In the hills of North Tapanuli, particularly around Tarutung, grows a wild plant that has long been part of the local community’s traditional medicinal knowledge. Known as Bosi-bosi (Timonius flavescens), the plant belongs to the Rubiaceae family. Its leaves have traditionally been boiled to produce an infusion that is consumed to relieve pain and help treat an illness locally known as sakit gula, or diabetes mellitus.
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For years, the use of Bosi-bosi has relied on experience and knowledge passed down from one generation to the next. Yet behind this tradition lies an intriguing scientific question: What compounds are contained in its leaves, and to what extent can their biological potential be demonstrated through modern research?
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This question led Muhammad Fauzan Lubis, a lecturer and researcher in the Department of Pharmaceutical Biology, Faculty of Pharmacy, Universitas Sumatera Utara (USU), and his team to investigate the potential of Bosi-bosi leaves through a scientific approach. In addition to examining their chemical constituents, the team also explored the potential anticancer activity of the plant extract against breast cancer.
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“The plant we used in this study is Timonius flavescens from the Rubiaceae family. Why was I interested in studying it? Based on the available literature, researchers who have explored this plant have mostly come from North Sumatra. Since my focus at the faculty is pharmaceutical biology and medicinal plants, I have a strong interest in exploring plants that are characteristic of our own region. From there, we tried to find out what other benefits the plant might have, including its potential against cancer,” Fauzan explained.
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The research, which began in 2023, was funded through the EQUITY Project LPDP scheme managed by Universitas Sumatera Utara in collaboration with the Ministry of Education, Culture, Research, and Technology. Through this research, traditional knowledge about Bosi-bosi was brought together with laboratory technology to identify, optimize, and test the potential of its compounds.
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<h2>Exploring the Potential of the Leaves Through Green Chemistry</h2>
In medicinal plant research, the extraction process plays an important role. This stage determines how optimally the desired compounds can be separated from plant material. The extraction method used can also influence the characteristics of the extract and its potential applications.
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The community generally knows Bosi-bosi through a simple method: boiling its leaves in water. The USU research team took a different approach. They employed a scientifically designed extraction method that considered both process efficiency and environmentally friendly principles.
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One of the approaches used was Natural Deep Eutectic Solvent (NADES), a solvent system developed by combining specific components. In this study, NADES was prepared by combining choline chloride as a hydrogen bond acceptor and D-glucose as a hydrogen bond donor, which were then dissolved together with water.
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This approach is consistent with the principles of green chemistry, which promote the development of chemical processes while taking their environmental impacts into consideration. The use of NADES was investigated as an alternative to dependence on conventional organic solvents, such as ethanol or methanol, which present their own safety and environmental considerations.
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To obtain the optimal solvent composition, the team applied the statistical Central Composite Design (CCD) method based on Response Surface Methodology (RSM). The extraction process was also combined with ultrasound technology, known as Ultrasound-Assisted Extraction (UAE).
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“We did not use the traditional boiling method practiced by the community. Instead, we tried to use a scientific approach to optimize the potential of Bosi-bosi leaves. Through the appropriate NADES solvent formulation, the polyphenol and flavonoid compounds in the leaves can be extracted much more optimally,” he explained.
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The success of the extraction formulation was subsequently evaluated through characterization using Fourier Transform Infrared Spectroscopy (FTIR) and Transmission Electron Microscope (TEM). The test results showed hydrogen-bond interactions between choline chloride and glucose, as well as spherical structures reported to have formed within the extract system.
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This stage was important before the extract underwent further testing. To understand the potential of a medicinal plant, researchers cannot simply establish that the plant contains certain compounds. The characteristics of the extract, its chemical constituents, and its biological activity must also be systematically examined.
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<h2>Investigating Compounds with Potential Against Cancer Cells</h2>
After obtaining the optimized extract, the team continued the research by identifying the bioactive compounds it contained. The analysis was conducted using Liquid Chromatography-High Resolution Mass Spectrometry (LC-HRMS), with support from the National Research and Innovation Agency (BRIN).
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Through this analysis, the team successfully identified 13 major bioactive compounds. The resulting extract also demonstrated high antioxidant activity. At a concentration of 500 μg/mL, its DPPH free-radical inhibition activity reached 89.32 percent.
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These findings provided an initial picture of the biological potential of Bosi-bosi leaf extract. However, the research did not stop at antioxidant activity. The team also examined the response of breast cancer cells to the extract through in vitro cytotoxicity testing using the MTT assay on three breast cancer cell lines.
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To gain a deeper understanding of cellular responses, the study was supplemented with flow cytometry analysis and immunocytochemical staining. The test results indicated two main mechanisms associated with the inhibition of cancer cell growth and cell death: cell cycle arrest and the induction of apoptosis.
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The first mechanism involved G0-G1 cell cycle arrest, in which the cell cycle is halted at the G0-G1 phase. Under normal conditions, cells pass through specific stages before dividing. In cancer cells, this process can occur uncontrollably. The study found a decrease in the expression of cyclin D1 protein (downregulation), a protein involved in regulating the cell cycle and cell division. The reduced expression of this protein indicates the extract’s potential to inhibit cancer cell proliferation.
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The second mechanism was the induction of apoptosis, a process of programmed cell death. In the testing, the extract increased cell death through both the early apoptosis and late apoptosis phases. This response was mediated by an increase in p53 protein expression (upregulation), which is known to play an important role in regulating the cell cycle and cellular responses to damage.
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“The decreased expression of cyclin D1 slows tumor cell division, while increased p53 expression triggers cancer cells to undergo programmed cell death. This combination is what makes Bosi-bosi leaf extract highly promising for further development as an adjunctive anticancer therapy,” Fauzan explained.
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Nevertheless, laboratory testing on cells cannot yet be equated with successful treatment in humans. These findings constitute preliminary evidence that requires further research to establish the mechanism of action, efficacy, dosage, and safety before its clinical potential can be assessed.
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<h2>Cross-University Collaboration Strengthens the Research</h2>
Behind the series of tests was collaboration among researchers from various institutions with complementary expertise. Medicinal plant research requires contributions from multiple disciplines, ranging from pharmaceutical biology and formulation to cell culture, anticancer testing, and toxicity evaluation.
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The research team was led by Muhammad Fauzan Lubis, M.Farm., Apt., from the Faculty of Pharmacy, USU. He worked with a number of researchers, including Dr. Retno Murwanti, M.Sc., Apt., from the Faculty of Pharmacy, Universitas Gadjah Mada (UGM), an expert in cell culture and anticancer research; Prof. Dr. Poppy Anjelisa Zaitun Hasibuan, M.Si., Apt., from the Faculty of Pharmacy, USU, an expert in anticancer research; and Prof. Dr. Sumaiyah, M.Si., Apt., from the Faculty of Pharmacy, USU, an expert in formulation and preparation.
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The team also included Nur Aira Juwita, S.Farm., from the Faculty of Pharmacy, USU; Khairani Fitri, S.Farm., M.Si., from the Institut Kesehatan Helvetia Medan; Dr. Ana Yulyana, M.Si., from the Faculty of Pharmacy, Institut Sains dan Teknologi Nasional (ISTN), Jakarta; Ririn Astyka, M.Si., from the Faculty of Vocational Studies, USU; Sri Yuliasmi, M.Si., Apt., from the Faculty of Pharmacy, USU; dr. Lokot Donna Lubis, Sp.PA, from the Faculty of Medicine, USU, an expert in histology and toxicology; and Wardiyah Daulay, S.Kep., Ns., M.Kep., from the Faculty of Nursing, USU.
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The collaboration enabled various stages of the research to be carried out with the appropriate expertise and facilities. Cancer cell testing was conducted using cell culture laboratory facilities at UGM, with support from Dr. Retno Murwanti. Meanwhile, toxicity testing and sample preparation were carried out at USU with researchers specializing in the relevant fields.
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“This research was not completed in a short period of time. We were greatly helped by having solid research partners. For the cancer cell testing, we used the cell culture laboratory facilities at UGM with assistance from Dr. Retno. For toxicity testing and sample preparation, we carried them out at USU together with Prof. Sumaiyah, Prof. Poppy, and Dr. Lokot Donna. We were also supported by colleagues from Universitas Pancasila, ISTN Jakarta, and Helvetia,” Fauzan said.
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This cross-institutional collaboration demonstrates that exploring local biodiversity requires collective support. From extraction to biological evaluation, each stage requires different levels of precision and expertise to ensure that the research findings are scientifically accountable.
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The findings have been published in the international journal Advances in Traditional Medicine, published by Springer, making the findings on the potential of Bosi-bosi leaves part of the growing body of scientific literature on traditional medicine.
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<h2>Safety as a Crucial Stage That Cannot Be Overlooked</h2>
Discovering potential anticancer activity is not the end of research into a medicinal plant. Before an extract can be considered for further development, safety must also receive serious attention.
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For this reason, the team conducted an in vivo acute toxicity test on mice as test animals, referring to OECD Guideline 420. The test used single doses of the optimized extract of up to 2,000 mg/kg body weight (BW) and 5,000 mg/kg BW, after which the test animals were observed for 14 days.
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Based on the reported observations, no deaths or toxic symptoms were found in the test animals. Body weight increased normally, while hematological and blood biochemical parameters, including indicators of liver and kidney function, remained within normal physiological ranges. Histopathological examinations of the heart and kidneys also showed intact and healthy cellular structures.
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These results provide an initial indication supporting the safety profile of the extract under the tested conditions. Nevertheless, acute toxicity testing alone is not sufficient to establish the safety of long-term use or the safety and efficacy of the extract in humans.
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Therefore, further research is still needed before the extract can be directed toward product development. More comprehensive safety evaluations are an important foundation for ensuring that the potential of medicinal plants can be developed responsibly.
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<h2>From Laboratory Findings Toward Technology Downstreaming</h2>
For Fauzan and his team, the findings obtained so far provide a foundation for moving to the next stage. They see opportunities to develop Bosi-bosi leaves as a raw material with potential applications in natural product development. However, the journey toward a product that can be used by the public still requires a series of research stages.
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Fauzan emphasized that the research remains at the preliminary study stage. The team has not yet produced a physical packaged product because the liquid extract was prepared specifically for biological activity and toxicity testing.
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“At present, we have not produced a packaged physical product because the liquid extract we prepared was entirely allocated for activity and toxicity testing. Going forward, we hope this research can proceed to formula standardization to ensure consistent quality, efficacy, and safety. We also need to conduct a subchronic toxicity test—administering the substance over a period of three months—before moving toward technology downstreaming,” he explained.
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Standardization is an important step in ensuring that the resulting extract has consistent characteristics and quality. In addition, further testing is needed to obtain a more comprehensive understanding of its safety, dosage, and potential applications.
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The hope of continuing this research is also driven by the strong public interest in natural-based medicine. For the research team, traditional knowledge about medicinal plants can serve as a valuable starting point for scientific research, provided that every claim of benefit is tested through measurable and scientifically accountable processes.
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“Our community is very receptive to herbal medicines. Our great hope as a research team is that the testing of Bosi-bosi can continue until it eventually produces a phytopharmaceutical product or a safe, scientifically validated adjunctive anticancer therapy whose benefits can be experienced by the wider community,” Fauzan concluded optimistically.
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The journey of Bosi-bosi leaves from the hills of North Tapanuli to modern laboratories demonstrates how local biodiversity can open new avenues for scientific discovery. Through green chemistry, bioactive compound identification, anticancer activity testing, and preliminary safety evaluation, a plant long familiar within local traditions is now being studied using modern scientific tools.
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The road toward clinical application remains long. Nevertheless, this research underscores one important point: the natural wealth of North Sumatra holds opportunities worthy of scientific exploration. Through sustained research, interdisciplinary collaboration, and rigorous testing, this potential can be further explored to open new possibilities for developing natural-product-based medicines in Indonesia.
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(RJ/Syaiba)

In the hills of North Tapanuli, particularly around Tarutung, grows a wild plant that has long been part of the local community’s traditional medicinal knowledge. Known as Bosi-bosi (Timonius flavescens), the plant belongs to the Rubiaceae family. Its leaves have traditionally been boiled to produce an infusion that is consumed to relieve pain and help

Research Trail from the Forests of Tarutung: Bosi-bosi Leaves Push the Boundaries of Green Extraction and Breast Cancer Research

Universitas

Raisha Andini

Indonesia's persistent development gap between its western and eastern regions—reflected in unequal access to education, healthcare, and financial services—continues to pose a structural challenge that cannot be resolved through economic growth alone. Against this backdrop, identifying the most effective policy measures to reduce income inequality has become an increasingly urgent issue that requires empirical rather than merely normative answers.
 
Addressing this challenge, Dr. Paidi, a lecturer at the Faculty of Economics and Business, Universitas Sumatera Utara (USU), conducted a study entitled "Examining the Connection Between Financial Inclusion and Income Inequality in Indonesia," published in the international journal Economies (MDPI). The research examines the determinants of income inequality across Indonesian provinces using dynamic panel data from 33 provinces between 2015 and 2023. North Kalimantan was excluded due to limited data availability during the early years of the study. The data were obtained from official sources, including Statistics Indonesia (BPS), the Indonesia Investment Coordinating Board (BKPM), the Financial Services Authority (OJK), and Bank Indonesia.
 
The 2015–2023 period was selected because it encompasses both the implementation of Indonesia's National Financial Inclusion Strategy (SNKI) and the COVID-19 pandemic, two significant events that substantially influenced income inequality and public access to financial services.
 
The study examined the impact of four key variables on income inequality: the Financial Inclusion Index, the Human Development Index (HDI), foreign direct investment (FDI), and domestic investment. The Financial Inclusion Index was constructed using Principal Component Analysis (PCA), enabling a more comprehensive representation of access to, availability of, and usage of financial services.
 
To identify causal relationships among these variables while accounting for the possibility that current inequality is influenced by inequality in previous years, the study employed the two-step Generalized Method of Moments (GMM), an econometric approach specifically designed for dynamic panel data. The model was subjected to validity and autocorrelation tests to ensure the methodological reliability of the findings.
 
The results reveal that income inequality in Indonesia exhibits a very high degree of persistence. In other words, provinces experiencing high levels of inequality in one period are likely to continue experiencing similar conditions in subsequent periods unless strong policy interventions are implemented. This finding indicates that inequality is shaped not only by current economic conditions but also by long-standing structural factors.
 
The study further demonstrates that expanding access to formal financial services has a negative and statistically significant relationship with income inequality, suggesting that greater financial inclusion can serve as an important instrument for promoting more equitable economic development.
 
Conversely, foreign investment tends to be concentrated in capital-intensive industries and already-developed regions, increasing the risk of widening regional disparities when not accompanied by more inclusive policies. Domestic investment, meanwhile, showed a positive but statistically insignificant relationship with income inequality, indicating that it remains concentrated in relatively developed regions and has yet to function effectively as a tool for economic equalization.
 
These findings provide valuable empirical evidence for designing more targeted financial inclusion policies while offering strategic recommendations for reducing regional development disparities across Indonesia.
 
According to Dr. Paidi, Indonesia's geographical characteristics as an archipelagic nation create unique structural challenges for financial inclusion, particularly in regions where conventional banking infrastructure remains difficult to access. This distinctive geographic context differentiates Indonesia from continental countries and explains why financial inclusion may play a particularly important corrective role within the country's highly decentralized institutional framework.
 
The study's most significant finding concerns financial inclusion itself. The broader the public's access to formal financial services—including savings accounts, microcredit, and digital payment systems—the lower the level of income inequality observed across provinces.
 
Dr. Paidi explained that access to formal financial services enables low-income households to escape dependence on loan sharks and high-interest informal lenders while providing them with the capital needed to develop productive businesses independently. This pattern is consistent with findings from similar studies conducted in developing countries, ranging from Ecuador to several African nations, where formal financial access has proven to be an effective pathway toward more equitable economic development.
 
Meanwhile, the Human Development Index showed a relationship consistent with economic theory: higher levels of education, health, and purchasing power are associated with lower income inequality. However, its effect was not statistically significant within the study period. Rather than suggesting that human development is unimportant, the findings indicate that its impact is more likely to materialize over the long term, particularly given the substantial disparities in educational quality among Indonesian provinces. For example, the gap between Jakarta and Papua remains too wide for improvements in human development to produce uniform equalizing effects in the short term.
 
One of the study's more surprising findings relates to investment. Foreign investment in Indonesia has largely been concentrated in capital-intensive sectors such as heavy manufacturing and mining, industries that generate relatively limited employment opportunities for local communities. Furthermore, these investments are primarily located in infrastructure-rich regions such as West Java, Banten, and Jakarta. Rather than serving as a driver of equitable development, such concentration risks widening the economic divide between investment-receiving regions and less-developed areas.
 
According to Dr. Paidi, these findings do not suggest that foreign investment should be restricted. Instead, investment policies should be redirected toward labor-intensive industries and regions that have historically received limited investment so that economic growth can be distributed more evenly across the country rather than remaining concentrated in already-developed areas.
 
Based on these findings, the study proposes more targeted policy recommendations than the general call to "expand financial access." For example, Indonesia's People's Business Credit (KUR) program should be more specifically directed toward provinces with the highest levels of inequality through dedicated credit guarantee schemes that effectively reach low-income communities.
 
Given Indonesia's archipelagic geography, the research also recommends prioritizing the expansion of financial technology (fintech) services and agent banking initiatives such as Laku Pandai over the construction of additional physical bank branches, as these approaches are considered more efficient in serving remote areas.
 
In addition, large-scale foreign investment projects should be required to establish supply-chain linkages with local micro, small, and medium-sized enterprises (MSMEs) rather than operating as isolated economic enclaves disconnected from surrounding communities.
 
The research demonstrates that financial inclusion should not be viewed solely as a financial sector development strategy but also as a key policy instrument for fostering more inclusive economic growth and reducing regional income inequality in Indonesia. Combined with more equitable human development and inclusive investment policies, financial inclusion has the potential to support more sustainable and balanced economic prosperity throughout the country.
 
Dr. Paidi also emphasized that while the study demonstrates strong statistical correlations based on nine years of data, the findings should not be interpreted as universally applicable causal relationships under all circumstances. He encouraged future research to investigate possible threshold effects—for example, whether financial inclusion becomes significantly more effective in reducing inequality only after a region reaches a certain level of human capital development—and to compare the mechanisms operating in western and eastern Indonesia, where financial infrastructure differs considerably.
 
This study serves as a clear example of how academic research conducted at the Faculty of Economics and Business, Universitas Sumatera Utara, extends beyond theoretical discussions by providing empirical evidence that can directly inform policymakers in their efforts to promote more inclusive and equitable economic growth across Indonesia.
 
Paper Details
<ul data-start="10156" data-end="10453" data-is-last-node="" data-is-only-node="">
<li data-section-id="23e0ig" data-start="10156" data-end="10189">
Journal: Economies (MDPI)</li>
<li data-section-id="lq49f6" data-start="10190" data-end="10292">
Title: Examining the Connection Between Financial Inclusion and Income Inequality in Indonesia
</li>
<li data-section-id="1ists42" data-start="10293" data-end="10312">
Author: Paidi</li>
<li data-section-id="51daw7" data-start="10313" data-end="10400">
Author Affiliation: Faculty of Economics and Business, Universitas Sumatera Utara</li>
<li data-section-id="7e20h7" data-start="10401" data-end="10453" data-is-last-node="">
DOI: <a class="decorated-link" href="https://doi.org/10.3390/economies14040122" data-start="10412" data-end="10453" rel="noopener" target="_new" data-is-last-node="">https://doi.org/10.3390/economies14040122</a>
</li>
</ul>

Examining the Connection Between Financial Inclusion and Income Inequality in Indonesia pada jurnal internasional Economies (MDPI)

USU Researchers Reveals the Key to Reducing Income Inequality in Indonesia

Dr. Paidi, SE., M.Si.

Research findings reveal that although soil-transmitted helminth (STH) infections have declined significantly worldwide, anemia prevalence among children under five and women of reproductive age continues to fluctuate. After adjusting for socioeconomic factors, STH was no longer found to have a significant effect on anemia. Instead, anemia among children under five was primarily associated with the Human Development Index (HDI), while anemia among women of reproductive age was linked to access to safe drinking water and universal health coverage. These findings support a shift in anemia prevention strategies from relying solely on deworming programs to adopting broader, multisectoral interventions.
 Anemia and neglected tropical diseases (NTDs), such as soil-transmitted helminth infections, have long been considered closely interconnected because they share similar geographic distributions and risk factors, particularly in low- and middle-income countries. A study entitled Impact of Soil-Transmitted Helminths Infections on Anemia Burden: A Global Analysis of Children Under Five and Reproductive-Age Women, published in BMC Public Health (2025) by Rahayu Lubis, Fauzi Budi Satria, Rasmaliah, Jemadi, and Siti Khadijah Nasution from the Faculty of Public Health, Universitas Sumatera Utara (USU), in collaboration with Rafdzah Ahmad Zaki from the University of Malaya, re-examined this assumption on a global scale using data from 187 countries collected between 2015 and 2019.
 In many developing countries, anemia and helminth infections are often regarded as inseparable health problems that are expected to improve simultaneously through mass deworming programs. However, anemia remains a major global health challenge, affecting approximately 1.62 billion people worldwide. Among children under five and pregnant women, anemia can result in long-term consequences, including impaired cognitive development and an increased risk of mortality. Children under five require higher iron intake to support growth and development, while women of reproductive age have greater iron requirements due to menstruation and pregnancy. Both groups are therefore highly vulnerable to anemia and remain key targets of the World Health Organization’s NTD Roadmap 2030.
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To better understand why these two conditions sometimes overlap and sometimes diverge at the population level, the researchers applied the SYSRA framework, which is commonly used to examine interactions between infectious disease programs and broader health systems. Four potential confounding factors were incorporated into the analysis: the Universal Health Coverage (UHC) Service Coverage Index, safe water and sanitation indicators under SDGs 6.1 and 6.2, Government Effectiveness, and the Human Development Index (HDI). The rationale was straightforward—both helminth infections and anemia are more prevalent in areas with poor sanitation, limited healthcare access, and weak governance. Without accounting for these structural factors, any observed relationship between STH and anemia could be misleading.
 Methodologically, the research employed an ecological study design, meaning that the unit of analysis was countries rather than individuals. Data on STH prevalence and anemia burden were obtained from the Global Burden of Disease (GBD) database, while UHC, water and sanitation, government effectiveness, and HDI data were sourced respectively from the World Health Organization (WHO), the World Bank’s Worldwide Governance Indicators, and the United Nations Development Programme (UNDP). Countries were categorized into high- and low-prevalence groups using the Receiver Operating Characteristic (ROC) Clustering approach. Statistical analyses included paired t-tests to assess annual trends, chi-square tests to examine associations between variables, and multiple logistic regression to identify independent determinants of anemia after controlling for confounding variables.
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The first major finding showed that the prevalence of STH infections declined significantly every year between 2015 and 2019 among both children under five and women of reproductive age, indicating that global interventions such as mass deworming and improved sanitation have been effective. However, anemia did not exhibit the same pattern. Its prevalence fluctuated throughout the study period without showing a consistent downward trend. Numerically, STH prevalence among children under five (87.37 per 100,000 population) was much lower than among women of reproductive age (10,140.04 per 100,000 population). In contrast, anemia prevalence was significantly higher among children under five (248.29 per 100,000 population) than among women of reproductive age (104.37 per 100,000 population).
 Among the 187 countries analyzed, 52.94% were classified as having relatively low anemia prevalence, while 47.06% experienced high anemia prevalence. Countries with the greatest anemia burden consistently shared similar characteristics, including low HDI, weak government effectiveness, inadequate water and sanitation infrastructure, and limited UHC coverage, illustrating a pattern of overlapping structural vulnerabilities.
The study’s most significant finding emerged from the multivariate logistic regression analysis. In the initial bivariate analysis using chi-square tests, STH appeared to be significantly associated with anemia among children under five, suggesting that helminth infections contributed to childhood anemia. However, after simultaneously controlling for HDI, government effectiveness, water and sanitation, and UHC, the association disappeared. STH was no longer a statistically significant determinant of anemia among either children under five (OR = 1.62; p = 0.59) or women of reproductive age (OR = 0.59; p = 0.21).
Instead, the analysis identified HDI as the strongest determinant of anemia among children under five. Countries with low HDI were 14.17 times more likely to experience high childhood anemia prevalence (p &lt; 0.05). Among women of reproductive age, the significant determinants were limited access to safe drinking water under SDG 6.1 (OR = 3.98; p &lt; 0.05) and low UHC coverage (OR = 4.09; p &lt; 0.05), indicating substantially higher risks of anemia in countries lacking these essential services.
 These findings differ from many previous studies that consistently reported positive associations between STH infections and anemia in both children and women of reproductive age. The discrepancy is likely attributable to the ecological nature of the study, which captures patterns at the national rather than individual level. Consequently, structural determinants such as human development and healthcare access appear more influential than the direct biological effects of helminth infections on hemoglobin levels. Differences in national deworming program coverage may also help explain the divergence from earlier research.
 The implications are substantial. The study suggests that efforts to reduce anemia among children under five and women of reproductive age should no longer rely exclusively on deworming initiatives, important though they remain within the global NTD agenda. Instead, broader interventions are needed, including comprehensive human development policies for children, expanded access to safe drinking water, and stronger universal health coverage for women of reproductive age. Poverty reduction, clean water infrastructure, and strengthened health systems should complement conventional public health programs rather than serve merely as supporting measures.
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Ultimately, the study demonstrates that although soil-transmitted helminth infections are declining globally due to successful deworming programs and improved sanitation, anemia persists because its underlying causes are far more complex, rooted in inequalities in development, limited access to clean water, and gaps within health systems. The researchers emphasize that, because of the ecological study design, the findings cannot establish causal relationships at the individual level. They therefore recommend future research using individual-level data while considering co-infections such as malaria and HIV to strengthen the evidence base and support more targeted interventions.
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<h3 class="PDq2pG_selectionAnchorContainer" data-section-id="ocad6k" data-start="9838" data-end="9861">Research Highlights</h3>
<ul data-start="9862" data-end="11168">
<li data-section-id="1m2a97n" data-start="9862" data-end="10081">Ecological study covering 187 countries (2015–2019) examining the relationship between STH infections and anemia burden among children under five and women aged 15–49 years using Global Burden of Disease data.</li>
<li data-section-id="1268h14" data-start="10082" data-end="10314">STH prevalence declined significantly each year (p &lt; 0.05) among children under five (87.37/100,000) and women of reproductive age (10,140.04/100,000), whereas anemia prevalence fluctuated without a consistent decline.</li>
<li data-section-id="19urs08" data-start="10315" data-end="10480">Anemia prevalence among children under five (248.29/100,000) was significantly higher than among women of reproductive age (104.37/100,000) (p &lt; 0.05).</li>
<li data-section-id="1l095bf" data-start="10481" data-end="10579">
52.94% of countries had low average anemia prevalence, while 47.06% had high prevalence.</li>
<li data-section-id="10rww2w" data-start="10580" data-end="10775">Multivariate analysis showed that STH was not a significant determinant of anemia among children under five (OR = 1.62; p = 0.59) or women of reproductive age (OR = 0.59; p = 0.21).</li>
<li data-section-id="1yy4e0q" data-start="10776" data-end="10885">Low HDI increased the risk of high childhood anemia prevalence by 14.17 times (95% CI: 4.25–44.66).</li>
<li data-section-id="ptvptp" data-start="10886" data-end="11044">Limited access to safe drinking water (SDG 6.1) increased the risk of anemia among women of reproductive age by 3.98 times (95% CI: 1.35–11.78).</li>
<li data-section-id="1qecl4v" data-start="11045" data-end="11168">Low UHC coverage increased the risk of anemia among women of reproductive age by 4.09 times (95% CI: 1.06–15.69).</li>
</ul>
<h3 data-section-id="h4yl2q" data-start="11170" data-end="11187">Paper Details</h3>
<ul data-start="11188" data-end="11959" data-is-last-node="" data-is-only-node="">
<li data-section-id="1dls5mn" data-start="11188" data-end="11252">
Journal: BMC Public Health, Vol. 25, Article 1356 (2025)</li>
<li data-section-id="1arwd63" data-start="11253" data-end="11401">
Title: Impact of Soil-Transmitted Helminths Infections on Anemia Burden: A Global Analysis of Children Under Five and Reproductive-Age Women
</li>
<li data-section-id="18r7ag9" data-start="11402" data-end="11515">
Authors: Rahayu Lubis, Fauzi Budi Satria, Rasmaliah, Jemadi, Siti Khadijah Nasution, and Rafdzah Ahmad Zaki</li>
<li data-section-id="oxn51a" data-start="11516" data-end="11905">
Affiliations: Faculty of Public Health, Universitas Sumatera Utara; Doctoral Program in Medical Science &amp; Department of Community Medicine, Faculty of Medicine, Universitas Sumatera Utara; Regional Collaborating Centre USU–SingHealth Duke-NUS Global Health Institute, Medan; Centre for Epidemiology and Evidence-Based Practice, Faculty of Medicine, University of Malaya, Kuala Lumpur</li>
<li data-section-id="1f4034f" data-start="11906" data-end="11959" data-is-last-node="">
DOI: <a class="decorated-link" href="https://doi.org/10.1186/s12889-025-22572-z" data-start="11917" data-end="11959" data-is-last-node="" rel="noopener" target="_new">https://doi.org/10.1186/s12889-025-22572-z</a>
</li>
</ul>

Impact of soil-transmitted helminths infections on anemia burden: a global analysis of children under five and reproductive-age women

USU Researchers: Global Soil-Transmitted Helminth Infections Decline, but Anemia in Children Under Five and Women of Reproductive Age Remains Unresolved

Nelly Anna, together with Evalina Herawati, Novita Anggraini, Jajang Sutiawan, Bagastha Olky Narsiga Bangun, and Lastrisa Desfa Banjarnahor, a research team from Universitas Sumatera Utara (USU), conducted field research in community plantations to determine whether jabon trees (Neolamarckia cadamba) grown alongside coffee plants truly become stunted or produce lower-quality timber, as many farmers have long feared. Jabon is a well-known native Indonesian tree species valued for its rapid growth and versatile timber, which is widely used for plywood, furniture, and packaging materials. Its sap and leaves have also traditionally been utilized for medicinal purposes in various regions.
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Through a study entitled "Growth and Wood Physical Properties of Neolamarckia cadamba (Jabon) under Agroforestry System," the researchers evaluated the growth of 161 thirteen-year-old jabon trees planted alongside coffee at a spacing of 3 × 3 meters. This planting pattern represents the agroforestry systems commonly practiced by local communities to integrate forestry and agricultural production sustainably. To examine wood quality in greater detail, three representative trees were felled and analyzed from the base to the top of the stem and from the heartwood to the outer layers. Such extensive fieldwork required considerable time, patience, and precision, reflecting the team's commitment to producing reliable scientific evidence.
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The results provide reassuring news for farmers who rely on jabon as an important source of income. At thirteen years of age, the trees in the mixed plantation reached an average height of 18 meters with an average stem diameter of 36 centimeters, demonstrating healthy growth comparable to jabon cultivated in monoculture plantations. Most trees exhibited consistent height and diameter classes, indicating stable and uniform development rather than exceptional performance by only a few individuals. The research site also featured favorable environmental conditions, including a cool climate, sufficient rainfall, and fertile soils commonly found in many community plantations across North Sumatra.
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The researchers extended their investigation beyond measuring tree height and diameter by examining the physical properties of the wood itself. They found that the lower sections of the stem contained higher moisture content than the upper sections, while wood density followed the opposite pattern, becoming denser and heavier toward the upper stem. These findings provide valuable information for wood processors and manufacturers by identifying which portions of the stem are better suited for specific applications. Denser wood can be prioritized for products requiring greater strength, while less dense sections remain suitable for products with lower structural demands.
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Most importantly, laboratory analyses demonstrated that the wood quality of jabon grown in the agroforestry system remained within the acceptable range for industrial use and was comparable to timber produced from monoculture plantations. These findings directly challenge the long-standing assumption that intercropping coffee with jabon reduces timber quality. The researchers also observed that faster-growing trees tended to produce slightly lighter wood because the wood tissue remained relatively juvenile and had not yet reached the density found in more slowly growing trees. Rather than weakening the study, this observation strengthens the credibility of the findings by providing a realistic explanation for natural variation in wood characteristics.
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For farmers, the implications extend well beyond scientific measurements. Growing coffee alongside jabon enables farming households to generate annual income from coffee harvests while simultaneously building long-term savings through timber production, without worrying that the wood will lose its market value at harvest. Such agroforestry systems also help maintain soil moisture and fertility through the complementary root systems of both crops, reducing the risks of erosion and drought. Equally important, farmers can meet future timber demand without clearing additional forest land, since timber production is integrated into the same agricultural landscape.
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Published in the Asian Journal of Forestry, this research represents more than an academic contribution. It provides practical scientific evidence that farmers can directly apply when making land management decisions. The dedication of Nelly Anna and her colleagues—carefully examining each section of the stem, measuring every wood sample, and analyzing each dataset—demonstrates how rigorous scientific research can generate tangible benefits for local communities. At a time when forest conservation remains an increasingly urgent challenge, the study offers an encouraging message: farmers do not have to choose between cultivating coffee or producing timber. Both can thrive together in a well-managed agroforestry system, creating sustainable environmental and economic benefits for farming families.

Growth and Wood Physical Properties of Neolamarckia cadamba (Jabon) under Agroforestry System

Growing Coffee While Investing in Timber: Scientific Evidence from Community Plantations in Deli Serdang

Amid the rapid pace of digital transformation, a company’s ability to process data and integrate systems has become more than just a supporting asset—it is now a critical factor in gaining a competitive advantage. The telecommunications industry, as the driving force behind connectivity, stands at the center of this transformation. Telecommunications companies are no longer expected to merely provide network infrastructure; they must continuously generate innovative solutions to remain relevant in a market characterized by rapidly evolving consumer demands.
 
A strategic study entitled “Enhancing Innovation Performance through Digital Platform Capability and Big Data Analytics: Evidence from Indonesia's Telecommunications Industry,” published in the International Journal of Data and Network Science, explores this phenomenon in depth. The national-scale research was conducted by a team from the Department of Management Science, Faculty of Economics and Business, Universitas Sumatera Utara (USU), consisting of Dicky Ardiansyah Aceh, Prihatin Lumbanraja, Yeni Absah, and Ritha F. Dalimunthe.
 
As a senior management scholar and the corresponding author of the study, Prihatin Lumbanraja highlighted the unique characteristics of Indonesia’s digital landscape. The telecommunications industry in Indonesia operates within a market that combines a massive mobile-user base with a very high level of digital adoption. This vast market creates intense competition, where consumer expectations can shift within days. Such conditions make Indonesia an ideal laboratory for examining the extent to which technological investments truly influence organizational innovation performance rather than merely serving as corporate buzzwords.
 
Using the theoretical frameworks of the Resource-Based View (RBV) and the Dynamic Capability View (DCV), Prihatin Lumbanraja and her team analyzed data from 331 managerial and supervisory-level respondents working at major Indonesian telecommunications companies, including Telkomsel, Indosat Ooredoo Hutchison, XL Axiata, and Smartfren. These managerial respondents were deliberately selected because they are directly involved in operational and strategic technological decision-making. The analysis, conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM), revealed that superior innovation performance stems from the synergy of two key digital strengths: Digital Platform Capability and Big Data Analytics Capability.
 
The study found that big data analytics capability contributes even more significantly to driving innovation performance. In today’s internet-driven environment, every screen tap, call duration, and browsing activity generates enormous volumes of raw data every second. However, this vast amount of data becomes little more than digital clutter if organizations lack the analytical infrastructure necessary to transform it into valuable insights.
 
When telecommunications companies optimize their analytical capabilities, they gain the ability to detect hidden consumer behavior patterns, forecast market trends with greater accuracy, and minimize business risks before launching new products. One direct impact is the shortening of product development cycles. Rather than relying on assumptions about customer preferences, companies can develop innovative data packages, value-added services (VAS), and personalized digital assistant applications—such as MyTelkomsel and myIM3—based on accurate, real-time data. In this context, data evolves from a mere information asset into a rare and difficult-to-replicate source of competitive advantage.
 
However, accurate data requires an agile integration platform. This is where the second pillar—digital platform capability—plays an equally important role. The USU research team confirmed that a strong digital platform serves as the foundation that integrates various business processes in a modular and flexible manner. Such a platform is not simply software; it is an integrated infrastructure that enables telecommunications companies to communicate, share data, and collaborate with external stakeholders, including content providers, SMEs, and third-party application developers.
 
With advanced platform capabilities, the marginal costs of collaboration can be significantly reduced. Knowledge exchange becomes faster, bureaucratic barriers are minimized, and organizations can absorb external information more efficiently. When markets experience sudden disruptions or shifts, companies with mature digital platforms can rapidly reconfigure their resources and develop more adaptive business models.
 
Through these findings, Prihatin Lumbanraja and the FEB USU research team deliver an important message to practitioners in the digital industry. Genuine digital transformation is not simply about investing large budgets in sophisticated technologies or building impressive data centers. Even the most advanced technology becomes ineffective if it is not supported by capable human resources.
 
Therefore, the greatest challenge facing telecommunications corporations in Indonesia today is fostering a cultural transformation within the workplace. Organizations are encouraged to actively develop data literacy among employees at all levels and ensure that strategic decisions are based on data-driven insights rather than intuition or outdated practices.
 
Furthermore, companies must cultivate work environments that encourage experimentation, support innovative ideas, and promote continuous learning. The combination of intelligent analytics technologies, flexible digital platforms, and a strong data-driven culture among employees forms a “golden triangle” that will enable corporations in developing countries such as Indonesia to remain competitive and lead the digital market on the global stage.

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