Journal of Preventive Medicine and Public Health

Original Articles

Effects of the Local Environment and Nutritional Status on the Incidence of Acute Respiratory Infections Among Children Under 5 Years Old in Indonesia: Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito; J Prev Med Public Health. 2024;57(5):461-470. Published online August 2, 2024; DOI: https://doi.org/10.3961/jpmph.24.246

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Abstract Summary PDF Supplementary Material

Objectives
This study aimed to map the incidence of acute respiratory infections (ARIs) among under-5 children in Indonesia, address the triple burden of malnutrition, and analyze the impact of malnutrition on ARIs, taking into account the environmental and wealth disparities in Indonesia.
Methods
This study utilized an ecological design, analyzing aggregate data from the Indonesia Nutrition Survey, 2022. It encompassed 33 provinces and 486 districts/cities, involving a total of 334 878 children under 5 years of age. Partial least squares structural equation modeling was employed to investigate the relationships among wealth, environment, malnutrition (stunting, wasting, and underweight), and ARIs.
Results
The proportion of ARI cases in Indonesia was generally concentrated in central Sumatra, the western and eastern parts of Java, and eastern Papua. In contrast, the northern part of Sumatra, central Kalimantan, central Sulawesi, and central Papua had a higher proportion of malnutrition cases compared to other regions. Negative associations were found between malnutrition and ARIs (path coefficient =-0.072; p<0.01) and between wealth and environment (path coefficient =-0.633; p<0.001), malnutrition (path coefficient=-0.399; p<0.001), and ARIs (path coefficient=-0.918; p<0.001).
Conclusions
An increasing wealth index is expected to contribute to reducing ARIs, malnutrition and environmental burdens in the future. This study emphasizes the necessity for focused strategies that address both immediate health challenges and the underlying socioeconomic determinants to improve child health outcomes in the Indonesian context.

Summary

Key Message
In Indonesia, Acute Respiratory Infections (ARI) cases were predominantly concentrated in central Sumatra, western and eastern Java, and eastern Papua, while malnutrition cases were more prevalent in northern Sumatra, central Kalimantan, central Sulawesi, and central Papua. A negative association was observed between malnutrition and ARIs. Additionally, wealth had significant negative associations with the environment, malnutrition, and ARIs, suggesting socio-environmental disparities contribute to health outcomes in these regions.

Citations

Citations to this article as recorded by

Multidimensional energy poverty and childhood respiratory health across 26 low and lower middle income countries
Cailiang Xia, Maryam Sadiq, Sidra Younas
Scientific Reports.2026;[Epub] CrossRef
Prevalence and risk factors of acute respiratory infection and diarrhea among children under 5 years old in low-middle wealth household, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Reiko Saito
Infectious Diseases of Poverty.2025;[Epub] CrossRef
Geographical variation in community-acquired pneumonia prevalence during the COVID-19 pandemic in northern Sumatra, Indonesia
Tri Bayu Purnama, Keita Wagatsuma, Masdalina Pane, Reiko Saito
Discover Public Health.2025;[Epub] CrossRef

Prescription of Systemic Steroids for Acute Respiratory Infections in Korean Outpatient Settings: Overall Patterns and Effects of the Prescription Appropriateness Evaluation Policy: Taejae Kim, Young Kyung Do; J Prev Med Public Health. 2020;53(2):82-88. Published online November 18, 2019; DOI: https://doi.org/10.3961/jpmph.19.090

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Abstract Summary PDF

Objectives
The objective of this study was to identify individual and institutional factors associated with the prescription of systemic steroids in patients with acute respiratory infections and to investigate the role of a policy measure aimed to reduce inappropriate prescriptions. Methods: We used data from the National Health Insurance Service-National Sample Cohort from 2006 to 2015 and focused on episodes of acute respiratory infection. Descriptive analysis and multiple logistic regression analysis were performed to identify individual-level and institution-level factors associated with the prescription of systemic steroids. In addition, steroid prescription rates were compared with antibiotic prescription rates to assess their serial trends in relation to Health Insurance Review and Assessment Service (HIRA) Prescription Appropriateness Evaluation policy. Results: Among a total of 9 460 552 episodes of respiratory infection, the steroid prescription rate was 6.8%. Defined daily doses/1000 persons/d of steroid increased gradually until 2009, but rose sharply since 2010. The steroid prescription rate was higher among ear, nose and throat specialties (13.0%) than other specialties, and in hospitals (8.0%) than in tertiary hospitals (3.0%) and other types of institutions. Following a prolonged reduction in the steroid prescription rate, this rate increased since the HIRA Prescription Appropriateness Evaluation dropped steroids from its list of evaluation items in 2009. Such a trend reversal was not observed for the prescription rate of antibiotics, which continue to be on the HIRA Prescription Appropriateness Evaluation list. Conclusions: Specialty and type of institution are important correlates of steroid prescriptions in cases of acute respiratory infection. Steroid prescriptions can also be influenced by policy measures, such as the HIRA Prescription Appropriateness Evaluation policy.

Summary

Korean summary
이 연구에서는 요양급여 청구자료를 기준으로 급성 상기도 감염에서 스테로이드를 처방하는 경우와 관련하여 다음과 같은 특징을 확인하였다. 첫째, 환자 특성과 기관 특성을 모두 고려하였을 때 진료과목과 기관의 종별 구분에서 감기 스테로이드 처방률은 상당한 변이를 보였다. 둘째, 약제급여적정성평가 항목에서 스테로이드가 제외된 직후 처방률이 시계열적으로 상승하였으며, 이는 처방 행태에 정책 요인이 중요한 영향을 미칠 수 있음을 뜻한다.

Citations

Citations to this article as recorded by

Assessment of systemic steroid use and its determinants among admitted patients at Debre Berhan University Hakim Gizawu Teaching Hospital
Abate Wondesen Tsige, Kalkidan Simegn, Dessale Abate Beyene, Kassahun Dires Ayenew, Yehualashet Teshome Wondmkun, Bedilu Linger Endalifer, Abyou Seyfu Ambaye, Samuel Berihun Dagnew, Siraye Genzeb Ayele
Scientific Reports.2024;[Epub] CrossRef
Measurement of Ambulatory Medication Errors in Children: A Scoping Review
Lisa Rickey, Katherine Auger, Maria T. Britto, Isabelle Rodgers, Shayna Field, Alayna Odom, Madison Lehr, Alexandria Cronin, Kathleen E. Walsh
Pediatrics.2023;[Epub] CrossRef
Trends and Patterns of Systemic Glucocorticoid Prescription in Primary Care Institutions in Southwest China, from 2018 to 2021
Xiaoyi Li, Zhen Zeng, Xingying Fan, Wenju Wang, Xiaobo Luo, Junli Yang, Yue Chang
Risk Management and Healthcare Policy.2023; Volume 16: 2849. CrossRef
Effects of monthly evaluations on the rates of irrational antimicrobial prescription in the outpatient and emergency departments at Ningbo No. 6 Hospital, Ningbo, China
Qiong Yang, Fangfang Yuan, Li Li, Jianfeng Jin, Junhong He
European Journal of Medical Research.2022;[Epub] CrossRef
Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China
Xiaobo Luo, Shitao Yu, Zhen Zeng, Xunrong Zhou, Yuxi Liu, Lei Wang, Jiaqi Hu, Yue Chang
Frontiers in Public Health.2022;[Epub] CrossRef
Effects of Antiviral Therapy and Glucocorticoid Therapy on Fever Duration in Pediatric Patients with Influenza
Ji Yoon Han, Eun Ae Yang, Jung-Woo Rhim, Seung Beom Han
Medicina.2021; 57(12): 1385. CrossRef

English Abstract

Factors Influencing Antibiotics Prescribing of Primary Health Physicians in Acute Upper Respiratory Infections.: Nam Soon Kim, Soong Nang Jang, Sun Mee Jang; J Prev Med Public Health. 2005;38(1):1-8.

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Abstract PDF: OBJECTIVES
To explore the factors influencing antibiotics prescription by primary health physicians for acute upper respiratory infections (URI). METHODS: We performed a survey of 370 primary health physicians randomly sampled in April, 2003. The questionnaire consisted of a prescription on the scenario of acute bronchitis case, along with opinions and reasons for prescribing antibiotics on URI. RESULTS: We found that 54.7% of the physicians prescribed antibiotics on the example case of acute bronchitis which is known as not needing antibiotics. Female physicians and ENT physicians had a greater tendency to prescribe antibiotics. The factors influencing antibiotics prescription on URI were the belief about the effectiveness of antibiotics, preference for their own experiences rather than clinical guidelines, perception of patients' expectations, and perception of competitive environment. The prescription of antibiotics in the example case was affected by how much they usually prescribe antibiotics (OR=2.400, 95% CI=1.470-3.917) and the physicians who thought that antibiotics were helpful for their income prescribed antibiotics more than others (OR=6.773, 95% CI=1.816-25.254). CONCLUSION: These findings demonstrated that the false belief on the effectiveness of antibiotics, patient's expectation of medication and fast relief of symptoms, and perception of competitive environment all affected the physicians' prescription of antibiotics on URI. It may help to find barriers to accommodate scientific evidence and clinical guidelines among physicians and to specify subgroups for education about appropriate prescription behaviors.; Summary

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