Public Health and Preventive Medicine Archive
ublic Health and Preventive Medicine Archive (PHPMA) is an open access, peer reviewed journal published by Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University. Issues covered in the journal are as the following: Environmental and occupational health Field and Clinical Epidemiology Global health Health policy analysis Health promotion Health systems and health care management Maternal and child health Program monitoring and evaluation Public health nutrition Reproductive health, sexually transmitted infections and HIV related issues Travel health and health tourism Population and family planning Disaster management
Articles
310 Documents
<![CDATA[The association between hypertension self-management and stroke event in male patients at the Badung District Hospital, Bali ]]>
<![CDATA[Ni Kadek Sutini]]>;
<![CDATA[Ni Wayan Septarini]]>;
<![CDATA[I Made Ady Wirawan]]>;
<![CDATA[Anak Agung Sagung Sawitri]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p02
<![CDATA[Background and purpose: Hypertension is a major risk factor for stroke. Despite efforts to control hypertension with pharmacological and non-pharmacological therapies, the prevalence of and death from stroke is reported to be increasing. This study aims to determine the association of hypertension self-management with the incidence of stroke in patients with hypertension. Methods: A case-control study was conducted involving 44 patients suffering from hypertension and who had suffered a stroke as cases, as well as 44 patients with hypertension and without stroke as controls. Cases and controls were conveniently selected at the outpatient clinic of Badung District Hospital. Data on self-management of diet, physical activity, stress mitigation efforts, alcohol consumption, and medication adherence were collected using self administered questionnaire. Data on the diagnosis of hypertension, stroke and history of comorbidities were obtained from the patient’s medical records. Multivariate analysis using logistic regression was employed to assess the association between hypertension self-management with the incidence of stroke in patients with hypertension. Results: Characteristics of cases and controls did not differ in education, marital and socioeconomic status, but differed in age and employment. Multivariate analysis showed that there were three components of hypertension self-management associated with the incidence of stroke, namely poor adherence to medication (AOR=7.28; 95%CI: 2.19-24.17), poor self-management of stress (AOR=5.45; 95%CI: 1.56-18.99), and poor management of self-regulated diet (AOR=5.28; 95%CI: 1.31-21.32). Conclusion: Medication adherence, diet and stress management are the three main components of self-management that are associated with stroke events among hypertension patients. Efforts to increase medication adherence, diet and stress management should be enhanced.]]>
<![CDATA[Factors affecting the use of electronic cigarettes in Udayana University students ]]>
<![CDATA[Luh Pitriyanti]]>;
<![CDATA[Dewa Nyoman Wirawan]]>;
<![CDATA[Komang Ayu Kartika Sari]]>;
<![CDATA[I Made Ady Wirawan]]>;
<![CDATA[Desak Putu Yuli Kurniati]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p03
<![CDATA[Background and purpose: Electronic cigarettes (e-cigarettes) have been marketable since 2003 and first became for sale in Indonesia in 2010. Users tend to be predominately young people. The purpose of this study is to determine the proportion, characteristics and factors that influence the use of e-cigarettes among university students. Methods: This study used a cross sectional survey with 351 undergraduate students from a variety of study programs at Udayana University. Students were selected by multistage random sampling. In the first step, 10 out of 47 study programs at Udayana University were chosen randomly. Students who responded by filling out online questionnaires were included in this study. Data collection was conducted using questionnaires with the Survey Monkey Application. Analysis with logistic regression was applied to determine the factors influencing e-cigarettes use. Results: The proportion of university students who used tobacco cigarettes was 14.53%. The number of respondents who reported had ever used e-cigarettes was 61 (17.38%, 95%CI: 13.46%-21.3%) and 25 of them (40.98%) were current smokers. As many as 88.52% of respondents who had ever used e-cigarettes were male and 11.48% were female. Students who had ever used e-cigarettes in the campus area were 22 (36.07%). The reasons of using e-cigarettes included a desire to stop using tobacco cigarettes (29.51%), the fact that e-cigarettes are considered safer (26.23%), are considered “cool” (22.95%) and other reasons (26.23%). Multivariate analysis showed that the variables found to be associated with the use of e-cigarettes were gender (AOR=14.72; 95%CI: 4.34-49.87), a history of smoking tobacco cigarettes (AOR=42.16; 95%CI: 13.56-131.08), a history of consuming alcoholic beverages (AOR=5.72; 95%CI: 2.04-16.04) and coming from a smoking household (AOR=3.87; 95%CI: 1.33-11.21). Conclusion: The proportion of university students who had ever used e-cigarettes was found to be higher than tobacco cigarettes users. In addition, use was found to be greater among male students than females. Influencing factors associated with the use of e-cigarettes are gender, a history of tobacco smoking, a history of consuming alcoholic beverages and coming from a smoking household. There is a need for prevention efforts including education and regulations to reduce the use of e-cigarettes among students as well as community in general.]]>
<![CDATA[Hospital facilities, occupational safety environment and self-efficacy as predictors of healthcare-associated infections prevention and control compliance in nurses of inpatient care units ]]>
<![CDATA[Luh Yulia Adiningsih]]>;
<![CDATA[Ni Made Sri Nopiyani]]>;
<![CDATA[Made Ady Wirawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p04
<![CDATA[Background and purpose: The implementation of healthcareassociated infections (HAIs) prevention and control program in hospitals remains sub-optimal. The present study aims to determine the relationships between nurse’s self-efficacy, hospital’s occupational safety environment, and the availability of facilities, with the compliance on HAIs prevention and control in hospital inpatient care units. Methods: Cross-sectional survey was conducted with 128 nurses selected using systematic random sampling at Buleleng District Hospital’s inpatient care units. Data collection was conducted in March 2018 using self-administered questionnaires. The questionnaire consisted of five sections including characteristics of respondents, HAIs prevention and control practices, self-efficacy, occupational safety environment and the availability of facilities. Bivariate analysis was conducted to calculate the Pearson correlation coefficients between variables. Multivariate analysis was performed with multiple linear regressions to examine self-efficacy, occupational safety environment and availability of facilities as predictors of the compliance on HAIs prevention and control. Results: The study shows that 56.2% of nurses reported good compliance on HAIs prevention and control practices. Bivariate analysis shows a significant correlation between HAIs prevention and control compliance scores and self-efficacy (r=0.45; p=0.00), occupational safety environment (r=0.53; p=0.00), and the availability of facilities (r=0.65; p=0.00). Multivariate analysis shows that the availability of facilities is a significant predictor of HAIs prevention and control compliance (β=0.49; p<0.01) while self-efficacy and the occupational safety environment are also found to be significant predictors, although with lower standardized coefficients: β=0.16 (p=0.03) and β=0.17 (p=0.04), respectively. Conclusion: The significant predictors of compliance on HAIs prevention and control are availability of facilities, self efficacy and hospital’s occupational safety environment. This study highlights the importance of optimizing the availability of facilities, improving the occupational safety environment, and enhancing nurses’ self-efficacy in order to reduce the incidence of HAIs in hospitals.]]>
<![CDATA[Relationship between maternal perception and full immunization coverage among children aged 1-3 years in Kalibagor Village, Situbondo District ]]>
<![CDATA[Ifa Nurhasanah]]>;
<![CDATA[Desak Putu Yuli Kurniati]]>;
<![CDATA[Dewa Nyoman Wirawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p05
<![CDATA[Background and purpose: Full immunization coverage in Indonesia and East Java Province is reported to remain below the target of Universal Child Immunization. The purpose of the study was to determine the association between maternal perception and full immunization coverage among children aged 1-3 years. Methods: A cross-sectional study was conducted with mothers who had children under 3 years in Kalibagor Village, Situbondo District, East Java Province. A total of 116 respondents were selected using systematic random sampling from 133 mothers of children aged 1-3 years. Listing of all mothers was conducted through home visits one month before data collection. Data collection was conducted by interview at respondents' house in October-May 2018. Data collected included sociodemographic characteristics, knowledge on immunization, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, information on immunization, and support from community leader, health provider and peer. Data analysis with logistic regression was conducted to determine the relationship between maternal perception with full immunization coverage. Results: This study showed that 79.3% of respondents reported to have provided full immunization to their children. The results of multivariate analysis showed that full immunization was related to the mother's perception on the benefits of immunization (AOR=59.75; 95%CI: 4.60-775.86), self-efficacy (AOR=6.25; 95%CI: 1.84-21.35) and knowledge on immunization (AOR=7.77; 95%CI: 1.92-31.49). Conclusion: Maternal perceptions on immunization’s benefits, selfefficacy and knowledge are related to the full immunization coverage in children. Education about the benefits of immunization needs to be prioritized in an effort to increase full immunization coverage in children.]]>
<![CDATA[Risk factors for hepatitis B virus infections among pregnant women in East Lombok District ]]>
<![CDATA[Eka Faizaturrahmi]]>;
<![CDATA[Luh Seri Ani]]>;
<![CDATA[Komang Ayu Kartika Sari]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p06
<![CDATA[Background and purpose: The World Health Organization (WHO) has set a target of 90% reduction in new hepatitis B infections by 2030. The WHO program includes prevention of new infections, and increases testing uptake and treatment. In order to effectively foster prevention, it is necessary to understand the risk factors for transmission. This study aims to determine the risk factors of hepatitis B infection in pregnant women. Methods: A case control study was carried out among 52 pregnant women with HBsAg (+) as cases and 104 pregnant women with HBsAg (-) as controls. The source of cases and controls was the register of pregnant women at the Pringgasela Public Health Center from January 2016 to October 2017. Cases were selected using systematic random sampling from 67 HBsAg (+) pregnant women and controls were selected in the same way from 1644 pregnant women with HBsAg (-). Cases and controls were matched by domicile. The data collected were age, age of first marriage, education, family income, parity, history of miscarriage, maternal or husband’s history of working abroad, frequency of marriage, history of injection, surgery, blood transfusion and dental care. Data collection was carried out with a pre-tested questionnaire in April-May 2018 through interviews at the home of each respondent. Multivariate analysis with logistic regression was carried out to determine the adjusted odds ratio of each risk factor. Results: Cases and controls characteristics were found to be similar in terms of age, domicile, education and income. Significant risk factors were the history of husband working abroad (AOR=4.28; 95%CI: 1.66- 11.08), age of first marriage ≤19 years (AOR=2.52; 95%CI: 1.16-5.48) and frequency of husband's marriage more than one time (AOR=3.08; 95%CI: 1.35-7.08). Conclusion: Husbands with history of working abroad, age of first marriage <20 years and frequency of husband's marriage more than one time were found to be the risk factors for hepatitis B infection in pregnant women. These factors require public health attention in order to reduce the transmission of hepatitis B.]]>
<![CDATA[Incidence of dengue fever, climate and vector density in Denpasar ]]>
<![CDATA[Irma Rubianti]]>;
<![CDATA[Dewa Nyoman Wirawan]]>;
<![CDATA[Anak Agung Sagung Sawitri2]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p07
<![CDATA[Background and purpose: Until 2009, Denpasar consistently had the highest rates of dengue fever in Bali. However, from 2010 onwards, dengue rates in Denpasar have declined and in 2017 ranked 7th for incidences of dengue fever in Bali. This study aims to determine the trend and the difference of dengue fever incidence rates, vector density and climate for the period 2007-2017. Methods: This study employed a secondary analysis of dengue fever incidence rates, climate data and vector density from 2007 to 2017. Data on dengue fever incidence, vector density and the number of field workers (known as juru pemantau jentik or jumantik) were obtained from the Denpasar City Health Office. Climate data for 2007-2017 were obtained from the Bali Province Meteorological, Climatological and Geophysical Agency. The data were analyzed by comparing the dengue fever incidence rates, climate data, and vector-density data of the period 2007-2012 and 2013-2017. Results: Incidences of dengue fever in Denpasar have declined since 2013. Climate-related variables found to differ significantly were air temperature, humidity, wind speed and sunlight duration. Air temperature (p=0.03) and wind speed (p<0.01) were significantly higher in 2013-2017 compared to the period of 2007-2012. Humidity and sunlight duration were significantly lower (p<0.01) in 2013-2107 compared to the period of 2007-2012. Rainfall was lower in 2013-2017 compared to the period of 2007-2012, however, the difference was not significant (p=0.57). The proportion of larva-free households was significantly higher (p<0.01) in 2013-2017 (96.9%) compared to the period of 2009-2012 (95.3%). The data of house index (HI), container index (CI) and Breteau index (BI) cannot be compared between these two periods because they are only available for 2013-2017. Conclusion: There has been a decrease in the incidence of dengue fever in Denpasar from 2013-2017 compared to 2007-2012. This is likely to be related to the performance of jumantik in the implementation of vector control programme (VCP) in Denpasar.]]>
<![CDATA[Association between participation in a chronic disease management program, medication adherence and decrease of blood pressure ]]>
<![CDATA[I Ketut Indra Wiguna Cakera]]>;
<![CDATA[Ni Made Sri Nopiyani]]>;
<![CDATA[I Made Ady Wirawan]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p08
<![CDATA[Background and purpose: The prevalence of hypertension is increasing globally. A comprehensive approach is necessary including a community based chronic disease management program which has been implemented in public health centres in Indonesia. Only few studies have been published in Indonesia that evaluate the program, especially regarding the management of hypertension in primary care settings. This study aims to examine the association between participation in a chronic disease management program,medication adherence and decrease of blood pressure. Methods: A cross-sectional study was conducted in public health centres in Tabanan District. A total of 136 patients with hypertension were recruited at five groups that participate in the community based chronic disease management program called Program Pengelolaan Penyakit Kronis (Prolanis). The prolanis groups were purposively selected based on the size of participants in the program. One group was selected at urban area and four groups at rural areas. Data were collected from May to June 2017 by conducting interviews, blood pressure measurements, and secondary data extraction from the medical record of the prolanis database. The logistic regression analysis was used to determine the association between participation in a chronic disease management program, medication adherence and decrease of blood pressure. Results: As many as 75.7% of respondents actively participated in the prolanis program, and 81.6% were found with decreased blood pressure. Our study found a significant association between blood pressure decrease and active participation in the prolanis program with an adjusted odds ratio (AOR) of 6.38 (95%CI: 1.96–20.79), the good adherence towards medication with AOR=11.94 (95%CI: 3.60–39.56), and routine physical activities with AOR=3.84 (95%CI: 1.16-12.73). Conclusion: Active participation in the prolanis program, good adherence to medication and routine physical activities are independent factors of decreased blood pressure. These findings suggest the need for scaling up the prolanis program and increasing its coverage.]]>
<![CDATA[Anemia as a risk factor of postpartum hemorrhage at dr. R. Soedjono Hospital, Selong, East Lombok ]]>
<![CDATA[Ernawati]]>;
<![CDATA[Komang Ayu Kartika Sari]]>;
<![CDATA[Nyoman Gede Budiana]]>;
<![CDATA[Luh Seri Ani]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p09
<![CDATA[Background and purpose: Globally, maternal mortality rate due to labor complications remains high, with postpartum hemorrhage as the most common cause. Studies on the risk factors of postpartum hemorrhage have been widely published, however, its association with maternal anemia is inconsistent. This study aims to explore anemia as a risk factor for postpartum hemorrhage. Methods: A case control study was carried out with 69 women who experienced postpartum hemorrhage as cases and 207 women who had given birth but did not experience hemorrhage as controls. Cases and controls were taken from medical records at the dr. R. Soedjono Hospital, Selong, East Lombok District, West Nusa Tenggara. Cases were selected by systematic random sampling from 147 mothers who experienced postpartum hemorrhage during 2017. Controls were selected in the same way from 2,855 mothers who did not experience postpartum hemorrhage. Cases and controls were matched for birth weight of infants and maternal employment. Data were obtained by medical record extraction in May 2018 consisting of information on hemoglobin concentration, parity, age at pregnancy, birthing method, gestational age, birth spacing and length of labor. Data analysis was performed using logistic regression to determine the adjusted odds ratio (AOR) of anemia. Results: Characteristics of cases and controls were found to be similar in terms of infant birth weight, maternal occupation, parity, gestational age and length of delivery but statistically different by maternal age at pregnancy and birth spacing. Analysis with logistic regression showed that anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was a significant risk factor for postpartum hemorrhage with AOR=16.32 (95%CI: 7.69-34.64). Delivery through caesarean section (SC) or oxytocin drip was also found to significantly reduce the risk of postpartum hemorrhage (AOR=0.03; 95%CI: 0.01-0.13). Conclusion: Anemia during pregnancy with hemoglobin concentration ≤10 gr/dL was found to be a risk factor for postpartum hemorrhage. Prevention and control of anemia in pregnant women need to be enhanced to prevent postpartum hemorrhage.]]>
<![CDATA[Pharmacist counseling intervention to improve patient antibiotic compliance ]]>
<![CDATA[I Gusti Ayu Rai Widowati]]>;
<![CDATA[I Made Ady Wirawan]]>;
<![CDATA[Ni Made Sri Nopiyani]]>;
<![CDATA[Komang Ayu Kartika Sari]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p10
<![CDATA[Background and purpose: Reported microbial resistance to antibiotics is increasing. One of the main factors is patient noncompliance in use of antibiotics. The purpose of this study was to determine the effectiveness of pharmaceutical counseling in a pharmacy setting to increase compliance with antibiotic use. Methods: A randomized controlled trial was conducted on 104 adult patients aged 18 years and over who purchased antibiotics by prescription at a pharmacy in Denpasar City, Bali Province. Subjects were divided into intervention and control groups using block randomization method. The intervention group was provided with pharmaceutical counseling by a pharmacist, while the control group was provided drug information according to the pharmacy service standard. Subject compliance was measured by telephone interview using the Morisky Medication Adherence Scale-8 questionnaire within 3-5 days after purchasing the medication. Statistical analysis with the Mann Whitney U Test was performed to determine the difference in mean rank of compliance scores. Logistic regression analysis was conducted to determine the adjusted compliance ratio. Results: The number of subjects analyzed was 98, as five subjects could not be contacted by telephone and one subject was hospitalized. The mean rank of compliance scores in the intervention group (61.05) was significantly higher (p<0.01) than the comparison group (37.95). The proportion of compliance in the intervention group was 65.3% and the control group was 18.4%, with the proportion ratio (PR) of 3.56 (95%CI: 1.90- 6.64). Logistic regression analysis showed that variables which significantly increased compliance with antibiotic use were pharmacist counseling (APR=9.33; 95%CI: 3.24 26.87), frequency of taking medication (APR=6.94; 95%CI: 2.01-23.92) and method of payment (APR=4.30; 95%CI: 1.18-15.66). Conclusion: Pharmaceutical counseling at a pharmacy setting was found to increase compliance of antibiotic use. Compliance of antibiotic use is also influenced by the frequency of taking medication and the method of payment. Pharmacist counseling when accessing medication at a pharmacy is crucial for improving patient compliance of antibiotic use.]]>
<![CDATA[Association between handwashing practices and quality of toilets with diarrhea among under-five years children ]]>
<![CDATA[Yesvi Zulfiana]]>;
<![CDATA[Luh Seri Ani]]>;
<![CDATA[Ni Wayan Arya Utami]]>
<![CDATA[ Public Health and Preventive Medicine Archive Vol. 6 No. 2 (2018) ]]>
Publisher : <![CDATA[Universitas Udayana ]]>
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DOI: 10.53638/phpma.2018.v6.i2.p11
<![CDATA[Background and purpose: The incidence of diarrhea among underfive years children in Indonesia is considerably high. Studies exploring risk factors of diarrhea have been extensively conducted in Indonesia. However, the association between handwashing practices of the mother and quality of toilets with diarrhea among under-five years children are still inconsistent across studies. This study aims to examine the association between handwashing practices of the mother, quality of toilets and the episodes of diarrhea among under-five years children. Methods: A cross-sectional survey was conducted involving 104 under-five years children in Selagalas Village. Samples were selected using systematic random sampling. Data were collected in July 2017 by observation and face-to-face interviews using questionnaires. Bivariate analysis and logistic regression were conducted to examine the association between hand washing practices, quality of toilets and diarrhea among under-five years children. Results: We found more than half of under-five years children (64.42%) had experienced at least one episode of diarrhea over the last three months. We found a significant association between diarrhea with unhygienic toilets with an adjusted odds ratio (AOR) of 2.84 and poor handwashing practices of the mother with AOR of 2.46, however, both have a lower limit of AOR confidence interval that close to one, namely 95%CI: 1.05-5.97 and 95%CI: 1.03-5.87. Conclusion: Poor hand washing practices and unhygienic toilets are associated with the episodes of diarrhea among under-five years children, however, both have a low programmatic importance. Further study should be carried out to understand the association between handwashing practices and quality of toilets with diarrhea. Despite of the low programmatic importance, good hand washing practice should be promoted and access to toilets that meet the health standard must be enhanced.]]>
