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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 949 Documents
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Urban–Rural Disparities in Metabolic Risk Factors for Hypertension Among the Elderly in Indonesia Nugraha, Susiana; Wulandari, Puri
Kesmas Vol. 21, No. 1
Publisher : UI Scholars Hub

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Abstract

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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Abstract

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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Abstract

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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Abstract

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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Abstract

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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Abstract

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.
Resilience and Social Support on Depression Risk for Chronic Obstructive Pulmonary Disease Patients in South Tangerang, Indonesia Menaldi, Adhityawarman; Asih, Sali Rahadi; Mardhiyyah, Farah Ainul
Kesmas Vol. 21, No. 2
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Chronic obstructive pulmonary disease (COPD) is a major public health concern with psychosocial impacts, such as reduced resilience and depression. This study examined the moderating role of perceived social support on the relationship between resilience and depression among individuals diagnosed with COPD in South Tangerang, Indonesia. A quantitative cross-sectional study was conducted between January and February 2024 using self-administered questionnaires. Participants were adult patients with clinically diagnosed COPD, recruited from all public health centers (PHC) in South Tangerang. A total of 125 participants met the inclusion criteria and were included in the analysis. Participants had a mean age of 41.46±15.69 years, with a balanced distribution (51.2% male, 48.8% female). Descriptive analysis showed high resilience (mean = 29.27±7.20), very high social support (mean = 70.36±14.47), and depression scores (mean = 4.65±4.59) below the cutoff. Moderation regression analysis using Hayes’ PROCESS Model 1 showed that resilience, with perceived social support as a moderator, explained 18% of the variance in depression scores (R² = 0.1807). These findings emphasized the importance of integrating psychosocial factors into COPD management. Strengthening resilience and social support within PHC settings may enhance mental health outcomes among COPD patients.
Knowledge, Attitudes, and Practices Among Hepatitis B Patients in Jakarta, Indonesia: A Cross-Sectional Study Arkok, Hashem S.; Wahyono, Tri Yunis Miko; Prihartono, Nurhayati Adnan; Aldila, Dipo
Kesmas Vol. 21, No. 2
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Abstract

Hepatitis B remains a major public health problem in Indonesia. This study assessed the knowledge, attitudes, and practices (KAP) of hepatitis B patients in Jakarta to identify gaps in prevention and control and to explore relationships among KAP components. A cross-sectional study was conducted among 128 patients at a government hospital in South Jakarta, using a structured questionnaire that collected demographic information and assessed knowledge, attitudes, and practices regarding hepatitis B transmission and prevention. Despite moderate knowledge levels, major gaps remained. Only a small proportion (10.9%) correctly identified common symptoms, transmission routes (10.2%), and possible complications (18.8%). Misconceptions about transmission and vaccine safety were common, although attitudes toward early diagnosis and treatment were generally positive. Practices also fell within a moderate range; notably, 46.1% of respondents still shared personal items that could facilitate transmission. Higher education, vaccination, income, and awareness participation were associated with better knowledge, attitudes, and practices. There were positive correlations among knowledge, attitude, and practice scores, indicating that better knowledge may lead to improved behaviors. In conclusion, the study reveals persistent misconceptions and behaviors that continue to place hepatitis B patients at risk, despite generally positive attitudes toward care.
Development and Validation of an Indonesian Questionnaire for Assessing Paracetamol Self-Medication Knowledge, Attitude, and Practice Putri, Widyana Sagita; Sauriasari, Rani; Septyowati, Priharika
Kesmas Vol. 21, No. 2
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Abstract

Paracetamol is a widely used over-the-counter medicine for self-medication and is often perceived as completely safe. However, inappropriate use may result in hepatotoxicity and other adverse effects, particularly at high doses. This study aimed to develop and validate a questionnaire to assess the general Indonesian population’s knowledge, attitude, and practice (KAP) regarding paracetamol self-medication. The validation procedure consisted of three stages: content, face, and construct validation. Three experts assessed the relevance of the items using the Content Validity Index, and five respondents were interviewed to assess the linguistic clarity and comprehensibility of the questions. Construct validity and reliability were assessed in 30 participants using Pearson’s correlation and Cronbach’s alpha. All items obtained excellent relevance scores. The final questionnaire demonstrated acceptable validity and reliability after revising and removing two low-performing practice items (P3 and P4), with Pearson’s correlation coefficients exceeding the r-table threshold (0.361) and Cronbach’s alpha values of 0.766, 0.734, and 0.640 for the KAP domains, respectively. The final instrument, comprising 20 items (10 knowledge items, 6 attitude items, and 4 practice items), was deemed suitable for assessing public KAP regarding safe self-medication with paracetamol.

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