Jurnal Berkala Epidemiologi

EVALUATION OF DIPHTHERIA SURVEILLANCE SYSTEM IN PROBOLINGGO DISTRICT: STUDY OF SYSTEM APPROACH AND ATTRIBUTES

Lidya Nur Maulina — 2025-05-31

Background: There is still an outbreak of diphtheria in the Probolinggo district in 2023. Diphtheria mainly affects children who are not immunized. Support through a surveillance system is needed to overcome the diphtheria problem. Purpose: This study aims to describe the quality of diphtheria surveillance systems based on system approach and surveillance attributes. Methods: Descriptive research was carried out on 17 samples with an evaluation study on the diphtheria surveillance system in 2023 at health centers in the working area of the Probolinggo District Health Office. Data were collected by interview and document study using questionnaires and check list sheets. Data analysis was carried out by describing the system components and attributes of the surveillance system in 17 respondents, compared with the Diphtheria control guideline book 2023, Indonesian Minister of Health Regulation No. 45 of 2014, and surveillance attributes from CDC. The information obtained was presented in the form of tables and narratives. Results: The evaluation of diphtheria surveillance system components (input, process, output) in Probolinggo District was done using surveillance guidelines. Meanwhile, the diphtheria surveillance system assessment based on attributes showed simplicity, flexibility, acceptability, representativeness, stability, and good data quality. However, the system is not yet sensitive, and timeliness is still low. Conclusion: The implementation of the diphtheria surveillance system has mainly been carried out well, supported by the completeness of several surveillance attributes. Optimizing the use of the Early Warning and Response System (EWS) application is necessary to improve the current surveillance system.

ADVERSE EVENTS FOLLOWING PENTAVALENT VACCINE ADMINISTRATION: A DESCRIPTIVE STUDY IN THE INDIAN CONTEXT

Roop Sharma — 2025-05-31

Background: Immunization is one of the best ways to prevent childhood diseases. The pentavalent vaccine protects against five serious illnesses with fewer injections. It is cost-effective and usually causes fewer adverse events following immunization (AEFI). However, there are still limited data on AEFI after giving the pentavalent vaccine, compared to giving the DPT, Hep-B, and Hib vaccines separately. Purpose: To determine the proportion and factors associated with adverse events following immunization with pentavalent vaccines. Methods: This was a descriptive study conducted at an immunization clinic in a tertiary care center in India between January 2023 and December 2023. The study population consisted of all infants attending the clinic for vaccination, and all eligible infants receiving pentavalent vaccines were included in the study. The study was done to understand the frequency and type of AEFIs and to ensure the vaccine safety. Results: A total of 93 infants were included in this study, and 264 adverse events were noted in our study. Fever was the most common presenting adverse effect (22.73 %), other adverse effects were pain at injection site (21.21%), swelling at injection site (15.53%), redness at site of injection (14.39%), 10.60% held their leg back due to pain, persistent crying (9.47%) and abscess formation (4.55 %.), and seizures (1.52%). Conclusion: Most of the adverse effects observed in present study were of mild nature and of non-serious type. No major AEFI or permanent damage was noted in our study. The benefits of vaccination far outweigh the risks.

THE INFLUENCE OF BODY MASS INDEX ON THE MENSTRUAL CYCLE IN ADOLESCENTS

Kurnia Dwi Artanti — 2025-05-31

Background: Imbalanced nutritional status in adolescents can affect the menstrual cycle. In 2018, the WHO stated that as many as 80% of women in the world have irregular menstrual cycles. More specifically, this condition is experienced by 11.70% of adolescents aged 15-19 years and 14.90% of women in urban areas. Purpose: To analyze the effect of body mass index (BMI) on the menstrual cycle in adolescents at Junior High School State 19 Surabaya. Methods: This quantitative research employed an observational analytic method with a case-control design at SMP Negeri 19 Surabaya. As many as 104 participants (52 cases with irregular menstrual cycles and 52 controls with regular cycles) were randomly selected in a 1:1 ratio. Data collection occurred from February to May 2024, and bivariate analysis was conducted using the Chi-square test. Results: This study showed that overall BMI had a significant effect on menstrual cycle regularity (p = 0.001). Students with normal BMI have a greater chance of experiencing regular menstruation than overweight/obese (OR = 4.694; 95% CI = 1.536 - 14.344; p = 0.007). Meanwhile, the categories of very thin (OR = 0.985; 95% CI = 0.235 - 4.127; p = 0.983) and underweight (OR = 0.433; 95% CI = 0.072 - 2.622; p = 0.363) did not show a significant influence on menstrual regularity (p > 0.05). Conclusion: Body mass index affects menstrual cycle regularity in adolescents. Maintaining nutritional status is important to minimize the risk of menstrual cycle disorders and ensure reproductive health.

SUSPECTED MEASLES AND IMMUNIZATION TRENDS BEFORE AND DURING COVID-19 IN EAST JAVA, INDONESIA

Munif Arifin — 2025-05-31

Background: Measles, caused by a virus belonging to the genus morbillivirus of the paramyxoviridae family, remains a global health challenge. The COVID-19 pandemic has affected measles prevention activities. Understanding measles characteristics before and during the pandemic is important to developing effective prevention programs. Purpose: This study aims to analyze measles suspects' epidemiological characteristics before and during the COVID-19 pandemic. Method: This study used a cross-sectional approach. The population in this study were all measles suspects before and during the COVID-19 pandemic. The data sources were the results of tracing measles suspects and the results of examination of BBLK Surabaya measles specimens (measles IgM) before the pandemic (2017-2019) and during the pandemic (2020-2022). The correlation test was carried out using Chi-square analysis. Results: The analysis results indicate the following p-values: age = 0.00, gender = 0.92, immunization status = 0.00, and test lab = 0.46. The findings showed a relationship between age and immunization status regarding suspected measles before and during the COVID-19 pandemic. However, there was no significant relationship between gender and lab results of suspected measles before and during the pandemic. Conclusion: There was a significant relationship between immunization status and age in measles suspects before and during the COVID-19 pandemic. Therefore, optimizing immunization coverage and ensuring immunization is carried out on time according to the specified age is necessary.

RELATIONSHIP BETWEEN CHARACTERISTIC PATIENT WITH RECURRENT CORONARY HEART DISEASE

Sri Haryuni — 2025-05-31

Background: Recurrent coronary heart disease (CHD) increases the risk of complications and mortality among hospitalized patients. Previous studies report a 58% mortality rate within one year of treatment and a 30% recurrence rate in CHD patients. Purpose: This study aimed to examine the relationship between patient characteristics and CHD recurrence. Methods: A retrospective quantitative study was conducted at Kediri City Regional Hospital. A total of 123 CHD patients were selected using proportional random sampling. Independent variables included age, gender, education, income, and knowledge, while the dependent variable was CHD recurrence. Data were analyzed using Chi-square tests and logistic regression. Results: Bivariate analysis showed significant associations between age (p = 0.000) and knowledge (p = 0.01) with CHD recurrence. No significant associations were found for income (p = 0.373), gender (p = 0.194), or education level (p = 0.983). Multivariate analysis confirmed age (p = 0.000, OR = 8.426, 95% CI: 3.266–21.736) and knowledge (p = 0.017, OR = 2.984, 95% CI: 1.215–7.33) as significant predictors of CHD recurrence. Conclusions: Older patients are at a significantly higher risk of CHD recurrence compared to younger ones. Additionally, patients with better knowledge about CHD are less likely to experience recurrence. These findings highlight the importance of age-specific and educational interventions in preventing CHD relapse.

SMARTPHONE USAGE AS A RISK FACTOR OF MYOPIA AMONG ELEMENTARY SCHOOL STUDENTS IN KEDIRI

Ladinna Amanda Sari — 2025-05-31

Background: Myopia is the inability to view distant objects. Most cases of myopia occur in school-age children. Working and studying from home due to the COVID-19 epidemic exacerbates myopia concerns. The Kediri City Health Office reports that school-age myopia cases rose in 2022. Purpose: This study aims to identify the risk factors of myopia related to smartphone usage among elementary school students in Kediri City. Method: This study is an observational study with a case-control approach. Random sampling is used in the sampling procedure. There were 144 participants: 72 students in the case group and 72 in the control group. Independent variables include smartphone duration, using a smartphone in a low-light environment, using a smartphone before sleep, and using a smartphone at an early age. Result: The study's findings revealed all factors were associated with myopia: smartphone duration (p-value = 0.001; OR = 4.5), using smartphone in low-light environment (p-value = 0.001; OR = 3.4), using smartphone before sleep (p-value = 0.001; OR = 3.3), and using smartphone in early age (p-value = 0.000; OR = 12. 4). Conclusion: This study shows that the duration of smartphone use of more than 3 hours increases the risk by 4.5 times, using a smartphone in low-light environment increases the risk by 3.4 times, using a smartphone before bed increases the risk by 3.3 times, and the risk of myopia increases 12.4 times for smartphone use at a younger age in elementary school students in Kediri City.

ANALYSIS OF TUBERCULOSIS PATIENT CHARACTERISTICS OF GORONTALO CITY HOSPITAL USING K-MEANS CLUSTERING METHOD

Made Hariadi Wijaya — 2025-05-31

Background: Tuberculosis (TBC) is a major health problem in Indonesia, especially in Gorontalo, with high spread due to poor ventilation, overcrowding, and unhealthy lifestyles. Purpose: To analyze the characteristics of TB patients in one of Gorontalo City's hospitals using K-Means Clustering. Methods: Data including age, gender, TBC history, HIV status, diabetes history, hypertension, drug resistance, drug side effects, and treatment results were analyzed for the number of clusters using the K-Means method because it is effective in grouping data based on similarity, easy to implement, and works well on large datasets. Results: The analysis resulted in three clusters. Cluster 0 (219 individuals): majority female (63.50%), mean age 45.37 years, low address score (0.49), low resistance and therapy (6.40%), no comorbidities, all experienced side effects (100%), and survival rate 4.10%. Cluster 1 (150 individuals): mean age 52.21 years, higher address score (0.77), resistance 7.30%, therapy 5.30%, comorbidities 100%, all experienced adverse events, and survival rate 4.70%. Cluster 2 (98 individuals): mean age 48.58 years, address score 0.65, very low resistance and therapy (2%), no side effects, 42.90% had comorbidities, and the highest survival rate (12.20%). Conclusion: Three clusters were obtained from the analysis using K-Means. Clustering supports specific interventions such as comorbidity management or intensive surveillance, improving TB control programs in Gorontalo.

FACTORS RELATED TO MENTAL HEALTH PROBLEMS IN BACHELOR STUDENTS OF PUBLIC HEALTH

Johannes Bastira Ginting — 2025-05-31

Background: Mental health is the ability to realize one’s potential and cope with the usual demands of daily life. Students in Public Health programs are especially at risk of developing mental health problems while studying as a result of academic stress. This study explored the factors related to mental health problems among the Bachelor of Public Health students at Universitas Prima Indonesia. Methods: This survey research is quantitative, and a cross-sectional design was employed. The population of this study was all Bachelor of Public Health students in the even semester of the year 2023/2024 at FKKGIK, Universitas Prima Indonesia. Primary data were collected using questionnaires, and secondary data included scientific articles and research papers published within the last 5-10 years. Univariate, bivariate, and multivariate data analysis was done. Results: The study found a positive correlation between academic pressure, interpersonal relations, learning strategies, social relations, individual motivation, group interactions, psychological well-being, and the severity of mental health problems among undergraduate public health students (p-value ≤ 0.05). However, the study's findings showed that gender, semester, place of residence, and psychological pressure have no relationship (p-value > 0.05). Conclusion: These results indicate that social and academic factors should be considered to promote students' mental health. Therefore, universities should design strategies to address these essential factors to support students’ mental health and learning achievements.

TUBERCULOSIS PREVENTIVE THERAPY AS A STRATEGY TO PREVENT AND CONTROL TUBERCULOSIS INCIDENCE 2010-2024: A BIBLIOMETRIC ANALYSIS

Yunita Sari — 2025-05-31

Background: Tuberculosis Preventive Therapy (TPT) is important in TBC control and elimination strategies at the individual and community levels. However, few studies have systematically mapped developing scientific themes and trends related to TPT, primarily through bibliometric analyses. Therefore, a comprehensive bibliometric study is needed to identify key research foci and gaps in the current TPT knowledge pool. Purpose: This study aimed to identify global research trends in TPT as a preventive strategy to reduce TBC incidence. Methods: This study used a systematic literature review approach and bibliometric analysis using Scopus and PubMed databases through the Publish or Perish (PoP) platform, publications from 2010 to 2024. The initial search yielded 266 articles, which were screened using Mendeley for abstracts and keywords, resulting in 109 relevant publications. Bibliometric analyses were then conducted using VOSviewer version 1.6.20. Results: IPT (Isoniazid Preventive Therapy) has a close relationship with Preventive therapy, tuberculosis, child, contact, and HIV. Other results also show that the number of publications discussing TPT from 2020 to 2024 has decreased from 23 to 2, and the latest research topics related to TPT were only found in 2019. Conclusion: Publications related to TPT from 2020-2024 continue to decline; therefore, it is necessary to revitalize research related to TPT, especially by exploring issues that have not been widely discussed, such as the implementation of TPT in high-risk groups other than children and PLHIV, such as people with chronic diseases, the elderly, and populations with limited access to health services.

ANALYSIS OF RISK FACTORS ASSOCIATED WITH DEPRESSION IN ELDERLY LEPROSY SURVIVORS IN TUBAN REGENCY

Itsna Jannatul Kamilah — 2025-05-31

Background: Leprosy is an infectious disease that has an impact on the physical, socioeconomic, spiritual, and psychological of sufferers with one example being depression. Purpose: This research aims to find the relationship between risk factors and depression in elderly leprosy survivors residing at the Leprosy Rehabilitation Center, Tuban. Methods: The research method used is analytical observational with a cross-sectional approach. The research population consists of 100 leprosy survivors at the Social Rehabilitation Unit for People with Chronic Illnesses, Nganget, Tuban. The total sample of the research is 64 respondents selected from the population using simple random sampling technique. The data analysis technique employed is the Chi-square test. Results: Most of the respondents had level 2 disability as much as 68.80% and as much as 65.50% experienced depression. The research findings indicate a relationship between the variables of gender (p=0.03; PR=1.49; 95% CI=1.00-2.21), level of disability (p=0.00; PR=2.26; 95% CI=1.08-4.71), disease perception (p=0.00; PR=2.05; 95% CI=1.27-3.31), self-stigma (p=0.00; PR=2.00; 95% CI=1.32-3.02), with depression among elderly leprosy survivors. Conclusion: The conclusion indicates that the factors of gender, level of disability, self-stigma, and disease perception have a significant relationship with depression in elderly leprosy survivors, while the factors of age, education level, and caregiver support are not related to depression in elderly leprosy survivors.

STRESS AND INADEQUATE FRUIT-VEGETABLE INTAKE AS MODIFIABLE RISK FACTORS FOR TYPE 2 DIABETES IN YOGYAKARTA

Solikhah Solikhah — 2025-05-31

Background: Type 2 diabetes mellitus (T2DM) remains a significant global public health issue, with rising prevalence, including in Indonesia. At the same time, numerous studies have investigated modifiable risk factors of T2DM. To date, stress, fruit, and green-leafy vegetable consumption as risk factors of T2DM remain limited. Purpose: This study investigated the association between stress, fruit, and green-leafy vegetable consumption with T2DM occurrence among individuals under the supervision of Kalasan Public Health Center, Sleman, Yogyakarta. Methods: A cross-sectional study was conducted among 356 registered outpatients selected through purposive sampling. Stress levels were measured using the WHO Self-Reporting Questionnaire, while fruit and vegetable consumption was assessed using the Indonesia Basic Health Research 2018 questionnaire. T2DM status was determined based on fasting blood sugar levels recorded in medical records and confirmed by a physician's diagnosis. Results: Stress was linked to a higher probability of T2DM (Adjusted Odds Ratio (AOR)=2.61; 95% CI=1.25–5.44). Consuming fruit and green-leafy vegetables 2–3 times per week was associated with a lower likelihood of having T2DM (AOR=0.27; 95% CI=0.13–0.56 and AOR=0.07; 95%CI=0.03–0.20, respectively). Conclusion: Stress increases the probability of T2DM. Fruit and green-leafy vegetable consumption 2-3 times per week was associated with a reduced likelihood of T2DM. These findings emphasize the need for targeted public health interventions promoting stress management and healthy dietary patterns strategies to mitigate T2DM risk in primary healthcare settings.

THE ROLE OF OLFACTORY FUNCTION AND MULTIMORBIDITY IN COGNITIVE IMPAIRMENT

Kevin Kristian — 2025-05-31

Background: As the population ages, the issue of cognitive impairment is becoming increasingly worrisome, especially with the rise in conditions like multiple chronic diseases and loss of smell among the elderly. Purpose: The goal of this research is to explore how multiple chronic diseases, sense of smell, and cognitive impairment are linked among the senior population. Methods: This study involved 128 individuals at a senior community in Jakarta with an average age of 68.34 years. The presence of multiple chronic diseases was determined by looking for highest prevalence of disease pairs, and the sense of smell was tested with an 8-smell test. Cognitive function was measured with the CERAD questionnaire, with a score below 52 indicating cognitive impairment. The analysis included Chi-square tests at a 95% confidence level. Results: The findings suggest a clear link between lower levels of education and cognitive impairment (p=0.018; OR=3.214), as well as between loss of smell and cognitive deterioration (p=0.049; OR=2.565). However, having more than three chronic diseases was found to significantly increase the risk of cognitive impairment (p=0.018; OR=2.678), but there was no significance to support that certain disease pairs were more likely to lead to cognitive impairment. Conclusion: This research underscores the significance of sense of smell and the presence of multiple chronic diseases, especially in greater numbers, as major risk factors for cognitive impairment in the elderly.