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Path Analysis on the Biopsychosocial Factors Associated with Hypertension

Istyanto, Febry, Mudigdo, Ambar, Rahardjo, Setyo Sri

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Hypertension is a non-communicable disease which may lead to premature death and disability. This study aimed to determine the biopsychosocial factors associated with the risk of hypertension.Subjects and Method: This was an analytic observational study with a case-control design. This study was conducted at Dr. Moewardi Hospital, from September to November 2018. A sample of 225 patients was selected by fixed disease sampling. The dependent variable was hypertension. The independent variables were anxiety, stress, quality of sleep, body mass index (BMI), physical activity, vegetables and fruit, coffee drink, and soft drink consumption. Blood pressure was measured by sphygmomanometer. Body weight was measured by scale. Body height was measured by microtoise. The other data were collected by questionnaire and analyzed by path analysis.Results: Hypertension directly increased with anxiety (b= 0.26; 95%CI= 0.02to 0.51; p= 0.037), stress (b= 0.28; 95%CI= 0.04 to 0.53; p= 0.022), poor quality of sleep (b= 0.46; 95%CI= 0.06 to 0.87; p= 0.026), BMI (b= 0.68; 95%CI= 0.051 to 1.31; p= 0.034), coffee drink consumption (b= 1.31; 95%CI= 0.17 to 2.46; p= 0.024), and soft drink consumption (b= 0.38; 95%CI= 0.04 to 0.72; p= 0.029). Hypertension directly decreased with high physical activity (b= -0.04; 95%CI= -0.07 to -0.004; p= 0.027), vegetable and fruit consumption (b= -1.13; 95%CI= -2.07 to -0.19; p= 0.037). Hypertension was indirectly affected by anxiety, physical activity, quality of sleep, and coffe drink consumption through BMI and quality of sleep.Conclusion: Hypertension is directly and positively affected by anxiety, stress, poor quality of sleep, BMI, coffee drink consumption, and soft drink consumption, but negatively affected by high physical activity, vegetable and fruit consumption.Keywords: hypertension, biopsychosocial, determinantsCorrespondence: Febry Istyanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Central Java 57126. Email: febryistyanto@gmail.com.Mobile: 082133452012Journal of Epidemiology and Public Health (2019), 4(2): 70-80https://doi.org/10.26911/jepublichealth.2019.04.02.02

Risk Factors of Hypertension among Women in Sragen, Central Java

Sudaryanto, Sudaryanto, Rahardjo, Setyo Sri, Indarto, Dono

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Hypertension has become a global problem because its prevalence continues to increase to the stage of worrying. Health profile data of Sragen District Health Office in 2014 showed that out of 175,750 people aged >18 years who took blood pressure measurement, there were 28.73% (50,499 people) identified as having high blood pressure and 25,928 of them were women. This study aimed to examine risk factors of hypertension among women in Sragen, Central Java, Indonesia.Subjects and Method: This was a case control study conducted in Sragen, Central Java. The total sample of 200 women was selected by fixed disease sampling. The dependent variable was hypertension. The independent variables were age, history of hypertension, stress, smoking, physical activity, alcohol consumption, salt consumption, coffee consumption, body mass index (BMI), and cholesterol level. Blood pressure was measured by sphygmomanometer. The other data were measured by questionnaire. The data were analyzed by a multiple logistic regression.Results: Age ?40 years (OR= 5.27; 95% CI= 1.81 to 15.28; p= 0.002), had history of hypertension (OR= 4.75; 95% CI= 1.46 to 15.39; p= 0.009), stress (OR= 5.32; 95% CI= 1.50 to 18.84; p= 0.009), smoking (OR= 17.51; 95% CI= 1.18 to 258.70; p= 0.037), low physical activity (OR= 7.89; 95% CI= 2.44 to 25.51; p = 0.001), alcohol consumption (OR= 23.06; 95% CI= 1.49 to 335.39; p= 0.025), salt consumption (OR= 16.68; 95% CI= 1.61 to 172.83; p= 0.018), coffee consumption (OR= 4.19; 95% CI= 1.03 to 16.98; p= 0.045), BMI (OR= 5.60; 95% CI= 1.23 to 9.71; p= 0.018), high total cholesterol (OR= 6.49; 95% CI = 2.00 to 21.05; p = 0.002) increased the risk of hypertension among women. Nagelkerke R Square= 72.2%.Conclusion: Age ?40 years, history of hypertension, stress, smoking, low physical activity, alcohol consumption, salt consumption, coffee consumption, BMI, high total cholesterol increase the risk of hypertension among women.Keyword: hypertension, determinants, womenCorrespondence: Sudaryanto. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126, Indonesia. Email: oment8147@gmail.com. Mobile: +6285727565551Journal of Epidemiology and Public Health (2019), 4(2): 227-237https://doi.org/10.26911/jepublichealth.2019.04.02.08

Contextual Effect of Village on the Risk of Pneumonia in Children Under Five in Magetan, East Java

Mustikarani, Yola Alqorien, Rahardjo, Setyo Sri, Qadridjati, Isna, Prasetya, Hanung

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Pneumonia is a major cause of illness and death in children under five worldwide. Studies into the contextual effect of village are lacking in Indonesia. This study aimed to determine contextual effect of village on the risk of pneumonia in children under five in Magetan, East Java.Subjects and Method: This was a case control study conducted in Magetan, East Java, from October 2018 to December 2018. A sample of 225 children under five from 25 villages was selected by fixed disease sampling. The dependent variable was pneumonia. The independent variables were nutritional status, vitamin A intake, maternal stress, maternal education, family income, family smoking, cooking fuel, house physical environment, and the presence of children in the kitchen when cooking. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Maternal stress (b= 1.91; 95% CI= 0.75 to 3.06; p= 0.001), family smoking habits (b = 1.39; 95% CI = 0.46 to 2.32; p = 0.003), cooking fuel (b= 1.51; 95% CI= 0.46 to 2.55; p= 0.005), and the presence of children in the kitchen when cooking (b= 1.37; 95% CI = 0.38 to 2.35; p= 0.007) increased the risk of pneumonia in children under five. The risk of pneumonia was reduced by good nutritional status (b= -1.74; 95% CI= -2.70 to -0.78; p <0.001), complete vitamin A status (b= -1.14; 95% CI= -2.04 to -0.24; p= 0.013), high maternal education (b= -1.41; 95% CI= -2.45 to -0.37; p= 0.008), high family income (b= -0.91; 95% CI= -1.80 to -0.02; p= 0.045), and healthy home physical environment (b= -1.86; 95% CI= -3.20 to -0.52; p= 0.007). Village had a strong contextual effect on pneumonia among children under five with ICC= 21.32%.Conclusions: Maternal stress, family smoking habits, cooking fuel, and the presence of children in the kitchen when cooking increase the risk of pneumonia in children under five. It is reduced by good nutritional status, complete vitamin A status, high maternal education, high family income, and healthy home physical environment. Village has a strong contextual effect on pneumonia among children under fiveKeywords: pneumonia, children under five, biopsychosocial, environmental, determinants, multilevel analysisCorrespondence: Yola Alqorien Mustikarani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java 57126, Indonesia. Email: yolla.mstika@gmail.com. Mobile: +6285856122288Journal of Epideiology and Public Health (2019), 4(2): 217-226https://doi.org/10.26911/jepublichealth.2019.04.02.07

Is Cognitive Impairment a Risk Factor for Post-Stroke Depression? A Meta-Analysis Study

Pratiwi, Dinda Ika, Tamtomo, Didik, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Depression is a psychiatric complication of stroke that often occurs and had a negative impact. Every year, 15 million people who experience strokes globally are at risk of developing post-stroke depression. Cognitive disorders are often associated with the presence of post-stroke depression. Understanding of risk factors for post-stroke depression can help in clinical identification and provide early intervention to improve stroke rehabilitation better. Therefore, it is very important to identify patients at risk for depression. This study aims to analyze cognitive impairment factors in the incidence of post-stroke depression.Subjects and Method: The meta-analysis was conducted from Pubmed, Science Direct, and Springer Link databases using "stroke", "depression", "post-stroke depression AND risk factor" keywords. The article chosen was an article published from January 1, 2009 to September 30, 2018. The data were analyzed using RevMan 5 program.Results: 6 studies consisting of 3140 patients were selected for this study. The results of a meta-analysis showed that cognitive impairment was a risk factor for post-stroke depression. Cognitive disorder was positively and significantly associated with post-stroke depression (OR = 1.24; 95% CI= 1.03 to 1.49; p = 0.02).Conclusion: Cognitive disorder is a risk factor for post-stroke depression.Keywords: depression, post-stroke, cognitive impairment, risk factor, meta-analysisCorrespondence: Dinda Ika Pratiwi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: dindaika.pratiwi@gmail.com.Mobile: +6281290610504.Journal of Epidemiology and Public Health (2019), 4(2): 81-87https://doi.org/10.26911/jepublichealth.2019.04.02.03

Risk Factors of Dengue Fever: Application of PRECEDE – PROCEED Model

Ayuningtyas, Kanthi Devi, Rahardjo, Setyo Sri, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Dengue infection is one of the main health problems in more than 100 tropical and subtropical countries. This study aims to analyze the factors that play a role in the occurrence of dengue fever cases by applying the PRECED - PROCEED model.Subjects and Method:This was an analytic observational study with a case control design. The study was conducted at 8 sub-districts in Sukoharjo, Central Java, from May to July 2018. A sample of 200 study subjects was selected for this study by fixed disease sampling, comprising 50 peoples with dengue fever and 150 peoples without dengue fever. The dependent variables were dengue fever. The independent variables were intention, attitude, education, dengue fever prevention, family income, and sanitation. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.Results: The risk of dengue fever was directly reduced by good environmental sanitation (b= -1.32, 95% CI= -2.09 to -0.54, p= 0.001) and good prevention behavior (b= -2.61, 95% CI= -3.55 to -1.67, p<0.001). The risk of dengue fever was indirectly affected by intention, attitude, education, and family income.Conclusion: The risk of dengue fever is directly reduced by good environmental sanitation and good prevention behavior. The risk of dengue fever is indirectly affected by intention, attitude, education, and family income.Keywords: dengue fever, preventive behavior, environmental sanitation, PRECEDE-PROCEED modelCorrespondence: Kanthi Devi Ayuningtyas. School of Health Sciences Patria Husada, Blitar. Jl. Sudanco Supriyadi No 168, Blitar, East Java. Email: kanthideviayuningtyas@gmail.com. Mobile: 08125266956.Journal of Epidemiology and Public Health (2019), 4(1): 37-46https://doi.org/10.26911/jepublichealth.2019.04.01.05

Factors Associated with Tuberculosis in Deli Serdang, North Sumatera

Syahputra, Fahmi, Parhusip, Rudolf S., Siahaan, Jekson Martiar

Journal of Epidemiology and Public Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Tuberculosis (TB) is still a major public health problem in most developing countries and its incidence is rising in many developed countries. This study aimed to examine factors associated with tuberculosis in Deli Serdang, North SumateraSubjects and Method: This was a cross-sectional study conducted in Deli Serdang, North Sumatera. A sample of 190 study subjects was selected for this study comprising of 95 TB patients and 95 non-TB patients. The dependent variable was tuberculosis. The independent variables were sex, education, BCG immunization, smoking, nutritional status, and dwelling density. Data on TB status were taken from medical record. The other variables were measured by questionnaire. The data were analyzed by a multiple logistic regression.Results: The risk of TB decreased with female sex (OR= 0.33; 95% CI= 0.11 to 0.98; p= 0.046). The risk of TB increased with low education (OR= 8.47; 95% CI= 3.01 to 23.80; p<0.001), had no BCG immunization (OR= 8.86; 95% CI= 3.28 to 23.94; p<0.001), smoking (OR 6.69; 95% CI= 2.20 to 20.38; p=0.001), high dwelling density (OR= 10.35; 95% CI= 4.06 to 26.41; p<0.001), and poor nutritional status (OR= 3.44; 95% CI= 0.85 to 14.03; p= 0.085).Conclusion: The risk of TB decreases with female sex, but increases with low education, had no BCG immunization, smoking, high dwelling density, and poor nutritional status.Keywords: Tuberculosis, sex, BCG immunization, dwelling density, nutritional statusCorrespondence: Fahmi Syahputra. Faculty of Medicine, Universitas Methodist Indonesia. Jl. Hang Tuah No.8, Madras Hulu, Medan Polonia, Kota Medan, Sumatera Utara 20151. Email: fahmisyahputra213@yahoo.comJournal of Epidemiology and Public Health (2019), 4(1): 55-59https://doi.org/10.26911/jepublichealth.2019.04.01.07

Associations of Contact History, Smoking Status, Nutrition Status, Anti Retrovirus Treatment, and TB HIV Co-infection Among People with HIV/AIDS

Manurung, Adymulianto

Journal of Epidemiology and Public Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Tuberculosis (TB) and HIV co-infection causes a heavy burden on health care systems and poses particular diagnostic and therapeutic challenges. Studies into predictors of TB-HIV co-infection is lacking in Indonesia. This study aimed to examine the associations of contact history, smoking status, nutrition status, ARV treatment, and TB HIV co-infection among people with HIV/AIDS (PLWH).Subjects and Method: This was a unmatched case-control study conducted in Balige, North Sumatera. A sample of 82 people living with HIV/AIDS was selected for this study, comprising 41 cases with and 41 controls without TB-HIV co-infection. The dependent variable was TB-HIV co-infection. The independent variables were contact history, smoking status, nutrition status, and anti retroviral (ARV) treatment. The data on HIV/AIDS co-infection were taken from the medical record at HKBP Committee HIV/AIDS service. Other variables were measured by questionnaire. Data were analyzed by a multiple logistic regression.Results: 82.9% of PLWH had no contact history with TB patients, 56.1% had poor nutrition status, 78% were smokers, and 58.5% had irregular ARV treatment. The risk of TB HIV co-infection increased with poor nutrition status (OR=3.48; p=0.014), smoking (OR=3.39; p=0.021), and irregular ARV treatment (OR=10.16; p<0.001). Test results multiple ARV treatment is the most dominant variable affecting the incidence of TB-HIV co-infection (OR= 8.04; 95% CI= 2.47 to 26.18; p<0.001).Conclusion: The risk of TB HIV co-infection increases with poor nutrition status, smoking status, and irregular ARV treatment.Keywords: TB, HIV co-infection, nutrition status, smoking, ARV treatment, people living with HIV/AIDSCorrespondence: Adymulianto Manurung. Masters Program in Public Health, Universitas Sumatera Utara, Jl. Universitas n0.21, Universitas Sumatera Utara, Medan 20115. Email: adymulianto_manurung@yahoo.com. Mobile: 085296652111.Journal of Epidemiology and Public Health (2019), 4(1): 60-64https://doi.org/10.26911/jepublichealth.2019.04.01.08

Hanging Clothes on Wire and Its Association with Malaria Incidence in Batubara, North Sumatera

Sinaga, Budi Junarman, Lubis, Rahayu, Mutiara, Erna

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The majority of the mosquito and parasite life-history traits that combine to determine malaria transmission intensity are environmental depen-dent. Earlier evidence suggests that certain malaria vectors can spend large parts of their adult life resting indoors. This study aimed to examine the practice of hanging clothes on wire and its association with malaria incidence in Batubara, North Sumatera. Subjects and Method: This was a case control study conducted in Batubara, North Sumatera in March 2018. A total of 176 people aged ? 15 years consisting of 88 cases of malaria and 88 controls were selected for this study. The dependent variable was malaria incidence. The independent variable was hanging clothes on wire. The data were collected by questionnaire and analyzed by a logistic regression. Results: Hanging clothes on wire was associated with an increased risk of malaria (OR= 3.33; 95% CI= 1.65 to 6.73; p= 0.001). Conclusion: Hanging clothes on wire increases the risk of malaria.Keywords: malaria, hanging clothes, wire.Correspondence: Budi Junarman Sinaga. Masters Program in Public Health, Universitas Sumatera Utara. Jl. Prof. T. Maas, Medan, North Sumatera. Email: budijunarman@yahoo.com. Mobile: 081361424297.Journal of Epidemiology and Public Health (2019), 4(2): 65-69https://doi.org/10.26911/jepublichealth.2019.04.02.01

Multilevel Analysis on Determinants of Diarrhea in Demak, Central Java

Ramadani, Aulia Noorvita, Rahardjo, Setyo Sri, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diarrhea is an infectious disease with high mortality in Indonesia. Diarrhea often occurs where risk factor control is weak, such as in rural area. This study aimed to examine the determinants of diarrhea in Demak, Central Java.Subjects and Method: A case-control study was conducted in Demak, Central Java, in October to November 2018. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was diarrhea. The independent variables were age, clean water supply, latrine availability, waste water management, waste management, hand wash behavior, family income, and education level. The data were collected by questionnaire and analyzed by a multilevel regression, run on Stata 13.Results: Diarrhea increased with poor clean water supply (b= 1.45; 95% CI= 0.23 to 2.67; p= 0.020), latrine unavailable (b= 1.86; 95% CI= 0.66 to 3.06; p= 0.002), poor waste management (b= 2.71; 95% CI= 1.52 to 3.90; p<0.001), poor garbage management (b= 1.34; 95% CI= 0.17 to 2.50; p= 0.024), irregular hand washing with soap (b= 1.34; 95% CI= 0.12 to 2.40; p= 0.030). Diarrhea decreased with high family income (b= -1.56; 95% CI= -2.78 to -0.34; p= 0.012) and high education (b= -1.75; 95% CI= -2.95 to -0.565; p= 0.004). Diarrhea was negatively associated with age but it was statistically non-significant (b= -0.33; 95% CI= -1.51 to 0.844; p= 0.578). Village had contextual effect on the incidence of diarrhea (ICC= 13.9%).Conclusion: Diarrhea increases with poor clean water supply, latrine unavailable, poor waste management, poor garbage management, irregular hand washing with soap. Diarrhea decreases with high family income and high education. Village has contextual effect on the incidence of diarrhea.Keywords: diarrhea, water supply, hand wash behavior, waste managementCorrespondence: Aulia Noorvita Ramadani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: aulia.noorviat@yahoo.com. Mobile: +6285641577322.Journal of Epidemiology and Public Health (2019), 4(2): 88-96https://doi.org/10.26911/jepublichealth.2019.04.02.04

Disclosure of Diagnosis and Prognosis to Cancer Patients in Traditional Societies: A Qualitative Assessment from Lebanon

Feghali, James, Semesmani, Hussein El, Abboud, Abdallah, Chacra, Lily, Choucair, Khalil, Fenianos, Madelin, Jebbawi, Lama Al, Sayed, Farah El, Kak, Faysal, Adib, Salim M.

Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The issue of when, how, and whether to disclose full information about cancer diagnosis and prognosis to patients is still debated in some parts of the world, including Lebanon. Despite formal academic emphasis on a larger autonomy for Lebanese patients in deciding the course of their disease, there has been no apparent impact on either clinical practices nor public expectations.  The topic of full disclosure is rarely if ever discussed in open fora, or in mass media channels in Lebanon. Subjects and Method: Seven key stakeholders were identified and interviewed regarding obstacles to spelling out clear guidelines within our national context. The interviews were transcribed and subsequently analyzed for recurrent patterns and concepts.Results: Senior oncologists interviewed generally favored gradual disclosure and most perceived a changing trend among both patients and physicians towards more disclosure. They also agreed on a need for the formal training of residents and fellows to better communicate bad news to patients. All the interviewed physicians attested to the benefits of candid disclosure in terms of patient psychology and overall wellbeing. They also mentioned that psychological services, which may facilitate the disclosure process, are greatly under-utilized in oncology. Lawyers highlighted the vagueness of the current Lebanese legislation regarding the obligation of truthful disclosure in comparison to laws in developed countries and the implications on patient autonomy. Conclusion: The study identified the need for improvements at various levels, including interventions to modify the expectations of the Lebanese public regarding cancer disclosure and to clarify existing legislative texts.Key-words: Ethics; Legislation; Middle-East; DisclosureCorrespondence: James Feghali. Faculty of Medicine, American University of Beirut (AUB), Lebanon, 1101 North Calvert Street, 610, Baltimore, Maryland, 21202. E-mail: jfeghal2@jhmi.edu. Telephone: +1-(267)-595-9995.Indonesian Journal of Medicine (2018), 3(2): 89-96https://doi.org/10.26911/theijmed.2018.03.02.05