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Household and environmental determinants of faecal contamination in groundwater-sourced drinking water: a path analysis study in urban and rural Indonesia in 2020

Por: Dharmayanti · I. · Tjandrarini · D. H. · Puspita · T. · Zahra · Z. · Anwar · A. · Irianti · S. · Irianto · J. · Marina · R. · Rachmat · B. · Yunianto · A. · Azhar · K.
Objectives

This study investigates how environmental and household variables relate to groundwater quality in Indonesia.

Design

The research uses data from the 2020 Cross-sectional Household Drinking Water Quality Study, the National Socioeconomic Survey 2020, and climate records.

Setting

Indonesia.

Participants

The study includes 5965 households across 34 provinces, using descriptive and path analysis techniques.

Primary outcome measures

The microbiological quality of drinking water was primarily focused on Escherichia coli as an indicator of microbial contamination.

Results

Out of 5965 households, only 5.15% had emptied faecal sludge (FS) in the last 3 years, while E. coli contamination was detected in 71.21% of the samples. Improved drinking water sources and proper FS emptying practices were associated with better water quality.

Conclusion

These findings highlight the urgent need for enhanced surveillance and evidence-based policymaking to safeguard both drinking water quality and sanitation practices, which are crucial for public health and environmental sustainability.

Prevalence, incidence and risk factors of chronic kidney disease in people with diabetes and hypertension, and the prognosis and kidney function decline in Indonesia: a multicentre cross-sectional study in primary care centres

Por: Hustrini · N. M. · Susalit · E. · Harimurti · K. · Haryoso · I. S. · Legrans · A. E. · Damarjati · K. · Minangsih · S. · Nurhisan · L. · Zaini · M. · Oktavianti · S. · Pratiwi · S. · Pradesa · M. G. · Anthony · G. · Sari · D. W. R. · Purnama · R. C. · Puspitasari · W. R. M. · Rajagukgu
Objectives

To examine chronic kidney disease (CKD) prevalence, incidence, prognosis, kidney function decline and associated risk factors among people with diabetes and/or hypertension.

Design

Cross-sectional multicentre study.

Setting

14 primary care centres across Jakarta.

Participants

Adults (≥18 years) with diabetes and/or hypertension were included. Exclusion criteria were receiving kidney replacement therapy, language barrier, cognitive impairments, refusal to consent and pregnancy. Participants were grouped into three categories: hypertension only, diabetes only and both.

Interventions

None.

Primary and secondary outcomes

Primary outcomes included CKD prevalence, incidence, number-needed-to-screen, KDIGO-based prognosis and annual kidney function decline. Secondary outcomes were risk factors for CKD, uncontrolled blood glucose, blood pressure and albuminuria.

Results

A total of 1263 participants were enrolled: 51% had hypertension, 17.6% diabetes and 31.4% both. Mean age: 57.1±10.2 years, 72.2% female and 76% obese. Renin angiotensin aldosterone system inhibitors were prescribed in 32.3%, and only 1.2% used insulin despite a median glycated haemoglobin of 7.5% (IQR: 6.5–9.1). CKD prevalence was 14.8%, with an incidence rate of 9.1 per 100 person-years; number-needed-to-screen was 7. Based on KDIGO criteria, 48.9% were at moderate-to-very high risk of adverse outcomes. Baseline estimated glomerular filtration rate was 80.9 (SE=10.1), declining by 4.7 (SE=9.9) mL/min/1.73 m2 annually. CKD incidence was higher with albuminuria (OR 3.6, p=0.007) in the combined group; older age (OR 4.5, p

Conclusions

CKD burden is high among people with diabetes and hypertension. Nearly half were at elevated risk despite preserved kidney function, highlighting the need for targeted early screening.

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