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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 9 Documents
 1 
Search results for , issue "Vol. 21, No. 1" : 9 Documents clear
Achieving and Sustaining Treatment Targets in Rheumatoid Arthritis: A Retrospective Cohort Analysis in Indonesia Fauzia, Fara; Hidayat, Rudy; Kusumo Wibowo, Suryo Anggoro; Sumariyono, Sumariyono; Parlindungan, Faisal; Ariane, Anna; Damanik, Johanda; Araminta, Abirianty Priandani; Damaratri, Suci
Kesmas Vol. 21, No. 1
Publisher : UI Scholars Hub

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Abstract

Achieving and sustaining low disease activity (LDA) and remission in rheumatoid arthritis (RA) remains challenging. This study examined the rates and predictors of LDA/remission and sustained LDA/remission in an Indonesian RA cohort. A retrospective study of newly diagnosed adult patients attending a rheumatology clinic in 2020-2021 was conducted. Patients were followed for 12 months to evaluate achievement of LDA/remission, defined as DAS28-ESR ≤3.2, and those meeting the target were observed for an additional 12 months to evaluate sustained LDA/remission. Cox regression was used to identify predictors of time to LDA/remission and loss of LDA/remission. Of 166 participants, 91 (54.8%) achieved LDA/remission, with a median time of 10 months. Among these, 39 (41.8%) maintained LDA/remission for 12 months. The median time to loss of LDA/remission was also 10 months. In multivariate analysis, no baseline variables (age, sex, rheumatoid factor (RF) positivity, disease activity, obesity, or disease duration) predicted achieving or sustaining LDA/remission. In this Indonesian cohort, over half of patients reached LDA/remission within 12 months. However, fewer than half sustained it over the following year, highlighting the need for ongoing monitoring and timely treatment adjustments, even after remission is achieved.
Balancing Education and Health Among Rural Schoolchildren During Prolonged Heat Wave in the Philippines Olapane, Elias
Kesmas Vol. 21, No. 1
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Intensifying heat waves disrupt learning environments in the Philippines, particularly in rural areas where schools often lack adaptive infrastructure. Many rural classrooms are built with heat-retaining materials, such as concrete, which trap excessive heat, leading to indoor temperatures exceeding safe comfort levels. These conditions lead to dehydration, fatigue, and reduced cognitive function, directly impairing students’ focus and academic performance. Schoolchildren are particularly vulnerable due to their developing thermoregulatory systems, higher metabolic demands, and potential preexisting health conditions. These risks are further amplified in rural communities with limited access to cooling, healthcare, and adaptive resources. These challenges require practical, context-specific interventions. Schools can adopt energy-efficient designs, improved ventilation, and passive cooling techniques to create safer indoor environments while reducing environmental and financial costs. Adjusting school schedules during periods of extreme heat can minimize exposure while minimizing disruption to education. Moreover, heat-health education programs can raise awareness and promote adaptive behaviors among students and families, thereby enhancing community resilience. Integrating climate change and heatwave preparedness into the curricula of the Commission on Higher Education and the Department of Education can equip learners with essential coping skills. Meanwhile, simple measures such as hydration protocols, shaded rest areas, and proper ventilation offer immediate protection for schoolchildren's health and learning outcomes.
The Role of Gynecologic Oncologists in Improving Survival Outcomes of Epithelial Ovarian Cancer: A Retrospective Cohort Study Hanafy, Widyorini LH; Dwipoyono, Bambang; Adisasmita, Asri C; Regina, Yosephine E; Lians, Airine S; Rahayu, Oktaviani P; Auwelia, Jane G
Kesmas Vol. 21, No. 1
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Epithelial ovarian cancer (EOC) is a leading cause of gynecological cancer mortality and is often diagnosed at an advanced stage, resulting in poor survival outcomes. Access to specialized gynecological oncology services has been associated with improved prognosis; however, data on its impact in Indonesia remain limited. This study aimed to evaluate the association between gynecologic oncologist (GO) services and disease-free survival (DFS) in patients with EOC. This retrospective cohort study included 76 patients with EOC who were treated at a national cancer hospital in Jakarta between 2015 and 2018. Patient data were obtained from medical records and followed for three years after the primary treatment. Survival outcomes were analyzed using the Kaplan-Meier curve and Cox proportional hazards model. The overall 3-year DFS rate was 41.6%. Patients treated by GO specialists had a higher DFS rate (54.3%) than those treated in hospitals without GO services (24.5%). Multivariate analysis showed a higher recurrence risk in patients treated without GO services (HR 2.75; 95% CI: 1.32 - 5.74). This study’s findings highlight the potential clinical benefits of facilitating early access to specialized GO care for patients with EOC.
Urban–Rural Disparities in Metabolic Risk Factors for Hypertension Among the Elderly in Indonesia Nugraha, Susiana; Wulandari, Puri
Kesmas Vol. 21, No. 1
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Hypertension remains a major public health challenge among the elderly in low- and middle-income countries. This cross-sectional study examined demographic and metabolic factors associated with hypertension among the elderly living in urban and rural areas of West and Central Java Provinces, Indonesia. This study included 1,920 adults aged ≥60 years who had resided in the study areas for at least six months, were able to communicate effectively, and provided informed consent. Data were collected between March and August 2023 using stratified multistage random sampling, structured questionnaires, and biochemical measurements. Multivariable logistic regression revealed distinct patterns of association across settings. In urban areas, hypertension was associated with older age (AOR =1.366; 95% CI: 1.043–1.789), female sex (AOR=1.681;95% CI: 1.198–2.359), central obesity based on waist circumference (AOR=2.031; 95% CI:1.477–2.793), and abnormal blood glucose levels (AOR=2.821; 95% CI: 1.754–4.536). In rural areas, hypertension was associated with older age (AOR=1.613; 95% CI: 1.228–2.119), lower education level (AOR=0.686; 95%CI:0.507–0.928), central obesity (AOR = 1.613; 95% CI: 1.204–2.161), and blood glucose levels (AOR=1.503; 95% CI: 0.978–2.310). These findings highlighted that while metabolic markers, such as waist circumference and blood glucose, were universal predictors, demographic factors, such as sex and education level, varied by environment. Consequently, public health interventions must adopt tailored, context-specific approaches to manage hypertension in urban and rural Indonesian communities effectively.
Factors Associated with Antiretroviral Therapy Adherence in Patients with HIV at a Public Hospital in Central Jakarta, Indonesia Fatimah, Kareena Sari; Hanifah, Laily; Simanjorang, Chandrayani; Fithri, Nayla Kamilia
Kesmas Vol. 21, No. 1
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Patients with human immunodeficiency virus (HIV) are required to take antiretroviral therapy (ART) to suppress the virus. However, suboptimal adherence remains a critical barrier that can lead to treatment failure and persistent transmission risks. This study aimed to identify factors associated with ART adherence in patients with HIV. This quantitative study with a cross-sectional design consisted of patients with HIV aged >18 years who received care at the voluntary counseling and testing clinic of a public hospital in Jakarta, Indonesia. Purposive sampling was used. This study used HIV care and ART overview forms as instruments. Data were analyzed using multiple logistic regression. The results showed that among 266 patients with HIV, 213 (80.1%) reported adherence to ART. This study found that age ≥44 years (adjusted POR 2.631; 95% CI 1.059–6.533), higher education level (adjusted POR 4.407; 95% CI 1.948–9.973), and CD4 count ≥200 (adjusted POR 2.593; 95% CI 1.219–5.517) were associated with higher adherence. Conversely, patients with an ART duration of 1–5 years (adjusted POR, 0.259; 95% CI, 0.100–0.673) and those who had never experienced drug side effects (adjusted POR, 0.108; 95% CI, 0.014–0.860) were less likely to be adherent. The dominant factor was the experience of drug side effects, suggesting that adherence should be enhanced through proactive counseling.
Factors Affecting Irritant Contact Dermatitis Among Horticulture Farmers in Semarang District, Indonesia Yuantari, Maria Goretti Catur; Haikal, Haikal; Susanna, Dewi
Kesmas Vol. 21, No. 1
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Irritant contact dermatitis is a common condition among farmers, but its underlying causes remain poorly understood. This study aimed to identify factors associated with irritant contact dermatitis among horticulture farmers in Semarang District, Indonesia. A cross-sectional survey was conducted among 427 farmers using a validated, reliable structured questionnaire. The results indicated complaints of dermatitis related to contact with irritants. Data were analyzed using the Chi-square test and logistic regression. Analysis revealed that sex, personal hygiene habits, education level, and the number of pesticide types used were significantly associated with irritant contact dermatitis. Female farmers were less likely to develop irritant contact dermatitis. Conversely, farmers with poor personal hygiene habits or lower levels of education were more likely to develop the condition. Farmers who used fewer types of pesticides had a lower risk of irritant contact dermatitis than those who used a greater variety. In conclusion, irritant contact dermatitis among farmers is influenced by both work-related exposures and hygiene practices. Improving personal hygiene habits and limiting the use of multiple pesticide types may help prevent irritant contact dermatitis under typical farming conditions.
Patterns of Tobacco Marketing and User Engagement on Social Media in Indonesia: Challenges for Digital Public Health Sutrisno, Resti Yulianti; Ekadinata, Nopryan; Sutantri, Sutantri; Binoriang, Dinasti Pudang; Aditjondro, Enrico; Rachfiansyah, Rachfiansyah; Rabindanata, Yosef; Dini, Silvia; Perl, Rebecca; Rachmawati, Riska; Wulandari, Bertha Tesma; Sugiyo, Dianita
Kesmas Vol. 21, No. 1
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Large-scale tobacco marketing on social media has resulted in widespread population-level exposure, particularly in Indonesia, which faces growing challenges in digital public health. This study aimed to assess the associations between platform type and marketing tactics and identify correlations of user engagement. An analytical cross-sectional study was conducted using secondary data from the Tobacco Enforcement and Reporting Movement (TERM), collected from January 2022 to August 2023. A total of 21,255 tobacco marketing posts from social media were analyzed. Platform–tactic associations were examined using Chi-square tests, and multivariable Poisson regression was used to identify factors associated with user engagement. The findings indicated that Instagram (66.8%) and Facebook (24.0%) accounted for the majority of tobacco marketing content. Community-based marketing was the most prevalent tactic (64.7%), followed by direct advertising (20.1%). Bivariate analysis demonstrated a significant association between social media platforms and marketing tactics (p-value <0.001). The Poisson regression model was statistically significant (p-value <0.001). Engagement varied substantially by platform. Compared to YouTube, TikTok demonstrated markedly higher engagement (OR = 35.8), followed by Instagram (OR = 1.88). Corporate social responsibility (OR = 2.39) and community-based marketing (OR = 1.70) were associated with higher engagement. Tobacco promotion on Indonesian social media employs platform-specific strategies to increase exposure and normalize consumption narratives. These patterns underscore substantial digital public health concerns and suggest that enforcement of digital TAPS remains inadequate. Therefore, relevant ministries should strengthen TAPS enforcement and expand targeted digital health education initiatives.
Low-Dose Prophylaxis Versus On-Demand Treatment for Children with Severe Hemophilia A in Indonesia: A Conceptual Model Khoe, Levina Chandra; Atika, Nur; Pertiwi, Dhia Ticha; Putri, Septiara
Kesmas Vol. 21, No. 1
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Hemophilia A is a rare bleeding disorder caused by a deficiency of clotting factor VIII, leading to recurrent bleeds, joint damage, and disability. Low-dose prophylaxis has been shown to achieve better clinical outcomes than on-demand treatment in reducing bleeding frequency. However, in Indonesia, access and affordability remain key challenges. This study aimed to develop a conceptual model for conducting a health economic evaluation of low-dose prophylaxis treatment for children with severe hemophilia A in Indonesia. This study followed the ISPOR-SMDM Modeling guidelines, outlining two-stage processes: conceptualization of the clinical problem and model development. A systematic literature review was conducted to identify relevant clinical and economic evidence on low-dose prophylaxis and on-demand treatment in pediatric hemophilia A. Indonesian clinical guidelines and expert input from two hematologists were incorporated to contextualize the model. Thirteen studies (three clinical and ten economic evaluations) consistently reported improved outcomes with low-dose prophylaxis. Most models applied health state transitions involving bleeding episodes, joint damage, complications, and death. Based on this review and discussion, the conceptual model was established to support the cost-effectiveness analysis of low-dose prophylaxis. A rigorous conceptual model serves as the key foundational step in developing a valid, health economic model for the Indonesian setting.
Short-Term Survival and Prognostic Factors in Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study Bundjali, Muhammad Trihatmowijoyo; Marbun, Maruhum Bonar Hasiholan; Rajabto, Wulyo; Rinaldi, Ikhwan; Shatri, Hamzah; Partiningrum, Dwi Lestari; Makmun, Dadang; Nugroho, Pringgodigdo; Koesnoe, Sukamto; Soewondo, Pradana
Kesmas Vol. 21, No. 1
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Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic blood pressure <110 mmHg (hazard ratio [HR] 3.354; 95% confidence interval [CI]: 2.346–4.795; p-value <0.001) and interdialytic weight gain ≥5% (HR 1.685; 95% CI: 1.125–2.521; p-value <0.011) as significant predictors of decreased survival. Other variables, including age, urea, albumin, vascular access, baseline creatinine, and cancer stage, were not significantly associated with short-term survival. These findings underscore the critical role of salt and fluid management, adherence to dietary and dialysis regimens, and close monitoring of weight in improving outcomes. Interventions targeting modifiable factors may improve the survival of cervical cancer patients who require HD. Such approaches, therefore, warrant further investigation.

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