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From SERVQUAL to Loyalty: A Review of Evidence in Primary Care Sinaga, Panuturi Ratih Elizabeth Thresna
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Service quality plays a vital role in shaping patient satisfaction and loyalty, yet most existing evidence comes from hospital settings. Understanding how service quality functions in primary care is crucial to improving patient experiences and strengthening health system trust. Objective : To map and synthesize empirical findings on the relationships between SERVQUAL dimensions, patient satisfaction, and patient loyalty in primary care services from 2020–2025. Research Methods/ Implementation Methods : A narrative review was conducted using 34 eligible studies that examined SERVQUAL dimensions—tangibles, reliability, responsiveness, assurance, and empathy—in relation to satisfaction and loyalty. Data were extracted on significant predictors, research design, and analytical approaches. Results : Responsiveness, empathy, and tangibles consistently showed the strongest influence on satisfaction, which often mediated the effect of service quality on loyalty. Findings for reliability and assurance varied by context. Most studies used cross-sectional survey designs with SEM-PLS analysis, and heterogeneity in instruments limited quantitative comparison. Conclusion/Lesson Learned : Evidence supports a quality–satisfaction–loyalty pathway in primary care. Future research should standardize instruments, include contextual variables such as financing models (e.g., BLUD), and adopt longitudinal designs to enhance causal interpretation and policy relevance

The Effectiveness of Social Media to Improve Healthy LifestylesAmong Millennials: A Literature Review Sophystikatty, Lady Arounda; Rohmah, Nur; Nurrachmawati, Annisa
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Changes in the lifestyle of modern society, particularly the millennial generation, show an increased risk of various non-communicable diseases. A sedentary lifestyle, unhealthy eating habits, and high stress levels are dominant factors that negatively affect the health quality of this generation. Health promotion that is packaged in an attractive, informative way and aligned with millennial communication styles has the potential to increase awareness toward a healthier lifestyle. Objective : The general objective of this review is to determine how effective health promotion through social media in improving healthy lifestyles among millennials. Research Methods : This study was conducted through a literature review of 30 scientific articles retrieved from databases such as PubMed, ScienceDirect, Scopus, ResearchGate, Google Scholar, and SINTA. Articles were selected based on relevance to the effectiveness of social media in increasing awareness and healthy lifestyle behaviors Results : The collected evidence includes randomized controlled trials (RCTs), systematic reviews, intervention studies, surveys, and content analyses on platforms such as Instagram, TikTok, YouTube, Facebook. Overall findings show that social media is effective in increasing knowledge, intentions, and certain behavioral indicators, with the highest effectiveness observed when interventions combine social support, social-norm messaging and credible influencers Conclusion : Based on the analysis of the reviewed journals, it can be concluded that social media isa highly effective tool for health promotion in improving healthy lifestyles among millennials when content incorporates social norms, uses engaging short-video formats, and is supported by community interaction.

The Effect of Screen Time on Dental Caries in Adolescents: A Narrative Review Silitonga, Hesty Erika; Pakki, Irfansyah Baharuddin; Asfirizal, Verry; Azmiardi, Akhmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Dental caries is a chronic disease with a high prevalence among adolescents. With the advancement of technology, screen time has become a a daily activity. Excessive screen time can lead to encourage a sedentary lifestyle, which may impact oral health. Objective : This review aims to synthesize scientific evidence from various studies to explain how prolonged screen time contributes to caries risk in adolescents. Research Methods/ Implementation Methods : This narrative review synthesizes relevant research articles to gain a comprehensive understanding of the relationship between screen time and dental caries. Articles were searched through major electronic databases, including PubMed, Google Scholar, and ScienceDirect, focusing on publications from 2016 to 2025. Articles included in the review discussed screen time habits among adolescents, the impact of screen time on dental caries or oral health, were written in Indonesian or English. Results : A literature review of 30 articles reported a positive association between high screen time and increased caries risk in adolescents. Behavioral changes were the main mediators of this association. Many studies described two primary mechanisms: prolonged screen time significantly increased cariogenic dietary habits while using devices and excessive screen time reduces oral hygiene practices. Conclusion/Lesson Learned : Excessive screen time acts as a significant behavioral risk factor for dental caries in adolescents because it can trigger unhealthy dietary patterns and reduce oral hygiene practices. Counseling, reducing screen time, education on tooth brushing, healthy eating, and fluoride using can reduce the risk of dental caries.

Characteristics of Patients with HIV/AIDS Undergoing Antiretroviral Therapy at Loa Bakung Community Health Center Permani, Relung Adiniah; Pakki, Irfansyah Baharuddin; Azmiardi, Akmad
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : HIV is a virus that attacks the body’s immune system, making the body more susceptible to various infections. AIDS refers to a collection of symptoms and infections associated with a weakened immune system due to HIV infection. Loa Bakung Community Health Center is one of the healthcare facilities in Samarinda that provides ART services for patients with HIV/AIDS. Objective : This study aims to describe characteristics of patients with HIV/AIDS undergoing ART at Loa Bakung Community Health Center. Research Methods/ Implementation Methods : This study used a retrospective descriptive method with secondary data from medical records and SIHA 2.1 application. The population included all HIV/AIDS patients undergoing ART at Loa Bakung Community Health Center from January 2023 to December 2024. The data were analyzed descriptively and presented in the form of frequency distribution tables and percentages. Results : Of the 33 HIV/AIDS patients undergoing ART, the majority were male (64%) aged 20-39 years (84%) and had a high school education (76%). Most patients were employed (55%) and single (52%). The largest population group was partners of key populations/PLHIV/STI patients (42%), followed by men who have sex with men (MSM) at 37%. The dominant ART regimen used was TLD (Tenofovir, Lamivudine, Dolutegravir) at 58%, with 87% of patients tested showing suppressed viral load results. Conclusion/Lesson Learned : Increasing early detection, education on risky sexual behaviors, and optimizing counseling and patient support services are strategic steps to improve the success of ART and reduce the rate of HIV transmission.

Not All Water is Equal: The Hidden Impact of Drinking Sources on Maternal Hemoglobin Saputra, Rudi; Angelina, Grace; Najla, Syarifah Amira; Tricindra, Dzulhannisa; Ulpah, Rini Wahidatul; Hamri, Ahmad Ahsyar; Nuryanto, Muhammad Khairul; Nugroho, Setyo; Adrianto, Ratno
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Water quality is vital for maternal health. In Indonesia, consuming untreated or lowquality water may increase anemia risk in pregnant women. Objective : This study examined the relationship between drinking water sources and hemoglobin levels and identified factors influencing water source selection. Research Methods / Implementation Methods : A cross-sectional study of 72 pregnant women was conducted at Palaran Health Center, Samarinda (Dec 2024–Jan 2025). Data on sociodemographics and drinking water sources were collected via questionnaire, while hemoglobin levels were obtained from laboratory records. Due to non-normal data distribution (p < 0.05), the Kruskal–Wallis test with post hoc comparisons was applied. Determinants of water source selection were analyzed using multinomial logistic regression. Results : Most respondents (76.4%) consumed unboiled refilled gallon water, which was associated with significantly lower hemoglobin levels than bottled or PDAM water (p = 0.002). The logistic model was significant (χ² = 75.233, df = 54, p = 0.030; Nagelkerke R² = 0.811). Significant predictors of water source choice included number of pregnancies, abortion or fetal death history, delivery history, household income, mother’s and husband’s education levels (p < 0.05). Conclusion / Lesson Learned : Unboiled refilled gallon water consumption is linked to lower hemoglobin levels and higher anemia risk. Reproductive and socioeconomic factors influence water source selection. Education on safe water handling and boiling practices is essential to improve maternal hematologic health.

Whole-Body Vibration Exposure Among Heavy Equipment Operators at PT X, West Kutai, East Kalimantan Sudjana, Putra Eka; Ramdan, Iwan Muhamad; Sultan, Muhammad; Lestari, Ida Ayu Indira Dwika
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Coal mining activities represent one of the industrial sectors with intensive use of heavy equipment, operating at large scales and for prolonged durations. The operation of these machines generates mechanical vibrations, which are significant physical risk factors in the working environment. Vibrations transmitted to the body of operators can not only cause discomfort but also have detrimental effects on health, such as circulatory disturbances, reduced visual focus, nerve problems, and musculoskeletal disorders. The incidence of occupational accidents and work-related diseases in mining sector continues to increase, highlighting the importance of managing ergonomic risk factors, especially whole body vibration, in the implementation of occupational safety and health programs. To protect workers, the government through the Ministry of Manpower Regulation No. 5 of 2018 To assess the whole-body vibration exposure among heavy equipment operators at PT X, West Kutai, East Kalimantan, and evaluate its compliance with the occupational exposure limits as regulated by the Minister of Manpower Regulation No. 5 of 2018 Measurements were conducted on 18 units of heavy equipment at PT X Kutai Barat using a Human Vibration Meter Svantek SV 106, following SNI 7186:2021. The results showed that 11 units exceeded the exposure limit of 0.8661 m/s² for an 8-hour work period, with the dominant vibration direction occurring along the vertical axis. The highest vibration levels were recorded in the Service Truck (1.7765 m/s²) and Dump Truck (1.8203 m/s²). It is recommended that control measures be implemented through adjustments to exposure duration, and vibration damping modifications to prevent musculoskeletal health risks among operators.

Comparative study of vitamin c content in rome Beauty apples (malus sylvestris mill) with several Processing methods Wahyuni, Leny Eka Tyas; Furkon, Leily Amalia; Safika, Erri Larene; Nisaa, Nur Rezky Khairun
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Apples are known to contain antioxidants and vitamin C, which play important roles in protecting the body from oxidative stress and degenerative diseases. However, vitamin C is sensitive to heat, light, and oxygen, which can lead to degradation during processing. Objective : This study aimed to compare the vitamin C content of Rome Beauty apple (Malus sylvestris Mill) in various processed forms commonly consumed by the public, including fresh apple, apple juice, cider, dodol, and apple chips. Research Methods/ Implementation Methods : The research was conducted using a titrimetric method with 2,6-dichlorophenol-indophenol dye to determine vitamin C content. Five samples were analyzed in duplicate. The data were statistically tested using the Kruskal–Wallis and Mann–Whitney tests to evaluate differences among samples. Results : The vitamin C content ranged from 2.85 to 12.36 mg/100 g. The highest content was found in fresh apples (12.36 mg/100 g), followed by apple juice (6.41 mg/100 g), apple extract (5.23 mg/100 g), apple dodol (2.85 mg/100 g), and apple chips (2.85 mg/100 g). Statistical analysis showed significant differences (p < 0.05) among the samples, particularly between fresh or juiced apples and processed forms such as dodol and chips. Conclusion/Lesson Learned : Processing significantly reduces the vitamin C content of Rome Beauty apples. Heat treatment, oxidation, and exposure to air during processing are the major factors contributing to vitamin C loss. Therefore, consuming fresh apples provides the greatest nutritional benefit in terms of vitamin C intake.

The Adverse Events Following Samarinda’s 2024 Mass PolioImmunization Gusrina, Sylvia; Al Banjari, Safriansyah; Fahruddin, Akhir
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Indonesia’s Ministry of Health (IMOH) declared a polio outbreak in 2022, resulting in fourteen polio cases through 2024. As the outbreak response, supplementary immunization activities (SIAs) using the novel oral polio vaccine type 2 (nOPV2) are carried out. Objective : This study aims to determine the prevalence of adverse events following immunization (AEFI) and factors associated with second-dose coverage of nOPV2 in Samarinda, East Kalimantan. Research Methods/ Implementation Methods : We conducted a cross-sectional analysis from the AEFI nOPV2 survey conducted by the Samarinda District Health Office (DHO) in 2024. AEFI are characterized by various symptoms, including fever, diarrhea, and other medical complications that occur within 1 to 14 days post-vaccination. The presence of incomplete information in the database served as an exclusion factor. We gathered the children's characteristics, immunization sites, pre- vaccination conditions, and AEFI symptoms. The data was analyzed with chi-square analysis. Results : We analyzed 470 full datasets from a total of 628 survey responses. We identified 56 cases (11.9%) of AEFI after the first dose and 18 cases (5.4%) out of 332 after the second dose among children who got nOPV2 in 2024. Nearly one-third (29.4%) did not receive a second dose of nOPV2. No serious AEFIs were noted. The predominant AEFIs associated with nOPV2 are fever (66.1% and 55.6%) and diarrhea (28.6% and 16.7%). A significant association was found between children with AEFI in the first dose and nOPV2 second-dose uptakes (RR 1.48, CI 1.02-2.78, P < 0.040), with vomiting and nausea being the prominent symptoms influencing the decision (RR 2.16, CI 1.27-3.41, P 0.010). Conclusion/Lesson Learned : The reported prevalence of AEFI was 11.9% for the first dose and 5.4% for the second dose. The majority are mild. A surveillance of mild AEFI and an extensive educational intervention and risk communication should be implemented regarding the risks of nOPV2's AEFI, which may impact adherence to the subsequent dose

Identification of microRNA-Based Targeted Therapy as Novel StrategyAgainst Colorectal Carcinoma: In Silico Analysis Adnan, Nohan Noer; Pratiwi, Sari Eka; Ulfah, Ridha
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Dysregulation of microRNAs plays a key role in the development of multiple cancers, including colorectal carcinoma (CRC), the second leading cause of cancer-related mortality worldwide. The high mortality rate is partly driven by the limited effectiveness of conventional therapies. Objective : This study aimed to explore the pathogenesis of CRC and identify candidate microRNAbased targeted therapeutic agents through an in silico approach. Research Methods/ Implementation Methods : MicroRNA expression profiles were retrieved from dbDEMC 3.0. Differentially expressed microRNAs (DEMs) were identified using GEO2R and OrangeApp with a cutoff P-value ≤ 0.05 and Log2FC < −1.5. Predicted target genes of DEMs were intersected with CRC-related genes obtained from GEPIA2. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were then conducted on the intersecting genes. Results : One DEM was identified as a potential therapeutic candidate for colon cancer (hsa-miR- 139-5p) and one for rectal cancer (hsa-miR-193b-3p). A total of 780 DEGs associated with hsa-miR- 139-5p and 4,744 DEGs associated with hsa-miR-193b-3p were found. Intersection with colon cancer (33,287 DEGs) and rectal cancer (29,599 DEGs) yielded 25 overlapping DEGs for hsa-miR- 139-5p and 10 for hsa-miR-193b-3p. GO and KEGG analyses showed involvement in key biological processes and cancer-related signaling pathways. Three target DEGs of hsa-miR-139-5p (FOXO1A, ZEB1, HOXA9) were linked to transcriptional misregulation in cancer, while one DEG targeted by hsa-miR-193b-3p (14-3-3 gene) was associated with the cell-cycle pathway. Conclusion/Lesson Learned : This in silico analysis identifies hsa-miR-139-5p and hsa-miR-193b-3p as promising microRNA-based therapeutic candidates for CRC, highlighting critical genes and pathways involved in CRC carcinogenesis.

Survival Analysis of Diabetic Retinopathy Among Type 2 Diabetic Patients: A Systematic Review Teruna, Muhammad Muaz Shahriman; Razak, Tajul Rosli; Yasin, Siti Munira; Ali, Abdullah Ashraf Rafique; Isa, Mohamad Rodi
Mulawarman International Conference on Tropical Public Health Vol. 2 No. 2 (2025): The 4th MICTOPH
Publisher : Faculty of Public Health Mulawarman University, Indonesia

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Background : Diabetic retinopathy (DR) is a major preventable microvascular complication of type 2 diabetes mellitus (T2DM) and a leading cause of visual impairment. Understanding survival time to DR onset and its modifiable predictors is essential for optimizing screening and management. This review synthesizes recent cohort and observational evidence on DR incidence, progression, and prognostic factors in adults with T2DM. Objective : This study aims to systematically review survival time to the onset or progression of diabetic retinopathy in adults with type 2 diabetes mellitus, evaluate prognostic factors influencing retinopathy-free survival, and compare survival patterns across populations and study designs to inform future prognostic models and prevention strategies. Research Methods/ Implementation Methods : A systematic search was conducted for articles published between 2016 and 2025 across major databases including PubMed, Scopus, ScienceDirect, and the Cochrane Library. Studies were included if they applied longitudinal, cohort, or survival analysis methods to assess the risk or progression of DR among T2DM patients. Seventeen eligible studies were identified, covering diverse populations across Asia and Europe. Data were extracted on study design, sample size, follow-up duration, key predictors, and outcomes. Findings were synthesized narratively due to heterogeneity in statistical models and outcome definitions. Results : Across the included studies, the cumulative incidence of DR ranged from 8% to 42% over follow-up periods of 3 to 15 years. Significant predictors of DR onset and progression included poor glycaemic control (HbA1c ≥ 7.5%), longer diabetes duration, hypertension, dyslipidaemia, and obesity indices. Novel biomarkers such as the glycaemic risk index (GRI), neutrophil-to-lymphocyte ratio, and vitamin D deficiency demonstrated emerging prognostic potential. Conversely, metformin use and higher physical activity levels were protective against DR development. Time-to-event analyses revealed that patients maintaining a tight glycaemic range (3.9–7.8 mmol/L) and regular physical activity exhibited longer DR-free survival. Geographic variations were observed, with higher incidence reported in East and Southeast Asian cohorts compared to European populations. Conclusion/Lesson Learned : This systematic review highlights the multifactorial determinants influencing the survival and progression of diabetic retinopathy among individuals with T2DM. Glycaemic variability, metabolic dysregulation, and inflammatory markers remain strong predictors of reduced DR-free survival, while lifestyle modification and pharmacological control confer protective benefits. These findings underscore the importance of integrated, longitudinal monitoring and early preventive strategies in diabetic eye care. Future survival models should incorporate composite risk indices and real-world data to improve prediction accuracy and clinical applicability.

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MUHAMAD ZAKKI SAEFURROHIM

Contact Email
saefurrohim@fkm.unmul.ac.id

Phone
+6287710112314

Journal Mail Official
saefurrohim@fkm.unmul.ac.id

Editorial Address
Gedung IsDB FKM Jl. Sambaliung, Gn. Kelua, Kec. Samarinda Utara, Kota Samarinda, Kalimantan Timur 75119

Location
Kota samarinda,

Kalimantan timur

INDONESIA

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name MUHAMAD ZAKKI SAEFURROHIM

Contact Email saefurrohim@fkm.unmul.ac.id

Phone +6287710112314

Journal Mail Official saefurrohim@fkm.unmul.ac.id

Editorial Address Gedung IsDB FKM Jl. Sambaliung, Gn. Kelua, Kec. Samarinda Utara, Kota Samarinda, Kalimantan Timur 75119

Location Kota samarinda, Kalimantan timur INDONESIA

Abstract

Abstract

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Contact Name
MUHAMAD ZAKKI SAEFURROHIM

Contact Email
saefurrohim@fkm.unmul.ac.id

Phone
+6287710112314

Journal Mail Official
saefurrohim@fkm.unmul.ac.id

Editorial Address
Gedung IsDB FKM Jl. Sambaliung, Gn. Kelua, Kec. Samarinda Utara, Kota Samarinda, Kalimantan Timur 75119

Location
Kota samarinda,

Kalimantan timur

INDONESIA