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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 (2018)
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 (2018)
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

Risk Factors for Diarrhea Cases in Communities Living Along Deli River, North Sumatera

Susanti, Elvita

Journal of Epidemiology and Public Health Vol 4, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diarrhea disease is the second leading cause of death in children under five yea­rs old, and is responsible for killing around 525,000 children every year. Interventions to pr­e­vent diarrhea, including safe drinking-water, use of improved sanitation and hand wa­sh­i­ng with soap can reduce disease risk. This study aimed to investigate risk factors of dia­r­r­h­e­a­ among communities living along Deli river, North Sumatera.Subjects and Method: This was a cross-sectional study conducted in communities living along Deli river, North Sumatera. A sample of 96 study subjects was selected for this study. Th­e dependent variable was diarrhea. The independent variables were use of toilet, clean water, hand wash, processing of waste, human excreta. The data were collected by questionnaire and analyzed by a multiple logistic regression.Results: The risk of diarrhea increased with lack of toilet use (OR= 1.67; 95% CI= 0.99 to 2.7­9; p= 0.040), poor use of clean water (OR= 1.66; 95% CI= 1.02 to 2.70; p= 0.035), hand wa­shing without soap (OR= 1.74; 95% CI= 1.12 to 2.68; p= 0.002), poor garbage management (OR= 2.50; 95% CI= 1.33 to 4.89; p= 0.001), and improper human excreta disposal (OR= 1.64; 95­%­ CI= 1.04 to 2.60; p= 0.032).Conclusion: The risk of diarrhea increases with lack of toilet use, lack of clean water, hand wa­shing without soap, poor waste management, and improper human excreta disposal.Keywords: diarrhea, personal hygiene, sanitationCorrespondence: Elvita Susanti. Masters Program in Public Health, Universitas Suma­t­e­ra U­tara, Jl. Universitas No. 21, Medan, North Sumatera. Email: elvitasusantiskm@gmail.­c­o­m. ­Mobile: 081375520310, 08116005324.Journal of Epidemiology and Public Health (2019), 4(1): 47-54https://doi.org/10.26911/jepublichealth.2019.04.01.06

Self Care, Drug Taking Adherence, and their Association with Complication in Type 2 Diabetes Mellitus Patients

Putri, Widya Kaharani, Rahardjo, Setyo Sri, Indarto, Dono

Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diabetes mellitus (DM) is a major global health issue. The incidence of DM worldwide was about 6.4% (285 million people) in 2010 and it is projected to increase to 7.7% in 2030. Diabetes is associated with a number of challenges. The disease has a great influence on the patient’s daily life, their relatives, nurses and physicians. Complications of diabetes represent the major causes of morbidity and mortality that are associated with this chronic metabolic disorder. This study aimed to examine the associations of self care and drug taking adherence with the risk of complication in type 2 diabetes mellitus patients.Subjects and Method: A case control study was conducted at Dr.Soeroto Hospital, Ngawi, East Java. A sample of 150 type 2 diabetes mellitus patients was selected for this study by fixed disease sampling, consisting of 75 patients with and 75 patients without complication. The dependent variable was complication. The independent variables were self care, drug taking adherence, motivation, duration of illness, family support, and health personnel support. Data on complication of type 2 DM were obtained from medical record. The other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of type 2 DM complication decreased with better self care (b = -3.34; 95% CI= -4.47 to -2.22; p<0.001) and adherence to drug taking (b = -3.73; 95% CI= -5.06 to -2.41; p<0.001). The risk of type 2 DM complication was indirectly affected by motivation, duration of illness, education, family support, and health personnel support.Conclusion: The risk of type 2 DM complication decreases with better self care and adherence to drug taking. The risk of type 2 DM complication is indirectly affected by motivation, duration of illness, education, family support, and health personnel supportKeywords: type 2 diabetes mellitus, complication, self care, drug taking adherenceCorrespondence: Widya Kaharani Putri. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: widya.kaharani@gmail.com. Mobile: +6281515932993.Journal of Epidemiology and Public Health (2018), 3(3): 369-375https://doi.org/10.26911/jepublichealth.2018.03.03.08

Multilevel Analysis: Factors Associated with Overweight and Obesity in Primary School Children in Surakarta, Central Java

Rini, Arum Kusuma, Pamungkasari, Eti Poncorini, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 4, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Life course studies have shown that early onset obesity is a risk factor for morbidity and mortality later in life. In both sexes, rates of diabetes, coronary heart disease, atherosclerosis, hip fracture, and gout were increased in those who were overweight as adolescents. Contextual factor at higher level such as school may have indirect effect on the incidence of overweight or obesity through eating behavior. However, studies into factors affecting child obesity in Indonesia using multilevel approach are lacking. This study aimed to examine factors associated with overweight and obesity in primary school children in Surakarta, Central Java, using multilevel analysis.Subjects and Method: A case control study was conducted at 25 primary schools in Surakarta, Central Java, from March to April 2018. A sample of 225 primary school children was selected by fixed disease sampling, consisting of 75 children with overweight or obesity and 150 children with normal weight. The variables of children were placed at the first level of the multilevel model. The potential contextual effect of school was determined at the second level. The dependent variable was overweight or obesity. The independent variables were maternal education, maternal body mass index (BMI), physical activity, family income, and school environment. The data were collected by questionnaire and analyzed by a multilevel logistic regression run on Stata 13.Results: Child overweight or obesity was positively associated with maternal BMI ≥25 (b= 0.11; 95% CI= 0.04 to 0.18; p= 0.002) and high family income (b= 0.04; 95% CI= 0.02 to 0.06; p< 0.001). Child overweight or obesity was negatively associated with high physical activity (b= -0.03; 95% CI= -0.05 to -0.01; p= 0.009). School environment had a negligible contextual effect on child obesity with ICC= 5.08%.Conclusion: Child obesity is positively associated with maternal BMI ≥25 and family income, and is negatively associated with physical activity. School environment has a negligible contextual effect on child obesity.Keywords: obesity, primary school children, maternal body mass index, physical activityCorrespondence: Arum Kusuma Rini. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: arumkusumarini@yahoo.com. Mobile: +6282133044191.Journal of Epidemiology and Public Health (2019), 4(1): 1-8https://doi.org/10.26911/jepublichealth.2019.04.01.01

Factors Associated with the Occurrence of Osteoarthritis: A Path Analysis Evidence from Surakarta, Central Java

Kusumaningtyas, Mei, Tamtomo, Didik, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 4, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Musculoskeletal conditions are an important public health problem. The population burden from arthritis is considerable. The implications of this burden are poor quality of life, restrictions in daily activities, and disability. This study aimed to analyze factors associated with the occurrence of osteoarthritis in Surakarta, Central Java, using a path analysis model.Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, in June 2018. A sample of 200 patients was selected by fixed disease sampling, consisting of 50 knee OA patients and 150 patients without knee OA. The dependent variable was knee OA. The dependent variables were age, gender, body mass index (BMI), diabetes mellitus, history of injury, and physical activity. Data on knee OA, BMI, and diabetes mellitus status were obtained from medical record. The other variables were measured by questionnaire. The data were analyzed by path analysis.Results: The risk of OA increased with diabetes mellitus (b=1.04; 95% CI= 0.17 to 1.92; p=0.020), older age (b= 4.03; 95% CI= 1.97 to 6.09; p<0.001), and BMI ≥25 (b= 1.28; 95% CI= 0.39 to 2.17; p= 0.005). The risk of OA decreased with history of knee injury (b= -0.90; 95% CI= 0.57 to 1.74; p= 0.003) and female (b= -1.19; 95% CI= -2.06 to -0.31; p=0.008). The risk of OA was indirectly affected by physical activity, female gender, and BMI.Conclusion: The risk of OA increases with diabetes mellitus, older age, and BMI ≥25, but decreases with history of knee injury and female gender.The risk of OA is indirectly affected by physical activity, female gender, and BMI.Keywords: knee osteoarthritis, sociodemographic factor, diabetes mellitus, path analysisCorrespondence:Mei Kusumaningtyas. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: meikusumaningtyas@gmail.com. Mobile : +6285725646444Epidemiology and Public Health (2019), 4(1): 9-19https://doi.org/10.26911/jepublichealth.2019.04.01.02

Individual and Environmental Risk Factors of Tuberculosis: A New Evidence from Ponorogo, East Java

Sayidah, Diana, Rahardjo, Setyo Sri, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: For centuries, TB has been linked anecdotally with environmental risk factors that go hand-in-hand with poverty: indoor air pollution, tobacco smoke, malnutrition, over­crowded living conditions, and excessive alcohol use. But to date, there is no empirical evidence from East Java, Indonesia, to support these anecdotal evidences. The purpose of this study was to provide new evidence on the individual and environmental risk factors of tuberculosis in Po­no­ro­go, East Java.Subjects and Method: A case control study was conducted in Ponorogo, East Java, from April to May 2018. A sample of 200 study subjects was selected for this study by fixed disease sampling. The dependent variable was tuberculosis. The independent variables were age, gen­der, education, nutritional status, dwelling density, smoking, and alcohol drinking. Data on tuberculosis infection status were obtained from the medical record at District Health Office Po­no­­rogo. The data were collected by questionnaire and analyzed by a multiple logistic re­gres­sion on Stata 13.Results: Age ≥ 44 years (b= 3.18; 95% CI= 1.66 to 4.69; p<0.001), nutritional status (b= 1.42; 95% CI= 0.02 to 2.82; p=0.046), dwelling density ≥ 5 (b= 1.87; 95% CI= 0.37 to 3.36; p=0.014), smoking (b= 2.23; 95% CI= 0.61 to 3.85; p=0.007), and alcohol drinking (b= 2.83; 95% CI= 1.38 to 4.27; p<0.001) were associated with increased risk of tuberculosis. Higher education (b= -2.56; 95% CI= -4.16 to -0.96; p=0.002) and female (b= -1.36; 95% CI= -2.92 to -0.20; p=0.087) were associated with decreased risk of tuberculosis.Conclusion: Age, nutritional status, dwelling density, smoking, alcohol drinking, education, and female, are shown in this study to be the risk factors of tuberculosis.Keywords: tuberculosis, individual factor, environmental factorCorrespondence: Diana Sayidah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: dianasayidah13@gmail.com. Mobile: +6282234721294.Journal of Epidemiology and Public Health (2018), 3(3): 353-360https://doi.org/10.26911/jepublichealth.2018.03.03.06

Biopsychosocial Factors Affecting the Risk of Musculoskeletal Disorders in Surakarta, Central Java

Romadhoni, Dea Linia, Rahardjo, Setyo Sri, Indarto, Dono

Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Musculoskeletal Disorders (MSDs) are injuries and disorders that affect the hu­man body’s movement or musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.). The impacts of MSD include reduced activity, reduction of work abi­lity, and use of health care (seeing a health professional or taking prescription or non­prescription medication). Studies investigating risk factors of MSD are lacking in Indonesia. The purpose of this study was to investigate biopsychosocial factors affecting the risk of MSD in Sura­karta, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was carried out at Dr. Moewardi hospital, Surakarta, Central Java from April to May 2018. A sample of 116 patients was selected by fixed disease sampling. The dependent variable was MSD. The independent variable were gender, history of chronic disease, body mass index (BMI), stress, occupational type, environmental working, and working posture. Data on MSD status were taken from medical record. Working posture was measured by REBA questionnaire. Other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of MSDs was directly increased with BMI ≥25 (OR= 1.22; 95% CI= 0.15 to 2.30; p= 0.026), history of chronic disease (OR= 2.02; 95% CI= 0.96 to 3.08; p<0.001), heavy occupational type (OR= 1.56; 95% CI= 0.43 to 2.68; p<0.007), and poor working posture (REBA score ≥4) (OR= 1.75; 95% CI= 0.65 to -2.86; p= 0.002). The risk of MSDs was indirectly affected by environmental working, stress, and gender.Conclusion: The risk of MSDs is directly increased with BMI ≥25, history of chronic disease, heavy occupational type, and poor working posture (REBA score ≥4), and is indirectly affected by environmental working, stress, and gender.Keywords: musculoskeletal disorders, biopsychosocial factorCorrespondence: Dea Linia Romadhoni. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: dealinia08@gmail.com. Mobile: +6282227862718.Journal of Epidemiology and Public Health (2018), 3(3): 361-368https://doi.org/10.26911/jepublichealth.2018.03.03.07

Analysis of the Contextual Effect of Village Characteristics and Other Determinants of Diarrhea in Children Under Five, Banjarnegara, Central Java

Cahyaningrum, Lusia Arina, Rahardjo, Setyo Sri, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diarrheal disease is the leading cause of child death and illness in the world. Diarrhea is one of the most potent endemic diseases in Indonesia. Children under five were the most affected group by this disease. This study aimed to determine the effect of nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation on the incidence of diarrhea in children under five in Banjarnegara District, Central Java, using multilevel analysis.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted in Banjarnegara, Central Java, from January to February 2018. A total of 25 villages was selected using stratified random sampling, based on village stratification criteria. A sample of 250 children under five was selected for this study by fixed disease sampling, consisting of 125 children with diarrhea and 125 healthy children. The dependent variable was diarrhea. The independent variables at level 1 were nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation. Village stratification was used as the contextual factor at level 2. The data were collected by a set of pre-tested questionnaire and analyzed by multilevel logistic regression analysis using Stata 13.Results: Poor nutritional status (b= 1.33; 95% CI= -0.14 to 2.82; p= 0.077), poor prevention behavior (b= 1.52; 95% CI= 0.81 to 2.24; p<0.001), low income (b= 1.52; 95% CI= 0.80 to 2.25; p<0.001), weak social capital (b= 1.80; 95 % CI= 1.04 to 2.56; p<0.001), and poor environmental sanitation (b= 1.12; 95% CI= 0.39 to 1.85; p= 0.003) increased the risk of diarrhea. Exposure to information (b= 0.90; 95% CI= 0.17 to 1.64; p= 0.015) decreased the risk of diarrhea. The village stratification showed a strong contextual effect on the incidence of diarrhea with intra-class correlation (ICC)= 15.78%.Conclusion: Poor nutritional status, poor personal hygiene, low income, weak social capital, and poor environmental sanitation increase the risk of diarrhea.Keywords: determinant, diarrhea, children under five, multilevel analysisCorrespondence: Lusia Arina Cahyaningrum. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: lusiaarina@gmail.com. Mobile: +6282226835687.Journal of Epidemiology and Public Health (2018), 3(3): 342-352https://doi.org/10.26911/jepublichealth.2018.03.03.05

Multilevel Analysis: Biopsychosocial Determinants and Environmental Factor on the Incidence of Diarrhea Among Children Under Five in Surakarta

Zicof, Erick, Rahardjo, Setyo Sri, Murti, Bhisma

Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diarrhea is an endemic disease with a potential to become an epidemic in Indonesia. Diarrhea most often occurs in children under five years of age. This study aimed to determine the relationship between biopsychosocial factors, environmental factor, and diarrhea occurrence in Surakarta, Central Java, using multilevel analysis.Subjects and Method: This was an observational analytic study with a cross-sectional approach. This study was conducted on October 2017 - April 2018. A sample of 200 children under five years of age was selected by fixed disease sampling, consisting of 100 children with diarrhea and 100 without diarrhea. The dependent variable was the incidence of diarrhea. The independent variables were the number of family members, maternal knowledge, maternal personal hygiene, and environmental sanitation. The data were collected by questionnaire and analyzed by multilevel logistic regression in Stata 13.Results: The number of family member (b= 1.09; 95% CI= 0.02 to 2.15; p< 0.046) increased the risk of diarrhea. Good maternal knowledge (b= -2.30; 95% CI= -3.46 to -1.14; p<0.001), good maternal personal hygiene (b= -2.09; 95% CI= -3.48to-0.70; p<0.003), and good environmental sanitation (b= -1.64; 95% CI= -2.84to -0.43; p= 0.008) decreased the risk of diarrhea in children under five. The village had a substantial contextual effect on the incidence of diarrhea with ICC= 66.14%.Conclusion: The number of family member increases the risk of diarrhea. Good maternal knowledge, good maternal personal hygiene, and good environmental sanitation decrease the risk of diarrhea in children under five. Village has a substantial contextual effect on the incidence of diarrheaKeywords: diarrhea, number of family member, maternal knowledge, maternal personal hygiene, village, contextual effectCorrespondence: Erick Zicof. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: erickzicof@gmail.com. Mobile: +6281363425870.Journal of Epidemiology and Public Health (2018), 3(3): 323-330https://doi.org/10.26911/jepublichealth.2018.03.03.03