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Gema Lingkungan Kesehatan
Published by Polilteknik Kesehatan Kemenkes Surabaya
ISSN : 16933761     EISSN : 24078948     DOI : 10.36568
Core Subject : Health, Science, Social,
Environmental Science Health Professions Immunology & microbiology Public Health
Jurnal GEMA Lingkungan Kesehatan [e-ISSN: 2407-8948 | DOI: 10.36568] is a journal aims to be a leading peer-reviewed platform and an authoritative source of information. We publish original research papers, review articles and case studies focused on environmental health or public health as well as related topics that has neither been published elsewhere in any language, nor is it under review for publication anywhere. This following statement clarifies ethical behavior of all parties involved in the act of publishing an article in this journal, including the author, the editor, the reviewer, and the publisher (Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya).
Arjuna Subject : Ilmu Lingkungan (semua ketegori) - Kesehatan, Toksikologi dan Mutasi Gen
Articles 193 Documents
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Predictive Value of Neutrophil-to-Limphocyte Ratio for Detecting Nonalcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Patients Daniswara, Gede Abhirama; Nurhasan Agung Prabowo; Putri, Desy Puspa; Shofiyah, Laily
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.455

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterized by insulin resistance, leading to increased blood glucose levels (hyperglycemia). Insulin resistance is a key factor in the development of nonalcoholic fatty liver disease (NAFLD), a condition defined by excessive hepatic fat accumulation that is not caused by alcohol consumption. NAFLD can progress from simple steatosis to hepatic inflammation and fibrosis. The neutrophil-to-lymphocyte ratio (NLR) is a simple biomarker for systemic inflammation. Elevated NLR values may indicate increased inflammation, such as that observed in NAFLD. This study aimed to determine differences in NLR values in T2DM patients with NAFLD and without NAFLD. This cross-sectional study used secondary data from the medical records of 88 T2DM patients from 2022 to 2024, divided into groups without NAFLD (n=45) and with NAFLD (n=43) based on ultrasonographic liver findings. The Welch t-test was applied to compare NLR values, and receiver operating characteristic (ROC) analysis was used to identify the optimal cut-off value for NLR. The NAFLD group had significantly higher NLR values (mean difference = 3.80; 95% CI: 2.75–5.24; p<0.001), with an AUC of 0.962 (95% CI: 0.915–1.000; p<0.001) and an optimal cut-off value of ≥3.1964 (sensitivity 90.7%; specificity 100%). In conclusion, NLR is significantly elevated in T2DM patients with NAFLD and demonstrates strong discriminatory ability, indicating its potential use as a simple inflammatory biomarker in T2DM managements.
The Effectiveness of Rice Straw and Cogongrass Straw Soaked Water Attractants on the Number of Aedes spp. Mosquitoes Wiratama, Alprian; -, Zairinayati
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.456

Abstract

Aedes spp. mosquitoes are the main vectors of Dengue Hemorrhagic Fever (DHF), which remains a public health problem in Indonesia. Chemical insecticide-based mosquito control has the potential to cause environmental pollution and vector resistance, so safer and more environmentally friendly control alternatives are needed. This study aimed to analyze the effectiveness of rice straw and cogongrass straw-soaked water attractants in attracting Aedes spp. mosquitoes. Method this study used a pure experimental design with a post-test only control group design. The study was conducted at Muhammadiyah Ahmad Dahlan University, Palembang. Traps were placed purposively with a total of 27 observation units consisting of three treatment groups, namely control (water without attractant), rice straw-soaked water attractant, and cogongrass straw-soaked water attractant, each with nine replications. Traps were set for 5–7 days. Data were analyzed using the Shapiro–Wilk normality test, homogeneity test, One Way ANOVA, and the Least Significant Difference (LSD) test with a significance level of 0.05. The results showed the total number of mosquitoes trapped in the control group was 16, in the rice straw attractant group was 31, and in the cogongrass straw attractant group was 32. The average number of mosquitoes in the control group was 2.00 ± 0.67, in the rice straw group was 3.00 ± 1.13, and in the cogongrass straw group was 4.00 ± 1.13. The results of the One- Way ANOVAanalysis showed a significant difference between the treatment groups (p = 0.01). Further LSD tests showed that both attractant groups were significantly different from the control, but there was no significant difference between the rice straw and cogongrass straw attractants. These findings indicate soaked water from rice straw and cogongrass straw was effective in increasing the number of trapped mosquitoes compared to the controlas a natural attractant to catch Aedes spp. mosquitoes and has the potential to be an alternative vector control that is cheap, easy to apply, and environmentally friendly.
Mosquito Larvae Identification in Water Storage and Assesment of Worker’s Knowledege, Attitudes, and Practices Nezma Meidina, Adinda; Handayani, Dwi; Dalilah, Dalilah; Dwi Prasasty, Gita; Susilawati, Susilawati
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.459

Abstract

Vector-borne diseases remain a major public health concern in tropical regions, with dengue fever continuing to be the predominant vector-borne disease in urban Indonesia. Public tourist areas with high human activity may provide favorable breeding sites, making sanitation workers’ roles crucial. This study aimed to identify mosquito breeding characteristics and larval presence in water-holding containers (WHCs) and to describe the knowledge, attitudes, and practices (KAP) of sanitation workers in a historic public open space in an urban setting. A descriptive cross-sectional study using a mixed-methods approach was conducted, combining quantitative entomological surveys with qualitative in-depth interviews. All accessible WHCs at the study site were inspected for larvae, which were collected and morphologically identified, and Aedes larval indices (ABJ/Angka Bebas Jentik, HI, CI) were calculated. Sanitation workers were selected purposively as qualitative informants, and KAP data were analyzed thematically. Seven WHCs were identified, of which two outdoor natural pools (28.57%) were positive for larvae, yielding 13 larvae, all identified as Culex spp., with no Aedes spp. detected. Consequently, Aedes-specific indices showed an ABJ of 100%, HI of 0%, and CI of 0%, indicating a low risk of dengue transmission according to WHO criteria (HI <4% and CI <3%). Sanitation workers demonstrated generally good knowledge, positive attitudes, and routine preventive practices, although understanding of the full 3M Plus concept varied. In conclusion, despite the presence of non-Aedes larvae in outdoor natural containers, the absence of Aedes breeding sites suggests effective dengue vector control supported by routine sanitation practices in the study area.
Preliminary Study of Life Cycle Assessment on Food Surplus Redistribution Compared to Food Waste Management in Surabaya Khairunisa; Rizki, Nuzulul Anggi; Adriani, Lies Wuryanita; Wijaya, Rizki Ainuna
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.462

Abstract

Food waste accounts for approximately 40% of total waste generation in Indonesia and contributes significantly to national greenhouse gas (GHG) emissions. While most food waste is still disposed of in landfills, food surplus redistribution through food banks has emerged as a potential mitigation strategy. This study evaluates the environmental performance of food surplus redistribution compared to conventional food waste management options using a life cycle assessment (LCA) approach. The analysis was conducted at Garda Pangan, Surabaya, with a functional unit of 1 ton of food surplus and assessed three scenarios: (1) landfill disposal, (2) composting and anaerobic digestion, and (3) food surplus redistribution. The assessment applied the CML IA Baseline method and focused on Global Warming Potential (GWP), using SimaPro 9.0 and the Ecoinvent 3 database. The results show that landfill disposal has the highest GWP at 1,920 kg CO₂-eq per ton of food waste, driven primarily by methane emissions from anaerobic decomposition. Composting and anaerobic digestion result in lower impacts, at 1,503 and 1,730 kg CO₂-eq per ton, respectively. In contrast, food surplus redistribution shows a markedly lower GWP of 1.24 kg CO₂-eq per ton of food surplus, as emissions are dominated by transportation activities within a simplified gate-to-gate system boundary. This preliminary analysis relied on secondary inventory data and excluded potential avoided food production impacts; therefore, the estimated GWP for redistribution may underestimate or overestimate actual emissions. These findings highlight the importance of prioritizing food waste prevention and the benefits of food surplus redistribution within integrated waste management strategies to reduce GHG emissions while delivering social co-benefits.
Estimated Health Risk of Cadmium and Chromium in Elderly Blood Cockle Consumers, Lantebug Gafur, Abd; Syam, Nasruddin
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.463

Abstract

This study assessed the non-carcinogenic health risks of Cadmium (Cd) and Chromium (Cr) exposure through blood cockle (Anadara granosa) consumption among elderly residents in Lantebung, Makassar Strait. Blood cockle samples were collected from six purposively selected points, and Cd and Cr concentrations were analyzed. Health risks were estimated using intake calculations and the Risk Quotient (RQ). Cd and Cr concentrations were generally below national and international food safety limits. However, some elderly individuals, particularly frequent consumers, exceeded the non-carcinogenic risk threshold (RQ > 1). The highest risks were associated with specific sampling points, reflecting localized contamination. Risk factors included high consumption rates, long exposure duration, and lower body weight. These findings suggest that compliance with contaminant limits alone may not ensure safety for vulnerable populations. Regular environmental monitoring, risk communication for high-risk groups, and strengthened pollution control measures are recommended. Public health interventions, including periodic health screening and guidance on safe seafood consumption, are needed to reduce long-term health impacts. 
The Effect of Feeding Rules Implementation on Children in Cimahi, Indonesia Zulva, Siti; Haifa Latifah, Fany
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.304

Abstract

Eating difficulties are when children do not want or refuse to eat in the type or amount according to age physiologically. Several cases of difficulty eating were found that caused malnutrition in children aged 6-24 months. According to data from the Cimahi City Health Office, Cipageran has the highest number of wasting sufferers in Cimahi city as many as 117 children from 2917 targets. In general, this study aims to identify and find out the differences in the diet of children aged 6-24 months before and after applying feeding rules. This study uses a quantitative comparative method where the researcher compares 2 treatments of a variable and is quasi experimental design with a two-group pre-post-test design with the number of respondents for the intervention group of 32 respondents and the control group of 32 respondents, so the total sample is 64 respondents. In the intervention group after the post test was carried out, the child's diet increased to be appropriate with a p value of 0.0001 <0.05, while in the control group there was no change in the pre post-test with a p value of 0.199 >0.05. There was a significant difference between pre and post-test feeding rules in the intervention group while in the control group there was no significant difference. The characteristics at the age of 11-24 months are most common in women and the age of parents is most found at the age of 26-35 years. By implementing feeding rules, it is proven that it can improve children's diets with a p-value of 0.0001 <0.05. On the other hand, not applying feeding rules proves that it cannot improve the pattern of children with a p-value of 0.199 >0.05. There was a difference in dietary changes with a p value of 0.0001 <0.05.
Environmental and Pet-Associated Risk Factor for Hookworm Infection in Coastal East Kalimantan Sedionoto, Blego; Anamnart, Witthaya; Fitrah, Muhammad Aidil
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.366

Abstract

Hookworm infection remains an important community health concern, particularly in the coastal areas of East Kalimantan, Indonesia, where environmental conditions facilitate transmission. Key risk factors in this region include the presence of domestic animals (cats and dogs), infection in these pets, and specific types of soil surrounding households. This study aimed to determine the prevalence of hookworm infection and its association with various environmental and behavioral risk factors. A cross-sectional survey was conducted in 2019 among 213 individuals from rural areas of Kutai Kartanegara Regency. Stool specimens were examined using Kato-Katz and Koga Agar Plate (KAP) culture technique. The prevalence of hookworm infection was 33.8% (72/213). Higher infection rates were significantly associated with older age (≥13 years), agricultural occupation, poor sanitation facilities, use of unsanitary water sources, and open defecation practices. Environmental factors, including wet soil, high soil organic carbon content, low elevation, high humidity, frequent rainfall, and proximity to rivers or plantation areas, were also significantly associated with hookworm infection (p < 0.05; ORs ranged approximately from 1.7 to 2.9). The presence of hookworm-infected domestic dogs was significantly associated with human infection (p < 0.001). These findings highlight that hookworm transmission in coastal East Kalimantan is influenced by an alliance of environmental, behavioral, and animal-related factors. Comprehensive control strategies focusing on sanitation improvement, environmental management, and control of zoonotic reservoirs are essential to reduce infection rates in endemic rural setting.
Association of Riverside Living with SIRS Incidence in Stroke Patient in South Kalimantan Fakhrurrazy, Fakhrurrazy; Pagan Pambudi; Ananda Dwi Latifah; Asti Afrida Yanti; Zein, Siti Habibah; Khatimah, Husnul; Anggun Wulandari
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.374

Abstract

South Kalimantan is a province that has 97 rivers, and many people who live on the riverside make the rivers a source of life. Currently, there is more and more river water pollution, which has an impact on the health status of people living on the riverside, especially inflammation. This study used an analytic-observational design. The study subjects were stroke patients who were treated at the stroke unit and nerve ward at Ulin Hospital, Banjarmasin, for the period October 2022-May 2023. There were 128 subjects who were divided into two groups based on whether they lived on the riverside (64 people) or not (64 people). Variable analysis used descriptive analysis, the chi-square test, and multivariate analysis using the logistic regression test. Based on the descriptive analysis, it was found that there were no variables that showed meaningful results. Bivariate analysis resulted in variables that had a significant relationship. In the multivariate analysis, it was found that living on the riverside and mortality rate were independent predictors, which together with the dependent predictor factor, i.e., the type of stroke, affected the incidence of SIRS in stroke patients. Living on the riverside and mortality can be used as predictors of SIRS in stroke patients. SIRS assessment in an appropriate manner in stroke patients who live on river banks should be a routine examination. Prevention and monitoring of risk factors can prevent stroke patients from experiencing SIRS conditions to avoid complications that can occur.
A Comparative Analysis of Taksimari and Taksinada in Alleviating Pain Following IUD Insertion Sumawati, Ni Made Risna; Purnamayanti, Pande Putu Indah; Maryadi, Ni Made Septiari
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.376

Abstract

The Intra Uterine Device (IUD) is the best contraceptive for most women but often causes problems, namely pain. Pain can cause physiologic changes such as increased blood pressure, increased heart rate, vasoconstriction (arterial) blood vessels, increased respiratory activity, loss of water, and extreme fatigue. This study aims to determine the comparison of the effectiveness of the use of Five Finger Relaxation Technique (Taksimari with Deep Breath Relaxation Technique (Taksinada) on post-installation pain of the IUD at UPTD Puskesmas Sidemen. The research design used in this study was posttest design with a control group, namely research conducted after treatment (posttest) with two groups of subjects, namely the control group and the treatment group. The sample in the study amounted to 30 respondents with the following criteria: women aged 18-45 years, new IUD acceptors, and IUD installation at Sidemen Community Health Center, 15 respondents were given Taksimari and 15 respondents were given Taksinada. The analysis test used was the Mann Whitney test. The results showed that there were 14 respondents (93.33%) experiencing moderate pain in the Taksimari group, while in the Taksinada group there were 15 respondents (100%) experiencing moderate pain. The results of the bivariate analysis test showed that there was no difference in the effectiveness of non-pharmacological therapy Taksimari with Taksinada with a value of p = 0.317. This study found that there was no difference in the effectiveness of non-pharmacological therapy Taksimari with Taksinada. This study can be used as a basis for consideration in carrying out independent midwifery interventions in pain management.
The Role of Prenatal Environmental Risk Factors in Autism Spectrum Disorder Severity: Insight from Lead Exposure, Tobacco Smoke, and Low Birth Weight Iskandar, Iskandar; Salan, Yosef Dwi Cahyadi; Utama, Adelia Anggraini; Putri, Niarsari Anugrahing; Putera, Gusti Muhammad Perdana; Sekartaji, Hapsari Lintang; Eriana, Nisa Nur Agistni; Suhartono, Eko
Gema Lingkungan Kesehatan Vol. 24 No. 1 (2026): Gema Lingkungan Kesehatan (on progress)
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v24i1.380

Abstract

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition influenced by interactions between genetic susceptibility and environmental exposures during critical developmental periods. However, evidence regarding how environmental factors relate to ASD severity remains limited. This study aimed to examine the associations between urinary lead (Pb) levels, prenatal cigarette smoke exposure, history of low birth weight (LBW), and ASD severity, providing insights into potential environmental influences on clinical outcomes. A cross-sectional study was conducted among 43 children diagnosed with ASD attending a special needs school (SLB C) in Banjarbaru, South Kalimantan, Indonesia. Urinary Pb concentrations were measured using UV-Visible spectrophotometry. Information on prenatal cigarette smoke exposure and birth history was obtained through structured parental interviews. ASD severity was assessed using the Childhood Autism Rating Scale, Second Edition (CARS-2), and classified as mild–moderate or severe. Higher urinary Pb levels, prenatal cigarette smoke exposure, and a history of LBW were significantly associated with ASD severity, highlighting potential environmental risk factors that may influence clinical presentation and management strategies. In conclusion, among children with ASD in this school-based population, environmental and perinatal factors were associated with differences in ASD severity. While these findings are promising, emphasizing the need for further research can foster a sense of hope and motivation among researchers, clinicians, and students. Due to the cross-sectional design, causal inferences cannot be drawn. Further studies using longitudinal designs and objective exposure measurements are warranted.

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