International Journal of Social Health

Analysis of Risk Factors for Comorbidities in Tuberculosis Patients and Resistance Patterns of Mycobacterium tuberculosis at Gunung Jati Regional Hospital

Hany Fauziyyah, Mohamad Erwin Indrakusuma, Emallia Fitriani — Fri, 08 May 2026 00:00:00 +0000

Tuberculosis (TB) treatment is complicated by drug resistance (especially MDR-TB) and comorbidities like diabetes, HIV, hypertension, kidney disease, cancer, lung diseases, psychiatric conditions, and malnutrition, all of which worsen outcomes and increase resistance risk. The purpose of the research was to find out and analyze the risk factors for tuberculosis patient comorbidities and the resistance pattern of Mycobacterium tuberculosis at the Gunung Jati Regional Hospital. The observational research method was analyzed with a crosssectional approach with univariate analysis, bivariate analysis (fisher's exact test) and multivariate analysis with logistic regression test with the backward method using medical record data of tuberculosis patients from January-November 2024 at the Gunung Jati Regional Hospital. The results of the comorbid results showed that the most tuberculosis patients were malnourished 75 (32.9%). The results of the characteristics of the most types of resistance were two drug combinations, namely INH and RIF Resistant, as many as 33 (14.5%). The results of fisher's exact test showed a significant relationship between DM and (p-value<0.001;OR= 4.42, 95% CI= 1.95-9.98) HIV (p-value=0.0.00;OR=4.19, 95% CI=1.67-10.5), kidney disease (p-value= <0.001;OR=4.81, 95% CI= 2.21-10.4), other lung diseases (p-value=0.015;OR= 2.52, 95% CI= 1.17-5.44), chronic hepatitis (p-value=0.005;OR= 2.86, 95% CI= 1.33-6.13), psychiatric conditions (p-value 0.004;OR=2.94, 95% CI= 1.37-6.32) and malnutrition (p-value=<0.001;OR= 5.35, 95% CI= 2.43-11.8) with Mycobacterium tuberculosis resistance. Conclusions: There is a significant association between DM, HIV, kidney disease, other lung diseases, chronic hepatitis, psychiatric conditions and malnutrition with Mycobacterium tuberculosis resistance patterns

Implementation of Community-Based Health Policy and Governance: A Qualitative Study of Posyandu Institutions in Rural Indonesia

Fri, 29 May 2026 00:00:00 +0000

This study examines the implementation of community-based health policy and governance through Posyandu institutions in rural Indonesia. The research is motivated by the continuing challenges of unequal healthcare access, limited institutional capacity, and weak policy integration in rural areas despite the government’s decentralization efforts. The objective of this study is to analyze the implementation of Sragen Regent Regulation Number 48 of 2020 in strengthening Posyandu institutions, evaluate the effectiveness of policy implementation, identify factors influencing governance, and formulate a sustainable community-based health governance model. This research employed a qualitative case study approach conducted in three villages in Sragen Regency, Central Java. Data were collected through in-depth interviews, participatory observation, and document analysis involving village officials, Posyandu cadres, health workers, and community members. The findings reveal that Posyandu implementation remains highly dependent on social capital, local leadership, and community participation. Weak policy communication, limited resources, inadequate institutional integration, and the absence of technical operational guidelines were identified as major obstacles. Nevertheless, Posyandu continues to function adaptively through informal community-based mechanisms. The study concludes that community-based health governance in rural Indonesia operates through a hybrid governance model combining formal policy structures with bottom-up community participation, emphasizing the importance of institutional strengthening, collaborative governance, and sustainable community empowerment.

The Relationship Between the Level of Knowledge and Community Behavior Towards the Incident of Hypertension in Sumberngepoh Village, Lawang District, Malang Regency

Dwi Aprilawati, Adikara Pagan — Wed, 13 May 2026 00:00:00 +0000

Lifestyle is one of the primary factors contributing to hypertension. The World Health Organization (WHO) estimates that approximately 1.28 billion adults aged 30–79 years worldwide are affected by this condition, with the majority residing in developing countries. A preliminary survey conducted in Sumberngepoh Village, Lawang District, Malang Regency revealed that 17 out of 24 respondents were unaware of their hypertension status and had never had their blood pressure measured. Additionally, 5 respondents were identified as having uncontrolled hypertension, attributed to irregular blood pressure monitoring and non-compliance with antihypertensive medication. Given these findings, this study aimed to examine the relationship between knowledge level and community behavior toward hypertension incidence in Sumberngepoh Village, with the goal of raising public awareness about the serious complications associated with this disease. The study employed a cross-sectional design, conducted from October 26 to 31, 2025. Knowledge was assessed using the Hypertension Knowledge-Level Scale (HK-LS), while a structured questionnaire was used to evaluate community behavior regarding hypertension prevention. Statistical analysis using the Chi-square test revealed no significant relationship between knowledge level and hypertension incidence, with a p-value of 0.271 (p > 0.05). However, a significant relationship was found between behavioral level and hypertension incidence, with a p-value of 0.024 (p < 0.05). Furthermore, Spearman correlation analysis indicated no significant association between knowledge level and hypertension prevention behavior, yielding a p-value of 0.392 (p > 0.05). These findings suggest that behavior plays a more influential role than knowledge alone in determining hypertension outcomes within this community.

Positive Academic Emotions and Academic Performance: A Structural Model Examining Resilience as a Mediator

Rika Dwi Agustiningsih, Saffana Nurfasyahaq Sondjaja, Raiza Fathia Azzahra — Fri, 29 May 2026 00:00:00 +0000

This study examines the relationship between positive academic emotions, resilience, and academic performance among vocational high school students. The background of this research is based on the increasing academic pressure experienced by twelfth-grade vocational students who are required to complete academic responsibilities while preparing for future careers or higher education. Positive academic emotions and resilience are considered important psychological factors that may influence students’ academic achievement. Therefore, this study aims to analyze the effect of positive academic emotions on academic performance and to investigate the mediating role of resilience. This research employed a quantitative approach using a cross-sectional design. Data were collected from 119 vocational high school students in Bandung through questionnaires distributed directly in classrooms. The data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS software. The analysis included validity, reliability, and structural model testing. The findings revealed that positive academic emotions significantly and positively affect academic performance. Positive academic emotions also showed a strong positive effect on resilience, while resilience significantly influenced academic performance. Furthermore, resilience was confirmed as a partial mediating variable in the relationship between positive academic emotions and academic performance. These results indicate that students with stronger positive emotions and resilience tend to achieve better academic outcomes. In conclusion, positive academic emotions and resilience play important roles in improving students’ academic performance. Educational institutions are encouraged to develop supportive learning environments that foster positive emotions and strengthen resilience among students.

Efficacy and Safety of Ixekizumab in Patients with Moderate-to-Severe Plaque Psoriasis: A Systematic Review and Meta-Analysis

Ni Luh Dina Resmi Setiari, Anak Agung Sagung Putra Dewi — Mon, 18 May 2026 00:00:00 +0000

Plaque psoriasis is a chronic inflammatory skin disease affecting approximately 1% of adults worldwide. However, studies of Ixekizumab have shown mixed results. To evaluate the effectiveness and safety of Ixekizumab in patients with moderate to severe plaque psoriasis. This systematic review followed the PRISMA 2020 guidelines and was conducted on PubMed, ScienceDirect, and Google Scholar. Primary outcomes included PASI 75, PASI 90, PASI 100, and treatment-related adverse events. Secondary outcomes included sPGA (0/1), sPGA (0), DLQI (0/1), DLQI (0), NAPSI, and NRS itch score (?4). Proportions were used to convey the incidence of primary and secondary outcomes. Risk of bias was assessed using the RoB2 tool. Statistical analysis was performed using R version 4.4.2. This meta-analysis included 9 RCTs, with a low risk of bias in all studies. Analysis of PASI outcomes 75% shows the proportion of events of 81.1% (95% CI: 72.78%-87.32%; I2 = 85.5%). PASI 90% shows the proportion of events of 65.72% (95% CI: 49.87%- 78.70%; I2 = 95.4%) and PASI 100% of 38.98% (95% CI: 31.81%-46.65%; I² = 93.3%). Side effects caused by the intervention were 66.07% (95% CI: 58.23%–73.12%; I² = 88.9%). sPGA score ?1, DLQI ?1, NAPSI, NRS with a proportion of 71.15% (95% CI: 61.12%–79.47%), 59.68% (95% CI: 39.84%–76.79%), 28.44% (95% CI: 15.80%–45.71%), 47.91% (95% CI: 33.77%–62.40%). Ixekizumab demonstrated high efficacy in the treatment of moderate to severe plaque psoriasis, with adverse events occurring in more than half of participants consistently reported across studies.

The Effect of Acid Type and pH on The Moisture, Ash, and Protein Content of Protein Isolate from Kecipir Seeds (Psophocarpus Tetragonolobus L.)

Ni Putu Vida Indriani Putri, I Gusti Ayu Krisma Widya Saraswati, Zaskia Jihan — Fri, 29 May 2026 00:00:00 +0000

This research aimed to determine the effects of acid type and pH value on the chemical characteristics of winged bean (Psophocarpus tetragonolobus L.) protein isolate, particularly moisture content, ash content, and protein content, as well as to identify the best treatment in the protein precipitation process. The study employed a completely randomized design (CRD) with a factorial pattern consisting of two factors: acid type, namely acetic acid and hydrochloric acid, and precipitation pH values of 4.0, 4.5, and 5.0. Each treatment was replicated three times, resulting in 18 experimental units. The observed parameters included the moisture content, ash content, and protein content of the winged bean protein isolate. Data were analyzed using analysis of variance (ANOVA), followed by a significance test when the treatments showed significant effects. The results indicated that acid type and pH value significantly affected the characteristics of winged bean protein isolate. The best treatment was obtained using hydrochloric acid at pH 4.0, producing a protein isolate with 7.58% moisture content, 3.60% ash content, and 90.04% protein content. The findings suggest that the appropriate selection of acid type and pH adjustment during precipitation can improve the quality of winged bean protein isolate as a potential plant-based protein source for food product development.