Malaria is an infectious disease that remains a global health concern, particularly in Asia and Africa. The success of malaria medication largely depends on patients' adherence to the prescribed therapeutic regimen. This article aims to identify the level of adherence to malaria treatment and the factors that influence it, based on observational studies. A narrative review was conducted using the PRISMA approach, involving 12 articles published between 2019 - 2023 from various countries. The results indicate that adherence levels vary widely, ranging from 15.6% to 93.31%, depending on respondent characteristics and the intervention strategies implemented. Factors influencing adherence include patient-related factors (perceived wellness, gender, age, education, place of residence, religion, medication storage habits, DOT supporters, forgetfulness, and knowledge of malaria treatment), therapy-related factors (type of antimalarial drug, drug characteristics, treatment duration), condition-related factors (vomiting, history of malaria), health system factors (type of health facility, drug availability, treatment education methods), and socioeconomic factors. These findings underscore the importance of a multidimensional approach to improving malaria treatment adherence as part of global malaria elimination efforts.
The Balanced Scorecard (BSC) has increasingly been adopted as a strategic performance management framework within healthcare organizations. Evidence from the past decade shows varied implementation outcomes, shaped by institutional readiness, leadership commitment, and the maturity of health information systems. This narrative review synthesizes findings from 47 scientific articles selected through a systematic screening process, covering studies conducted in hospitals, primary health centers, and pharmacy units in Indonesia, Morocco, Iran, China, and other countries. The studies employed case study and descriptive cross-sectional designs using both quantitative and qualitative approaches. Overall, BSC implementation contributed to improvements in service performance across the financial, customer, internal process, and learning and growth perspectives. Key enabling factors included integration of BSC into organizational strategic planning processes, sustained leadership support, regular capacity building for staff, and the reinforcement of a patient-centered culture. Nonetheless, several constraints were identified, including the absence of standardized healthcare KPIs, resistance to change, limited resource allocation, and gaps in data quality and reporting mechanisms. Recent developments demonstrated the use of complementary analytical tools such as SWOT, the Analytic Hierarchy Process, and Health Technology Assessment to strengthen strategic decision-making. These findings indicate that BSC serves as an effective and adaptive performance management framework capable of supporting holistic service improvement in healthcare settings. To maximize its impact, contextual adaptation, enhanced human resource capacity, and stronger health information systems are essential. Further research is needed to examine determinants of successful BSC implementation and to assess its long-term implications for healthcare service performance and policy development.
In 2023, tuberculosis (TB) reached its highest incidence with 8.2 million new cases reported by the World Health Organization (WHO). The virulence of Mycobacterium tuberculosis (MTB) is strongly governed by protein-protein interactions (PPIs) that regulate essential processes such as cell wall biosynthesis, immune evasion, and persistence. This study aims to map and analyze the mechanisms of key PPIs in MTB using a scoping review approach. Data was retrieved from PubChem and related literature with the keyword ``PPIs Network TB''. Our findings highlight crucial PPI-driven mechanisms, including the role of DprE1/DprE2 in arabinogalactan synthesis, VapB4/VapC4 in stress response and self-toxicity, ESX-1 and Type VII Secretion System (T7SS) in virulence factor delivery, and the DosRST system in latent infection. Additionally, host-response proteins such as IL-6 and MMP-9 are identified as potential diagnostic biomarkers. By revealing these molecular interaction pathways, this review provides a roadmap for developing targeted anti-TB drugs and precision diagnostics tailored to MTB strain diversity.
Quality of life (QoL) is a critical outcome measure in schizophrenia management, yet antipsychotic side effects may negatively impact patients' well-being. Objective: This study aimed to compare the QoL of schizophrenia patients receiving aripiprazole monotherapy versus a risperidone-clozapine combination at West Java Mental Hospital. An analytical observational study with a cross-sectional design was conducted at the outpatient clinic of West Java Mental Hospital from March to May 2025. The Indonesian version of the WHOQOL-BREF questionnaire was used to assess QoL. A total of 58 outpatients with schizophrenia who met the inclusion criteria were enrolled, comprising 28 patients in the aripiprazole monotherapy group and 30 in the risperidone-clozapine combination group. Data were analyzed using the Mann-Whitney test. The majority of patients in both groups had a moderate QoL (71.4% vs. 70.0%). The median QoL score was 52.5 (IQR: 45.0-60.0) in the monotherapy group and 51.0 (IQR: 43.0-62.0) in the combination group. The Mann-Whitney test revealed no statistically significant difference between the two groups (p = 0.418). No significant difference in overall quality of life was observed between schizophrenia patients treated with aripiprazole monotherapy and those treated with a risperidone-clozapine combination. Within the limitations of this cross-sectional study, neither regimen demonstrated superiority in terms of patient QoL. Clinicians should consider individual patient factors and side effect profiles when selecting antipsychotic therapy, as overall QoL outcomes may be comparable between these two strategies.
Tuberculosis (TB) treatment is often interrupted by adverse drug reactions (ADRs). However, few studies have thoroughly examined these ADR patterns in TB treatment, and no research has assessed the prevalence of ADRs in specific organs. This narrative review describes the patterns of ADRs in tuberculosis treatment, including how common each type is and its impact on organs across different countries and populations. A structured narrative literature review was conducted to identify relevant original studies published in PubMed database between 2019 and 2025. The search combined Medical Subject Headings (MeSH) and free-text terms related to ``tuberculosis'' and ``adverse drug reactions''. Eligible original studies reporting ADR prevalence and affected organ systems during TB treatment were reviewed, and findings were synthesized narratively without meta-analysis or pooled prevalence estimates. ADRs occurred in 23%–90% of patients, with the highest rates seen in those receiving treatment for drug-resistant TB. Severe ADRs such as hepatotoxicity, ototoxicity, hematologic toxicity, and QT prolongation often lead to dose adjustments or discontinuation in up to 28% of cases. The prevalence of ADRs varied geographically, ranging from 1% to 90% in Africa, 7% to 57% in Asia, and 1% to 82% in Europe. ADRs are highly prevalent and affect multiple organ systems among patients receiving TB therapy. These findings highlight the importance of adopting integrated, patient-centered strategies for managing ADRs in TB. Future studies should adopt standardized definitions and reporting methods to improve the comparability of ADR prevalence across settings.
