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All Journal Journal of Epidemiology and Public Health Indonesian Journal of Medicine Journal of Health Policy and Management Journal of Health Promotion and Behavior Journal of Maternal and Child Health
Setyo Sri Rahardjo
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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A Meta-Analysis on the Risk Factors of Low Back Pain in Health Workers Muh. Syaiful Akbar; Setyo Sri Rahardjo; Dono Indarto
Journal of Epidemiology and Public Health Vol. 5 No. 2 (2020)
Publisher : Masters Program in Public Health

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Background: Low back pain is a common prob
Indoor Smoke Exposure and Other Risk Factors of Pneumonia among Children Under Five in Karanganyar, Central Java Atika Nikmah; Setyo Sri Rahardjo; Isna Qadrijati
Journal of Epidemiology and Public Health Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health

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Background: Globally, pneumonia is an infectious disease with high morbidity and mortality rates. It causes one of five deaths in children under five years old worldwide. Approximately 61 million new cases of pneumonia occur annually. This study aimed to examine risk factors of pneumonia among children under five in Karanganyar, Central Java.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Karanganyar District, Central Java, from October to November, 2017. Study subjects were selected by fixed disease sampling consisting of 68 children under five years old with pneumonia and 136 without pneumonia. The dependent variable was pneumonia. The independent variables were nutritional status, exclusive breastfeeding, maternal stress, type of labour, maternal education, maternal job status, family income, quality of house, quality of environment, and indoor smoke exposure. The data was collected by questionnaire and analyzed by path analysis.Results: The risk of pneumonia increased with indoor smoke exposure (b= 2.63; 95% CI= 1.70 to 3.55; p<0.001). The risk of pneumonia decreased with good house environment (b= -0.93; 95% CI= -1.72 to -0.14; p= 0.020), healthy behavior (b= -1.41; 95% CI= -2.22 to -0.60; p=  0.001), and good nutritional status (b= -1.83; 95% CI= -2.72 to -0.93; p < 0.001). Good house environment was positively affected by good quality of house (b= 1.53; 95% CI= 0.94 to 2.13; p<0.001). Indoor smoke exposure was negatively affected by good quality of house (b= −1.79; 95% CI= -2.40 to -1.19; p < 0.001). The likelihood of exclusive breastfeding decreased with maternal stress (b= −0.65; 95% CI= -1.22 to -0.08; p= 0.024) and history of cesarean section (b= −0.59; 95% CI= -1.20 to 0.01; p= 0.053). Good nutritional status was positively affected by exclusive breastfeeding (b= 0.65; 95% CI= 0.04 to 1.26; p= 0.036). Number of children was negatively affected by high maternal education (b= -0.71; 95% CI= -1.29 to -0.14; p= 0.015). Family income was positively affected by maternal working outside the house (b= 0.89; 95% CI= 0.31 to 1.46; p= 0.002). Maternal working outside the house was positively affected by high maternal education (b= 0.67; 95% CI= 0.98 to 1.24; p= 0.022).Conclusion: The risk of pneumonia increases with indoor smoke exposure, but decreases with good house environment, healthy behavior, and good nutritional status.Keyword: risk factor, pneumonia, children under fiveCorrespondence: Atika Nikmah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: atikanikmah123@gmail.com.Journal of Epidemiology and Public Health (2018), 3(1): 25-40https://doi.org/10.26911/jepublichealth.2018.03.01.03 
Socioeconomic, Environmental, and Behavioral Determinants of Leprosy in Kediri, East Java Anindita Hasniati Rahmah; Ruben Dharmawan; Setyo Sri Rahardjo
Journal of Epidemiology and Public Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health

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Background: Leprosy remains a major public health problem in the world, particularly in developing countries. Leprosy can be so progressive that damages skin, nerve, extremity, and eye organs of the affected patients. Cumulative incidence of leprosy amounted to 200,000 cases worldwide, with the highest incidences occuring in India, Brazil, and Indonesia. This study sought to examine the social economic, environmental, and behavioral determinants of leprosy in Kediri, East Java, using path analysis approach.Subjects and Method: This was an analytic observational study with case control design. The study was conducted at Leprosy Hospital, Kediri, East Java, from November to December 2017. A total sample of 150 study subjects consisting of 75 leprosy patients and 75 non-diseased subjects were selected for this study by fixed disease sampling. The dependent variable was leprosy. The independent variables were personal hygiene, education, employment status, family income, dwelling density, humidity, and migration. Data on leprosy diagnosis was taken from medical record. The other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of leprosy increased with poorer personal hygiene (b= -1.20; 95% CI= -1.92 to -0.49; p=0.001), higher humidity (b= 0.73; 95% CI= 0.33 to 1.43; p=0.040), and migration (b= 0.94; 95% CI= 0.14 to 1.74; p= 0.022). Being employed status increased family income (b= 1.41; 95% CI= 0.72 to 2.11; p< 0.001). Low family income  increased the likelihood of migration (b= -14; 95% CI= -1.71 to -3.19; p= 0.007) and dwelling density (b= -1.02; 95% CI= -1.71 to -0.32; p=0.004). Higher education level increased the likelihood of being employed (b= 1.41; 95% CI= 0.72 to 2.11; p< 0.001) and better personal hygiene (b= 1.15; 95% CI= 0.44 to 1.85; p= 0.001). Dwelling density increased the likelihood of humidity (b= 4.29; 95% CI= 3.22 to 5.37; p< 0.001).Conclusion: Migration, higher humidity, and poorer personal hygiene directly increase the risk of leprosy. Education, employment status, family income, and dwelling density indirectly affect the risk of leprosy. Keywords: Leprosy, social economic, environmental, personal hygieneCorrespondence: Anindita Hasniati Rahmah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: aninditarahma22@gmail.com.Journal of Epidemiology and Public Health (2018), 3(2): 253-262https://doi.org/10.26911/jepublichealth.2018.03.02.05 
Multilevel Analysis on the Biological, Social Economic, and Environmental Factors on the Risk of Pneumonia in Children Under Five in Klaten, Central Java Nurul Ulya Luthfiyana; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health

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Background: Pneumonia is one of the leading causes of death in children under five in the world, particularly in the developing countries including Indonesia. Imbalance between host, agent, and environment, can cause the incidence of pneumonia. This study aimed to examine the biological, social economic, and environmental factors on the risk of pneumonia in children under five using multilevel analysis with village as a contextual factor.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Klaten District, Central Java, from October to November, 2017. A total sample of 200 children under five was selected for this study by fixed disease sampling. The dependent variable was pneumonia. The independent variables were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, quality of house, indoor smoke exposure, and cigarette smoke exposure. The data were collected by questionnaire and checklist. The data were analyzed by multilevel logistic regression analysis.Results: Birth weight ≥2.500 g (OR=0.13; 95% CI= 0.02 to 0.77; p= 0.025), exclusive breastfeeding (OR= 0.15; 95% CI= 0.02 to 0.89; p= 0.037), good nutritional status (OR=0.20; 95% CI= 0.04 to 0.91; p= 0.038), immunizational status (OR= 0.12; 95% CI= 0.02 to 0.67; p= 0.015), maternal educational status (OR= 0.18; 95% CI= 0.03 to 0.83; p= 0.028), high family income (OR= 0.25; 95% CI= 0.07 to 0.87; p= 0.030), and good quality of house (OR= 0.21; 95% CI= 0.05 to 0.91; p= 0.037) were associated with decreased risk of pneumonia. High indoor smoke exposure (OR= 8.29; 95% CI= 1.49 to 46.03; p= 0.016) and high cigarette smoke exposure (OR=6.37; 95% CI= 1.27 to 32.01; p= 0.024) were associated with increased risk of pneumonia. ICC= 36.10% indicating sizeable of village as a contextual factor. LR Test p= 0.036 indicating the importance of multilevel model in this logistic regression analysis.Conclusion: Birth weight, exclusive breastfeeding, good nutritional status, immunizational status, maternal educational status, high family income, and good quality of house decrease risk of pneumonia. High indoor smoke exposure and high cigarette smoke exposure increase risk of pneumonia.Keyword: pneumonia, biological, social economic, environmental factor, children under fiveCorrespondence: Nurul Ulya Luthfiyana, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: ulya.luthfiyana@gmail.com.Journal of Epidemiology and Public Health (2018), 3(2): 128-142https://doi.org/10.26911/jepublichealth.2018.03.02.03 
Evaluation of Multi-Drug Resistant Tuberculosis Predictor Index in Surakarta, Central Java Putri Pamungkas; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health

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Background: Tuberculosis (TB) remains a global public health problem. New cases of lung Tuberculosis in 2015 were 10.4 million worldwide. One of the challenging in TB control to be addressed is the development of Multi-Drug Resistant Tuberculosis (MDR-TB). There were an estimated 15,380 TB cases in Indonesia by 2015 with 1,860 positive TB cases and 1,566 cases successfully treated. This study aimed to determine the predictor index for MDR-TB.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from August to November 2017. The study subjects were selected by fixed disease sampling including 75 MDR-TB patients and 75 TB patients. The dependent variable was MDR-TB. The independent variables were medical history, co-morbidity (Diabetes Mellitus), drug side effect, drug-taking supervisor, and regularity of treatment. The data were collected by questionnaire and medical record. The data were analyzed by a multiple logistic regression.Results: MDR-TB Occurrence Index increased with drug-taking supervisor (b = 2.33; 95% CI= 3.83 to 27.91; p<0.001), drug-side effect (b = 0.73; 95% CI= 0.58 to 7.45; p=0.026), medical history (b = 2.35; 95% CI= 3.80 to 29.38; p<0.001). MDR-TB Occurrence Index decreased by absence of type 2 Diabetes Mellitus (b = -0.56; 95% CI= 0.18 to 1.78; p= 0.033), regular treatment (b = -1.73; 95% CI= 0.06 to 0.46; p<0.001).Conclusion: MDR-TB Occurrence Index is determined by the drug-taking supervisor, drug side effect, medical history, Type 2 Diabetes Mellitus, and regular treatment.Keywords: MDR-TB Occurrence Index, medical history, drug-taking supervisor, drug side effect, Type 2 Diabetes Mellitus, regular treatmentCorrespondence: Putri Pamungkas. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Central Java. Email: pamungkasputri95@gmail.com.Journal of Epidemiology and Public Health (2018), 3(2): 263-276https://doi.org/10.26911/jepublichealth.2018.03.02.06 
Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java Afriza Umami; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health

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Background: Cervical cancer is the fourth most common cancer in women worldwide and the second most common cancer in women in developing countries after breast cancer. The prevalence of cervical cancer in Indonesia was 0.8‰ with an estimated 98.692 cases. This study aimed to determine the biopsychosocial and genital hygiene factors for cervical cancer.Subjects and Method: This was an analytic observational study with a case-control design, conducted at Dr. Moewardi Hospital, Surakarta, from December 2017 to February 2018. A total of 178 study subjects including 95 women with cervical cancer (case) and 83 women without cervical cancer (control) were selected by fixed disease sampling. The dependent variable was cervical cancer. The independent variables were the age at first sexual intercourse, a number of sexual partners, body mass index (BMI), stress, education, income, and genital hygiene. Cervical cancer data was collected by medical record. The other data were collected by questionnaire. The data were analyzed by path analysis model.Results: The risk of cervical cancer increased with the number of sexual partner >1 (b=1.91; 95% CI= 0.31 to 3.49; p=0.019), BMI ≥25 (b= 0.98; 95% CI= -0.06 to 2.04; p=0.067), and stress (b= 1.59; 95% CI= 0.39 to 2.80; p=0.009). The risk of cervical cancer decreased with higher education (b= -3.58; 95% CI= -4.77 to -2.39; p<0.00­1), higher income (b= -1.49; 95% CI= -2.73 to -0.25; p=0.019), age at first sexual intercourse ≥18 years (b= -1.36; 95% CI= -2.52 to -0.21; p= 0.020), and genital hygiene (b= -1.24; 95% CI= -2.35 to -0.13; p=0.028).­ Income increased with higher education (b= 2.48; 95% CI= 1.71 to 3.25; p<0­.001). Genital hygiene increased with education (b= 1.16; 95% CI= 0.47 to 1.86; p=0.001). Age at first sexual intercourse ≥18 years increased with higher education (b= 1.30; 95% CI= 0.58 to 2.01; p<0.001). Stress increased with number of sexual partner >1 (b= 1.36; 95% CI= 0.12 to 2.61; p=0.032).Conclusion: The risk of cervical cancer increases with the number of sexual partners, BMI, and stress, but decreases with higher education, higher income, age at first sexual intercourse, and genital hygiene.Keywords: cervical cancer, biopsychosocial determinants, genital hygiene, path analysisCorrespondence:
Multilevel Analysis: Biopsychosocial Determinants and Environmental Factor on the Incidence of Diarrhea Among Children Under Five in Surakarta Erick Zicof; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 3 (2018)
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Background: Diarrhea is an endemic disease with a potential to become an epidemic in Indonesia. Diarrhea most often occurs in children under five years of age. This study aimed to determine the relationship between biopsychosocial factors, environmental factor, and diarrhea occurrence in Surakarta, Central Java, using multilevel analysis.Subjects and Method: This was an observational analytic study with a cross-sectional approach. This study was conducted on October 2017 - April 2018. A sample of 200 children under five years of age was selected by fixed disease sampling, consisting of 100 children with diarrhea and 100 without diarrhea. The dependent variable was the incidence of diarrhea. The independent variables were the number of family members, maternal knowledge, maternal personal hygiene, and environmental sanitation. The data were collected by questionnaire and analyzed by multilevel logistic regression in Stata 13.Results: The number of family member (b= 1.09; 95% CI= 0.02 to 2.15; p< 0.046) increased the risk of diarrhea. Good maternal knowledge (b= -2.30; 95% CI= -3.46 to -1.14; p<0.001), good maternal personal hygiene (b= -2.09; 95% CI= -3.48to-0.70; p<0.003), and good environmental sanitation (b= -1.64; 95% CI= -2.84to -0.43; p= 0.008) decreased the risk of diarrhea in children under five. The village had a substantial contextual effect on the incidence of diarrhea with ICC= 66.14%.Conclusion: The number of family member increases the risk of diarrhea. Good maternal knowledge, good maternal personal hygiene, and good environmental sanitation decrease the risk of diarrhea in children under five. Village has a substantial contextual effect on the incidence of diarrheaKeywords: diarrhea, number of family member, maternal knowledge, maternal personal hygiene, village, contextual effectCorrespondence:
Analysis of the Contextual Effect of Village Characteristics and Other Determinants of Diarrhea in Children Under Five, Banjarnegara, Central Java Lusia Arina Cahyaningrum; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 3 (2018)
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Background: Diarrheal disease is the leading cause of child death and illness in the world. Diarrhea is one of the most potent endemic diseases in Indonesia. Children under five were the most affected group by this disease. This study aimed to determine the effect of nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation on the incidence of diarrhea in children under five in Banjarnegara District, Central Java, using multilevel analysis.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted in Banjarnegara, Central Java, from January to February 2018. A total of 25 villages was selected using stratified random sampling, based on village stratification criteria. A sample of 250 children under five was selected for this study by fixed disease sampling, consisting of 125 children with diarrhea and 125 healthy children. The dependent variable was diarrhea. The independent variables at level 1 were nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation. Village stratification was used as the contextual factor at level 2. The data were collected by a set of pre-tested questionnaire and analyzed by multilevel logistic regression analysis using Stata 13.Results: Poor nutritional status (b= 1.33; 95% CI= -0.14 to 2.82; p= 0.077), poor prevention behavior (b= 1.52; 95% CI= 0.81 to 2.24; p<0.001), low income (b= 1.52; 95% CI= 0.80 to 2.25; p<0.001), weak social capital (b= 1.80; 95 % CI= 1.04 to 2.56; p<0.001), and poor environmental sanitation (b= 1.12; 95% CI= 0.39 to 1.85; p= 0.003) increased the risk of diarrhea. Exposure to information (b= 0.90; 95% CI= 0.17 to 1.64; p= 0.015) decreased the risk of diarrhea. The village stratification showed a strong contextual effect on the incidence of diarrhea with intra-class correlation (ICC)= 15.78%.Conclusion: Poor nutritional status, poor personal hygiene, low income, weak social capital, and poor environmental sanitation increase the risk of diarrhea.Keywords: determinant, diarrhea, children under five, multilevel analysisCorrespondence:
Individual and Environmental Risk Factors of Tuberculosis: A New Evidence from Ponorogo, East Java Diana Sayidah; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 3 No. 3 (2018)
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Background: For centuries, TB has been linked anecdotally with environmental risk factors that go hand-in-hand with poverty: indoor air pollution, tobacco smoke, malnutrition, over
Path Analysis on the Biopsychosocial Factors Associated with Hypertension Febry Istyanto; Ambar Mudigdo; Setyo Sri Rahardjo
Journal of Epidemiology and Public Health Vol. 4 No. 2 (2019)
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Background: Hypertension is a non-communicable disease which may lead to premature death and disability. This study aimed to determine the biopsychosocial factors associated with the risk of hypertension.Subjects and Method: This was an analytic observational study with a case-control design. This study was conducted at Dr. Moewardi Hospital, from September to November 2018. A sample of 225 patients was selected by fixed disease sampling. The dependent variable was hypertension. The independent variables were anxiety, stress, quality of sleep, body mass index (BMI), physical activity, vegetables and fruit, coffee drink, and soft drink consumption. Blood pressure was measured by sphygmomanometer. Body weight was measured by scale. Body height was measured by microtoise. The other data were collected by questionnaire and analyzed by path analysis.Results: Hypertension directly increased with anxiety (b= 0.26; 95%CI= 0.02to 0.51; p= 0.037), stress (b= 0.28; 95%CI= 0.04 to 0.53; p= 0.022), poor quality of sleep (b= 0.46; 95%CI= 0.06 to 0.87; p= 0.026), BMI (b= 0.68; 95%CI= 0.051 to 1.31; p= 0.034), coffee drink consumption (b= 1.31; 95%CI= 0.17 to 2.46; p= 0.024), and soft drink consumption (b= 0.38; 95%CI= 0.04 to 0.72; p= 0.029). Hypertension directly decreased with high physical activity (b= -0.04; 95%CI= -0.07 to -0.004; p= 0.027), vegetable and fruit consumption (b= -1.13; 95%CI= -2.07 to -0.19; p= 0.037). Hypertension was indirectly affected by anxiety, physical activity, quality of sleep, and coffe drink consumption through BMI and quality of sleep.Conclusion: Hypertension is directly and positively affected by anxiety, stress, poor quality of sleep, BMI, coffee drink consumption, and soft drink consumption, but negatively affected by high physical activity, vegetable and fruit consumption.Keywords: hypertension, biopsychosocial, determinantsCorrespondence:
Co-Authors Afriza Umami Agus Kristiyanto Agustaria Budinugroho Alifiya Zulfa Indana Ambar Mudigdo Ambar Sari Anindita Hasniati Rahmah Arlina Azka Arum Nuryati Atika Febri Anggriani Atika Mima Amalin Atika Nikmah Aulia Noorvita Ramadani Ayu Laela Fitriyani Azura Arisa Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Burhannuddin Ichsan Danti Narulita Dian Surya Kartika Diana Sayidah Dono Indarto Dwi Kurniawati Eka Siti Chasanah Endang Sutisna Sulaeman Erick Zicof Eti Poncorini Pamungkasari Faricha Indra Hapsari Farida Nurhayati Febry Istyanto Firdausi Nuzula Firman Pardosi Gabriela Advitri Febriani Genn Andrean Pratama Gigih Cita Pambudi Hanung Prasetya Hanung Prasetya Hanung Prasetya Hanung Prasetya Hanung Prasetya Hanung Prasetya Harsono Salimo Hermanu Joebagio Herry Putut Cahyono Ika Sumiyarsi Sukamto Ika Sumiyarsi Sukamto Isna Qadridjati Isna Qadrijati Khairina Nur Hidayati Lailatul Rohmah Lidia Aditama Putri Lusia Arina Cahyaningrum Maria Regina Tri Yonita Maya Ayu Riestiyowati Muh. Syaiful Akbar Muhibbah Fatati Natalino de Jesus Varela Niken Kartika Sari Ninik Hartini Ninil Dwi Pangestu Nisrina Nafisa Nur Isniani Ningsih Nurul Ulya Luthfiyana Okid Parama Astirin Pawito Pawito Philipus Prihantiko Kurniagung Puspita Mayangsari Prabowo Putri Pamungkas Putu Anggi Widia Karmany RB Soemanto Retno Sulistyani Revi Gama Hatta Novika Revi Gama Hatta Novika Revi Gama Hatta Novika Ristamaya Danar Dewi Rizki Kurniawan Saputra Ruben Dharmawan Satriyo Fajar Wicaksono Sri Mulyani Sumardiyono Sumardiyono Sumardiyono Sumardiyono Tri Godha Fitriani Victoria Husadani Permata Sari Vitri Widyaningsih Yola Alqorien Mustikarani Yovita Eka Ratna Kumala Yulia Lanti Retno Dewi Yulia Lanti Retno Dewi Yusuf Ryadi