-003 (Qdenga®) and CYD-TDV (Dengvaxia®)—showing varying efficacy and safety profiles. Objective : This narrative review aims to synthesize the current scientific evidence on the effectiveness, safety, and policy implications of dengue vaccination among school-aged children living in endemic regions. Research Methods/ Implementation Methods : This study employed a narrative review approach. Literature was searched through PubMed, ScienceDirect, and Google Scholar databases for publications from 2020 to 2025. A total of 20 eligible articles were included, comprising randomized controlled trials, quasy experiment, observational studies and spatial epidemiological studies. The inclusion criteria encompassed studies published in English or Indonesian, focusing on dengue vaccines among children aged 4–16 years in endemic countries. Key data on vaccine efficacy, immunogenicity, safety, and implementation outcomes were descriptively synthesized. Total 20 included articles were analyze narratively. Results : Findings consistently indicate that TAK-003 provides an efficacy of 62–80% against symptomatic dengue and over 85% against hospitalized cases up to three years post-vaccination, with favorable safety and immunogenicity, especially among seropositive children. In contrast, CYD-TDV demonstrated high efficacy only among seropositive individuals aged ≥9 years but carried an increased risk in seronegative recipients. Economic modeling studies in Indonesia found dengue vaccination to be cost-effective, while mathematical models showed that higher vaccine coverage substantially reduces the basic reproduction number (R0). Conclusion/Lesson Learned : Current evidence supports TAK-003 as an effective and safe vaccine for school-aged children in endemic regions compare to CYD-TDV. Integration of dengue vaccination with vector control and risk-based surveillance is recommended to enhance national dengue prevention strategies and achieve long-term disease reduction.
Comparative Patterns of Non-Communicable Disease Risk Factors Across Age Groups in Samarinda, Indonesia Arfandi, Muh. Amri; Saefurrohim, Muhamad Zakki; Azka, Arlina; Pakki, Irfansyah Baharuddin; Siswanto, Siswanto; Risva, Risva; Azmiardi, Akhmad; Asrianti, Tanti
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Non-communicable diseases (NCDs) have become a major public health concern, with risk factors increasingly observed among younger populations. Examining how these risks differ between age groups may provide insight into early prevention priorities. Objective : To describe and compare behavioral and biological NCD risk factors among older adolescents (15–19 years), young adults (20–24 years), and adults (25–59 years) in Samarinda, Indonesia. Research Methods/ Implementation Methods : A descriptive cross-sectional study was conducted among 242 respondents selected through household interviews in Samarinda. Data were collected using the WHO STEPwise approach to NCD risk factor surveillance (STEPS) questionnaire, covering behavioral factors (tobacco, alcohol, physical activity, diet) and biological factors (BMI, blood pressure, blood glucose, cholesterol). Data were analyzed descriptively using STATA 17. Results : Variations were observed across age groups. Smoking was more frequent among young adults (22.2%) compared to adolescents (9.3%) and adults (17.7%). Alcohol use was generally low but relatively higher among adolescents (12.4%). Physical activity levels and sedentary time showed comparable patterns, with young adults reporting slightly more sedentary behavior (40%). Most respondents consumed fruits less than four days per week. The proportion of overweight and obesity was greater among adults (54.4%) than in young adults (24.4%) and adolescents (19.4%). Differences were also seen in clinical indicators, with adults showing a higher proportion of hypertension (44.1%) and high cholesterol (35.3%) compared to younger groups. Conclusion/Lesson Learned : The study highlights varying patterns of NCD risk factors among age groups, with several behavioral risks already present during adolescence. These findings emphasize the importance of early preventive actions focused on healthy lifestyles, especially among youth, supported by community-based education and health monitoring initiatives.
Case Control Study on Pediatric Tuberculosis Risk Factors at KarangAsam Health Center Samarinda Maharani, Siti Malikha Zalzabila; Pakki, Irfansyah Baharuddin; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that mainly affects the respiratory system and poses significant health and economic burdens. In Samarinda, the Karang Asam Health Center recorded the highest TB cases in 2024, with 162 cases, including 14 pediatric cases completing treatment and 148 treated at other facilities. Objective : The study aimed to describe the characteristics and risk factors associated with the incidence of TB in children at the Karang Asam Health Center in Samarinda City. Research Methods/ Implementation Methods : This case-control study involved 20 cases and 40 controls. The independent variables were close contact, nutritional status, and immunization status, with childhood tuberculosis as the dependent variable. Samples were obtained by purposive sampling. Data were analyzed using the Chi-Square test with a 95% confidence level, reporting p- values and OR (p < 0.05 significant). Results : The results showed that most of the 20 children with TB were aged 0-5 years (65%), male (60%), had a history of contact (85%), poor nutritional status (80%), and incomplete immunization status (70%). Based on the Odds Ratio (OR) calculation, it shows a large risk value for the incidence of TB in children, namely contact history (OR= 13,222; 95% CI= 3,256 – 53,691), nutritional status (OR = 6.000; 95% CI = 1.693-21.262), and immunization status (OR = 7.000; 95% CI = 2.120- 23.113). Conclusion/Lesson Learned : Contact history, nutritional status, and immunization status were significant risk factors for pediatric TB. Communities are encouraged to enhance prevention through regular health checks and proper TB management in at-risk children.
Narrative Review: Periodontitis Risk Factors in Prolanis Participants With Systemic Comorbid Diseases Sigit, Ratih Fianni; Pakki, Irfansyah Baharuddin; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background: Periodontitis is a chronic inflammatory disease affecting the supporting tissues of the teeth and is increasingly recognized for its systemic implications. Chronic periodontal inflammation contributes to persistent immune activation, endothelial dysfunction, insulin resistance, and dyslipidemic profiles, thereby elevating the risk of cardiovascular and metabolic disorders. Objective : This narrative review aims to summarize current evidence regarding risk factors of periodontitis among patients with systemic comorbidities, particularly those enrolled in chronic disease management programs. Research Methods/ Implementation Methods : A literature search was conducted across PubMed, Science Direct, and BMC Oral Health databases for articles published between 2020 and 2025 using keywords such as “periodontitis,” “systemic inflammation,” “diabetes mellitus,” “hypertension,” and “cardiovascular disease.” Inclusion criteria consisted of full-text research articles in Indonesian or English focusing on associations between periodontitis and systemic diseases. A total of 33 relevant articles were identified and narratively synthesized. The review consistently demonstrates that systemic comorbidities significantly influence periodontal status. Results : Patients with diabetes, hypertension, and dyslipidemia experience more severe periodontitis due to poor metabolic control and inflammation. Inadequate oral hygiene worsens this condition, while non-surgical periodontal therapy can improve HbA1c, lipid levels, and blood pressure. Conclusion/Lesson Learned : Systemic factors synergistically worsen periodontitis through chronic inflammation and endothelial impairment. Integrating oral health services into chronic disease management may improve metabolic outcomes and prevent systemic complications.
The Effect of Screen Time on Dental Caries in Adolescents: A Narrative Review Silitonga, Hesty Erika; Pakki, Irfansyah Baharuddin; Asfirizal, Verry; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Dental caries is a chronic disease with a high prevalence among adolescents. With the advancement of technology, screen time has become a a daily activity. Excessive screen time can lead to encourage a sedentary lifestyle, which may impact oral health. Objective : This review aims to synthesize scientific evidence from various studies to explain how prolonged screen time contributes to caries risk in adolescents. Research Methods/ Implementation Methods : This narrative review synthesizes relevant research articles to gain a comprehensive understanding of the relationship between screen time and dental caries. Articles were searched through major electronic databases, including PubMed, Google Scholar, and ScienceDirect, focusing on publications from 2016 to 2025. Articles included in the review discussed screen time habits among adolescents, the impact of screen time on dental caries or oral health, were written in Indonesian or English. Results : A literature review of 30 articles reported a positive association between high screen time and increased caries risk in adolescents. Behavioral changes were the main mediators of this association. Many studies described two primary mechanisms: prolonged screen time significantly increased cariogenic dietary habits while using devices and excessive screen time reduces oral hygiene practices. Conclusion/Lesson Learned : Excessive screen time acts as a significant behavioral risk factor for dental caries in adolescents because it can trigger unhealthy dietary patterns and reduce oral hygiene practices. Counseling, reducing screen time, education on tooth brushing, healthy eating, and fluoride using can reduce the risk of dental caries.
Narative Review : Factors Related to the Occurrence of Diarrhea Among Under-Five Children Herliani, Resda; Ningsih, Riyan; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Diarrhea in children under five years of age remains a significant global health crisis, particularly in developing countries, characterized by high morbidity and mortality rates. Although risk factors have been identified, geographic variations and the concentration of preventive interventions require a synthesis of updated evidence. Objective : This narrative review aims to provide a comprehensive update on the key determinants influencing diarrhea incidence in children aged 0-59 months. Research Methods/ Implementation Methods : The review was conducted on research articles published 2019-2024. The articles were retrieved from PubMed, Google Scholar, and ResearchGate databases, using keywords such as "toddlers," "diarrhea," and "determinants." The selection focused on studies reporting diarrhea prevalence, as well as risk or protective factors related to WASH (Water, Sanitation, and Hygiene), immunization, and sociodemographics. Inclusion criteria for articles were original research, written in Indonesian and English, and full papers. A total of 34 articles were analyzed narratively. Results : The prevalence of diarrhea in children under five in community-based studies varies (9.6% to 26.4%), with the highest incidence concentrated in the 6–23 month age group. Conclusion/Lesson Learned : The prevalence of diarrhea in children under five (9.6% to 26.4%). Children from families with low maternal education and limited socioeconomic resources are at greater risk. Strengthening access to safe water, sanitation, hygiene practices, and vaccination coverage is therefore essential for reducing diarrhea burden among under-five children.
Narrative Review: Physical Environmental , Sociodemographic, and Biological Factors on Dengue Fever in Children Aged 0-15 Years Aziz, Rusna Azizah; Sedionoto, Blego; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Objective : This review aims to synthesize evidence narratively regarding the relationship between physical environmental , sociodemographic, and biological factors and the incidence of dengue fever in children aged 0-<15 years. Research Methods/ Implementation Methods : This narrative review was conducted by searching articles in the PubMed and Google Scholar databases from 2016 to 2025. The main keywords used included "Dengue Hemorrhagic Fever," "Physical Environment," "Sociodemographics," and "Biology." The criteria for articles were exposure to physical, sociodemographic, and biological environmental factors associated with the outcome of DHF in children. Other criteria were that articles were written in Indonesian or English and were full-text articles. After screening based on these criteria, 34 research articles were selected for narrative analysis. Results : The results of a literature review of 34 articles analyzed consistently indicate that physical, sociodemographic, and biological environmental factors have a significant influence on the increase in the incidence of dengue fever. The majority of studies reported an increase in the incidence of dengue fever measured in the assessment of physical, sociodemographic, and biological environmental factors. Good physical environmental management, interventions in sociodemographic factors, and effective and efficient control of biological factors can help reduce the incidence and mortality due to dengue fever. Conclusion/Lesson Learned : Physical, sociodemographic, and biological environmental factors are associated with dengue fever incidence in children. These findings recommend enhancing promotional and preventive efforts by increasing collaboration with Jumantik (Family Disaster Mitigation Team) cadres and other cross-sectoral organizations to optimize efforts to reduce dengue fever incidence.
Characteristics of Hypertension Patients at Loa Bakung Community Health Center Noorhayaty, Noorhayaty; Iriyani, Iriyani; Azmiardi, Akhmad; Pakki, Irfansyah Baharuddin
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Hypertension is a non- communicable disease that is one of the main causes of premature death in the world. The World health Organization (WHO) estimates that in 2025 there will be an increase in hypertension cases by around 80%, in 2000 from 639 million cases to 1.5 billion cases. Hypertension is the third leading cause of death in Indonesia for all ages. In 2015, surveys showed that 1 in 4 women and 1 in 5 men suffer from hypertension. Less than 1 in 5 people have hypertension that is well controlled and more than 9 million deaths are related to hypertension Objective : This study aims to determine the characteristics of hypertensive patients in Loa Bakung Community Health Center. The characteristics referred to gender, age, BMI, hypertension degree, and sub district. Research Methods/ Implementation Methods : The method used is descriptive, with a total sampling technique of 251 people. Results : The study results showed that 80 (31.9%) were male patients with hypertension, while 171 (68.1%) were female. There were 146 adult patients aged 18-59 (58.2%), and 105 elderly patients (41.8%) aged over 60 years. There were 96 hypertensive patients with a normal BMI (38.2%), 98 overweight patients (39%), and 57 obese patients (22.7%). The number of patients with normal hypertension (after regular treatment) was 67 (26.7%), 53 pre-hypertension patients (21.1%), 94 grade I hypertension patients (37.5%), and 37 grade II hypertension patients (14.7%). Patients who live in Loa Bakung sub-district are 220 (87.6%), Loa Buah sub-district 21 (8.4%), other sub-districts 10 (4%). Conclusion/Lesson Learned : The conclusion is that based on gender, there are more female patients than male patients, more adult hypertension patients (aged 15-59 years) than elderly patients, and more overweight patients have a BMI than other nutritional statuses. The number of hypertension patients with grade 1 hypertension is higher. Most hypertension patients who seek treatment at the Loa Bakung Community Health Center live in the Loa Bakung sub-district.
Co-Authors -, Ardyasih - Abrori, Abrori Adi Saputro, Endri Aditya, Mifta Adrianto, Ratno Agustina, Elvi Ahmad Zamani, Ahmad Al-Ayubi, Moch Thoriq Assegaf Anamnart, Witthaya Anasulfalah, Hakim Anjani, Aiko Nurrahma Anom Dwi Prakoso Aqsyari, Rizki Ardia Pramesti, Risa Ardiansyah, Andika Nicholas Iqbal Arfandi, Muh. Amri Arifah Chofsoh, Salma Arlina Azka Asrianti, Tanti Atmojo, Joko Tri Aulia, Hanifah Dina Auraldi Nansurya, Alga Ayu Anulus Aziz, Rusna Azizah Baehaqi Baiq Santi Rengganis Bakhtiar, Rahmat Baruni, Amandha Basrowi, Ray Wagiu Bekti Sayekti , Muna Bhisma Murti Blego Sedionoto, Blego Budi Rahardjo Budi Rahardjo Budi Utomo Cahyana, Yudi Jaya Dara Fitri Andrian Daryanto Daryanto Dewi Lieskusumastuti, Anita Dewi Puspito Sari Dewi Puspito Sari Dewi Puspito Sari, Dewi Puspito Dian setyaningsih Didik Tamtomo, Didik Dina Irawati Dodiet Aditya Setyawan Dwi Lestari Eri Pramuja, Wanda Ernawati, Heni Ester Kristian Pamurti Febri Susanti, Rinandita Gabriela Advitri Febriani Hanif, Ihsan Hanifah Dina Aulia Hanifah, Lilik Haryanti, Titik - Henda Ardiani, Intan Hendra Dwi Kurniawan, Hendra Dwi Herliani, Resda Hidayati, Anisa Husna, Gusti Nurul Ihdina Fityatal Hasanah, Yesi Iik Sartika Ika Yuli Ayuningrum Indah Wulandari, Dwi Indarto Indarto Indriani, Dilla C Insany, Vicca Yulia Intan Kurnia, Intan Irfansyah Baharuddin Pakki Irirwanas, Intannia D Iriyani, Iriyani Ismail, Aem Iswahyuni, Sri Joko Triwibowo, Joko Joko Yulianto, Dwi K., Iriyani Karmadi, Karmadi Khansa Azizah, Fara Kuntari, Saras Kurniasih, Hefi Lestari, Ida Ayu Indira Dwika M Taufik Maharani, Siti Malikha Zalzabila Maratul Munawar, Siti Miranda Juandrina, Shella Mirsanti, Faradilla Mirshanti, Farahdila Mochamad Makin, Mochamad Mubarok, Ahmad Syauqi Muh. Amri Arfandi Muhammad Zakki Saefurrohim Nabila Vebiana Soviadi Ningrum, Vallina Laurensia Indika Noerlita Ningrum, Andriani Noorhayaty, Noorhayaty Novitasari, Meliana Nozomi, Alwan Zakki Nuning Nuning Nur Fauziah, Ani Nur Rokhmatun, Puji Nurhayati, Isnani Nurrochim, Nurrochim Pakki, Irfan Baharuddin Pamowa, Agustina Simanangi Permata Fitrianisa, Salsayabila Pradana Putri, Anggie Pradana, Anggie Prasetya, Hanung Puji Lestari, Apriliani Puspitasary, Kiki Puspitasary, Kiky Rahayu, Anisa Rahma Widyaningrum, Nova Ramadhani, Reza W Rasyid Ridha, Achmad Ratih Puspita Febrinasari Ratih Wirapuspita Wisnuwardani Rejo, Rejo Reza Kurnia, Febria Risva Risva Risva Riyan Ningsih Rohmi, Rohmi Roma Yuliana Ruqayyah, Siti S Siswanto Sabngatun, Sabngatun Saefurrohim, Muhamad Zakki Sayekti Heni Sunaryanti, Sri Sekar Wijayanti , Nia Septiana, Lisa Setiawan Manurung, Budi Setyorini, Catur Shinta, Amara Wahyu Febrianshinta Sigit, Ratih Fianni Silitonga, Hesty Erika Sindi Wardani, Galuh Siswanto Siti Lutfiyah Ulfa Siti Maesaroh SITI MARIA ULFA siti nurlela Solly Aryza Suci Susilastuti , Mustika Suciyati Suciyati, Suciyati Sudiro Sudiro Sumardiyono Sumardiyono Suryono Suryono Syauqi Mubarok, Ahmad Syawalia, Zheditya Ayu Sylvia Gusrina Titik Haryanti Tri Atmojo, Joko Tri Darmayanti, Aquartuti Tri Handayani, Rina Tri Yuniarti, Tri Utami, Dian Margi Verasita, Prissy Verry Asfirizal Wardani, Nunuk Kusuma Widiyanto, Aris Wirapuspita Wisnuwardani, Ratih Yadi, Yadi Zainafree , Intan Zakki Saefurrohim, Muhamad