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All Journal Scientia Psychiatrica Indonesian Community Empowerment Journal Sriwijaya Journal of Obstetrics and Gynecology Sriwijaya Journal of Neurology Crown: Journal of Dentistry and Health Research
Fatimah Mursyid
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Religion Humanities Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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The Impact of Early Intervention on Motor Outcomes in Infants with Cerebral Palsy: A Longitudinal Study with Advanced Neuroimaging Correlates in Surabaya, Indonesia Habiburrahman Said; Novalika Kurnia; Fatimah Mursyid; Sophia Lucille Rodriguez; Theresia Putri Sinaga; Aline Hafidzah
Sriwijaya Journal of Neurology Vol. 1 No. 2 (2023): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i1.29

Abstract

Introduction: Cerebral palsy (CP) is a prevalent neurodevelopmental disorder affecting motor function in children. Early intervention (EI) has been shown to improve motor outcomes in infants with CP, but the underlying neural mechanisms remain poorly understood. This longitudinal study investigated the impact of EI on motor outcomes and its association with neuroimaging correlates in infants with CP in Surabaya, Indonesia. Methods: We recruited 60 infants diagnosed with CP aged 6-18 months in Surabaya, Indonesia. Participants were randomly assigned to either an EI group receiving 6 months of individualized, home-based intervention or a control group receiving standard care. Motor function was assessed using the Gross Motor Function Measure (GMFM-88) at baseline, 6 months, and 12 months. Advanced neuroimaging techniques, including diffusion tensor imaging (DTI) and functional magnetic resonance imaging (fMRI), were used to assess brain structure and function at baseline and 12 months. Results: Infants in the EI group demonstrated significantly greater improvements in GMFM-88 scores compared to the control group at 6 and 12 months (p < 0.05). DTI revealed increased fractional anisotropy (FA) in the corticospinal tract and corpus callosum in the EI group at 12 months, indicating improved white matter integrity. fMRI showed increased functional connectivity in motor networks in the EI group compared to the control group at 12 months. Conclusion: Early intervention significantly improved motor outcomes in infants with CP in Surabaya, Indonesia. These improvements were associated with enhanced white matter integrity and functional connectivity in motor-related brain regions. Our findings highlight the importance of early intervention in promoting neuroplasticity and improving motor function in infants with CP.
The Prevalence and Risk Factors for Polycystic Ovary Syndrome (PCOS) among Adolescents in Indonesia: Implications for Early Intervention Habiburrahman Said; Rheina Weisch Fedre; Saurie Hernandez; Sophia Lucille Rodriguez; Fatimah Mursyid; Irna Nettles
Sriwijaya Journal of Obstetrics and Gynecology Vol. 2 No. 1 (2024): Sriwijaya Journal of Obstetrics and Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v1i2.83

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting adolescents, with potential long-term health implications. This study aimed to determine the prevalence and identify risk factors associated with PCOS among Indonesian adolescents. Methods: A cross-sectional study was conducted involving adolescent girls aged 15-19 years from selected schools in Jakarta, Indonesia. Data were collected through questionnaires, physical examinations, and biochemical assessments. PCOS diagnosis was based on the Rotterdam criteria. Logistic regression analysis was used to identify risk factors associated with PCOS. Results: The prevalence of PCOS among Indonesian adolescents was found to be 6.5%. Significant risk factors associated with PCOS included obesity (OR=3.2, 95% CI 2.1-4.8), family history of PCOS (OR=2.5, 95% CI 1.6-3.9), irregular menstrual cycles (OR=4.1, 95% CI 2.8-6.0), and hirsutism (OR=2.8, 95% CI 1.9-4.2). Conclusion: PCOS is prevalent among Indonesian adolescents. Early identification of risk factors such as obesity, family history, irregular menstruation, and hirsutism is crucial for early intervention and management to mitigate potential long-term health consequences.
Prenatal Exposure to Maternal Stress and Neurodevelopmental Outcomes in Children: A Longitudinal Study with Epigenetic Analysis in Jakarta, Indonesia Fatimah Mursyid; Akmal Hasan; Tomiola Owkwulu; Maximillian Wilson; Yi-Fen Huang; Husin Sastranagara
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.81

Abstract

Introduction: Prenatal exposure to maternal stress has been identified as a potential risk factor for adverse neurodevelopmental outcomes in children. This study aimed to investigate the association between prenatal maternal stress and neurodevelopmental outcomes in children in Jakarta, Indonesia, and to explore the potential mediating role of epigenetic modifications. Methods: A longitudinal cohort study was conducted involving 300 pregnant women recruited from antenatal clinics in Jakarta. Maternal stress was assessed during the second trimester of pregnancy using the Perceived Stress Scale (PSS). Neurodevelopmental outcomes in children were evaluated at 12 and 24 months of age using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III). Epigenetic analysis of cord blood DNA methylation was performed using the Illumina Infinium MethylationEPIC BeadChip. Results: Higher maternal stress scores during pregnancy were significantly associated with lower cognitive, language, and motor scores in children at 12 and 24 months of age. Epigenetic analysis revealed differential methylation patterns in genes related to neurodevelopment in children exposed to high prenatal maternal stress. Mediation analysis indicated that DNA methylation partially mediated the association between prenatal maternal stress and neurodevelopmental outcomes. Conclusion: Prenatal exposure to maternal stress is associated with adverse neurodevelopmental outcomes in children, and epigenetic modifications may play a mediating role in this relationship. These findings highlight the importance of addressing maternal stress during pregnancy to promote optimal child neurodevelopment.
Development and Validation of the Jakarta Post-Infectious Neurological Complication Risk Score (JPINCoRS) for Children Fatimah Mursyid; Husin Sastranagara; Rheina Weisch Fedre; Daphne Marshall
Sriwijaya Journal of Neurology Vol. 3 No. 1 (2025): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v2i2.181

Abstract

Introduction: Post-infectious neurological complications (PINCs) in children represent a significant burden, particularly in developing countries like Indonesia. The early identification of high-risk children is crucial for timely intervention and resource allocation. We aimed to develop and validate a clinically applicable risk stratification score for PINCs in a Jakarta-based pediatric population. Methods: A prospective cohort study was conducted at three major tertiary hospitals in Jakarta, Indonesia, between January 2020 and December 2022. Children aged 1 month to 18 years admitted with a primary infectious diagnosis were eligible. Potential risk factors were collected through detailed medical history, physical examination, and laboratory investigations. The primary outcome was the development of a PINC, defined as any new neurological deficit persisting for at least 24 hours after the acute infectious phase, and categorized using a modified Rankin Scale (mRS). Multivariable logistic regression was used to identify independent predictors and develop the Jakarta Post-Infectious Neurological Complication Risk Score (JPINCoRS). Results: A total of 1250 children were enrolled, with 188 (15.0%) developing a PINC. The final JPINCoRS model included six independent predictors: (1) Type of infection (Central Nervous System [CNS] infection: odds ratio [OR] 4.5, 95% CI 3.2-6.3; Systemic infection with sepsis: OR 2.8, 95% CI 1.9-4.1), (2) Duration of fever >5 days (OR 2.2, 95% CI 1.5-3.2), (3) Presence of seizures during the acute infection (OR 3.5, 95% CI 2.4-5.1), (4) Altered mental status (Glasgow Coma Scale [GCS] <13) at admission (OR 3.0, 95% CI 2.1-4.3), (5) Thrombocytopenia (platelet count <100 x 10^9/L) (OR 1.9, 95% CI 1.3-2.8), and (6) Elevated C-reactive protein (CRP) >50 mg/L (OR 2.1, 95% CI 1.4-3.0). The JPINCoRS demonstrated good discrimination (area under the receiver operating characteristic curve [AUC] = 0.85, 95% CI 0.82-0.88) and calibration. Risk categories were defined as low (0-3 points), moderate (4-7 points), and high (8-12 points), with corresponding PINC rates of 3.5%, 18.2%, and 48.6%, respectively. Internal validation confirmed the model's robustness. Conclusion: The JPINCoRS is a simple, clinically applicable tool for predicting PINCs in children in Jakarta, Indonesia. It can aid clinicians in identifying high-risk patients who may benefit from closer monitoring, neuroimaging, and early intervention strategies. Further external validation in other settings is warranted.
The Impact of Tuina Massage Therapy on Sensory Processing, Sleep Disturbances, and Maladaptive Behaviors in Young Children with Autism Spectrum Disorder in Jakarta, Indonesia: A Controlled Clinical Study Fatimah Mursyid; Lin Chia; Khairiel Anwar; Istiqomah Putri; Bjorka Alma
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.191

Abstract

Introduction: Autism spectrum disorder (ASD) is a complex neurodevelopmental condition characterized by challenges in social communication, restricted interests, and repetitive behaviors, often accompanied by sensory processing abnormalities, sleep disturbances, and maladaptive behaviors. Current interventions offer variable efficacy, prompting exploration of complementary therapies. Tuina, a form of therapeutic massage in Traditional Chinese Medicine (TCM), has shown potential in pediatric neurodevelopmental issues. This study aimed to investigate the impact of Tuina massage therapy on sensory processing, sleep quality, and maladaptive behaviors in young children with ASD in Jakarta, Indonesia. Methods: A controlled clinical study was conducted with 88 children aged 3-7 years, diagnosed with ASD according to DSM-5 criteria and confirmed using the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Participants were recruited from specialized pediatric clinics in Jakarta and assigned to either an intervention group (n=44) receiving a standardized Tuina protocol thrice weekly for 12 weeks alongside standard care, or a control group (n=44) receiving standard care only. Standard care included established interventions such as behavioral therapy, speech therapy, occupational therapy, or special education programs. Outcome measures included the Sensory Profile 2 (SP-2), the Children's Sleep Habits Questionnaire (CSHQ), and the Aberrant Behavior Checklist-Community (ABC-C), administered at baseline, week 6, week 12 (post-intervention), and at a 3-month follow-up (week 24). Results: At 12 weeks, the Tuina group demonstrated statistically significant improvements compared to the control group in sensory processing, specifically in auditory filtering (mean difference [MD] -8.5, 95% CI -11.2 to -5.8, p<0.001) and tactile sensitivity (MD -7.9, 95% CI -10.5 to -5.3, p<0.001) on SP-2 quadrant scores. Total CSHQ scores indicated significantly better sleep in the Tuina group (MD -6.8, 95% CI -9.1 to -4.5, p<0.001), particularly in subscales of bedtime resistance and sleep anxiety. ABC-C scores for irritability (MD -5.2, 95% CI -7.0 to -3.4, p<0.001) and hyperactivity (MD -6.1, 95% CI -8.3 to -3.9, p<0.001) were also significantly lower in the Tuina group. These improvements were largely maintained at the 3-month follow-up. No serious adverse events were reported. Conclusion: This study provides evidence that Tuina massage therapy, as an adjunct to standard care, can significantly improve sensory processing, reduce sleep disturbances, and mitigate maladaptive behaviors in young children with ASD in an Indonesian context. These findings suggest Tuina may be a valuable complementary intervention for managing core and associated symptoms of ASD. Further research with larger, diverse samples and longer follow-up periods is warranted.
Biological Pathways of Oral Health Inequality: A Longitudinal Analysis of Stunting, Enamel Defects, and Salivary Immunity on Caries Trajectories in Indonesian Children Firman Hadi; Moon Kaeun; Fatimah Mursyid; Venny Melinda
Crown: Journal of Dentistry and Health Research Vol. 2 No. 2 (2024): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v2i2.239

Abstract

Introduction: The syndemic of stunting and Early Childhood Caries (ECC) constitutes a major public health crisis in developing nations. While an association is established, the specific biological mechanisms remain poorly quantified. This study aimed to longitudinally determine the direct and indirect effects of early childhood stunting on caries increment, testing the mediating roles of enamel hypoplasia and salivary immunity after controlling for key confounders. Methods: We conducted a 3-year prospective cohort study of 542 two-year-old children in West Java, Indonesia. Stunting at baseline was defined as a height-for-age Z-score (HAZ) < -2 SD. The primary outcome was the 3-year increment in decayed, missing, and filled primary tooth surfaces (Δdmfs). Putative mediators—enamel hypoplasia and salivary secretory immunoglobulin A (s-IgA) and lactoferrin—were assessed. Longitudinal mixed-effects models and structural equation modeling (SEM) were used to analyze the pathways, adjusting for socio-demographic factors and fluoride exposure. Results: At baseline, 31.4% of children were stunted. After adjusting for confounders including fluoride exposure, stunting remained a powerful predictor of accelerated caries increment (an additional 1.95 surfaces/year; p<0.001). SEM analysis revealed the total effect of stunting on Δdmfs was substantial (Standardized β=0.45, p<0.001). This effect was significantly mediated by enamel hypoplasia (indirect effect β=0.17, accounting for 37.8% of total effect) and suppressed salivary s-IgA levels (indirect effect β=0.10, accounting for 22.2% of total effect). The direct effect of stunting, independent of these mediators, remained significant (β=0.18, p<0.001). Conclusion: Stunting in early life is a critical determinant of a high future caries burden, an effect that persists even after accounting for fluoride exposure. This relationship is substantially driven by two major biological pathways: compromised tooth structure (enamel hypoplasia) and impaired oral mucosal immunity (suppressed s-IgA). Public health strategies must integrate nutritional support within the first 1,000 days of life with oral health promotion to disrupt these pathways and combat the dual burden of stunting and ECC.
Enhancing 'First 1,000 Days' Nutrition Literacy via a Posyandu Kader 'Train-the-Trainer' Model: A Mixed-Methods Impact Evaluation on Child Nutritional Status in Eastern Indonesia Fatimah Mursyid; Novalika Kurnia; Sana Ullah; Lestini Wulansari; Muhammad Yoshandi
Indonesian Community Empowerment Journal Vol. 5 No. 1 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i1.53

Abstract

The 'First 1,000 Days' (HPK) period is critical for preventing stunting, a significant public health challenge in Indonesia, particularly in Eastern provinces. Posyandu kader (community health volunteers) are pivotal, but their effectiveness is often hampered by inadequate and unstandardized training. This study evaluates the impact of a structured 'Train-the-Trainer' (ToT) model on kader nutrition literacy and, subsequently, on child nutritional status. We conducted a quasi-experimental, convergent parallel mixed-methods study in two districts of East Nusa Tenggara (NTT) province, Indonesia. The intervention district (n=50 kader, n=312 mother-child dyads) received the ToT intervention, while the control district (n=50 kader, n=309 mother-child dyads) continued standard practices. The ToT model involved training Puskesmas (health center) staff as 'Master Trainers' who then cascaded structured training and mentorship to kader over 12 months. Quantitative data (kader literacy scores, child anthropometry [Height-for-Age Z-score, HAZ]) were collected at baseline and 12-month follow-up, analyzed using Difference-in-Differences (DiD) and linear mixed-effects models (LMM). Qualitative data (n=24 in-depth interviews, n=6 focus group discussions) explored the intervention's mechanisms, fidelity, and contextual facilitators. At 12 months, kader nutrition literacy in the intervention group increased significantly (mean score change: +29.8 points) compared to the control group (+2.1 points, p < 0.001). The LMM analysis, controlling for covariates, showed a significant 'time × group' interaction effect on child HAZ (β = 0.28, 95% CI [0.15, 0.41], p < 0.001), indicating a meaningful improvement in child growth attributable to the intervention. Stunting prevalence (HAZ < -2 SD) in the intervention group decreased by 8.7 percentage points, while it remained stagnant in the control group. Qualitative themes revealed that the ToT model enhanced kader self-efficacy, shifted their role from passive data collectors to active counselors, and provided mechanisms to address local socio-cultural barriers to nutrition. In conclusion, the 'Train-the-Trainer' model is an effective and scalable strategy for enhancing kader nutrition literacy and precipitating measurable improvements in child nutritional status in high-burden settings. This model provides a sustainable framework for strengthening community health systems to combat stunting, aligning with Indonesia's national strategy and Sustainable Development Goal 3.
Co-Authors Akmal Hasan Aline Hafidzah Bjorka Alma Daphne Marshall Firman Hadi Habiburrahman Said Husin Sastranagara Irna Nettles Istiqomah Putri Khairiel Anwar Lestini Wulansari Lin Chia Maximillian Wilson Moon Kaeun Muhammad Yoshandi Novalika Kurnia Rheina Weisch Fedre Sana Ullah Saurie Hernandez Sophia Lucille Rodriguez Theresia Putri Sinaga Tomiola Owkwulu Venny Melinda Yi-Fen Huang