Iwan Ariawan
Department Of Biostatistics And Population Studies, Faculty Of Public Health, Universitas Indonesia, Depok, Indonesia; Reconstra Utama Integra, Jakarta, Indonesia

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Efek Bullying, Kekerasan Fisik, dan Kekerasan Seksual terhadap Gejala Depresi pada Pelajar SMP dan SMA di Indonesia: Analisis Data Global School-Based Student Health Survey Indonesia 2015 Khaliza, Cindy Nur; Besral, Besral; Ariawan, Iwan; EL-Matury, Herlina J
Jurnal Penelitian dan Pengembangan Kesehatan Masyarakat Indonesia Vol 2 No 2 (2021): JPPKMI: November 2021
Publisher : Asosiasi Institusi Pendidikan Tinggi Kesehatan Masyarakat Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jppkmi.v2i2.53149

Abstract

Salah satu penyakit yang menjadi beban terbesar di kalangan remaja adalah depresi. Riskesdas 2018 melaporkan prevalensi depresi kelompok umur 15-24 tahun 6,2%, kelompok umur 25-34 tahun 5,4%. Tujuan penelitian ini untuk mengetahui efek bullying, kekerasan fisik, dan kekerasan seksual terhadap gejala depresi pada pelajar SMP dan SMA di Indonesia. Analisis data sekunder dari Global School-Based Student Health Survey Indonesia 2015 dengan desain cross sectional dan sampel sebanyak 8.517 pelajar SMP dan SMA di Indonesia. Hasil penelitian menunjukkan sebesar 20,7% pelajar SMP dan SMA tahun 2015 di Indonesia mengalami gejala depresi. Sebesar 18.5% pelajar pernah mengalami bullying, 29.4% pernah mengalami kekerasan fisik, dan 3.1% pernah mengalami kekerasan seksual. Remaja yang pernah mengalami bullying, kekerasan fisik, dan kekerasan seksual berisiko lebih tinggi untuk mengalami gejala depresi. ORa bullying sebesar 2.5 (95%CI 2.1—3.0), ORa kekerasan fisik sebesar 2.1 (95%CI 1.8—2.4), dan ORa kekerasan seksual sebesar 1.8 (95%CI 1.4—2.3). Faktor lain pada pelajar yang berisiko tinggi untuk mengalami gejala depresi adalah jenis kelamin perempuan (ORa 1.9, 95%CI 1.7—2.2), pendidikan SMA (ORa 2.1, 95%CI 1.6—2.6), minum alkohol (ORa 1.7, 95%CI 1.3—2.1), dan merokok (ORa 1.6, 95%CI 1.2—2.0). Disarankan kepada Kementerian Pendidikan agar menerapkan sekolah ramah anak untuk mengurangi peristiwa bullying dan kekerasan fisik atau seksual, yang dapat berisiko menimbulkan gejala depresi pada pelajar SMP dan SMA, terutama perempuan.
The Effect of Parity on Neonatal Mortality in Indonesia Arianty Siahaan; Iwan Ariawan
Jurnal Ilmu Kesehatan Masyarakat Vol. 12 No. 3 (2021): Jurnal Ilmu Kesehatan Masyarakat (JIKM)
Publisher : Association of Public Health Scholars based in Faculty of Public Health, Sriwijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.101 KB) | DOI: 10.26553/jikm.2021.12.3.250-262

Abstract

The neonatal mortality rate in Indonesia is still relatively high (15 per 1,000 live births). The number of children born to a woman (parity) is also still high. The Total Fertility Rate (TFR) is 2.4 per woman. This study aims to determine the effect of parity on neonatal deaths in Indonesia. We used 2017 IDHS data with a cross-sectional design includes 14,827 live births in the 2012-2017 period. Data were analyzed using the multiple logistic regressions method. The results showed that primipara had a statistically insignificant relationship (p-value > 0.05) compared with multipara. While parity≥4 had a risk of 1.90 times experienced on neonatal mortality compared with multipara (95% CI:1,00-3,63) after being controlled by the maternal age, birth attendant, and place of delivery and statistically significant (p-value≤0,05). Thus, parity ≥4 was significantly associated with neonatal mortality. The more children born to mothers, the higher the risk of neonatal death. While parity 1 did not have a significant relationship with neonatal mortality. It is recommended that family planning programs be increased to reduce parity to avoid the risk of neonatal death. The BKKBN program should be improved in reducing TFR.
Diseases in Chronic Non-infective Diarrhea Marcellus Simadibrata; Aziz Rani; Daldiyono Daldiyono; Ari Fahrial Syam; GNJ Tytgat; Vera Yuwono; L A Lesmana; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 5, ISSUE 1, April 2004
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/51200415-18

Abstract

Background: Chronic diarrhea is common in Indonesia. The chronic non-infective diarrhea cases seem to be increasing recently. The aim of this study is to reveal the pattern of diseases that can cause chronic non-infective diarrhea. Methods: We examined all patients suffering from chronic non-infective diarrhea over a six years period. The patients underwent physical examination and performed laboratory tests, colon enema X-ray, colonoscopy, ileoscopy, upper gastrointestnal endoscopy and small bowel X-ray. Result: Chronic non-infective diarrhea was observed in 107 (51.7%) cases from 207 chronic diarrhea cases respectively. The frequently found abnormalities that had caused chronic non-infective diarrhea were carbohydrate maldigestion (62.61%), colorectal cancer (14.01%), Crohn’s disease (11.21%), ulcerative colitis (9.34%), irritable bowel syndrome (8.41%), colorectal polyp (8.41%) etc. Conclusion: The most frequent abnormality found in chronic non-infective diarrhea was maldigestion.   Keywords: Chronic diarrhea, non-infective
Portal Hypertensive Enteropathy in Liver Cirrhosis Marcellus Simadibrata; Vera Yuwono; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; Laurentius Lesmana; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 7, ISSUE 3, December 2006
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/73200661-66

Abstract

Background/Aim: Some studies found that portal hypertension cause complication such as portal hypertensive gastroenterocolopathy. This study was done to find any abnormalities in the small intestinal mucosa and villi of the portal hypertensive patients. Method: Thirty patients with liver cirrhosis, portal hypertension and esophageal varices between 2000 - 2001 were included in this study. A duodenoscopic examination was performed to determine any abnormalities. Biopsy specimens were taken from the descending part of duodenum and the duodenal bulb for histopathological examination. The findings were compared to 37 functional dyspepsia patients. Result: In the duodenal bulb and descending part of duodenum: the width of the villous of the portal hypertensive group was larger than the control (p 0.001), the diameter of the mucosal villous vessel was larger than in the control (p 0.001) and the thickness of the mucosal villous vessel wall was thicker than in the control (p 0.001). Conclusion: There were abnormalities of the mucosa in portal hypertensive enteropathy patients including the mucosal vessel diameter, wall thickness, number of goblet cells. Keywords: portal hypertensive enteropathy, liver cirrhosis
Normal Histological Appearances of the Duodenum Jejunum and Terminal Ileum in Indonesian People Marcellus Simadibrata; Vera Yuwono; FJW Ten Kate; GNJ Tytgat; Laurentius Lesmana; Daldiyono Daldiyono; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8, ISSUE 3, December 2007
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/83200771-75

Abstract

Background: There is no literature specifically on the normal appearance of small bowel mucosa amongst Indonesians. Diseases of the small bowel can cause chronic diarrhea. Chronic diarrhea is common in Indonesia. Methods: Thirty seven patients with normal stomach and small bowel on endoscopic and histopathologic examination were included in this study. Biopsies were taken from the duodenal bulb, descending part of duodenum, jejunum and terminal ileum. The scoring Method for the inflammatory cells (lymphocytes, plasma cells and eosinophil cells) was carried out using the symbols 0 (negative), +, ++, and +++. Results: The mean height of the villi of the duodenal bulb was 265.00 ± 81.89 mm, the mean height of the crypts of the duodenal bulb was 196.67 ± 56.01 mm, the mean width of the villi were 59.14 ± 74.14 mm. The mean height of the villi of the duodenum pars descendens was 317.27 ± 99.66 mm and the mean height of the crypts was 218.79 ± 84.66 mm. The mean height of the villi of the jejunum was 341.76 ± 76.06 mm and the mean height of the crypts was 189.41 ± 58.15 mm. The mean height of the villi of the terminal ileum was 235.41 ± 73.32 mm, and the mean height of the crypts was 186.22 ± 64.09 mm. Conclusion: Histologically, the mean height of the villi of the normal small bowel was between 235.41 ± 73.32 to 341.76 ± 76.06 mm and the mean height of the crypts of the normal small bowel was between 186.22 ± 64.09 to 218.79 ± 84.66 mm. Keywords: normal, duodenum, jejunum, terminal ileum, histological appearances, villous height, villous width, crypt height
Abnormalities of the Small Bowel in Chronic Non-Infective Diarrhea: A Histopathological Study Marcellus Simadibrata Kolopaking; Vera Yuwono; Ari Fahrial Syam; FJW Ten Kate; GNJ Tytgat; Daldiyono Daldiyono; L A Lesmana; Nurul Akbar; Chudahman Manan; Iwan Ariawan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 4, ISSUE 2, August 2003
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/42200329-38

Abstract

Background: The incidence of chronic non-infectious diarrhea cases is increasing in line with the developments of medical technology and science. The objective of this study was to uncover the histopathologic abnormalities of the small bowel in cases of chronic non-infectious diarrhea. Methods: All chronic non-infectious diarrhea patients in Cipto Mangunkusumo Hospital from 1996 until 2000 were included in this study. For the control group, we used 37 endoscopically-normal patients with functional dyspepia with the same characteristics (sex and age). All of the patients underwent gastroduodeno-jejunoscopic and ileocolonoscopic examinations. Patients with infection were excluded from this study. Biopsies were taken from the duodenal bulb, descending duodenum, jejunum near the Treitz ligament, terminal ileum, and colon. Histopathological tests were performed on all of the biopsies. Result: Histopathological examination was carried out on 31 patients and 37 control patients. In the duodenal bulb, the width of villi, lymphocyte infiltration, eosinophil infiltration, stage of inflammation, and polymorphonuclear cells infiltration were all lower in the chronic non-infectious diarrhea group than in the control group (p 0.01). In the descending part of duodenum and jejunum, lymphocyte infiltration, the stage of inflammation, and polymorphonuclear cell infiltration were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Within the terminal ileum, lymphocyte infiltration, the stage of inflammation and lymphoid follicle hyperplasia were found to be higher in the chronic non-infectious diarrhea group than in the control group (p 0.01). Conclusion: Histopathologically, increased lymphocyte infiltration, inflammation and lymphoid follicle hyperplasia were discovered in specified areas of small intestine in chronic non-infectious diarrhea patients. Keywords: Histopathological examination, chronic non-infectious diarrhea, lymphocyte infiltration, mucosal inflammation, lymphoid follicle hyperplasia
Evaluasi Sistem Informasi Surveilans Malaria (SISMAL) di Wilayah Kerja Dinas Kesehatan Kota Malang Indrayana, Muhammad Irvan; Ariawan, Iwan
Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan Vol. 2, No. 3
Publisher : UI Scholars Hub

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Abstract

Malaria merupakan salah satu penyakit menular yang memiliki potensi tinggi dalam penyebarluasan penyakit. Berdasarkan dari Badan Pusat Statistik, Jawa Timur memiliki 7.256 kasus malaria suspek dan di kota Malang memiliki 11 kasus suspek pada tahun 2020 dan mayoritas berasal dari kasus impor dimana pasien berasal atau pernah melakukan perjalanan di luar wilayah Kota Malang yang kemudian merasakan gejala dan melakukan pemeriksaan di Kota Malang. Sistem Informasi Surveilans Malaria (SISMAL) adalah instrumen guna melakukan kegiatan pencatatan, pelaporan dan untuk meningkatkan validitas dan kelengkapan dalam pelaporan data malaria yang merupakan salah satu hal penting untuk mendukung terselenggaranya sistem Surveilans yang baik. Sistem Informasi ini digunakan oleh semua pemangku kepentingan, terutama Dinas Kesehatan. Penelitian ini bertujuan untuk menelaah SISMAL serta penerimaan pengguna di Dinas Kesehatan Kota Malang dan Puskesmas Pandanwangi, Puskesmas Gribig dan Puskesmas Cisadea. Penelitian ini merupakan studi kualitatif dengan menggunakan desain studi kasus serta metode Hot-Fit dengan pengambilan data melalui wawancara dan observasi. Penelitian ini menunjukkan SISMAL dapat menurunkan kesalahan dalam pelaporan dan pencatatan menjadi lebih baik sehingga meningkatkan efektifitas dan efisiensi dalam pekerjaan, meskipun terdapat pengguna yang merasa bahwa penggunaan SISMAL di Puskesmas masih belum merasa terampil dalam menggunakan SISMAL karena jarang digunakan dan belum mendapat pelatihan secara khusus.
Indeks Sosio-ekonomi Menggunakan Principal Component Analysis Ariawan, Iwan
Kesmas Vol. 1, No. 2
Publisher : UI Scholars Hub

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Abstract

Pada penelitian survei, kita dapat mengukur tingkat status sosio-ekonomi rumah tangga melalui pemasukan, pengeluaran dan kepemilikan barang-barang berharga. Penggunaan variabel pemasukan dan pengeluaran di negara berkembang memiliki banyak kelemahan, sehingga banyak peneliti lebih suka menggunakan variabel kepemilikan barang berharga untuk mengukur status sosio-ekonomi. Namun, penggunaan variabel kepemilikan barang berharga menimbulkan masalah lain, yaitu banyaknya variabel untuk mengukur status sosio-ekonomi. Tujuan penulisan ini adalah menyederhanakan banyak variabel kepemilikan barang berharga menjadi 1 indeks sosio-ekonomi. Data yang digunakan adalah data Survei Demografi Kesehatan Indonesia 2002-2003 yang memiliki 7 variabel binomial tentang kepemilikan barang berharga dan 3 variabel ordinal tentang keadaan rumah untuk membuat indeks sosio-ekonomi. Indeks dibentuk dengan menggunakan principal component analysis (PCA), korelasi tetrakorik dan polikorik. Kami memperlihatkan bagaimana membuat indeks sosio-ekonomi dengan bantuan perangkat lunak Stata. Matriks korelasi tetrakorik dibentuk dengan perintah tetrachoric dan matriks korelasi polikorik dibentuk dengan perintah polychoric. Dua indeks sosio-ekonomi dibentuk, 1 indeks berdasarkan 7 variabel binomial kepemilikan barang berharga dan 1 indeks lagi berdasarkan ke 7 variabel binomial tersebut ditambah 3 variabel ordinal kondisi rumah. Kedua indeks dibentuk dengan prosedur PCA. Pada model 7 variabel binomial, indeks yang terbentuk dapat menjelaskan 57% varians kepemilikan barang berharga dan pada model 7 variabel binomial ditambah 3 variabel ordinal, indeks dapat menjelaskan 54% varians kepemilikan barang berharga dan kondisi rumah. Kami juga memperlihatkan penggunaan perintah xtile untuk membagi subyek penelitian menurut kuintil indeks sosio-ekonomi. PCA, korelasi tetrakorik dan polikorik dapat digunakan untuk membentuk indeks sosio-ekonomi berdasarakan informasi tentang kepemilikan barang berharga dan kondisi rumah. In household survey, we could measure socio-economic status through income, expenditure and ownership of valuable goods. Measuring income and expenditure in developing countries has many weaknesses, therefore many researchers prefer to use the ownership of valuable goods as proxy of socio-economic status. Using ownership of valuable goods as proxy indicator creates another problem of having many variables for the socio-economic proxy. To show how to simplify many variables of ownership of valuable goods into 1 socio-economic index. Using principal component analysis with Stata. Using Indonesia Demographic & Health Survey 2002-2003 data, 7 binomial variables of ownership of valuable goods and 3 ordinal variables of housing condition to construct socio-economic indices using principal component analysis (PCA), tetrachoric and polychoric correlation.We used Stata to construct the socio-economic index. Correlation matrices were derived using tetrachoric command for tetrachoric correlation and polychoric command for polychoric correlation. Two socio-economic indices were constructed, 1 index was based only on 7 binomial variables of ownership of valuable goods and 1 index was based on 7 binomial variables of ownership of valuable goods and 3 ordinal variables of housing conditions. PCA was used to construct those 2 indices. In 7 variables model, the socio-economic index could explain 57% variance and in 10 variables model, the socio-economic index could explain 54% variance. We also showed the use of xtile command to regroup the subjects based on quintile of socio-economic indices. PCA, tetrachoric and polychoric correlation could be used to construct socio-economic indices based on information of ownership of valuable goods and housing conditions.
Penggugusan Provinsi di Indonesia Berdasarkan Kondisi Kesehatan Prasetyo, Sabarinah; Ariawan, Iwan; Yelda, Fitra
Kesmas Vol. 7, No. 6
Publisher : UI Scholars Hub

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Abstract

Untuk melaksanakan penelitian di Indonesia yang dapat mewakili 33 provinsi, sampling bertahap banyak dilakukan, dan tahap awalnya adalah memilih provinsi. Pada penelitian bidang kesehatan, agar provinsi terpilih mewakili kondisi kesehatan penduduk Indonesia, seyogyanya provinsi dikelompokkan berdasarkan variabel terkait kesehatan. Untuk itu, secara statistik dapat dilakukan analisis gugus (cluster analysis) memakai data dari berbagai sumber, dengan 27 variabel mencakup prevalensi beberapa penyakit infeksi dan status gizi, akses ke pelayanan kesehatan, status demografi, indeks pembangunan manusia, dan aspek keuangan. Hasil akhir menunjukkan bahwa ada 4 gugus provinsi di Indonesia, pada masing-masing gugus terdapat sebanyak 4, 8, 7, dan 14 provinsi. Proses penggugusan dengan analisis gugus semacam ini dapat diterapkan dengan memakai data yang diperbaharui dan hasilnya dapat dimanfaatkan sebagai salah satu pertimbangan untuk sampling provinsi di Indonesia. A multistage sampling procedure is often used in conducting a research that represents all 33 provinces in Indonesia, and the first step for the procedure is the sample selection of provinces. In the area of health research, it is recommended that the province selection is based on the stratification of provinces using health related variables. Cluster analysis is a statistical technique possibly employed utilizing data from many sources. In this particular application, it involves 27 important health variables which reflect important communicable diseases and nutritional status, access to health services, demographic situation, human development index, and financial factor. This cluster analysis produces four clusters of province, with each of them comprising of 4, 8, 7, and 14 provinces. This statistical clustering technique of provinces can be implemented and considered in the sampling process of provinces in Indonesia using the updated data.
Konsumsi Jamu Ibu Hamil sebagai Faktor Risiko AsfiksiaBayi Baru Lahir Purnamawati, Dewi; Ariawan, Iwan
Kesmas Vol. 6, No. 6
Publisher : UI Scholars Hub

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Jamu merupakan obat tradisional yang dibuat dengan cara mengolah bahan alamiah yang mempunyai khasiat obat dengan beberapa bahan campuran. Efektivitas dan efek samping pengobatan tradisional sebagai upaya pelayanan kesehatan masih perlu dibuktikan, khususnya jika digunakan oleh ibu yang sedang hamil. Penelitian ini bertujuan untuk mengetahui pengaruh konsumsi jamu pada ibu hamil terhadap kejadian asfiksia pada bayi baru lahir di Bekasi tahun 2008. Desain penelitian adalah kasus kontrol dengan metode kuantitatif dan kualitatif. Hasil penelitian menunjukkan hubungan yang signifikan antara konsumsi jamu terhadap kejadian asfiksia pada bayi baru lahir (nilai p = 0,005; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9; (AFE) = 0,85; dan (AFP) = 0,43). Terdapat hubungan antara jumlah antenatal care (ANC) dan asfiksia pada bayi baru lahir dengan jumlah ANC = 4-8 kali (nilai p = 0,052; OR = 1,68; dan 95% CI = 0,99 – 2,83) sedangkan jumlah ANC kurang dari 4 kali (nilai p = 0,019; OR = 3,02; dan 95% CI = 1,2 – 7,58). Berdasarkan hasil wawancara mendalam diketahui bahwa mayoritas ibu hamil belum paham tentang perilaku sehat selama hamil dan tidak mendapatkan penjelasan yang cukup dari petugas kesehatan. Oleh karena itu, perlu ada peningkatan kualitas pelayanan kesehatan pada saat kehamilan dan persalinan serta perlu standardisasi penggunaan jamu untuk ibu hamil. Jamu are traditional medicine which is made by natural ingredience which has medicational effect combining with several ingrediences. The successful of traditional medicine as self medication in health care still need to prove for its efectiveness and the side effect especially if it used by pregnant women. The goal of this study is to know how the effect of consuming jamu for pregnant women with birth asphyxia in Bekasi in 2008. Quantitaive and qualitative study designs were used in this study. Case control design used to see how the odds ratio of the mother who have experience to take jamu during pregnancy. The result showed that there are relation and risk of consume jamu with birth asphyxia (p value = 0,000; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9) and frequencies of antenatal care (ANC) with birth asphyxia (4 – 8 times during pregnancy, p value = 0,052; OR = 1,68; and less than 4 times during pregnancy, p value = 0,019; OR = 3,02). The result of indepth interview tells us that majority of mother doesn’t know about the health attitude during pregnancy and doesn’t have enough information from providers about it. Therefore increase the quality of health services during pregnancy and birth delivery and standart for using jamu for pregnant women are needed.