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Genetic and Environmental Influences on Autism Spectrum Disorder: A Multi-Center Study Exploring Gene-Environment Interactions and Biomarkers in Indonesia Vita Amanda; Rashidah Unaib Al-Zayid; Winata Putri; Sonya Syarifah; Tiffany Gabriele; Leonardo Simanjuntak; Cinthya Callathea
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.v1i1.30

Abstract

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental condition with a complex etiology involving genetic and environmental factors. This multi-center study investigated gene-environment interactions and potential biomarkers associated with ASD in the Indonesian population. Methods: Children diagnosed with ASD (n=500) and age-matched typically developing controls (n=500) were recruited across five major Indonesian cities. Whole-exome sequencing targeted genotyping, and environmental risk factor assessments were conducted. Biomarker analyses included cytokine levels, oxidative stress markers, and neurotransmitters. Results: Genetic analysis revealed both rare and common variants associated with ASD risk, including variants in CHD8, SCN2A, NRXN1, and novel genes. Prenatal exposures (maternal medication use, infections), perinatal complications (preterm birth, low birth weight), and postnatal factors (pesticide exposure, air pollution) were associated with increased ASD risk. Children with ASD exhibited elevated inflammatory markers (TNF-α, IL-6, IL-1β), increased oxidative stress (higher MDA, lower GSH), and altered neurotransmitter levels (lower serotonin and dopamine) compared to controls. Conclusion: This study provides insights into the interplay of genetic and environmental factors contributing to ASD risk in Indonesia. The identified genetic variants, environmental risk factors, and potential biomarkers may contribute to our understanding of ASD etiology and inform the development of targeted interventions and early detection strategies.
Social Determinants of Health and Their Influence on Preterm Birth in Rural Indonesian Communities Miranda Aisah; Tomiola Owkwulu; Winata Putri; Theresia Putri Sinaga; Syaifudin Syaifudin; Reza Andrianto
Sriwijaya Journal of Obstetrics and Gynecology Vol. 1 No. 2 (2023): 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.v1i1.22

Abstract

Introduction: Preterm birth (PTB), defined as birth before 37 completed weeks of gestation, is a major contributor to neonatal mortality and morbidity globally, with a disproportionate burden in low-resource settings like rural Indonesia. This study aimed to investigate the influence of social determinants of health (SDOH) on PTB in rural Indonesian communities. Methods: A retrospective cohort study was conducted using data from the Indonesian Maternal and Perinatal Health Survey (IMPHS) 2018-2021. A total of 15,480 women residing in rural areas with singleton pregnancies were included. SDOH variables examined included maternal education, socioeconomic status (SES), access to healthcare, and geographical remoteness. Multivariable logistic regression analysis was performed to assess the association between SDOH and PTB, adjusting for potential confounders. Results: The prevalence of PTB in the study population was 12.3%. Lower maternal education, lower SES, limited access to healthcare, and residing in remote areas were significantly associated with increased odds of PTB. Women with no formal education had 2.1 times higher odds of PTB compared to those with higher education (adjusted odds ratio [aOR] 2.1, 95% CI 1.8-2.5). Similarly, women in the lowest SES quintile had 1.8 times higher odds of PTB compared to the highest quintile (aOR 1.8, 95% CI 1.5-2.2). Conclusion: SDOH significantly influence PTB in rural Indonesian communities. Addressing these social inequities through targeted interventions, such as improving access to education, healthcare, and economic opportunities, is crucial for reducing the burden of PTB and improving maternal and child health outcomes.
The Impact of Dental Anxiety on Oral Health-Related Quality of Life in Children: A Longitudinal Study in Jakarta, Indonesia Ni Made Nova Indriyani; Dea Albertina; Desiree Montesinos; Rheina Weisch Fedre; Winata Putri
Crown: Journal of Dentistry and Health Research Vol. 1 No. 2 (2023): 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.v1i2.88

Abstract

Introduction: Dental anxiety is a common problem among children, and it can have a significant impact on their oral health-related quality of life (OHRQoL). This longitudinal study aimed to investigate the impact of dental anxiety on OHRQoL in children in Jakarta, Indonesia. Methods: A cohort of 200 children aged 6-12 years was recruited from six elementary schools in Jakarta. Dental anxiety was assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) at baseline, 6 months, and 12 months. OHRQoL was measured using the Child Perceptions Questionnaire (CPQ11-14) at the same time points. Sociodemographic data and oral health status were also collected. Linear mixed models were used to assess the association between dental anxiety and OHRQoL over time, adjusting for potential confounders. Results: Dental anxiety was significantly associated with lower OHRQoL scores at all time points. Children with higher dental anxiety scores reported more problems with oral symptoms, functional limitations, emotional well-being, and social well-being. This association persisted even after adjusting for age, gender, socioeconomic status, and oral health status. Conclusion: Dental anxiety has a significant negative impact on OHRQoL in children. Early identification and management of dental anxiety are crucial to improve children's oral health and overall well-being.
The Impact of Trauma-Informed Care on Mental Health Outcomes for Incarcerated Youth: A Longitudinal Study in Bandung, Indonesia Dedi Affandi; Ericca Dominique Perez; Winata Putri; Anies Fatmawati; Alex Putra Pratama
Scientia Psychiatrica Vol. 6 No. 3 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.183

Abstract

Introduction: Incarcerated youth represent a vulnerable population with disproportionately high rates of trauma exposure and mental health disorders. This study investigated the longitudinal impact of a trauma-informed care (TIC) program on mental health outcomes for incarcerated youth in Bandung, Indonesia. Methods: A quasi-experimental design was employed, comparing a group of incarcerated youth who received TIC with a control group receiving standard care. Participants (n=200) were assessed at baseline, 6 months, and 12 months using validated instruments measuring PTSD symptoms, depression, anxiety, and behavioral problems. Data analysis included repeated measures ANOVA and correlational analyses. Results: Youth in the TIC group demonstrated significant reductions in PTSD symptoms, depression, and anxiety over time compared to the control group. Improvements in behavioral problems were also observed in the TIC group. These positive changes were sustained over the 12-month period. Conclusion: This study provides evidence for the effectiveness of TIC in improving mental health outcomes for incarcerated youth. Implementing TIC programs in juvenile detention facilities is crucial for addressing the mental health needs of this vulnerable population.
The Indonesian Otitis Media Severity Score (IOMSS): A Prospective Cohort Study Evaluating its Prognostic Value in Pediatric Patients Winata Putri; Aline Hafidzah; Lisye Tiur Simanjuntak; Badrool Nizham; Istiqomah Putri
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 1 (2025): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v2i2.187

Abstract

Introduction: Acute otitis media (AOM) and otitis media with effusion (OME) are common pediatric illnesses with varying clinical courses. A reliable prognostic tool to predict outcomes and guide treatment decisions in the Indonesian context is lacking. This study aimed to evaluate the prognostic value of the Indonesian Otitis Media Severity Score (IOMSS) in predicting treatment response and complications in pediatric patients with AOM and OME. Methods: A prospective cohort study was conducted at five tertiary care hospitals in Indonesia (Medan, Jakarta, Samarinda, Makassar, and Denpasar) from January 2020 to December 2022. Children aged 6 months to 12 years diagnosed with AOM or OME were enrolled. The IOMSS, which incorporates clinical findings (otalgia, fever, otorrhea, tympanic membrane appearance, and hearing loss), was calculated at baseline. Patients were followed up for 6 months to assess treatment response (resolution of symptoms, tympanic membrane healing), and the development of complications (e.g., recurrent AOM, chronic suppurative otitis media (CSOM), mastoiditis, hearing loss). Statistical analyses, including Cox proportional hazards regression and receiver operating characteristic (ROC) curve analysis, were performed to evaluate the association between IOMSS and clinical outcomes. Results: A total of 850 children (mean age 5.2 ± 2.8 years, 55% male) were included. Higher IOMSS scores at baseline were significantly associated with a lower probability of complete resolution of AOM/OME at 6 months (hazard ratio [HR] 0.85 per 1-point increase in IOMSS, 95% CI 0.80-0.90, p<0.001). The IOMSS also predicted the development of complications, with a higher score significantly increasing the risk of recurrent AOM (HR 1.20, 95% CI 1.10-1.31, p<0.001), CSOM (HR 1.35, 95% CI 1.18-1.54, p<0.001), and persistent hearing loss (HR 1.28, 95% CI 1.12-1.46, p<0.001). ROC curve analysis demonstrated good discriminatory ability of the IOMSS for predicting complications (AUC = 0.82, 95% CI 0.78-0.86). Conclusion: The IOMSS is a valuable prognostic tool for predicting treatment outcomes and the risk of complications in Indonesian children with AOM and OME. Its use can aid clinicians in identifying high-risk patients who may benefit from more aggressive management and closer follow-up.
Empowering Educators, Supporting Students: A Quasi-Experimental Evaluation of a Train-the-Trainer Model for School Mental Health in Indonesia Ahmad Badruddin; Omar Alieva; Ifah Shandy; Henny Kesuma; Benyamin Wongso; Winata Putri; Habiburrahman Said
Indonesian Community Empowerment Journal Vol. 5 No. 2 (2025): Indonesian Community Empowerment Journal
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/icejournal.v5i2.49

Abstract

Adolescent mental health is a pressing concern in urban Indonesian schools, where a significant gap exists between student needs and the availability of professional support. This study evaluated the efficacy of a culturally-adapted, school-based "Train-the-Trainer" (TtT) community service model designed to build sustainable mental health support capacity by empowering teachers. A quasi-experimental study with a matched control group was conducted in 20 public high schools in South Sumatera, Indonesia. Ten schools (n=150 teachers, n=1500 students) received the TtT intervention, where core teachers were trained to cascade mental health literacy and foundational support skills to their peers. Ten matched schools (n=145 teachers, n=1450 students) served as a control group. Data on teacher self-efficacy, student-reported support awareness, and school mental health policies were collected at baseline, 6-months, and 12-months. A linear mixed-effects model revealed a significant time-by-group interaction, with teachers in the intervention group reporting substantially higher confidence in supporting students at 12 months (M=4.15, 95% CI [4.01, 4.29]) compared to the control group (M=2.51, 95% CI [2.37, 2.65]), a large effect (d=2.41). Intervention students were significantly more likely to know how to access support (78% vs. 27%; OR=9.82, 95% CI [8.11, 11.89], p < 0.001). Intervention schools demonstrated a massive increase in formalized mental health protocols compared to control schools (IRR=7.94, p < 0.001). In conclusion, the TtT model is a highly effective and scalable strategy for building a foundational mental health support system within existing school structures in resource-constrained settings. By investing in local educators, this model fosters a sustainable, multi-tiered support ecosystem, offering a viable pathway for national policy and practice in Indonesia.
Three-Year Clinical Performance of Silver Diamine Fluoride (SDF) versus Glass Ionomer Cement in Arresting Carious Lesions in Primary Molars: A Community-Based Cohort Study Winata Putri; Sophia Lucille Rodriguez; Sarah Armalia; Alexander Mulya
Crown: Journal of Dentistry and Health Research Vol. 3 No. 1 (2025): 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.v3i1.238

Abstract

Introduction: Early Childhood Caries (ECC) is a significant global health problem. Minimally invasive treatments like Silver Diamine Fluoride (SDF) and Glass Ionomer Cement (GIC) are crucial, but long-term comparative effectiveness data from real-world community settings are scarce. This study aimed to compare the three-year clinical performance of 38% SDF versus high-viscosity GIC in arresting active carious lesions in the primary molars of preschool children. Methods: This study was designed as a three-year, prospective, non-randomized, community-based cohort study in an underserved urban population in South Sumatra, Indonesia. A total of 450 children aged 3-5 years with at least one active cavitated carious lesion (ICDAS 5/6) in a primary molar were enrolled. Following parental consent and choice, lesions were treated with either a single application of 38% SDF or a high-viscosity GIC restoration using the Atraumatic Restorative Treatment (ART) technique. Calibrated examiners assessed the lesions for caries arrest at 6, 12, 24, and 36 months using standardized visual-tactile criteria. The primary outcome was the proportion of arrested lesions. Survival analysis was performed using Kaplan-Meier curves and a Cox proportional hazards model. Results: A total of 620 lesions (309 SDF, 311 GIC) were treated and followed. At the 36-month follow-up, the caries arrest rate in the SDF group was 81.2%, which was significantly higher than the 64.8% arrest rate observed in the GIC group (χ² = 24.5, p < 0.001). The Kaplan-Meier survival analysis demonstrated a significantly higher probability of lesions remaining in an arrested state in the SDF group over the three-year period (log-rank test, p < 0.001). The Cox regression model identified the treatment modality as the primary predictor of failure, with GIC having a hazard ratio of 2.15 (95% CI: 1.55-2.98) compared to SDF. Conclusion: Within the parameters of this community-based cohort study, a single application of 38% SDF was significantly more effective in arresting active carious lesions in primary molars over a three-year period than high-viscosity GIC applied via the ART technique. These findings support the prioritization of SDF in public health programs for managing ECC.