Journal of Asian-african Focus in Health

Influence of factors individual characteristics, health services, and medical treatment on the incidence of tuberculosis in HIV/AIDS patients

2026-08-31T08:18:59+00:00

This study aims to analyze the influence of individual characteristics, health services, and medical treatment on the incidence of tuberculosis in HIV/AIDS patients. This study uses associative research with a quantitative approach. The data used came from TB incidence services in HIV/AIDS patients from 2019 to 2022, with a sample of 500 patients selected using non-probability sampling techniques with purposive sampling methods. The variables studied included age, gender, marital status, place of residence, type of health facility, right to treatment class, treatment complications, and delay in ARV treatment. Data analysis was performed using logistic regression model. The results showed a significant effect of age, gender, marital status, residence, type of health facility, right to treatment class, treatment complications, and delayed ARV treatment on the incidence of tuberculosis in HIV/AIDS patients.

Literature Review: The Impact of Obesity on the Incidence of Osteoarthritis

2026-08-31T06:52:26+00:00

Osteoarthritis is a chronic degenerative joint disease that is one of the main causes of pain, activity limitations, and disability in adults and the elderly. Obesity is known to be an important risk factor that plays a role in the occurrence and progression of osteoarthritis through biomechanical and inflammatory mechanisms. The increasing prevalence of obesity in various countries makes the relationship between obesity and osteoarthritis a health problem that requires attention. The purpose of this study was to determine the relationship between obesity and the incidence of osteoarthritis based on the results of published studies. This study used a literature review method by examining scientific articles obtained from the PubMed, Google Scholar, ScienceDirect, SpringerLink, ProQuest, and ResearchGate databases. The selected articles were published between 2016–2026, available in Indonesian or English, and discussed the relationship between obesity and osteoarthritis. Analysis was conducted using a narrative approach and the PICOS framework on 10 articles that met the inclusion criteria. The results showed that all articles analyzed showed a relationship between obesity and osteoarthritis, especially knee osteoarthritis. Individuals with obesity have a higher risk of developing osteoarthritis than individuals of normal weight. The risk increases with increasing body mass index (BMI). In addition to increasing the mechanical load on joints, obesity also triggers chronic inflammation through the production of adipokines and proinflammatory cytokines that accelerate cartilage damage. Obesity is associated with increased pain, decreased physical function, decreased quality of life, and an increased risk of sarcopenia in osteoarthritis patients. Weight loss, physical exercise, and bariatric surgery have been shown to significantly improve symptoms and joint function. Obesity is an important risk factor associated with the occurrence and progression of osteoarthritis through biomechanical and inflammatory mechanisms. Weight control through a healthy lifestyle, regular physical activity, and weight loss interventions is an important strategy in the prevention and management of osteoarthritis.

The Efficacy of Intra-articular Hyaluronic Acid Injections in Patients with Knee Osteoarthritis and Concomitant Vitamin D Deficiency: Literature Review

2026-08-31T06:46:47+00:00

Knee osteoarthritis is a chronic degenerative joint disorder involving articular cartilage, subchondral bone, synovium, and periarticular structures. Intra-articular hyaluronic acid (IAHA) is widely used as a viscosupplementation therapy; however, its clinical effectiveness remains controversial with heterogeneous outcomes across studies. Vitamin D deficiency has been implicated in musculoskeletal dysfunction, inflammation, and oxidative stress, which may influence therapeutic response in osteoarthritis patients. This literature review aims to evaluate the effectiveness of intra-articular hyaluronic acid in patients with knee osteoarthritis and concomitant vitamin D deficiency or insufficiency based on recent evidence from 2021–2026. A systematic literature review was conducted using PubMed, PubMed Central, Google Scholar, ScienceDirect, Cochrane Library, BMJ, Frontiers, MDPI, and clinical guidelines. Eligible studies included randomized controlled trials, systematic reviews, meta-analyses, cohort studies, and consensus reports. Narrative synthesis was applied due to limited direct evidence evaluating combined IAHA and vitamin D intervention. Results of the study show that IAHA demonstrates small to moderate effects in reducing pain and improving functional outcomes in knee osteoarthritis, particularly in mild-to-moderate disease stages. However, pooled evidence suggests limited clinical superiority compared to placebo in several meta-analyses. Vitamin D deficiency is consistently associated with increased pain severity, reduced functional status, and lower quality of life. Emerging evidence indicates that vitamin D supplementation combined with IAHA may reduce synovial oxidative stress and improve clinical outcomes, although the evidence remains preliminary and non-conclusive. IAHA should not be recommended as a universal treatment for knee osteoarthritis. In patients with vitamin D deficiency or insufficiency, correction of vitamin D status may be considered as part of a multimodal approach and may enhance clinical response to IAHA. High-quality randomized controlled trials are required to confirm the synergistic effect.

The Role of the Gut–Brain Axis in Depression and Anxiety Disorders: A Systematic Literature Review

2026-08-31T06:56:05+00:00

Depression and anxiety disorders are among the most prevalent mental health conditions worldwide and have a substantial impact on individuals' quality of life. For decades, the pathogenesis of these disorders has primarily been attributed to neurotransmitter imbalances, hypothalamic–pituitary–adrenal (HPA) axis dysfunction, genetic factors, and alterations in neuroplasticity. However, emerging evidence has highlighted the significant role of the gut–brain axis in regulating brain function through bidirectional communication among the central nervous system, enteric nervous system, immune system, endocrine system, and gut microbiota. Disruption of gut microbial homeostasis (gut dysbiosis) has been associated with inflammation, altered neurotransmitter metabolism, and an increased risk of depression and anxiety. Objective of the research to analyze the role of the gut–brain axis in depression and anxiety disorders based on a systematic review of the scientific literature. This study employed a Systematic Literature Review (SLR) methodology. The findings indicate that depression and anxiety disorders are closely associated with alterations in gut microbiota composition, reduced abundance of short-chain fatty acid (SCFA)-producing bacteria, disrupted tryptophan metabolism, increased immune activation, and dysfunction of the HPA axis. The gut–brain axis operates through neuroimmunological, neuroendocrine, and metabolic pathways involving neurotransmitters, inflammatory cytokines, hormones, and microbiota-derived metabolites. Furthermore, numerous studies have demonstrated that microbiota-based interventions, including probiotics, prebiotics, synbiotics, and dietary modifications, have the potential to alleviate symptoms of depression and anxiety, although variations in dosage and intervention duration warrant further investigation. The gut–brain axis plays a crucial role in the pathogenesis of depression and anxiety disorders through complex interactions among the gut microbiota, immune system, endocrine system, and central nervous system. Microbiota-based interventions show promise as adjunctive therapeutic strategies; however, high-quality clinical studies are still needed to determine their optimal efficacy, dosage, and duration.

Accuracy of the Bi-Rads Classification on Ultrasonography in Predicting Malignancy of Breast Lesions Based on Histopathology: A Literature Review

2026-08-31T08:54:32+00:00

Breast cancer remains a major health concern, and early detection is essential for improving treatment outcomes. Ultrasonography combined with the Breast Imaging Reporting and Data System (BI-RADS) is widely used to assess breast lesions and estimate their risk of malignancy. This literature review aimed to analyze the accuracy of BI-RADS classification on breast ultrasonography in predicting malignancy based on histopathological examination as the gold standard. A narrative literature review was conducted using articles retrieved from PubMed/NCBI, Google Scholar, ScienceDirect, SpringerLink, the Cochrane Library, and other relevant scientific sources. Articles published within the last five years were selected based on predefined inclusion and exclusion criteria. A total of 20 relevant articles were included and narratively synthesized. The findings showed that BI-RADS ultrasonography generally demonstrated high sensitivity, ranging from 83% to 98.4%, whereas specificity varied from 25.0% to 93.8%. The likelihood of histopathologically confirmed malignancy increased progressively with higher BI-RADS categories. BI-RADS 3 was predominantly associated with benign lesions, BI-RADS 4 showed heterogeneous malignancy risks requiring subdivision into categories 4A, 4B, and 4C, and BI-RADS 5 was strongly associated with malignancy. Variations in diagnostic performance were influenced by the BI-RADS cutoff, lesion characteristics, breast density, operator experience, equipment quality, population characteristics, and study design. In conclusion, BI-RADS ultrasonography is an effective tool for breast lesion risk stratification, particularly because of its high sensitivity. However, it cannot replace histopathological examination, which remains necessary for definitive diagnosis, especially for BI-RADS 4 and 5 lesions.

The Risk of Passive Smoking on Respiratory Problems and the Incidence of Low Birth Weight (LBW) in Neonates: Literature Review

2026-08-31T08:29:06+00:00

Secondhand smoke during pregnancy is a major risk factor that can impair fetal growth and increase the incidence of respiratory disorders in newborns. Exposure occurs not only through inhalation of cigarette smoke in the air (secondhand smoke), but also through toxic residues attached to clothing, hair, skin, and surfaces belonging to smokers, known as thirdhand smoke. Exposure to harmful substances such as nicotine, carbon monoxide, tobacco-specific nitrosamines (TSNAs), and heavy metals can enter the pregnant woman’s body through inhalation, skin absorption, or indirect contact, thereby triggering impaired placental perfusion, fetal hypoxia, oxidative stress, and inflammation that contribute to fetal growth restriction, low birth weight (LBW), preterm birth, and developmental disorders of the fetal respiratory system. These conditions represent a global health issue as they increase neonatal morbidity and mortality and impact children’s long-term quality of life. This study aims to analyze the relationship between passive smoking exposure during pregnancy and the incidence of LBW and respiratory disorders in neonates based on recent literature. The method used was a narrative review, which involved examining various scientific articles obtained from the PubMed, ScienceDirect, and Google Scholar databases, as well as other indexed scientific journals. The literature search was conducted using keywords related to secondhand smoke, pregnancy, low birth weight, and neonatal respiratory disorders. The study findings indicate that secondhand smoke increases the risk of low birth weight, fetal growth restriction, and various neonatal respiratory disorders. Other contributing risk factors include household environmental conditions, maternal nutritional status, maternal age, body mass index, and exposure to air pollution such as PM2.5. Additionally, infants with low birth weight face a higher risk of developing respiratory distress syndrome, bronchopulmonary dysplasia, and long-term lung function impairment. Interventions such as cessation of tobacco exposure, health education, antenatal screening, and the implementation of smoke-free zones have proven to be effective preventive strategies. Secondhand smoke exposure during pregnancy is a multifactorial risk factor that contributes to low birth weight and respiratory disorders in newborns; therefore, a comprehensive preventive approach is needed to reduce its impact on the health of mothers and children.

Literature Review: The Influence of Socioeconomic Status and Nutritional Intake on Anemia in Pregnant Women

2026-08-31T09:00:58+00:00

Anemia in pregnancy remains a major public health problem, particularly in low- and middle-income countries, including Indonesia. This condition is influenced by multiple factors, especially socioeconomic status and nutritional intake, which may affect maternal hemoglobin levels and pregnancy outcomes. This study aimed to analyze the influence of socioeconomic status and nutritional intake on the incidence of anemia among pregnant women. A systematic literature review was conducted using the PICOS framework and PRISMA 2020 guidelines. Articles were searched through PubMed, Google Scholar, ScienceDirect, ResearchGate, ProQuest, and other scientific sources, with publication years ranging from 2020 to 2025. The inclusion criteria covered full-text peer-reviewed articles written in Indonesian or English, using cross-sectional, cohort, or case-control designs, and focusing on pregnant women and anemia-related socioeconomic or nutritional factors. From 1,250 initially identified articles, 15 studies met the eligibility criteria and were included in the final analysis. The review showed that low education, limited family income, informal employment, rural residence, poor access to health services, and inadequate antenatal care were associated with a higher risk of anemia in pregnancy. Nutritional factors, including insufficient intake of iron, protein, folic acid, vitamin B12, vitamin C, calcium, and low dietary diversity, were also strongly related to reduced hemoglobin levels. These findings indicate that anemia in pregnant women is influenced by the interaction between socioeconomic conditions and nutritional adequacy. Therefore, prevention strategies should integrate nutrition improvement, iron-folic acid supplementation, health education, socioeconomic support, and improved access to antenatal care.

Antibacterial Activity Test of Red Gedi Leaf Ethanol Extract (Abelmoschus manihot L. Medik) against Staphylococcus aureus Bacteria

2026-08-31T08:44:38+00:00

A critical threat to global public health is posed by antimicrobial resistance, with particular urgency highlighted by Methicillin-Resistant Staphylococcus aureus (MRSA), thereby necessitating the rapid discovery of alternative botanical antibacterial agents. Although traditional therapeutic applications in North Sulawesi have long utilized red gedi leaves (Abelmoschus manihot L. Medik), the corresponding antibacterial efficacy against S. aureus remains largely uncharacterized. In this investigation, the antibacterial capacity of an ethanolic extract derived from red gedi leaves was evaluated against S. aureus, and its minimum effective threshold was determined. Extraction was achieved via maceration in 96% ethanol, with subsequent disk diffusion assays conducted at concentrations of 3%, 5%, and 10%; meanwhile, tetracycline and 10% dimethyl sulfoxide were employed as positive and negative controls, respectively. The resulting zones of inhibition were subjected to statistical evaluation via a one-way analysis of variance (One-Way ANOVA) Moderate antibacterial suppression was elicited by all tested extract concentrations, with recorded zones of inhibition spanning , , and , respectively. Conversely, robust antibacterial susceptibility was demonstrated by tetracycline, yielding an inhibition zone of , whereas no inhibitory effects were registered by the negative control. No statistically significant variations in the zones of inhibition were exposed across the various extract concentrations by the One-Way ANOVA (, ), suggesting that an escalation in crude extract concentration did not yield a commensurate increase in antibacterial potency. Ultimately, moderate antibacterial efficacy against S. aureus is exhibited by the ethanolic extract of red gedi leaves, confirming its viability as a natural therapeutic candidate. Nonetheless, the identification of an optimal dosage remains to be established through broader concentration gradients and subsequent verification via Minimum Inhibitory Concentration (MIC) assays.