ABSTRACT

Introduction: South Sumatra Province in Indonesia has a relatively high prevalence of stunting and there is limited research about this phenomenon in this area. The study aimed to identify what factors affected stunting in children aged 6-23 months in the province.
Methods: Using a comparative cross-sectional design involving 139 mothers with children aged 6-23 months, the study collected data from September to December 2022 via anthropometric measurements and interviews using a questionnaire. Data on parental, child, socioeconomic, and environmental factors were analysed using chi-square test and logistic regression analysis.
Results: Overall, there were significant relationships among the following variables: child’s age (p=0.031), birth length (p=0.017), and weight-for-age (WAZ) status (p<0.001) with stunting. Children in the underweight and severely underweight categories were 28.7 times at risk of stunting compared to those in the normal category of WAZ status; children aged 12-23 months had a 2.8 times risk of stunting compared to children aged 6-11 months, while stunted birth length showed a 4.6 times risk of stunting compared to that of normal birth length.
Conclusion: This research found that child age, birth length, and WAZ status were significant factors affecting stunting in the South Sumatra Province. Given these results, this study offers recommendations for the provincial government to focus on intervention programmes that provide additional food for pregnant women with chronic energy deficiency, monitor the growth of toddlers, and manage toddlers with nutritional problems in this province.
Key words: birth length, child age, stunting, WAZ status

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ABSTRACT

Introduction: Iron overload in thalassaemia major patients mainly occurs due to periodic transfusions. When iron exceeds transferrin capacity, non-transferrin bound iron accumulates and causes tissue damage, including in the gastrointestinal tract, resulting in impaired enterocyte function and amino acid absorption. The aim of this study was to evaluate amino acid profiles in patients with thalassaemia major after repeated transfusions and chelation.
Methods: Whole blood amino acids were analysed from dried blood spots using liquid chromatography tandem mass spectrometry. This study consisted of two parts: a cross-sectional and a cohort study in thalassaemia-β-major patients. In the cross-sectional study, amino acid profiles were analysed in 219 thalassaemia patients who received routine transfusion and chelation therapy, and 60 healthy control subjects. The cohort study included 21 subjects, from whom blood samples were taken at pre-transfusion, 1-day posttransfusion, one and three months post-chelation to evaluate changes in amino acid levels.
Results: There were significant differences between amino acid levels in thalassaemia subjects and controls. Positive correlations were found between serum iron and transferrin with age, also between transferrin with proline, valine, phenylalanine, aspartic acid, and glutamic. Phenylalanine and aspartic acid were significantly lower in subjects with transferrin lower than 180 μg/dL. Significant correlations were found between haemoglobin with essential and non-essential amino acid groups. From the cohort study, significant changes were observed in glycine, alanine, leucine, and aspartic acid.
Conclusion: Amino acid profiles in thalassaemia patients differed compared to healthy controls, even after transfusion and chelation. Phenylalanine and aspartic acid were significantly lower in subjects with low transferrin levels.
Key words: amino acid, chelation, iron overload, thalassaemia, transfusion

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ABSTRACT

Introduction: COVID-19 pandemic presents a challenge to ensuring optimal infant feeding practices. This study aimed to assess infant feeding practices and investigate potential factors associated with exclusive and continued breastfeeding practices during the COVID-19 pandemic in Indonesia.
Methods: An online survey was conducted during December 2020 – August 2021. A total of 817 Indonesian mothers aged ≥18 years old with infants aged <18 months were obtained through convenience sampling. Exclusive breastfeeding was the practice at the time of the survey among infants <6 months old; continued breastfeeding was considered when infants aged >6 months received any type of breastfeeding in the previous day.
Results: Most subjects were aged 25-34 years old (81.3%), had a high education level (85.7%), with middle household income level (40.5%), and lived in Java Island (81.6%). Infants’ age and sex were comparable between younger vs. older infants and boys vs. girls, respectively. Exclusive breastfeeding was 81.3%. Continued breastfeeding was 93.4%, with 74.3% meeting the minimum acceptable diet. Breastfeeding intention (92.9%) and husband’s support for infant feeding (67.2%) were reported during the COVID-19 pandemic. Multivariate analyses showed that breastfeeding intention was one of the factors associated with exclusive breastfeeding [aOR=12.6; 95%CI (4.1-39.1)] and continued breastfeeding [10.9 (4.4-27.0)].
Conclusion: The study suggested that mothers’ intention to breastfeed during the COVID-19 pandemic provided affirmation of good breastfeeding experiences by allowing mothers to have more time for childcare activities and more opportunities to develop meaningful coparenting practices while staying at home.
Key words: breastfeeding intention, COVID-19 pandemic, continued breastfeeding, exclusive breastfeeding, minimum acceptable diet

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Introduction: There are very few studies of vitamin D deficiency in Indonesia. Since vitamin D deficiency is indicated by the level of 25-hydroxyvitamin D (25(OH) D) in blood, the present study aimed to analyse the predictive factors of 25(OH) D concentration in early pregnancy.
Methods: The present study was a crosssectional observational study. The sample consisted of 67 pregnant women in their 1st trimester of pregnancy. Parameters assessed included levels of 25(OH)D, glucose, and haemoglobin in the blood. Demographic information such as parity, family history of diabetes mellitus (DM), exposure to cigarette smoke, physical activity level, dietary intake, and anthropometric measurements were recorded. Linear regression analysis was employed.
Results: Mean concentration of 25(OH)D was 16.5 (6.6-34.1) ng/ml. Majority of the participants (77.6%) were deficient in vitamin D (25(OH)D <20ng/mL); only 1.5% had normal vitamin D levels (25(OH)D >30 ng/ mL). Bivariate analysis performed revealed that vitamin D intake (p=0.002) and family history of DM (p=0.043) played a significant role in determining 25(OH)D concentration. Additionally, dietary vitamin D intake, blood glucose level, exposure to cigarette smoke, and parental DM history served as predictors of 25(OH)D concentration in 54.5% of cases.
Conclusion: The findings indicate that vitamin D deficiency was high in the target population. Thus, it is critical to ensure that for pregnant women to take vitamin D supplements, since nearly 80% of pregnant mothers are vit D deficient. Vitamin D supplementation can be included in national pregnancy programmes
Key words: cigarette, diabetes mellitus, pregnant women, vitamin D concentration, vitamin D intake.

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ABSTRACT

Introduction: Hypertension is the most common cardiovascular disease, especially in the elderly. Previous studies have reported that vitamin D plays a role in blood pressure. This study aimed to analyse the effect of vitamin D supplementation on serum 25(OH)D levels and blood pressure.
Methods: This was a double-blind, randomised placebo-controlled trial (RCT) on elderly subjects. Serum 25(OH)D levels were examined using chemiluminescent immunoassay (CLIA) method, while blood pressure was checked using a digital sphygmomanometer. Supplementation was given once per day for eight weeks; the control group was given a placebo, while the treatment group was given 2,000 IU vitamin D3 for subjects with insufficiency and 4,000 IU for subjects with deficiency.
Results: A total of 62 subjects aged 60-89 years participated and were randomised into 30 control and 32 treatment group subjects. Data analysis showed that vitamin D supplementation significantly increased 25(OH)D levels in treatment group (D=18.2±5.2 ng/mL) compared to control group (D=4.2±2.5 ng/mL) (p<0.001). However, vitamin D supplementation did not cause significant reduction in systolic blood pressure (D=-4.6(-25 - -0.5) mmHg for control group and D=-9.2(-20 - -27) mmHg for treatment group; p=0.109), and diastolic blood pressure (D=-7.2(-16 - -2) mmHg for control group and D=-8.4(-14.5 - -8.5) mmHg for treatment group; p=0.559).
Conclusion: Vitamin D supplementation significantly increased serum 25(OH)D levels, but did not significantly reduce systolic and diastolic blood pressures in the elderly. Elderly people need to regularly check their vitamin D levels so that the provision of supplementation can be timely and their quality of life can be improved.
Key words: blood pressure, elderly, serum 25(OH)D level, vitamin D supplementation

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