Variants of glucose-6-phosphate dehydrogenase in Indonesia.
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Blood Protein Electrophoresis↗
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Destructive fires are not just Indonesia's problem.
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Agriculture↗
Indonesia spared tsunami as disaster quake strikes.
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Disaster Planning↗
Indonesia struggles to control bird flu outbreak.
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Adult↗
Cancer in Yogyakarta, Indonesia: relative frequencies.
Some 1220 male and 2102 female cases of malignant neoplasms diagnosed histologically at the Department of Pathology of the Gadjah Mada University in Yogyakarta during the period 1970-73 were analysed. The most frequent tumour sites were among men: nasopharyngeal cancer, 21-8% and skin cancer, 17-6%. Among women the genital cancers were the most frequent with: cervix uteri, 25-7% chorionepithelioma, 3-7%, other uterus, 4-4% and ovary, 7-4%. Breast cancer comprised 17-0%, skin 9-6% and nasopharyngeal cancer 7-9%. Low frequencies were observed in both sexes for cancers of the gastro-intestinal tract and of the respiratory organs; previous reports of the rarity of gastric cancer were confirmed. The observed distribution is discussed in the light of possible biases, and compared with other material on the frequency of cancer from South East Asia.
Breast Neoplasms↗
The eco-cultural context of the undernourished children in a study on the effects of early supplementary feeding in Indonesia.
OBJECTIVES: This paper describes the ecological and cultural backdrop of the subjects enrolled in an experimental study to test the validity of a conceptual model about the intellectual delay of undernourished children. DESIGN: The experiment was a 12-month clinical, randomized trial on the effects of early supplementary feeding on two cohorts of children classified as nutritionally-at-risk. Three different supplements (condensed milk + micronutrients; skimmed milk + micronutrients; skimmed milk) were given to the children during 6 or 12 months of the study. SETTING: The plantations are 1500-1800 m above sea level in Pangalengan, 50 km south of Bandung, West Java. Temperature fluctuates from 10 to 17 degrees C. A high yearly precipitation is approximately 3000 mm. Communities are laid out at 5-15 km from one another. Living conditions are modest. SUBJECTS: The 156 subjects were recruited from 24 day-care-centers (DCC) that serviced families of 24 communities in six tea plantations. The 12- and 18-month-old cohorts included 73 and 83 children, respectively; each cohort included three subgroups that received distinct supplements. OBSERVATIONS: The interactions of the caretakers with the children in the DCCs were consistent with the socialization for survival mode. A primary concern was the physical growth, health, cleanliness, sanitation and safety of the children. Stimulating children, providing toys and initiating play or other activities that would emphasize educational development had a low priority.
Child Day Care Centers↗
Effects of an energy and micronutrient supplement on growth and development in undernourished children in Indonesia: methods.
OBJECTIVES: To describe the methodologies of a clinical trial on the effects of an energy and micronutrient supplement on the growth and development of undernourished children. DESIGN: This trial included two cohorts of children classified as nutritionally-at-risk who were randomly assigned to three treatments (condensed milk + micronutrients (E); skimmed milk + micronutrients (M); skimmed milk (S)). Supplements were given for a period up to 12 months. SETTING: Six tea plantations in Pangalengan, West Java were the site for this study. SUBJECTS: A 12-month-old (N=53) and an 18-month-old (N=83) cohort were recruited from 24 day-care-centers (DCC). Twenty children that received the S supplement were part of the 12- and 18 month-old cohort. Criteria for case inclusion were absence of chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. VARIABLES: Social variables included assessment of health facilities, childcare, housing, income and parental education. Nutrition and growth variables included dietary intake measured over a 24 hr period every 2 months; hemoglobin and three iron indicators measured at baseline, 6 and 12 months; anthropometry measured every 2 months and skeletal maturation measured every 6 months. Cognition and behavior included the assessment of mental and motor development and the behavior of the child under natural conditions. DATA ANALYSIS: An ANOVA was the statistic most frequently used to test inter-group differences and structural equation modeling was used to test the internal validity of the conceptual model of the study.
Analysis of Variance↗
A preliminary test of a developmental model for the study of undernourished children in Indonesia.
OBJECTIVES: Structural equation modeling of an abbreviated version of the conceptual model of the effects of micronutrient and energy supplementation on growth and development of undernourished children in West Java. The study focused on the baseline data from the Pangalengan longitudinal project. DESIGN: This trial included two cohorts of children classified as nutritionally-at-risk who were randomly assigned to three treatments (condensed milk + micronutrients (E); skimmed milk + micronutrients (M); skimmed milk (S)). Supplements were given for a period of up to 12 months. SETTING: The sites were six tea plantations in Pangalengan. SUBJECTS: A 12-month-old (n=53) and an 18-month-old (n=83) cohort were recruited from 24 day care centers. Twenty children that received the S supplement were part of the 12- and 18-month-old cohorts. Criteria for inclusion were: no chronic disease; length-for-age < -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. VARIABLES: Indicators of socioeconomic status were economic and educational resources; length-for-age and weight-for-length were used as indicators of nutritional status; motor development and motor activity were measured with custom-made procedures; and carrying by caretaker and manipulation of objects were used as indicators of caretaking and exploratory behavior. RESULTS: The model fitted the data of the older but not of the younger cohort (chi2 statistic and three other indices of goodness to fit). However, there were no differences between cohorts in the estimation of the models.
Anthropometry↗
Nutritional intake of an undernourished infant population receiving an energy and micronutrient supplement in Indonesia.
OBJECTIVES: This paper reports the dietary intake (home, day care centers, supplement and breast milk) of the children in the clinical trial in Pangalengan. DESIGN: Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Twenty children who received S belong to the 12- and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. Evaluations of intake were made at baseline and every 2 months thereafter. RESULTS: For the 12-month-old cohort the mean increase in daily energy intake approximately 2931 kJ for E, approximately 1675 kJ for M, and approximately 837 kJ increase over the 6 months for the S group. For the 18-month-old cohort the changes were approximately 2512 kJ for E approximately 1675 for the M group and approximately 1047 for the S group.
Anthropometry↗
Effects of an energy and micronutrient supplement on anthropometry in undernourished children in Indonesia.
OBJECTIVES: This paper reports the effects of early supplementary feeding on body weight, length, head circumference and arm circumference among the children in the Pangalengan study. DESIGN: Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care centers. Twenty children that received S belonged to the 12- and 18-month cohorts. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: Length was measured with a portable measuring board; a Detecto scale with an accuracy of 0.1 kg was used for the measurement of body weight. Arm and head circumferences were measured using similar fiberglass tapes. RESULTS: Body weight showed effects on both cohorts at 2, 8 and 12 months; head circumference showed effects at 4 months in the 12-month-old cohort and at 10 months among the females of the 18-month-old cohort; and arm circumference showed effects across cohorts at 2, 8 and 12 months. In general the benefits are clearer for females and for the 12-month-old cohort.
Age Factors↗
Effects of an energy and micronutrient supplement on growth and activity, correcting for non-supplemental sources of energy input in undernourished children in Indonesia.
OBJECTIVES: This paper investigates simultaneously the growth and activity of children that received an early energy and micronutrient supplement, adjusting for all non-supplemental energy intakes. Any additional change in growth and activity after this adjustment was then compared across supplements at three points felt to be representative of the study. DESIGN: Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 209 kJ + 12 mg iron; S = 104 kJ. Supplementation was given for 12 months. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: A 12-month-old (n = 53) and an 18-month-old (n = 83) cohort were recruited from day-care-centers. Twenty children that received S belonged to the 12- and 18-month-old cohorts. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: Length was measured with a portable measuring board; a Detecto scale with an accuracy of 0.1 kg was used for the measurement of body weight. Arm and head circumferences were measured using similar fiberglass tapes. Motor activity was assessed through continuous 4 h observations at home and at day care centers. Anthropometry and activity were measured every two months over 12 months. RESULTS: After correcting for non-supplemental sources of energy intake, the effects of the supplement on weight and activity were observed at 2 months; effects on length and activity were observed at 6 months; and effects on weight alone were observed at 12 months.
Anthropometry↗
Effects of an energy and micronutrient supplement on play behavior in undernourished children in Indonesia.
OBJECTIVES: This paper reports the effects of an energy and micronutrient supplementation on quantitative and qualitative aspects of play among poorly nourished children. At issue is whether the supplement led to a progression in complexity of play. DESIGN: Two cohorts of children were randomly assigned to three treatments: E = 1171 kJ + 12 mg iron; M = 12 mg iron + 209 kJ; S = 104 kJ. Supplementation was given for 6 months. Evaluations of play behavior were repeated four times. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: The present study utilized a subsample of 55 children recruited for the larger Pangalengan project 6 months into the study. Thirty-eight children were recruited late enough to allow for longitudinal observations. The remaining cases were used for cross sectional observations only. Inclusion criteria were: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: The children were videotaped during play. These tapes were coded for eight mutually exclusive categories of activities. Four activities coded represented manipulative, relational, functional and symbolic play. RESULTS: Treatment did not affect qualitative play. Girls that received E increased functional play but boys showed the opposite effect. Children in the S group were breastfed more during play as compared to the E group. Children in the E group waited less to begin play.
Brain↗
Effects of an energy and micronutrient supplement on iron deficiency anemia, physical activity and motor and mental development in undernourished children in Indonesia.
OBJECTIVES: This paper reports the effects of an energy and micronutrient supplementation on mental and motor development, activity and behavior under natural conditions of children classified as iron deficient anemic and iron replete. DESIGN: Children were randomly assigned to two different nutritional supplements: (1) 12 mg iron + either 1171 or 209 kJ; (2) 104 kJ + 0 iron. Treatment lasted for 6 months. SETTING: The sites were six tea plantations in Pangalengan, West Java. SUBJECTS: Eighteen anemic subjects (hemoglobin < 110 g/L; transferrin saturation (TS) < 16%) and 18 matched (sex and age) controls (hemoglobin > 110 g/L; TS > 16%) were selected from a pool of children with the following characteristics: no chronic disease; length-for-age < or = -1 standard deviation (s.d.) and weight-for-length between -1 and -2 s.d. of the median of the reference of the World Health Organization. METHODS: Hemoglobin, ferritin, transferrin saturation and erythrocyte protoporphyrin were evaluated before and 6 months after treatment. The following psychological measurements were obtained at baseline and 2, 4 and 6 months later. Mental and motor development was evaluated with the Bayley Scale. Motor activity was measured by 4 h continuous observations at home and at day care centers. The interactions between the child and its social and physical environment were also evaluated during 4 h of observations. RESULTS: Anemic children showed faster motor development and greater physical activity than the control children did. None of the other tests showed inter-group differences.
Anemia, Iron-Deficiency↗
The potential of various foods to serve as a carrier for micronutrient fortification, data from remote areas in Indonesia.
OBJECTIVE: To estimate the potential of various industrially produced foods, to serve as a carrier for micronutrient fortification based on the frequency of their consumption in different socio-economic strata; to determine the role of fortified instant noodles as a source of micronutrients; to assess the contribution of plant foods, animal foods and fortified foods to vitamin A intake. SETTING: A survey was conducted in rural South Sulawesi and urban South Kalimantan between November 1996 and January 1997. SUBJECTS: Households (1500 in South Sulawesi; 2112 in South Kalimantan) were selected randomly by multi-stage cluster sampling. From each household, data were collected from the mother and her youngest child (0-5 y). DATA COLLECTION: Mothers were interviewed on various topics, including socio-economic status, food consumption, receipt of high-dose vitamin A capsules, health and nutritional status. RESULTS: Monosodium glutamate and salt were consumed daily in almost all households in both areas, and consumption was not associated with socio-economic status. Instant noodles were consumed in nearly all households in both areas, but consumption of fortified noodles was related to socio-economic status; it was highest among households of government employees and private investors, and lowest among farmers and share-croppers. Vegetables were the most important source of vitamin A in rural South Sulawesi, while foods of animal origin were the most important source in urban South Kalimantan. CONCLUSIONS: The results support double or triple fortification of salt and/or monosodium glutamate with iodine, vitamin A and/or iron. Efforts to overcome associated technical and logistical difficulties are urgently needed. SPONSORSHIP: Opportunities for Micronutrient Interventions (OMNI); United States Agency for International Development (USAID). European Journal of Clinical Nutrition (2000) 54, 822-827
Adult↗
Effectiveness of weekly vitamin A (10,000 IU) and iron (60 mg) supplementation for adolescent boys and girls through schools in rural and urban East Java, Indonesia.
OBJECTIVE: High prevalences of vitamin A deficiency and anaemia among adolescents warrant interventions. This study evaluated the effectiveness of school-based supplementation to reduce anaemia and improve vitamin A status. DESIGN: School-based, grade-randomized, intervention. SUBJECTS AND SETTING: In all, 1757 girls and 1859 boys, aged 12-15 y, in 24 Junior High Schools. INTERVENTIONS: Weekly supplementation for 14 weeks with 60 mg iron and 250 microg folate (Fe group; n=978), 10 000 IU vitamin A (VA group; n=970) or both (VAFe group; n=1042) to subjects in 15 schools, compared to subjects in nine other schools not receiving supplements (control; n=626). RESULTS: The baseline anaemia prevalence (Hb <120 g/l) in girls was 20% (prepubertal) and 26% (pubertal), and in boys 24% (pre-pubertal) and 11% (pubertal). Serum retinol concentrations were low (<1.05 micromol/l) in 41% of boys and 45% of girls. The interventions did not increase haemoglobin concentrations. Serum retinol concentration of boys, but not girls, in the VA group increased (0.33 vs 0.07 micromol/l in controls; P<0.01). The risk factors for low serum retinol concentration were lower baseline serum retinol concentration (OR 0.02-0.03) with, for girls, nightblindness at baseline (OR 5.88), and for boys, not receiving vitamin A (OR control: 1.00; VA: 0.37; Fe: 0.77; VAFe: 0.34) and maternal illiteracy (OR mother never attended school 1.00, mother received any formal education 0.17-0.33). CONCLUSIONS: Supplementation with vitamin A increased serum retinol concentration of boys. Iron supplementation did not change Hb. This appeared to be due to poor compliance, and partly related to side effects.
Adolescent↗
Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia.
OBJECTIVE: To examine the effect of Ramadan fasting on basic hematological parameters, in addition to the effects on body weight and blood pressure of fasters and nonfasters. DESIGN, SETTING, AND SUBJECTS: One hundred male outdoor workers at a vehicle terminal in a city in East Java were recruited for this study. Anthropometric measurements and blood sampling were conducted on two separate occasions, just before the start of Ramadan and in the third week of the month of Ramadan (October-November 2004). The degree of subjective compliance with Ramadan fasting (complete, partial, or none) was evaluated using a questionnaire. RESULTS: The mean body mass index (BMI) of the fasting group was, as expected, significantly lower at the second sampling period, and the decrease in BMI correlated significantly with decreased blood pressure in this group. The blood pressure was also reduced in the partial fasting and nonfasting groups, which was an unexpected result. While red blood cell production was suppressed, as evidenced by lower levels of hemoglobin, red blood cell (RBC), and packed cell volume (PCV) at the second sampling, the subjects were normocytic and normochromic, based on normal mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) levels. CONCLUSIONS: These results indicate that, regardless of fasting status, blood pressure is lower and RBC production is suppressed in subjects during the Ramadan period. These findings should be taken into account when evaluating the effects of Ramadan on the general population. To avoid the adverse effects of anemia, increased intake of iron-rich foodstuffs is recommended during the Ramadan month, regardless of fasting practice.
Adolescent↗
Dental fluorosis and caries prevalence in the fluorosis endemic area of Asembagus, Indonesia.
OBJECTIVES: The aim of this study was to determine the prevalence and severity of dental fluorosis and caries in a fluorosis endemic area, with fluoride content in drinking water ranging from 0.51 to 3.15 ppm. MATERIALS AND METHODS: Children (n = 474), aged 6-12 years, were randomly selected from one primary school in each of ten villages in the subdistrict of Asembagus. The villages were grouped into four according to the fluoride content in the drinking water: Group A: 0.41-0.50; Group B: 0.73-0.90; Group C: 2.01-2.41 and Group D: 3.07-3.25. Fluorosis examination used Bischoff's modification (1976), which was based on Dean's classifications, and caries was scored according to WHO standard 1997. RESULTS: D(T) from Group A to D increased from 0.46, 0.55, 0.66 to 1.03; while d(T) decreased from 0.89, 0.87, 0.86 to 0.32. CFI increased from 1.36, 1.67, 2.03 to 1.80. Kruskal-Wallis one-way ANOVA was significant for the relationship between fluoride water content and CFI, D(T), and d(T). There was no significant linear relationship between fluoride water content and D(T) or d(T), but there was a positive correlation with CFI. Caries prevalence in the subdistrict was 62% for permanent teeth and 68% for primary teeth. Fluorosis prevalence was 96% with a mean CFI of 1.71. CONCLUSIONS: The high CFI values of 1.36 and 1.67 in villages A and B may relate to the main side-dishes eaten in the two villages. Of these, 88% contained fish, 68% dried salted fish and 61% a type of shellfish gathered locally.
Analysis of Variance↗
Correlation between maximum bite force and craniofacial morphology of young adults in Indonesia.
The present study was conducted to evaluate the relationship between maximum bite force and craniofacial morphology. Sixty-four Indonesian female dental students aged 19-27 years with normal occlusion served as the subjects. The Dental Prescale System was used to measure the maximum bite force using a pressure sensitive sheets while craniofacial morphology measurements were determined from conventional lateral radiograms. The antero-posterior and right-left position of the occlusal load centre (the OLC) were measured also. Stepwise multiple regression analysis was performed to evaluate the relationship between bite force and craniofacial morphology while correlation analysis was used to evaluate the antero-posterior position of the OLC related to craniofacial morphology. Fifty-five per cent of the bite force could be explained by variations in the posterior facial height, gonial angle, antero-posterior size of the maxilla, and posterior length of the cranial base. The result showed a larger bite force implies a greater posterior facial height, smaller gonial angle, larger maxilla and straighter posterior length of the cranial base. This study suggests that among Indonesians, maximum bite force could be explained by craniofacial morphology as found in Caucasians. In addition, we proposed a clinical standard of the OLC for the comprehensive evaluation of occlusion.
Adult↗