Journal of Epidemiology and Public Health (JEPH)
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Multilevel Analysis on the Biological, Social Economic, and Environmental Factors on the Risk of Pneumonia in Children Under Five in Klaten, Central Java
Get PDFBackground: Pneumonia is one of the leading causes of death in children under five in the world, particularly in the developing countries including Indonesia. Imbalance between host, agent, and environment, can cause the incidence of pneumonia. This study aimed to examine the biological, social economic, and environmental factors on the risk of pneumonia in children under five using multilevel analysis with village as a contextual factor.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Klaten District, Central Java, from October to November, 2017. A total sample of 200 children under five was selected for this study by fixed disease sampling. The dependent variable was pneumonia. The independent variables were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, quality of house, indoor smoke exposure, and cigarette smoke exposure. The data were collected by questionnaire and checklist. The data were analyzed by multilevel logistic regression analysis.Results: Birth weight ≥2.500 g (OR=0.13; 95% CI= 0.02 to 0.77; p= 0.025), exclusive breastfeeding (OR= 0.15; 95% CI= 0.02 to 0.89; p= 0.037), good nutritional status (OR=0.20; 95% CI= 0.04 to 0.91; p= 0.038), immunizational status (OR= 0.12; 95% CI= 0.02 to 0.67; p= 0.015), maternal educational status (OR= 0.18; 95% CI= 0.03 to 0.83; p= 0.028), high family income (OR= 0.25; 95% CI= 0.07 to 0.87; p= 0.030), and good quality of house (OR= 0.21; 95% CI= 0.05 to 0.91; p= 0.037) were associated with decreased risk of pneumonia. High indoor smoke exposure (OR= 8.29; 95% CI= 1.49 to 46.03; p= 0.016) and high cigarette smoke exposure (OR=6.37; 95% CI= 1.27 to 32.01; p= 0.024) were associated with increased risk of pneumonia. ICC= 36.10% indicating sizeable of village as a contextual factor. LR Test p= 0.036 indicating the importance of multilevel model in this logistic regression analysis.Conclusion: Birth weight, exclusive breastfeeding, good nutritional status, immunizational status, maternal educational status, high family income, and good quality of house decrease risk of pneumonia. High indoor smoke exposure and high cigarette smoke exposure increase risk of pneumonia.Keyword: pneumonia, biological, social economic, environmental factor, children under fiveCorrespondence: Nurul Ulya Luthfiyana, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected] of Epidemiology and Public Health (2018), 3(2): 128-142https://doi.org/10.26911/jepublichealth.2018.03.02.03
Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java
Get PDFBackground: Cervical cancer is the fourth most common cancer in women worldwide and the second most common cancer in women in developing countries after breast cancer. The prevalence of cervical cancer in Indonesia was 0.8‰ with an estimated 98.692 cases. This study aimed to determine the biopsychosocial and genital hygiene factors for cervical cancer.Subjects and Method: This was an analytic observational study with a case-control design, conducted at Dr. Moewardi Hospital, Surakarta, from December 2017 to February 2018. A total of 178 study subjects including 95 women with cervical cancer (case) and 83 women without cervical cancer (control) were selected by fixed disease sampling. The dependent variable was cervical cancer. The independent variables were the age at first sexual intercourse, a number of sexual partners, body mass index (BMI), stress, education, income, and genital hygiene. Cervical cancer data was collected by medical record. The other data were collected by questionnaire. The data were analyzed by path analysis model.Results: The risk of cervical cancer increased with the number of sexual partner >1 (b=1.91; 95% CI= 0.31 to 3.49; p=0.019), BMI ≥25 (b= 0.98; 95% CI= -0.06 to 2.04; p=0.067), and stress (b= 1.59; 95% CI= 0.39 to 2.80; p=0.009). The risk of cervical cancer decreased with higher education (b= -3.58; 95% CI= -4.77 to -2.39; p<0.001), higher income (b= -1.49; 95% CI= -2.73 to -0.25; p=0.019), age at first sexual intercourse ≥18 years (b= -1.36; 95% CI= -2.52 to -0.21; p= 0.020), and genital hygiene (b= -1.24; 95% CI= -2.35 to -0.13; p=0.028). Income increased with higher education (b= 2.48; 95% CI= 1.71 to 3.25; p<0.001). Genital hygiene increased with education (b= 1.16; 95% CI= 0.47 to 1.86; p=0.001). Age at first sexual intercourse ≥18 years increased with higher education (b= 1.30; 95% CI= 0.58 to 2.01; p<0.001). Stress increased with number of sexual partner >1 (b= 1.36; 95% CI= 0.12 to 2.61; p=0.032).Conclusion: The risk of cervical cancer increases with the number of sexual partners, BMI, and stress, but decreases with higher education, higher income, age at first sexual intercourse, and genital hygiene.Keywords: cervical cancer, biopsychosocial determinants, genital hygiene, path analysisCorrespondence
Analysis of the Contextual Effect of Village Characteristics and Other Determinants of Diarrhea in Children Under Five, Banjarnegara, Central Java
Get PDFBackground: 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
Predictors of Hypertension in Post-Menopausal Women in Surakarta, Central Java
Get PDFBackground: Hypertension caused 45% mortality of heart disease and 51% mortality of stroke in 2014. Young women have a lower risk of hypertension than men. The risk increases after menopause due to lower estrogen production. This study aimed to estimate the biopsychosocial factors affecting hypertension in post-menopausal women in Surakarta, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in Surakarta, Central Java, from January to February 2018. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was hypertension. The independent variables were obesity, healthy diet, history of contraceptive use, family support, and family history of hypertension. Data of blood pressure was measured by sphygmomanometer. Other variables were measured by questionnaire. The data were analyzed by a multiple logistic regression.Results: The risk of hypertensionin post-menopuse women increased with obesity (OR= 13.00; 95% CI=2.99 to 56.51; p=0.001), family history of hypertension (OR=9.99; 95% CI=2.54 to 39.19; p=0.001), and history of hormonal contraceptive use (OR=10.11; 95% CI=2.60 to 39.25; p=0.001). The risk of hypertension in post-menopuse women decreased with healthy diet (OR= 0.16; 95% CI= 0.04 to 0.55; p= 0.004) and strong family support (OR= 0.09; 95% CI=0.19 to 0.39; p=0.001).Conclusion: The risk of hypertension post-menopause women is affected by obesity, family history of hypertension, history of hormonal contraceptive use, healthy diet, and strong family support
Self Care, Drug Taking Adherence, and their Association with Complication in Type 2 Diabetes Mellitus Patients
Get PDFBackground: 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 patien
The Correlation of Age with Uric Acid in Kadipiro, Surakarta
Get PDFBackground: Uric acid is the final product of purine metabolism. Purines (adenine and guanine) are nucleic acid contituents. Purine rotation occurs continuously in the body along with the synthesis and decomposition of DNA and RNA, although there is no intake of purine, a substantial amount of uric acid will still be formed. Uric acid is synthesized mainly in the liver by the xanthine oxidase enzyme. This study aimed to examine the correlation of age with uric acid.Subjects and method: This was a cross-sectional study conducted in Gambirsari Health Center, Kadipiro Village, Mojosongo, Surakarta, Central Java. A sample of 50 gout patients was selected by purposive sampling. The dependent variable was uric acid. The independent variable was age. The data were analyzed by Pearson correlation.Results: There was a correlation between age and uric acid (r= 0.37; p= 0.009).Conclusion: There is a correlation between age and uric acid.Keywords: gout, age, uric acidCorrespondence
Path Analysis on the Influence of Educational Level, Stages of Cancer, Social Support, and Coping Strategy toward the Quality of Life of Breast Cancer Patients in Dr. Moewardi Hospital, Surakarta
Get PDFBackground: Breast cancer develops into main health problem for women globally. Patients of breast cancer will endure transformation both physically as well as psychologically, it will give impact to the quality of life. The study aimed to analyze the influence of educational level, stages of cancer, social support, and coping strategy toward the quality of life of breast cancer patients.Subjects and Method: The study employed mixed method with quantitative and qualitative approach. The study was conducted in Dr. Moewardi Hospital, Surakarta in August – October 2017. There were a total of 150 study subjects selected with stratified random sampling. Purposive sampling was used for qualitative study with 3 informants. The dependent variable was quality of life. The independent variables were educational level, stages of cancer, social support and coping strategy. Quantitative data collection was conducted by using questionnaires. Social support variable was measured by using Multidimensional scale of perceived social support (MSPSS) questionnaires, coping strategy variable was measured by brief COPE questionnaires and life quality variable was measured by WHOQOL BREF questionnaires. Data qualitative collection was by means in depth interview. Quantitative data was analyzed by using path analysis, qualitative data was analyzed by using interactive model Miles and Huberman.Result: Quality of life was influenced by educational level (b= 8.69, SE= 1.84, p<0.001), stages of cancer (b= -6.41, SE= 2.94, p= 0.029), social support (b= 1.03, SE= 0.34, p= 0.003), coping strategy (b= 2.07, SE= 0.43, p<0.001). Coping strategy was influenced by educational level (b= 0.97, SE= 0.34, p= 0.004) and social support (b= 0.37, SE= 0.06, p<0.001).Conclusion: Quality of life of breast cancer patients is influenced by educational level, stages of cancer, social support, and coping strategy. Coping strategy was influenced by educational level and social support. Key words: social support, coping strategy, quality of life, path analysisCorrespondence: Sri Nuryati. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6282138283802.Journal of Epidemiology and Public Health (2017), 2(3): 225-235https://doi.org/10.26911/jepublichealth.2017.02.03.0
Health Belief Model and PRECEDE PROCEED on the Risk Factors of Multidrug Resistant Tuberculosis in Surakarta, Central Java
Get PDFBackground: Tuberculosis (TB) is one of the lethal infectious diseases in the world. One of the current biggest challenges of Tuberculosis control is the widespread emergence of Multidrug Resistant Tuberculosis (MDR-TB). There are several potential risk factors of MDR-TB that can be explained by Health Belief Model and PRECEDE PROCEED model framework. This study aimed to analyzed factors associated with MDR-TB using Health Belief Model and PRECEDE PROCEED.Subjects and Method: This was an analytic observational study with case control design. The study was conducted at Dr. Moewardi Hospital and BBKPM, Surakarta, from September to November 2017. The study subjects were selected using fixed disease sampling, consisting of 76 MDR-TB patients and 228 TB patients. The dependent variable was MDR-TB. The independent variables were educational level, self-efficacy, drug-taking adherence, smoking, nutritional status, perceived of susceptibility, perceived barrier, perceived severity, perceived benefit, and drug-taking supervisor. The data were collected using questionnaire and analyzed by path analysis. Results: The risk of MDR-TB was increased by lack of drug-taking adherence (b= -1.69; 95% CI= -2.28 to -1.09; p <0.001), poor nutritional status (b= 1.32; 95% CI= 0.72 to 1.92; p<0.001), and smoking (b= 1.32; 95% CI= 0.72 to 1.92; p <0.001). Drug-taking adherence was increased by perceived susceptibility (b= 0.91; 95% CI= 0.18 to 1.63; p=0.015), perceived severity (b= 1.01; 95% CI= 0.28 to 1.74; p=0.007), perceived benefit (b= 1.69; 95% CI= 0.97 to 2.41; p<0.001), drug-taking advisor (b= 2.16; 95% CI= 1.44 to 2.88; p<0.001), self efficacy (b= 1.58; 95% CI= 0.86 to 2.31; p<0.001), and low perceived barrier (b= -1.10; 95% CI= -1.82 to -0.38; p=0.003). Conclusion: The risk of MDR-TB is increased by the lack of drug-taking adherence, poor nutritional status, and smoking.Keyword: Health belief model, PRECEDE-PROCEED, MDR-TBCorrespondence: Vera. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected] of Epidemiology and Public Health (2017), 2(3): 241-254https://doi.org/10.26911/jepublichealth.2017.02.03.0
Risk Factors of Breast Cancer in Women at Dr. Moewardi Hospital, Surakarta, Central Java
Get PDFBackground: Breast cancer is a leading type of cancer affecting women around the world. Its incidence is increasing in developed and developing countries. Breast cancer is the leading cause of death among women in Indonesia with 19,731 cases of death in 2014. In addition to mortality, breast cancer causes psychosocial effect in the affected and the family. This study aimed to determine the risk factors of breast cancer in women at Dr. Moewardi Hospital, Surakarta, Central Java.Subjects and Method: This was an analytical observational study with case control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, from October to December, 2017. A total sample of 200 study subjects consisting of 100 women with breast cancer and 100 women without breast cancer were selected for this study by fixed disease sampling. The dependent variable was breast cancer. The independent variables were age at menarche, age at first pregnancy, parity, duration of breastfeeding, use of fertility hormone, duration of hormonal contraceptive use, and age at menopause. The data was collected by questionnaire and analyzed by multiple logistic regression.Results: The risk of breast cancer increased with earlier age at menarche <12 years old (OR= 2.71; 95% CI= 1.06 to 6.96; p= 0.037), delayed age at first pregnancy ≥30 years old (OR=3.01; 95% CI= 1.16 to 7.78; p= 0.023), delayed age at menopause ≥55 years old (OR=1.07; 95% CI=0.82 to 6.30; p= 0.001), longer hormonal contraceptive use ≥10 years (OR=3.25; 95% CI= 1.20 to 9.63 p= 0.003).Conclusion: The risk of breast cancer increases with earlier age at menarche, delayed age at first pregnancy, delayed age at menopause, longer hormonal contraceptive use.Keyword: Breast Cancer, Risk FactorCorrespondence: Yana Listyawardhani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email:[email protected] of Epidemiology and Public Health (2018), 3(2): 118-127https://doi.org/10.26911/jepublichealth.2018.03.02.02
Socioeconomic Determinants of Healthy Ageing and the Contextual Effect of Peer Group: A Multilevel Evidence from Blora, Central Java
Get PDFBackground: Healthy ageing is about "optimizing opportunities for good health, so that older people can take an active part in society and enjoy an independent and high quality of life". This study aimed to examine the socioeconomic determinants of healthy ageing and the contextual effect of peer group in Blora, Central Java.Subjects and Method: This was a cross-sectional study conducted in Blora, Central Java.A sample of 200 elderly was selected for this study by snowball sampling. The dependent variable was healthy ageing. The independent variables were nutrition intake, age, religiosity, education, and perceived financial position. Data on healthy ageing was collected by WHOQOL-BREF. The other variables were measured by questionnaire. The data were analyzed by a multilevel model.Results: Healthy ageing was positively affected by strong religous belief (b= 6.75; 95% CI= 3.91 to 9.59; p<0.001), better education (b= 8.16; 95% CI= 4.26 to 12.07; p<0.001), better perceived financial position (b= 6.46; 95% CI= 2.86 to 10.07; p<0.001), and good nutritional status (b= 6.79; 95% CI= 3.76 to 9.83; p<0.001).Conclusion: Healthy ageing is positively affected by strong religous belief, better education, better perceived financial position, and good nutritional status.Keywords: healthy ageing, religious belief, elderly, ageing, peer support groupCorrespondence