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Narra J
Published by PT Narra Sains Indonesia
ISSN : -     EISSN : 28072618     DOI : https://doi.org/10.52225/narraj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health
Narra J is a multidisciplinary journal and it is published three times (April, August, December) a year. The objective is to promote articles on infection, public health, global health, tropical infection, one health and diseases in tropics. Narra J publishes original research work across all disciplines of medicine and allied sciences, related to infection, public health, global health, tropical infection, one health and diseases in tropics. The journal publishes Original articles, Short Report, Review articles, and Letters to the Editor. All articles published in Narra J are peer-reviewed and published online for immediate access and citation. Narra J publishes the primary research papers, review articles, short communications and letters on topics but not limited to: Public health Global health Infection Tropical diseases One health Biomedical sciences Epidemiology and clinical epidemiology Molecular biology Environmental health Microbiology Pharmacological sciences Diseases in tropics
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 565 Documents
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Employment of people with Down syndrome: A scoping review Ting, Chuong H.; Rahman, Md M.; Chen, Yoke Y.; Safii, Razitasham; Puteh, Sharifa EW.; Saimon, Rosalia; Adenan, Abg S.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1431

Abstract

Down syndrome is the most prevalent genetic condition contributing to intellectual disability. Advancements in medical care have significantly increased the life expectancy of people with this condition, making employment a vital component for independent living and quality of life. The aim of this study was to examine the current literature on the employability and employment experiences of individuals with Down syndrome, focusing on the evolution of the employment rate and factors influencing employment such as cognitive and personal factors, societal attitudes, challenges, and effective support systems. Using Arksey and O’Malley's methodology, a scoping review of relevant qualitative and quantitative articles from  PubMed, Scopus, Web of Science (WoS), CINAHL, and Medline was conducted. The search focused on the keywords found in the title and abstract of articles from 1980 to 2023. The search strategy utilized medical subject headings (MeSH), including "work", "Down syndrome", and "employment". All articles employing qualitative, quantitative, and mixed methods that were published in English were included. Of an initial 4,296 articles, 32 full-text articles were evaluated, and nine met the inclusion criteria. The data indicated improved employment rates for people with Down syndrome, with a recent employment rate of 53%. However, jobs are often limited to sectors like food service and are underutilizing their skills. Key factors associated with employment status include cognitive abilities, family support, and social attitudes. Despite positive perceptions, significant barriers such as systemic bias persist. Effective support systems are crucial but are often hindered by limited opportunities. In conclusion, employment opportunities for people with Down syndrome have improved, but challenges such as limited job diversity and systemic barriers remain. Comprehensive policies are recommended to promote inclusive employment practices and tailored support systems.
Impact of early-life malaria exposure on childhood stunting: A case-control study in high endemic malaria area, Papua, Indonesia Sahiddin, Muhamad; Ishak, Hasanuddin; Arsin, Andi A.; Pramestiyani, Mustika
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1451

Abstract

Papua faces public health challenges as a region with high malaria endemicity and a very high prevalence of stunting. Infectious diseases are one of the risk factors for stunting. The aim of this study was to investigate the effect of early-life malaria exposure on stunting among children in Papua. The study was conducted in 14 public health centers (PHCs) in Papua in 2023. Six hundred eighty-one children (227 stunted and 454 non-stunted) were selected using simple random sampling. The study data were gathered from medical records, structured parent interviews, and direct anthropometric measurements of the children. Chi-square tests were performed to determine unadjusted OR, while adjusted OR was calculated using multivariate analysis. The height-for-age z-score was calculated using WHO Anthro version 3.2.2. The results showed that 45.1% of mothers who had malaria during pregnancy had stunted children. The average z-score height-for-age of children from mothers who experienced malaria during pregnancy vs those who did not was -1.69±1.23 vs -1.41±1.55. Among the 84 children who had malaria under one year old, 45.2% experienced stunting. The average z-score height-for-age of children who had malaria under one year old vs those who did not was -1.83±1.24 vs -1.38±1.6. In the unadjusted analysis, malaria during pregnancy (OR 1.74; 95%CI:  1.06–2.87), malaria in children under one year old (OR 1.78; 95%CI: 1.12–2.83), low birth weight status (OR 1.82; 95%CI: 1.08–3.05), family income (OR 1.75; 95%CI: 1.09–2.81), and mother’s ethnicity (OR 1.45; 95%CI: 1.05–2.01) were associated with stunting incidence in children. In the multivariate analysis, mother’s ethnicity (aOR 1.41; 95%CI: 1.00–1.97) and low birth weight status (aOR 1.72; 95%CI: 1.00–2.94) were the only risk factor for stunting. This study suggests a potential association between early-life malaria exposure and stunting in children. In malaria-endemic areas, health interventions targeting malaria prevention during pregnancy and early childhood are necessary to reduce the risk of stunting.
Projecting the impact of a national strategy to accelerate stunting prevention in East Nusa Tenggara, Indonesia, using the Lives Saved Tool Andriani , Helen; Arsyi, Miftahul; Sutrisno, Alphyyanto E.; Waits, Alexander; Rahmawati, Nurul D.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1462

Abstract

Stunting remains a critical public health issue in East Nusa Tenggara (ENT), Indonesia, with prevalence rates among the highest in the country, despite national efforts to reduce its occurrence. The aim of this study was to project the impact of the 2018–2024 National Strategy to Accelerate Stunting Prevention on children under five years old in ENT, using the Lives Saved Tool. A cross-sectional approach was employed, integrating data from various sources, including the 2020 Census of Indonesia, the Global Data Lab-Area Database, the Central Bureau of Statistics Republic Indonesia, the National Socioeconomic Survey, the 2017 Indonesia Demographic and Health Survey, the 2018 Basic Health Research, and the 2021 Indonesia Nutrition Status Survey. The analysis considered three scenarios: (1) a baseline scenario reflecting ENT’s 2017 coverage, maintained through 2028; (2) a scenario assuming Indonesia achieves the Health Plan Action Stunting targets; and (3) a projection of stunting rates based on ENT-specific coverage. Under scenarios 1 and 2, the prevalence of stunting was projected to decrease from 40.04% in 2018 to 39.82% and 39.78%, respectively, by 2028, with scenario 3 reflecting a similar trend.  The findings revealed a sharp increase in the number of stunting cases averted among children under five years old between 2017 and 2021, followed by a more gradual decline, culminating in the 2028 projections: 2,249 children (scenario 2), 2,130 children (scenario 3), and 1,966 children (scenario 1). Breastfeeding promotion emerged as the most impactful intervention, accounting for over half of the total stunting cases averted under both Indonesia-wide and ENT-specific coverage scenarios. This was followed by interventions such as multiple micronutrient supplementation and vitamin A supplementation. The study highlights that reducing the prevalence of stunting among children requires a comprehensive prioritization of intervention strategies. The implementation of breastfeeding promotion, combined with appropriate complementary feeding practices, is expected to contribute significantly to achieving the sustainable development goal targets.
Occupational risk factors related to musculoskeletal disorders among Praewa silk weavers in the Northeast region, Thailand Yota, Wuttichai; Neubert, Manida S.; Kaewdok, Teeraphun
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1480

Abstract

Praewa silk weavers are subject to numerous occupational risk factors that contribute to musculoskeletal disorders (MSDs), primarily due to inadequate occupational safety measures, limited access to health services, and substandard working conditions. The aim of this study was to assess the prevalence rate and determinants of MSDs among Praewa silk weavers. A cross-sectional study employing a convenience sampling method was conducted, involving 198 Praewa silk weavers from four provinces in the Northeast region of Thailand. Data collection was facilitated through a two-part research tool. The first part included a questionnaire assessment using demographic information, workplace conditions, and self-reported MSDs. The second part involved an ergonomic risk assessment using rapid upper limb assessment (RULA) and hand activity level (HAL). Descriptive statistics and multiple logistic regression analyses were conducted to determine the prevalence and associated factors of MSDs among participants. The findings revealed that the prevalence rates of MSDs in the past 7 days and 12 months were 68.68% and 96.46%, respectively. The highest prevalence rates of MSDs (over 60.00%) were observed in the wrists, fingers, and neck, with similar trends reported in both the past 7 days and 12 months. Key factors associated with MSDs over the past 12 months included low hand strength test results (adjusted odds ratio (AOR)=2.09; 95%CI: 0.44–11.05), quite low hand strength test results (AOR=2.49; 95%CI: 0.29–21.15), weaving experience of 21–30 years (AOR=1.07; 95%CI: 0.20–5.64), age between 31–40 years  (AOR=2.63; 95%CI: 0.49–13.91), age above 41 years (AOR=1.13; 95%CI: 1.08–1.19), RULA level 4 (AOR=3.62; 95%CI: 0.66–19.96), and HAL score exceeding 0.78 (AOR=0.63; 95%CI: 0.80–0.98) were significantly associated with MSDs during the past 12 months. This study highlights the high prevalence of MSDs among Praewa silk weavers, attributed to occupational risk factors such as low hand strength, high hand activity level, extensive weaving experience, and poor working posture. The weaving process itself is a significant contributor to these disorders. In conclusion, ergonomics interventions aimed at preventing MSDs, including postural training, injury prevention programs, and re-designed pull-cloth devices, are recommended to mitigate these risks.
Impacts of COVID-19 on malaria elimination strategies in Asia: A scoping review Arisanti, Risalia R.; Saputri, Grace ND.; Ahmad, Riris A.; Utarini, Adi
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1492

Abstract

The global malaria program has faced setbacks due to disruptions in health services caused by COVID-19 pandemic. Despite these challenges, Asia that primarily comprised of low and middle-income countries (LMICs), continues to make strides towards malaria elimination. This scoping review explored the impact of the COVID-19 pandemic on malaria control programs in Asian countries with varying levels of malaria endemicity. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was applied to search for articles published between January 2020 and May 2024 that examined the impact of COVID-19 on malaria control programs in Asia on six databases (PubMed, Scopus, Google Scholar, WHO COVID-19 Research Database, Garuda and Sinta). The findings of these articles were organized into five themes: epidemiology and surveillance, case management (including diagnosis and coinfection), vector control, prevention, and program management. Overall, 54 articles from countries with various endemicity levels were included. These studies focused on malaria epidemiology, surveillance, and case management, with few studies on vector control. The COVID-19 pandemic has affected malaria control differently in different regions. In malaria-free, low-, and high-endemic countries, malaria cases were reduced mainly due to strict public health measures such as travel restrictions, quarantines, and COVID-19-related stigma, which reduced clinic attendance. Conversely, increased malaria cases owing to increased imports, relapses of malaria cases triggered by COVID-19, social conflicts, and underreporting have contributed to this surge. The priority shift to COVID-19 has affected malaria centers, resulting in personnel shortages, budget limits, and an increased number of malaria cases and outbreaks. The pandemic has also spurred innovative malaria prevention methods, such as using social media to raise awareness in China. The COVID-19 pandemic has had a mixed impact on the number of malarial cases reported across Asia. The three main factors were travel restrictions, COVID-19-related stigma, and shifting priorities to COVID-19. Integrating malaria control and COVID-19 strategies, strengthening the healthcare system, developing flexible malaria control strategies during crises, and developing innovative solutions could mitigate these impacts.
Psoriasis severity assessment: Optimizing diagnostic models with deep learning Maulana, Aga; Noviandy, Teuku R.; Suhendra, Rivansyah; Earlia, Nanda; Prakoeswa, Cita RS.; Kairupan, Tara S.; Idroes, Ghifari M.; Subianto, Muhammad; Idroes, Rinaldi
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1512

Abstract

Psoriasis is a chronic skin condition with challenges in the accurate assessment of its severity due to subtle differences between severity levels. The aim of this study was to evaluate deep learning models for automated classification of psoriasis severity. A dataset containing 1,546 clinical images was subjected to pre-processing techniques, including cropping and applying noise reduction through median filtering. The dataset was categorized into four severity classes: none, mild, moderate, and severe, based on the Psoriasis Area and Severity Index (PASI). It was split into 1,082 images for training (70%) and 463 images for validation and testing (30%). Five modified deep convolutional neural networks (DCNN) were evaluated, including ResNet50, VGGNet19, MobileNetV3, MnasNet, and EfficientNetB0. The data were validated based on accuracy, precision, sensitivity, specificity, and F1-score, which were weighted to reflect class representation; Pairwise McNemar's test, Cochran's Q test, Cohen’s Kappa, and Post-hoc test were performed on the model performance, where overall accuracy and balanced accuracy were determined. Findings revealed that among the five deep learning models, ResNet50 emerged as the optimum model with an accuracy of 92.50% (95%CI: 91.2–93.8%). The precision, sensitivity, specificity, and F1-score of this model were found to be 93.10%, 92.50%, 97.37%, and 92.68%, respectively. In conclusion, ResNet50 has the potential to provide consistent and objective assessments of psoriasis severity, which could aid dermatologists in timely diagnoses and treatment planning. Further clinical validation and model refinement remain required.
Exploring factors contributing to falls in home-dwelling older adults: A cross-sectional study in Northeastern Thailand Boonkhao, Laksanee; Choochouy, Nattagorn; Rattanachaikunsopon, Pongsak; Laosupap, Kitti; Saenrueang, Thitima; Labcom, Chiraporn; Chakhamrun, Nittaya; Boonsang , Arun; Butsorn, Aree
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1545

Abstract

Falls are the most common accidents among older adults in home settings. Older adults experience falls due to several risk factors. In 2005, Thailand became an aging society, with projections indicating that by 2021, older adults would represent the majority of the population, and by 2035, approximately 30 percent of the population would be older adults. Approximately 3 million fall episodes transpire among older adults each year in Thailand, leading to almost 60,000 hospitalizations. The aim of this study was to examine the factors associated with falls among older adults in northeastern Thailand, hypothesizing that characteristics such as cognitive capacity, visual acuity, hearing acuity, balance ability, and mobility are associated with fall risk in this population. A cross-sectional analytical study involved 264 older adults aged 60 years or older using a questionnaire and a battery of tests that assessed the participants’ cognitive capacity, eyesight proficiency, hearing ability, balancing ability, and mobility. The variables that exhibited a statistically significant association (p<0.05) were employed in a binary logistic regression analysis. The results revealed that falls among home-living older adults were significantly associated with sex, family size, congenital issues, and mobility. Older adults who were female and had a large family, congenital disorders, or mobility impairments were at a higher risk of falls, which emphasizes the need for personalized prevention strategies. It is recommended to adopt a proactive healthcare strategy to prevent falls and ensure safe living conditions. Interventions aimed at improving balance, mobility, and mental health, as well as encouraging an active lifestyle, may reduce the risk of falls among older adults living in the community. The findings may aid private and government agencies in developing effective fall prevention programs for older adults living at home.
Neuroprotective and inflammatory biomarkers in pediatric drug-resistant epilepsy: Interplay between GDNF, IL-1β and vitamin D 25-OH Saing, Johannes H.; Sari, Dina K.; Supriatmo, Supriatmo; Fithrie, Aida; Rusda, Muhammad; Amin, Mustafa M.; Pratama, Muhammad A.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1581

Abstract

Drug-resistant epilepsy in pediatric patients is associated with neuroinflammation and neurodegeneration. Vitamin D 25-OH exerts neuroprotective effects, while glial cell line-derived neurotrophic factor (GDNF) and the proinflammatory cytokine interleukin-1β (IL-1β) are implicated in the mechanisms of neuroinflammation and epileptogenesis. The aim of this study was to investigate the relationship between vitamin D 25-OH, IL-1β, and GDNF levels with seizure severity and frequency in children with drug-resistant epilepsy. A cross-sectional study was conducted at Adam Malik Hospital, Medan, Indonesia, among children with drug-resistant epilepsy. Vitamin D 25-OH, IL-1β and GDNF levels were measured using enzyme-linked immunosorbent assay (ELISA). Epilepsy severity was assessed using the Hague Seizure Severity Scale (HASS), while seizure frequency was assessed using the Global Assessment of Severity of Epilepsy (GASE). The present study identified a significant correlation between GDNF levels and epilepsy severity, as measured by the HASS score (r=0.318; p=0.006). However, no significant correlation was observed between vitamin D 25-OH or IL-1β levels and epilepsy severity or seizure frequency (p>0.05). IL-1β levels correlated significantly with GDNF levels (r=0.525; p=0.001), but IL-1β did not directly correlate with seizure frequency or epilepsy severity. In conclusion, GDNF levels significantly correlated with epilepsy severity, suggesting that GDNF may serve as a potential biomarker for assessing epilepsy severity. However, further studies investigating the role of GDNF as a potential neurotrophic factor in the pathophysiology of epilepsy and its possible application as a therapeutic target are important.
Prognosis value of circulating telomere repeat binding factor 2 and leukocyte telomere length in breast cancer mortality Sasmita, Dhyas MA.; Anwar, Sumadi L.; Heriyanto, Didik S.; Paramita, Dewi K.; Hendrawan, Fandi; Aryandono, Teguh
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1601

Abstract

Telomere repeat binding factor 2 (TRF2) is currently a novel tumor marker, yet its clinical implication has not been investigated. The aim of this study was to investigate the prognostic value of circulating TRF2 and leukocyte telomere length in 5-year mortality in breast cancer patients. In this cohort retrospective study, breast cancer patients were included and the length of telomeres and circulating TRF2 were quantified. Receiver operating characteristics and the Youden index were used to determine the optimal cut-off. To analyze the overall survival rate in 5 years, Kaplan Meier analysis was used, while the prognostic value of both variables was analyzed in Cox proportional hazard regression on both univariate and multivariate models. Our data indicated that the optimal cut-off points for TRF2 and leukocyte telomere length were 598 pg/mL and 0.93 kb, respectively. Based on the optimal cut-off points, the participant’s data was grouped, and our data indicated that the high TRF2 group had a poorer overall survival rate in comparison to the low group (91.3% vs 83.87%; log-rank test; p<0.01). The overall survival between short and long telomeres was comparable (88.24% vs 88.37%; log-rank test; p=0.64). TRF2 (hazard ratio (HR): 3.66; 95%CI: 1.45–9.29) and molecular subtype (p=0.04) were identified as independent factors to predict mortality. In conclusion, a high circulating TRF2 in breast cancer participants was associated with lower overall 5-year survival rates in comparison with the low TRF2 group. Moreover, high TRF2 could predict the mortality of the breast cancer population to be 3.66 times higher than the lower group. In contrast, telomere length was not associated with overall survival rate nor predicting mortality in five years.
Apium graveolens leaf ethanolic extract triggers apoptosis in human tongue cancer cells via caspase-3 and poly(ADP-ribose) polymerase pathways: An in vitro study Sandra, Ferry; Hartono, Tiffany; Hayuningtyas, Ria A.; Ranggaini, Dewi; Halim, Johni; Lee, Kyung H.
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.1634

Abstract

Recent advances in cancer treatment have focused on developing alternative therapies with reduced adverse effects. Chemoprevention using natural products derived from plants has gained significant attention. Apium graveolens has demonstrated anticancer properties against various cancer cell types, suggesting its potential efficacy against tongue cancer cells. The aim of this study was to evaluate the cytotoxic effects and mechanisms of action of Apium graveolens leaf ethanolic extract (AGLEE) on the HSC-3 tongue cancer cell line. The leaves were processed and extracted with 70% ethanol to obtain an ethanolic extract. HSC-3 cells were cultured, subjected to starvation, and pre-treated with or without Z-DEVD-FMK, a caspase-3 inhibitor. Subsequently, the cells were treated with or without doxorubicin or varying concentrations of AGLEE. To assess cell viability and apoptosis, MTT and sub-G1 assays were performed. Additionally, treated HSC-3 cells were collected, lysed, and analyzed for levels of cleaved-caspase-3 and cleaved-poly (ADP-ribose) polymerase (cleaved-PARP) using ELISA. The inhibitory concentration (IC50) value of AGLEE for reducing viable HSC-3 cells was determined to be 48.29 μg/mL. AGLEE significantly decreased HSC-3 cell viability and increased the percentage of apoptotic cells. It exhibited a concentration-dependent reduction in cell viability and an increase in apoptosis. Furthermore, the extract elevated the levels of cleaved-caspase-3 and cleaved-PARP in HSC-3 cells. Pre-treatment with Z-DEVD-FMK reduced the levels of cleaved-caspase-3 and cleaved-PARP induced by AGLEE. Taken together, AGLEE could be proposed as a potential natural therapeutic agent by inducing apoptosis through the caspase-3/PARP pathway in tongue cancer cells.

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