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Indonesia has targeted a reduction in stunting prevalence to 14,2% in 2029. However, this effort still faces major challenges such as the complexity of the double burden of malnutrition and suboptimal feeding practices during the first 1000 days of life. At individual level, a child can experience more than one malnutrition problem at once, which called the double burden of malnutrition. Limited studies have examined the double burden of malnutrition at individual level in Indonesia. Therefore, this study was conducted to identify the association of complementary feeding practices and the double burden of malnutrition among children aged 6-23 months in Indonesia. This was a cross-sectional study using secondary data from the 2022 Indonesia Nutritional Status Survey. The double burden of malnutrition was assessed in forms of coexisting stunting-wasting and stunting-overweight, while complementary feeding practices was measured based on WHO and UNICEF IYCF indicators. A total of 69.884 children were analyzed for stunting-wasting and 72.158 children for stunting-overweight after meeting data completeness and no extreme values. Multiple logistic regression analysis was conducted to estimated asjusted prevalence odds ratio (aPOR). This study found the prevalence of stunting-wasting and stunting-overweight was 2.7% and 0.7%, respectively. Among the children, 50.9% met the minimum dietary diversity (MDD), 83.5% met the minimum meal frequency (MMF), 45.3% met the minimum acceptable diet (MAD), 72.5% consumed eggs and flesh foods (EFF), 24.9% consumed sweet beverages (SwB), and 21.6% had zero consumption of fruits and vegetables (ZVF). SwB and ZVF indicators were significantly associated with both forms of the double burden of malnutrition. Children who did not consume sweet beverages had a 10% lower risk of stunting-wasting (aPOR: 0.90; 95% CI: 0.81–0.996) and a 31% lower risk of stunting-overweight (aPOR: 0.69; 95% CI: 0.57–0.84) compared to children who consume sweet beverages. Meanwhile, children who consumed fruits and vegetables had a 20% lower risk of stunting-wasting (aPOR: 0.80; 95% CI: 0.71–0.90) and a 29% lower risk of stunting-overweight (aPOR: 0.71; 95% CI: 0.57–0.89) than those with zero intake of fruits and vegetables. These findings highlight the importance of improving the diversity and quality of foods provided in government programs, along with strengthening nutrition education and sweet beverages nutrition labeling policies to prevent the double burden of malnutrition among children.
Latar belakang: Inisiasi seksual adalah indikator utama dari kesehatan dan kesejahteraan seksual remaja. Sebagai kejadian transisi pada hidup individu, inisiasi seksual idealnya terjadi secara terencana atas persetujuan seluruh pihak yang melakukannya dengan relasi yang setara. Namun, penelitian sebelumnya menunjukkan bahwa terdapat berbagai risiko yang menyertai inisiasi seksual, terutama apabila dilakukan pada usia yang lebih awal.
Tujuan: Penelitian ini bertujuan menemukan gambaran dan mengidentifikasi faktor-faktor yang berhubungan dengan inisiasi seksual pada remaja laki-laki dan remaja perempuan di Indonesia.
Metode: Dengan menggunakan desain potong lintang, penelitian ini melakukan analisis chi square dan regresi logistik terhadap 6.005 sampel remaja berusia 13 s.d. 17 tahun yang diperoleh dari Survei Nasional Pengalaman Hidup Anak dan Remaja Tahun 2024. Terdapat tiga belas variabel yang diteliti dalam penelitian ini, yaitu inisiasi seksual sebagai variabel dependen; gender sebagai variabel penstratifikasi; serta status pendidikan, status pekerjaan, pengetahuan terkait HIV, konsumsi alkohol, konsumsi NAPZA, struktur keluarga, dukungan keluarga, status sosial ekonomi, status perkawinan, riwayat berpacaran, dan dukungan teman sebagai variabel independen. Adapun inisiasi seksual dalam penelitian ini didefinisikan sebagai pengalaman hubungan seksual pertama kali.
Hasil: Sebanyak 1,0% remaja berusia 13 s.d. 17 tahun di Indonesia pernah mengalami inisiasi seksual dengan rincian 0,7% pada remaja laki-laki dan 1,4% pada remaja perempuan. Penelitian ini juga menemukan bahwa determinan dari inisiasi seksual pada remaja meliputi status bekerja pada remaja laki-laki (aOR: 5,30; 95% CI: 1,75—16,09); pernah mengonsumsi alkohol seumur hidup pada remaja secara gabungan (aOR: 7,30; 95% CI: 3,71—14,33), remaja laki-laki (aOR: 9,17; 95% CI: 3,06—27,44), dan remaja perempuan (aOR: 5,71; 95% CI: 1,59—20,54); status telah menikah pada remaja secara gabungan (aOR: 1.059,50; 95% CI: 226,60—4.953,98) dan remaja perempuan (aOR: 451,08; 95% CI: 76,84—2.648,17); dan riwayat pernah berpacaran pada remaja secara gabungan (aOR: 9,51; 95% CI: 4,21—21,45), remaja laki-laki (aOR: 6,81; 95% CI: 1,68—27,70), dan remaja perempuan (aOR: 8,67; 95% CI: 3,13—24,06). Adapun status sosial ekonomi rendah-sedang memiliki hubungan negatif dengan inisiasi seksual pada remaja secara keseluruhan (aOR: 0,44; 95% CI: 0,21—0,93; P value = 0,030) dan remaja laki-laki (aOR: 0,15; 95% CI: 0,06—0,43; P value < 0,001).
Kesimpulan: Faktor individu, situasional, keluarga, dan relasi berkaitan dengan inisiasi seksual. Faktor-faktor ini perlu dipertimbangkan dalam intervensi yang meliputi pendidikan seksualitas yang komprehensif, pemberian layanan kesehatan reproduksi remaja, dan penegakan hukum. Penelitian dengan desain longitudinal diperlukan untuk memastikan ada/tidaknya hubungan kausalitas antarvariabel.
Background: Sexual initiation is the core indicator for adolescent sexual health and well-being. As a transition event on adolescents’ life, sexual initiation is ideally performed with plan and consent from each of the parties involved and within an equal relation. However, previous studies have shown that there are increased risks that follow sexual initiation, especially if it happens early. Aim: This study aimed to describe and identify factors related to sexual initiation on male and female adolescents in Indonesia. Methods: Using cross-sectional design, this study was analyzed using chi square and logistic regression analysis on 6.005 samples of adolescents ranging from 13 to 17 years old accessed from National Survey of Life Experiences of Children and Adolescents 2024. This study focuses on sexual initiation as dependent variable; gender as stratifying variable; educational status, working status, knowledge about HIV, alcohol use, drug use, family structure, family support, socioeconomic status, marital status, dating history and peer support as indendent variables. Sexual initiation, in this study, is defined as the experience of first sexual intercourse. Results: One percent (1,0%) of adolescents in Indonesia have had their first sexual intercourse. The percentage is ranging from 0,7% on male adolescents and 1,4% on female adolescents. This research also finds that the determinants of sexual initiation on adolescents are male adolescents who are currently working (aOR: 5,30; 95% CI: 1,75—16,09); have consumed alcohol in lifetime on both adolescents (aOR: 7,30; 95% CI: 3,71—14,33), male adolescents (aOR: 9,17; 95% CI: 3,06—27,44), and female adolescents (aOR: 5,71; 95% CI: 1,59—20,54) who have consumed alcohol in lifetime; being married on adolescents cumulatively (aOR: 1.059,50; 95% CI: 226,60—4.953,98) and female adolescents (aOR: 451,08; 95% CI: 76,84—2.648,17); and ever dated someone on both adolescents(aOR: 9,51; 95% CI: 4,21—21,45), male adolescents (aOR: 6,81; 95% CI: 1,68—27,70), and female adolescents (aOR: 8,67; 95% CI: 3,13—24,06). Low-middle socioeconomic status is negatively associated with sexual initiation on both adolescents (aOR: 0,44; 95% CI: 0,21—0,93) and male adolescents (aOR: 0,15; 95% CI: 0,06—0,43; P value < 0,001). Conclusion: Individual, situasional, family and relational factors are related to sexual initiation. These factors should be considered during interventions that include comprehensive sexuality education, adolescent reproductive health service and law enforcement. Researches with longitudinal nature are required to identify the presence of causal associations between variables.
Rheumatoid arthritis (RA)) is a systemic and chronic autoimmune disease which main manifestations involve the joints. AR management requires pharmacological and non-pharmacological therapy. One of the pharmacological RA treatments is methotrexate (MTX). There are many factors that influence the success of RA treatment but in Indonesia there has not been found a study that examines obesity on the success of MTX treatment in RA patients in Indonesia. Researchers wanted to know the effect of obesity on MTX monotherapy failure in patients with AR Methods. A retrospective cohort study using medical records from the Rheumatology Internal Medicine Polyclinic, Cipto Mangunkusumo Hospital (RSCM) from March 2017 to December 2021. A descriptive and estimation analysis was performed to see the sample characteristics based on each variable and a modified Cox regression analysis to see the relationship between obesity and MTX treatment failure. Results. Of the 72 subjects, the proportion of MTX treatment failure in obese patients was 57.1% (20/35), while in patients who were not obese it was 37.8% (14/37). The risk of MTX treatment failure in obese subjects was 1.45 times that of non-obese patients (RR 1.45; 95% CI 0.76-2.78). Number of joints involved, RF factor (RF), C-reactive protein factor (CRP), age, erythrocyte sedimentation rate (ESR), gender, and early onset of disease were not become confounding factors in this study. Conclusion. In this study, RA patients with obesity have an increased risk of MTX treatment failure compared to RA patients without obesity, but further studies using larger samples are needed to increase statistical power.
