Gema Lingkungan Kesehatan
type: channel
description: Gema Lingkungan Kesehatan (GeLinKes) (e-ISSN: 2407-8948) is a peer-reviewed, open-access scientific journal dedicated to advancing knowledge in health sciences and medicine, with a particular emphasis on environmental health. The journal is published by Politeknik Kesehatan Kemenkes Surabaya and serves as an academic platform for disseminating evidence-based research, applied studies, and policy-relevant findings that contribute to environmental sustainability and population health improvement. Starting in 2025, the journal adopts a quarterly publication schedule, issuing four editions annually to accommodate the growing number of high-quality submissions.
publisher: Poltekkes Kemenkes Surabaya
language: en
publication name: Gema Lingkungan Kesehatan
issn: 2407-8948
items: Estimated Health Risk of Cadmium and Chromium in Elderly Blood Cockle Consumers, Lantebug
items: Preliminary Study of Life Cycle Assessment on Food Surplus Redistribution Compared to Food Waste Management in Surabaya
items: Mosquito Larvae Identification in Water Storage and Assesment of Worker’s Knowledege, Attitudes, and Practices
items: The Effectiveness of Rice Straw and Cogongrass Straw Soaked Water Attractants on the Number of Aedes spp. Mosquitoes
items: Correlation Between TNF-α Levels and APRI Score with Ejection in Hepatic Cirrhosis
items: Design and Performance Evaluation of a Digital Chlorinator for Domestic Wastewater Disinfection in Healthcare Facilities
items: Maternal Age at Marriage and Risk of Childhood Stunting: Evidence from a Case-Control Study in North Sumatra, Indonesia
items: Factors Associated with Breast Milk Quality Related to Cigarette Smoke Exposure: A Cross Sectional Study in Balai Agung Health Center, Musi Banyuasin Regency
items: The Effectiveness of Beetroot and Date Juice as Phytopharmaceuticals in Treating Anaemia in Pregnant Women
items: The Effectiveness of Moringa Leaf Powder Capsules (Moringa oleifera Lam.) in Reducing the Severity of Anaemia in Pregnant Women
items: The Effect of TNF-α and FIB-4 Score on Diastolic Dysfunction in Child Pugh C Liver Cirrhosis
items: Climate-Sensitive Diseases and Community Vulnerability in Coastal Indonesia: A Systematic Review with Narrative Synthesis
items: Impact of Air Temprature and Humidity on Sick Building Syndrome among Bank Employees
items: Respiratory and Neurological Health Effects of Chromium and PM Exposure among Troso Woven Fabric Workers: A Cross Sectional Study in Jepara
items: Evaluation of Hospital Sustainability Initiatives in South-east Asia
items: Mothers’ Knowledge and Skills as Key Factors in Preventing Stunting in Toddlers: A Case Study in Malingping, Banten
items: Association Between Community-Based Total Sanitation (CLTS) Pillars and Diarrhea Incidence in Wetland Communities of South Indralaya
items: Biodigesters for Wastewater Treatment and Biogas Generation in Poultry Slaughterhouses
items: The Role of PPAR in Liver Cirrhosis: An Update Review
items: A Analysis of Land Use on Water Quality in Merjosari Village, Lowokwaru Subdistrict, Malang City
items: The Relationship of Water and Sanitation with the Incidence of Stunting: A Bibliometric Analysis
items: Effect of Turmeric Ethanol Extract (Curcuma Longa Linn.) on Tumor Necrosis Factor alpha (TNFα) and the extent of wound lesions (Experimental Study on Wistar Rats Exposed to UVB Rays)
items: Effect of Turmeric Ethanol Extract (Curcuma Longa Linn) on IL-6, IL-10 Levels and Skin Moisture
items: Holistic Approach: Emotional Touch Intervention (Kissing and Hugging) and Macronutrient Nutrition in Stunting Prevention in Early Childhood)
items: Case Study: Physiotherapy Program in Down Syndrome Patients with Neuro Development Treatment Intervention at Dustira Hospital
items: The Relationship Between Cigarette Smoke Exposure and Environmental Sanitation with The Incidence of Acute Respiratory Tract Infections in Toddlers
items: Pulmonary Function Impairment Associated with PM2.5, CO, and CO₂ Exposure in Home-Based Chips Industry Workers in Indonesia: A Cross-Sectional Study
items: Pesticide Spraying Practices and Hypertension Risk among farmers in Bumen Village, Indonesia
items: Effectiveness of Banana Peel Ash, Zeolite and Clam Shells in Reducing Waterturbidity and Iron (Fe) Contentration
items: Effect of Crystalloid Preloading on Blood Pressure Stability in Cesarean Section Under Spinal Anesthesia: A Study at Regional General Hospital of Sekarwangi

Estimated Health Risk of Cadmium and Chromium in Elderly Blood Cockle Consumers, Lantebug
type: item
description: This study assessed the non-carcinogenic health risks of Cadmium (Cd) and Chromium (Cr) exposure through blood cockle (Anadara granosa) consumption among elderly residents in Lantebung, Makassar Strait. Blood cockle samples were collected from six purposively selected points, and Cd and Cr concentrations were analyzed. Health risks were estimated using intake calculations and the Risk Quotient (RQ). Cd and Cr concentrations were generally below national and international food safety limits. However, some elderly individuals, particularly frequent consumers, exceeded the non-carcinogenic risk threshold (RQ > 1). The highest risks were associated with specific sampling points, reflecting localized contamination. Risk factors included high consumption rates, long exposure duration, and lower body weight. These findings suggest that compliance with contaminant limits alone may not ensure safety for vulnerable populations. Regular environmental monitoring, risk communication for high-risk groups, and strengthened pollution control measures are recommended. Public health interventions, including periodic health screening and guidance on safe seafood consumption, are needed to reduce long-term health impacts.
subject: Research Articles
  topic: section
subject: Cadmium
  topic: keywords
subject: Chromium
  topic: keywords
subject: Blood Cockle
  topic: keywords
subject: Non-Carcinogenic Risk
  topic: keywords
subject: Elderly
  topic: keywords
creator: Abd Gafur
creator: Nasruddin Syam
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-05
publication date: 2026-02-05
starting page: 49
ending page: 61
doi: 10.36568/gelinkes.v24i1.463

Preliminary Study of Life Cycle Assessment on Food Surplus Redistribution Compared to Food Waste Management in Surabaya
type: item
description: Food waste accounts for approximately 40% of total waste generation in Indonesia and contributes significantly to national greenhouse gas (GHG) emissions. While most food waste is still disposed of in landfills, food surplus redistribution through food banks has emerged as a potential mitigation strategy. This study evaluates the environmental performance of food surplus redistribution compared to conventional food waste management options using a life cycle assessment (LCA) approach. The analysis was conducted at Garda Pangan, Surabaya, with a functional unit of 1 ton of food surplus and assessed three scenarios: (1) landfill disposal, (2) composting and anaerobic digestion, and (3) food surplus redistribution. The assessment applied the CML IA Baseline method and focused on Global Warming Potential (GWP), using SimaPro 9.0 and the Ecoinvent 3 database. The results show that landfill disposal has the highest GWP at 1,920 kg CO₂-eq per ton of food waste, driven primarily by methane emissions from anaerobic decomposition. Composting and anaerobic digestion result in lower impacts, at 1,503 and 1,730 kg CO₂-eq per ton, respectively. In contrast, food surplus redistribution shows a markedly lower GWP of 1.24 kg CO₂-eq per ton of food surplus, as emissions are dominated by transportation activities within a simplified gate-to-gate system boundary. This preliminary analysis relied on secondary inventory data and excluded potential avoided food production impacts; therefore, the estimated GWP for redistribution may underestimate or overestimate actual emissions. These findings highlight the importance of prioritizing food waste prevention and the benefits of food surplus redistribution within integrated waste management strategies to reduce GHG emissions while delivering social co-benefits.
subject: Research Articles
  topic: section
subject: Food Surplus
  topic: keywords
subject: Food Waste
  topic: keywords
subject: Waste management
  topic: keywords
subject: Life Cycle Assesment
  topic: keywords
creator: Khairunisa
creator: Nuzulul Anggi Rizki
creator: Lies Wuryanita Adriani
creator: Rizki Ainuna Wijaya
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-05
publication date: 2026-02-05
starting page: 62
ending page: 68
doi: 10.36568/gelinkes.v24i1.462

Mosquito Larvae Identification in Water Storage and Assesment of Worker’s Knowledege, Attitudes, and Practices
type: item
description: Vector-borne diseases remain a major public health concern in tropical regions, with dengue fever continuing to be the predominant vector-borne disease in urban Indonesia. Public tourist areas with high human activity may provide favorable breeding sites, making sanitation workers’ roles crucial. This study aimed to identify mosquito breeding characteristics and larval presence in water-holding containers (WHCs) and to describe the knowledge, attitudes, and practices (KAP) of sanitation workers in a historic public open space in an urban setting. A descriptive cross-sectional study using a mixed-methods approach was conducted, combining quantitative entomological surveys with qualitative in-depth interviews. All accessible WHCs at the study site were inspected for larvae, which were collected and morphologically identified, and Aedes larval indices (ABJ/Angka Bebas Jentik, HI, CI) were calculated. Sanitation workers were selected purposively as qualitative informants, and KAP data were analyzed thematically. Seven WHCs were identified, of which two outdoor natural pools (28.57%) were positive for larvae, yielding 13 larvae, all identified as Culex spp., with no Aedes spp. detected. Consequently, Aedes-specific indices showed an ABJ of 100%, HI of 0%, and CI of 0%, indicating a low risk of dengue transmission according to WHO criteria (HI <4% and CI <3%). Sanitation workers demonstrated generally good knowledge, positive attitudes, and routine preventive practices, although understanding of the full 3M Plus concept varied. In conclusion, despite the presence of non-Aedes larvae in outdoor natural containers, the absence of Aedes breeding sites suggests effective dengue vector control supported by routine sanitation practices in the study area.
subject: Research Articles
  topic: section
subject: Knowledge
  topic: keywords
subject: Attitude
  topic: keywords
subject: Practices
  topic: keywords
subject: Larvae Identification
  topic: keywords
subject: Larvae Index
  topic: keywords
creator: Adinda Nezma Meidina
creator: Dwi Handayani
creator: Dalilah Dalilah
creator: Gita Dwi Prasasty
creator: Susilawati Susilawati
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-02
publication date: 2026-02-02
starting page: 38
ending page: 48
doi: 10.36568/gelinkes.v24i1.459

The Effectiveness of Rice Straw and Cogongrass Straw Soaked Water Attractants on the Number of Aedes spp. Mosquitoes
type: item
description: Aedes spp. mosquitoes are the main vectors of Dengue Hemorrhagic Fever (DHF), which remains a public health problem in Indonesia. Chemical insecticide-based mosquito control has the potential to cause environmental pollution and vector resistance, so safer and more environmentally friendly control alternatives are needed. This study aimed to analyze the effectiveness of rice straw and cogongrass straw-soaked water attractants in attracting Aedes spp. mosquitoes. Method this study used a pure experimental design with a post-test only control group design. The study was conducted at Muhammadiyah Ahmad Dahlan University, Palembang. Traps were placed purposively with a total of 27 observation units consisting of three treatment groups, namely control (water without attractant), rice straw-soaked water attractant, and cogongrass straw-soaked water attractant, each with nine replications. Traps were set for 5–7 days. Data were analyzed using the Shapiro–Wilk normality test, homogeneity test, One Way ANOVA, and the Least Significant Difference (LSD) test with a significance level of 0.05. The results showed the total number of mosquitoes trapped in the control group was 16, in the rice straw attractant group was 31, and in the cogongrass straw attractant group was 32. The average number of mosquitoes in the control group was 2.00 ± 0.67, in the rice straw group was 3.00 ± 1.13, and in the cogongrass straw group was 4.00 ± 1.13. The results of the One- Way ANOVAanalysis showed a significant difference between the treatment groups (p = 0.01). Further LSD tests showed that both attractant groups were significantly different from the control, but there was no significant difference between the rice straw and cogongrass straw attractants. These findings indicate soaked water from rice straw and cogongrass straw was effective in increasing the number of trapped mosquitoes compared to the controlas a natural attractant to catch Aedes spp. mosquitoes and has the potential to be an…
subject: Research Articles
  topic: section
subject: Aedes spp.
  topic: keywords
subject: Natural attractants
  topic: keywords
subject: Rice straw
  topic: keywords
subject: Cogongrass straw
  topic: keywords
subject: Mosquito traps
  topic: keywords
creator: Alprian Wiratama
creator: Zairinayati -
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-05
publication date: 2026-02-05
starting page: 69
ending page: 75
doi: 10.36568/gelinkes.v24i1.456

Correlation Between TNF-α Levels and APRI Score with Ejection in Hepatic Cirrhosis
type: item
description: Cirrhotic cardiomyopathy is a condition of heart dysfunction characterized by impaired myocardial contractility, left ventricular hypertrophy, diastolic dysfunction, chronotropic dysfunction, and electrophysiological disturbances of the heart. One of the complications in patients with hepatic cirrhosis is influenced by several factors, particularly TNF-α levels and the APRI score. This study aimed to analyze the effect of TNF-α and APRI score on ejection fraction in Child-Pugh C hepatic cirrhosis. Methods: This study employed an analytical observational design with a cross-sectional approach. The sample consisted of 40 inpatients with Child-Pugh C hepatic cirrhosis at the dr. Moewardi Surakarta Regional General Hospital. Samples were selected using consecutive sampling. Data analysis was performed using Spearman’s correlation test and linear regression. Results: The correlation between TNF-α levels and ejection fraction in Child-Pugh C hepatic cirrhosis is r = -0.559, p<0.001 (moderate correlation). The correlation between APRI score and ejection fraction in Child-Pugh C hepatic cirrhosis is r = -0.445, p<0.001 (moderate correlation). There is a significant correlation between TNF-α levels and APRI score with ejection fraction in Child-Pugh C hepatic cirrhosis. The implication is that clinicians may incorporate TNF-α levels and the APRI score into clinical algorithms to monitor cirrhotic patients who are at high risk of developing cardiovascular complications.
subject: Research Articles
  topic: section
subject: Tumor Necrosis Factor-alpha
  topic: keywords
subject: APRI Score
  topic: keywords
subject: Ejection Fraction
  topic: keywords
subject: Hepatic Cirrhosis
  topic: keywords
creator: Muslim Thaher
creator: Triyanta Yuli Pramana
creator: Heru Sulastomo
creator: Dhani Redhono
creator: Eti Poncorini Pamungkasari
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-01-02
publication date: 2026-01-02
starting page: 1
ending page: 6
doi: 10.36568/gelinkes.v24i1.454

Design and Performance Evaluation of a Digital Chlorinator for Domestic Wastewater Disinfection in Healthcare Facilities
type: item
description: Domestic wastewater from healthcare facilities such as hospitals, community health centres, and polyclinics contains organic loads, toxic chemical compounds, and pathogenic microorganisms that have the potential to cause environmental pollution and pose a risk to public health if not treated adequately. Various conventional treatment methods, including UV, ozonation, aeration, and biofiltration, have been used to reduce pollutants, but cost limitations, high energy requirements, and technical reliability make chlorination the preferred option because it is relatively inexpensive, easy to implement, and produces disinfectant residues that provide continued protection. However, uncontrolled use of chlorine can lead to excessive residues, disinfection by-products (DBPs), and operational inefficiencies. To address these challenges, this study aims to design and evaluate the performance of a digital chlorinator equipped with an automatic control system with dual energy source flexibility (AC/DC and solar panels). This study used a one group pre-test and post-test design with domestic wastewater samples from hospitals, health centres, and polyclinics in Magetan Regency. The water quality parameters analysed included pH, BOD, COD, ammonia, chlorine demand, residual chlorine, and total coliforms. Initial measurements showed BOD of 105–145 mg/L, COD of 198–260 mg/L, ammonia of 13–18 mg/L, and total coliform of 8.5 × 10⁵ to 1.2 × 10⁶ MPN/100 mL, far above the national quality standards. After treatment using a digital chlorinator with an optimum dose of 200 ppm, BOD decreased by 77–82%, COD by 72–78%, ammonia by 75–80%, and total coliforms by more than 99%, while the pH remained stable in the range of 7.1–7.3 and the chlorine residue was maintained at 0.2–0.5 mg/L according to the recommended standard. A comparison of energy sources showed that the effectiveness of solar cells was almost equivalent to that of AC/DC, with a small difference in the reduction of BOD and COD that…
subject: Research Articles
  topic: section
subject: Digital chlorinator
  topic: keywords
subject: Wastewater disinfection
  topic: keywords
subject: Solar energy
  topic: keywords
subject: Healthcare facilities
  topic: keywords
creator: Beny Suyanto
creator: Hurip Jayadi
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-08-01
publication date: 2025-08-01
starting page: 481
ending page: 487
doi: 10.36568/gelinkes.v23i3.412

Maternal Age at Marriage and Risk of Childhood Stunting: Evidence from a Case-Control Study in North Sumatra, Indonesia
type: item
description: Stunting remains a major public health issue in Indonesia, particularly in urban areas such as Medan. While socioeconomic and nutritional factors are well recognized, the influence of maternal age at marriage on child growth is less explored. This study examined the association between maternal age at marriage and childhood stunting in Medan, Indonesia. Methods. An analytical observational study with a case–control design was conducted from January to March 2025 across several community health centres in Medan. A total of 124 mother–child pairs (62 stunted and 62 non-stunted children) were selected using cluster random sampling. Data were collected through structured interviews and health-record reviews. Stunting was defined as height-for-age Z-score < -2 SD based on WHO standards. Logistic regression was used to assess the relationship between maternal age at marriage (<25 years vs ≥25 years) and stunting, adjusting for maternal education, maternal health during pregnancy, socioeconomic status, and birth weight. Children of mothers who married before age 25 had significantly higher odds of being stunted compared with those whose mothers married later (adjusted OR = 2.85; 95% CI: 1.71-4.76; p < 0.001). Low maternal education (adjusted OR = 2.12; p = 0.021) and low birth weight (adjusted OR = 2.43; p = 0.030) were also independent predictors of stunting. Conclusion. Maternal marriage before 25 years is a strong determinant of childhood stunting in urban Medan. Delaying maternal marriage, enhancing women’s education, and strengthening maternal health programs could substantially reduce stunting prevalence. This study contributes new evidence to Indonesia’s national efforts to prevent stunting through life-course and policy-oriented interventions.
subject: Research Articles
  topic: section
subject: Stunting maternal age at marriage, maternal education, birth weight, Indonesia
  topic: keywords
creator: Anjas Domini Sidabutar
creator: Irza Haicha Pratama
creator: Qori Fadillah
creator: Wilbert Angwyn
creator: Yeni Rimadeni
creator: Theresia Anggriani
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-20
publication date: 2025-11-20
starting page: 549
ending page: 555
doi: 10.36568/gelinkes.v23i4.403

Factors Associated with Breast Milk Quality Related to Cigarette Smoke Exposure: A Cross Sectional Study in Balai Agung Health Center, Musi Banyuasin Regency
type: item
description: The quality of breast milk is an important factor in supporting infant growth and health, but it can be influenced by environmental and behavioural factors, including exposure to cigarette smoke. This study aims to analyse the relationship between exposure to cigarette smoke, exposure to household cigarette smoke, and breastfeeding patterns with breast milk quality in breastfeeding mothers in the working area of the Balai Agung Community Health Centre, Musi Banyuasin Regency. This study used an analytical observational design with a cross-sectional approach involving 60 breastfeeding mothers of infants aged 0–6 months who were selected purposively. Data were collected through structured interviews and breast milk quality tests in the laboratory, then analysed descriptively and bivariately using statistical tests with a significance level of 5%. The results showed that the majority of respondents were exposed to cigarette smoke (63.3%) and lived with smokers at home (70.0%). Mothers exposed to cigarette smoke had a nine times greater risk of producing poor-quality breast milk compared to mothers who were not exposed (OR = 9.00; p = 0.002). Exposure to cigarette smoke in the household was also significantly associated with breast milk quality (OR = 6.00; p = 0.015). In addition, non-exclusive breastfeeding patterns increased the risk of poor-quality breast milk by more than five times (OR = 5.44; p = 0.004). This study concluded that exposure to cigarette smoke and breastfeeding patterns are important determinants of breast milk quality, so efforts to protect breastfeeding mothers from cigarette smoke and strengthen exclusive breastfeeding practices need to be prioritised in primary health care services.
subject: Research Articles
  topic: section
subject: Breast milk quality
  topic: keywords
subject: Exposure to cigarette smoke
  topic: keywords
subject: Smoke-free households
  topic: keywords
subject: Breastfeeding patterns
  topic: keywords
subject: Breastfeeding mothers
  topic: keywords
creator: Marlini
creator: Manisah Manisah
creator: Icuk Muhammad Sakir
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-02
publication date: 2026-02-02
starting page: 12
ending page: 18
doi: 10.36568/gelinkes.v24i1.394

The Effectiveness of Beetroot and Date Juice as Phytopharmaceuticals in Treating Anaemia in Pregnant Women
type: item
description: Anaemia during pregnancy is a health problem that has serious implications for the condition of both mother and foetus. Treatment efforts should not only rely on iron supplementation, but can also involve natural approaches that are more acceptable and safer, such as administering beetroot juice and dates. This study aims to determine the effectiveness of a combination of beetroot juice and dates in increasing haemoglobin levels in pregnant women with mild anaemia. The study design used a quasi-experimental pretest–posttest control group design involving 32 pregnant women in their third trimester who were divided evenly into a control group and a treatment group. The control group only received iron tablets, while the treatment group received iron tablets along with beetroot and date juice intervention administered daily for 14 consecutive days, with a composition of 100 grams of beetroot and 50 grams of dates in each serving. The results showed that the combination of beetroot juice and dates was able to increase haemoglobin levels in pregnant women with mild anaemia compared to iron supplementation alone. This intervention proved to be safe, well-tolerated, and has the potential to be developed as a complementary phytopharmaceutical to support efforts to prevent and treat anaemia in pregnancy.
subject: Research Articles
  topic: section
subject: Jus buah bit
  topic: keywords
subject: Terapi komplementer
  topic: keywords
creator: Fadhila Azkiya
creator: Filda Fairuza
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-12-22
publication date: 2025-12-22
starting page: 593
ending page: 599
doi: 10.36568/gelinkes.v23i4.387

The Effectiveness of Moringa Leaf Powder Capsules (Moringa oleifera Lam.) in Reducing the Severity of Anaemia in Pregnant Women
type: item
description: Anaemia is an iron deficiency that causes anaemia in pregnant women, which can have a negative impact on foetal or infant growth and development during and after pregnancy. One way to increase haemoglobin levels in pregnant women with anaemia is to consume moringa leaf powder capsules (Moringa oleifera Lam.), which have haematopoietic activity and are beneficial in increasing platelet counts. The purpose of this study was to determine the effect of moringa leaf powder capsules (Moringa oleifera Lam.) on haemoglobin levels in pregnant women with mild to moderate anaemia with haemoglobin levels of 8–11 g/dL at the Reva Medika Clinic, Lebak Regency in 2025. The intervention was carried out for seven consecutive days with a dose of 2 moringa leaf capsules per day. Hemoglobin levels were measured using a digital hemoglobinometer EasyTouch® HB (Taiwan) in accordance with WHO standard procedures to ensure the accuracy of the test results. The sampling technique used was the Ishak and Michel method. The research respondents were pregnant women aged 20–35 years with a gestational age of 20–32 weeks who had mild to moderate anaemia with haemoglobin levels of 8–11 g/dL and no comorbidities. The study was conducted from January to March 2025. The results of the study after administering moringa leaf powder capsules for anaemia in pregnancy showed that the majority of pregnant women experienced mild anaemia (27 people or 84.4%) and severe anaemia (5 people or 15.6%). A significant difference was found between before and after the administration of moringa leaf powder capsules for anaemia in pregnancy. The Wilcoxon Sign Rank test showed a p-value of 0.000 0.05. It can be concluded that the administration of moringa leaf powder capsules had an effect on anaemia in pregnancy at the Reva Medika Clinic, Lebak District, in 2025.
subject: Research Articles
  topic: section
subject: Pregnant women
  topic: keywords
subject: Anaemia
  topic: keywords
subject: Moringa capsules
  topic: keywords
creator: Filda Fairuza
creator: Sandy Rahman
creator: Sukmiyant Sukmiyant
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-02
publication date: 2026-02-02
starting page: 30
ending page: 37
doi: 10.36568/gelinkes.v24i1.386

The Effect of TNF-α and FIB-4 Score on Diastolic Dysfunction in Child Pugh C Liver Cirrhosis
type: item
description: Liver cirrhosis is a major global health concern, often complicated by cardiac dysfunction such as diastolic heart failure. Tumor necrosis factor-alpha (TNF-α) and FIB-4 score are widely used biomarkers in cirrhotic patients, but their predictive value for cardiac complications remains unclear. To determine the effect of TNF-α and FIB-4 scores on the severity of diastolic dysfunction in patients with Child-Pugh C liver cirrhosis. This analytical cross-sectional study included 40 Child-Pugh C cirrhotic patients. Serum TNF-α levels were measured using ELISA. Diastolic function was evaluated using echocardiography. Ordinal logistic regression was used to analyze the association between TNF-α, FIB-4, and diastolic dysfunction grades. The majority of participants had moderate (65.0%) or severe (35.0%) chronic inflammation based on TNF-α levels, with a median TNF-α of 45.52 pg/mL. Significant liver fibrosis (FIB-4 >3.25) was observed in 82.5% of participants. Grade I diastolic dysfunction was the most prevalent (52.5%). TNF-α levels were significantly associated with the degree of diastolic dysfunction (p=0.042), whereas FIB-4 scores showed no significant correlation (p=0.533). Elevated TNF-α is strongly associated with worsening diastolic dysfunction in Child-Pugh C cirrhosis, suggesting its role in systemic inflammation and myocardial injury. In contrast, the FIB-4 index may not reflect cardiac involvement in advanced cirrhosis. TNF-α may serve as a potential biomarker for cardiovascular risk stratification in cirrhotic patients, supporting early intervention and integrated care approaches.
subject: Research Articles
  topic: section
subject: Tumor Necrosis Factor-alpha
  topic: keywords
subject: FIB-4 Score
  topic: keywords
subject: Diastolic Dysfunction
  topic: keywords
subject: Child-Pugh C Cirrhosis
  topic: keywords
subject: Inflammation
  topic: keywords
creator: Muhammad Yusuf Karim
creator: Triyanta Yuli Pramana
creator: Heru Sulastomo
creator: Arief Nurudhin
creator: Eti Poncorini Pamungkasari
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-12-22
publication date: 2025-12-22
starting page: 587
ending page: 592
doi: 10.36568/gelinkes.v23i4.384

Climate-Sensitive Diseases and Community Vulnerability in Coastal Indonesia: A Systematic Review with Narrative Synthesis
type: item
description: Climate change is increasingly exacerbating health risks in tropical regions, particularly in archipelagic nations such as Indonesia. This study aims to systematically identify and synthesize scientific evidence on climate-sensitive diseases and community vulnerability in coastal Indonesia. A systematic review with narrative synthesis was conducted across four databases (PubMed, Scopus, ScienceDirect, and Google Scholar). The search was performed on 15 June 2025, covering studies published between 2013–2024. Of the 263 records identified, 20 studies met the eligibility criteria, consisting of 12 observational studies, 5 modelling studies, and 3 review or mixed-method papers. The findings indicate consistent associations between rising temperatures, shifting rainfall patterns, flooding, drought, and sea-level rise with increased incidence of dengue, malaria, diarrhea, filariasis, and climate-related mental health outcomes. These climate-sensitive risks are amplified by structural vulnerabilities, including inadequate sanitation, high population density, dependence on climate-sensitive livelihoods, and limited access to healthcare in coastal and remote areas. Most included studies originated from Indonesia and Southeast Asia, underscoring strong contextual relevance. The synthesis highlights that fragmented, sectoral approaches remain insufficient in addressing health impacts of climate change. Integrated strategies—such as climate-informed disease surveillance, community-based early warning systems, and strengthened cross-sectoral coordination—are urgently needed to enhance adaptive capacity. This review is limited by the absence of quantitative meta-analysis and the geographic focus on Indonesia. Future studies should employ longitudinal designs, higher-resolution spatial climate data, and interdisciplinary approaches to support more robust climate-health adaptation strategies.
subject: Review Article
  topic: section
subject: Coastal
  topic: keywords
subject: Disease
  topic: keywords
subject: Climate change
  topic: keywords
subject: Community
  topic: keywords
creator: Reza Indra Wiguna
creator: Lia Arian Apriani
creator: Maulin Halimatunnisa
creator: Mustika Ayu Lestari
creator: Edy Surya Pratama
rights: Copyright (c) 2026 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-02-02
publication date: 2026-02-02
starting page: 19
ending page: 29
doi: 10.36568/gelinkes.v24i1.381

Impact of Air Temprature and Humidity on Sick Building Syndrome among Bank Employees
type: item
description: Sick Building Syndrome (SBS) is a condition in which inhabitants develop health problems or discomfort as a result of extended exposure to indoor surroundings. The purpose of this study was to investigate the association between air temperature and humidity in air-conditioned rooms and the prevalence of SBS, specifically mental weariness (burnout) instances, among employees of Bank Syariah Indonesia (BSI) in Banjarbaru City, Indonesia. The study followed a quantitative design with an analytical cross-sectional survey approach. Data were gathered using questionnaires and devices that measured air temperature and humidity. Univariate analysis defined the variable features, whereas bivariate analysis looked at the correlations between air temperature and humidity (independent variables) and the prevalence of SBS mental fatigue cases (dependent variable). The survey included 30 bank employees, with an average age of 32.4 years. The average air temperature was 25.8°C, with a relative humidity of 84.2%, which was outside of the permissible limit. The prevalence of SBS was 43.3%, with common symptoms including nose discomfort, eye irritation, headache, and fatigue. The prevalence of mental weariness was 36.7%. Pearson correlation analyses found significant positive relationships between air temperature and SBS prevalence (r = 0.48, p < 0.01), relative humidity and SBS prevalence (r = 0.39, p < 0.05), air temperature and mental fatigue (r = 0.41, p < 0.05), and relative humidity and mental fatigue. The findings emphasize the need of maintaining adequate indoor environmental conditions to reduce SBS risk and increase employee well-being in air-conditioned workplaces.
subject: Research Articles
  topic: section
subject: Air temperature
  topic: keywords
subject: Humidity
  topic: keywords
subject: Sick Building Syndrome (SBS)
  topic: keywords
subject: Mental fatigue
  topic: keywords
subject: Bank employees
  topic: keywords
creator: Arifin
creator: Tien Zubaidah
creator: Muhamad Ratodi
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-28
publication date: 2025-11-28
doi: 10.36568/v23i4.136

Respiratory and Neurological Health Effects of Chromium and PM Exposure among Troso Woven Fabric Workers: A Cross Sectional Study in Jepara
type: item
description: The Troso weaving industry in Jepara, Indonesia, is a traditional craft sector that relies on synthetic dyes and manual production, thereby exposing workers to chromium (Cr) and particulate matter (PM2.5 and PM10) with potential respiratory and neurological risks. This study aimed to analyze their association with respiratory and neurological disorders among workers. A cross-sectional design was applied involving 101 weaving workers from four production sites. Environmental sampling measured Cr concentrations in wastewater and PM2.5/PM10 in the ambient air, while worker characteristics and health complaints were assessed using the ECSC-87 and Q18 questionnaire. Data were analyzed using chi-square tests and odds ratios. Cr concentrations in wastewater ranged from <0.010 to 0.104 mg/L, remaining below the effluent quality standard of 1.0 mg/L but confirming the continuous use of chromium-based dyes discharged without treatment. Average PM2.5 and PM10 levels were 108.75 µg/m³ and 117.75 µg/m³, both exceeding national air quality standards (55 and 75 µg/m³). Bivariate analysis showed that respiratory disorders were significantly associated with exposure duration ≥40 hours/week (OR=7.333; p=0.0001) and working period >5 years (OR=20.935; p=0.0001), whereas dye type, dyeing frequency, and PPE use were not significant. Neurological disorders were significantly associated with exposure duration (p=0.001), working period (p=0.001), type of dye (p=0.0001), frequency of dyeing (p=0.018), and PPE use (p=0.0001). Environmental monitoring confirmed elevated PM levels and chromium-based dye use, while statistical analysis showed that prolonged exposure and long working periods associated with respiratory disorders, and neurological disorders were linked to multiple occupational factors.
subject: Research Articles
  topic: section
subject: Weaving industry
  topic: keywords
subject: Chromium
  topic: keywords
subject: Respiratory disorders
  topic: keywords
subject: Neurological disorders
  topic: keywords
creator: Yusniar Hanani Darundiati
creator: Tri Joko
creator: Onny Setiani
creator: Mursid Raharjo
creator: Nurjazuli Nurjazuli
creator: Muhammad Auliya Rahman
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-14
publication date: 2025-11-14
starting page: 503
ending page: 511
doi: 10.36568/gelinkes.v23i4.371

Evaluation of Hospital Sustainability Initiatives in South-east Asia
type: item
description: The increasing growth of hospitals in South-east Asia has not been in line with awareness and commitment to sustainability in healthcare facilities. Hospitals play an important role in maintaining public health and contributing to environmental sustainability. However, due to the region's vulnerability to the impacts of climate change, hospitals in South-east Asia have not yet fully transformed into green healthy hospital. This study compares the sustainability of each hospital in South-east Asia that is a member of the Global Green Healthy Hospital (GGHH) based on ten sustainability agendas. This study employs secondary data analysis sourced from the official GGHH website and utilises descriptive quantitative design techniques that include frequency and percentage calculations. The highest percentage of sustainability agenda implementation in the South-east Asia region is waste (72.3%), energy (63.49%), and leadership (52.48%). The lowest percentages are transportation (16.77%), pharmacy (24.92%), and chemicals (31.20%). Hospitals in South-east Asia show a low level of awareness about the implementation of green and healthy hospital practices. Only two countries, the Philippines and Indonesia, have healthcare facilities capable of implementing ten sustainability agendas.
subject: Research Articles
  topic: section
subject: South-east Asia
  topic: keywords
subject: Green Hospital
  topic: keywords
subject: Sustainability
  topic: keywords
creator: Ari Nurfikri
creator: Rachmadhi Purwana
creator: Tri Edhi Budhi Soesilo
creator: Deni Danial Kesa
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-14
publication date: 2025-11-14
starting page: 523
ending page: 532
doi: 10.36568/gelinkes.v23i4.372

Mothers’ Knowledge and Skills as Key Factors in Preventing Stunting in Toddlers: A Case Study in Malingping, Banten
type: item
description: Stunting in children under five years of age remains a serious public health problem in Indonesia because it affects physical growth, cognitive development, and long-term productivity. This study aims to analyse mothers' knowledge and skills in preventing stunting and the relationship between sociodemographic characteristics and these two aspects in the working area of the Malingping Community Health Centre, Banten. The study used a descriptive-analytical survey design with a cross-sectional approach involving 80 mothers of toddlers selected through purposive sampling. Data were collected using a structured questionnaire and analysed univariately and bivariately using the Chi-square test. The results showed that most mothers did not know the definition of stunting (81.3%), its causes (86.3%), signs (83.8%), or how to prevent it (88.8%). Mothers' skills in prevention were also low, with 78.8% unable to prepare a balanced complementary feeding menu, 73.7% lacking hygiene when preparing food, and 81.2% rarely monitoring their children's growth. Bivariate analysis showed no significant relationship between education and knowledge (p = 0.721), but there was a significant relationship between education and skills (p = 0.039). This study concludes that although mothers' knowledge about stunting is still low, practical skills are more influenced by education level. These findings emphasise the importance of educational interventions that not only increase knowledge but also build mothers' practical skills through community-based approaches and support from health cadres.
subject: Research Articles
  topic: section
subject: Stunting
  topic: keywords
subject: Mothers' knowledge
  topic: keywords
subject: Mothers' skills
  topic: keywords
subject: Toddlers
  topic: keywords
creator: Yayah Rokayah
creator: Kadar Kuswandi
creator: Yaneu Nuraeneu
creator: Nintinjri Husnida
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-20
publication date: 2025-11-20
starting page: 533
ending page: 539
doi: 10.36568/gelinkes.v23i4.365

Association Between Community-Based Total Sanitation (CLTS) Pillars and Diarrhea Incidence in Wetland Communities of South Indralaya
type: item
description: Diarrhea remains a major global health problem and a leading cause of mortality among children under five, often exacerbated by inadequate sanitation and limited access to clean water. Community-Led Total Sanitation (CLTS) represents a national strategy for preventing environment-based diseases, including diarrhea. However, researchers have not comprehensively studied the effectiveness of each CLTS pillar within specific geographical contexts, such as wetland areas. This study aims to identify the relationship between sanitation factors of Community-Led Total Sanitation (CLTS) pillars and diarrhea incidence in the South Indralaya wetland community. This quantitative research employed a cross-sectional design and selected 100 respondents using a purposive sampling technique. Data were collected through questionnaires and analyzed using chi-square test for bivariate analysis and logistic regression for multivariate analysis. Our results indicated a diarrhea prevalence of 45% among total respondents. Multivariate analysis revealed that two CLTS pillars significantly associated with diarrhea incidence. Pillar 1, concerning latrine availability, showed that households without latrines had a 3.4 times higher risk of experiencing diarrhea (OR = 3.400; 95% CI: 1.037–11.155). Pillar 4, regarding unsafe waste management, also served as a strong predictor, increasing diarrhea likelihood up to 3.296 times (P-value = 0.008; Exp(B) = 3.296; 95% CI: 1.359–7.996). We found that latrine type (P = 0.053) acted as a confounder, which influenced the risk estimation of the main variables in the model. This study concludes that CLTS pillars 1 and 4, related to feces and solid waste management, are key determinants of diarrhea incidence in South Indralaya. Interventions focusing on improving access to and quality of latrines, as well as safe waste management practices, are crucial for reducing diarrhea incidence in the region.
subject: Research Articles
  topic: section
subject: Diarrhea
  topic: keywords
subject: Sanitation
  topic: keywords
subject: Latrine
  topic: keywords
subject: Waste Management
  topic: keywords
creator: Inoy Trisnaini
creator: Widya Ayu Pratiningsih
creator: Dini Arista Putri
creator: Annisa Juniarni
creator: Dwita Febriana
creator: Hanifaus Safana
creator: Amirarosa Firdaus
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-14
publication date: 2025-11-14
starting page: 512
ending page: 522
doi: 10.36568/gelinkes.v23i4.363

Biodigesters for Wastewater Treatment and Biogas Generation in Poultry Slaughterhouses
type: item
description: This study evaluates the integration of a biodigester reactor into the wastewater treatment system at a poultry slaughterhouse to improve effluent quality and produce biogas as an alternative energy source. Wastewater samples were collected before and after biodigester treatment, and the parameters analyzed included Chemical Oxygen Demand (COD), Biological Oxygen Demand (BOD), Total Suspended Solids (TSS), oil and grease, and pH stability. Biogas production was also monitored daily. The results showed significant reductions in COD (from 350 mg/L to 148 mg/L), BOD (from 225 mg/L to 82.4 mg/L), and TSS (from 180 mg/L to 32 mg/L), with average decreases of 57.83%, 63.38%, and 82.1%, respectively. Oil and grease levels decreased by 89.5%, although this reduction did not reach statistical significance (p=0,197). The pH values remained stable within the range of 6.0 to 9.0, supporting optimal microbial activity. Biogas production averaged 7.48 m³/hour in the morning and 6.70 m³/hour in the afternoon, demonstrating the biodigester’s capacity to generate renewable energy. The findings confirm that integrating a biodigester enhances organic pollutant removal efficiency, reduces reliance on fossil fuels, and minimizes wastewater pollution, offering both economic and environmental benefits. However, further optimization is needed to effectively reduce oil and grease concentrations. This study highlights the potential of biodigester technology as a sustainable solution for managing poultry slaughterhouse wastewater, contributing to environmental protection and energy recovery
subject: Research Articles
  topic: section
subject: Biodigester
  topic: keywords
subject: Poultry slaughterhouse
  topic: keywords
subject: Wastewater Treatment
  topic: keywords
subject: Biogas
  topic: keywords
subject: Pollutant Removal
  topic: keywords
creator: Bambang Suwerda
creator: Narto Narto
creator: Ibnu Rois
creator: Aliya Nugrafitra Murti
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-10-31
publication date: 2025-10-31
starting page: 488
ending page: 496
doi: 10.36568/gelinkes.v23i4.355

The Role of PPAR in Liver Cirrhosis: An Update Review
type: item
description: Liver cirrhosis is the final stage of various chronic liver diseases characterized by fibrosis and nodule formation in the liver. The pathophysiology of liver cirrhosis involves a complex process, in which the role of peroxisome proliferator-activated receptors (PPAR) is very important. PPARα, which is mainly expressed in the liver, plays an important role in the regulation of hepatic lipid metabolism. In cirrhosis, PPARα expression is decreased, resulting in impaired fatty acid oxidation and increased lipogenesis. This contributes to the accumulation of fat in the liver, which is one of the characteristics of NAFLD that can progress to cirrhosis. PPARγ, although better known for its role in adipose tissue, also has important functions in the liver. In cirrhosis, PPARγ plays a role in inhibiting the activation and proliferation of HSCs, and modulating macrophage polarization. PPARγ activation can reduce liver inflammation and fibrosis, and increase insulin sensitivity. Recent studies have shown that PPARγ agonists can improve steatosis, reduce inflammation, and significantly improve the response to hepatitis viruses. PPARδ, which is widely expressed in various tissues including the liver, plays a role in lipid metabolism and liver inflammation. Moreover PPARs role in viral hepatitis induced liver chirrosis is still remain controversial. Although research on PPARδ in the context of liver cirrhosis is still limited, several studies have shown its potential anti-fibrotic effects. Thus, a deeper understanding of the role of PPARs in the pathophysiology of liver cirrhosis opens up new opportunities for the development of more effective therapies to treat this chronic liver disease.
subject: Review Article
  topic: section
subject: PPAR
  topic: keywords
subject: Liver Cirrhosis
  topic: keywords
subject: Hepatitis
  topic: keywords
creator: Mentari Maratus Sholihah
creator: Triyanta Yuli Pramana
creator: Muhammad Ifham Hanif
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-09-01
publication date: 2025-09-01
starting page: 468
ending page: 480
doi: 10.36568/gelinkes.v23i3.346

A Analysis of Land Use on Water Quality in Merjosari Village, Lowokwaru Subdistrict, Malang City
type: item
description: Malang City faces several environmental challenges, including inadequate sanitation and water management, which have not been fully addressed across all aspects of life. This is not in line with the Sustainable Development Goals, which aim to ensure the availability and sustainable management of clean water and sanitation for all people. Malang City is also experiencing increasingly massive land use changes, from green open land to housing, which can impact clean water quality. This study aims to assess the quality of clean water from the non-Local Water Supply Utility in Merjosari Village, Lowokwaru Subdistrict, Malang City, which is undergoing land-use transformation. A quantitative observational approach was employed using the National Sanitation Foundation's Water Quality Index (NSF-WQI) method, which evaluates water quality based on physical, chemical, and biological parameters. The results showed that the water quality index in Merjosari Village, Lowokwaru District, Malang City, analyzed using the NSP-WQI method, has a value of 77.53 and falls within the good criteria. However, several parameter values exceed the clean water standard. The average value of the DO parameter, at 5.85 mg/,L is less than the quality standard of 6 mg/L. The average value of the BOD parameter, at 8.12 mg/,L exceeds the quality standard of 2 mg/L. The pH parameter at several sample points exceeds the quality standard of above 8.5, and the Nitrate Parameter at several sample points exceeds the quality standard of 20 mg/L. In conclusion, the land cover change in the Merjosari area, Lowokwaru District, Malang City, does not significantly affect the quality of clean water. However, the values of several water parameters exceed the clean water standard, which has the potential to impact public health negatively.
subject: Research Articles
  topic: section
subject: Water quality
  topic: keywords
subject: Land use change
  topic: keywords
subject: National Sanitation Foundation's-Water Quality Index
  topic: keywords
creator: Maharani Pertiwi K
creator: Muhammad Reza Anshary
creator: Hartati Kartikaningsih
creator: Rizki Fadila
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-20
publication date: 2025-11-20
starting page: 540
ending page: 548
doi: 10.36568/gelinkes.v23i4.343

The Relationship of Water and Sanitation with the Incidence of Stunting: A Bibliometric Analysis
type: item
description: This research analyzes trends in studies regarding the relationship between water, sanitation, and stunting in children under five through bibliometric analysis. Water, sanitation, and hygiene (WASH) interventions are recognized as critical factors in addressing childhood stunting, yet the research landscape remains fragmented across disciplines. A total of 130 publications from the Scopus database covering 2010-2024 were analyzed using VOSViewer software. Co-occurrence analysis, co-authorship analysis, and citation analysis were performed to identify research patterns, collaboration networks, and knowledge clusters. The results reveal that medical sciences dominate the field (34.6%), followed by nursing (15.4%) and environmental sciences (13.8%), with research articles comprising 77.2% of publications. The United States leads in publication output with 35 documents, while Johns Hopkins Bloomberg School of Public Health emerges as the most prolific institution with 8 publications. Publication trends show significant growth from 2010 to 2020, peaking at 23 publications in 2020. International collaboration analysis demonstrates strong cooperation networks, particularly between the United States and the United Kingdom. Keyword co-occurrence analysis identified three distinct clusters: Cluster 1 focusing on growth disorders and child development, Cluster 2 emphasizing stunting epidemiology and risk factors, and Cluster 3 addressing WASH interventions and pathogen exposure. The research landscape reveals disciplinary fragmentation that may explain contradictory findings and limited intervention effectiveness. Enhanced interdisciplinary collaboration and integration of clinical, epidemiological, and intervention perspectives are essential for developing comprehensive stunting prevention strategies, particularly in low- and middle-income countries.
subject: Review Article
  topic: section
subject: Stunting
  topic: keywords
subject: Water
  topic: keywords
subject: Sanitation
  topic: keywords
subject: Toddlers
  topic: keywords
subject: Bibliometric Analysis
  topic: keywords
creator: Elsa Yuniarti
creator: Nabila Azzahra
creator: Fitra Arya Dwi Nugraha
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2026-01-02
publication date: 2026-01-02
starting page: 605
ending page: 613
doi: 10.36568/gelinkes.v24i1.341

Effect of Turmeric Ethanol Extract (Curcuma Longa Linn.) on Tumor Necrosis Factor alpha (TNFα) and the extent of wound lesions (Experimental Study on Wistar Rats Exposed to UVB Rays)
type: item
description: Continuous exposure to ultraviolet B (UVB) radiation can induce photoaging and accelerate premature skin aging. Turmeric (Curcuma longa) is a medicinal plant that contains curcumin, an active compound known for its anti-inflammatory properties and its role in accelerating wound healing. This study aimed to evaluate the effect of turmeric ethanol extract on TNF-α levels and wound lesion areas in Wistar rats exposed to UVB radiation. A post-test-only control group design was employed, involving 24 Wistar rats divided into four groups: a healthy control group (K1), a negative control group (K2), and two treatment groups receiving oral turmeric ethanol extract at doses of 100 mg/kg BW (K3) and 200 mg/kg BW (K4) for 14 days, with concurrent UVB exposure. TNF-α levels were assessed using one-way ANOVA followed by Tukey's post hoc test, while wound lesion areas were analyzed using the Kruskal–Wallis test followed by the Mann–Whitney U test. The results showed that the highest TNF-α levels were observed in the healthy control group (129.14 ng/L), although no statistically significant differences were found between groups (p = 0.538). In contrast, a significant difference was observed in wound lesion areas (p < 0.001), with the largest lesions occurring in the negative control group. In conclusion, oral administration of turmeric ethanol extract did not significantly affect TNF-α levels but was effective in reducing the area of wound lesions caused by UVB exposure.
subject: Research Articles
  topic: section
subject: Anti-inflammatory
  topic: keywords
subject: TNF-α
  topic: keywords
subject: Turmeric
  topic: keywords
subject: UVB
  topic: keywords
subject: Wound
  topic: keywords
creator: Denasa Dwi Sopandita Rahim
creator: Titiek Sumarawati
creator: Chodidjah
creator: Siti Thomas Zulaikhah
creator: Sri Priyantini
creator: Setyo Trisnadi
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 427
ending page: 431
doi: 10.36568/gelinkes.v23i3.331

Effect of Turmeric Ethanol Extract (Curcuma Longa Linn) on IL-6, IL-10 Levels and Skin Moisture
type: item
description: Ultraviolet B (UVB) radiation is known to induce skin damage, including erythema, roughness, sagging, wrinkles, and reduced skin moisture, contributing to premature aging. Turmeric (Curcuma longa Linn.) contains curcumin, an active compound with potent anti-inflammatory properties. This study investigated the effect of turmeric ethanol extract on IL-6 and IL-10 levels, as well as skin moisture, in UVB-exposed rats. A total of 24 Wistar rats were randomly divided into four groups: healthy controls (K1), UVB-exposed without treatment (K2), UVB-exposed treated with turmeric ethanol extract at 100 mg/kg BW (K3), and 200 mg/kg BW (K4). The extract was administered orally for 14 days. IL-6 and IL-10 levels were measured using ELISA, and skin moisture was assessed macroscopically. Statistical analysis was performed using one-way ANOVA. Rats in groups K2, K3, and K4 exhibited very dry skin, redness, visible wrinkles, and peeling following UVB exposure. IL-6 levels were significantly lower in treated groups, with the lowest levels observed in K4 (1.85 ± 0.24 ng/L), compared to K1 (4.36 ± 0.75 ng/L) and K2 (4.46 ± 0.74 ng/L) (p = 0.000). IL-10 levels increased in the treated groups, notably in K3 (376.48 ± 78.24 pg/mL) and K4 (351.06 ± 78.24 pg/mL), compared to K1 (285.34 ± 45.54 pg/mL) and K2 (306.89 ± 45.54 pg/mL) (p = 0.001). These findings suggest that oral administration of turmeric ethanol extract modulates inflammatory responses by reducing IL-6 and enhancing IL-10 in UVB-exposed skin, although significant dryness persists.
subject: Research Articles
  topic: section
subject: Turmeric Ethanol Extract
  topic: keywords
subject: IL-6
  topic: keywords
subject: IL-10
  topic: keywords
subject: UVB
  topic: keywords
subject: Skin Moisture
  topic: keywords
creator: Gilda Putri Anggraeni
creator: Titiek Sumarawati
creator: Chodidjah
creator: Joko Wahyu Wibowo
creator: Siti Thomas Zulaikah
creator: Setyo Trisnadi
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 421
ending page: 426
doi: 10.36568/gelinkes.v23i3.330

Holistic Approach: Emotional Touch Intervention (Kissing and Hugging) and Macronutrient Nutrition in Stunting Prevention in Early Childhood)
type: item
description: Stunting can lead to complications such as decreased intelligence and impaired growth, which may further deteriorate development into adulthood. This study aimed to examine the effectiveness of maternal kissing, hugging, and macronutrient intake in the prevention of stunting. A randomized clinical trial was conducted involving 170 mothers with toddlers aged 6 to 60 months who were at risk of stunting in 2024. Participants were randomly assigned to intervention and control groups. In both groups, parenting behaviors involving maternal hugging and kissing were measured using a structured questionnaire, while macronutrient intake, particularly protein-rich intake, was assessed using microtoise and length boards. The results showed a significant improvement in the intervention group compared to the control group (p < 0.001). The incidence of stunting was significantly lower in the intervention group than in the control group (p < 0.001). Additionally, the effectiveness of the Emotional Touch Intervention (Kissing and Hugging) and Macronutrient Nutrition (a local playful interaction technique) was statistically significant with a p-value of 0.000 (< 0.05). These findings indicate that maternal kissing, hugging, and adequate macronutrient intake are beneficial strategies in stunting prevention among toddlers. This study contributes to health innovations by promoting a combined approach of affectionate parenting and nutritional support to enhance toddler health and well-being.
subject: Research Articles
  topic: section
subject: Hug
  topic: keywords
subject: Kiss
  topic: keywords
subject: Macronutrient Intake
  topic: keywords
subject: Stunting
  topic: keywords
subject: Toddler
  topic: keywords
creator: Enny Fitriahadi
creator: Menik Sri Daryanti
creator: Rosmita Nuzuliana
creator: Mufdlilahi
creator: Yekti Satriyandari
creator: Thuy Hong Nguyen
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-11-14
publication date: 2025-11-14
starting page: 497
ending page: 502
doi: 10.36568/gelinkes.v23i4.326

Case Study: Physiotherapy Program in Down Syndrome Patients with Neuro Development Treatment Intervention at Dustira Hospital
type: item
description: Down Syndrome is a genetic disorder in which there is an extra chromosome on chromosome 21. This extra chromosome results in excessive amounts of certain proteins, which can interfere with the body's normal growth and cause changes in brain development. This case study report aims to determine the effect of physiotherapy intervention with Neuro Developmental Treatment (NDT) on improving motor skills in Down Syndrome children. This case study report was carried out in the children's growth and development clinic at the hospital Dustira Cimahi on January 15, 2024 to February 1, 2024. The intervention used is Neuro Development Treatment through a stimulation and facilitation approach. The results of the Early Growth and Development Detection examination from T1 to T6 showed increased developmental achievements in aspects of fine motor skills, observation and speech. The evaluation results of the Gross Motor Functional Measurement examination showed a total score at T1: 11% and T6: 18%, there was an increase in gross motor skills of 7%. Conclusion: Intervention using Neuro Development Treatment is a therapy that has been proven to be effective in improving the motor skills of Down Syndrome children
subject: Research Articles
  topic: section
subject: Down syndrome
  topic: keywords
subject: Gross motor functional measure
  topic: keywords
subject: Neuro developmet treatment
  topic: keywords
creator: Rizqy Dimas Monica
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-08-04
publication date: 2025-08-04
starting page: 460
ending page: 467
doi: 10.36568/gelinkes.v23i3.324

The Relationship Between Cigarette Smoke Exposure and Environmental Sanitation with The Incidence of Acute Respiratory Tract Infections in Toddlers
type: item
description: Acute Respiratory Infections (ARI) constitute infectious pathologies affecting superior or inferior respiratory pathways, capable of producing diverse clinical manifestations ranging from mild infectious processes to severe pathological conditions. Statistical records from the Malang City Health Department documented 56,000 ARI cases over 12 months in 2022, escalating to 43,000 cases within 6 months in 2023, demonstrating significant epidemiological increases. Documentation from TPMB Endang revealed that among 110 toddlers experiencing ARI, 37 originated from Gading Village, with the remaining cases from surrounding communities. Environmental assessment observations identified suboptimal residential hygiene conditions, sugar factory proximity, and prevalent family smoking behaviours. This investigation aimed to establish the relationship between cigarette smoke exposure and environmental sanitation with acute respiratory infection incidence among toddlers in Gading Village, Bululawang District. The research methodology employed quantitative approaches utilising analytical observational design with a cross-sectional framework. The study population encompassed all toddlers residing in Gading Village, totalling 55 individuals, with a sample of 35 toddlers selected according to predetermined inclusion criteria. Multiple linear regression analysis was implemented for data examination. Data analysis results demonstrate significant associations between cigarette smoke exposure and environmental sanitation with acute respiratory tract infection occurrence. This relationship is evidenced through regression variance analysis, specifically the Fh value of 145.846 > Ftable. Additionally, statistical significance is confirmed by the values of 3.178 (cigarette smoke exposure) > t table 1.690 and 2.567 (environmental sanitation) > t table 1.690. The study concludes that definitive relationships exist between cigarette smoke exposure and environmental sanitation with acute respirat…
subject: Research Articles
  topic: section
subject: Cigarette
  topic: keywords
subject: Environmental sanitation
  topic: keywords
subject: Respiratory infection
  topic: keywords
creator: Sayuti
creator: Qotimah
creator: Susana Setyowati
creator: Rokhamah
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 432
ending page: 437
doi: 10.36568/gelinkes.v23i3.321

Pulmonary Function Impairment Associated with PM2.5, CO, and CO₂ Exposure in Home-Based Chips Industry Workers in Indonesia: A Cross-Sectional Study
type: item
description: Wood remains a traditional fuel source for many rural communities, particularly for cooking purposes. The incomplete combustion of wood, combined with prolonged heating of cooking oil at high temperatures, can release harmful carbon compounds and carcinogenic particles, posing significant risks to respiratory health. The World Health Organization (WHO) reported in 2024 that approximately 3.2 million premature deaths annually are attributable to exposure to such pollutants. This study seeks to evaluate pulmonary function impairments among workers employed in chip home industries that predominantly utilize wood as a primary energy source. The research was conducted across two chip-producing home industries located in Senduro Subdistrict, Lumajang Regency. A total of 44 respondents participated through total sampling, where all workers underwent pulmonary function examinations. The average workplace temperature, particularly near cooking pans and wood-burning stoves, was recorded at 34,7 °C. Concentrations of PM2.5 reached 694,8 µg/m³, while CO and CO2 levels were measured at 6 ppm and 4,460 ppm, respectively. Based on the threshold limits established by the Indonesian Ministry of Health—25 µg/m³ for PM2.5, 25 ppm for CO, and 5,000 ppm for CO₂ (Regulation No. 70 of 2016), only PM 2.5 concentrations significantly exceeded the permissible exposure levels. Although most workers reported few respiratory complaints due to perceived adaptation, field assessments revealed that 79% experienced pulmonary function impairment, either restrictive or obstructive types. Statistical analysis revealed a significant association between pulmonary impairment and age (p=0.001) as well as duration of employment (p=0.001). It is therefore recommended that home industry owners improve workplace environments, particularly by optimizing chimney systems and stove combustion processes, to safeguard workers' respiratory health over the long term.
subject: Research Articles
  topic: section
subject: Lung function
  topic: keywords
subject: Air pollution
  topic: keywords
subject: Personal factors
  topic: keywords
creator: Brilian Monica Kautsar
creator: Sudarmaji
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 327
ending page: 332
doi: 10.36568/gelinkes.v23i3.318

Pesticide Spraying Practices and Hypertension Risk among farmers in Bumen Village, Indonesia
type: item
description: This study investigated the association between pesticide spraying practices and hypertension in horticultural farmers in Bumen Village, Sumowono District, Indonesia. A cross-sectional study was conducted among 132 male farmers selected through purposive sampling. Data were collected through structured interviews, blood pressure measurements, and field observations. Logistic regression revealed that mixing ≥2 pesticide types (OR=4.828; p=0.028), spraying ≥4 times per week (OR=4.552; p=0.010), and incomplete PPE use (OR=3.551; p=0.015) were significantly associated with hypertension. These findings underscore the need for stricter pesticide regulation, improved PPE use, and regular health monitoring to reduce health risks among farmers.
subject: Research Articles
  topic: section
subject: Hypertension
  topic: keywords
subject: Pesticide Exposure
  topic: keywords
subject: Occupational Health
  topic: keywords
subject: Personal Protective Equipment
  topic: keywords
subject: Horticultural Farmers
  topic: keywords
creator: Wulan Masyithah
creator: Onny Setiani
creator: Yusniar Hanani Darundiati
creator: Suhartono
creator: Mursid Raharjo
creator: Jamal Hisham Hasim
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 406
ending page: 411
doi: 10.36568/gelinkes.v23i3.317

Effectiveness of Banana Peel Ash, Zeolite and Clam Shells in Reducing Waterturbidity and Iron (Fe) Contentration
type: item
description: One method to reduce iron content and water turbidity is to use banana peel coagulants and zeolite and clam shell filtration. The biochemical components in banana peels are believed to be effective in reducing turbidity and heavy metals, while zeolites and clam shells function to reduce iron levels in water. This study aims to determine the effectiveness of kepok banana peel ash coagulant (Musa acuminate balbisiana C.) and zeolite and clam shell filtration in reducing turbidity and iron (Fe) content in river water in Punggur Kecil Village, Sungai Kakap District, Kubu Raya Regency. The research method used was a quasi-experiment with a one-group pretest-posttest design, taking river water samples in Punggur Kecil Village, as many as 27 samples from 9 repetitions. Data were analyzed descriptively with the paired sample t-test statistical test. The results of the analysis showed that river water treatment using banana peel ash coagulant and clam shell filtration and zeolite decreased the average iron (Fe) content from 2.21 mg/l to 0.25 mg/l, with an effectiveness of 88.18%, but there was no significant change. While the average decrease in turbidity levels was from 57.67 NTU to 17.6 NTU, with an effectiveness of 65.56%, the results were also not significant. The results of the paired t-test showed a significant difference before and after treatment in iron content with a value of 0.000 (p < 0.05) and turbidity content with a value of 0.003 (p < 0.05). The conclusion of this study shows a significant difference in iron (Fe) and turbidity levels, but this treatment method has not been effective in reducing the level of turbidity of river water. The conclusion of this study shows a significant difference in iron (Fe) and turbidity levels, but this treatment method has not been effective in reducing the level of turbidity of river water.
subject: Research Articles
  topic: section
subject: Banana peel ash
  topic: keywords
subject: Clam shell
  topic: keywords
subject: Zeolite
  topic: keywords
subject: Iron (Fe)
  topic: keywords
creator: Selviana Selviana
creator: Kamaran
creator: Linda Suwarni
creator: Suharno
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 357
ending page: 369
doi: 10.36568/gelinkes.v23i3.314

Effect of Crystalloid Preloading on Blood Pressure Stability in Cesarean Section Under Spinal Anesthesia: A Study at Regional General Hospital of Sekarwangi
type: item
description: Spinal anesthesia is a form of regional anesthesia administered by injecting a local anesthetic into the subarachnoid space and is commonly employed in cesarean section (C-section) procedures. One of its major side effects is hypotension, which, if not properly managed, can compromise uteroplacental perfusion and potentially result in fetal hypoxia, acidosis, and neonatal complications. Preoperative intravenous fluid administration is a preventive strategy aimed at stabilizing blood pressure by increasing central blood volume. This study aimed to examine the effect of preoperative fluid administration on blood pressure stability in C-section patients undergoing spinal anesthesia at the Regional General Hospital at Sekarwangi. A quantitative analytic approach with a pre-test and post-test design was employed. The study population consisted of 62 C-section patients who received spinal anesthesia within the last three months. Data were analyzed using the Paired Samples t-test. The results showed a statistically significant difference in blood pressure before and after fluid administration (p = 0.000 < 0.05), indicating that preoperative fluid administration had a significant effect on blood pressure stability. Future studies are recommended to employ research designs that better control for external variables and address the limitations of the present study.
subject: Research Articles
  topic: section
subject: Blood Pressure Stability
  topic: keywords
subject: Cesarean Section
  topic: keywords
subject: Preoperative Fluid Administration
  topic: keywords
subject: Spinal Anesthesia
  topic: keywords
creator: Irawan Danismaya
creator: Burhanuddin Basri
creator: Erna Safariyah
creator: Amir Hamzah
rights: Copyright (c) 2025 Gema Lingkungan Kesehatan https://creativecommons.org/licenses/by-sa/4.0
date: 2025-07-28
publication date: 2025-07-28
starting page: 344
ending page: 349
doi: 10.36568/gelinkes.v23i3.313