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The Quality of Life in Heart Failure Reduced Ejection Fraction (HFrEF) Patients: A Phenomenon of Obesity Paradox
Full text linkBackground: Obesity place patients at risk of cardiovascular disease (CVD). There may be an inverse relationship between obesity and CVD prognosis-a phenomenon known as the “obesity paradox”. Obese HF patients might have a better prognosis, especially in terms of quality of life (QoL).
Aims: The purpose of this study was to examine the QoL of HF patients based on obesity classification.
Methods: This cross-sectional study was conducted at the HF clinic of Hasna Medika Cardiovascular Hospital, Cirebon, Indonesia. Samples were HFrEF patients who had received medication at the HF clinic for at least 6 months and the patient must have received optimal guidelines directed medical therapy (GDMT) with at least 3 pillar drugs according to Indonesian heart failure guidelines. Inclusion criteria were HF patients with ejection fraction <40% on echocardiographic examination. Exclusion criteria were HF patients with motor impairments, such as post-stroke, severe osteoarthritis, paralysis, and patients who did not receive optimal GDMT.
Results: A total of 40.3% sample were obese, 9.7% were underweight and 67.5% had central obesity. Coronary artery disease (89.6%), smoking (67.5%) and hypertension (49.4%) were the most common comorbidities and risk factors found. About 12.3% of sample experienced rehospitalization 3 times a year. Based on Kansas City Cardiomyopathy Questionnaire (KCCQ)-12, about 3.2% of the sample had poor QoL, 55.8% had good QoL and 9.7% had excellent QoL. HFrEF patients with excellent QoL had a proportion of 66.7% obese and 20% overweight. While there were no obese patients in HFrEF patients with poor QoL. The proportion of HFrEF patients with excellent QoL who had central obesity was 80%. Meanwhile, 65.1% of HFrEF patients with good QoL were obese.
Conclusion: Obese HF patients have better QoL outcomes. This phenomenon is called obesity paradox. A good quality of life in HF patients is an important goal of HF management in addition to reducing mortality.
Received: 02 December 2024 | Reviewed: 17 December 2024 |
Revised: 24 December 2024 | Accepted: 10 January 2025
TNF-α -308 G/A Gene Polymorphism as a Risk Factor for Pulmonary Tuberculosis in Cirebon, Indonesia
Full text linkBackground: Mycobacterium tuberculosis, the causative agent of pulmonary tuberculosis, spreads via droplets. The TNF-α-308 G/A gene polymorphism is one of the host genetic variables that may affect an individual's vulnerability to the disease. However, this polymorphism has not been studied in Cirebon.
Aims: To analyze the TNF-α -308 G/A gene polymorphism as a risk factor for the occurrence of pulmonary tuberculosis in Cirebon.
Methods: A total of 64 participants joined part in an analytical observational study using a case-control design at the Biomolecular and Genetics Laboratory, Faculty of Medicine, Universitas Swadaya Gunung Jati, Indonesia. DNA extraction from blood samples, ARMS-PCR genotyping, and 1.5% electrophoresis gel visualization were all part of the data gathering process. The chi-square test was used to analyze the data. This study including inclusion criteria, exclusion criteria, and sample control for the research.
Results: According to the study, there is no link between Cirebon's risk of pulmonary tuberculosis and the polymorphism in the TNF-α-308 G/A gene (OR = 0.462; P > 0.05). However, the study shown a protective factors which means that individuals with the TNF-α -308 G/A gene polymorphism have a lower risk of developing pulmonary tuberculosis compared to those without the polymorphism.
Conclusion: The TNF-α-308 G/A gene variant is not associated with an increased risk of pulmonary tuberculosis in the Cirebon community
Effectivity Test of n-Hexane, Ethyl Acetate, and Butanol Fractions of Mango Peel (Mangifera indica L.) Gedong Gincu Variety on the Growth of Escherichia coli
Full text linkBackground: Escherichia coli was the most common cause of diarrhea. Diarrhea reached a high prevalent in West Java. The cause of antibiotic resistance to Escherichia coli was noncompliance medication. Mango peel (Mangifera indica L.) of the Gedong Gincu variety had secondary metabolites compound which act as antibacterial that can be used as alternative medication.
Aims: To analyze phytochemicals and determine effectiveness of n-hexane, ethyl acetate, and butanol fractions of mango peel Gedong Gincu variety in the growth of Escherichia coli.
Methods: This study used laboratory true experimental research with post-test only control group design. This research consisted 14 groups, divided into 2 control groups, namely control (+) given ciprofloxacin and control (-) given 10% DMSO, and 12 treatment groups given n-hexane, ethyl acetate, and butanol fractions concentration of Gedong Gincu 6.25%v/v, 12.5% v/v, 25% v/v, and 50% v/v. The test used well diffusion method on Mueller-Hinton Agar media.
Results: The secondary metabolites in the n-hexane fraction included alkaloids, steroids, and saponins, while ethyl acetate and butanol fractions contained flavonoids, phenols, alkaloids, triterpenoids, and tannins. The results of the oneway ANOVA test obtained p<0.001 which indicated n-hexane, ethyl acetate, and butanol fractions were significantly inhibit the growth of Escherichia coli with the greatest mean inhibitory zones of 6.86 mm, 12.08 mm, and 9.35 mm, respectively.
Conclusion: The most effective fraction of mango peel (Mangifera indica L.) Gedong Gincu variety in inhibit the growth of Escherichia coli was ethyl acetate fraction at a 50% concentration (12.08 mm)
Relationship Analysis of Risk Factors Concerning the Incidence of Pulmonary Tuberculosis in Children at Panti Abdi Dharma Hospital, Cirebon, Indonesia
Full text linkBackground: Tuberculosis (TB) is an infectious disease caused by the Mycobacterium tuberculosis germ. The germs are spread from people with TB through the air. Nearly a quarter of the world’s population is infected with Mycobacterium tuberculosis germs and 11% are children.
Aims: To analyze the association of risk factors that most influence the incidence of pulmonary tuberculosis in children at Panti Abdi Dharma Hospital, Cirebon City in 2024.
Methods: Using a cross sectional analytical observational approach, systematic sampling technique on 138 respondents using bivariate analysis (chi-square) and multivariate analysis (logistic regression).
Results: The results showed that risk factors associated with the incidence of tuberculosis in children were age (P-value 0.002), gender (P-value 0.027), father's education (P-value 0.032) and parents' socioeconomic status (P-value 0.001). The risk factor that most influenced the incidence of tuberculosis was parents' socioeconomic status (Exp(B) value 3.798).
Conclusion: In the 10 risk factors studied, 4 risk factors were found to have an association with the incidence of tuberculosis in children, namely child age, child gender, father's education, and parents' socioeconomic status. The most influential risk factor in this study was parents' socioeconomic status
Reviewer Acknowledgements: Bridging Science, Care, and Community – GHMJ (Global Health Management Journal), Volume 8, Number 2, 2025
Full text linkAs the GHMJ (Global Health Management Journal) continues to advance integrated solutions for global health challenges, this edition highlights cutting-edge research and innovations spanning from molecular science to health systems strengthening. This issue of the Global Health Management Journal (Vol. 8, No. 2, 2025) presents an interconnected range of studies that reflect the dynamic challenges and innovations in global health. Beginning with clinical and pharmacological research, the issue highlights a study on radiographic patterns in tuberculosis patients with and without diabetes (Fatihah et al., 2025)—a dual burden increasingly relevant in both endemic and developing contexts. This clinical insight is followed by two experimental studies on plant-based therapies: one evaluating the hypoglycemic effect of bay leaf and celery extract in diabetic rats (Laorenz et al., 2025), and another investigating the antiviral potential of cassava leaf-derived nicotiflorin against dengue virus serotype 1 (Yulianti et al., 2025), reflecting a growing interest in local bioresources as alternatives to conventional treatment.
The issue then transitions into broader public health and educational themes. A study from Ghana examines the risks of adolescent pregnancy complicated by diabetes (Ameyaw et al., 2025), while orthopedic data from Indonesia compares healing outcomes in different types of tibial fractures post-ORIF (Sakinah et al., 2025), offering evidence to improve trauma recovery. A thoughtful paper from South Africa challenges the way we conduct educational research with students with disabilities (Muzite & Gasa, 2025), advocating for more inclusive and participatory approaches. From Thailand, we see how self-efficacy–based programs can significantly reduce fall risk among older adults (Sukaree et al., 2025), offering a preventive approach to managing geriatric health. Meanwhile, a retrospective study from Türkiye (Boğa, 2025) shifts the focus to acute care, identifying critical predictors of ICU admission among emergency patients—highlighting the importance of timely response systems within hospital settings. These health system perspectives are further reinforced by a report from Zimbabwe that emphasizes the foundational role of laboratory capacity in supporting diagnosis, surveillance, and treatment for HIV/AIDS and other diseases (Mayavo, 2025). The issue concludes with a photo essay that captures the human side of scholarship—tracing how digital connections sparked a decade-long journey of academic friendship and collaboration (Yeyentimalla et al., 2025).
Link to download: https://publications.inschool.id/index.php/ghmj/issue/view/GHMJ.08.02
Editor-in-chief
Prof. Andrew John Macnab
Managing Editors
Doni Marisi Sinaga, M.Sc.
Kukuh Madyaningrana, M.Biotech. Ph.D.
Journal Managers
Suyitno, M.PHM
Maretalinia, M.A
External Reviewers
Witri Pratiwi, M.Kes. (Universitas Swadaya Gunung Jati, Indonesia)
Tiar Masykuroh Pratamawati, M.M., M.Biomed. (Universitas Swadaya Gunung Jati, Indonesia)
Tiisetso Chuene, M.PH (University of Limpopo, South Africa)
Crossman Mayavo, Ph.D (Midlands State University, Zimbabwe)
Prof. Dr. Atthawit Singsalasang (Nakhon Ratchasima Rajabhat University, Thailand)
Prof. Dr. Benchaporn Sukprasert (Suranaree University of Technology, Thailand)
Elmiawati Latifah (Universitas Muhammadiyah Magelang, Indonesia)
Türker Karaboğa (Esenyurt Necmi Kadıoğlu State Hospital, Türkiye)
Lasata Shrestha, M.PH. (University of Washington, United States)
Emmanuel Ameyaw (Kwame Nkrumah University of Science and Technology, Ghana)
We express our sincere gratitude to the reviewers who have generously contributed their time and expertise to this edition of the Global Health Management Journal. Their commitment to scholarly excellence and constructive peer feedback has helped ensure the integrity and impact of every article published.
Eligible reviewers may be considered for future roles on our Editorial Board, and receive Exclusive Publishing Opportunity and the chance to publish Guest Editorial Papers at no cost. Simply register on our website and select the "Reviewer" option during sign-up.
Acceptance Rate : 17 %
Days to First Editorial Decision : 18 days
Days to accept : 75 days
Published: 28 July 2025
Climate Change: The Urgent Need for Global Health Strategies to Counter Adverse Impacts on Human Health
Full text linkThe environmental consequences of climate change have become a global health emergency. Reports and reviews continue to document multiple health impacts from increasing temperatures, rising sea levels and more frequent extreme weather events like severe drought, flooding and wildfires. The consequences of global warming on human health include heat-related morbidity and mortality, an increase in vector borne and infectious diseases, greater severity of respiratory diseases, adverse nutritional effects from food insecurity, higher rates of injury and multiple effects from financial, educational, social and psychological stressors. The extent to which climate change is impacting human health and lives is such that action by the public health community is urgently required to provide public education and define effective intervention, prevention and treatment strategies. Only in this way can the initiatives and policies be generated that are required to inform and engage everyone in society, and make people aware that action is needed to counter the dangers to health posed by climate change.
Published: 05 February 2025
Making School-Based Children’s Mental Health Screening A National Priority in Post-War Liberia
Full text linkChildren’s mental health remains one of Liberia’s most urgent and under-addressed public health challenges. Post-war trauma, extreme poverty, and inadequate infrastructure have exposed millions of children to emotional and behavioral risks, yet Liberia lacks a national policy framework for early identification and intervention. Despite the national mental health policy commitments, the implementation of school-based mental health services has been limited and fragmented. The purpose of this opinion-based policy perspective is to emphasize the magnitude of children’s mental health problems in Liberia, explain the importance of school-based universal mental health screening as a potential early identification and intervention approach, and provide possible recommendations to implement universal screening approach as a national priority to promote children’s mental health for optimum lifelong functioning. To conclude, a series of short-, medium-, and long-term policy recommendations, centered on intersectoral coordination, culturally adapted screening tools, teacher training, and national monitoring systems, are proposed based on international evidence and grounded in local realities. The recommendations highlight sustainable actions to integrate mental health screening into routine school operations, strengthen early identification, and improve the long-term cognitive, emotional, and physical well-being of the next generation
Drug Resistant Profile among the Pulmonary Tuberculosis Patients at Waled General Hospital, Cirebon Regency, Indonesia
Full text linkBackground: Tuberculosis (TB) is an infectious bacterial disease caused by Mycobacterium tuberculosis, most commonly affecting the lungs. Drug Resistance Tuberculosis (DR-TB) is a TB disease resistant to one or more anti-tuberculosis drugs. In a global report in 2022, Indonesia ranked 5th for the burden of drug-resistant tuberculosis (DR-TB), and in the tuberculosis information system (SITB) data in West Java is one of the provinces with TB-RO case finding coverage that exceeds the national target with a percentage of 78%.
Aim: To determine the profile of drug-resistant pulmonary tuberculosis patients at Waled General Hospital, Cirebon Regency between 2022 and 2023.
Methods: This study used a retrospective descriptive method. Sampling was done using a total sampling technique, and a sample of 43 respondents was obtained. Data were collected through medical records and tuberculosis information system (SITB) and then analyzed by univariate statistics without comparisons or association tests.
Results: Based on socio-demographic characteristics, the majority of patients aged 46-55 years were 12(27.9%), patients with the most gender were male totaling 29(67.4%), patients with the most recent education were elementary school and high school had the same number of 15(34.9%), most patients' occupations were working at 32(74.4%). The most common classification of DR-TB is MDR-TB, totaling 35(81.4%), the history of previous tuberculosis treatment is mostly new patients at 18(41.3%), and most patients do not have comorbidities totaling 19(44.2%).
Conclusion: The profile of patients with DR-TB based on socio-demographics at Waled General Hospital, Cirebon between 2022 and 2023 is mainly aged 19-59 years with the most gender is male, the last education of elementary and high school has the same number, most patients work. Most patients with previous TB treatment histories were new, and most did not have comorbidities. A comprehensive approach to DR-TB control should incorporate; public education on treatment adherence, enhanced case management and surveillance, and consistent application of molecular diagnostics. Such measures may effectively decrease DR-TB prevalence and associated mortality. This study further highlights the importance of TB awareness and environmental hygiene in Indonesia's ongoing TB elimination efforts
Thailand Policies for PM 2.5 and the Hidden Problems
Full text linkThe PM 2.5 pollution problem in Thailand is intensifying in major cities and across the country, significantly impacting public health. According to surveys in Thailand, PM 2.5 originates from three primary factors: automobiles, outdoor biomass burning/factories, and the inversion phenomenon or stagnant air conditions. Although Thailand has implemented policies to address these three key causes, their practical execution has fallen short of achieving the desired outcomes. A deeper analysis reveals hidden problems within these policies, which hinder their effectiveness. This presentation aims to highlight these hidden issues and propose preliminary solutions to mitigate them, thereby contributing to more successful PM 2.5 management in the future.
Published: 08 February 2025
Potassium Inwardly Rectifying Channel Subfamily J Member 11 (KCNJ11) RS5219 Gene Polymorphism as a Risk Factor for Type 2 Diabetes Mellitus in Indonesia: A Case Control Study
Full text linkBackground: Diabetes Mellitus (DM) is a chronic metabolic disease caused by the failure of the pancreas to produce the hormone insulin or ineffective use of the hormone insulin. It is estimated that 537 million adults aged 20-79 years worldwide suffer from DM. Genetics is one of the risk factors involved in the pathophysiology of type 2 DM. The KCNJ11 gene encodes the Kir6.2 protein that is responsible for adenosine triphosphate-sensitive potassium ion channels (kATP) synthesis in pancreatic beta cells plasma membrane.
Aims: This study aims to examine the KCNJ11 rs5219 gene polymorphism as a risk factor for type 2 diabetes mellitus in Cirebon population.
Methods: This case control study involved 29 cases of type 2 diabetes mellitus and 29 healthy controls with purposive sampling technique. Sample data was obtained through the examination of blood sugar, DNA extraction, PCR-RFLP with Eco24I restriction enzyme, then visualization of the results with Gel Electrophoresis.
Results: The frequency of G allele was found more in the case group (70%) while the frequency of A allele was found more in the control group (38%). The frequency of heterozygous GA genotype was found more in the control group (48.3%) and the frequency of homozygous mutant AA genotype was more in the case group (17.2%) compared to the control group (13.8%). Chi-Square Test results obtained p-value 0.115, OR value 2.318.
Conclusion: This study showed no significant association between Potassium Inwardly Rectifying Channel Subfamily J Member 11 (KCNJ11) rs5219 gene polymorphism and the incidence of Type 2 Diabetes Mellitus in Cirebon population