Evaluation of the malaria elimination programme in Muara Enim Regency: a qualitative study from Indonesia.

BACKGROUND: Malaria remains an enduring public health concern in Indonesia, exacerbated by its equatorial climate that fosters the proliferation of Anopheles mosquitoes. This study seeks to assess the performance of the malaria elimination programme comprehensively. METHODS: Between May and August 2022, a qualitative study was conducted in Muara Enim Regency, South Sumatra Province, involving 22 healthcare professionals from diverse backgrounds. These informants were strategically chosen for their pivotal roles in providing profound insights into various facets of the malaria elimination programme. This encompasses inputs such as human resources, budgetary allocation, and infrastructural support; processes like case identification and management, capacity enhancement, epidemiological surveillance, prevention measures, outbreak control, and enhanced communication and educational initiatives; and, notably, the programme's outcomes. Data were collected through 3-h Focus Group Discussions (FGDs) divided into two groups, each with 12 participants: healthcare professionals and programme managers. Additionally, in-depth interviews (IDIs) were conducted with ten informants. Employing the Input-Process-Output (IPO) model, this study meticulously analysed the healthcare system dynamics and the interventions' efficacy. RESULTS: The study unveiled many challenges during the input phase, including the absence of entomologists and a shortage of diagnostic tools. Despite these obstacles, it documented remarkable accomplishments in the output domain, marked by significant advancements in the distribution of mosquito nets and the successful implementation of the Early Warning System (EWS). Despite the adversities, the programme has made substantial strides towards malaria elimination. CONCLUSIONS: Urgent action is imperative to bolster the effectiveness of the malaria elimination programme. Key measures encompass augmenting the entomologist workforce, optimizing resource allocation, and ensuring stringent adherence to regional regulations. Addressing these concerns will enhance programme efficacy, yielding enduring public health benefits. This research substantially contributes to Indonesia's ongoing malaria elimination endeavours, furnishing actionable insights for programme enhancement. Consequently, this research holds significant importance for the malaria elimination drive.

Risk factors of malaria transmission in mining workers in Muara Enim, South Sumatra, Indonesia.

Eliminating malaria by 2030 is stated as goal three in the UN's Sustainable Development Goals (SDGs). However, malaria still remains a significant public health problem. This study aims to identify the factors determining malaria transmission in artisanal or small-scale miner (ASM) communities in three villages: Tanjung Agung, Tanjung Lalang, and Penyandingan, located in the Tanjung Enim District, Muara Enim, South Sumatra, Indonesia. Researchers conducted a cross-sectional study involving 92 participants from the study area. They used a logistic regression model to investigate the risk factors related to malaria occurrence. The multivariable analysis revealed that age (Adjusted Prevalence Ratio (APR) = 7.989 with 95% CI 1.724-37.002) and mosquito breeding (APR = 7.685 with 95% CI 1.502-39.309) were risk factors for malaria. On the other hand, higher education (APR = 0.104 with 95% CI 0.027-0.403), the use of mosquito repellent (APR = 0.138 with 95% CI 0.035-0.549), and the condition of house walls (APR = 0.145 with 95% CI 0.0414-0.511) were identified as protective factors. The current study highlights age and mosquito breeding sites as risk factors for malaria. Additionally, higher education, insect repellent use, and the condition of house walls are protective factors against malaria. Therefore, reducing risk factors and increasing protective measures through effective communication, information, and education are highly recommended to eliminate malaria in mining areas.

Environmental determinants and risk behaviour in the case of indigenous malaria in Muara Enim Regency, Indonesia: A case-control design.

INTRODUCTION: Malaria is a significant public health concern in Indonesia. Muara Enim Regency is one of the districts in South Sumatra with the most important number of indigenous malaria cases in the last three years (2018-2020). Therefore, this study aimed to identify determinants of indigenous malaria in the Muara Enim Regency. METHODS: This study was designed as a case-control study. A stratified random sample in 2018, 2019, and 2020 was used at the Primary Health Centres (PHCs) areas of Tanjung Enim and Tanjung Agung. The sample included 49 cases and 49 controls. Indigenous malaria determinants were discovered using both bivariable and multivariable logistic regression models. RESULT: The multivariable logistic regression model results show that mosquito repellent reduces malaria risk by 71% (AOR = 0.29, 95% CI: 0.11-0.64). Besides, the presence of wire mesh on ventilation reduces the risk of malaria by 76% (AOR = 0.24, 95% CI: 0.10-0.57), and the distance from mosquito breeding sites near hundred meters and fewer increases the risk of malaria by 3.88 fold (AOR = 3.88; 95% CI: 1.67-8.97). CONCLUSIONS: Multivariable analysis revealed distance from mosquito breeding sites as a risk factor for malaria. Besides, the study shows that using insect repellent, wire netting in ventilation, eliminating mosquito breeding sites, mosquito repellent or protective clothing, and improving house conditions were protective factors for indigenous malaria. Therefore, preventive and promotional efforts are essential as the first step toward malaria elimination at the study site, including avoiding direct contact between residents and vectors near mosquito breeding sites.

Physical Exercise Increased Brain-Derived Neurotrophic Factor in Elderly Population with Depression.

BACKGROUND: Depression is very common in the elderly population. Physical exercise is one of the non-pharmacological procedures that promise to be a solution to improve the severity of depression. Brain-Derived Neurotrophic Factor (BDNF) plays a role in maintaining the survival of neuronal cells and in the regulation of synapse plasticity, affecting serotonin production in the hippocampus and thus the depressive symptoms. AIM: This study aimed to assess the role of physical exercise in affecting BDNF levels in elderly with depression. METHODS: Thirty-five elderly women (age ≥ 50 years) with depressive episodes based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-V criteria were enrolled as treatment group, and 35 elderly women without depressive episodes were enrolled as control group, and underwent physical exercise in the form of treadmill with a speed of 6 km/h for 15 minutes. Physical exercise was carried out once a day for 28 days. As much as 1 ml of blood from the study, subjects were obtained from the cubital vein before the exercise commenced. Brain-Derived Neurotrophic Factor (BDNF) serum level was assessed by Enzyme-Linked Immunosorbent Assay (ELISA). Data were presented in the form of mean ± SD. An independent T-test was used to test levels after exercise in the depression group compared to the non-depression group. RESULTS: Pre-exercise BDNF levels in the depression group were lower than the group of elderly without depression. Physical exercise increased BDNF production in both elderly groups with and without depression. In the depression group, the increasing percentage of BDNF level was higher compared to non-depressive elderly. CONCLUSION: The increasing percentage of BDNF level was found to be higher in depressive elderly performing physical exercise. Physical exercise may be beneficial in supporting the therapy of elderly with depression.

The Impact of Physical Exercise on Brain-Derived Neurotrophic Factor (BDNF) Level in Elderly Population.

BACKGROUND: Memory function disorder is a major health problem in geriatric patients. Physical exercise has the potency to decrease the incidence of many degenerative and chronic health problem, related to cognitive deterioration (dementia). AIM: This research aimed to observe the effect of physical exercise in various doses and duration on memory function by analysing the role of Brain-Derived Neurotrophic Factor (BDNF) as a regulatory protein affected by exercise. METHODS: This was an analytical observational study with a cohort design. Thirty participants were included in each group, classified as exercise and non-exercise group. The exercise was in the form of jogging for at least fifteen minutes every day. The observation was done for sixty days. Cognitive function assessment was done by using the Mini-Mental State Examination (MMSE) questionnaire. Meanwhile, the BDNF level was assessed by ELISA. Statistical analysis was done using Independent T-test. RESULTS: Exercise group showed better MMSE score (28.56 ± 1.76), and a higher concentration of BDNF (235.34 ± 12.56 pg/mL), both were statistically significant. CONCLUSION: Physical exercise was able to maintain geriatric cognitive function performance by BDNF protein regulation.