Journal of Epidemiology and Public Health (JEPH)
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Biopsychosocial Factors Associated with Child Growth at Ngembal Kulon Community Health Center, Kudus
Get PDFBackground: The first five years of life is widely acknowledged as a sensitive period for child growth. Any interruption exposing during this period may cause problems in child growth. Various internal and external factors can affect child growth. This study aimed to analyze the effects of biopsychosocial factors associated with child growth with life course perspective.Subjects and Method: This was an observational analytic study with cross-sectional design. It was conducted at Ngembal Kulon community health center, Kudus, Central Java, from December 2016 to February 2017. A total sample of 160 children aged 1 to 5 years old and their mothers were selected for this study by purposive sampling. The dependent variable was child growth as measured by weight for age (WAZ) and height for age (HAZ). The independent variables were birth weight, body length at birth, maternal height, number of children, and family income. The data was collected by a set of questionnaire. Child and maternal heights were measured by microtoise. Data on birthweight and body length at birth were obtained from maternal and child health book. Multiple linear regression was used for data analysis.Results: Child growth (WAZ) was associated with family income (b= 0.36; 95% CI= 0.22 to 0.49; p<0.001), birthweight (b= 0.42; 95% CI= 0.25 to 0.58; p<0.001), and number of children (b= -0.25; 95% CI= -0.42 to -0.08; p=0.004). Child growth (HAZ) was associated with family income (b= 0.26; 95% CI= 0.12 to 0.39; p<0.001), body length at birth (b=0.21; 95% CI= 0.12 to 0.30; p<0.001), and maternal height (b= 0.43; 95% CI= 0.27 to 0.58; p<0.001).Conclusion: Child growth (WAZ) is associated with family income, birthweight, and number of children. Child growth (HAZ) is associated with family income, body length at birth, and maternal height. Life course influences were demonstrated in this study.Keywords: child growth, WAZ, HAZ, birthweight, body length at birth, number of children, maternal height, family incomeCorrespondence: Th. Catur Wulan Setyaningrum. Academy of Midwifery Mardi Rahayu, Kudus. Email: [email protected]. Mobile: 085641897987.Journal of Epidemiology and Public Health (2017), 2(2): 130-140https://doi.org/10.26911/jepublichealth.2017.02.02.0
Knowledge, Attitude, Sexual Behavior, Family Support, and Their Associations with HIV/AIDS Status in Housewives
Get PDFBackground: Approximately 36.7 million people in the world were infected by HIV and 2.1 million new cases occured in 2015. A total of 191,073 HIV cases were reported in Indonesia in 2016, including 77,940 AIDS cases, and 13,247 deaths. Housewives ranked highest among HIV/AIDS patients in Indonesia. This study aimed to investigate knowledge, attitude, sexual behavior, family support, and their associations with HIV status in housewives using PRECEDE PROCEED model.Subjects and Method: This was an analytic observational study with cross-sectional design. The study was conducted at Toroh community health center, Grobogan, Central Java, in July, 2017. A total sample of 129 housewives were selected for this study using exhaustive sampling technique. The dependent variable was HIV status. The independent variables were knowledge, attitude, sexual behavior, and family support. The data was measured by a set of questionnaire and analyzed using path analysis.Results: HIV status was directly and positively associated with risky sexual behavior (b= 4.48; 95% CI= 2.30 to 6.65; p<0.001). Risky sexual behavior was associated with attitude (b= -1.27; 95% CI = -0.03 to -2.51; p<0.045) and family support (b= -1.86; 95% CI= -0.69 to -3.03; p<0.002). Attitude was associated with knowledge (b= 2.06; 95% CI = 0.86 to 3.25; p<0.001).Conclusion: HIV status is directly and positively associated with risky sexual behavior. HIV status is indirectly associated with attitude, knowledge, and family support.Keywords: HIV, AIDS, risky sexual behavior, housewives, PRECEDE PROCEED modelCorrespondence: Budi Laksana. Diploma III Program in Midwifery Muhammadiyah, Madiun, East Java. Email: [email protected]. Mobile: +6285655612000.Journal of Epidemiology and Public Health (2017), 2(2): 154-163https://doi.org/10.26911/jepublichealth.2017.02.02.0
Maternal Employment Status, Ethnicity, Food Intake, and Their Effects on Teenage Obesity, in Surakarta
Get PDFBackground: Obesity is one of the main causesof premature death in adulthood. The prevalence of teenage obesity in Indonesia hasbeen increasing from 1.4% in 2007 to 7.3%. It is hypothesized that the risk of obesity is influenced by lifestyle and socio-economic status. This study aimed to determine the effect of maternal job status, ethnicity, and food intake, on the risk of obesity in teenagers.Subjects and Method: This was an analytical observational using case-control design. This study was conducted in Surakarta, in September – November 2016. A total of 120 teenagers were selected for the study, consisting of 41obese teenagers aged 16-18 years old and 79 normal weight teenagers, using fixed disease sampling. The dependent variable was obesity. The independent variables were maternal employment status, ethnicity, carbohydrate intake, fat intake, and energy intake. The data were collected using a set of questionnaires. Food intake was measured by 24 hour food recall. The data were analyzed using path analysis model.Results: Energy intake had positive, significant, and direct effect on the risk of teenage obesity (b = 6.75; 95%CI = 4.36 to 9.14; p = <0.001). Working mother indirectly had positive and significant effect on teenage obesity, via fat intake (b=0.77; 95% CI = 0.03 to 1.52; p=0.040). Fat intake indirectly had positive and significant effect on teenage obesity, via energy intake (b=4.16; 95%CI=1.95 to 6.38; p=0.001). Likewise, carbohydrateintake had positive and significant effect on teenage obesity, via energy intake(b = 3.31; 95% CI= 1.73 to 4.88; p = 0.001). Ethnicity (Chinese versus Javanese) did not have significant effect on teenage obesity (b =-1.14; 95% CI =-3.56 to 1.28; p = 0.355).Conclusion: Energy intake has direct effect on the risk of teenage obesity. Fat intake, carbohydrate intake, and maternal employment status, have indirect effect on the risk of teenage obesity.Keywords: maternal employment status, ethnicity,food intake, obesity, teenager.Correspondence: Rahmah Purwaningsih Febri Susanti. Master Program in Public Health Sebelas Maret University. Email: [email protected] of Epidemiology and Public Health (2016), 1(2): 75-85https://doi.org/10.26911/jepublichealth.2016.01.02.0
Risk Factors Affecting Multi-Drug Resistant Tuberculosis in Surakarta and Ngawi, Indonesia
Get PDFBackground: The success rate of Tuberculosis treatment in Indonesia decreased by 81.3% in 2014, which below the 85% target. The current increasing problem in the developing world is multidrug resistance of Tuberculosis (MDR-TB). Many factors may contribute to MDR-TB. At the individual level these factors may include adherence to medication, perception of vulnerability, seriousness, benefit, barrier, and nutritional status. At the institutional level these factors may include the availability of drugs and implementation of DOTS program. This study aimed to analyze factors that affect MDR-TB in Surakarta and Wonogiri district, Central Java, Indonesia.Subjects and Method: This was an observasional analytic study with case control design. It was carried out in August-October 2016 in Surakarta and Ngawi, Indonesia. A total of 120 patients were selected by fixed disease sampling. Another sample of 44 health workers was also selected for the study. The endogenous variables: adherence, nutritional status, and implementation of the treatment of DOTS. The exogenous variables: perception of vulnerability, seriousness, benefits, barriers, the availability of anti Tuberculosis drugs. The data was collected by questionnaire and analyzed by path analysis.Results: Nutritional status (b=-2.98; 95% CI =-5.31 to -0.64; p = 0.012), adherence to anti Tuberculosis drugs (b=-3.38; 95% CI =-5.94 to -0.82; p = 0.010), treatment with DOTS for MDR TB (b=-0.88; 95% CI = 1.43-3.18 ; p = 0.456) were associated with MDR-TB. Perceived vulnerability (b= 2.81; 95% CI= 0.99 to 4.64; p = 0.003), seriousness (b=4.47; CI 95% = 2.38 to 6.57; p 0.001), benefits (b= 3.4; CI 95%= 1.52 to 5.18; p=0.001), barriers (b =-1.81; 95% CI=-3.48 to -1.39; p=0.034), as well as availability of DOTS treatment (b = 3.14; CI 95% = 0.95 to 5.32; p = 0.002), were associated with adherence to treatment.Conclusion: Nutritional status, adherence to treatment, implementation of DOTS strategy for MDR-TB affect the risk of MDR TB. Perceived vulnerability, seriousness, benefit, and barrier, as well as availability of DOTS treatment, affect adherence to treatment. Partnership between patients and health care personnel is recommended to increase the success of TB treatment.Keywords: tuberculosis, risk factor, MDR-TB, adherence to treatmentCorrespondence: Novi Indah Aderita. Polytechnic of Health Sciences Bhakti Mulia, Sukoharjo, Central Java Email: [email protected] of Health Promotion and Behavior (2016), 1(2): 86-99https://doi.org/10.26911/jepublichealth.2016.01.02.02
Multilevel Analysis on the Contextual Effects of Hygiene, Environmental Sanitation, and Diarrhea Prevention in Elementary School Students in Ngawi, East Java
Get PDFBackground: Clean and healthy behavior in school is an important factor to prevent diarrhea and improve the health status of school children. This study aimed to determine the effects of hygiene and school environmental sanitation on diarrhea prevention behavior.Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in Ngawi, East Java, in October 2018. A sample of 225 elementary school students was selected randomly from 25 elementary high schools in Ngawi. The dependent variable was diarrhea prevention. The independent variables were the studen
Biopsychosocial Determinants of Quality of Life in the Elderly at Tresna Werdha Social Nursing Home, Yogyakarta
Get PDFBackground: Aging process is a multidimensional natural process with implicating problem involving various aspects, i.e. biological, psychological, and social aspects. Efforts are needed to prolong life expectancy and to improve the quality of life of the elderly. This study aimed to analyze biopsychosocial determinants of quality of life in the elderly at Tresna Werdha Social Nursing Home, Yogyakarta.Subjects and Method: This study was analytic observational study with cross-sectional design. It was conducted at Abiyoso and Budi Luhur units, Tresna Werdha Social Nursing Home, Yogyakarta, in April 2017. A sample of 100 elderly were selected for this study by purposive sampling and simple random sampling. The independent variables were health status, level of independence, intellectual function, depression, and social activities. The dependent variable was quality of life. The data were collected by a set of pre-tested questionnaire and analyzed by logistic regression.Results: Biopsychosocial determinants of quality of life in the elderly included health status (OR= 11.66; 95% CI= 2.18 to 62.14; p= 0.004), level of independence (OR= 4.12; 95% CI= 1.08 to 15.60; p= 0.037), intellectual function (OR= 9.75; 95% CI = 1.09 to 87.08; p= 0.036), depression (OR= 3.38; 95% CI= 1.01 to 11.24; p= 0.047), and social activities (OR= 6.02; 95% CI = 1.12 to 32.25; p= 0.047).Conclusion: Health status, level of independence, intellectual function, depression, and social activities, are biopsychosocial determinants of quality of life in the elderlyKeywords: biopsychosocial, determinant, quality of life, elderlyCorrespondence: Sobma Swastika. Masters Program in Public Health, Sebelas Maret University. Jl. Ir. Sutami 36 A, Surakarta, Central Java. Email: [email protected]. Mobile: +628113239862.Journal of Epidemiology and Public Health (2017), 2(1): 82-92https://doi.org/10.26911/jepublichealth.2017.02.01.0
Case Study onMulti-Drug Resistance Tuberculosis in Grobogan, Central Java
Get PDFBackground: Tuberculosis is a communicable disease that remains a major public health issue worldwide. Tuberculosis epidemics have become a primary public health concern for the last few decades. The problem becomes aggrevated due to the emergence of Multiple Drugs Resistant Tuberculosis (MDR-TB). It is estimated there are 6,100 MDR-TB cases annually in Indonesia. Grobogan is one of the 6 districts in ex-residentialPatiin Central Java with the second highest MDR-TB cases after Kudus. Between 2011 and 2016 the annual incidence was 23 cases with case fatality rate of 52.17%. This study aimed to investigate the different roles of MDR-TB patients, families, TB progammers, and health providers, in the incidence of MDR-TB in Grobogan, Central Java.Subjects and Method: This was an analytic qualitative study with case study approach. The study was conducted in Grobogan, Central Java, from May to June 2017. A total of 26 informants were selected purposively for this study, consisting of 7 MDR-TB patients, 7 family members who served as drug-taking supervisor, 7 TB programmers at Community Health Centers, 1 TB programmer at District Hospital, 3 Community Health Center doctors, and 1 District Hospital doctor. The data were collected by in-depth interview, direct observation, and document review. Interactive analysis was used to analyze data, including data collection, reduction, presentation, and verification.Results: All MDR-TB patientshad favorable perceived susceptibility, perceived severity, and self-efficacy, that drove them to adhere to TB treatment. Most patients reported that the treatment was beneficial. The existing barrier was not of serious concern that made them to stop treatment.Families of the patients had positive attitude towards TB treatment so they provided the necessary support in acessing treatment and adherence to treatment. However, TB program management at District Hospital, was sub-optimal as it did not administer appropriately the standard DOTS-TB treatment guideline, despite the existence of TB standard operating procedure. Likewise, TB treatment management by hospital doctors and private practice doctors was inadequate, due to the lack of DOTS-TB training. The lack of adherence in implementing thestandard DOTS-TB treatment guideline was the dominant causal factor for the incidence of MDR-TB in Grobogan district, Central Java.Conclusion: Adequate DOTS-TB treatment management and quality health services at both primary and secondary level facilities are needed in the efforts to prevent MDR TB. It is suggested that the government through the District Health Office hold DOTS-TB promotion program and invest in developing skilled DOTS-TB providers.Keywords:multidrug resistance, tuberculosis, TB management program, adherence.Correspondence: Gunawan Cahyo Utomo. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6281390046456.Journal of Epidemiology and Public Health (2017), 2(3): 186-200https://doi.org/10.26911/jepublichealth.2017.02.03.0
Risk Factors of Gonorrhoea Among Female Indirect Sex Workers
Get PDFBackground: Gonorrhoea is one of sexually transmitted infections (STI) with high incidence, besides chlamydia, syphilis, and trichomoniasis. STIs are spread predominantly by sexual context including vaginal, anal, and oral. STIs have a profound impact on sexual and reproductive health worldwide. STIs can increase the risk of HIV acquisition three fold or more. This study aimed to determine the risk factors of gonorrhoea among female indirect sex workers.Subjects and Method: This was a case control study carried out in Wonosobo district, Central Java, from April to May 2017. A sample of 84 female indirect sex workers were selected for this study consisting of 42 cases of gonorrhea and 42 control. The dependent variable was gonorrhoea. The independent variables were sex combination and condom use. Data on gonorrhoea was collected from STI clinic. The other data were collected by questionnaire. The data were analyzed using logistic regression.Results: The risk of gonorrhoea among female indirect sex workers increased with sex combination practice (OR=3.17; p=0.027; 95% CI= 1.14 to 8.82) and absence of condom use (OR= 8.04; 95% CI= 2.30 to 28.12; p=0.001).Conclusion: The risk of gonorrhoea among female indirect sex workers increases with sex combination practice and absence of condom use.Keywords : gonorrhoea, sex combination, condom use, female, indirect sex workersCorrespondence: Anita Nugrahaeni. Masters Program in Epidemiology, Diponegoro University, Jl. Imam Bardjo SH No. 5, Semarang, Central Java. Email: [email protected]. Mobile: 081335980666.Journal of Epidemiology and Public Health (2017), 2(3): 216-224https://doi.org/10.26911/jepublichealth.2017.02.03.0
Biological, Physical, Social, and Environmental Factors Associated with Dengue Hemorrhagic Fever in Nganjuk, East Java
Get PDFBackground: Dengue Hemorrhagic Fever (DHF) is an infectious disease transmitted by mosquitoes that carry dengue virus (DV). This disease is endemic in more than 100 countries. Nganjuk district, East Java, is a DHF endemic area with sharp increase in DHF incidence by 286% from 2014 to 2015, of which 9 cases died. This study aimed to examine biological, physical, social, and environmental factors associated with dengue hemorrhagic fever in Nganjuk, East Java.Subjects and Method: This study was observational analytic with case control design. It was conducted in Nganjuk District, East Java, from May to June, 2017. A sample of 120 children aged less than 15 years old were selected for this study by fixed disease sampling. This sample consisted of 40 children with DHF selected as cases and 80 neighboring children without DHF selected as controls. The independent variables were the existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control (PSN), and activity of larva monitoring cadre. The dependent variable was DHF cases. The data were collected by a set of pre-tested questionnaire and observation with a checklist. Logistic regression was employed for data analysis.Results: Incidence of DHF case was determined by the existence of bush surrounding the house (OR=2.14; 95% CI =0.99 to 4.6; p=0.052), existence of mosquito larvae (OR=14.94; 95% CI =5.91 to 37.73; p<0.001), still water (OR=11.42; 95% CI= 4.68 to 27.89; p<0.001), hung clothes (OR=4.31; 95% CI =1.92 to 9.70; p<0.001), mosquito breeding place control (OR=0.06; 95% CI= 0.02 to 0.15; p<0.001), and activity of larva monitoring cadre (OR=0.14; 95% CI= 0.06 to 0.32; p<0.001).Conclusion: Existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control, and activity of larva monitoring cadre, are the determinants of DHF incidence.Keywords: biological, physical, social, environmental factor, mosquito breeding place control, Dengue Hemorrhagic FeverCorrespondence: Ike Nurrochmawati. Diploma Program in Midwifery, STIKes Satria Bhakti, Nganjuk, East Java. Email: [email protected]. Mobile: +6282141578108.Journal of Epidemiology and Public Health (2017), 2(2): 93-105https://doi.org/10.26911/jepublichealth.2017.02.02.0
Effects of Predisposing, Enabling, and Reinforcing Factors on Completeness of Child Immunization in Pamekasan, Madura
Get PDFBackground: According to WHO Weekly Epidemiological Record, Indonesia ranked fourth the lowest country in immunization coverage after India, Nigeria, and Democratic Republic of Congo. Likewise, Pamekasan District in Madura was one of districs in East Java with the lowest immunization coverage. This study aimed to determine the effects of predisposing, enabling, and reinforcing factors on completeness of child immunization, using PRECEDE and PROCEED model and health belief model.Subjects and Method: This was an observational analytic study with case control design. This study was carried out at 4 community health centers in Pamekasan District, Madura, East Java, in March to April, 2017. A sample of 135 mothers who had infants aged 10 to 12 months were selected for this study by fixed disease sampling. The dependent variable was completeness of immunization use. The independent variables were maternal education, attitude towards immunization, perceived susceptibility, perceived severity, perceived benefit, perceived barrier, self efficacy, family support, and distance to health service. The data were collected by questionnaire and analyzed using path analysis.Results: Perceived barrier (b= -0.5; 95% CI = -1.5 to 0.4; p= 0.255) and distance to health service (b= -1.0; 95% CI= -2.0 to -0.1; p= 0.037) had a negative effect on completeness of immunization. Perceived susceptibility (b= 1.1; 95% CI= 0.2 to 2.0; p= 0.022), perceived severity (b= 1.5; 95% CI= 0.5 to 2.5; p= 0.003), perceived benefit (b= 0.7; 95% CI= -0.1 to 1.6; p= 0.110), and self efficacy (b= 0.6; 95% CI= -0.3 to 1.5; p= 0.193) had a positive effect on completeness of immunization. Perceived susceptibility was affected by maternal education (b= 1.0; 95% CI= 0.3 to 1.7; p= 0.005). Perceived severity was affected by maternal education (b= 0.9; 95% CI= 0.5 to 1.6; p= 0.018) and attitude towards immunization (b= 1.0; 95% CI= 0.3 to 1.8; p= 0.007). Perceived benefit was affected by family support (b= 0.7; 95% CI= -0.1 to 1.4; p= 0.078). Likeliwise, self efficacy was affected by family support (b= 0.6; 95% CI = 0.1 to 1.3; p= 0.134).Conclusion: Perceived barrier and distance to health service have a negative effect on completeness of immunization. Perceived susceptibility, perceived severity, perceived benefit, and self efficacy have a positive effect on completeness of immunization.Keywords: completeness of immunization, PRECEDE and PROCEED model, health belief modelCorrespondence: Nur Jayanti. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6282233829768.Journal of Epidemiology and Public Health (2017), 2(2): 106-118https://doi.org/10.26911/jepublichealth.2017.02.02.0