Objective This study evaluates the community-based intervention of chronic disease management (CDM) through the Integrated Non-Communicable Diseases Health Post (Posbindu-NCD) conducted by a community of health workers (CHWs) in Indonesia's rural areas. Methods A cohort retrospective study evaluated 577 participants from Posbindu-NCD in 7 public health centers (PHCs) in 2019. Activities of intervention of CDM for Posbindu-NCD was included, identified risk factors to NCDs, and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month, the 6 months, and the 12th month. Results There were statistically significant differences for alcohol consumed and diabetes mellites (χ2 = 10.455; P = 0.001). There were significant differences on gender (χ2 = 3.963; P = 0.047), on ethnicity (χ2 = 19.873; P < 0.001), and hypertension. In addition, there were also significant differences on ethnicity (χ2 = 15.307; P < 0.001), vegetable consumption (χ2 = 4.435; P = 0.035), physical exercise (χ2 = 6.328; P = 0.012), and the current diseases of hypercholesterolemia of participants. Furthermore, the survival rate among patients who have overweight, abdominal overweight, hypertension, diabetes mellitus, and hypercholesterolemia increased among participants who regularly visited Posbindu-NCD compared with the non-regularly one. Conclusions The CDM program's community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia's rural areas. Therefore, this program can be further developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in participating in Posbindu-NCD activities in rural areas of Indonesia.

Background: Recurrent Clostridium difficile infection (RCDI) continues to increase in incidence and severity around the world. Fecal microbiota transplantation (FMT) is commonly used to treat RCDI in adults, but its efficacy and safety in the pediatric population are infrequently studied. Here, we performed a systematic review to evaluate the efficacy and safety of FMT for RCDI in children.Methods: Systematic literature search was performed using PubMed, Science Direct, Nature, Cochrane Library, and Springer to identify original studies in English language published from 2010-2020. The clinical resolution, bacterial resolution, and failure of therapy were calculated as indicators of efficacy of FMT. Adverse events were also calculated as indicators of FMT safety.Results: A total of 21 studies, with 498 pediatric patients were included in this review. There were 418/498 (84%) patients reported clinical and bacterial resolution. There were 67/498 (13%) patients who experienced FMT-related adverse events, with 97% of them had mild adverse event. There was one patient who reported FMT-related serious adverse events which were aspiration pneumonia and dehydration.Conclusion: We found evidence that supports the efficacy and safety of the use of FMT for treatment of recurrent C. difficile infection in children.

Malaria is still an essential epidemiological disease worldwide, including in Indonesia. Several approaches are performed to control the disease, as well as vaccine development. The Cysteine-rich interdomain region α of Plasmodium falciparum erythrocyte membrane protein 1 (CIDRα-PfEMP1) is a pivotal domain in the malaria pathogenesis make it a malaria vaccine candidate. The development of the malaria vaccine is performed using recombinant technology. Recombinant protein production is an important step. The study aimed to determine the optimized condition for CIDRα-PfEMP1 recombinant protein expression in Escherichia coli BL21(DE3) expression system. Serial IPTG concentrations from 0.05, 0.1, 0.3, and 0.5 mM and two different incubation periods of 4 h and 8 h were optimized. The recombinant protein expression was visualized in SDS-PAGE, measured using the Bradford protein assay, and calculated using software Image J. SDS-PAGE visualization showed a 27 kDa band expressed CIDRα-PfEMP1 recombinant protein. The optimized condition for CIDRα-PfEMP1 recombinant protein expression was at 0.03 mM IPTG concentration and 8 h incubation period.

Liver cancer, predominantly Hepatocellular Carcinoma (HCC), is a tumor that originates from hepatocytes and is clinically progressive. In Indonesia, according to the Ministry of Health in 2019, liver cancer is the second most common cancer in men, amounting to 12.4 per 100,000 population with an average death rate of 7.6 per 100,000 population. There are very few studies on HCC in RSD dr. Soebandi Jember. This study aims to determine the characteristics and factors that can be predictors of death in HCC patients. This study uses an observational analytic research type with a case-control research design. The data of this study used secondary data from the medical records of HCC patients at RSD dr. Soebandi Jember, as well as primary data in the form of telephone interviews. The results of this study with a total of 72 samples showed that there was a significant difference between liver cirrhosis and HCC patient mortality within 90 days (p = 0.005), and could be used as a predictor of HCC mortality (OR = 17.15; 95% CI = 1.532-192.017). Keywords: HCC, predictors of death, HCC mortality

Optimizing the role of the community in the Healthy Community Movement (HCM) through the facilitation of health cadres at the Integrated Development Post (IDP) of non-communicable diseases (NCDs) to become an effective solution of health promotion program using empowerment and partnerships in the community as a form of active participation in health. The purpose of this community service was to increase community empowerment and partnerships in overcoming NCDs problems through HCM to reduce hypertension in Glagahwero Village, Panti District, Jember Regency. The activities were carried out for 3 months (August - November 2020) in the form of education and health counseling about HCM and hypertension, anti-hypertensive exercise, hypertension diet, empowerment of family cooking in the management of family salt consumption, and IDP of NCDs. The fostered village service activities involved 70 target groups. The results were found that the community was able to do HCM to control blood pressure by doing anti-hypertensive exercises once a week, mothers were able to prepare a low-salt menu in their families, and IDP of NCDs activities were carried out once a month. The further impact was a decrease in mean systolic blood pressure (130.5 ± 22.5 mmHg Vs. 122.3 ± 18.3 mmHg; p = <0.001) and diastolic (81.83 ± 10.4 mmHg Vs. 79.4 ± 9.1 mmHg; p = 0.015), decreased body weight (60.6 ± 12.1 kg Vs. 59.7 ± 12 kg; p <0.001), and decreased abdominal circumference (88.5 ± 14.2 cm Vs 82.7 ± 14.1 cm; p <0.001) after 3 months of community service development. Thus, it can be concluded that the partnership and empowerment of the community in HCM is able to prevent PTM, so it is suggested that IDP of NCDs activities need to be carried out in a sustainable manner in the community.