E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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The Effect of Leunca Fruit (Solanum nigrum Linn) Infusion in Inhibiting the Increase of Serum Glutamate Pyruvate Transaminase Level in CCL4 Induced Hepatitis Wistar Rats
Get PDFBackground: Hepatitis may cause liver cell damage due to the oxidation processes and can be inhibited by antioxidant components. Antioxidant acts as hepatoprotector by slowing down the oxidation process. Leunca fruits (Solanum nigrum Linn) contain antioxidants such as vitamin C and flavonoid. This study aimed to explore the effect of Leunca fruit infusion to inhibit the increase of serum Glutamate Pyruvate Transaminase (SGPT) level in Wistar rats’ blood.Methods: This was an experimental study using male Wistar rats, conducted in the Animal Laboratory, Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Padjadjaran between September−October 2012. The Hepatitis rats model was induced with carbon tetrachloride (CCl4) in 10% paraffin intraperitoneally as much as 8 mL/kgBW on day 8th. A 3 mL of leunca fruit infusion was given with a concentration of 22.5 g, 45 g, and 90 g per 100 mL, respectively. On the 10th day, serum was taken and SGPT was examined. Only food and distilled water were given to the negative control group. The result was analyzed by using a Kruskal-Wallis non-parametric test, followed by Mann-Whitney post hoc.Results: There was a significant difference between the negative control and hepatitis positive control group (p=0.009), indicating that the induction was successful. The dose 90 g/100 mL leunca had a significant different in SGPT concentration (p=0.047), suggesting that leunca fruit infusion had a significant effect on reduced SGPT level.Conclusions: Leunca fruit infusion has a hepatoprotective effect by inhibiting the increase of the SGPT level in CCl4 induced rats. Studies on the leunca effectiveness in human hepatitis need further exploration
Vitamin D Deficiency Prevalence And Its Association with Bacterial Load Sputum in Newly Diagnosed TB Patients
Get PDFVitamin D plays a role in innate and adaptive immune functions, and its deficiency has become a risk factor for TB infection. This study aimed to describe the prevalence of vitamin D deficiency in newly diagnosed TB patients and to examine the relationship between vitamin D levels and sputum smear positivity that reflects bacterial load. This is a cross-sectional study conducted at several primary health care facilities in Medan and Deli Serdang from November 2015 to June 2016. As many as 86 subjects adult TB patients with positive smear sputum who had not received therapy or had at most 1 week on therapy were recruited. Sputum examination were interpreted using IUATLD (International Union Against Tuberculosis and Lung Disease) grading scale. Serum 25 (OH) vitamin D level was estimated using enzyme-linked immunosorbent assay (ELISA) and interpreted as deficiency (<20 ng/ml), insufficiency (20–29 ng/ml), or optimum (30–100 ng/ml). The association between vitamin D level and positivity level of AFB sputum was analyzed using Spearman correlation test. The prevalence of VDD in new pulmonary TB patients with positive smear sputum was 17.4%. There was a weak relationship between vitamin D level and positivity level of AFB sputum (p = 0.014), with a correlation coefficient of (-0.264). Many of newly diagnosed TB patients had vitamin D deficiency despite the fact that Indonesia is an equatorial area with sufficient sunshine throughout the year. This study shows vitamin D indeed affect bacterial load and a low 25 (OH) vitamin D level is associated with higher bacterial load. Prevalensi Defisiensi Vitamin D pada Pasien TB Paru Baru dan Hubungan dengan Derajat Kepositifan Sputum Basil Tahan AsamVitamin D berperan dalam imunitas bawaan dan adaptif. Kekurangan vitamin D merupakan faktor risiko terinfeksi TB. Penelitian ini bertujuan menggambarkan prevalensi defisiensi vitamin D pada pasien TB baru dan mengetahui hubungan kadar vitamin D dengan derajat kepositifan sputum yang mencerminkan kepadatan bakteri. Penelitian potong lintang ini dilakukan di beberapa Puskesmas di wilayah Medan dan Deli Serdang pada November 2015 hingga Juni 2016. Subjek penelitian sebanyak 86 pasien TB dewasa dengan sputum basil tahan asam (BTA) positif, yang belum atau maksimal 1 minggu mengkonsumsi obat. Pemeriksaan sputum dinilai menggunakan skala IUATLD. Kadar vitamin D serum 25 (OH) dinilai dengan metode ELISA dan diklasifikasikan menjadi defisiensi (<20 ng/mL), insuffisiensi (20–29 ng/mL), optimum (30–100 ng/mL). Hubungan kadar vitamin D dengan tingkat kepositifan sputum BTA dilakukan dengan uji korelasi Spearman. Prevalensi VDD pada pasien TB paru baru dengan sputum positif adalah 17,4%. Terdapat hubungan antara kadar vitamin D dan tingkat kepositifan sputum BTA (p=0,014), dengan koefisien korelasi (-0,264). Banyak pasien TB paru baru yang mengalami kekurangan vitamin D, meskipun Indonesia berada di khatulistiwa dengan kecukupan sinar matahari sepanjang tahun. Penelitian ini menunjukkan bahwa vitamin D berhubungan dengan kepositifan sputum dan kadar vitamin D yang rendah berhubungan dengan kepadatan bakteri yang lebih tinggi
Distribution of VDR Gene Polymorphisms Bsm-I rs1544410 and Apa-I rs7975232 among HIV/AIDS Patients from West Java
Get PDFVitamin D receptor, encoded by VDR gene, mediates vitamin D functions by not only regulating calcium metabolism and homeostasis but also in regulating immune response. Polymorphisms in VDR gene may increase the progression of human immunodeficiency virus (HIV) infection into acquired immunodeficiency syndrome (AIDS). This study aimed to explore the distribution of VDR polymorphisms among HIV sero-positive patients in West Java. A cross-sectional study was performed, recruiting 96 patients infected with HIV and VDR polymorphisms were analyzed. The genotype distributions of Bsm-I among HIV-infected patients were 2.2%, 18.5%, and 79.3% for BB, Bb, and bb, respectively whereas the distributions of Apa-I were 54.4%, 38.9%, and 6.7% for AA, Aa and aa, respectively. The frequency of VDR polymorphisms in Bsm-I among HIV-infected patients in West Java were considered high for b allele (88.6%), and in contrast for A allele in Apa-I that was 73.91%. Further studies involving healthy controls are needed to explore the VDR polymorphisms distribution in general population. Moreover, a cohort study, albeit challenging, is needed to further assess the association between VDR polymorphisms and the progression of HIV infection.Distribusi Polimorfisme gen VDR Bsm-I rs1544410 dan Apa-I rs7975232 pada Pasien HIV/AIDS di Jawa BaratReseptor vitamin D yang dikode oleh gen VDR mempunyai peranan penting terhadap fungsi vitamin D, tidak hanya dalam regulasi metabolisme dan keseimbangan kalsium namun juga berperan dalam meregulasi respon imun. Polimorfisme pada gen VDR ditengarai dapat meningkatkan progresivitas infeksi human immunodeficiency virus (HIV) menjadi acquired immunodeficiency syndrome (AIDS). Penelitian ini bertujuan mengetahui distribusi polimorfisme gen VDR pada pasien HIV di Jawa Barat. Penelitian ini melibatkan 96 pasien HIV dan dilakukan analisis polimorfisme gen VDR. Distribusi genotip Bsm-I pada pasien HIV di Jawa Barat adalah 2,2%, 18,5%, dan 79,3% untuk BB, Bb, dan bb, secara beurutan; sedangkan pada Apa-I adalah 54,4%, 38,9%, dan 6,7% untuk AA, Aa, dan aa. Frekuensi polimorfisme pada Bsm-I pada pasien HIV di Jawa Barat tergolong tinggi pada alel b (88,6%) dan berbanding terbalik pada dan Apa-I dengan alel A yaitu 73,91%. Penelitian lebih lanjut yang melibatkan individu kontrol diperlukan untuk mengetahui distribusi polimorfisme gen VDR pada populasi umum. Selain itu, studi kohort pada pasien HIV/AIDS diperlukan untuk menilai hubungan antara polimorfisme gen VDR terhadap progresivitas infeksi HIV
Implementation of Comprehensive Geriatric Assessment in Elderly-Friendly Public Health Centers and General Public Health Centers in Bandung
Get PDFBackground: Comprehensive Geriatric Assessment (CGA) is a comprehensive, multi-dimensional biopsychosocial examination. The CGA is conducted at the primary health facility such as the public health centers (Pusat Kesehatan Masyarakat, Puskesmas); categorized as Eldery-Friendly Public Health Centers (Puskesmas Santun Lansia), a puskesmas where one of its programs provides health care for the elderly, and Puskesmas in general, where there is no specific program for the elderly. The purpose of the study was to analyze the difference between Puskesmas santun lansia and Puskesmas in providing CGA.Methods: A comparative analytical study was carried out from August to November 2019, involving Puskesmas Santun Lansia (n=6) and puskesmas (n=12) in Bandung City. From each Puskesmas, two elderly were selected and observed for the CGA. The assessment consisted of the identity of the elderly, anamnesis, vital sign examination, physical examination, assessment of nutritional status, functional, psychosocial, social, cognitive, and mental assessment. The collected data were analyzed using the Chi-square or Fisher’s exact test.Results: This study showed that there was no difference between Puskesmas Santun Lansia and Puskesmas in the CGA, except in the simple nutritional anamnesis (p=0.003), anamnesis of the symptoms or signs of the dysfunction of the organ system (p=0.034), and body mass index measurement (p=0.009).Conclusions: The CGA is not well implemented in both Puskesmas. In the future, both of the Puskesmas should enhance their knowledge and skills to provide the CGA as mentioned in the regulation of the Minister of Health No. 67/2015.
Correlation between Proteinuria and Glomerular Filtration Rate in Type 2 Diabetes Mellitus
Get PDFIndonesia faces a double burden of communicable and non-communicable diseases, including metabolic and degenerative problems. Delay in the detection of diabetic nephropathy (DN) as one of the chronic microvascular complications is often seen, leading to the need for hemodialysis due to the end-stage renal disease (ESRD). An assessment of diabetes mellitus (DM) control target achievement, based on the guideline from the Indonesian Society of Endocrinology (Perkumpulan Endokrinologi Indonesia, PERKENI), and nephropathy early detection was performed in 54 Type-2 DM patients from 5 private hospitals in Pekanbaru Riau, Indonesia, from November 2018 to September 2019. Results showed poor achievement of DM control with 61.1% had abnormal body mass index, 57.5% had HbA1c>7%, and 77.7% had LDL serum >100 mg/dL. Nevertheless, most patients achieved good blood pressure control (74%). A high percentage of nephropathy-proteinuria was seen (40.7%) with 40.9% of them revealed renal insufficiency classified as chronic kidney disease (CKD) stage 3 and 4. There was a significant correlation between proteinuria and declined GFR (p=0.016), onset of DM (p=0.02), and diastolic blood pressure (p=0.03). No correlation was found between HbA1c and declined GFR, which may be due to the cross-sectional nature of the study. It will be interesting to perform a prospective study on proteinuria modification as a predictor of nephropathy early detection in DM patients since kidney biopsy and urine albumin creatinine ratio assessment are not available in primary health care services in remote areas. Korelasi antara Proteinuria dan Laju Filtrasi Glomerulus pada Diabetes Melitus Tipe 2Indonesia menghadapi beban ganda penyakit menular dan tidak menular, termasuk masalah metabolisme dan degeneratif. Keterlambatan dalam deteksi nefropati diabetik sebagai salah satu komplikasi mikrovaskular kronis sering terlihat, mengarah pada kebutuhan untuk hemodialisis karena penyakit ginjal stadium akhir (ESRD). Dari 54 pasien diabetes melitus (DM) tipe-2 tanpa keluhan edema, sesak, dan lemas dari 5 rumah sakit swasta di Pekanbaru, Riau, Indonesia, dari November 2018 hingga September 2019, dilakukan penilaian kontrol DM sesuai panduan Perkumpulan Endokrinologi Indonesia (PERKENI). Didapatkan hasil bahwa pencapaian kontrol DM masih buruk dengan 61,1% memiliki indeks massa tubuh abnormal 57,5% memiliki HbA1c >7%, dan 77,7% memiliki serum LDL >100 mg/dL. Namun demikian, sebagian besar pasien mencapai kontrol tekanan darah yang baik (74%). Pasien terdeteksi proteinuria >25 mg/dL mencapai 40,7% dengan 40,9% diantaranya mengalami gangguan filtrasi ginjal yang didefinisikan sebagai GFR <60 diklasifikasikan penyakit ginjal kronis tahap 3 dan 4. Walaupun secara statistik tidak ditemukan hubungan bermakna antara kontrol glikemik dengan insufisiensi renal, namun ditemukan hubungan yang bermakna antara nefropati dengan penurunan laju filtrasi glomerulus (GFR) (p=0.016), awitan DM (p=0,02), dan tekanan darah diastolik (p=0,03). Tidak ada hubungan bermakna antara HbA1c dan penurunan GFR yang mungkin disebabkan observasi sesaat. Akan menarik untuk melakukan studi prospektif pada modifikasi proteinuria sebagai prediktor deteksi dini nefropati pada pasien DM karena biopsi ginjal dan penilaian rasio albumin kreatinin urin tidak tersedia di layanan perawatan kesehatan primer di daerah terpencil
Correlation between Quality of Life and Gastroesophageal Reflux Disease
Get PDFGastroesophageal reflux disease (GERD) is a disease characterized by the rise of stomach acid into the esophagus which leads to heartburn and regurgitation. The prevalence of adult GERD cases worldwide is 11-38.8%. This study aimed to determine the correlation between GERD and quality of life among patients affected by this disease. This was a cross-sectional study conducted on 92 GERD patients in Atma Jaya Hospital, Jakarta, Indonesia from April 2018 to June 2018. Two questionnaires, GERD-Q and GERD-HRQL were used in this study. A validation of the Indonesian version of the GERD-HRQL questionnaire was performed prior to this study. The Mann Whitney test was used to identify the correlation between GERD and the quality of life in patients with upper gastrointestinal symptoms. This study indicated that the GERD-HRQL questionnaire showed good validity and reliability. Results showed that there was a correlation between GERD and quality of life (p = 0.005) in patients with upper gastrointestinal symptoms. In conclusion, GERD affects the quality of life of patients affected by this disease. Korelasi antara Kualitas Hidup dan Penyakit Refluks GastroesofagusGastroesophageal reflux disease (GERD) atau penyakit refluks gastroesofagus adalah penyakit yang ditandai dengan naiknya asam lambung ke kerongkongan yang menyebabkan sensasi terbakar di dada dan regurgitasi. Prevalensi kasus GERD di seluruh dunia pada orang dewasa adalah 11–38,8%. Penelitian ini bertujuan mengetahui korelasi antara GERD dan kualitas hidup di antara pasien yang terkena penyakit ini. Penelitian dilakukan pada 92 pasien GERD di Rumah Sakit Atma Jaya, Jakarta, Indonesia dari April 2018 hingga Juni 2018. Dua kuesioner, GERD-Q dan GERD-HRQL digunakan dalam penelitian ini. Validasi kuesioner GERD-HRQL versi bahasa Indonesia dilakukan sebelum penelitian ini. Analisis uji Mann Whitney digunakan untuk mengidentifikasi korelasi antara GERD dan kualitas hidup pada pasien dengan gejala gastrointestinal bagian atas. Penelitian ini menunjukkan bahwa kuesioner GERD-HRQL memperlihatkan validitas dan reliabilitas yang baik. Hasil penelitian ini juga menunjukkan erdapat korelasi antara GERD dan kualitas hidup (p=0,005) pada pasien dengan gejala gastrointestinal atas. Simpulan, GERD mempengaruhi kualitas hidup pasien yang terkena penyakit ini
Correlation between Hemoglobin Concentration and Cardiorespiratory Fitness in Adolescent Sportsmen
Get PDFBackground: Sport is a physical activity that increases human body oxygen demand. Hemoglobin has a major role to fulfill the oxygen demand. The body capacity to fulfill the increasing oxygen demand could be seen as cardiorespiratory fitness. Sportsmen have a high cardiorespiratory fitness due to the intensity and frequency of training. This study aimed to explore how hemoglobin concentration affects the cardiorespiratory fitness of adolescence sportsmen. Method: This study used a cross-sectional approach. The sampling started in October – November 2019. Sample of this study were 15-19 years old male badminton and basketball sportsmen at Jakarta and Bogor (n=72). Hemoglobin concentration measured with a digital hemoglobinometer which used an azide-methemoglobin method. VO2max estimated with a beep test. FITNESSGRAM® Performance Standard was used for the classification of cardiorespiratory fitness. All measurement’s ethical issues had been approved. The result of hemoglobin concentration and cardiorespiratory fitness was processed by SPSS program with Spearman and Kruskal-Wallis analysis method. Results: There was a correlation between hemoglobin concentration and cardiorespiratory fitness (p = 0.001, p < 0.05). Spearman analysis showed there was a weak correlation (r = 0.38) between hemoglobin concentration and cardiorespiratory fitness. Kruskal-Wallis analysis showed there was a meaningful mean difference in hemoglobin concentration on cardiorespiratory fitness groups (p = 0.005, p < 0.05). Conclusion: The mean of the hemoglobin concentration on the Healthy Fitness Zone (HFZ) cardiorespiratory group was higher than on the Need Improvement (NI) group and the Need Improvement within Health Risk (NI-HR) group.
Effect of Exercise Duration on Klotho and GluN2B Gene Expressions in Hippocampus of Wistar Rats with Moderate Intensity Exercise
Get PDFExercise could delay the degeneration process by increasing Klotho, which is an endogen antioxidant. Klotho protects against oxidative damages, regulates hippocampal synaptic plasticity, and enhances GluN2B expression. This study aimed to analyze the effect of 14-day and 8-week moderate-intensity exercise on Klotho and GluN2B mRNA expressions in rat hippocampus. This study was an animal experimental study using Wistar rats that was performed from June to September 2019 at the Central Laboratory, Universitas Padjadjaran, Indonesia. Rats were divided into 4 groups: control (14-day control and 8-week control) and exercise group (14-day exercise and 8-week exercise). The exercise groups ran at a moderate intensity (20m/min) for 30min/day, 5x/week. Hippocampus was then subjected to klotho and GluN2B gene expression analysis. The exercise groups showed a higher Klotho expression, both in 14 days (0.844±0.124 vs. 1.057±0.013) and 8 weeks (0.897±0.072 vs. 1.380±0.168) although statistically insignificant (p=0.24). No difference in GluN2B gene expression was observed between control and exercise groups on 14 days (1±0.09 vs. 1.22±0.09) and 8 weeks (1.24±0.03 vs. 1.38±0.05; p=0.11). In conclusion, 14-day and 8-week moderate-intensity exercise did not alter Klotho and GluN2B expressions in rat hippocampus. Pengaruh Durasi Olahraga terhadap Perubahan Ekspresi Gen Klotho dan GluN2B di Hipokampus Tikus Galur Wistar yang Mendapatkan Perlakuan Lari Intensitas SedangOlahraga dapat menghambat proses degenerasi saraf dengan meningkatkan salah satu antioksidan endogen, yaitu Klotho. Klotho dapat melindungi sel neuron dari kerusakan oksidatif dan meningkatkan sinaptik plasticity pada hipokampus. Penelitian ini bertujuan untuk melihat pengaruh olahraga lari pada hewan coba pada 14 hari dan 8 minggu terhadap perubahan ekspresi gen Klotho and GluN2B di hipokampus. Penelitian ini merupakan penelitian eksperimental dilaksanakan pada bulan Juni hingga September 2019 di Laboratorium Sentral Universitas Padjadjaran. Penelitian ini menggunakan tikus jantan galur wistar. Tikus dibagi menjadi 4 kelompok perlakuan dan kontrol. Olahraga dilakukan dengan treadmill tikus, kecepatan 20m/min, 30 menit perhari selama 5 kali perminggu. Kemudian, mRNA otak digunakan untuk PCR dengan menggunakan primer klotho dan GluN2B. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan yang bermakna (p=0.24) pada ekspresi gen Klotho pada 14 hari (0.844±0.124 vs 1.057±0.013) dan 8 minggu (0.897±0.072 vs 1.380±0.168) antara kelompok kontrol dan kelompok lari. Ekspresi gen dari GluN2B juga tidak menunjukkan perbedaan yang signifikan (p=0.11) pada 14 hari (1±0.09 vs 1.22±0.09) dan 8 minggu (1.24±0.03 vs 1.38 ± 0.05). Simpulan, bahwa 8 minggu olahraga tidak meningkatan ekspresi Klotho dan GluN2B yang signifika
Perspective of Cikahuripan Villagers on Traditional Health Service Provisions in Government Regulation No. 103 Year 2014
Get PDFBackground: Traditional health service is one of the health services that is still currently used in Indonesia, especially in rural communities. The government has been regulating these services since 2014. Despite its long existence, there is a recent increase of potential regulation violation among traditional health service providers. This study aimed to explore the perspective of the Cikahuripan Villagers on Government Regulation on traditional health services.Methods: This was a qualitative study using in-depth interviews and direct observations on traditional health services in Cikahuripan Village. Sixteen informants consisting of 8 villagers who met the inclusion criteria and another 8 informants in the triangulation negative case analysis, member checking, peer debriefing, and observation was involved.Results: There were two different perspectives in the community on traditional health service provisions in the Government Regulation. Supporters of the regulation believed that the regulation would make traditional health services more responsive and safer, which would improve service quality and health benefits as well as imposing effective sanctions. In contrast, the opposition believed that regulations were too late, would make the costs for licensing expensive, and too complicated.Conclusion: There are two different public perspectives on the regulation of traditional health services, which are supporting and opposing the regulation. It is expected that the local government create a derivative of the regulation by making adjustment to the community’s situation
Anxiety in Pregnant Women During Coronavirus (Covid-19) Pandemic in East Java, Indonesia
Get PDFThe 2019 coronavirus pandemic has been recognized as a trigger for anxiety, especially in pregnant women. Pregnant women are among those with a high-risk for contracting coronavirus, not only for themselves but also for the unborn child. Continuous information is needed for pregnant women to avoid anxiety because anxiety will result in complications for both mother and child, such as low birth weight baby and postpartum psychological disorder. The purpose of this study was to identify the prevalence of anxiety in pregnant women during the Coronavirus pandemic in Madura, East Java, Indonesia. This study was a cross-sectional descriptive study conducted from April 13 to May 8, 2020. Data were collected using a Google form distributed to all pregnant women in the Madura Region based on the list of pregnant women from the midwives in each city in this region. Seventy pregnant women returned the completed form, and data were analyzed using frequency tables and percentages. Results showed that 31.4% of pregnant women experienced very severe anxiety, 12.9% experienced severe anxiety, and the remainings did not experience anxiety. In conclusion, the coronavirus pandemic indeed increases anxiety in pregnant women which will need to be addressed to avoid negative impacts on the mother and unborn child. Counseling is needed to reduce anxiety by asking the women to stay at home, wash their hands, wear masks, eat nutritious food, have their pregnancy checked, perform exercise for pregnant women at home, and seek for help when facing emergencies. Tingkat Kecemasan Ibu Hamil pada Masa Pandemi Viruscorona (Covid-19) di Jawa Timur, Indonesia Pandemi virus corona 2019 ini menyebabkan kecemasan, terutama pada ibu hamil, karena ibu hamil merupakan kelompok risiko tinggi untuk tertular virus corona, terutama pada janin yang dikandungnya, sehingga diperlukan informasi secara terus menerus kepada ibu hamil supaya tidak terjadi kecemasan, karena kecemasan ini akan berakibat komplikasi pada ibu dan janinnya. Dampak kecemasan pada ibu hamil dan janin adalah Berat Badan Lahir Rendah dan gangguan psikologis pada ibu setelah melahirkan. Tujuan penelitian ini mengidentifikasi tingkat kecemasan ibu hamil di masa pandemi virus Corona di wilayah Madura, Jawa Timur. Penelitian ini dilakukan tanggal 13 April sampai dengan 8 Mei 2020 dan merupakan penelitian desktriptif dengan menggunakan google form yang disebarkan ke seluruh ibu hamil di Wilayah Madura melalui bidan yang ditunjuk setiap kota yang ada di Madura. Tujuh puluh ibu hamil mengembalikan formulir yang telah diisi dan data dianalisis menggunakan tabel frekuensi dan persentase. Hasil penelitian menunjukkan bahwa 31.4% mengalami kecemasan sangat berat, 12.9% mengalami kecemasan berat, dan sisanya ibu tidak mengalami kecemasan atau dalam keadaan normal. Simpulan, pandemi virus corona memang meningkatkan kecemasan pada ibu hamil yang perlu diatasi untuk menghindari dampak negatif pada ibu dan janinnya. Konseling diperlukan untuk mengurangi kecemasan dengan meminta ibu-ibu untuk tinggal di rumah, mencuci tangan, memakai masker, makan makanan bergizi, memeriksakan kehamilannya, melakukan senam ibu hamil di rumah, dan mencari pertolongan saat menghadapi keadaan darurat