Journal of Epidemiology and Public Health (JEPH)
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Determinants of Promoting Assisted Delivery in the Lagdo Health District in Northern Cameroon
Full text linkBackground: Discrepancies in findings on assisted delivery (AD) in the Northern Cameroun persist. In order to reduce maternal mortality, it is hypothesized that specific determinants may help promote the use of AD. This study aimed to assess the possible association between these determinants and AD.Subjects and Method: A cross-sectional study was carried out on 1,175 postpartum women, in the Lagdo health district from May 10th to June 5th, 2023. A three-stage cluster sampling technique was used. Independent variables included the factors related to AD. The dependent variable was the use or no use of AD. A validated questionnaire was employed to gather information. Data analysis was performed with SPSS software version 25. Frequencies, odds ratios (OR), and corresponding 95% confidence intervals (CI) were calculated. The statistical significance was 0.05.Results: The prevalence of AD was 43.9%. After adjustment for age, educational attainment, and parity, a direct association was detected between AD and funded delivery fees (OR=2.5; 95%CI= 1.95 to 3.40; p<0.001), and the presence of motorcycle taxi driver (OR=1.70; 95%CI =1.31 to 2.19; p<0.001). An inverse relationship was observed between AD and distance to health centers (OR= 0.32; 95%CI = 0.18 to 0.58; p<0.001), and lack of community leaders' involvement (OR=0.45; 95%CI = 0.31 to 0.67; p<0.001).Conclusion: Our findings suggest funding delivery fees, reducing distance to health facilities, and sensitizing women by community leaders may help promote AD
Analysis of Environmental Risk Factors for Leptospirosis in Bantul, Yogyakarta, Indonesia
Full text linkBackground: Leptospirosis is a disease caused by the bacterium leptospira sp. The number of cases and deaths due to leptopirosis from year to year is always increasing. The purpose of this study is to analyze environmental risk factors for the incidence of leptospirosis in Bantul Regency, Special Region of Yogyakarta, Indonesia.Subjects and Method: This study uses an observational analytical approach with a cross-sectional design. The research location is in Bantul Regency with a sample of 200 research subjects. The sampling technique is fixed disease sampling. The dependent variable was the incidence of leptospirosis and the independent variables were the physical condition of the house, the condition of the residential environment, the presence of rats, the presence of livestock or pets, near rivers, flooded areas, occupation, habits of using personal protective equipment, age and gender. The research instruments used were questionnaires and checklists and the data was analyzed using logistic regression analysis.Results: Risk factors that increase the incidence of leptospirosis are poor home conditions (OR= 2.18; 95% CI = 1.12 to 4.24; p=0.022); Poor residential environmental conditions (OR = 2.58; 95% CI = 1.33 to 5.03; p = 0.005); presence of rats inside and/or outside the home (OR = 4.51; 95% CI = 1.40 to 14.55; p = 0.012). The risk of leptospirosis infection decreases with the use of PPE (OR = 0.17; 95% CI= 0.08 to 0.37; p<0.001).Conclusion: Poor house conditions, poor residential environmental conditions, the presence of rats inside and or outside the house are risk factors that increase the incidence of leptospirosis. Meanwhile, the use of PPE reduces the risk of leptospirosis infectio
Incidence of Tuberculosis in Primary Health Care during the COVID-19 Pandemic: A Longitudinal Study and Perspective from Eastern Indonesia
Full text linkBackground: Efforts to fight tuberculosis (TB) infection requires a deep understanding of disease control trends to consistently sustain and enhance the identification and treatment of at-risk populations. Indonesia is the third highest globally in TB cases, followed by India and China, accounting for about 10% of all cases. Over the past ten years, Indonesia has witnessed significant TB case reporting and treatment coverage growth. This study aimed to analyze TB case occurrences in a primary health-care setting during the COVID-19 pandemic.Subjects and Method: A cross-sectional study, which included data from the Puskesmas Lau reports from July 2021 to July 2022. A total of 71 patients were conducted using the total sampling method. The collected data were processed descriptively to summarize participants' demographic characteristics and clinical profiles and various important indicators from WHO were analyzed to determine its effectiveness.Results: The center's tuberculosis screening efforts have not reached their optimal level, falling below the national standard of ≥70% for the Case Detection Rate (CDR). However, the treatment success rate (SR) exceeds 90%.Conclusion: The evaluation of the TB control program at Puskesmas Lau reveals achievements in some areas but also highlights challenges posed by the pandemic and the need for strengthened strategies to improve case detection and management. Perceived vulnerability, seriousness, benefit, and barrier, as well as the availability of DOTS treatment, affect treatment adherence. Partnership between patients and health care personnel is recommended to increase the success of TB treatment.
Keywords: Tuberculosis, primary health care, COVID-19, longitudinal study, health service
An Epidemiological Study Incidence Rates of Risk Factors for Colorectal Cancer's Early Symptoms in the Community in Gondanglegi District, Malang, East Java, Indonesia: An Epidemiological Study
No full textBackground: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. CRC is most typical symptom is hematochezia while the risk factors encompass sex, age, genetic predispositions, history of colorectal polyps or cancer, chronic inflammatory bowel diseases, physical exercise, and specific dietary choices, including high red meat intake, fried food, and low fiber consumption. This study aims to screen the risk factors of colorectal cancer.Subjects and Method: This research was conducted on residents in the Sepanjang village, Malang Regency, involved in community service by the Internist Association of Malang. Community service was carried out in July 2023 and 148 residents were involved in collecting data on risk factors for colorectal carcinoma. Data collection was carried out using a questionnaire with a cross-sectional approach. The questionnaire assesses the presence of symptoms of bloody stools and several habits related to colorectal carcinoma risk factors, including age, gender, exercise routine, and dietary history. Data presentation and analysis were carried out as in the table.Results: Among the risk factors listed assessed using the questionnaire, Men (p=0.021), lack of exercise (p= 0.008), consumption of fried food (p= 0.021), and consumption of instant noodles (p= 0.013) significantly affect the prevalence of hematochezia.Conclusion: Men, lack of exercise, consumption of fried food, and consumption of instant noodles significantly affect the hematochezia indicating CRC
Correlations between Physical Activity, Work Duration, and Stress on the Risk of Musculoskeletal Disorders in Online Motorcycle Drivers in Surakarta
Full text linkBackground: Motorcycle taxi drivers drive motorcycles with a static posture and there are significant deviations in angles of certain body joints that trigger susceptibility to movement system injuries, namely musculoskeletal disorders (MSDs). The study aimed to analyze the correlation between the determinants of MSDs, namely physical activity, work duration, and stress on the risk of MSDs incidents in online motorcycle taxi drivers in Surakarta.Subjects and Method: This observational analytical study with a cross-sectional study approach. A sample of 250 online motorcycle taxi drivers in Surakarta was selected using a cluster random sampling technique. The dependent variable of the study was MSDs. The independent variables of the study were physical activity, duration of work, and stress. The data collection technique was conducted through interviews by using questionnaire sheets with instruments i.e. International Physical Activity Questionnaire (IPAQ), Work Stress Scale (WSS), and Nordic Body Map (NBP). Data analysis was carried out using a multivariate STATA application with multiple binary logistic regression.Results: The risk of MSDs in online motorcycle taxi drivers in Surakarta increased with the age of older than or equal to 34 years (OR= 2.66; CI 95%= 1.54 to 4.59; p= <0.001), BMI of more than 25 (OR= 1.33; CI 95%= 0.77 to 2.27; p= 0.303), work duration of more than 4 hours per day (OR= 2.43; CI 95%= 1.24 to 4.78; p= 0.010), high stress level (OR= 1.58; CI 95%= 0.89 to 2.83; p = 0.126), and status as an active smoker (OR= 1.27; CI 95%= 0.74 to 2.19; p= 0.378). The risk of MSDs in online motorcycle taxi drivers in Surakarta decreased with active physical activity (OR= 0.36; CI 95%= 0.15 to 0.86; p = 0.021). Age, BMI, physical activity, work duration, stress, and smoking status influenced the risk of MSDs by 8.2%, and the rest were influenced by other determinants.Conclusion: There is a statistically significant correlation between age, physical activity, and duration of work on the risk of MSDs, however, there was no significant correlation between BMI, stress, and smoking status on the risk of MSDs.
Keywords: Physical activity, stress, musculoskeletal disorders, motorcycle taxi driver
Efficient Biomedical Waste Management- Need of the Time: A Lesson Learnt From COVID-19 Pandemic
Full text linkBackground: Medical waste management (MWM) is of concern to the medical and general com-munity. Adequate knowledge regarding the management of healthcare waste is an important precursor to the synthesis of appropriate attitudes and practices of proper handling and disposal of medical waste by healthcare workers (HCWs). This study aimed to investigate the knowledge, attitudes, and practices of doctors, nurses, laboratory technicians, and housekeeping staff, regarding BMW management at a tertiary hospital in Telangana.Subjects and Method: This was a cross‑sectional study carried out at a tertiary health care center in Mahbubnagar district, Telangana, India. A stratified sampling technique was used to select the different cadre of healthcare providers from the hospital. A self‑administered questionnaire assessing the knowledge, attitude, and practices of 300 study participants was prepared. Data were analyzed using SPSS software version 26. Descriptive statistics were used to summarize the data.Results: The majority of respondents were nursing staff 43% (143/300) followed by doctors, interns, sanitation workers, and lab technicians. About 3/4th of the HCWs had experience of more than 3 years. Only 65% of the doctors have correct knowledge of the colour coding of bags. About only 20% of the nursing staff practiced segregation of the waste on-site. The practice of hand washing was significantly higher among female HCWs (p = 0.010).Conclusion: This study showed that there is a clear lack of BMW management among the HCW especially class IV staff who handle a large. Thus ongoing training should be provided to HCWs on MWM, with more attention to knowledge of regulatory requirements, and involvement of HCWs in the development of MWM policies to enhance compliance
Biopsychosocial Factors Associated with the Risk of Hypertension in Elderly in Klaten, Central Java: A Cross-Sectional Study
Full text linkBackground: Hypertension is also a major preventable risk factor for cardiovascular disease, and plays a role in all causes of death worldwide, characterized by systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. The purpose of this study was to analyze the effect of biopsychosocial factors on the risk of hypertension among the elderly in Klaten Regency.Subjects and Method: This study was cross-sectional from April-May 2024. The sample used was 200 elderly people in 25 elderly health posts and selected using random sampling techniques in Klaten Regency, Central Java. The dependent variable of this study was the incidence of hypertension. The independent variables of this study were age, gender, anxiety, stress, and income level. The data were collected using questionnaire and analyzed using path analysis run on Stata 13.Results: Systolic blood pressure is directly affected by anxiety (b= 1.34; CI 95%= -0.13 to 2.82; p= 0.075), the existence of retirement funds (b= -0.09; CI 95%= -0.01 to -0.03; p= 0.003), and female (b= 1.22; CI 95%= -5.38 to 7.84; p= 0.716). Anxiety is influenced by stress (b= 0.38; CI 95%= 0.29 to 0.48; p<0.001), the existence of retirement funds (b= -0.01; CI 95% <0.01 to <0.01; p= 0.038), and age (b= 0.04; CI 95%= 0.07 to 0.08; p= 0.020).Conclusion: Systolic blood pressure is directly affected by anxiety, the existence of retirement funds, and female. Anxiety is influenced by stress, the existence of retirement funds, and age
Improving Glycated Hemoglobin Control in a Rural Filipino Community: The Influence of Medication, Nutrition, and Lifestyle Counseling on Type 2 Diabetes Mellitus Patients
Full text linkBackground: The Philippines is experiencing a growing diabetes prevalence in line with global patterns, despite free diabetes medications available at Rural Health Units (RHUs). This rise could be linked to factors like insufficient awareness and ability to self-manage the illness resulting in medica-tion non-adherence, negatively affecting patients’ health outcomes. The study aimed to evaluate the impact of counseling on glycated hemoglobin levels among Filipino diabetic patients in rural settings.Subjects and Method: A quasi-experimental research design was employed to determine the effect of one-on-one counseling on nutrition, lifestyle, and medication management on the HbA1C levels of the participants in a rural setting. A purposive sampling technique was used, and participants were selected based on predefined inclusion and exclusion criteria. Out of 60 diabetic patients enrolled in the study from Sinait RHU, 34 patients were qualified and randomly assigned into ‘test’ and ‘control’ groups (n=16). The ‘test’ group (n=18) received monthly counseling sessions lasting 20 to 25 minutes each, during monthly home visits for 3 months. Data on HbA1c reductions were compared using an unpaired t-test.Results: After 3-month counseling interventions, HbA1c level in the test group (Mean=6.38; SD= 1.21) was lower than the control group (Mean=9.27; SD=1.38) and it was statistically significant (p= 0.010). A substantial decrease in the HbA1c levels was observed in the test group whereas a significant increase was noted in the control group.Conclusion: The study’s findings suggest that counseling can help improve diabetic patients' perceptions of disease, diet, and lifestyle changes, resulting in better glycemic control and, ultimately, a higher quality of life.
Keywords:HbA1c, Type 2 diabetes, nutrition counseling, medication counseling, lifestyle counseling, Philippine
Effect Size Estimation of Child Stunting Determinants in Surakarta, Central Java
Full text linkBackground: Child growth is one of the public health indicators in monitoring the nutritional and health status of a population. One of the nutritional problems that is of major concern is the prevalence of stunting in toddlers. Stunting is still a problem in the world. This study aims to analyze the reestimation of the magnitude of the determinant effect of stunting on children under five in the city of Surakarta, Central Java.Subjects and Method: This was a cross-sectional study conducted in Pajang and Sibela community health centers (Puskesmas) in Surakarta, Central Java. Total sample of 200 children under five was selected using fixed disease sampling, consisted of 50 stunted children and 150 normal children. The dependent variable was stunting. The independent variables were exclusive breastfeeding, maternal height, maternal history of illness, maternal age at pregnancy, maternal height, and family income. The data were collected using questionnaire and analyzed using a multiple logistic regression.Results: Maternal age ≥20 years (aOR= 0.19; 95% CI= 0.06 to 0.58; p=0.004), maternal height ≥160 cm (aOR= 0.30; 95% CI= 0.12 to 0.74; p= 0.009), and family income high (aOR= 0.29; 95% CI= 0.12 to 0.72; p=0.008) reduces the risk of stunting. Children under five who were not exclusively breastfed (aOR= 27.06; 95% CI= 8.13 to 90.05; p <0.001) and frequent illness in mothers (aOR= 12.69; 95% CI= 4.59 to 35.10; p<0.001) increases the risk of stunting.Conclusion: Maternal age ≥20 years, maternal height ≥160 cm, and family income high reduce the risk of stunting. Children under five who were not exclusively breastfed and frequent illness in mothers increase the risk of stunting.
Keywords: stunting, maternal age, maternal height, income, breastfed, illness, childre
Enhancing Anxiety Management in Post-Tuberculosis Patients through Psychoeducational Intervention in Baki Community Health Center
Full text linkBackground: Tuberculosis is an infectious disease caused by mycobacterium tuberculosis by air-borne transmission. TB patients are at risk of psychosocial disorders during treatment and post-treatment. This study aims to analyze the effect of psychoeducation on the level of anxiety experienced relapse in patients after Tuberculosis treatment.Subjects and Method: This study used a quasi-experimental design of a posttest pretest at the Baki Health Center, Sukoharjo Regency, Central Java, Indonesia from June to July 2023. The sample was 30 people in the treatment group, namely post-tuberculosis treatment patients, and 30 people in the control group by paying attention to the inclusion criteria, the sample was selected in total sampling. The dependent variable is anxiety and the independent variable is psychoeducation. Psychoeducation was provided with intervention for 3 sessions with a time of 25-30 minutes and anxiety was measured by the HALS questionnaire. The data was analyzed by the Mann-Whitney test.Results: After the intervention, the psychoeducational group had a decrease in anxiety scores (Mean = 7; SD= 4.68) than the control group (Mean= 4.07; SD= 3.14) with p=0.006.Conclusion: Psychoeducation for post-tuberculosis treatment patients can continue to be carried out to reduce the level of anxiety about tuberculosis recurrence and awareness of the impact of the disease