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Journal of Epidemiology and Public Health
Published by Universitas Sebelas Maret
ISSN : 25490273     EISSN : 25490273     DOI : -
Core Subject : Health,
Public Health
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 know­led­ge 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.
Arjuna Subject : -
Articles 419 Documents
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Factors Associated with Post-Sternotomy Wound Infection: A Meta-Analysis  Aris Widiyanto; Sri Iswahyuni; Krisnanda Aditya Pradana; Perdana Prabasari Putri Ichsani; Rina Tri Handayani; Hakim Anasulfalah; Ahmad Syauqi Mubarok; Joko Tri Atmojo
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.2026.11.01.01

Abstract

Background: Sternal wound infection is a serious complication following cardiac surgery, contributing to increased morbidity, mortality, and length of hospital stay. Obesity, diabetes mellitus, smoking habits, and re-operation are suspected to contribute to the incidence of post-sternotomy wound infections. This study aimed to estimate the magnitude of the influence of obesity, diabetes, smoking, and re-operation as risk factors for post-sternotomy wound infections. Subject and Method: This study is a systematic review and meta-analysis. Articles were obtained from databases including PubMed, Google Scholar and ScienceDirect, limited to publications from 2015 to 2025. The keywords and MeSH terms used were: “sternotomy, AND sternal wound infection OR deep sternal wound infection OR surgical site infection, AND “obesity OR body mass index, AND diabetes mellitus OR hyperglycemia AND smoking OR tobacco use AND re-operation AND cardiac surgery”. Article selection was based on eligibility criteria defined using the PICO model: P = patients post-sternotomy; I = obesity, diabetes, smoking, re-operation; C = non-obese, non-diabetic, non-smokers, no re-operation; O = post-sternotomy wound infection. Only full-text articles with a cross-sectional study design were included. Data were analyzed using RevMan version 5.3. Results: A total of 16 articles were included in this meta-analysis, originating from Finland, Denmark, Australia, Saudi Arabia, Colombia, Italy, France, China, Pakistan, Brazil, and United States. The meta-analysis showed that the risk of post-sternotomy wound infection was significantly increased in patients with obesity (aOR = 1.50; 95% CI: 1.31–1.72; p < 0.001), diabetes (aOR = 2.02; 95% CI: 1.26–3.25; p = 0.004), smoking (aOR = 2.44; 95% CI: 1.36–2.27; p = 0.05), obstructive sleep apnea (aOR = 1.76; 95% CI: 1.36–2.27; p < 0.001), and re-operation (aOR = 2.90; 95% CI: 1.49–5.64; p = 0.002). All findings were statistically significant. Conclusion: Risk of sternal wound infection post-sternotomy significantly increases with obesity, diabetes, smoking, and re-operation.
Enhancing Physical Adaptation and Functional Independence in Post-Stroke Patients Through Motivational Interviewing-Based Health Coaching Bernadetta Germia Aridamayanti; Shenda Maulina Wulandari; Maulidya Septiany; Agianto; Chrisnawati
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.2026.11.01.05

Abstract

Background: Stroke is a leading cause of long-term disability worldwide and is highly prevalent in Indonesia, especially in underserved and geographically isolated regions such as riverside communities. Many stroke survivors struggle with impaired physical adaptation and low functional independence. This study aimed to evaluate the effectiveness of motivational interviewing-based health coaching, guided by the Roy Adaptation Model, on improving physical adaptation and functional independence among post-stroke patients in Banjar Regency. Subjects and Method: A quasi-experimental study with a pre-test and post-test control group design was conducted from January to April 2025 in two riverside subdistricts of Banjar Regency, South Kalimantan. A total of 90 post-stroke patients aged ≥45 years were recruited through purposive sampling. Participants were assigned to either the intervention (n=45) or control group (n=45). The intervention group received six sessions of structured health coaching based on motivational interviewing principles, while the control group received routine care. Physical adaptation was measured using the Roy Adaptation Assessment Guide (RAAG), and functional independence was assessed using the Barthel Index. Data were analyzed using the paired t-test and Mann–Whitney U test. Results: The intervention group showed significant improvements in physical adaptation (Mean pre-test=54.87; post-test=66.02; p<0.001) and functional independence (Mean pre-test=60.44; post-test=78.91; p<0.001). In contrast, the control group showed no significant changes in physical adaptation (p=0.062) or functional independence (p=0.084). Between-group comparisons at post-test showed significantly higher scores in the intervention group for both physical adaptation (p<0.001) and functional independence (p<0.001). Conclusion: Motivational interviewing-based health coaching significantly improves physical adaptation and functional independence among post-stroke patients in riverside communities. Integrating this approach into community-based rehabilitation may enhance recovery outcomes in underserved areas.
Factors Affecting the Severity of Non-Hemorrhagic Stroke Nurul Sri Wahyuni; Eky Okviana Armyati; Aisyah Miftakhur Rohmah
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.02

Abstract

Background: Stroke severity is influenced by multiple factors, including sociodemographic characteristics, health access, and time of treatment. Timely recognition of stroke onset and early hospital arrival are critical to reduce neurological damage. However, evidence on these factors in local Indonesian settings remains limited. This study aimed to analyze factors affecting the severity of non-hemorrhagic stroke among patients at Darmayu Ponorogo Public Hospital. Subjects and Method: This cross-sectional study was conducted at Darmayu Ponorogo Public Hospital from July to September 2025. A total of 200 patients aged ≥18 years, diagnosed with non-hemorrhagic stroke, were selected using an accidental sampling method. The dependent variable was stroke severity, measured using the National Institutes of Health Stroke Scale (NIHSS). Independent variables included age, gender, education, occupation, income, health insurance, distance from home to hospital, and prehospital delay. Data were collected using structured questionnaires and medical records. Analysis was performed using simple logistic regression for bivariate analysis and multiple logistic regression for multivariate analysis. Results: Bivariate analysis showed that prehospital delay was most powerfully significant factor, where patients arriving within ≤4.5 hours had lower odds of severe stroke compared to those with delays >4.5 hours (OR = 0.20; p = 0.020). Multivariate analysis confirmed prehospital delay as an independent predictor (OR = 0.09; 95% CI = 0.01 to 0.62; p = 0.015). Conclusion: Prehospital delay is the most significant determinant of non-hemorrhagic stroke severity. Early hospital arrival (≤4.5 hours) substantially reduces the risk of severe stroke.
A Review of Solid Medical Waste Management in Indonesian Hospitals  Anggreini Beta Citra Dewi; Aurina Firda Kusuma Wardani; Ervansyah Wahyu Utomo; Siti Rachmawati
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.2026.11.01.02

Abstract

Background: Hospitals generate hazardous medical waste that threatens both environmental sanitation and human health. Common challenges include a lack of awareness, insufficient training, inadequate disposal infrastructure, and limited resources. Proper management is essential to minimize ecological impacts and prevent hospital-acquired infections (HAIs) at every stage—collection, segregation, transport, and storage. This study systematically evaluates global hospital waste management practices. Subjects and Method: This study is a systematic review  literature review conducted on  selected databases (PubMed, Science Direct, Google Schoolar) with a publication year between 2020 and 2025. Literature uses Indonesian and English. The literature included was literature with qualitative and quantitative method. The quality assessment of the literature was carried out using the JBI Critical Appraisal. Results: The research results from nine (9) articles related to solid medical waste management in Indonesia show that the process of sorting, transportation, temporary storage and final disposal in the management of medical waste from several hospitals has met the requirements in accordance with applicable regulations. Conclusion: While segregation and temporary storage show high compliance, final disposal remains a critical challenge due to incinerator licensing issues and third-party dependency. Addressing this requires practical staff training, routine audits, and a transition to alternative technologies like autoclaving. Strengthening contract governance and cost-benefit analysis between internal investment and outsourcing is essential for sustainable waste management in Indonesia.
Maternal Death Review Through the Maternal Perinatal Death Notification Surveillance System: An Aggregate Analysis at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia Muhammad Ardian Cahya Laksana; Nurani Zulfa Zakiya; Nur Sahila; Ayu Dyah Primaningrum; Asti Alya Rahmahdia; Dinda Zhafira
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.2026.11.01.04

Abstract

Background: Maternal mortality remains a major concern in Indonesia, particularly in referral hospitals that manage high-risk pregnancies. This study aimed to examine maternal deaths and assess contributory factors at Universitas Airlangga Hospital in 2024 using the maternal perinatal death notification (MPDN) system. Subjects and Method: A retrospective-descriptive study was conducted, including all maternal deaths recorded from January to December 2024. Quantitative data were analyzed descriptively, and factors contributing to maternal mortality were classified using the Three Delays Model. A mixed method with multidisciplinary hospital staff provided qualitative insights into clinical and institutional gaps. Results: A total of 11 maternal deaths occurred during the study period, resulting in an MMR of 557 per 100,000 live births. Most deaths occurred in women over 35 years (81.8%) and during the third trimester (81.8%). Non-obstetric complications were the leading cause (40%), followed by pregnancy-related infections (20%) and hypertensive disorders (10%). First, delay factors, particularly socio-cultural barriers, were present in 36.4% of cases, while third, delay factors, including delayed diagnosis and treatment, were identified in 45.5%. FGDs highlighted gaps in emergency preparedness, blood availability, and interprofessional communication. Conclusion: These findings highlight the combined role of clinical complexity and systemic delays, emphasizing the need to strengthen referral readiness, rapid multidisciplinary response, and decision-making to reduce preventable maternal deaths.
The Relationship between the TCF7L2 rs7903146 Gene Polymorphism and Anthropometric Parameters and Muscle Mass among Patients with Type 2 Diabetes Mellitus at Puskesmas Waruroyom, Cirebon Muhammad Ajmalunnas; Yuni Susanti Pratiwi; Tiar Masykuroh Pratamawati; Donny Nauphar; Edhyana Sahiratmadja; Leonardo Lubis
Journal of Epidemiology and Public Health Vol. 11 No. 2 (2026)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2026.11.02.05

Abstract

Background: Polymorphism of the TCF7L2 gene (rs7903146) is involved in glucose homeostasis and has been strongly associated with type 2 diabetes mellitus (T2DM). However, its relationship with anthropometric characteristics, particularly by glycemic control status, remains unclear. Subjects and Method: This cross-sectional study included 75 patients with type 2 diabetes mellitus (T2DM) in the working area of Puskesmas Waruroyom, Cirebon. The target population comprised all registered T2DM patients, and total sampling was applied through screening. Subjects were classified into controlled (n = 37; 49.3%) and uncontrolled (n = 38; 50.7%) groups based on glycemic status. TCF7L2 rs7903146 genotypes (CC, CT, TT) were identified, and anthro­pometric parameters (height, body weight, BMI, waist circumference, and muscle mass) were analyzed using chi-square or Fisher’s exact tests, with additional analyses for continuous variables. Results: The most frequent genotype was CT (69.3%), followed by TT (25.3%) and CC (5.3%). No significant differences were observed in anthropometric parameters across TCF7L2 rs7903146 genotypes in both controlled and uncontrolled groups, including BMI (p= 0.580 and p= 0.830), waist circumference (p= 1.000 and p= 0.760), and muscle mass (p= 1.000 and p= 0.420), respectively. Conclusion: The TCF7L2 rs7903146 polymorphism was not associated with anthropometric profiles among patients with T2DM, regardless of glycemic control status. This suggests that the influence of TCF7L2 is more strongly related to metabolic regulation through insulin signaling pathways rather than to determinants of body composition.
The Influence of Social Trust, Income Inequality, and Employment Status on the Risk of Depression Dhina Nur Irfani; Bhisma Murti; Yulia Lanti Retno Dewi; Revi Gama Hatta Novika; Ika Sumiyarsi Sukamto
Journal of Epidemiology and Public Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.04.10

Abstract

Background: Depressive disorders are among the most common and complex mental health problems worldwide, including in Indonesia. The determinants of depression are closely linked to social and economic factors. This study aimed to estimate the effects of social trust, income inequality, and employment status on the risk of depression. Subjects and Method: An observational study with a cross-sectional design utilized the fifth wave of the Indonesia Family Life Survey (IFLS5). The dataset includes more than 29,716 individuals across 13 provinces. The sample was selected using a purposive sampling method. Results: The risk of depression increased significantly among individuals who were unmarried (b = 0.97; 95% CI: 0.84 to 1.07; p < 0.001), female (b = 0.16; 95% CI: 0.06 to 0.26; p = 0.002), unemployed (b = 0.25; 95% CI: 0.14 to 0.35; p < 0.001), and living in provinces with higher income inequality (b = 0.32; 95% CI: 0.21 to 0.42; p < 0.001). Conversely, the risk of depression decreased significantly with higher social trust (b = -0.18; 95% CI: -0.29 to -0.08; p < 0.001), good sleep quality (b = -0.20; 95% CI: -0.21 to -0.19; p < 0.001), older age (b= -0.81; 95% CI: -0.99 to -0.63; p < 0.001), and higher education level (≥senior high school) (b= -0.36; 95% CI: -0.46 to -0.25; p < 0.001). Conclusion: The risk of depression increases with unmarried, female, unemployed, and living in provinces with higher income inequality. The risk of depression decreases with higher social trust, good sleep quality, older age, and education ≥senior high school.
Patient Safety and Hospital-Based Health Promotion in Preventing Infections and Their Impact on Childhood Stunting: A Systematic Review Jasmin Ambas; Yasinta Indah Widyaningsih
Journal of Epidemiology and Public Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.04.07

Abstract

Background: Child stunting is influenced by nutrition, recurrent infections, and the quality of health services. Patient safety and hospital-based health promotion play key roles in preventing infections that increase stunting risk. This study aimed to analyze the role of patient safety and hospital-based health promotion in infection prevention and its impact on childhood stunting. Subjects and Method: A systematic review was conducted following the PRISMA guidelines and the PICO framework. The Joanna Briggs Institute (JBI) Checklist was used for quality assessment. Articles were collected from Scopus, ScienceDirect, ProQuest, SpringerLink, Google Scholar, Nature, JSTOR, and Emerald Insight, covering publications from 2020 to 2025. The keywords used were: “patient safety” AND “hospital-based health promotion” AND “infection prevention” AND “childhood stunting”, and “hospital governance” AND “infection control” AND “child growth”. Boolean operators and Medical Subject Headings (MeSH) were applied to each database. Results: This systematic review consisted of 10 articles that met the inclusion criteria. The studies, published between 2020 and 2025, originated from Indonesia, Ethiopia, Southeast Asia, and other developing regions. The findings showed that patient safety programs and infection control effectively reduced neonatal and childhood infections. Health promotion interventions, such as caregiver education and cadre training, improved hygiene and preventive behavior. Integration of hospital governance and policy strengthened infection prevention and service quality. Across the reviewed evidence, exposure to infection during the first 1,000 days of life was consistently linked to an increased risk of stunting (OR=1.85; 95% CI=1.42–2.37; p=0.001). Conclusion: Patient safety and hospital-based health promotion are crucial for preventing infections and reducing stunting. Strengthening hospital governance through integrated infection prevention strategies is essential to accelerate stunting reduction.
Implementation of Theory of Planned Behavior on Behavior Change and Outcomes in Type 2 Diabetes Mellitus Patients in Surakarta, Central Java, Indonesia Burhannudin Ichsan; Bhisma Murti; Revi Gama Hatta Novika
Journal of Epidemiology and Public Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.04.12

Abstract

Background: The Theory of Planned Behavior (TPB) can serve as a conceptual framework for improving healthy behaviors among patients with type 2 diabetes mellitus (T2DM). The application of TPB is essential for predicting both behavioral patterns and health outcomes in individuals with T2DM. This study aimed to assess the implementation of TPB on behavioral change and outcomes in T2DM patients Subjects and Method: This cross-sectional study was conducted in Surakarta, Indonesia. There was 200 type 2 DM patients selected by purposive sampling. The dependent variables were HbA1c and behavior. The independent variables were behavioral belief, outcome evaluation, normative belief, motivation, control belief, control power, attitude, subjective norm, perceived behavioral control, and intention.  Data were collected using a set of questionnaires and analyzed using path analysis. Results: HbA1c ≥6.5% was directly reduced by strong behavior, but it was statistically non signi­ficant (b= -0.22; 95%CI= -0.15 to 1.08; p= 0.745). Behavior was directly and significantly increased by strong intention (b= 1.66; 95% CI= 1.03 to 2.30; p<0.001) and high perceived behavior control (b= 0.87; 95% CI= 0.23 to 1.50; p= 0.007). Conclusion: The Theory of Planned Behavior can be used to predict healthy behavior among patients with type 2 DM.
Analysis of Risk Factors Associated with Rabies Cases in South Timor Tengah Regency, East Nusa Tenggara, Indonesia Lucitania Floreca Mokos; Setro Sri Rahardjo; Bhisma Murti; Yulia Lanti Retno Dewi; Nur Hafidha Hikmayani
Journal of Epidemiology and Public Health Vol. 10 No. 4 (2025)
Publisher : Masters Program in Public Health

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/jepublichealth.2025.10.04.11

Abstract

Background: Rabies is a zoonotic infectious disease that can be directly transmitted to humans and is fatal, leading to death in South Timor Tengah Regency. Rabies has been officially declared an outbreak in this region. This study aimed to analyze the effects of selected risk factors on rabies cases in South Timor Tengah Regency, East Nusa Tenggara Province, Indonesia. Subjects and Method: This study used primary data and employed an analytic observational design with a case–control approach. A total of 200 participants were included, consisting of 100 rabies cases and 100 controls, drawn from a population of 4,749 cases and controls using random sampling across 32 subdistricts in South Timor Tengah Regency. The dependent variable was rabies case status. The independent variables included community knowledge, history of contact with dogs, vaccination status of pet dogs, age, sex, stray dog bites, and stray dog population density. Data were collected using a questionnaire that had been tested for validity and reliability. Path analysis was conducted using STATA version 13. Results: The study found significant associations between rabies cases and community knowledge (OR= 0.06; 95% CI= 0.03–0.16; p < 0.001), stray dog population density (OR= 2.72; 95% CI= 1.30–5.70; p= 0.008), stray dog bites (OR = 4.59; 95% CI= 1.97–10.69; p < 0.001), age (OR= 0.97; 95% CI= 0.95–0.99; p= 0.008), and sex (OR= 0.33; 95% CI= 0.16–0.71; p = 0.005). In contrast, history of contact with dogs (OR= 1.30; 95% CI= 0.62–2.71; p= 0.487), vaccination of pet dogs (OR= 0.89; 95% CI= 0.37–2.13; p = 0.796), and educational level (OR = 1.31; 95% CI= 0.54–3.15; p= 0.553) were not statistically significant. Conclusion: High stray dog population density and stray dog bites increase the risk of rabies, while higher community knowledge, female sex, and age ≥35 years serve as protective factors against rabies in the population of South Timor Tengah Regency.

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