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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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Multilevel Analysis on Determinants of Diarrhea in Demak, Central Java Aulia Noorvita Ramadani; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 4 No. 2 (2019)
Publisher : Masters Program in Public Health

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Abstract

Background: Diarrhea is an infectious disease with high mortality in Indonesia. Diarrhea often occurs where risk factor control is weak, such as in rural area. This study aimed to examine the determinants of diarrhea in Demak, Central Java.Subjects and Method: A case-control study was conducted in Demak, Central Java, in October to November 2018. A sample of 200 study subjects was selected by fixed disease sampling. The dependent variable was diarrhea. The independent variables were age, clean water supply, latrine availability, waste water management, waste management, hand wash behavior, family income, and education level. The data were collected by questionnaire and analyzed by a multilevel regression, run on Stata 13.Results: Diarrhea increased with poor clean water supply (b= 1.45; 95% CI= 0.23 to 2.67; p= 0.020), latrine unavailable (b= 1.86; 95% CI= 0.66 to 3.06; p= 0.002), poor waste management (b= 2.71; 95% CI= 1.52 to 3.90; p<0.001), poor garbage management (b= 1.34; 95% CI= 0.17 to 2.50; p= 0.024), irregular hand washing with soap (b= 1.34; 95% CI= 0.12 to 2.40; p= 0.030). Diarrhea decreased with high family income (b= -1.56; 95% CI= -2.78 to -0.34; p= 0.012) and high education (b= -1.75; 95% CI= -2.95 to -0.565; p= 0.004). Diarrhea was negatively associated with age but it was statistically non-significant (b= -0.33; 95% CI= -1.51 to 0.844; p= 0.578). Village had contextual effect on the incidence of diarrhea (ICC= 13.9%).Conclusion: Diarrhea increases with poor clean water supply, latrine unavailable, poor waste management, poor garbage management, irregular hand washing with soap. Diarrhea decreases with high family income and high education. Village has contextual effect on the incidence of diarrhea.Keywords: diarrhea, water supply, hand wash behavior, waste managementCorrespondence:
Contextual Effect of Village on the Risk of Pneumonia in Children Under Five in Magetan, East Java Yola Alqorien Mustikarani; Setyo Sri Rahardjo; Isna Qadridjati; Hanung Prasetya
Journal of Epidemiology and Public Health Vol. 4 No. 2 (2019)
Publisher : Masters Program in Public Health

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Background: Pneumonia is a major cause of illness and death in children under five worldwide. Studies into the contextual effect of village are lacking in Indonesia. This study aimed to determine contextual effect of village on the risk of pneumonia in children under five in Magetan, East Java.Subjects and Method: This was a case control study conducted in Magetan, East Java, from October 2018 to December 2018. A sample of 225 children under five from 25 villages was selected by fixed disease sampling. The dependent variable was pneumonia. The independent variables were nutritional status, vitamin A intake, maternal stress, maternal education, family income, family smoking, cooking fuel, house physical environment, and the presence of children in the kitchen when cooking. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Maternal stress (b= 1.91; 95% CI= 0.75 to 3.06; p= 0.001), family smoking habits (b = 1.39; 95% CI = 0.46 to 2.32; p = 0.003), cooking fuel (b= 1.51; 95% CI= 0.46 to 2.55; p= 0.005), and the presence of children in the kitchen when cooking (b= 1.37; 95% CI = 0.38 to 2.35; p= 0.007) increased the risk of pneumonia in children under five. The risk of pneumonia was reduced by good nutritional status (b= -1.74; 95% CI= -2.70 to -0.78; p <0.001), complete vitamin A status (b= -1.14; 95% CI= -2.04 to -0.24; p= 0.013), high maternal education (b= -1.41; 95% CI= -2.45 to -0.37; p= 0.008), high family income (b= -0.91; 95% CI= -1.80 to -0.02; p= 0.045), and healthy home physical environment (b= -1.86; 95% CI= -3.20 to -0.52; p= 0.007). Village had a strong contextual effect on pneumonia among children under five with ICC= 21.32%.Conclusions: Maternal stress, family smoking habits, cooking fuel, and the presence of children in the kitchen when cooking increase the risk of pneumonia in children under five. It is reduced by good nutritional status, complete vitamin A status, high maternal education, high family income, and healthy home physical environment. Village has a strong contextual effect on pneumonia among children under fiveKeywords: pneumonia, children under five, biopsychosocial, environmental, determinants, multilevel analysisCorrespondence:
Multilevel Analysis on the Contextual Effects of Hygiene, Environmental Sanitation, and Diarrhea Prevention in Elementary School Students in Ngawi, East Java Dian Surya Kartika; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 4 No. 2 (2019)
Publisher : Masters Program in Public Health

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Background: Clean and healthy behavior in school is an important factor to prevent diarrhea and improve the health status of school children. This study aimed to determine the effects of hygiene and school environmental sanitation on diarrhea prevention behavior.Subjects and Method: This was an analytic observational study with a cross-sectional design. This study was conducted in Ngawi, East Java, in October 2018. A sample of 225 elementary school students was selected randomly from 25 elementary high schools in Ngawi. The dependent variable was diarrhea prevention. The independent variables were the student
Multilevel Analysis on the Contextual Effect of Village on the Incidence of Hemorrhagic Dengue Fever in Grobogan, Central Java Ambar Sari; Setyo Sri Rahardjo; Endang Sutisna Sulaeman
Journal of Epidemiology and Public Health Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health

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Factors Associated with Pneumonia in Children Under Five after Earthquake: A Path Analysis Evidence from West Nusa Tenggara, Indonesia Nur Isniani Ningsih; Harsono Salimo; Setyo Sri Rahardjo
Journal of Epidemiology and Public Health Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health

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Background: Pneumonia is an infectious disease which is the main killer among children under five. This study aims to analyze socio-economic and environmental determinants of the incidence of pneumonia in children under five after the earthquake.Subjects and Method: This study used observational analytic using case control. The total sample of 237 children under five aged 12-59 months old and the sampling technique was fixed disease sampling. The independent variables in this study were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, healthy behavior, physical quality of the house, exposure to cooking fuel smoke, smoking activities of family members and active village influences. Collecting the variables was through questionnaires and analyzed by using path analysis.Results: Birth weight
Biological and Social Economic Determinants of Adherence and Cure of Tuberculosis Treatment: Path Analysis Evidence from Yogyakarta Tri Godha Fitriani; Setyo Sri Rahardjo; Hanung Prasetya
Journal of Epidemiology and Public Health Vol. 4 No. 4 (2019)
Publisher : Masters Program in Public Health

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Abstract

Background: Tuberculosis (TB) was an infectious disease which was still a health problem world
Overweight, Alcohol, and Tobacco Consumption Are Associated with Hypertension among Police and Military Personnel: A Meta-Analysis Firman Pardosi; Setyo Sri Rahardjo; Yulia Lanti Retno Dewi
Journal of Epidemiology and Public Health Vol. 5 No. 1 (2020)
Publisher : Masters Program in Public Health

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Background: Increased blood pressure for a long time can increase the risk of kidney failure, coronary heart disease, brain damage, and other diseases. In 2019, it is estimated that hypertension is experienced by 1.13 billion people in the world with most (two thirds) living in low and middle income countries. Other study also shows that the police and military are at risk of developing hypertension due to a number of factors such as low know-ledge about healthy and nutritious food, co-workers who are smokers, and consuming alcohol. This study aimed to analyze the risk factors for hypertension in the police and military in the world using meta analysis.Subjects and Method: This was a meta-analysis and systematic review. The articles used were obtained from Google Scholar, Springer Link, ProQuest, and Science Direct databases. Selected articles published from 2000 to 2020. Keywords to search for articles are as follows: hypertension police personnel and military, or hypertension police personnel and military. The articles studied are 3 full text articles with cross sectional study designs and 1 full text articles with case control study design. Articles are collected using PRISMA diagrams, and analyzed using the Review Manager application 5.3.Results: Overweight (aOR= 1.42; 95% CI = 1.01 to 2.00; p= 0.04), alcohol consumption (aOR= 1.55; 95% CI= 1.12 to 2.12; p= 0.007), cigarette consumption (aOR= 1.45 ; 95% CI= 1.06 to 1.97; p= 0.020) is a risk factor for hypertension in the police and military.Conclusion: Overweight, alcohol consumption, and cigarette consumption, are risk factors for hypertension in police and military personnel.Keywords: overweight, alcohol, smoking, hypertension, meta analysisCorrespondence: Firman Pardosi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: pardosi.fp@gmail.com.Mobile: +6285261423865.Journal of Epidemiology and Public Health (2020), 05(01): 88-96https://doi.org/10.26911/jepublichealth.2020.05.01.09.
Village as Contextual Factors and Other Risk Factors Related with the Incidence of Clinical Tuberculosis in Children in Wonogiri, Central Java: A Multilevel Analysis Khairina Nur Hidayati; Bhisma Murti; Setyo Sri Rahardjo
Journal of Epidemiology and Public Health Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.03.02

Abstract

Background: Indonesia is in the second rank with the highest burden of tuberculosis (TB) in the world. Childhood is a period of rapid growth, the body still has a low immune system so it is susceptible to disease including tuberculosis in children which requires control efforts. This study aims to analyze the influence of risk factors and village contextual factors on the incidence of TB in children.Subjects and Method: Case-control study research was conducted in 82 villages in Wonogiri Regency, from November to December 2023. A sample of 200 children aged 0 to 4 years old was selected through fixed disease sampling. The dependent variable of this study was the incidence of TB in children. The independent variables in this study were stunting, contact history, exposure to cigarette smoke, home sanitation, gender, parental education, child age, parental income, BCG immunization status, and village contextual influences. Data on TB disease was obtained from the Tuberculosis Information System Application (SITB) at the Wonogiri District Health Service in 2023. Other data was collected through questionnaires. The data analysis was done through multilevel multiplelogistic regression.Results: The factors that increased the incidence of TB in children were stunting (OR= 10.94; CI 95%= 2.50 to 47.90; p= 0.001), contact history to TB (OR= 8.37; CI 95%= 1.60 to 43.83; p= 0.012), and exposure to cigarette smoke (OR= 7.36; CI 95%= 1.99 to 27.14; p= 0.003). The reducing factors were healthy sanitation (OR= 0.24; CI 95%= 0.08 to 0.78; p= 0.017), female children (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062), and parents with ≥high school education (OR= 0.40; CI 95%= 0.15 to 1.05; p= 0.062). There was no relationship between age (OR= 0.93; CI 95%= 0.13 to 6.23; p= 0.940), parental income (OR= 1.14; CI 95%= 0.40 to 3.25; p= 0.807), and BCG immunization status (OR= 0.12; CI 95%= 0.00 to 105.98; p= 0.550). Village has a contextual influence on the incidence of clinical TB in children (ICC= 52.95%).Conclusion: The risk of clinical TB in children increased with stunting, a history of TB contact and exposure to cigarette smoke, it decreased with healthy home sanitation, female gender, parents with ≥high school education. There was no relationship between age, parental income, and BCG immunization status. The village has a contextual effect on the incidence of clinical TB in children.
Enhancing Anxiety Management in Post-Tuberculosis Patients through Psychoeducational Intervention in Baki Community Health Center Agustaria Budinugroho; Setyo Sri Rahardjo; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.03.09

Abstract

Background: Tuberculosis is an infectious disease caused by mycobacterium tuberculosis by air-borne transmission. TB patients are at risk of psychosocial disorders during treatment and post-treatment. This study aims to analyze the effect of psychoeducation on the level of anxiety experienced relapse in patients after Tuberculosis treatment.Subjects and Method: This study used a quasi-experimental design of a posttest pretest at the Baki Health Center, Sukoharjo Regency, Central Java, Indonesia from June to July 2023. The sample was 30 people in the treatment group, namely post-tuberculosis treatment patients, and 30 people in the control group by paying attention to the inclusion criteria, the sample was selected in total sampling. The dependent variable is anxiety and the independent variable is psychoeducation. Psychoeducation was provided with intervention for 3 sessions with a time of 25-30 minutes and anxiety was measured by the HALS questionnaire. The data was analyzed by the Mann-Whitney test.Results: After the intervention, the psychoeducational group had a decrease in anxiety scores (Mean = 7; SD= 4.68) than the control group (Mean= 4.07; SD= 3.14) with p=0.006.Conclusion: Psychoeducation for post-tuberculosis treatment patients can continue to be carried out to reduce the level of anxiety about tuberculosis recurrence and awareness of the impact of the disease.
Determinants of Tuberculosis Incidence Among Children Under Five in Karanganyar, Central Java, Indonesia Ninik Hartini; Bhisma Murti; Setyo Sri Rahardjo; Sumardiyono; Yulia Lanti Retno Dewi
Journal of Epidemiology and Public Health Vol. 11 No. 1 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.01.06

Abstract

Background: Tuberculosis (TB) remains a major infectious disease and a leading cause of mortality worldwide, with 10.8 million cases and 1.25 million deaths reported in 2023. Indonesia is classified as a high-burden TB country, with 78,566 cases reported among children under five years of age. Young children are particularly vulnerable due to their immature immune systems. In Karanganyar Regency, Central Java, Indonesia, 137 cases of TB among under-five children were recorded in 2023. This study aimed to analyze the risk factors associated with TB incidence among children under five in Karanganyar Regency. Subjects and Method: This study employed an analytic observational design using a case-control approach. A total of 200 children under five were randomly selected, comprising 50 TB cases and 150 non-TB controls. Data were analyzed using simple logistic regression and path analysis to examine direct and indirect relationships among variables. Results: The incidence of TB among children under five increased with a history of contact with TB patients (b = 0.18; 95% CI = 0.10–0.26; p < 0.001) and living in homes with high humidity (b = 0.09; 95% CI = 0.01–0.17; p = 0.019). Conversely, TB incidence decreased with good lighting (b = -0.11; 95% CI = -0.19 to -0.03; p = 0.005), presence of bedroom windows (b = -0.41; 95% CI = -0.51 to -0.31; p < 0.001), living room windows (b = -0.31; 95% CI = -0.41 to -0.22; p < 0.001), and residence in highland areas (b = -0.13; 95% CI = -0.21 to -0.06; p < 0.001). Nutritional status was negatively affected by TB (b = -0.30; 95% CI = -0.43 to -0.15; p < 0.001) and positively influenced by family income (b = 0.17; 95% CI = 0.03–0.31; p = 0.016), with income exerting both direct and indirect effects through TB. The path analysis model demonstrated good fit (Chi-square p = 0.068; RMSEA = 0.052; CFI = 0.981; TLI = 0.960). Conclusion:  The risk of TB among children under five increases with exposure to adult TB cases and living in humid housing conditions. Conversely, TB incidence decreases in children residing in well-lit homes with bedroom and living room windows and in highland areas. Nutritional status is influenced by both TB and family income, with income affecting TB directly and indirectly.
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