Sumardiyono
Faculty of Medicine, Universitas Sebelas Maret

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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.
Correlations between Physical Activity, Work Duration, and Stress on the Risk of Musculoskeletal Disorders in Online Motorcycle Drivers in Surakarta Isna Andriani; Sumardiyono; Bhisma Murti
Journal of Epidemiology and Public Health Vol. 9 No. 1 (2024)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2024.09.01.09

Abstract

Background: Motorcycle taxi drivers drive motorcycles with a static posture and there are significant deviations in angles of certain body joints that trigger susceptibility to movement system injuries, namely musculoskeletal disorders (MSDs). The study aimed to analyze the correlation between the determinants of MSDs, namely physical activity, work duration, and stress on the risk of MSDs incidents in online motorcycle taxi drivers in Surakarta.Subjects and Method: This observational analytical study with a cross-sectional study approach. A sample of 250 online motorcycle taxi drivers in Surakarta was selected using a cluster random sampling technique. The dependent variable of the study was MSDs. The independent variables of the study were physical activity, duration of work, and stress. The data collection technique was conducted through interviews by using questionnaire sheets with instruments i.e. International Physical Activity Questionnaire (IPAQ), Work Stress Scale (WSS), and Nordic Body Map (NBP). Data analysis was carried out using a multivariate STATA application with multiple binary logistic regression.Results: The risk of MSDs in online motorcycle taxi drivers in Surakarta increased with the age of older than or equal to 34 years (OR= 2.66; CI 95%= 1.54 to 4.59; p= <0.001), BMI of more than 25 (OR= 1.33; CI 95%= 0.77 to 2.27; p= 0.303), work duration of more than 4 hours per day (OR= 2.43; CI 95%= 1.24 to 4.78; p= 0.010), high stress level (OR= 1.58; CI 95%= 0.89 to 2.83; p = 0.126), and status as an active smoker (OR= 1.27; CI 95%= 0.74 to 2.19; p= 0.378). The risk of MSDs in online motorcycle taxi drivers in Surakarta decreased with active physical activity (OR= 0.36; CI 95%= 0.15 to 0.86; p = 0.021). Age, BMI, physical activity, work duration, stress, and smoking status influenced the risk of MSDs by 8.2%, and the rest were influenced by other determinants.Conclusion: There is a statistically significant correlation between age, physical activity, and duration of work on the risk of MSDs, however, there was no significant correlation between BMI, stress, and smoking status on the risk of MSDs. Keywords: Physical activity, stress, musculoskeletal disorders, motorcycle taxi drivers