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All Journal JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Pratama, Yusuf Alif
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Chemistry Education Health Professions Medicine & Pharmacology Other

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Effect of Integrated TOGA-Nutrition Education on Stunting Prevention Knowledge among Health Volunteers and Adolescents in Lamongan, Indonesia: A Pre-Post Intervention Study Kusumawati, Idha; Puspitasari, Hanni Prihhastuti; Soesilawati, Pratiwi; Izzah, Zamrotul; Fitria, Anisa Lailatul; Ramadhani, Firmansyah Ardian; Rullyansyah, Subhan; Pratama, Yusuf Alif; Pattymahu, Charlyna Veronika Puspitasari; Gamar, Fahmi Haitsami Ibnu; Ruzainah Ali
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA Vol. 12 No. 3 (2025): JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jfiki.v12i32025.342-354

Abstract

Background: Lamongan, Indonesia, is facing a significant public health issue, with high rates of stunting (27.5% in 2022) and adolescent anemia (60.0% in Babat district). A significant knowledge gap exists in the community, particularly regarding the effective use of Family Medicinal Plants (TOGA) for prevention, highlighting the need for structured intervention programs to address these public health issues. This study evaluated an integrated education program designed to improve knowledge and shift perceptions regarding TOGA, assessing differential knowledge gains between health volunteers and adolescents. Methods: This pre-post intervention study involved 54 female participants (27 health volunteers and 27 adolescents) from Kebalanpelang Village, Babat District, Lamongan. All participants received the same 120-minute integrated TOGA-nutrition education based on Social Cognitive Theory, covering stunting prevention, complementary feeding, breastfeeding optimization, and TOGA applications using evidence-based traditional medicinal plants. Knowledge was assessed using the same validated 10-item questionnaire (Cronbach's α=0.81) for both groups, covering three domains: complementary feeding guidelines (3 items), breastfeeding optimization (3 items), and TOGA applications for stunting prevention (4 items), administered before and immediately after the intervention. Results: The intervention was highly effective, yielding a statistically significant 25.4% mean knowledge gain across all participants (3.6±2.1-point gain, p<0.001). Adolescents showed the most dramatic improvement, achieving a 39.7% knowledge increase (a 4.8-point gain). While health volunteers had a more modest gain of 14.7% (a 2.4-point increase), the intervention successfully narrowed the initial knowledge disparity between the two groups by 57% (reducing the gap from Δ4.2 to Δ1.8 points). Domain-specific analysis revealed significant gains across all areas: complementary feeding (+26.8%), breastfeeding (+26.7%), and TOGA applications (+23.9%, all p<0.001). A strong inverse correlation between age and knowledge gain (r=-0.72, p<0.001) indicated that younger participants, particularly those aged 15-17 years, demonstrated superior learning capacity. Conclusions: The implementation of integrated TOGA-nutrition education significantly enhanced stunting prevention knowledge. This intervention is particularly effective for adolescents, which employs role-specific content, successfully mitigates cultural barriers and leads to a measurable reduction in knowledge equity gaps. Strong evidence of participant confirms the program's cultural fit and operational readiness, making a compelling case for its integration and scaling within Indonesia’s broader stunting prevention efforts.
Response Surface Method-driven Design of Experiments for The Sublingual Immunotherapy Tablets of Indonesian House Dust Mites Allergenic Extract Pratama, Yusuf Alif; Marhaeny, Honey Dzikri; Prasetya, I Made Slamet Putra; Pramesthi, Anak Agung Istri Evinia; Winarto, Sulistyanengci; Miatmoko, Andang; Ardianto, Chrismawan; Rahmadi, Mahardian; Taher, Muhammad; Khotib, Junaidi
JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA 2026: IN PRESS ISSUE (JUST ACCEPTED MANUSCRIPT)
Publisher : Universitas Airlangga

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Abstract

Background: Allergic diseases represent a significant global health burden, and current pharmacological treatments primarily offer symptomatic relief without addressing the underlying immune dysregulation. Allergen-specific immunotherapy (AIT) is the only disease-modifying approach capable of inducing long-term remission by targeting the immunological mechanisms that drive the allergic response. Sublingual immunotherapy (SLIT) is a noninvasive alternative to subcutaneous immunotherapy, leveraging the rich vascularisation and antigen-presenting cell population of the oral mucosa. Objective: SLIT tablets were formulated using Indonesian house dust mite (IHDM) allergenic extracts, with the aim of optimising tablet properties by modulating the disintegrant concentration and croscarmellose-to-crospovidone ratios. Methods: Six formulations, each with three batches, were prepared via direct compression, varying the total disintegrant content (5.25 and 10.5% w/w) and excipient ratios. The tablets were evaluated for hardness, disintegration time, friability, and dissolution, and specific allergenic protein release (Der p 1 as a marker) was quantified using ELISA. A 2 × 3 factorial experimental design was used in the DoE approach, with data analysed using GraphPad Prism and Minitab, and response surface methodology (RSM) applied via Stat-Ease 360. Results: Higher disintegrant concentrations reduced tablet hardness but increased friability and disintegration rates. Pareto analysis revealed that both the total disintegrant content and disintegrant ratio significantly influenced tablet performance. All formulations demonstrated favourable dissolution profiles. The optimised formulation (F2), containing 5.25% (w/w) total disintegrants with a croscarmellose-to-crospovidone ratio of 1.5:2, achieved a disintegration time of 4.33 ± 0.88 s, hardness of 89.20 ± 6.12 N, and friability of 0.00 ± 0.01 %. Conclusion: These findings support the potential of IHDM-based SLIT tablets as an effective and mechanistically rational platform for allergen immunotherapy, contributing not only to symptoms but also to long-term modification of allergic diseases
Co-Authors Chrismawan Ardianto Fitria, Anisa Lailatul Gamar, Fahmi Haitsami Ibnu Idha Kusumawati Junaidi Khotib Mahardian Rahmadi Marhaeny, Honey Dzikri Miatmoko, Andang Pattymahu, Charlyna Veronika Puspitasari Pramesthi, Anak Agung Istri Evinia Prasetya, I Made Slamet Putra Pratiwi Soesilawati Puspitasari, Hanni Prihhastuti Ramadhani, Firmansyah Ardian Ruzainah Ali Subhan Rullyansyah Taher, Muhammad Winarto, Sulistyanengci Zamrotul Izzah