Background Many prognostic models of diabetic microvascular complications have been developed, but their performances still varies. Therefore, we conducted a systematic review and meta-analysis to summarise the performances of the existing models. Methods Prognostic models of diabetic microvascular complications were retrieved from PubMed and Scopus up to 31 December 2020. Studies were selected, if they developed or internally/externally validated models of any microvascular complication in type 2 diabetes (T2D). Results In total, 71 studies were eligible, of which 32, 30 and 18 studies initially developed prognostic model for diabetic retinopathy (DR), chronic kidney disease (CKD) and end stage renal disease (ESRD) with the number of derived equations of 84, 96 and 51, respectively. Most models were derived-phases, some were internal and external validations. Common predictors were age, sex, HbA1c, diabetic duration, SBP and BMI. Traditional statistical models (i.e. Cox and logit regression) were mostly applied, otherwise machine learning. In cohorts, the discriminative performance in derived-logit was pooled with C statistics of 0.82 (0.73‑0.92) for DR and 0.78 (0.74‑0.83) for CKD. Pooled Cox regression yielded 0.75 (0.74‑0.77), 0.78 (0.74‑0.82) and 0.87 (0.84‑0.89) for DR, CKD and ESRD, respectively. External validation performances were sufficiently pooled with 0.81 (0.78‑0.83), 0.75 (0.67‑0.84) and 0.87 (0.85‑0.88) for DR, CKD and ESRD, respectively. Conclusions Several prognostic models were developed, but less were externally validated. A few studies derived the models by using appropriate methods and were satisfactory reported. More external validations and impact analyses are required before applying these models in clinical practice. Systematic review registration PROSPERO CRD42018105287

ABSTRACT Small intestine infection caused by Giardia lamblia (giardiasis) occurs mostly in children living in developing country with poor sanitation. This study aims to determine the risk of giardiasis and personal hygiene conditions in pre-school students at KB-TK Al Amin Paciran Lamongan aged 2-6 years. Number of samples were 61 students, the dependent variable was the incidence of giardiasis, and independent variable was personal hygiene including nail hygiene, hand washing habit, footwear habit, and defecating habits. The result showed that 5 out of 61 students (8,2%) were infected with Giardia lamblia. All children (100%) with giardiasis had poor nail hygiene, footwear habit, and defecating habit. As many as 80% of students with giardiasis have poor handwashing habits. Students with poor footwear habit (OR=43,71; 95% CI 3,98-2046,9); open defecation habits (OR=13,33; 95% CI 1,40-628,05); poor nail hygiene (OR=12,31; 95% CI 1,29-580,49); poor hand washing habits (OR=5,73; 95% CI 0,5-290,96) had a greater risk of developing giardiasis. Supervision and healthy behavior are highly recommended, including using footwear when playing on the ground, defecating in the latrine, maintaining nail hygiene, and washing hands with soap before eating or after defecating. Keywords: Prevalence, giardiasis, personal hygiene, pre-school students   ABSTRAK Infeksi usus halus disebabkan oleh Giardia lamblia (giardiasis) banyak terjadi pada anak-anak yang tinggal di negara berkembang dengan tingkat sanitasi buruk. Penelitian ini bertujuan untuk mengetahui risiko terjadinya giardiasis dan kondisi hygiene perorangan pada murid PAUD  di KB-TK Al Amin Paciran Lamongan usia 2-6 tahun. Jumlah sampel adalah 61 murid, variabel dependen adalah kejadian giardiasis, dan variabel independen adalah hygiene perorangan meliputi kebersihan kuku, kebiasaan mencuci tangan, kebiasaan menggunakan alas kaki, dan kebiasaan buang air besar (BAB). Hasil penelitian menunjukkan bahwa 5 dari 61 murid (8,2%) terinfeksi Giardia lamblia. Seluruh murid (100%) dengan giardiasis mempunyai kebersihan kuku, kebiasaan menggunakan alas kaki dan kebiasaan BAB yang kurang baik. Sebanyak 80% murid dengan giardiasis mempunyai kebiasaan mencuci tangan yang kurang baik. Murid dengan kebiasaan menggunakan alas kaki kurang baik (OR=43,71; 95% CI 3,98–2046,9); kebiasaan BAB sembarangan (OR=13,33; 95% CI 1,40–628,05); kebersihan kuku kurang baik (OR=12,31; 95% CI 1,29-580,49); kebiasaan mencuci tangan yang kurang baik (OR=5,73; 95% CI 0,5–290,96) mempunyai risiko lebih besar terkena giardiasis. Pengawasan dan berperilaku hidup sehat sangat dianjurkan antara lain menggunakan alas kaki ketika bermain di tanah, membiasakan BAB di jamban, menjaga kebersihan kuku, dan mencuci tangan dengan sabun sebelum makan atau setelah buang air besar. Kata kunci: Prevalensi, giardiasis, hygiene perorangan, murid PAUD

Introduction: The Tuban Regency Health Profile in 2019 stated that the villages with ODF status had reached 64 villages (19.5%) out of 328 total villages, while the villages reported having implemented Community-Based Total Sanitation (CBTS) have reached 100%. The low ODF status achieved indicates that most people still defecate openly, which will increase health risks due to environmental pollution. This study aimed to determine the distribution map of diarrhea in toddlers in each district of Tuban Regency in 2019. Methods: This study was an observational research type supported by mapping through an application with a cross-sectional research design. This study was all districts in Tuban Regency. Data were obtained from secondary data, which were the Tuban Regency Health Profile in 2019. Results and Discussion: The percentage of latrine ownership was 71.15%, the open defecation was 70%, the percentage of children under five was not more than 14.69%, and cases of diarrhea among toddlers were relatively diverse in each district with the lowest number of cases was 0, and the highest number of cases was 841. Conclusion: Diarrhea in toddlers was commonly distributed in the Eastern and Southeastern Tuban Regency, directly adjacent to the Bengawan Solo River. There was a strong possibility that the occurrence of diarrhea was related to the water quality of Bengawan Solo River that was consumed for daily household activities.