Tropical Health and Medical Research

Evaluation of Cinnamomum verum Bark Essential Oil as a Natural Antifungal Agent Against Dermatophytes

2026-07-26T19:52:46+07:00

Dermatophytosis is a superficial fungal infection that remains a public health problem, particularly in tropical regions, with Trichophyton rubrum and Trichophyton mentagrophytes as the primary causes. Increasing limitations in the use of synthetic antifungals have encouraged the development of natural products as alternative therapies, including Cinnamomum verum stem bark essential oil. This study aimed to analyse the antifungal activity of C. verum stem bark essential oil against T. rubrum and T. mentagrophytes using the disc diffusion method. The study used a true experimental design with a posttest-only control group design. The essential oil was obtained through steam-water distillation with a yield of 0.25% (v/w). Tests against T. rubrum used concentrations of 1%, 2%, 5%, and 10%, while tests against T. mentagrophytes used concentrations of 5%, 10%, 15%, and 20%. Ketoconazole 2% was used as a positive control and dimethyl sulfoxide as a negative control. The inhibition zone diameter was measured after incubation and analysed using One-Way ANOVA and Post Hoc tests. The results showed that the essential oil inhibited the growth of both fungal species at all concentrations tested. The inhibition zone diameter against T. rubrum increased from 21.7 mm to 54.1 mm, while against T. mentagrophytes it increased from 33.6 mm to 48.2 mm. Statistical analysis showed a significant difference between the concentrations of both species (p<0.001). It was concluded that C. verum bark essential oil exhibited in vitro antifungal activity against both T. rubrum and T. mentagrophytes, with the inhibitory activity generally increasing with increasing concentrations. These findings demonstrate the potential of C. verum essential oil as a candidate for a natural antifungal agent based on local resources. Therefore, further research on the characterisation of active compounds, determination of MIC/MFC values, development of topical formulations, and in vivo testing and clinical trials are needed to support its use in dermatophytosis therapy.

Factors Associated with Stunting in Toddlers in Indonesia: Analysis of the 2024 Indonesian Nutrition Status Survey (SSGI) for Evidence-Based Nutrition Policy

2026-08-15T10:18:45+07:00

Stunting remains a major public health challenge in Indonesia and is associated with multiple biological, maternal, social, and environmental factors. This study aimed to identify factors associated with stunting among toddlers in Indonesia and characterize geographic variation in stunting prevalence across provinces using the 2024 Indonesian Nutrition Status Survey (SSGI). This cross-sectional observational study used data from 298,970 toddlers across 38 provinces and 510 districts/cities. Weighted multivariable logistic regression with province as a fixed effect was used to estimate adjusted odds ratios (AORs), complemented by Global Moran’s I, Local Indicators of Spatial Association (LISA), and quantile mapping to assess geographic distribution and spatial autocorrelation. The prevalence of stunting was 22.7%. Males (OR 1.11), children living in rural areas (OR 1.32), those aged 24–35 months (OR 1.29), those with low birth weight (OR 2.08), and those born prematurely (OR 1.34) had higher odds of stunting. Lower parental education, iron supplementation of <90 tablets, incomplete antenatal care, maternal anaemia, chronic energy deficiency, inadequate sanitation (OR 1.44), inadequate drinking water (OR 1.45), and high residential density (OR 1.38) were also significantly associated with stunting (p < 0.05). Significant differences in adjusted odds were observed across provinces (?² = 618.977; p < 0.001), with the highest AORs in Highlands Papua (5.82; 95% CI: 3.55–9.56) and East Nusa Tenggara (4.69; 95% CI: 3.70–5.95), compared with Bali as the reference province. Spatial analysis demonstrated significant positive spatial autocorrelation (Moran’s I = 0.3634; Z = 2.7271; p = 0.01), with high-prevalence clustering in the eastern region. Stunting was associated with multiple individual, household, and environmental factors and showed significant geographic clustering across Indonesian provinces. Evidence-based, geographically targeted strategies should prioritise interventions from pregnancy through the first two years of life, nutritional literacy, immunisation coverage, sanitation, drinking water, and healthy housing, particularly in high–high spatial clusters.

Comparative Antibacterial Activity of Citrus hystrix DC. Leaf Essential Oil Against ESBL Klebsiella pneumoniae and Multidrug-Resistant Serratia marcescens

2026-07-26T19:51:32+07:00

The increasing antimicrobial resistance has driven the development of natural antibacterial sources, one of which is essential oils. This study aimed to analyse the antibacterial activity of lime leaf essential oil (Citrus hystrix DC.) against Extended Spectrum ?-Lactamase (ESBL)-producing Klebsiella pneumoniae and multidrug-resistant Serratia marcescens. The study used a true experimental design with a posttest-only control group design. The essential oils were tested at concentrations of 50%, 60%, 70%, 80%, 90%, and 100% using the well diffusion method with four replications. Ciprofloxacin served as a positive control and dimethyl sulfoxide as a negative control. Data were analysed using the Shapiro–Wilk test, Levene's test, one-way ANOVA, or Welch ANOVA, followed by post hoc tests according to data characteristics at a significance level of p<0.05. The results showed that lime leaf essential oil had antibacterial activity against both bacteria at all concentrations tested. For Klebsiella pneumoniae ESBL, the inhibition zone diameter increased from 6.83 mm at 50% concentration to 9.30 mm at 90% concentration, then decreased to 8.08 mm at 100%. For multidrug-resistant Serratia marcescens, the inhibition zone diameter increased from 7.80 mm to 14.00 mm at 90% concentration, then decreased to 11.20 mm at 100%. Statistical analysis showed a significant difference between the concentrations for both bacteria (p<0.001). In general, Serratia marcescens showed higher sensitivity than Klebsiella pneumoniae ESBL. Although its inhibitory power was still lower than ciprofloxacin, lime leaf essential oil has the potential to be developed as a natural antibacterial source against resistant Gram-negative bacteria.

Gender Determines Pneumonia Risk Factor Patterns in Toddlers in South Kalimantan, Banjar Regency, Indonesia

2026-07-26T19:48:06+07:00

Pneumonia remains one of the leading causes of mortality among children under five worldwide. Previous studies have reported inconsistent findings regarding sex differences in pneumonia susceptibility, suggesting that risk factors may differ between male and female toddlers. This study aimed to identify and compare sex-specific risk factors for pneumonia among toddlers in Banjar Regency, Indonesia. This case–control study included 300 toddlers: 169 male toddlers (61 cases and 108 controls) and 131 female toddlers (45 cases and 86 controls). We assessed 41 demographic, socioeconomic, behavioural, child-related, environmental, and housing indicators through interviews and direct household measurements. We analysed male and female datasets separately. Candidate variables with p<0.25 in simple logistic regression were entered into multivariable logistic regression using the backward stepwise method to identify independent predictors of pneumonia. Among male toddlers, four independent risk factors were identified: stunted child development (OR=7.022; 95% CI: 1.680–29.345), low family income (<minimum wage) (OR=3.305; 95% CI: 1.328–8.228), living within 15 m of the riverbank (OR=2.830; 95% CI: 1.336–5.994), and age 12–59 months (OR=2.236; 95% CI: 1.025–4.878). Among female toddlers, three independent predictors were identified: low family income (OR=3.211; 95% CI: 1.077–9.571), predominant infant formula feeding (OR=2.748; 95% CI: 1.040–7.261), and inadequate household occupancy density (OR=2.641; 95% CI: 1.187–5.876). The findings demonstrate distinct sex-specific risk factor patterns for pneumonia among toddlers. These results suggest that pneumonia prevention strategies should incorporate gender-specific approaches, with greater emphasis on improving child development and environmental conditions for boys, and promoting breastfeeding and adequate housing conditions for girls.

Antibacterial Activity of Limau Kuit (Citrus hystrix DC.) Leaf Essential Oil Against Methicillin-Resistant Staphylococcus aureus and Multidrug-Resistant Pseudomonas aeruginosa

2026-07-26T19:50:04+07:00

Antibiotic resistance in pathogenic bacteria, including Methicillin-resistant Staphylococcus aureus (MRSA) and Multi-drug-resistant Pseudomonas aeruginosa (MDR P. aeruginosa), has encouraged the development of alternative antibacterial agents from natural sources. This study aimed to analyse the antibacterial Activity of Limau Kuit (Citrus hystrix DC.) leaf essential oil against MRSA and MDR P. aeruginosa. The study used a true experimental design with a posttest-only control group design. The essential oil was obtained through steam-water distillation of Limau Kuit leaves and then tested at concentrations of 50%, 60%, 70%, 80%, 90%, and 100% using the well diffusion method. Positive controls included ciprofloxacin and ceftazidime, while dimethyl sulfoxide served as the negative control. Each treatment was repeated four times. Data were analysed using Welch ANOVA and Games-Howell tests for MRSA and Kruskal-Wallis and Mann-Whitney tests for MDR P. aeruginosa. The essential oil yield was 0.60% (v/w). All concentrations showed antibacterial activity against both test bacteria. The largest inhibition zone diameter against MRSA was obtained at 90% (22.23 ± 1.75 mm), while against MDR P. aeruginosa at 80% (13.98 ± 1.48 mm). Statistical analysis showed a significant difference between concentrations in MRSA (p < 0.001) and MDR P. aeruginosa (p = 0.003). Antibacterial activity against MRSA is higher than against MDR P. aeruginosa, which is thought to be related to differences in cell wall structure and resistance mechanisms of the two bacteria. Lime leaf essential oil has potential as a natural antibacterial against antibiotic-resistant bacteria. However, further research is needed to determine active compound content, mechanism of action, and the minimum inhibitory concentration and minimum bactericidal concentration.