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P.M Ridzuan, K. Proveen, Kamarulzaman Siti-Arffah
Jurnal Berkala Epidemiologi, Volume 9, pp 123-129; doi:10.20473/jbe.v9i22021.123-129

Abstract:
Background: Dermatophytosis is one of the most common skin diseases that affects cats and dogs. Geographic factors play an important role in determining prevalence, showing high rates of prevalence in warm and humid environments. Purpose: The aim of this study was to determine the macroscopic and microscopic identification of different types of dermatophytes present on stray dogs. Methods: The design of this study was laboratory-based research. Each sample was collected from an infection site (nail, hair, or skin) that was identified by conducting a physical examination of a stray dog that was infected with fungi. The skin scraping, nail clipping, and fur cutting samples were collected from infected dogs and then cultured on Sabouraud Dextrose Agar (SDA). The cultures were incubated at 26°C for five weeks. The isolates of fungi were then examined macroscopically and microscopically. The Lactophenol Cotton Blue (LPCB) staining technique was used for fungi morphology identification. Results: Overall, the most common type of dermatophytes that affected the dogs were Trichophyton spp. (64.70%), Aspergillus spp. (10.10%), Microsporum spp. (7.20%), and Curvularia spp. (5.60%). Conclusion: This study revealed the most common dermatophyte infections found on stray dogs in Selangor, Malaysia. This study can assist investigators in understanding the prevalence of the dermatophyte burden in stray dogs and help prevent further complication, such as the spread of illness, especially zoonotic infection.
Febriyanti Febriyanti, Santi Martini, Atik Choirul Hidajah, Febi Dwirahmadi
Jurnal Berkala Epidemiologi, Volume 9, pp 105-114; doi:10.20473/jbe.v9i22021.105-114

Abstract:
Background: The earthquake that hit the Jailolo sub-district in 2015 caused massive damage and loss. This catastrophic event affected not only impacted the local government's economy but also affected many communities, households and individuals living in these communities. Purpose: Aim of this study is to assess the economic resilience of communities in the Jailolo sub-district in response to earthquakes. Methods: This research was based on a descriptive observational study and employed a survey method to assess the economic resilience of communities in the Jailolo sub-district. The study was conducted in five villages, namely Tedeng, Payo, Saria, Matui, and Buku Maadu. The cut-off point for each indicator was classified as very high criteria (>1.05), high (0.95–1.05), moderate (0.85–0.94), low (0.74–0.84), and very low (≤0.73). Results: The proportion of community home ownership was found to be 100% (Resilience Factor Index (RFI)=1.67). The proportion of community work was 33.75% (RFI=0.68). The proportion of dual-income sources of communities in the Jailolo sub-district was 50.89% (RFI=1.02). The proportion of community income that exceeded the provincial minimum wage (PMW) was 8.71% (RFI=0.10). Based on the results of these indicators, the economic resilience of people in the Jailolo sub-district, which was obtained by considering the average RFI of each indicator, was 0.86. Conclusion: Community economic resilience in the Jailolo sub-district was found to be in the medium category. The highest and lowest resilience factors resulted from home ownership and income, respectively.
Armya Zakiah Safitri, Risna Nur Fajariyah, Erni Astutik
Jurnal Berkala Epidemiologi, Volume 9, pp 184-191; doi:10.20473/jbe.v9i22021.184-191

Abstract:
Background: Over the last decades, the number of new diabetic cases and the prevalence of diabetes have tended to increase. The diabetes prevalence rate in Indonesia in 2020 reached 6.20%. Purpose: The aim of this study is to examine the relationship between the variables of age, level of education, smoking status, and Body Mass Index (BMI) and the prevalence of diabetes in the urban areas. Methods: This was a cross-sectional study and used secondary data from the Indonesia Family Life Survey (IFLS 5) in 2015. The data was analyzed using descriptive analysis and simple logistic regression. The dependent variable in this study was Diabetes Mellitus (DM); the independent variables were age, education level, smoking status, and BMI. Results: In terms of the respondents’ characteristics, individuals were mainly over 35 years of age (130 respondents, 83.87%). The highest level of education was attained by 93 respondents (60.00%). There was a correlation between respondents who were over 35 years of age, with p=0.01; prevalence ratio (PR)=5.60; 95%Cl=3.64–8.62) and the level of education (p=0.01; PR=1.69; 95%Cl=1.22–2.34) with the incidence of diabetes in urban areas in Indonesia. There was no correlation between the smoking status (p=0.55; PR=0.67; 95%Cl=0.01–2.73) and the BMI of respondents with the prevalence of diabetes in urban areas in Indonesia. Conclusion: The age and the level of education were linked to the incidence of diabetes in urban areas in Indonesia.
Destasari Tri Hartanti, Yunias Setiawati, Dominicus Husada, Irwanto Irwanto
Jurnal Berkala Epidemiologi, Volume 9, pp 192-201; doi:10.20473/jbe.v9i22021.192-201

Abstract:
Background: Internet addiction has become a serious problem in the world, especially for adolescents. Temperament plays an important role in influencing internet addiction in adolescents. Purpose: The aim of this study was to analyze the relationship between students’ characteristics and temperament with their internet addiction levels in one of the junior high schools in Surabaya, Indonesia. Methods: This was a cross-sectional study, which used primary data that was obtained from students who filled out a questionnaire. The study sample included 114 students in one of the junior high schools in Surabaya. The dependent variable was the internet addiction level; the dependent variables were gender, age, student grade, and temperament. An Internet Addiction Test (IAT) and an Early Adolescents Temperament Questionnaire-Revised (EATQ-R) were the tools used for data collection. Data was collected in November 2019. The sample selection was done through the stratified random sampling technique. The data was subsequently analyzed using the Fisher’s exact and Spearman correlation tests. Results: There was a significant positive correlation between age (p<0.01), student grade (p<0.05), negative affectivity (p<0.01), and surgency (p<0.05) toward internet addiction levels. There was a significant negative correlation observed between effortful control (p<0.05) and internet addiction levels. Conclusion: There was a significant relationship between age, student grade, negative affectivity, surgency, and effortful control and adolescents’ internet addiction levels.
Alfira Nailatul Izzah, Irwanto Irwanto, Andriati Andriati, Prastiya Indra Gunawan
Jurnal Berkala Epidemiologi, Volume 9, pp 166-174; doi:10.20473/jbe.v9i22021.166-174

Abstract:
Background: Cerebral palsy is non-progressive disorder that can cause limited movement and lead to postural deformity in children, which can affects all the psychosocial aspects and, thus, impacts children’s’ quality of life as well. Assessment of quality of life is important to evaluate suitable intervention measures for children with cerebral palsy. Purpose: This study aims to investigate the domains and determine the quality of life in children with cerebral palsy between ages 2 and 18. Methods: This was a descriptive study that employed a cross-sectional design approach. Primary data was obtained through a questionnaire. This study used the pediatric quality of life inventory (PedsQL)TM 3.0 cerebral palsy module. The study was conducted from November 2019 to February 2020. The data was collected at the Department of Medical Rehabilitation at the Dr. Soetomo Hospital, Peduli CP Foundation, and the Happy CP Community. This study involved 52 subjects, aged 2–18 years. Results: Almost all of the subjects (76.90%) had an impaired or poor quality of life. From the seven existing domains, only one domain received a good score: the domain of movement and balance. Conclusion: Based on the PedsQLTM 3.0 cerebral palsy module, parents reported that the quality of life in children (ages 2–18 years) having cerebral palsy was still low. Only the movement and balance domain got a good score.
Nina Widyasari, Hari Basuki, Chatarina Umbul Wahjuni
Jurnal Berkala Epidemiologi, Volume 9, pp 130-139; doi:10.20473/jbe.v9i22021.130-139

Abstract:
Background: The COVID-19 pandemic caused by the SARS-CoV-2 virus has left infected patients with comorbidities in severe and deadly conditions. Hypertension is a non-communicable disease (NCD) and is one of the most common comorbidities observed in COVID-19 patients. Purpose: This study aims to understand the relationship between hypertension and the risk of death through COVID-19. Method: The study employed a systematic review of journals. Journals and articles related to hypertension and COVID-19 were collected and analyzed. The inclusion criteria was COVID-19 articles pertaining to hypertensive patients, and the exclusion criteria was articles that did not use English as well as those that did not display full text. Result: Hypertension is a multifactorial disease. The presence of hypertension is often not realized by the sufferer. A COVID-19 infection can worsen the condition of the person and can cause damage to vital organs. The use of antihypertensive drugs of the angiotensin-converting enzyme inhibitor (ACEI) and the angiotensin receptor blocker (ARB) groups can be continued to be administered to hypertensive patients. There should be no cause for concern for these patients to develop COVID-19 infections by taking these drugs. Conclusion: The risk of developing hypertension is that it can cause organ damage and lead to various complications. The SARS-CoV-2 infection in people with hypertension as a comorbidity, could worsen the condition of the individual until death occurs. Thus, hypertension management is necessary to properly minimize the severity.
Tjatur Sembodo, Hesti Wahyuningsih Karyadini, Yusti Nur Aisyah Sanna
Jurnal Berkala Epidemiologi, Volume 9, pp 148-156; doi:10.20473/jbe.v9i22021.148-156

Abstract:
Background: Research on scabies in boarding schools has been widely carried out, however, the nature of transmission has not yet been analyzed. The transmission can occur due to the risk of direct contact when using shared beds. Purpose: This study aims to analyze the risk of bed usage in the event of a scabies infection in boarding schools. Methods: This study adopted a case-control design method. The independent variable was the use of beds, including using a shared bed and using one's own bed. The dependent variable was scabies, which was determined on the basis of the diagnostic criteria set for scabies. The sample size was 60 students, who had lived for at least four weeks in boarding schools. The sample comprised two groups: the group that used a shared bed (30 students) and the group that used their own beds (30 students). A non-probability sampling method was employed to record data. The data was collected by using a scabies checklist. Direct examinations and interviews were conducted at the Fathul Huda Demak and the Selamat Kendal boarding schools in February 2020. Statistical tests were carried out using chi-square analysis. Results: This study revealed the risk of developing scabies when a shared bed was used, with p=0.00 (p<0.05); OR=7.67; and 95%CI= 2.42–24.25. Conclusion: Students who used a shared bed in boarding schools were at 7.67 times the risk of developing scabies compared to students who used their own beds.
M Rasyid Ridha, Kasman Kasman, Evi Liani, Liestiana Indriati
Jurnal Berkala Epidemiologi, Volume 9, pp 140-147; doi:10.20473/jbe.v9i22021.140-147

Abstract:
Background: Malaria has caused high morbidity and mortality rates and has decreased the productivity of human resources and national development. Malaria is endemic in several districts in South Kalimantan. Purpose: This study aims to describe the malaria situation in South Kalimantan by examining the malaria cases, Case Fatality Rate (CFR), Annual Parasite Incidence (API), and Slide Parasite Rate (SPR) in the South Kalimantan Province during the period of 2010–2018. Method: This research was a descriptive study with the South Kalimantan population, who were at risk of getting malaria. This study adopted a total participation technique and included all the cases of malaria recorded in the electronic- Surveillance Information System of Malaria (e-SISMAL) data of South Kalimantan province in the period 2010–2018. The study used secondary data from the South Kalimantan Provincial Health Office during 2010–2018. The data included the number of malaria cases, morbidity, and the mortality rate of malaria. The data collected was analyzed using CFR, API, and the SPR formulae. Results: The number of malaria cases in South Kalimantan from 2010 to 2018 fluctuated. The highest number of malaria cases occurred in 2011, while a decreasing trend was observed up to 2018. At the same time, the number of deaths during 2012–2018 increased. The death rate from 2010–2018 decreased in South Kalimantan. Conclusion: The number of cases as well as deaths caused due to malaria in South Kalimantan continues to decrease. By 2025, all districts in South Kalimantan could be free from malaria.
Wildana Widad Fitriyana, Dewi Puji Ayuningrum
Jurnal Berkala Epidemiologi, Volume 9, pp 202-210; doi:10.20473/jbe.v9i22021.202-210

Abstract:
Background: The relationship between Tuberculosis (TB) and nutritional status is a significant one. Patients with TB who are underweight face a higher risk of death. Purpose: This research aims to analyze the factors related to the occurrence of being underweight among TB patients at the Public Health Center (PHC) in Perak Timur, Surabaya. Method: This was an analytical observational study and used a cross-sectional design. The sample for this research was 41 respondents, who were TB patients and were undergoing treatment at the PHC in Perak Timur, Surabaya. Data collection was done from March 2020 to June 2020. Primary data was collected by conducting interviews using a questionnaire. Data analysis was performed using a chi-square test. Results: The results indicated that, out of the 41 respondents, there were 21 respondents who were underweight (51.22%). Descriptively, underweight TB patients were more likely to be in the intensive phase of treatment (90%), have a low income (56.76%), have a low education status (65.38%), and be unemployed (59.38%), with PR=0.43 and 95%CI=0.76–9.38. The results of this research indicated a link between the treatment phase and TB patients being underweight (p=0.01; PR=2.33; 95% CI=1.43–3.79), the level of education attained by underweight TB patients (p=0.04; PR=0.41; 95% CI=0.17–0.99), and the income of underweight TB patients (p=0.04; PR=0.43; 95%CI=0.30–0.63). The results of this research indicated that there was a correlation between the work status and TB patients being underweight (p=0.07; PR=2.67; 95%CI=0.76–9.38). Conclusion: The treatment phase, education level and income are significantly related to TB patients being underweight.
Jurnal Berkala Epidemiologi, Volume 9, pp 157-165; doi:10.20473/jbe.v9i22021.157-165

Abstract:
Background: Pneumonia is an acute respiratory infection and the second leading cause of toddler deaths in Indonesia. Nutritional status, immunization status, and humidity in the house constitute risk factors for the incidence and prevalence of pneumonia. Purpose: The objective of this research is to analyze the determinants of nutritional status, immunization status, and air humidity against the incidence of pneumonia in toddlers in Jambi City. Methods: This was an observational study. A case-control design approach was adopted. The research location was the Public Health Center of Talang Bakung in Jambi City, which has the highest prevalence of pneumonia cases. This study was conducted from January 2019 to August 2019. The number of samples in this study was 66 toddlers, with a 1:1 ratio of cases. Data was collected using a multistage random sampling technique. Primary and secondary data obtained was analyzed with a logistic regression test method. Results: The highest proportion of pneumonia cases was observed in toddlers between the ages of 12 and 35 months (75.76%). The proportion of female toddlers was 57.58%, with the number of siblings being ≥1 (93.94%). The proportion of people who completed secondary level maternal education was 60.61%, which was higher than the proportion of people who completed secondary level paternal education (54.55%). The employment status of fathers was 96.97%. Underweight status was associated with pneumonia (AOR=5.81; 95%CI=1.07–31.68). Inadequate air humidity was associated with the incidence of pneumonia (AOR=7.37; 95%CI=1.80–30.13). Conclusion: Nutritional status and air humidity were identified as determinants of pneumonia in toddlers in Jambi city.
Anugrah Lintang Indrawati, Santi Martini
Jurnal Berkala Epidemiologi, Volume 9, pp 175-183; doi:10.20473/jbe.v9i22021.175-183

Abstract:
Background: Hypertension is still a major health problem in the world. One of the factors causing hypertension is exposure to cigarette smoke. Purpose: The aim of this study was to analyze the relationship between cigarette smoke exposure and the incidence of hypertension in housewives in houses in Dampit village. Methods: This research adopted an analytical observational approach. This was a cross-sectional design study. The population for this study was all housewives in Dampit village in March 2020. A total number of 115 housewives was selected using the cluster proportional random sampling technique. The dependent variable was the incidence of hypertension; the independent variables were the duration of cigarette smoke exposure in houses, the number of instances contact was made by being in close proximity to smokers, and the contact duration with smokers. Data collection was done by interviewing respondents using a questionnaire. Data analysis was carried out using frequency tables and Epi Info. Results: The study indicated that there was a relationship between the duration of cigarette smoke exposure (over 33 years) in houses with the incidence of hypertension in housewives (p=0.01; OR=3.52; 95%CI=1.53–8.05). Similarly, there was a relationship established between the number of occasions contact was made by being in close proximity to smokers every day (over three times every day) (p=0.01; OR=36; 95%CI=7.64–168.76) and the contact duration with smokers (p=0.01; OR=8.09; 95%CI=3.13–20.87) with the incidence of hypertension in housewives. Conclusion: There was a link between the duration of cigarette smoke exposure in houses, the number of instances of being in close proximity to smokers every day, and the contact duration with smokers with the incidence of hypertension in housewives in Dampit village.
Dewi Puji Ayuningrum, Risna Nur Fajariyah, Randy Novirsa, Erni Astutik
Jurnal Berkala Epidemiologi, Volume 9, pp 115-122; doi:10.20473/jbe.v9i22021.115-122

Abstract:
Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p<0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.
Gracia Satyawestri Pribadi, A.B. Firman Cahyono
Jurnal Berkala Epidemiologi, Volume 9, pp 96-104; doi:10.20473/jbe.v9i12021.96-104

Abstract:
Background: Acquired immunodeficiency syndrome (AIDS) is a health problem in East Java. Opportunistic infections are one of the causes of morbidity and mortality in patients with human immunodeficiency virus (HIV) and AIDS in Indonesia. Purpose: This study aimed to describe the characteristics and opportunistic infections of AIDS patients in East Java Province, 2018. Methods: This study was conducted as observational descriptive research, and a survey was used as the research design. The research location was in East Java Provincial Health Office, and the study was carried out in August 2019. We used secondary data taken from the results of surveillance of AIDS patients in 2018. The sampling method of the study was total sampling, with 1,138 AIDS patients. The variables studied included the patients’ characteristics (sex, age, type of work, and risk factors) as well as the number and types of opportunistic infections. Results: The majority of the AIDS patients in East Java in this sample were male (70.74%), belonged to the adults (26–45 years old) group (62.65%), and worked as employees/laborers (46.08%). In terms of sexual orientation, the majority were heterosexuals (81.81%) or homosexuals (10.63%). The majority of patients experienced one type of opportunistic infection (46.08%), with histoplasmosis (48.77%) and tuberculosis (TB) (42.62%) as the most frequently experienced opportunistic infections. Conclusion: Characteristics that are risk factors for contracting AIDS in East Java include being male, being of adult age, working as an employee/laborer, and being heterosexual. There are also risks of opportunistic infections, particularly histoplasmosis and TB.
Nurul Layly Firdausi, Kurnia Dwi Artanti, Chung-Yi Li
Jurnal Berkala Epidemiologi, Volume 9, pp 18-25; doi:10.20473/jbe.v9i12021.18-25

Abstract:
Background: Chronic obstructive pulmonary disease (COPD) is a lung disease caused by the occurrence of airflow limitation in the lungs and also causes 60% of all deaths in Indonesia. Purpose: This study aimed to analyze the risk factors that affect the incidence of COPD in Indonesia. Methods: This study was conducted in July–August 2019 in Indonesia as an analytic research study with a cross-sectional design, using data from the Indonesia Family Life Survey-5. The sample consisted of respondents aged >15 years, giving a total of 34,231 respondents. Data analysis was partially carried out using the chi-square test to analyze the relationships between the variables. Results: The majority of respondents were female, were aged 40 years (p = 0.02; PR = 1.20; 95% CI = 1.02–1.41), male gender (p = 0.01; PR = 1.26; 95% CI = 1.07–1.49), smoking (p = 0.01; PR = 1.22 ; 95% CI = 1.03–1.44), first smoking age < 40 years (p = 0.02; PR = 1.22; 95% CI = 1.03–1.44), residence in urban areas (p = 0.01; PR = 1.43; 95% CI = 1.20–1.70), being underweight (p = 0.01; PR = 2.17; 95% CI = 1.76–2.66). Conclusions: The risk factors that affect the incidence of COPD include being aged >40 years, being male, smoking, taking up smoking when aged
Rahmawati Sinusi, Arief Hargono
Jurnal Berkala Epidemiologi, Volume 9, pp 88-95; doi:10.20473/jbe.v9i12021.88-95

Abstract:
Background: Based on the Indonesia basic health research report in 2018, the prevalence of chronic kidney disease (CKD) in the productive age group in Indonesia had increased from the previous year, to 1.97%. This condition can cause various complications that contribute to the high morbidity, which affects quality of life and productivity, so risk factors for CKD need to be understood to prevent the occurrence of the disease. Purpose: This study aimed to analyze the risk factors associated with CKD in the Indonesian productive-age population. Method: This study used data sourced from Indonesian Family Life Survey 5 (IFLS-5) with a cross-sectional research design. The study population was composed of all Indonesian residents who were respondents of IFLS-5. The research sample was made up of respondents aged 15–64 for whom complete information was available. The sample size was 29,120 respondents. The variables analyzed in this study were diabetes, hypertension, obesity, smoking, and CKD. The analysis method used was the chi-square test. Results: Bivariate analysis showed a significant relationship between CKD and diabetes (p = 0.01; prevalence ratio [PR] = 2.71; 95% CI = 1.74–4.22), hypertension (p = 0.01; PR = 2.62; 95% CI = 2.08–3.30), obesity (p = 0.01; PR = 1.67; 95% CI = 1.25–2.23), and smoking (p = 0.01; PR = 1.43; 95% CI = 1.17–1.75) in the productive age group in Indonesia. Conclusion: Diabetes, hypertension, obesity, and smoking have a significant relationship with CKD in the productive age group in Indonesia.
Alfilia Lusita, Fariani Syahrul, Ponconugroho Ponconugroho
Jurnal Berkala Epidemiologi, Volume 9, pp 62-69; doi:10.20473/jbe.v9i12021.62-69

Abstract:
Background: Immunization success rates can be determined by several factors. The factors that can cause occurrences of immunization preventable disease (PD3I) cases include the quality of the cold chain and invalid doses of immunization medicines. Purpose: The aim of this research was to analyze the implementation of cold chain management in the city of Surabaya. Methods: This research was conducted as a descriptive study with a cross-sectional research design. The population consisted of all primary health care centers in the city of Surabaya, and the data used were secondary data, guided by interviews with informants. Results: The majority of cold chain management personnel were found to have a medical education background of 98.42%, and primary health care workers have received cold chain-related training (100%). All primary health care equipment has a 100% cold chain. The completeness of cold chain reporting was 93.51%, and the accuracy of the cold chain reporting was 71.52%. Regarding the quality of the equipment, some vaccine refrigerators were found 12% of vaccine refrigerators were found not to be in optimal condition, and 14% of temperature monitoring devices was not activated. Conclusion: The implementation of cold chain management in public health center and the availability of equipment in the Surabaya City are going well, although there are still some problems such as undisciplined reporting and inadequate quality of tools for cold chain implementation as well as the discovery of vaccine refrigerators easily leaks, and their temperature can rise easily.
Wismoyo Nugraha Putra, Bayu Satria Wiratama, Rachmah Indawati, Diah Indriani
Jurnal Berkala Epidemiologi, Volume 9, pp 10-17; doi:10.20473/jbe.v9i12021.10-17

Abstract:
Background: Hypertension is a major risk factor for cardiovascular disease that can lead to death; it is a condition that is related to age, nutritional status and smoking habit. The likelihood of a person being overweight or obese increases every year, and there are still many people who have a smoking habit. Purpose: This study aims to analyze the effect of age, smoking habit and nutritional status on incidences of hypertension in East Java Province. Methods: This was an analytical observational study using a cross-sectional design and employing secondary data derived from the 5th Indonesian Family Life Survey (IFLS). Data collection was carried out among all household members in East Java who were still at a productive age (15–64 years) making a total of 3,803 respondents. The variables observed were age, gender, nutritional status, smoking habit, physical activity, and consumption of high-fat foods. The data analysis used the chi-squared test and logistic regression. Results: The findings of this study show that there is a relationship between age and nutritional status and the incidence of hypertension. However, there was no significant relationship between smoking habit and the incidence of hypertension. Elderly respondents were shown to have 12 times the risk of developing hypertension than teenage respondents. Conclusion: Age is the dominant factor causing hypertension in East Java Province. Adults and the elderly in East Java Province are expected to maintain a healthy lifestyle.
I Dewa Agung Panji Dwipayana, I Dewa Ayu Agung Diah Sutarini
Jurnal Berkala Epidemiologi, Volume 9, pp 1-9; doi:10.20473/jbe.v9i12021.1-9

Abstract:
Background: Currently, many COVID-19 vaccine candidates are being developed to end the pandemic; however, immunosuppressed cancer patients have been excluded from the participating criteria. It is important that they are able to examine their options for achieving immunity against COVID-19. Purpose: This review aims to discuss the available options that can be taken to vaccinate immunosuppressed cancer patients when no vaccine is being developed for their safety. Method: A literature study was conducted using Google Scholar, DOAJ, and GARUDA Library on November 2, 2020, focusing on articles examining vaccination guidelines for immunosuppressed cancer patients. Results: The search found 200 articles, which were curated to obtain 13 articles that satisfied all inclusion criteria. These consist of four guidelines, five reviews, and four research articles. Based on the literature, immunosuppressed cancer patients have the option to use the vaccines currently under development, with precautions set for live attenuated and potentially infectious vaccines. Vaccination timing also needs to be adjusted so as to fall at a certain time before or after the immunosuppressive condition. Moreover, a more complete COVID-19 immunity can be achieved through a synergy between individual vaccination and the construction of herd immunity. Conclusion: Most of the vaccines currently under development may be safe for cancer patients, being mindful of several considerations. Here, herd immunity can serve as a complement to individual immunity.
Thresya Febrianti, Ayunda Larasati, Munaya Fauziah
Jurnal Berkala Epidemiologi, Volume 9, pp 54-61; doi:10.20473/jbe.v9i12021.54-61

Abstract:
Background: Pneumonia is an ongoing public health problem in Indonesia, ranking as the second most prevalent disease in South Tangerang. Purpose: This study aimed to examine the physical housing environment characteristics in relation to pneumonia occurrence rates among children under-five years of age in South Tangerang City. Method: This research was carried out as a quantitative study with a case-control study design. The population consisted of children under five who were diagnosed with pneumonia at Public Health Center (PHC) of Pamulang and PHC of Ciputat Timur between January 2017 and March 2018. The data were analyzed using the chi-square statistical test. Results: The following characteristics of the housing environment were shown to be associated with pneumonia are bad routines of opening windows (p = 0.00; OR = 11; 95% CI = 2.59–46.78), location of the kitchen is in similar area with other rooms (p = 0.04; OR = 4.03; 95% CI = 1.20–13.53), unqualified humidity in the house (p = 0.05; OR = 3.86; 95% CI = 1.18–12.60), unqualified light intensity in the house (p = 0.01; OR = 9.04; 95% CI = 1.74–46.89), unqualified ventilation area (p = 0.02; OR = 4.50; 95% CI = 1.38–14.82), and unqualified occupancy (p = 0.03; OR = 4.84; 95% CI = 1.29–18.26). Conclusion: The community needs to maintain the physical environment in their houses, such as by opening the windows in the morning so that light comes in and the house does not get damp.
Damayanti Damayanti, Karina Dyahtantri Pratiwi, Wisnu Triadi Nugroho
Jurnal Berkala Epidemiologi, Volume 9, pp 70-78; doi:10.20473/jbe.v9i12021.70-78

Abstract:
Background: Psoriasis Vulgaris is a chronic inflammatory skin disease that affects patients’ quality of life. Methotrexate is the first-line and most effective systemic therapy in psoriasis vulgaris management. Purpose: The aim of this study was to evaluate clinical improvement after methotrexate therapy and any adverse effects of methotrexate therapy in psoriasis vulgaris management. Methods: The data for this descriptive, retrospective study were retrieved from the medical records of 22 psoriasis vulgaris patients who were treated with methotrexate therapy between January 2017 and June 2018 in the Child Kemuning Ward (IRNA), Dr. Soetomo General Hospital in Surabaya, East Java. Results: Data for a total of 22 subjects were collected for this study. The majority of the subjects were in the age group 25–59, and the average age was 40.50±17.20. Good clinical improvement (decrease in the body surface area of the lesion) was found in all patients. The adverse effects of methotrexate were evaluated based on the elevation of liver and renal function test levels. An elevation of aspartate aminotransferase levels was found in 11 patients, and an elevation in alanine aminotransferase levels was found in 13 patients. Elevated blood urea nitrogen levels were found in eight patients, and elevated serum creatinine levels were found in four patients. Conclusion: Methotrexate is an effective treatment for severe psoriasis vulgaris management when administered with careful selection and regular monitoring of patients. Application of methotrexate therapy in accordance with the guidelines remains suitable for psoriasis vulgaris management with vigilance regarding methotrexate’s adverse effects.
I Komang Widarma Atmaja, , I Ketut Suarjana
Jurnal Berkala Epidemiologi, Volume 9, pp 36-43; doi:10.20473/jbe.v9i12021.36-43

Abstract:
Background: Needlestick and sharp injuries (NSIs) remain one of the main occupational hazards among health care workers (HCWs) that lead to blood-borne pathogen exposure. Purpose: This study examined the risk factors for NSIs among HCWs at a tertiary referral hospital in Bali. Methods: A case-control study was conducted at Sanglah General Hospital, Bali, involving 171 HCWs, divided into 81 cases and 90 control subjects. The sample was selected using a simple random sampling technique. Data were collected using questionnaires and analyzed using multiple logistic regression. Results: The majority of respondents had experienced NSIs once, in the morning shift, and had affected an individual’s hands. The most frequent activity leading to NSIs was giving an injection and most of the situations causing NSIs involved accidental self-action, and recapping needles. Factors associated with the incidence of NSIs were work career or experience of
Sri Wahyuni, Christantie Effendy, Fitrina Mahardani Kusumaningrum, Fatwa Sari Tetra Dewi
Jurnal Berkala Epidemiologi, Volume 9, pp 44-53; doi:10.20473/jbe.v9i12021.44-53

Abstract:
Background: Health in the elderly does not merely refer to a condition free from disease but should also have elements regarding functionality and independence. Purpose: This study aimed to measure Activities of Daily Living (ADLs) and to identify the factors affecting ADLs among the elderly population in Sleman District. Methods: A cross-sectional study was carried out using secondary data from the Multidimensional Elderly Care project, nested on the Health Demographic and Surveillance System in Sleman, involving 549 elderly participants. The independence of these elderly people was measured using an Activities of Daily Living Scale questionnaire. Factors measured were cognitive (using the Mini-Mental State Examination questionnaire), psychological (using the Geriatric Depression Scale or Cornell Scale for Depression in Dementia questionnaires), economic (using the Financial Management Behavior Scale questionnaire), and nutritional status (using the Mini Nutritional Assessment questionnaire). The data were analyzed using the chi-square test, Fisher test, and Poisson test for bivariate analysis, while multivariate analysis using a logistic regression test. Results: The prevalence of elderly dependence was 14.03%. Elderly dependence was significantly related to age, job, residence, financial management, dementia, depression, malnutrition, and stroke disease in the bivariate analysis. However, after multivariate analysis, only age (>86 years) (PR = 4.31; 95% CI = 1.91–9.72), malnutrition (PR = 6.62; 95% CI = 3.79–11.57), and stroke (PR = 3.06; 95% CI = 2.03–4.61) were still shown to be related to elderly dependence. Conclusion: Increasing age, malnutrition, and stroke in elderly people lead to higher dependency in their ADLs.
Retno Tri Hastuti, Lucia Yovita Hendrati
Jurnal Berkala Epidemiologi, Volume 9, pp 79-87; doi:10.20473/jbe.v9i12021.79-87

Abstract:
Background: Jombang District is an endemic area of dengue hemorrhagic fever (DHF). Purpose: The aim of this study was to spatially analyze various factors simultaneously (multivariate analysis) in relation to the incidence of DHF in Jombang District during the period 2014–2018. The factors studied were population density, larvae free index, rainfall, coverage of healthy homes, and healthy lifestyle coverage. Methods: The research was conducted as an observational study with an ecology research design. The data were secondary data from the Health Office and Statistic Central Bureau of Jombang District. The population consisted of 21 sub-districts in Jombang District in 2014–2018. The sample used the total population. The data analysis tool used in this study was GeoDa regression Moran's I software. Results: The bivariate analysis showed that there was a correlation between larvae free index (p = 0.04), healthy lifestyle coverage (p = 0.02), rainfall intensity (p = 0.20), population density (p = 0.07), and coverage of healthy houses (p = 0.22) with DHF incidence. According to Moran's I for spatial dependence (multivariate analysis), showed that there was a correlation between all the variables and DHF (p = 0.03). Conclusions: The variables of larvae free index and healthy lifestyle coverage related to the Incidence Rate (IR) of DHF cases. There was no correlation between IR and variable population density, rainfall, or coverage of healthy homes. Various spatial factors are simultaneously related to IR, even though only two variables are shown to be related to IR in the bivariate analysis.
Gita Sekar Prihanti, Nilam Rizki Julianto, Aditya Hendra Sasmita, Aldi Nurfahmi, Annisa Setyautami, Debby Rosyida, Tiara Muslimawaty, Nur’Aini Fatmawati
Jurnal Berkala Epidemiologi, Volume 9, pp 26-35; doi:10.20473/jbe.v9i12021.26-35

Abstract:
Background: Tuberculosis (TB) is one of the most severe global health problems. The World Health Organization recommends the application of and compliance with infection control measures, one of which is cough etiquette to prevent transmission of pathogenic droplets. Purpose: The aim of the current research was to determine the effectiveness of cough etiquette counseling on changes in the knowledge, behavior, and awareness of patients with confirmed and suspected TB at Public Health Center (PHC) of C in K city. Methods: This research was designed as a pre-experimental study and was conducted in July 2018. The target population of the research comprised TB patients who were being treated in PHC of C in K city. The inclusion criteria were patients at PHC of C in K city with confirmed TB recorded between January and June 2018 and those with suspected TB reported between May and June 2018. This research was analyze based on univariable and bivariable analysis using T-testing and Wilcoxon testing. Results: There were significant differences in knowledge changes before and after cough etiquette counseling (mean difference = 3.72; p < 0.00). There was a significant difference in behavior before and after counseling (mean difference = 1.12; p = 0.04). There was also a significant difference in awareness before and after counseling (mean difference = 5.89; p < 0.00). Conclusion: Changes in knowledge, behavior, and awareness were observed in confirmed and suspected TB patients after cough etiquette counseling.
Ainun Jaria, Chatarina Umbul Wahjuni
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 293-300; doi:10.20473/jbe.v8i32020.293-300

Abstract:
Background: Dengue hemorrhagic fever (DHF) has been occurring in Indonesia for more than 50 years, and there were 65,602 cases of it in 2018 alone. Sumenep District reported the 12th highest number of DHF cases (292) in East Java Province in 2018. Purpose: This research aims to describe DHF in Sumenep District in 2018. Methods: This research is a descriptive study employing a cross-sectional design. The data used in this research were secondary data gathered from the Sumenep Health Office in 2018. The variables observed in this research were the epidemiological characteristics included in the epidemiological triangle—people, place (region), and time. Descriptive analysis was conducted to examine the DHF case distribution, using a frequency table, among the people, place (region), and time variables. Results: Sumenep District is home to 1,085,227 citizens, with a population density of 518 people/km2. The number of DHF cases in Sumenep District was 292, with the highest concentration of cases in the age range of 5–14 years (47.30%); the most cases were also male (57.19%). DHF often occurred in sub-districts with high population density, and more commonly in January. Conclusion: Most of the Sumenep District’s DHF cases in 2018 were males in the age group of 5–14 years old.
Esravila Ariya Wibisono, Diah Mira Indramaya, Maftuchah Rochmanti
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 236-245; doi:10.20473/jbe.v8i32020.236-245

Abstract:
Background: Acne Vulgaris (AV) is one of the most common diseases in the field of dermatology and ranks as the eighth most prevalent disease worldwide. Early management of this potentially deforming skin disease may reduce the pathophysiological burden and improve the quality of life of patients. Purpose: This study aimed to determine the pharmacotherapy for new patients with AV. Methods: This cross-sectional study used new patients with AV of the Cosmetic Division of the Outpatient Skin and Venereal Health Unit, Regional Public Hospital (RSUD) Dr. Soetomo, from January to December 2013 that were descriptively presented. The variable was the pharmacotherapy given. This study used secondary data collection by looking at the patients’ medical records. The variables studied were acne lesions and pharmacotherapy regimens, including the administration route and the medicine used. Results: The number of samples that met the inclusion criteria was 951 patients. Comedonal acne was most commonly given topical tretinoin. Papulopustular acne was most commonly given a topical combination of clindamycin and tretinoin, while acne conglobata was most commonly given a combination of topical clindamycin and tretinoin with oral doxycycline. Conclusion: The new patients with comedonal acne were mostly prescribed topical tretinoin pharmacotherapy. A pharmacotherapy combination of topical clindamycin and tretinoin was given to most new patients with papulopustular acne, whereas new patients with conglobata acne were given a pharmacotherapy combination of topical tretinoin and clindamycin with oral doxycycline.
Mugi Wahidin, Fiona Kong, Hadi Safaat
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 208-217; doi:10.20473/jbe.v8i32020.208-217

Abstract:
Background: Pandeglang, a district in Banten province, Indonesia, was the worst affected area of the Sunda Strait tsunami which occurred on 22nd December, 2018. Aside from threats of communicable disease outbreaks, the district faced the challenges of managing non-communicable diseases (NCD) in the community. Purpose: The aim of the study is to describe the post tsunami impact on cases of hypertension and diabetes mellitus and the expected one-year projections of these diseases in the district of Pandeglang, Banten. Methods: In January 2019, we collected primary data from Pandeglang District Health Office (DHO) and 15 Public Health Centres (PHCs) that were heavily affected by the tsunami. Surveillance officers were also interviewed for their subjective opinions on disease projections in both the DHO and PHCs. Aggregated data of cases presenting to the PHCs for assistance were analysed in relation to the post tsunami period. The diseases of interest included hypertension and diabetes mellitus. Results: Reported cases of hypertension and diabetes mellitus increased a few days after the tsunami. For hypertension, the cases spiked on the 5th and 8th days, but for diabetes mellitus the spike came much later. Average cases of hypertension and diabetes mellitus per PHC were 62 and 3, respectively. At district and PHC level, hypertension and diabetes mellitus were considered as minor contributing factors to the morbidity and mortality in the affected communities. The projection of these diseases was optimistic after the first month. Conclusion: It can be concluded that the volume of cases with hypertension and diabetes in the district of Pandeglang tended to be in the first few weeks post tsunami These diseases are projected to lessen in the second month after the disaster due to the recovery of local health services.
Denisca Vanya Almeida, Fariani Syahrul
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 228-235; doi:10.20473/jbe.v8i32020.228-235

Abstract:
Background: Pneumonia is one of the leading causes of death for children and is caused by pneumococcus, staphylococcus, and streptococcus bacteria. Exclusive breastfeeding and exposure to cigarette smoke are risk factors for pneumonia in children less than two years old. Purpose: The aim of this research was to analyze the relationship between exclusive breastfeeding or exposure to cigarette smoke and pneumonia in children aged less than two years at Public Health Center (PHC) of Wates, Kediri District. Methods: This research employed analytic observational research using a case–control research design. The number of research samples used was 60, consisting of 30 case respondents and 30 control respondents. The samples were taken in the PHC of Wates, Kediri District’s working area in July 2019. The determination of the samples was carried out through simple random sampling. The data were analyzed using chi-square analysis. Results: The research variables related to pneumonia in children less than two years old at PHC of Wates, Kediri District were exclusive breastfeeding with Odds Ratio (OR) = 3.50 (95% Confidence Interval (CI) = 1.20–10.19), the age of the mothers of the two-year-old infants with OR = 0.19 (95% CI = 0.04–0.78), and the education of the mothers of children less than two years old with OR = 3.14 (95% CI = 1.07–9.27). Conclusion: Exclusive breastfeeding, maternal age, and mothers’ level of education are some of the risk factors for pneumonia. The suggestion from this research is to hold socialization in the form of pneumonia prevention, education on exclusive breastfeeding for mothers who have children under two years of age, and the dangers of smoking for children's health.
Marisa Gita Putri, K. Heri Nugroho Hs, Mateus Sakundarno Adi, Suhartono Suhartono, Bagoes Widjanarko
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 256-264; doi:10.20473/jbe.v8i32020.256-264

Abstract:
Background: Type 2 diabetes mellitus is a chronic disease that is still a global health problem. Uncontrolled diabetes mellitus (DM) can result in poor glycemic status, with factors that affect patients including long-term DM and medication compliance. Purpose: This study aimed to determine the risk factors of long-term DM and non-compliance with medication on the poor glycemic control status of patients with type 2 DM. Methods: This type of research used observational analysis with a case–control design. Samples were taken from patients with type 2 DM, with 40 cases and 40 controls. The criteria for sample inclusion were that the patients had a glycosylated hemoglobin level check, were willing to be research respondents, and could communicate well. The exclusion criterion was patients experiencing a drastic decline in health status during the study. The sampling technique used was consecutive sampling. This research was conducted at the Panti Wilasa Citarum Hospital in Semarang City from July to September 2019. The relationship and the risk of long-term DM and adherence to taking medication with glycemic status were tested using the chi-square test. Results: This study showed that a duration of DM >5 years (p = 0.01; Odss Ratio (OR) = 3.46; 95% confidence interval [CI] = 1.37 < OR < 8.69) and non-compliance with taking medication (p = 0.02; OR = 3.15; 95% CI = 1.25 < OR < 7.93) are risk factors for poor glycemic status. Conclusion: Duration of DM >5 years and non-compliance with taking medication are risk factors for poor glycemic status in patients with type 2 DM.
Ratna Muliawati, Mushidah Mushidah, Siti Musyarofah
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 265-274; doi:10.20473/jbe.v8i32020.265-274

Abstract:
Background: Pinworm infection remains a global public health problem in Indonesia, with the highest prevalence in primary school–aged children. The government has made helminthiasis control efforts through annual deworming every six months, yet data on the enterobiasis prevalence and its risk factors are still limited. Purpose: This research aimed to determine the role of personal hygiene and anthelmintic or worm medicine consumption in the prevention of enterobiasis among primary school children. Methods: This research employed an analytic observational method with a cross-sectional design. The population used was primary school children in the Public Health Center (PHC) of Kaliwungu area, Kendal District, Central Java Province. The research sample was 150 students from first grade to third grade at 1 Primary Elementary School 1 Kutoharjo. The data sources were obtained from interviews of risk factors and perianal swab examinations. The data were analyzed by a chi-square test and multiple logistic regression. Results: The prevalence of pinworm infection among primary school children remains high (37.33%). The results of the multivariate analysis showed that there are three determinant variables of pinworm infections: not washing hands with soap before eating (p < 0.01; Prevalence Odds Ratio (POR) = 6.47; 95% Confidence Interval [CI] = 2.87 < POR < 14.59); not washing hands with soap after defecation (p = 0.01; POR = 3.36; 95% CI = 1.40 < POR < 8.05); and not consuming anthelmintic drugs within the past six months (p = 0.03; POR = 2.43; 95% CI = 1.08 < POR < 5.50). Conclusion: Hand washing habits and annual deworming are important factors to prevent pinworm infections.
Andro Pramana Witarto, , I.G.B. Adria Hariastawa, I Gusti Made Reza Gunadi Ranuh
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 218-227; doi:10.20473/jbe.v8i32020.218-227

Abstract:
Background: Hirschsprung-associated enterocolitis (HAEC) is one of the worst and most common complications of Hirschsprung’s disease (HD). The mortality rate of HD patients with enterocolitis is still considered to be higher compared to that of those without enterocolitis. Purpose: This study aimed to identify and evaluate potential risk factors for HAEC development. Methods: A cross-sectional study was conducted using secondary data from the medical records of HD patients treated from January 2015 to September 2018 at Regional Public Hospital (RSUD) Dr. Soetomo, Surabaya. The inclusion criteria were HD patients who had or had not experienced enterocolitis. The analysis was done by comparing the presence of risk factors between groups of HD patients with and without preoperative and/or postoperative HAEC. The results were presented as the median value and frequency. To evaluate further, a prevalence ratio (PR) with a 95% confidence interval was performed. The Mann–Whitney U test was also performed with a significance level of p < 0.05 for one factor: length of aganglionic intestinal segments. Results: This study showed that 12 of the 40 HD patients studied (30%) had experienced enterocolitis. The risk of developing HAEC was associated with patients who had a history of previous enterocolitis (PR 6.60 [2.94 < PR < 14.80]). Regarding surgical details, patients who had had surgery only once (31.30% compared to 14.30%), surgery with one surgical method (29.40% compared to 20.00%), and a primary procedure had a higher incidence of HAEC (29.40% compared to 27.30%). Conclusion: HD patients with a history of previous enterocolitis were found to have a higher risk of developing HAEC.
Ronald Mbulu, Muhammad Bagus Qomaruddin, Oedojo Soedirham
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 283-292; doi:10.20473/jbe.v8i32020.283-292

Abstract:
Background: Pulmonary tuberculosis has a huge impact on the lives of patients—physically, economically, and socially—and can thus cause stress. Prolonged stress can cause illness and affect one's health behavior, so that it requires proper coping efforts such as management problems and emotional regulation so that adaptive health behavior can be formed. Purpose: The aim of this study was to analyze the effect of coping efforts (problem management and emotional regulation) on the treatment behavior of patients with lung tuberculosis in the city of Surabaya using the theoretical approach of transactional stress and coping. Methods: This study was an observational study with a cross-sectional design conducted in 13 Public Health Center (PHC) in Surabaya with the highest number of new cases of positive acid resistant bacteria of tuberculosis (TB-BTA+) with 229 populations. The sampling technique used was simple random sampling and found 142 respondents, with the inclusion criteria being patients with pulmonary TB who were undergoing treatment in the first quarter. The data collection used a questionnaire, and the data analysis was performed using logistic regression. Results: This study found that there was an influence of problem management (p = 0.01; prevalence ratio [PR] = 1.36; 95% confidence interval [CI] = 1.04 < PR < 1.78) on treatment behavior, while the emotional regulation variable and the characteristic variable did not influence treatment behavior. Conclusion: The results of this study showed that patients with pulmonary TB who performed good coping efforts formed good treatment behavior.
Desak Gde Ushadi Bulan Dewata, Hermina Novida, Aryati Aryati
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 301-309; doi:10.20473/jbe.v8i32020.301-309

Abstract:
Background: Diabetic ketoacidosis (DKA) is one of many life-threatening complications of diabetes mellitus (DM), which is characterized by severe hyperglycemia, metabolic acidosis and ketonemia. This complication can eventually lead to coma and death if not treated properly. Purpose: The aim of this study is to describe the profile of the DKA patients who were at Regional Public Hospital (RSUD) Dr. Soetomo in 2017. Methods: This study was a descriptive study that used the medical record data of DKA patients who were at RSUD Dr. Soetomo in 2017. The study’s total sample size was 63 patients. The study’s variables were gender, age, type of DM, severity of DKA, precipitating factors, main complaints, vital signs, random plasma glucose level, electrolyte level, and blood gas analysis. The frequency, mean, and standard deviation were analyzed. Results: Most of the 63 DKA patients were female (66.67%), aged from 50–59 years (38.10%). The DKA cases being handled by the Dr. Soetomo Hospital were overwhelmingly of type 2 DM patients (88.89%). More than half the patients (58.73%) experienced severe DKA. Altered states of consciousness (46.03%) and shortness of breath (26.98%) were the most common main complains made by the DKA patients. Almost all patients experienced infection (88.89%) as the precipitating factor; the most common infections were sepsis (92.86%), pneumonia (30.36%), and urinary tract infections (23.21%). Two thirds of the patients (66.67%) had a length of stay of 0–7 days. About 57.14% of the DKA patients died while undergoing treatment. Conclusion: The number of severe DKA patients and the mortality rate in our study were higher than in other studies. Females and the elderly were more prone to DKA, and the most common precipitating factor was infection.
Rizka Aprilidyawati, Chatarina Umbul Wahjuni, Rosita Dwi Yuliandari
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 275-282; doi:10.20473/jbe.v8i32020.275-282

Abstract:
Background: A high prevalence of tuberculosis (TB) infection rates is followed by high rates of TB infection in children. The TB Preventive Treatment (TPT) for children with Isoniazid (INH) is one of the primary activities to improve TB cases by finding them early to prevent the transmission of TB to children. Purpose: This study aimed to describe the implementation of TPT with prophylactic INH among children in Surabaya. Methods: This research was a descriptive observational study with a case series design using secondary data on the provision of TPT in children, child TB cases in Surabaya City in 2016–2018, and a network of partnerships with hospitals/clinics/doctors’ private practices for the prevention and control of TB in the city of Surabaya in 2016–2018 as the population. The data were collected by in-depth interviews with the holders of the TB prevention and control program of Surabaya. The data were analyzed by comparing and describing the targets and achievements of the INH administration in children. Results: The implementation of INH for children in Surabaya is not optimal and has not reached the targets. The networking of health facilities with providers for the provision of TPT with INH for children is still low in Surabaya City. Conclusions: Delivery of INH for children in Surabaya has been implemented and has increased, however, it is not optimal because it has not reached the targeted districts/municipalities that determined.
Lilis Masyfufah, Erwin Astha Triyono
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8, pp 246-255; doi:10.20473/jbe.v8i32020.246-255

Abstract:
Background: The success of individual antiretroviral drug (ARV) treatment in patients with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) was determined by conducting a routine evaluation of the patients’ Cluster of Differentiation 4 (CD4) count. The indicators used to measure the success of the HIV and AIDS treatment were mortality, mobility, and quality of life (QoL). Purpose: The purpose of this research was to analyze the relationship between clinical status (smoking status, duration of ARV therapy, the CD4 count, and body mass index [BMI]) and the QoL of patients with HIV and AIDS who were stable during treatment. Methods: This type of research was quantitative analytical research with a cross-sectional design. This research was conducted at Dr. Soetomo Hospital, Surabaya, from September to November 2017. The study population was patients with HIV and AIDS in Dr. Soetomo Hospital, Surabaya. The research sample was taken by purposive sampling with the inclusion criteria being patients with HIV and AIDS who had been treated for ≥6 months with adherence ≥95% and who came directly to the hospital. Results: The majority of respondents were female (53.36%), junior/senior high school graduates (66.67%), married (62.22%), non-smoking (75.56%), had undergone ARV therapy for ±10 years (77.78%), and had a QoL in the adequate category (62.22%). The basic clinical status with a significant relationship with the respondents’ QoL were the CD4 count (p = 0.00) and BMI (p = 0.00). Conclusion: There was a relationship of the CD4 count and BMI with the QoL of the patients with HIV and AIDS.
Alpha Fardah Athiyyah, Sofia Wardhani, Andy Darma, Reza Gunadi Ranuh, Dadik Raharjo, Toshiro Shirakawa, Subijanto Marto Sudarmo
Published: 20 September 2020
Jurnal Berkala Epidemiologi, Volume 8; doi:10.20473/jbe.v8i32020.200-207

Abstract:
Background: Norovirus has become a major cause of severe outbreaks of gastroenteritis since the discovery of the rotavirus vaccine, with the main symptom being diarrhea. Until now, research on the epidemiological analysis of norovirus has not been carried out at Regional Public Hospital (RSUD) Dr. Soetomo, Surabaya. Purpose: This study aims to provide clinical epidemiology data and an analysis of norovirus infections in children with diarrhea at Regional Public Hospital (RSUD) Dr. Soetomo, Surabaya, Indonesia, including the prevalence of norovirus infection in each age group and sex, its clinical appearance, and its seasonal variation. Methods: A cross-sectional study was conducted in children aged 1–60 months hospitalized for diarrhea in RSUD Dr. Soetomo between April 2013 and March 2014. Identification of the virus in the stool was done by norovirus enzyme immunoassay Quick NaviTM Noro2. The proportion, age, sex, clinical symptoms, and patterns of the norovirus seasonal data were calculated. Results: Norovirus was detected in 64 samples (19%) of the 340 stool samples, with a mean patient age of 11.75 months; it was mostly found in patients less than 24 months of age (95%), and 64% were male. The monthly pattern of norovirus infection was mostly found in November, followed by May and April. The clinical symptoms were fever (72%), vomiting (66%), bloating (59%), abdominal cramps (34%), perianal inflammation (27%), abdominal distension (16%), and seizures (8%). Conclusion: The prevalence of norovirus was found to be high in patients with diarrhea aged 1–60 months hospitalized in RSUD Dr. Soetomo, with a proportion of 19%. Further research is needed to determine the severity of norovirus infection.
Jurnal Berkala Epidemiologi, Volume 8, pp 109-116; doi:10.20473/jbe.v8i22020.109-116

Abstract:
Background: Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) patients are vulnerable to a decreasing nutritional status. Nutritional status is one of the factors that can affect body mass, which correlates with handgrip strength. Purpose: This study aims to describe the body mass index (BMI) and handgrip strength profiles of HIV and AIDS inpatients. Method: A cross-sectional design was used in this observational study. The population were HIV and AIDS inpatients between August and September 2018. The patients were selected using a purposive sampling technique; 16 patients met the inclusion criteria of the study. Primary data were collected via questionnaire and measuring handgrip strength, while secondary data were collected from the patients’ medical records. A descriptive test was used for the analysis. Results: Most of the HIV and AIDS inpatients were male (81.25%), were between 20 and 39 years old (75.00%), were employed (50.00%), had a middle education level (62.50%), had been hospitalized for four to five days (categorized as a short length of stay; 75.00%), had been diagnosed with HIV for five years or more (87.50%), and were in the third HIV clinical stage (68.75%). The HIV and AIDS inpatients had an average BMI of 19.19±2.48 kg/m2; with 18.75% severely underweight patients, 25% mildly underweight patients, and no overweight patients. The average handgrip strength was 20.58±10.6 kg and 43.75% of patients were classified as having a low handgrip strength. Conclusion: Malnutrition still leads to nutritional problems in HIV and AIDS inpatients.
Noorul Faiza Binti Mohamed Bharuddin, Ezza Fazlen
Jurnal Berkala Epidemiologi, Volume 8, pp 134-140; doi:10.20473/jbe.v8i22020.134-140

Abstract:
Background: Over the past two decades, a high body mass index (BMI) has become the world’s largest public health concern. There have been numerous studies suggesting that breakfast patterns and lifestyle choices are associated with an individual’s BMI. Purpose: This research aims to describe the distribution of breakfast patterns and lifestyle choices according to BMI in Shah Alam, Malaysia. Method: This is a descriptive study with a cross-sectional design. The respondents in this study are people who live in Shah Alam, Malaysia, and are between the ages of 18 and 35 years old. The instrument used is a questionnaire. Results: The data shows that the majority of respondents who were obese (28.24%) were non-smokers (14.62%), never drank alcohol (15.95%), had not exercised in the past two weeks (17.28%), slept six to eight hours per day (17.28%), and had a pattern of skipping breakfast (23.92%). On other hand, the majority of respondents who were in the normal BMI range (34.55%) were non-smokers (29.57%), never drank alcohol (30.56%), slept six to eight hours per day (18.94%), and had a pattern of eating breakfast (20.60%). Conclusion: Obesity is more common in people who skip breakfast, as weight gain occurs because of unhealthy food choices made to replace breakfast. An unhealthy lifestyle also contributes to a high BMI, including smoking, alcohol consumption, and a sedentary lifestyle.
Anita Dewi Prahastuti Sujoso, ,
Jurnal Berkala Epidemiologi, Volume 8, pp 181-189; doi:10.20473/jbe.v8i22020.181-189

Abstract:
Background: Green tobacco sickness (GTS) is a type of disease that is still not widely understood, but is often experienced by tobacco farmers. The duration and frequency of contact, the work procedures associated with wet tobacco, and individual vulnerability are risk factors for GTS. Purpose: This study aimed to measure the factors associated with incidences of GTS in tobacco farmers in Jember, Indonesia, to contribute to the prevention of GTS. Method: The research design used case-control. This research was conducted in Jember District, within a group of tobacco farmers. The case group included farmers who experienced GTS and the control group included farmers who did not experience GTS. The study measured age, sex, nutritional status, passive smoking status, alcohol consumption status, subjective complaints, individual hygiene, Occupational Health and Safety (OHS) attitudes, OHS actions, use of personal protective equipment, principal occupation, extra work, type of tobacco leaf, length of service, length of work-rest period, and workload. The study population were tobacco farmers. The sample size was determined using the Lemeshow sampling formula for case-control. The sampling technique was simple random sampling. Data analysis was conducted using chi-squared tests. Results: Variables related to GTS cases in tobacco farmers were sex (p = 0.01) and nutritional status (p = 0.03). There were no significant occupational factors. Conclusion: Factors that influence GTS are sex and nutritional status.
Jurnal Berkala Epidemiologi, Volume 8, pp 149-155; doi:10.20473/jbe.v8i22020.149-155

Abstract:
Background: Rabies is a zoonotic disease that can cause death. Ambon City is a city in Indonesia with a fairly high dog population of 62,613; we found 3,444 bite cases and 747 positive results from dog brain specimens between 2014 and 2018. Purpose: The aim of this study was to examine the correlation between the knowledge of dog owners and the role of health workers in preventing rabies in Ambon City. Method: This research used a quantitative design within a cross-sectional study. There were two groups of respondents: the dog owner population and the health worker population. The population of dog owners was 4,509 and the sample was 113. The health worker population and sample size was 22. The research began with the preparation, implementation, and writing stages. The data sources were both primary and secondary. Primary data were obtained at the time of the study and secondary data were obtained from the Ambon City Health Office, Ambon City Agriculture and Food Security Service, and Ambon City Health Centers. Results: There was a relationship of statistical significance between dog owner knowledge and rabies prevention (p = 0.01) and a significant relationship between the role of health workers and rabies prevention (p = 0.03). Conclusion: Dog owner knowledge and the role of health workers have a relationship with efforts to prevent rabies.
Jurnal Berkala Epidemiologi, Volume 8, pp 164-171; doi:10.20473/jbe.v8i22020.164-171

Abstract:
Background: West Sumatra is a target area for malaria elimination in 2020; the Annual Parasite Incidence (API) in Padang City increased from 0.12 per 1000 inhabitants to 0.13 per 1000 inhabitants between 2015 and 2016. Purpose: This study aimed to analyze the effect of factors contributing to malaria events based on the environmental and behavioral conditions of people in Padang City. Method: This is a quantitative study using a case-control approach. The research was conducted in Padang from August 2017 until January 2018. The case-control study was conducted on a sample of 62 people, consisting of 31 cases and 31 controls. Cases were identified through random sampling and controls were selected by purposive sampling. Data collection was via observation and questionnaires and both univariate and bivariate analyses were conducted. Results: Descriptively, malaria patients were more likely to live in at-risk physical conditions at home (74.12%), had a history of visiting endemic areas (41.90%), did not use mosquito repellent equipment (58%), and had the habit of being outdoors at night (32.28%). Statistical tests showed the risk factors for the incidence of malaria were the physical condition of the house (OR = 3.43; 95% CI 1.20–9.20) and a history of visiting endemic areas (OR = 9; 95% CI 1.20–394). Conclusion: Environmental and behavioral factors affect the incidence of malaria. It is recommended that the Padang City Health Office provide counseling through health promotion officers about healthy homes and advise people not to go to endemic areas.
, Bimasatyaji Surya Ramadhan,
Jurnal Berkala Epidemiologi, Volume 8, pp 190-199; doi:10.20473/jbe.v8i22020.190-199

Abstract:
Background: Healthy houses in developing countries are a critical factor in human health, as the increase in population is not balanced by improvements in local community welfare. This has negative impacts on the environment and human health. Purpose: The aim of this study was to identify unhealthy houses in Kerinci, Indonesia. Method: This research used a descriptive cross-sectional approach. A survey of 122 houses was conducted to determine the characteristics of houses in Kerinci District, Jambi Province, Indonesia. Stratified random sampling was used to obtain representative healthy house data, by using four repetitions on each single question to minimize errors. Results: The results showed that 90% of respondents had a high occupant density. A high number of diseases were already experienced by residents in the area. These diseases were an indication that the area could be classified as unhealthy and included diarrhea (20%), acute respiratory infections (ARI; 13%), malaria (10%), skin diseases (15%), and other diseases (29%). Only 12% of the total respondents reported having no diseases. Conclusion: In the Kerinci District, 98% of houses were classified as unhealthy and as having potentially negative impacts on the health of residents. We recommend the government establish regulations to improve the health of houses and increase economic growth in Kerinci District, Indonesia.
Jurnal Berkala Epidemiologi, Volume 8, pp 97-99; doi:10.20473/jbe.v8i22020.97-99

Abstract:
INTRODUCTIONThe response to the COVID-19 pandemic is a tragic aberration gripping the world. As the disease evolves, uncertainty and fear of harm rise, which can significantly diminish community health and wellbeing. This article stresses the importance of public health preparedness in overcoming social and health risks associated with public panic.Since the COVID-19 outbreak began in late 2019, the numbers of people affected and fatalities continue to mount, causing panic and crippling vital economic and social activities. Authorities have failed to prevent inaccurate and misleading headlines that agitate the public and impinge on public communication. Fake news and rumors about magical products claiming to cure the virus abound. Additionally, people assumed emergency preparation meant stockpiling resources. Amid growing fears, consumers raided supermarkets and pharmacies for supplies, from masks to hygiene products, and people have fought over protective gear as tensions flared among anxious customers.When general panic starts driving political decision-making, public health professionals may be unable to implement strategies based on informed decisions. Researchers argue that government secrecy and non-transparency diminish people’s confidence and trust, creating panic (Wilson et al., 2007). Even naming the disease possibly triggered epidemic-related trauma and the ensuing public mistrust and disbelief of authorities; the panic has also sparked a wave of racial prejudice (Titanji, 2020). Although a series of emerging and re-emerging infectious diseases, from Avian flu to Zika virus, may have created more public awareness, whether leaders can translate this newfound awareness into meaningful policies and action is debatable.Globally, attention is growing on responses from state leaders, as some try to downplay the epidemic’s severity to maintain “business as usual”. In early March 2020, the Indonesian government was still in a state of denial and was attempting to convince the general public that the country was free from COVID-19 (Lindsey & Mann, 2020) Instead, currently confirmed cases are growing rapidly, suspected cases are far above the testing capacity, and case fatality is at an alarming rate.In contrast, several countries took drastic action by declaring travel restrictions and locking down cities. As an example, New Zealand decided to implement level-4 measures, with strict movement restrictions, not long after they confirmed their first case on 28 February 2020; they have recently begun a gradual exit from coronavirus lockdown (Knight, 2020).The public expects leaders to curb the spread of COVID-19 responsibly, appropriately, effectively, and proactively. Meanwhile, leaders are urging the public to stay calm and adopt new norms during this rapidly evolving situation. This crisis is not limited to any individual and requires cooperation rather than a unilateral response. DISCUSSIONHow to do this?A critical approach to pandemics is to ensure the preparedness of both healthcare capacity and public health systems (Jain, Duse, & Bausch, 2018). To respond to emergency needs—to have the capacity to treat rapidly increasing numbers of COVID-19 patients—it is important for each country to have existing policies and action plans for healthcare facilities to temporarily expand service capacity, cancel or postpone elective procedures, and engage in rapid intervention to conserve medical supplies, including personal protective equipment (Gan, Tseng, & Lee, 2020). Measures including recalling recently retired healthcare workers and providing drive-through services for chronic disease medications have been implemented to lessen pressures on hospitals (Wang, Ng, & Brook, 2020).While healthcare capacity is the ability to care for patients with COVID-19, the public health system aims to prevent people from being infected and mitigating the health risks associated with COVID-19. The public health system is important for strengthening community vigilance by promoting effective sanitation, a healthy lifestyle, and food safety, and preventing injuries, inequality, and violence. This involves not only healthcare professionals, but also well-planned strategies that consider various stakeholders’ perspectives and concerns (Glik, 2007). Despite the lockdown, we have seen healthcare workers and people in the community providing the basic essentials for those in need—from food, Personal Protective Equipment (PPE), mental health support, and evidence-based research communication, to virtual musical performances and concerts. Organizations in the virtual sphere, including WhatsApp (WhatsApp Inc, 2020) and TikTok, are partnering with health agencies to increase accessibility to health information.The best outbreak response is a collective response (Gille & Brall, 2020), which could effectively contain the disease and the panic caused by the disease. People naturally experience fear when dealing with a catastrophic event. This unprecedented threat triggered panic purchasing or falling for viral hoaxes, which reflects misconceptions about the problem, most likely because people lack trust in the measures taken (Heide, 2004), When designing and implementing public health measures, we must ensure we do not just acknowledge that, but actively engage relevant stakeholders. In an age of uncertainty, community solidarity and collective action are key to maintaining community vigilance against the crisis (Aldrich et al., 2015).
Septiana Lazasniti, Putri Bungsu Machmud, Sudarto Ronoatmodjo
Jurnal Berkala Epidemiologi, Volume 8, pp 100-108; doi:10.20473/jbe.v8i22020.100-108

Abstract:
Background: The percentage of cesarean deliveries in Indonesia increased from 12% in 2012 to 17% in 2017. Purpose: The aim of this study was to determine the factors that influenced the rate of cesarean deliveries in Indonesia in 2017. Method: The study used a cross-sectional design, gathering secondary data from the Indonesian Health Demographic Survey (IDHS) in 2017. The sample included mothers who gave birth to their last child in Indonesia in the last five years; a survey was conducted after respondents with missing data were excluded. The selection of samples was based on the availability of data in the IDHS 2017 dataset (8,683 respondents). A stratified two-stage sampling method was used. Data were gathered through a household questionnaire and a women of childbearing age questionnaire. Univariate, bivariate, and multivariate analyses were conducted using the chi-squared test and a simple logistic regression. Results: The factors that influenced the rate of cesarean section deliveries in Indonesia in 2017 were birth attendants (p value = 0.01; PR = 3.12; 95% CI = 2.88–3.38), number of Antenatal Care (ANC) visits (p=0.02; PR=1.23; 95%CI=1.03–1.47), low wealth index (p=0.02; PR=0.89; 95%CI=0.81–0.98), place of delivery (p=0.01; PR=0.87; 95%CI=0.81–0.94), and ANC provider (p=0.01; PR=0.57; 95%CI=0.53–0.62). The results of the analyses also obtained confounding factors; namely, parity and birth interval. Conclusion: Factors that influenced cesarean delivery in Indonesia in 2017 were a low wealth index, number of ANC visits, ANC provider, place of delivery, and birth attendants.
Jurnal Berkala Epidemiologi, Volume 8, pp 117-124; doi:10.20473/jbe.v8i22020.117-124

Abstract:
Background: Low public awareness of the impact of smoking makes the implementation of smoke-free areas (KTR) difficult. Smoke-free areas aim to protect the public from the direct and indirect effects of smoking. Purpose: This study aimed to analyze the correlation between the application of smoke-free areas and the prevalence of active and ex-smokers in Indonesia. Method: This study implemented a cross-sectional design, using secondary data from the Riskesdas 2018 on active and ex-smokers. KTR application data were obtained from the Profile of Non-Communicable Diseases in 2016. A Pearson product-moment test was conducted by a computer application to determine the correlation coefficient (r). This coefficient was used to describe the level of correlation between the two variables; significance was determined as a p value of 5%. Results: This study showed that the average application of KTR throughout Indonesia was 50.83%, active smokers comprised 23.49% of the population, and ex-smokers comprised 4.94%. Most active smokers were in Java and Sumatra, while the majority of ex-smokers were in Java and Sulawesi and the majority of KTR was in Java. This study shows that there is a positive correlation between KTR application and the percentage of ex-smokers (r = 0.46; p value = 0.01). Conclusion: There is a positive correlation between the application of KTR and an increase in ex-smokers. The government needs to increase the application of KTR policies.
Jurnal Berkala Epidemiologi, Volume 8, pp 125-133; doi:10.20473/jbe.v8i22020.125-133

Abstract:
Background: Premenstrual syndrome (PMS) is a group of symptoms consisting of physical, psychological, and behavioral disorders that can occur in women before menstruation and can be triggered or aggravated by factors such as their degree of stress and physical activity. Purpose: This research aimed to analyze the relationship between degree of stress and physical activity and premenstrual syndrome occurrence in female students. Method: This study used analytical observational research with a cross-sectional research design. Female students of the S1 Public Health class of 2016-2019 were used as the sample (n = 93) in this research. Sampling was conducted via the simple random sampling technique. A bivariate analysis was conducted using chi-square testing. The research was conducted between August and September of 2019 at the Faculty of Public Health, Universitas Airlangga. Results: Severe to extreme symptoms felt most often by respondents were muscle and joint pain, abdominal pain, and irritability. The prevalence of premenstrual syndrome with moderate to severe symptoms in female students of the S1 Public Health class was 46.24% and the prevalence of stressed female students was 70.97%. Statistical test results showed a relationship between the degree of stress and premenstrual syndrome occurrence (p = 0.01) and a relationship between physical activity and premenstrual syndrome occurrence (p = 0.04). Statistical tests also showed no relationship between the age of menarche and premenstrual syndrome occurrence (p = 0.50). Conclusion: There was a significant relationship between degree of stress and physical activity and premenstrual syndrome occurrence.
Nopia Wati, Agus Ramon, Emma Rachmawati, Al. Asyary Upe, Hasan Husin, M. Amin, Oktarianita Oktarianita
Jurnal Berkala Epidemiologi, Volume 8, pp 172-180; doi:10.20473/jbe.v8i22020.172-180

Abstract:
Background: The morbidity rate for toddlers with malaria in Indonesia had increased from 2013. Bengkulu city is a malaria-endemic area in Indonesia. Caregivers are people who stay with toddlers daily. Purpose: This study intended to identify the correlation between the malaria prevention knowledge and behavior of caregivers and malaria rates among toddlers in Basuki Rahmad Health Center in Bengkulu City. Method: This research was conducted in the Basuki Rahmad Health Center in Bengkulu City from March to April 2018. The research design was cross-sectional. The population size was 1,575 and the sample size was 127. Data were analyzed by descriptive statistics and the chi-squared test. Results: The majority of caregivers were female, with a low educational background, with good knowledge of malaria that was not reflected in their behavior. There was a relationship between knowledge of the signs and symptoms of malaria (p = 0.01), knowledge of malaria prevention practices (p = 0.01), health behaviors (p = 0.01), and use of malaria prevention practices (p = 0.01) and malaria in toddlers. Conclusion: There was a significant correlation between caregiver knowledge of the signs and symptoms of malaria, knowledge of malaria prevention practices, health service use, use of prevention practices, and malaria incidence in toddlers.
Jurnal Berkala Epidemiologi, Volume 8, pp 141-148; doi:10.20473/jbe.v8i22020.141-148

Abstract:
Background: Multidrug resistant tuberculosis (MDR TB) is a major public health problem marked by the Mycobacterium tuberculosis strain that is resistant to first line anti TB drugs, including rifampicin and isoniazid simultaneously. A patient confirmed as having MDR TB can transmit this form of TB to other individuals. Therefore, treatment success is the main target when addressing MDR TB. Purpose: This study aimed to assess the treatment outcomes of MDR TB patients in East Java Province from 2014 to 2017. Method: This is a quantitative-descriptive study using the secondary data of drug resistant TB patients sourced from the e-TB Manager website in the East Java Province Health Office. Results: The results show that the average MDR TB patients was 47 years old, 57.44% were male, 37.52% had a negative HIV status, 44.87% were relapse patients, 71.95% had undergone two or less previous treatments, and 69.24% had sputum culture conversion. The treatment outcomes included 161 patients (31.14%) confirmed as cured, 27 patients (5.22%) completing treatment, 174 patients (33.65%) defaulting, two patients (0.38%) confirmed as having failed treatment, and 59 patients (11.41%) dying during the treatment period. Conclusion: The treatment success rate was low and the number of defaults was high. Therefore, it is hoped that there will be support from those closest to the patient and health workers who will maintain and increase the patient's motivation to complete the treatment.
Putu Ayu Widyary Dewanti, Retno Adriyani
Jurnal Berkala Epidemiologi, Volume 8, pp 156-163; doi:10.20473/jbe.v8i22020.156-163

Abstract:
Background: Dental caries in children is a common multifactorial dental health problem. There are some important risk factors in the incidence of dental caries in children. Purpose: The aim of this study was to determine the incidence of dental caries and the relationship between risk factors and dental caries in 7th grade students in Rembang, Central Java. Method: An observational research design was applied, through the use of a cross-sectional study. The study population was 574, with a total sample of 75 respondents. The research sample was determined using a random sampling method. The locations of this research are SMPN 1 Lasem and SMPN 2 Rembang, Rembang, Central Java. This study was conducted between May and August 2018. Data collection techniques included dental examination for dental caries and a questionnaire to determine the risk factors. Analysis of the study was conducted via a chi-square statistical test. Results: Of the respondents, 46.67% had active caries. There was a relationship between a history of caries and a current caries incidence (p = 0.01) and between the time of toothbrushing and caries incidence in grade 7 junior high school students in Rembang Regency, Central Java (p = 0.01). Conclusion: A previous history of caries and the time of toothbrushing have a relationship with the incidence of dental caries in 7th grade junior high school students in Rembang Regency, Central Java.
Jurnal Berkala Epidemiologi, Volume 8, pp 42-49; doi:10.20473/jbe.v8i12020.42-49

Abstract:
Background: Diarrhea is still a major health problem in Indonesia. The Province of East Java ranks the second-highest number of diarrhea incidence after West Java, which reached 1,048,885 patients. The most dominant factors contributing to diarrheal diseases are water and family latrines. Purpose: This study aims to analyze the relationship between access to drinking water and proper sanitation with the incidence of diarrhea in East Java. Methods: This study was an observational study with a correlation study design. The population used was all people suffering from diarrheal diseases handled by each district in East Java Province in 2017. The method of sampling used aggregate data on the number of cases of diarrhea handled and the number of people with access to drinking water and proper sanitation per district/city in East Java province based on the East Java Health Profile 2017. The variables studied were the number of people who had access to drinking water (feasible), the number of people who had access to proper sanitation facilities (healthy latrines), and the number of diarrhea cases handled in East Java Province, with analysis techniques in the form of Pearson correlation. Results: This study showed that there was a relationship between residents who had access to inadequate drinking water (p = 0.00) which had a strong relationship of 0.48 (strong enough) and there was also a relationship between residents with inadequate access to sanitation facilities (not have healthy latrines) (p = 0.00) which had a strong relationship of 0.53 (strong enough). Conclusion: There is a relationship between access to drinking water and sanitation that is not feasible with the incidence of diarrhea found in East Java.
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