Rahardjo, Setyo Sri
Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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

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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: Aulia Noorvita Ramadani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: aulia.noorviat@yahoo.com. Mobile: +6285641577322.Journal of Epidemiology and Public Health (2019), 4(2): 88-96https://doi.org/10.26911/jepublichealth.2019.04.02.04
Biopsychosocial Factors Affecting the Risk of Musculoskeletal Disorders in Surakarta, Central Java Romadhoni, Dea Linia; Rahardjo, Setyo Sri; Indarto, Dono
Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Musculoskeletal Disorders (MSDs) are injuries and disorders that affect the hu­man body’s movement or musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.). The impacts of MSD include reduced activity, reduction of work abi­lity, and use of health care (seeing a health professional or taking prescription or non­prescription medication). Studies investigating risk factors of MSD are lacking in Indonesia. The purpose of this study was to investigate biopsychosocial factors affecting the risk of MSD in Sura­karta, Central Java.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was carried out at Dr. Moewardi hospital, Surakarta, Central Java from April to May 2018. A sample of 116 patients was selected by fixed disease sampling. The dependent variable was MSD. The independent variable were gender, history of chronic disease, body mass index (BMI), stress, occupational type, environmental working, and working posture. Data on MSD status were taken from medical record. Working posture was measured by REBA questionnaire. Other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of MSDs was directly increased with BMI ≥25 (OR= 1.22; 95% CI= 0.15 to 2.30; p= 0.026), history of chronic disease (OR= 2.02; 95% CI= 0.96 to 3.08; p<0.001), heavy occupational type (OR= 1.56; 95% CI= 0.43 to 2.68; p<0.007), and poor working posture (REBA score ≥4) (OR= 1.75; 95% CI= 0.65 to -2.86; p= 0.002). The risk of MSDs was indirectly affected by environmental working, stress, and gender.Conclusion: The risk of MSDs is directly increased with BMI ≥25, history of chronic disease, heavy occupational type, and poor working posture (REBA score ≥4), and is indirectly affected by environmental working, stress, and gender.Keywords: musculoskeletal disorders, biopsychosocial factorCorrespondence: Dea Linia Romadhoni. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: dealinia08@gmail.com. Mobile: +6282227862718.Journal of Epidemiology and Public Health (2018), 3(3): 361-368https://doi.org/10.26911/jepublichealth.2018.03.03.07
Evaluation of Multi-Drug Resistant Tuberculosis Predictor Index in Surakarta, Central Java Pamungkas, Putri; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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 
Multilevel Analysis on the Contextual Effects of Hygiene, Environmental Sanitation, and Diarrhea Prevention in Elementary School Students in Ngawi, East Java Kartika, Dian Surya; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 4, No 2 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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’s knowledge, attitude, hygiene, school sanitation, school health unit, canteen sanitation, and maternal education. The data were collected by questionnaire and analyzed by a multilevel logistic regression run on Stata 13.Results: Good hygiene facility (b=1.77; 95% CI= 0.66 to 2.87; p= 0.002), good school sanitation (b=1.37; 95% CI= 0.27 to 2.48; p=0.015), clean canteen (b=1.84; 95% CI= 0.23 to 3.44; p= 0.025), school health unit (b= 1.49; 95% CI= 0.31 to 2.68; p= 0.013), high student’s knowledge (b=2.30; 95% CI= 1.20 to 3.40; p<0.001), positive attitude (b=2.03; 95% CI= 0.96 to 3.10; p<0.001), maternal education ≥senior high school (b= 1.60; 95% CI= 0.37 to 2.83; p=0.011) were positively associated with diarrhea prevention. School had contextual effect on diarrhea prevention with ICC= 54.03%.Conclusion: Good hygiene facility, good school sanitation, clean canteen, school health unit, high student’s knowledge, positive attitude, maternal education ≥senior high school are positively associated with diarrhea prevention in elementary school students. The school has a contextual effect on diarrhea prevention.Keywords: diarrhea prevention, hygiene, school sanitation, elementary school studentCorrespondence: Dian Surya Kartika. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Central Java 57126, Indonesia. Email: kartikadiansurya@gmail.com. Mobile: +6282230003592Journal of Epidemiology and Public Health (2019), 4(2): 97-108https://doi.org/10.26911/jepublichealth.2019.04.02.05
Multilevel Analysis: Biopsychosocial Determinants and Environmental Factor on the Incidence of Diarrhea Among Children Under Five in Surakarta Zicof, Erick; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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: Erick Zicof. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: erickzicof@gmail.com. Mobile: +6281363425870.Journal of Epidemiology and Public Health (2018), 3(3): 323-330https://doi.org/10.26911/jepublichealth.2018.03.03.03
Effect of Age and Socio Economic Status on the Quality of Life of Patients with Cervical Cancer Undertaking Chemotherapy at Dr. Moewardi Hospital Surakarta Fadhilla, Hidayah Nur; Mudigdo, Ambar; Rahardjo, Setyo Sri
Journal of Epidemiology and Public Health Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Cervical cancer is a type of cancer affecting women with high incidence and mortality in the world. Patient with cervical cancer have to undertake prolonged sequential treatment and therefore may experience physical, physicological and social changes, which may affect their quality of life. This study aimed to examine effect of age and socio economic status on the quality of life of patients  with cervical cancer undertaking chemotherapy at Dr. Moewardi hospital Surakarta.Subjects and Method: This was an analytic observational study with cross-sectional design.  This study was conducted at Dr. Moewardi Hospital, Surakarta, from February to March 2017. A sample of 100 patients was selected by fixed disease sampling. The dependent variable was quality of life. The independent variables were age, education and family income. The data were collected by questionnaire and medical record, and then were analyzed by linear regression model.Results: Education ≥ Senior High School (b= 10.25; 95% CI=5.24 to 15.26; p<0.001) and family income ≥ Minimum Regional Wage (b= 0.47; 95% CI=0.12 to 0.83; p=0.009) increased quality of life in patients with cervical cancer. Age ≥ 45 years (b=-0.53; 95% CI=-0.84 to -0.21; p=0.001) decreased quality of life in patients with cervical cancer.Conclusion: The quality of life of patient with cervical cancer is determine by age, education, and family income. Key Words: age, social economic status, quality of life, cervical cancer, chemotherapyCorrespondence: Hidayah Nur Fadhilla. Masters Program in Public Health, Sebelas Maret University, Surakarta. Email: fadhillahidayah@student.uns.ac.id. Mobile: +6285729955373.Journal of Epidemiology and Public Health (2017), 2(1): 11-19https://doi.org/10.26911/jepublichealth.2017.02.01.02
Self Care, Drug Taking Adherence, and their Association with Complication in Type 2 Diabetes Mellitus Patients Putri, Widya Kaharani; Rahardjo, Setyo Sri; Indarto, Dono
Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Diabetes mellitus (DM) is a major global health issue. The incidence of DM worldwide was about 6.4% (285 million people) in 2010 and it is projected to increase to 7.7% in 2030. Diabetes is associated with a number of challenges. The disease has a great influence on the patient’s daily life, their relatives, nurses and physicians. Complications of diabetes represent the major causes of morbidity and mortality that are associated with this chronic metabolic disorder. This study aimed to examine the associations of self care and drug taking adherence with the risk of complication in type 2 diabetes mellitus patients.Subjects and Method: A case control study was conducted at Dr.Soeroto Hospital, Ngawi, East Java. A sample of 150 type 2 diabetes mellitus patients was selected for this study by fixed disease sampling, consisting of 75 patients with and 75 patients without complication. The dependent variable was complication. The independent variables were self care, drug taking adherence, motivation, duration of illness, family support, and health personnel support. Data on complication of type 2 DM were obtained from medical record. The other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of type 2 DM complication decreased with better self care (b = -3.34; 95% CI= -4.47 to -2.22; p<0.001) and adherence to drug taking (b = -3.73; 95% CI= -5.06 to -2.41; p<0.001). The risk of type 2 DM complication was indirectly affected by motivation, duration of illness, education, family support, and health personnel support.Conclusion: The risk of type 2 DM complication decreases with better self care and adherence to drug taking. The risk of type 2 DM complication is indirectly affected by motivation, duration of illness, education, family support, and health personnel supportKeywords: type 2 diabetes mellitus, complication, self care, drug taking adherenceCorrespondence: Widya Kaharani Putri. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: widya.kaharani@gmail.com. Mobile: +6281515932993.Journal of Epidemiology and Public Health (2018), 3(3): 369-375https://doi.org/10.26911/jepublichealth.2018.03.03.08
Path Analysis on the Biopsychosocial Determinants and Genital Hygiene on Cervical Cancer at Dr. Moewardi Hospital, Surakarta, Central Java Umami, Afriza; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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: Afriza Umami. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: afrizaumami20@gmail.com. Mobile : +6282254348041Journal of Epidemiology and Public Health (2018), 3(2): 277-291https://doi.org/10.26911/jepublichealth.2018.03.02.07
Risk Factors of Dengue Fever: Application of PRECEDE – PROCEED Model Ayuningtyas, Kanthi Devi; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Dengue infection is one of the main health problems in more than 100 tropical and subtropical countries. This study aims to analyze the factors that play a role in the occurrence of dengue fever cases by applying the PRECED - PROCEED model.Subjects and Method:This was an analytic observational study with a case control design. The study was conducted at 8 sub-districts in Sukoharjo, Central Java, from May to July 2018. A sample of 200 study subjects was selected for this study by fixed disease sampling, comprising 50 peoples with dengue fever and 150 peoples without dengue fever. The dependent variables were dengue fever. The independent variables were intention, attitude, education, dengue fever prevention, family income, and sanitation. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.Results: The risk of dengue fever was directly reduced by good environmental sanitation (b= -1.32, 95% CI= -2.09 to -0.54, p= 0.001) and good prevention behavior (b= -2.61, 95% CI= -3.55 to -1.67, p<0.001). The risk of dengue fever was indirectly affected by intention, attitude, education, and family income.Conclusion: The risk of dengue fever is directly reduced by good environmental sanitation and good prevention behavior. The risk of dengue fever is indirectly affected by intention, attitude, education, and family income.Keywords: dengue fever, preventive behavior, environmental sanitation, PRECEDE-PROCEED modelCorrespondence: Kanthi Devi Ayuningtyas. School of Health Sciences Patria Husada, Blitar. Jl. Sudanco Supriyadi No 168, Blitar, East Java. Email: kanthideviayuningtyas@gmail.com. Mobile: 08125266956.Journal of Epidemiology and Public Health (2019), 4(1): 37-46https://doi.org/10.26911/jepublichealth.2019.04.01.05
Multilevel Analysis on the Biological, Social Economic, and Environmental Factors on the Risk of Pneumonia in Children Under Five in Klaten, Central Java Luthfiyana, Nurul Ulya; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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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.2018.03.02.03ÂÂ