Epidemiology and Society Health Review (ESHR)

Comparative Study on the Effectiveness of Papaya Leaf (Carica papaya Linn) and Citrus Leaf (Citrus sp.) Infusions in Reducing Aedes aegypti Larvae Mortality

2025-11-08T02:22:02+00:00

Background: Dengue Hemorrhagic Fever (DHF) is an infectious disease caused by the dengue virus and transmitted through the bite of the Aedes aegypti mosquito. Vector control efforts have thus far relied heavily on chemical larvicides, which can cause resistance and pollute the environment. This study aims to determine and compare the effectiveness of papaya leaf (Carica papaya Linn) and citrus leaf (Citrus sp.) infusions as natural larvicides against Aedes aegypti larvae.

Method: This study was a laboratory experiment with a post-test-only control group design, using 150 Aedes aegypti instar III larvae divided into six test containers, each containing 25 larvae, with three replicates for papaya leaf infusion and three replicates for 40% concentrated citrus leaf infusion. The infusion was made from dried leaves, which were ground into powder, then boiled at 90°C for 15 minutes before being filtered. Each treatment was tested by adding 5 mL of infusion to a container containing 100 mL of water. The 24-hour mortality data were analyzed using a two-sample independent T-test or Mann–Whitney U test if the data were not normal, with a significance level of p < 0.05.

Results: The results showed that there was a significant difference in larval mortality between papaya leaf infusion and citrus leaf infusion (p = 0.017). Citrus leaf infusion had a higher lethality rate than papaya leaf infusion. Citrus leaf infusion caused 100% larval mortality within 12 hours, while papaya leaf infusion showed an average mortality rate of 11.66 larvae within 24 hours.

Conclusion: Infusions of citrus leaves and papaya leaves have been shown to have potential as natural larvicides against Aedes aegypti larvae. However, citrus leaf infusions are more effective.

Meta-Analysis: Effectiveness of Enhanced Recovery After Caesarean Surgery (ERACS) on Length of Stay (LoS)

2025-11-08T02:16:25+00:00

Background: Enhanced Recovery After Caesarean Surgery (ERACS) has evolved as a comprehensive perioperative care protocol to optimise patient recovery and reduce length of hospitalisation. Although individual studies show promising results, there has been no comprehensive meta-analysis of the effectiveness of ERACS on length of stay with a homogeneous methodology. This study aims to analyse the effectiveness of the ERACS protocol compared to conventional treatment on the length of hospitalisation through a systematic review and meta-analysis

Method: A Systematic review was conducted following the PRISMA 2020 guidelines for studies that compared ERACS with conventional treatment in the section caesarea. Meta-analysis was performed using a random-effects model with the Jamovi software ESCI package. Heterogeneity was assessed using I² statistics, and sensitivity analysis was performed to test the robustness of the results.

Results: Meta-analysis of 6 studies with a total of 820 subjects showed that the ERACS protocol significantly reduced the length of hospitalisation with a weighted mean difference of -21.6 hours (95% CI: -28.3 to -14.9, p = 0.001). Despite the high heterogeneity (I² = 99.5%), all studies showed consistent directional effects in favour of ERACS with a p-value of < 0.05 in all individual studies.

Conclusion: Implementing the ERACS protocol provides significant clinical benefits in reducing the length of hospitalisation by almost 1 day compared to conventional treatment, with important implications for healthcare efficiency and cost-effectiveness.

Correlation of Clinical and Immunological Factors With Overall Survival in Luminal B HER2-Negative Breast Cancer Patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, Denpasar

2025-12-03T21:04:02+00:00

Background: This study aimed to explore the relationship between clinico-pathological characteristics and overall survival (OS) among patients with Luminal B HER2-negative breast cancer treated at Prof. Dr. I.G.N.G Ngoerah Hospital, Denpasar.

Method: A retrospective cohort study was conducted involving 248 patients diagnosed with Luminal B HER2-negative breast cancer between January 2018 and December 2022. Data were collected from medical records and the Bali Cancer Registry, including variables such as age, menopausal status, tumor size (T), nodal involvement (N), metastasis (M), lymphovascular invasion (LVI), tumor-infiltrating lymphocytes (TIL), and treatment modalities. OS was analyzed using the Kaplan–Meier method, and independent prognostic factors were identified through multivariate Cox proportional hazards regression.

Results: Most patients were aged ≥40 years (84.8%), premenopausal (58.1%), and had LVI-positive tumors (65.9%). The 5-year OS rate was 60.8%, with a mean survival of 48 months. Kaplan–Meier analysis demonstrated shorter survival among older and postmenopausal patients. In multivariate analysis, TIL (HR = 0.342; 95% CI = 0.171–0.684; p < 0.001), age ≥40 years (HR = 1.459; 95% CI = 1.233–1.875; p < 0.001), and postmenopausal status (HR = 4.553; 95% CI = 2.378–8.733; p < 0.001) were identified as independent predictors of poorer survival.

Conclusion: These findings underscore the prognostic importance of immunological and demographic factors in Luminal B HER2-negative breast cancer. The assessment of tumor-infiltrating lymphocytes may serve as a practical and feasible prognostic marker to support risk stratification and individualized management, particularly in resource-limited healthcare settings, while highlighting the need for strengthened early detection and follow-up strategies among older and postmenopausal women.

Risk Factors for Measles Infection During Measles Outbreaks in Southeast Asia: Literature Review

2025-11-08T02:10:33+00:00

Background: Measles remains a major health problem in Southeast Asia due to high transmission rates. In 2025, Indonesia ranked seventh with 5,035 cases, while the 2020-2025 trend shows significant fluctuations in Indonesia, the Philippines, and Laos due to outbreaks during certain periods. This study aims to identify risk factors for measles infection during outbreaks in Southeast Asia through a literature review.

Method: The literature review was conducted using databases of PubMed, ProQuest, ScienceDirect, and Google Scholar with measles related keywords. Full-text, open-access articles published within the last 10 years and originating from Southeast Asia were included. Of the 21,051 articles identified and seven articles met PRISMA criteria. Data were extracted, assessed using JBI checklist, and synthesized to identify measles risk factors.

Results: The results showed that risk factors for measles during outbreaks included individual factors (young age, malnutrition, incomplete immunization, history of contact), health services (limited access, delayed treatment), environment (housing density), and socio-demographics (negative perceptions of immunization, indigenous peoples).

Conclusion: Therefore, by identifying these risk factors, measles outbreak control in Southeast Asia can be focused on immunization, nutrition, health services, and community education.

Health Equity in Dengue Prevention and Control: A Review of Social Vulnerability, Participation, and Climate-Related Risks

2026-02-10T05:32:11+00:00

Background: Dengue remains a major public health problem in tropical and subtropical regions, with transmission and disease outcomes strongly influenced by social, economic, and environmental conditions. Evidence indicates that inequities in socioeconomic status, community participation, healthcare access, and climate vulnerability contribute to unequal dengue burden, yet these aspects are rarely synthesized comprehensively.

Methods: This narrative review was conducted following the PRISMA guidelines. A literature search was performed using Google Scholar to identify original research articles published between 2020 and 2025 that explicitly addressed equity-related aspects of dengue prevention and control. Data were analyzed using narrative synthesis.

Results: Six studies from Asia, the Caribbean, and Latin America were included. The findings showed consistent inequities related to socioeconomic status, geographic access to healthcare, community participation, financial protection, and climate-related vulnerability. Low-income and marginalized populations experienced poorer preventive practices, higher out-of-pocket healthcare costs, and greater exposure to dengue risk, while unequal institutional capacity limited the implementation of climate-based early warning systems.

Conclusion: Dengue prevention and control are shaped by multidimensional inequities operating across social, community, and health system levels. An equity-oriented approach is needed to strengthen dengue control strategies, particularly through inclusive community engagement, improved healthcare access, and climate-informed public health interventions.

Characteristics of Child Perpetrators of Violence with Substance Use Disorders at Grhasia Psychiatric Hospital, Yogyakarta

2026-02-04T02:24:30+00:00

Background: Children who perpetrate violence in the context of substance use disorders constitute a high-risk subgroup requiring a comprehensive understanding of their clinical and social characteristics to inform effective prevention and intervention strategies. In Indonesia, evidence describing the profiles of child perpetrators of violence within specialized mental health services, including psychiatric hospitals, remains limited. This study aimed to describe the demographic and clinical characteristics, patterns of substance use, and associated risk factors among child perpetrators of violence treated or examined at Grhasia Psychiatric Hospital between 2018 and 2022.

Methods: A retrospective descriptive study was conducted using medical records of child patients (≤18 years) identified as perpetrators of violent acts and diagnosed with substance use disorders at Grhasia Psychiatric Hospital from 2018 to 2022. Variables analyzed included age, sex, and types of substances used.

Results: Of the eligible cases, most child perpetrators of violence with substance use disorders were male adolescents aged 11–18 years (82.35% and 94.11%, respectively). These findings indicate that male adolescents represent the most vulnerable group for involvement in violence associated with substance use disorders within psychiatric service settings.

Conclusion: Substance-related violence among adolescents represents a substantial public health burden. The predominance of male adolescents among violent child perpetrators underscores the need for targeted, multidisciplinary prevention and intervention strategies, alongside strengthened psychiatric health information systems to support effective clinical management and evidence-based policy development.