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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Mortality due to pneumonia in childhood is strongly associated with malnutrition&#44; poverty&#44; as well as inadequate access to health services&#46; As a result of this&#44; more than 98&#37; of deaths caused by pneumonia in children occurred in 68 countries&#44; of which progress in reducing under-five mortality was the most critical&#46; The burden of pneumonia on families and health systems in low-resource countries exacerbates inequality&#59; especially&#44; children who are poor&#44; hungry&#44; and live in secluded areas most likely will be visited by this &#8220;forgotten killer&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Pneumonia still be a globally major cause of childhood mortality and morbidity&#46; Accurate diagnosis and attribution of the cause of pneumonia are important for measuring the load of disease&#44; implementing appropriate prevention and treatment strategies&#44; and expand more effective interventions&#46; Human adenovirus &#40;HAdV&#41; infection causes serious pneumonia in children&#44; leading to significant morbidity and mortality rates&#46; However&#44; diagnostic biomarkers for HAdV-associated pneumonia are unavailable&#46; Serum microRNAs &#40;miRNAs&#47;miRs&#41; have been recently reported as diagnostic biomarkers for several diseases&#46; The present study performed microRNA sequencing to identify potential biomarkers among serum exosomes miRNAs&#44; with the aim of identifying candidate biomarkers for the diagnosis of pneumonia in adenovirus-infected children&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">2&#44;3</span></a> Biomarkers are usually biological&#44; chemical&#44; or physical substances that can diagnose and examine various parts of the body such as blood and tissues&#46; Biomarkers can show normal or pathological processes that occur in the body&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Globally the proportion of childhood deaths that occur in the neonatal period is increasing&#46; Since 1990 there has been a 47&#37; reduction in deaths in children less than five years of age&#46; Maternal mortality is higher in women living in rural areas and among poorer communities&#46; Young adolescents face a higher risk of complications and death as a result of pregnancy than other women&#46; Skilled care before&#44; during&#44; and after childbirth can save the lives of women and newborn babies&#46; Only a small proportion of women in developing countries less than 30&#37; receive adequate postpartum care&#46; Culture is defined as passed down values&#44; beliefs&#44; attitudes&#44; and behaviours&#44; including knowledge&#44; art&#44; traditions&#44; customs&#44; abilities&#44; and similar skills and habits that human beings gain as a member of society&#46; The postpartum period lasts for approximately 6&#8211;8-weeks&#44; starting from childbirth and ending with the restoration of the reproductive organs and other body systems to their pre-pregnancy state&#46; In this period&#44; significant physiological&#44; social&#44; and emotional changes occur in the woman&#46; Thus&#44; in many cultures&#44; the postpartum period is considered as a sensitive period and various traditional practices are performed to protect the health of the mother and the baby&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The WHO and Indian guidelines still recommend oral cotrimoxazole as an alternative to amoxicillin for outpatient treatment for CAP &#40;community acquired pneumonia&#41;&#46; All children aged 2 months to 5 years with WHO criteria for CAP were prospectively enrolled&#46; Children on antibiotics or having received antibiotics within the previous 2 weeks&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">7&#44;8</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Literature search procedure</span><p id="par0025" class="elsevierStylePara elsevierViewall">This review literature source by accessing in the free journal database via Science Direct&#44; Pubmed&#44; Elseiver&#44; MDPI&#44; WHO&#44; Riskesdas&#44; Google Scholar&#46; Collecting the latest information using keywords as biomarkers&#44; toddlers&#44; grill culture&#46; After that to find the articles into Mendeley software to be synthesized and reviewed&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Result</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Research selection</span><p id="par0030" class="elsevierStylePara elsevierViewall">Find the journals in other sources as 76&#44;211 articles 2013&#8211;2020 years about biomarkers pneumonia&#44; matching the keywords required to be analyzed&#46; In the next step&#44; the articles are being strained by title&#44; abstract&#44; and keywords&#44; obtained 173 articles were then revised founded on their full text&#46; A number of 45 articles were removed because &#40;most of them did not discuss the biomarker pneumonia under five children&#44; environmental sanitation&#44; and grill culture&#41;&#46; Finally&#44; from journal reading theme&#44; that 21 choices articles near with my sources&#44; with my inclusion criteria sources&#46; We can see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; Prisma flow diagram&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Research characteristics</span><p id="par0035" class="elsevierStylePara elsevierViewall">This section defines demographic data items from the 21 particular articles&#46; The results of this study indicate that 21 studies recognized the biomarker pneumonia under five children in grill culture&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Based on the reading results of the article&#44; it shows that the incidence of pneumonia increased from year to year and became the main cause of under five children died&#46; So it needs prevention from the upstream sector to reduce&#46; Childhood clinical pneumonia is caused by a combination of exposure to risk factors related to the host&#44; the environment&#44; and infection&#46; To identify the former two categories of causal factors for the development of pneumonia at the community level&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> In various societies and cultures&#44; pregnancy and childbirth are socio-cultural events that have different meanings&#46; This often translates into social expectations about what certain societies expect to do &#40;or not do&#41; during a woman&#39;s pregnancy&#44; birth&#44; and&#47;or postnatal period&#46; This paper reports a study exploring beliefs around childbirth in Nepal&#44; a low-income country with a largely Hindu population&#46; The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted &#40;or dirty even&#41; after childbirth&#46; This paper explores social and cultural practices that have health implications in the childbirth and postnatal periods of rural Nepali women&#59; and places it in the context of the global literature on such practices&#46; The study explores the extent to which such practices&#44; especially in low-income countries&#44; are part of the cultural adaptation of becoming a mother and identifies why women might not access services&#44; particularly PNC&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> Depression and have greater barriers to accessing treatment are more likely to occur in mothers living in poverty&#46; Numerous studies have demonstrated many factors associated with PPD including obstetric history&#44; biochemical genetic&#44; and other social stressors&#58; age&#59; socioeconomic&#59; culture&#59; education&#59; negative life events&#46; To prevent&#44; early treatment of PPD&#44; increase earnings&#44; and improve the quality of life for women&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> This literature describes the incidence of pneumonia in relation to the culture of postpartum mothers in their treatment practices&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">Pneumonia remains the leading cause of death in children outside the neonatal period&#44; despite advances in prevention and management&#46; Over the last 20 years&#44; there has been a substantial decrease in the incidence of childhood pneumonia and pneumonia-associated mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Pneumonia is the biggest cause of deaths in young children in developing countries&#44; but early diagnosis and intervention can effectively reduce mortality&#46; We aimed to assess the diagnostic value of clinical signs and symptoms to identify radiological pneumonia in children younger than 5 years and to review the accuracy of WHO criteria for a diagnosis of clinical pneumonia&#46; WHO-approved signs age-related fast breathing &#40;six studies&#59; pooled sensitivity 0&#46;62&#44; 95&#37; CI 0&#46;26&#8211;0&#46;89&#59; specificity 0&#46;59&#44; 0&#46;29&#8211;0&#46;84&#41; and lower chest wall indrawing showed poor diagnostic performance&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In general&#44; biomarkers are biological&#44; chemical&#44; or physical substances that can be detected and measured in various parts of the body&#44; such as blood and tissues&#46; Biomarkers can show normal or pathological processes that occur in the body&#46; Biomarkers can be in the form of certain cells&#44; molecules&#44; genes&#44; gene products&#44; enzymes&#44; or hormones&#46; Biomarkers can be used for diagnostic purposes&#44; disease processes&#44; disease degree&#44; disease prognosis &#40;cancer biomarkers&#41;&#44; and biomarkers to monitor clinical response to intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The results of research in Cambodian villages&#44; for traditional beliefs&#44; some postpartum women have modern medicine during childbirth and then use traditional medicine right away&#46; Like drinking traditional medicine consisting of plants from leaves&#44; bark&#44; and roots&#46; One explanation for this is that the mother doesn&#8217;t know what to care about&#44; so will listen more to the older person&#44; the mother&#46; However&#44; in the next pregnancy&#44; she will have more confidence&#44; knowledge&#44; and experience so she will move in her own way towards modern medicine even though some traditional medicines may continue to be used&#46; They still use traditional medicine to maintain this habit&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The results of the study in Nepal&#44; a country where income levels are low&#44; pregnancy&#44; and childbirth are socio-cultural events that have different meanings in different societies and cultures&#46; This often translates into social expectations of what certain societies expect &#40;or should not do&#41; during pregnancy&#44; birth&#44; and&#47;or the postnatal period&#46; The study explores beliefs around childbirth&#44; then establishes issues such as the period in which women were seen as polluted &#40;or even dirty&#41; after childbirth&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Postpartum women in addition to maintaining the health of their babies also maintain their reproductive health&#46; The role of culture in maintaining postpartum sexual abstinence in women in Swazi&#46; The literature shows that periods of abstinence and resumption of sexual activity are influenced by many factors and variations from existing cultures&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The culture of the Timorese people in the Timor Tengah Selatan district of NTT province is that mothers are required to give birth in a roundhouse &#40;traditional house&#41; and receive 40 days of care by a dukun or someone who is believed to have experience in caring for the mother&#46; Treatment for postpartum mothers is usually in the form of baking a fire&#46; This cultural event will adversely affect the mother and the baby who will roast the body over medium heat and also affect the faster healing of wounds after childbirth&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conclusion</span><p id="par0075" class="elsevierStylePara elsevierViewall">From the references we read&#44; it was explained that the incidence of pneumonia is very risk disease in vulnerable group of infants and toddlers&#44; so early prevention must be carried out&#46; Pneumonia treatment intervention by examining biomarkers to determine the cause of pneumonia&#46; The results of the biomarker examination are a marker of the case and prevention management will be carried out using existing cultural approaches&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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Biomarkers of pneumonia disease in under five children in “grill culture”
Sintha Lisa Purimahuaa,b,
Autor para correspondencia
, A. Arsunan Arsinc, Anwar Daudc, Ridwan M. Thahac, Darmawangsac, Agus Bintara Birawidac
a Graduated Student of Public Health, Hasanuddin University, Makassar 90245, Indonesia
b Faculty of Public Health, Nusa Cendana University, Kupang 85001, Indonesia
c Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Mortality due to pneumonia in childhood is strongly associated with malnutrition&#44; poverty&#44; as well as inadequate access to health services&#46; As a result of this&#44; more than 98&#37; of deaths caused by pneumonia in children occurred in 68 countries&#44; of which progress in reducing under-five mortality was the most critical&#46; The burden of pneumonia on families and health systems in low-resource countries exacerbates inequality&#59; especially&#44; children who are poor&#44; hungry&#44; and live in secluded areas most likely will be visited by this &#8220;forgotten killer&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Pneumonia still be a globally major cause of childhood mortality and morbidity&#46; Accurate diagnosis and attribution of the cause of pneumonia are important for measuring the load of disease&#44; implementing appropriate prevention and treatment strategies&#44; and expand more effective interventions&#46; Human adenovirus &#40;HAdV&#41; infection causes serious pneumonia in children&#44; leading to significant morbidity and mortality rates&#46; However&#44; diagnostic biomarkers for HAdV-associated pneumonia are unavailable&#46; Serum microRNAs &#40;miRNAs&#47;miRs&#41; have been recently reported as diagnostic biomarkers for several diseases&#46; The present study performed microRNA sequencing to identify potential biomarkers among serum exosomes miRNAs&#44; with the aim of identifying candidate biomarkers for the diagnosis of pneumonia in adenovirus-infected children&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">2&#44;3</span></a> Biomarkers are usually biological&#44; chemical&#44; or physical substances that can diagnose and examine various parts of the body such as blood and tissues&#46; Biomarkers can show normal or pathological processes that occur in the body&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Globally the proportion of childhood deaths that occur in the neonatal period is increasing&#46; Since 1990 there has been a 47&#37; reduction in deaths in children less than five years of age&#46; Maternal mortality is higher in women living in rural areas and among poorer communities&#46; Young adolescents face a higher risk of complications and death as a result of pregnancy than other women&#46; Skilled care before&#44; during&#44; and after childbirth can save the lives of women and newborn babies&#46; Only a small proportion of women in developing countries less than 30&#37; receive adequate postpartum care&#46; Culture is defined as passed down values&#44; beliefs&#44; attitudes&#44; and behaviours&#44; including knowledge&#44; art&#44; traditions&#44; customs&#44; abilities&#44; and similar skills and habits that human beings gain as a member of society&#46; The postpartum period lasts for approximately 6&#8211;8-weeks&#44; starting from childbirth and ending with the restoration of the reproductive organs and other body systems to their pre-pregnancy state&#46; In this period&#44; significant physiological&#44; social&#44; and emotional changes occur in the woman&#46; Thus&#44; in many cultures&#44; the postpartum period is considered as a sensitive period and various traditional practices are performed to protect the health of the mother and the baby&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">The WHO and Indian guidelines still recommend oral cotrimoxazole as an alternative to amoxicillin for outpatient treatment for CAP &#40;community acquired pneumonia&#41;&#46; All children aged 2 months to 5 years with WHO criteria for CAP were prospectively enrolled&#46; Children on antibiotics or having received antibiotics within the previous 2 weeks&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">7&#44;8</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Literature search procedure</span><p id="par0025" class="elsevierStylePara elsevierViewall">This review literature source by accessing in the free journal database via Science Direct&#44; Pubmed&#44; Elseiver&#44; MDPI&#44; WHO&#44; Riskesdas&#44; Google Scholar&#46; Collecting the latest information using keywords as biomarkers&#44; toddlers&#44; grill culture&#46; After that to find the articles into Mendeley software to be synthesized and reviewed&#46;</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Result</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Research selection</span><p id="par0030" class="elsevierStylePara elsevierViewall">Find the journals in other sources as 76&#44;211 articles 2013&#8211;2020 years about biomarkers pneumonia&#44; matching the keywords required to be analyzed&#46; In the next step&#44; the articles are being strained by title&#44; abstract&#44; and keywords&#44; obtained 173 articles were then revised founded on their full text&#46; A number of 45 articles were removed because &#40;most of them did not discuss the biomarker pneumonia under five children&#44; environmental sanitation&#44; and grill culture&#41;&#46; Finally&#44; from journal reading theme&#44; that 21 choices articles near with my sources&#44; with my inclusion criteria sources&#46; We can see <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; Prisma flow diagram&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Research characteristics</span><p id="par0035" class="elsevierStylePara elsevierViewall">This section defines demographic data items from the 21 particular articles&#46; The results of this study indicate that 21 studies recognized the biomarker pneumonia under five children in grill culture&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Based on the reading results of the article&#44; it shows that the incidence of pneumonia increased from year to year and became the main cause of under five children died&#46; So it needs prevention from the upstream sector to reduce&#46; Childhood clinical pneumonia is caused by a combination of exposure to risk factors related to the host&#44; the environment&#44; and infection&#46; To identify the former two categories of causal factors for the development of pneumonia at the community level&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">9</span></a> In various societies and cultures&#44; pregnancy and childbirth are socio-cultural events that have different meanings&#46; This often translates into social expectations about what certain societies expect to do &#40;or not do&#41; during a woman&#39;s pregnancy&#44; birth&#44; and&#47;or postnatal period&#46; This paper reports a study exploring beliefs around childbirth in Nepal&#44; a low-income country with a largely Hindu population&#46; The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted &#40;or dirty even&#41; after childbirth&#46; This paper explores social and cultural practices that have health implications in the childbirth and postnatal periods of rural Nepali women&#59; and places it in the context of the global literature on such practices&#46; The study explores the extent to which such practices&#44; especially in low-income countries&#44; are part of the cultural adaptation of becoming a mother and identifies why women might not access services&#44; particularly PNC&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a> Depression and have greater barriers to accessing treatment are more likely to occur in mothers living in poverty&#46; Numerous studies have demonstrated many factors associated with PPD including obstetric history&#44; biochemical genetic&#44; and other social stressors&#58; age&#59; socioeconomic&#59; culture&#59; education&#59; negative life events&#46; To prevent&#44; early treatment of PPD&#44; increase earnings&#44; and improve the quality of life for women&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> This literature describes the incidence of pneumonia in relation to the culture of postpartum mothers in their treatment practices&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">Pneumonia remains the leading cause of death in children outside the neonatal period&#44; despite advances in prevention and management&#46; Over the last 20 years&#44; there has been a substantial decrease in the incidence of childhood pneumonia and pneumonia-associated mortality&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">4</span></a> Pneumonia is the biggest cause of deaths in young children in developing countries&#44; but early diagnosis and intervention can effectively reduce mortality&#46; We aimed to assess the diagnostic value of clinical signs and symptoms to identify radiological pneumonia in children younger than 5 years and to review the accuracy of WHO criteria for a diagnosis of clinical pneumonia&#46; WHO-approved signs age-related fast breathing &#40;six studies&#59; pooled sensitivity 0&#46;62&#44; 95&#37; CI 0&#46;26&#8211;0&#46;89&#59; specificity 0&#46;59&#44; 0&#46;29&#8211;0&#46;84&#41; and lower chest wall indrawing showed poor diagnostic performance&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">12</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In general&#44; biomarkers are biological&#44; chemical&#44; or physical substances that can be detected and measured in various parts of the body&#44; such as blood and tissues&#46; Biomarkers can show normal or pathological processes that occur in the body&#46; Biomarkers can be in the form of certain cells&#44; molecules&#44; genes&#44; gene products&#44; enzymes&#44; or hormones&#46; Biomarkers can be used for diagnostic purposes&#44; disease processes&#44; disease degree&#44; disease prognosis &#40;cancer biomarkers&#41;&#44; and biomarkers to monitor clinical response to intervention&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">13</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The results of research in Cambodian villages&#44; for traditional beliefs&#44; some postpartum women have modern medicine during childbirth and then use traditional medicine right away&#46; Like drinking traditional medicine consisting of plants from leaves&#44; bark&#44; and roots&#46; One explanation for this is that the mother doesn&#8217;t know what to care about&#44; so will listen more to the older person&#44; the mother&#46; However&#44; in the next pregnancy&#44; she will have more confidence&#44; knowledge&#44; and experience so she will move in her own way towards modern medicine even though some traditional medicines may continue to be used&#46; They still use traditional medicine to maintain this habit&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The results of the study in Nepal&#44; a country where income levels are low&#44; pregnancy&#44; and childbirth are socio-cultural events that have different meanings in different societies and cultures&#46; This often translates into social expectations of what certain societies expect &#40;or should not do&#41; during pregnancy&#44; birth&#44; and&#47;or the postnatal period&#46; The study explores beliefs around childbirth&#44; then establishes issues such as the period in which women were seen as polluted &#40;or even dirty&#41; after childbirth&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Postpartum women in addition to maintaining the health of their babies also maintain their reproductive health&#46; The role of culture in maintaining postpartum sexual abstinence in women in Swazi&#46; The literature shows that periods of abstinence and resumption of sexual activity are influenced by many factors and variations from existing cultures&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The culture of the Timorese people in the Timor Tengah Selatan district of NTT province is that mothers are required to give birth in a roundhouse &#40;traditional house&#41; and receive 40 days of care by a dukun or someone who is believed to have experience in caring for the mother&#46; Treatment for postpartum mothers is usually in the form of baking a fire&#46; This cultural event will adversely affect the mother and the baby who will roast the body over medium heat and also affect the faster healing of wounds after childbirth&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conclusion</span><p id="par0075" class="elsevierStylePara elsevierViewall">From the references we read&#44; it was explained that the incidence of pneumonia is very risk disease in vulnerable group of infants and toddlers&#44; so early prevention must be carried out&#46; Pneumonia treatment intervention by examining biomarkers to determine the cause of pneumonia&#46; The results of the biomarker examination are a marker of the case and prevention management will be carried out using existing cultural approaches&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of interest</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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