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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 632 Documents
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Challenges and strategies of implementing active case finding for tuberculosis: A qualitative study at a high-burden primary healthcare center, Yogyakarta, Indonesia Nafiu, Hafizha U.; Padmawati, Retna S.; Bintoro, Bagas S.
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3073

Abstract

Tuberculosis (TB) remains a major public health problem in Indonesia, and strengthening active case finding (ACF) is essential to improve early detection and interrupt transmission in high-burden settings. This study aimed to analyze the implementation of TB ACF at Depok II Primary Health Center, Sleman, Indonesia, using the Donabedian framework consisting of input, process and output components, with a focus on implementation processes, challenges, and strategies from a health promotion perspective. A qualitative case study design was employed. Data were collected through in-depth interviews, field observations, and document reviews involving 14 informants, including primary health center staff, district health office representatives, community health cadres, TB patients, a community leader, and a representative from a non-governmental organization. Data were analyzed thematically using the Miles and Huberman framework with support from NVivo version 12. The findings showed that the input component was generally well established, supported by policy commitment, multidisciplinary human resources, adequate basic logistics, program financing, and strong multisectoral partnerships, although challenges remained in village-level budget execution, limited cadre incentives, and dependence on external diagnostic services such as mobile chest X-ray. The process component was generally effective, characterized by structured service delivery, adaptive outreach strategies, strong health education, and patient-centered implementation. However, variation in community responsiveness, internalized stigma, and referral delays remained important barriers. The outcome component was reflected not only in case detection, but also in improved community awareness, acceptance of diagnosis, treatment adherence, and recognition of TB symptoms. Overall, TB ACF at Depok II Primary Health Center was generally effective and supported by strong system readiness and community engagement; however, its sustainability requires strengthened financing, referral access, and health promotion capacity to address remaining operational, behavioral, and social challenges.
Phytochemical profiling and enzyme inhibitory activity of Sterculia populifolia DC stem bark extract and fractions against elastase and tyrosinase Khairi, Nur; Nursamsiar, Nursamsiar; Utami, Novi F.; Marwati, Marwati; Nur, Syamsu; Indrisari, Maulita; Kursia, Sukriani
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.1778

Abstract

The demand for natural ingredients in cosmetic and medical applications is steadily increasing, particularly for anti-aging and skin-lightening products. Sterculia populifolia DC, a member of the Sterculia genus, is known to contain diverse bioactive compounds such as flavonoids, phenolics, and terpenoids, which may offer pharmacological benefits. The aim of this study was to evaluate the anti-aging potential of S. populifolia stem bark extract and its solvent-partitioned fractions through enzyme inhibition assays coupled with phytochemical profiling. The stem bark was extracted using 96% ethanol via maceration, followed by sequential liquid-liquid partitioning with n-hexane, ethyl acetate, n-butanol, and water. Phytochemical constituents were characterized using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The inhibitory activities of the extract and fractions against tyrosinase and elastase enzymes were evaluated using spectrophotometric assays, with kojic acid and quercetin as positive controls, respectively. IC₅₀ values were calculated to quantify enzyme inhibition potency. LC-MS/MS analysis revealed key bioactive compounds, including 4-[(E)-(3,5-diamino-1H-pyrazol-4-yl)diazenyl]phenol, isofraxidin, and (22E)-ergosta-4,6,8(14),22-tetraen-3-one. Among the tested samples, the ethanol extract exhibited the most potent activity, with an IC₅₀ of 93.35 µg/mL for elastase inhibition and 133.15 µg/mL for tyrosinase inhibition—classified as strong and moderate activity, respectively. Collectively, these findings demonstrate that S. populifolia stem bark extract possesses promising anti-aging and depigmenting properties, supporting its potential development as a natural bioactive ingredient in cosmetic and skincare formulations.
Development of an inactivated viral transport medium for diagnostic testing in low-resource countries Rahmani, Silmi; Meitha, Karlia; Septiani, Popi; Priharto, Neil; Kamarisima, Kamarisima; Ningrum, Ratih A.; Angelina, Marissa; Agustiyanti, Dian F.; Wisnuwardhani, Popi H.; Nugroho, Herjuno A.; Tan, Marselina I.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2068

Abstract

Viral transport medium (VTM) is crucial for retaining clinical specimens, such as the virus or its genetic material from the mucus of respiratory tract of coronavirus disease 2019 (COVID-19) suspected patients. However, the locally produced VTM in Indonesia lacks the ability to inactivate the virus, risking the safety of diagnostic personnel. The aim of this study was to formulate inactive VTM (iVTM) incorporating chaotropic agents like guanidine salt, along with anionic detergents, chelators, buffers, and surfactants, to inactivate the virus while maintaining RNA integrity. Viral RNA stability in iVTM (pH 4 and pH 6) was evaluated for 30 days at 4°C and 25–28°C. In vitro inactivation test was performed on SARS-CoV-2 isolate (variant B1). The stability test revealed that storing the clinical specimens in iVTM at pH 6 maintained severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) detectability by qPCR for up to 30 days at cold and room temperatures. Stability assessments conducted over a 4-month period (at 25–28°C) on iVTM with a pH of 6 revealed clear appearance, consistent pH stability, no alteration in the solution color, and no indications of bacterial or fungal contamination. Results from an in vitro inactivation assay demonstrated that iVTM pH 6 eliminated SARS-CoV-2 infectivity within just five minutes of contact. These findings suggest that iVTM pH 6 offers a safer and cost-effective alternative for handling and transportation of clinical specimens.
Navigating the intersection of COVID-19 and lower extremity acute limb ischemia: A retrospective cohort study of clinical characteristics and outcomes at Dr. Cipto Mangunkusumo Hospital Muradi, Akhmadu; Fachriza, Ihza; Pratama, Dedy; Suhartono, Raden; Harunarashid, Hanafiah
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2557

Abstract

Acute limb ischemia (ALI), a critical condition threatening limb viability and patient survival, has demonstrated an increased incidence during the COVID-19 pandemic, primarily due to virus-associated thrombotic complications. The pandemic has also led to delays in the diagnosis and treatment of non-COVID conditions, including ALI. The aim of this study was to evaluate the clinical characteristics and outcomes of ALI patients treated at Dr. Cipto Mangunkusumo Hospital between 2018 and 2022, comparing outcomes before and during the COVID-19 pandemic. Patients were categorized into two cohorts: pre-pandemic (n=28) and pandemic (n=53), with March 2020 marking the onset of the pandemic period. Treatment outcomes—revascularization success, re-intervention, and mortality—were assessed using multivariate logistic regression. Among the 81 patients, 34.6% were treated before the pandemic and 65.4% during the pandemic. Revascularization success was significantly higher during the pandemic (relative risk (RR): 2.46; 95% confidence interval (CI): 1.16–5.24; p=0.013), whereas no significant differences were observed in re-intervention or mortality rates (both with p>0.05). A prior history of COVID-19 was not significantly associated with revascularization outcome (p=0.933). The use of fluoroscopic guidance was significantly associated with improved revascularization success (RR: 36.58; 95%CI: 6.54–204.6; p=0.001). Rutherford classification was a significant predictor of re-intervention success (p=0.022), while the presence of dyslipidemia and cardiovascular disease were independently associated with mortality (RR: 0.08–0.76, p=0.0o5, and RR: 2.24–25.18, p=0.001, respectively). In conclusion, fluoroscopy appears to enhance revascularization outcomes in the treatment of ALI. Comorbidities such cardiovascular disease, and COVID-19 history should be taken into account when managing patients with ALI.
Chronic exercise reduces astrocytic c-Fos and CCL2 via conditioned serum and cerebrospinal fluid Allahyari, Victoria; Behroozi, Zahra; Akhavan, Maziar M.; Shahrezaei, Aidin; Nasirinezhad, Farinaz
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2726

Abstract

Inflammation, a critical immune response to infection and tissue damage, is mediated by pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), which upregulate the expression of cellular proto-oncogene Fos (c-Fos) and chemokine ligand 2 (CCL2). Chronic exercise has been shown to exert systemic anti-inflammatory effects, yet its impact on astrocytic inflammatory signaling remains unclear. The aim of this study was to investigate whether chronic exercise modulates astrocytic expression of c-Fos and CCL2 through factors present in conditioned serum and cerebrospinal fluid (CSF). Male wistar rats were assigned to an exercise group (progressively increased swimming, five times per week for four weeks) or a sedentary control group. Conditioned serum and CSF were collected and applied to astrocyte cultures with or without TNF-α induction. After 120 minutes, c-Fos and CCL2 expression were quantified using western blot analysis. Conditioned serum and CSF from exercise rats significantly reduced TNF-α induced c-Fos and CCL2 expression compared with controls. These findings suggest that chronic exercise may attenuate neuroinflammatory responses by modulating astrocytic expression of c-Fos and CCL2. The parallel reductions observed in both serum and CSF indicate that exercise-induced circulating factors may possess anti-inflammatory properties within neural environments. This study provides preliminary in vitro evidence for mechanistic link between chronic exercise and reduced neuroinflammation, underscoring the need for in vivo validation and translational research to assess therapeutic potential.
Death contemplation and mental well-being in elderly Thai Buddhist meditation practitioners Glushich, Alla; DeMaranville, Justin; Wongpakaran, Tinakon; Wedding, Danny; Wongpakaran, Nahathai
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2753

Abstract

Depression is prevalent among older adults in Southeast Asia, with fear of death as a key contributing factor. In Thailand, Buddhist death contemplation practices promote acceptance of mortality and may support mental well-being. However, their impact on mental health among elderly Thai Buddhist meditation practitioners remains underexplored. The aim of this study was to examine the interrelationships among death contemplation practice, positive death attitudes, and key psychological outcomes: well-being, depression, and gratitude among elderly Thai Buddhist meditation practitioners. A cross-sectional study design was employed, and data were collected from elderly Thai Buddhist meditation practitioners in Northern Thailand. Participants completed validated instruments assessing death attitudes (Morana Questionnaire; MoQ), death contemplation practice (Modified Meditation Evaluation Questionnaire; MMEQ), well-being (WHO-5-T), depression (Outcome Inventory-21), and gratitude (Gratitude Inventory-6). Descriptive statistics, Pearson correlations, and analysis of covariance (ANCOVA) were used to examine associations among variables and differences across levels of death contemplation practice. A total of 332 elderly participants (mean age=68.12 years; 66% female) were included. Death contemplation practice showed a significant negative association with depression (p=0.011) but not with well-being (p=0.116) or gratitude (p=0.226) after controlling for covariates. Positive death attitudes were independently associated with lower levels of depression (p<0.001), as well as higher levels of well-being (p<0.001) and gratitude (p<0.001), remaining a significant predictor across all outcomes. The association between contemplation and depression weakened when positive attitudes were included in the model, suggesting a mediating effect. These findings underscore the central role of positive death attitudes, cultivated through contemplative practice, in supporting mental health among elderly Thai Buddhist meditation practitioners. Integrating such practices into interventions may offer culturally appropriate strategies for enhancing well-being in aging Buddhist populations.
Integrated analysis of dengue transmission risk and insecticide resistance in Aedes aegypti from Vichada, Colombia Mejia-Jaramillo, Ana M.; Cantillo-Barraza, Omar; Medina, Cesil S.; Jaimes-Dueñez, Jeiczon; Triana-Chavez, Omar
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2795

Abstract

Dengue is the primary arbovirus transmitted by Aedes aegypti mosquitoes. Effective management of dengue demands a multidisciplinary approach. The aim of this study was to conduct an integrated analysis of dengue transmission, focusing on its vector mosquitoes, to establish a baseline for dengue control and prevention in an endemic region of Colombia. The study was conducted from 2015 to 2018 across four municipalities in the Vichada department near the Venezuelan border. Five complementary approaches were employed: (1) determining the natural infection rate and circulation of various dengue virus serotypes in mosquitoes; (2) evaluating the insecticide susceptibility status and examining mosquito genotypes for three knockdown (kdr) mutations linked to insecticide resistance; (3) performing a phylogenetic analysis to identify the lineage of Ae. aegypti; (4) creating risk maps for dengue transmission based on predictive models in two municipalities in the department; and (5) empowering the community. Molecular analysis using RT-PCR indicated dengue virus infections in all municipalities of the Vichada department. Eleven positive pools for serotypes DENV-1, DENV-2, DENV-3, and DENV-4 were detected. The highest minimum infection rate (MIR) was found in Cumaribo, followed by La Primavera, which showed the greatest diversity of dengue virus serotypes. Mosquitoes from all three populations showed susceptibility to malathion and lambda-cyhalothrin pyrethroid, except for mosquitoes from Puerto Carreño, which presented moderate resistance to lambda-cyhalothrin (resistance ratio of 8). Importantly, all mosquitoes had the F1534C mutation, while the V1016I and V419L mutations were found at lower frequencies. Risk classification maps for Puerto Carreño and La Primavera showed neighborhoods with high risk, indicating potential hotspots for intervention and vector control. This study established a necessary baseline for the ongoing monitoring and improvement of the early warning system for all municipalities in the Vichada department. The integrative approach employed in this study highlights the importance of incorporating these methodologies into dengue epidemiological surveillance in endemic regions.
Factors associated with the incidence of young-onset colorectal cancer: A cross-sectional study Sianturi, Natallina; Dahlia, Debie; Edison, Chiyar
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2853

Abstract

The factors associated with the incidence of young-onset colorectal cancer (YO-CRC) remain uncertain and are continuously being studied. The aim of this study was to investigate the factors associated with the incidence of young-onset colorectal cancer. This cross-sectional study examined multiple factors (demographic status, medical comorbidities, smoking, alcohol intake, nighttime sleep duration, family history of cancer, sedentary behavior, daily consumption of fried foods, fast food, and processed meat) among 171 patients from two cancer referral hospitals in Jakarta, Indonesia. Logistic regression analysis revealed that the low-income group had a higher risk of YO-CRC compared to high-income group (p=0.004). Those with comorbid diseases such as inflammatory bowel disease, diabetes, or high cholesterol were more likely to develop YO-CRC compared to those without these conditions (p=0.002). Frequent consumption of processed meat (vs seldom) (p=0.003) and fried food (vs no consumption) (p=0.001) were associated with higher risk. Those with high sedentary behavior (vs low) (p=0.021) also had higher risk of YO-CRC. Notably, nighttime sleep emerged as the strongest predictor (odds ratio (OR): 10.462). These findings underscore the need for targeted public health interventions promoting adequate sleep, healthy diets, and active lifestyles, particularly among Indonesian youth and low-income groups. Further studies are recommended to investigate these associations in larger and more diverse populations across Indonesia.
Antimicrobial resistance and empirical antibiotic use in diabetic foot infections: A retrospective study from Indonesia Tarigan, Menang B.; Saragih, Rama M.; Tarigan, Kevin A.; Ginting, Franciscus
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2895

Abstract

Diabetic foot infection (DFI) represents a major complication of diabetes mellitus with significant morbidity, frequently leading to amputation if not optimally managed. The aim of this study was to analyze clinical, microbiological, and antibiotic susceptibility data from patients with type 2 diabetes who presented with foot infections in Indonesia. The retrospective study, conducted at St. Elisabeth Hospital in North Sumatra, Indonesia, predominantly comprised male farmers with a mean diabetes duration of 8.6 years, most of whom exhibited advanced ulcer severity (64.5% at Wagner grade III). Surgical debridement was performed in 79.0% cases, and amputation in 21.0% of cases. Laboratory investigations revealed poor glycemic control (mean HbA1c 10.12%) and biochemical markers indicative of systemic inflammation and renal impairment. Microbial cultures identified a predominance of Gram-negative bacteria (58.1%), primarily Klebsiella pneumoniae, Proteus mirabilis, and Escherichia coli, whereas Gram-positive isolates (41.9%) were dominated by Staphylococcus aureus, including methicillin-resistant strains. Empirical outpatient and inpatient antibiotic regimens commonly included amoxicillin, ciprofloxacin, metronidazole, and ceftriaxone; however, in vitro susceptibility testing demonstrated limited efficacy of β-lactams such as ampicillin and amoxicillin (<10% sensitivity). In contrast, linezolid, amikacin, vancomycin, carbapenems, and fosfomycin exhibited superior activity against the isolated pathogens. These findings emphasize the critical need for empirical antibiotic guidelines tailored to local microbial ecology and resistance profiles, integrated with early surgical management, stringent glycemic control, and multidisciplinary care. This comprehensive approach is essential to reduce the risk of amputation and improve clinical outcomes in tropical, resource-limited settings.
SARS-CoV-2 lineages and naso-oropharyngeal bacterial communities in COVID-19 reinfection: A study in West Java, Indonesia Sativa, Alvira R.; Asyifa, Isnaini Z.; Adzdzakiy, Muhammad M.; Iryanto, Syam B.; Nugroho, Herjuno A.; Wulandari, Ari S.; Yanthi, Nova D.; Nasrulloh, Mukh F.; Rahmawati, Ema; Alamanda, Cut NC.; Ristandi, Ryan B.; Rachman, Rifky W.; Robiani, Rini; Agustiyani, Dian F.; Wisnuwardhani, Popi H.; Wardiana, Andri; Ningrum, Ratih A.; Dharmayanthi, Anik B.; Prasetyoputri, Anggia; Fibriani, Azzania; Saputra, Sugiyono
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.2901

Abstract

Continuous emergence of new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may influence viral transmission dynamics and alter interactions with the respiratory microbiota, potentially increasing the risks of reinfection. This study investigated cases of coronavirus disease 2019 (COVID-19) reinfection in West Java, Indonesia, with the aim of identifying the SARS-CoV-2 variants involved, characterizing their genomic mutations, and profiling the nasal and oropharyngeal microbiota associated with reinfection. Naso-oropharyngeal swab samples were collected from 42 COVID-19 reinfection cases and nine new infection cases. Whole genome sequencing was performed using Oxford Nanopore Technologies (ONT) MinION Mk1C and variant analysis was conducted using ARTIC workflow. Nexstrain and PANGOLIN were used to determine the lineages. Phylogenetic trees were constructed using IQ-tree and FigTree. Key mutations were identified by Cov-GLUE. Additionally, 16s rRNA amplicon sequencing was conducted on nine samples from each group to analyze bacterial communities using EPI2ME and MicrobiomeAnalyst. All identified SARS-CoV-2 strains in this study were Delta variant (B.1.617.2), predominantly lineage AY.23 (n=46, 90%), followed by AY.24 (n=3) and AY.109 (n=2). No differences in SARS-CoV-2 lineages were observed between reinfection and new infection cases. Unique hotspot mutations found only in COVID-19 reinfections included NSP3, V220A, S_T676I, ORF7a_V82A, and ORF7a_TI20I. Bacterial community analysis revealed no significant diversity differences (alpha and beta) between the two groups. While the most dominant phylum remained Terrabacteria in both groups, Streptococcus was dominant in COVID-19 reinfections, whereas Prevotella was dominant in new infection cases. Notably, Haemophilus parainfluenzae, Fusobacterium periodonticum, Fusobacterium nucleatum, and Leptotrichia buccalis had significant increases in reinfection cases. Despite the similarity in SARS-CoV-2 lineages causing both COVID-19 reinfection and new infection cases, the presence of distinct key mutations and bacterial species suggest their potential as biomarkers within this group.

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