Jurnal Berkala Epidemiologi https://e-journal.unair.ac.id/JBE <p><strong>Jurnal Berkala Epidemiologi</strong> <strong>or Periodic Epidemiology Journal (JBE)</strong><em> </em>is open access and peer-reviewed journal. It aims to publish original research or literature review related to the field of Epidemiology. It also publishes commentary articles written by epidemiologists who discuss the latest issues that occur in the world.</p> <p><strong>Jurnal Berkala Epidemiologi or Periodic Epidemiology Journal (JBE)</strong> was first published in May 2013 on an old website at <a href="http://journal.unair.ac.id/JBE@jurnal-berkala-epidemiologi-media-140.html" target="_blank" rel="noopener">http://journal.unair.ac.id/JBE@jurnal-berkala-epidemiologi-media-140.html</a>. In 2014, JBE used the open journal system (OJS) and the portal moved to <a href="https://ojs2.e-journal.unair.ac.id/JBE/" target="_blank" rel="noopener">https://ojs2.e-journal.unair.ac.id/JBE/</a>. The scope of <strong>JBE</strong> is Epidemiology of Communicable Disease, Epidemiology of Non-communicable Disease, Epidemiology of Tropical Disease, Epidemiology Surveillance, Outbreak Management, Epidemiology of Vaccine-Preventable Diseases, Epidemiology of Cancer, and Disaster Management. <strong>JBE</strong> is published three times (January, May, September) containing original article, literature review, or article commentary. Jurnal Berkala Epidemiologi is published by Faculty of Public Health, Universitas Airlangga.</p> <p><strong>Jurnal Berkala Epidemiologi or Periodic Epidemiology Journal (JBE)</strong> has been accredited as a 2<sup>nd</sup> Grade Scientific Journal (Sinta 2, Peringkat 2) by the Ministry of Science, Research, Technology and Higher Education of Indonesia (RISTEKDIKTI RI) since January 2019 <a style="font-size: 0.875rem;" href="https://e-journal.unair.ac.id/JBE/pages/view/Accreditation%20Certificate">(View certificate here)</a><span style="font-size: 0.875rem;"> with accreditation number: </span><a style="background-color: #ffffff; font-size: 0.875rem;" href="https://drive.google.com/open?id=1HMzDtTOKuoWiBpm1egx1YHgEYHdlO0xD" target="_blank" rel="noopener">3/E/KPT/2019.</a> <span style="font-size: 0.875rem;"> </span></p> <p>All articles in<strong> JBE, </strong>starting at 7<sup>th</sup> Volume, 2<sup>nd</sup> Issue, May 2019, have been published in English. Submissions are open year-round. Before submitting, please ensure that the manuscript is in accordance with JBE's <a title="Focus &amp; Sscope" href="https://e-journal.unair.ac.id/JBE/about#focusAndScope"><strong>focus and scope</strong></a>, written in English, and follows our <a title="Author Guidelines" href="https://e-journal.unair.ac.id/JBE/GFA"><strong>author guidelines</strong></a> and <a href="https://e-journal.unair.ac.id/JBE/DT"><strong>manuscript template</strong><strong>.</strong></a></p> en-US <ul><li>Every manuscript submitted to must observe the policy and terms set by the Jurnal Berkala Epidemiologi</li><li>Publication rights to manuscript content published by the Jurnal Berkala Epidemiologi is owned by the journal with the consent and approval of the author(s) concerned. <a title="COPYRIGHT TRANSFER AGREEMENT" href="https://drive.google.com/file/d/131CpPb7zgjFvQY_E5BCOUGqN4gNTrXKF/view" target="_blank">(download copyright agreement)</a></li><li>Complete texts of electronically published manuscripts can be accessed free of charge if used for educational and research purposes according to copyright regulations.</li></ul><p><a href="http://creativecommons.org/licenses/by-sa/4.0/" rel="license"><img src="https://i.creativecommons.org/l/by-sa/4.0/88x31.png" alt="Creative Commons License" /></a><br />JBE by <a href="/index.php/JBE/" rel="cc:attributionURL">Universitas Airlangga </a>is licensed under a <a href="http://creativecommons.org/licenses/by-sa/4.0/" rel="license">Creative Commons Attribution-ShareAlike 4.0 International License</a>.</p> jbe@fkm.unair.ac.id (Arief Hargono) kurnia-d-a@fkm.unair.ac.id (Kurnia Dwi Artanti) Sat, 31 May 2025 00:27:44 +0700 OJS 3.3.0.10 http://blogs.law.harvard.edu/tech/rss 60 EVALUATION OF DIPHTHERIA SURVEILLANCE SYSTEM IN PROBOLINGGO DISTRICT: STUDY OF SYSTEM APPROACH AND ATTRIBUTES https://e-journal.unair.ac.id/JBE/article/view/70181 <p><strong>Background: </strong>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. <strong>Purpose:</strong> This study aims to describe the quality of diphtheria surveillance systems based on system approach and surveillance attributes. <strong>Methods: </strong>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. <strong>Results: </strong>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. <strong>Conclusion: </strong>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.</p> Lidya Nur Maulina, Siti Shofiya Novita Sari; Abubakar Tarawally; Sholikah Sholikah, Retno Anjar Copyright (c) 2025 Lidya Nur Maulina, Siti Shofiya Novita Sari; Abubakar Tarawally; Sholikah Sholikah, Retno Anjar https://e-journal.unair.ac.id/JBE/article/view/70181 Sat, 31 May 2025 00:00:00 +0700 ADVERSE EVENTS FOLLOWING PENTAVALENT VACCINE ADMINISTRATION: A DESCRIPTIVE STUDY IN THE INDIAN CONTEXT https://e-journal.unair.ac.id/JBE/article/view/61205 <p><strong>Background:</strong> 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. <strong>Purpose:</strong> To determine the proportion and factors associated with adverse events following immunization with pentavalent vaccines. <strong>Methods:</strong> 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. <strong>Results:</strong> 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%). <strong>Conclusion:</strong> 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.</p> Roop Sharma, Bhanupriya Sharma, Yashu Saini, Ramesh Bairwa, Munish Kakkar Copyright (c) 2025 Roop Sharma, Bhanupriya Sharma, Yashu Saini, Ramesh Bairwa, Munish Kakkar https://e-journal.unair.ac.id/JBE/article/view/61205 Sat, 31 May 2025 00:00:00 +0700 THE INFLUENCE OF BODY MASS INDEX ON THE MENSTRUAL CYCLE IN ADOLESCENTS https://e-journal.unair.ac.id/JBE/article/view/70054 <p><strong>Background:</strong> 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. <strong>Purpose: </strong>To analyze the effect of body mass index (BMI) on the menstrual cycle in adolescents at Junior High School State 19 Surabaya. <strong>Methods: </strong>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. <strong>Results:</strong> 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 &gt; 0.05). <strong>Conclusion:</strong> 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.</p> Kurnia Dwi Artanti, Angelinasyarga Sutera Dewangga, Tazkia Azrielda Munib, Taufiq Hidayat Copyright (c) 2025 Kurnia Dwi Artanti, Angelinasyarga Sutera Dewangga, Tazkia Azrielda Munib, Taufiq Hidayat https://e-journal.unair.ac.id/JBE/article/view/70054 Sat, 31 May 2025 00:00:00 +0700 SUSPECTED MEASLES AND IMMUNIZATION TRENDS BEFORE AND DURING COVID-19 IN EAST JAVA, INDONESIA https://e-journal.unair.ac.id/JBE/article/view/64202 <p><strong>Background: </strong>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.<strong> Purpose: </strong>This study aims to analyze measles suspects' epidemiological characteristics before and during the COVID-19 pandemic. <strong>Method: </strong>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<strong>. Results: </strong>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.<strong> Conclusion: </strong>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.</p> Munif Arifin, Meilinda Alya' Putri Haryanik, Irma Prasetyowati Copyright (c) 2025 Munif Arifin, Meilinda Alya' Putri Haryanik, Irma Prasetyowati https://e-journal.unair.ac.id/JBE/article/view/64202 Sat, 31 May 2025 00:00:00 +0700 RELATIONSHIP BETWEEN CHARACTERISTIC PATIENT WITH RECURRENT CORONARY HEART DISEASE https://e-journal.unair.ac.id/JBE/article/view/64731 <p><strong>Background: </strong> 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. <strong>Purpose</strong>: This study aimed to examine the relationship between patient characteristics and CHD recurrence. <strong>Methods: </strong> 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. <strong>Results: </strong> 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. <strong>Conclusions: </strong> 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.</p> Sri Haryuni; Nurma Afiani; Abdurahman Wahid, Novita Ana Anggraini, Idola Perdana Sulistyoning Suharto, Indah Jayani Copyright (c) 2025 Sri Haryuni; Nurma Afiani; Abdurahman Wahid, Novita Ana Anggraini, Idola Perdana Sulistyoning Suharto, Indah Jayani https://e-journal.unair.ac.id/JBE/article/view/64731 Sat, 31 May 2025 00:00:00 +0700 SMARTPHONE USAGE AS A RISK FACTOR OF MYOPIA AMONG ELEMENTARY SCHOOL STUDENTS IN KEDIRI https://e-journal.unair.ac.id/JBE/article/view/62324 <p><strong>Background</strong>: 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. <strong>Purpose</strong>: This study aims to identify the risk factors of myopia related to smartphone usage among elementary school students in Kediri City. <strong>Method</strong>: 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. <strong>Result</strong>: 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). <strong>Conclusion</strong>: 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.</p> Ladinna Amanda Sari, Ari Udijono, Dwi Sutiningsih, Mohammad Arie Wurjanto Copyright (c) 2025 Ladinna Amanda Sari, Ari Udijono, Dwi Sutiningsih, Mohammad Arie Wurjanto https://e-journal.unair.ac.id/JBE/article/view/62324 Sat, 31 May 2025 00:00:00 +0700 ANALYSIS OF TUBERCULOSIS PATIENT CHARACTERISTICS OF GORONTALO CITY HOSPITAL USING K-MEANS CLUSTERING METHOD https://e-journal.unair.ac.id/JBE/article/view/67879 <p><strong>Background:</strong> Tuberculosis (TBC) is a major health problem in Indonesia, especially in Gorontalo, with high spread due to poor ventilation, overcrowding, and unhealthy lifestyles. <strong>Purpose:</strong> To analyze the characteristics of TB patients in one of Gorontalo City's hospitals using K-Means Clustering. <strong>Methods:</strong> 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. <strong>Results:</strong> 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%). <strong>Conclusion:</strong> 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.</p> Made Hariadi Wijaya, Siti Nur Rahmatiya Abas, Ahmad Fahrian Hipmi, Endang Darmawan, Woro Supadmi, Sugiyarto Surono Copyright (c) 2025 Made Hariadi Wijaya, Siti Nur Rahmatiya Abas, Ahmad Fahrian Hipmi, Endang Darmawan, Woro Supadmi, Sugiyarto Surono https://e-journal.unair.ac.id/JBE/article/view/67879 Sat, 31 May 2025 00:00:00 +0700 FACTORS RELATED TO MENTAL HEALTH PROBLEMS IN BACHELOR STUDENTS OF PUBLIC HEALTH https://e-journal.unair.ac.id/JBE/article/view/65258 <p><strong>Background:</strong> 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. <strong>Methods: </strong>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. <strong>Results: </strong>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 &gt; 0.05). <strong>Conclusion:</strong> 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.</p> Johannes Bastira Ginting, Styfani Karo-Karo, Hasnita Ayu Suntiarma Situmeang, Putri Mustika Ananda, Hartono Hartono Copyright (c) 2025 Johannes Bastira Ginting, Styfani Karo-Karo, Hasnita Ayu Suntiarma Situmeang, Putri Mustika Ananda, Hartono Hartono https://e-journal.unair.ac.id/JBE/article/view/65258 Sat, 31 May 2025 00:00:00 +0700 TUBERCULOSIS PREVENTIVE THERAPY AS A STRATEGY TO PREVENT AND CONTROL TUBERCULOSIS INCIDENCE 2010-2024: A BIBLIOMETRIC ANALYSIS https://e-journal.unair.ac.id/JBE/article/view/70886 <p><strong>ABSTRACT</strong></p> <p><strong>Background:</strong> Tuberculosis (TBC) is a contagious infectious disease that is the leading cause of death in the world. TPT is one of the ways that needs to be done as a strategy in controlling and eradicating TBC at the community and individual level.</p> <p><strong>Purpose:</strong> To identify research trends related to TBC preventive therapy (TPT) as a strategy to prevent and control TBC incidence. <strong>Methods:</strong> This study uses a systematic literature review approach and meta-analysis procedures, using Scopus and PubMed databases accessed through the Publish or Perish (PoP) platform, from 2010 -2024, totalling 266 literatures. The literature search was conducted in December 2024.&nbsp; Data analysis was carried out by filtering abstracts and keywords of literature using the Mendeley application which produced 109 literatures and bibliometric analysis using the VOSViewer 1.6.20 application. <strong>Results:</strong> 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 that discuss TPT from 2020 to 2024 has decreased from 23 to 2 publications and the latest research topics related to TPT are only found in 2019. <strong>Conclusion:</strong> Publications related to TPT from 2020-2024 continue to decline, therefore it is necessary to increase research or research related to TPT in order to provide more complete and extensive information for health agencies in conducting TPT programmes.</p> Yunita Sari, Atik Choirul Hidajah, Nur Sahiral Layaly, Fransisca Susilastuti Copyright (c) 2025 Yunita Sari, Atik Choirul Hidajah, Nur Sahiral Layaly, Fransisca Susilastuti https://e-journal.unair.ac.id/JBE/article/view/70886 Sat, 31 May 2025 00:00:00 +0700 ANALYSIS OF RISK FACTORS ASSOCIATED WITH DEPRESSION IN ELDERLY LEPROSY SURVIVORS IN TUBAN REGENCY https://e-journal.unair.ac.id/JBE/article/view/69085 <p><strong>Background:</strong>&nbsp;Leprosy is an infectious disease that has an impact on the physical, socioeconomic, spiritual, and psychological of sufferers with one example being depression. <strong>Purpose:</strong> This research aims to find the relationship between risk factors and depression in elderly leprosy survivors residing at the Leprosy Rehabilitation Center, Tuban. <strong>Methods:</strong> The research method used is analytical observational with a cross-sectional approach. The research population consists of 100 leprosy survivors at the UPT Rehabilitasi Sosial Bina Lara Kronis, 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. <strong>Results:</strong> Most of the respondents had level 2 disability as much as 68.8% and as much as 65.5% experienced depression. The research findings indicate a relationship between the variables of gender (p = 0.033; PR = 1.491; 95% CI = 1.005 - 2.214), level of disability (p = 0.003; PR = 2.265; 95% CI = 1.088 - 4.716), disease perception (p = 0.000; PR = 2.057; 95% CI = 1.277 - 3.312), self-stigma (p = 0.000; PR = 2.000; 95% CI = 1.322 - 3.026), with depression among elderly leprosy survivors. &nbsp;<strong>Conclusion:</strong> 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.</p> Itsna Jannatul Kamilah, Ulfa Mudia Sari, Lucia Yovita Hendrati Copyright (c) 2025 Itsna Jannatul Kamilah, Ulfa Mudia Sari, Lucia Yovita Hendrati https://e-journal.unair.ac.id/JBE/article/view/69085 Sat, 31 May 2025 00:00:00 +0700 STRESS AND INADEQUATE FRUIT-VEGETABLE INTAKE AS MODIFIABLE RISK FACTORS FOR TYPE 2 DIABETES IN YOGYAKARTA https://e-journal.unair.ac.id/JBE/article/view/69915 <p><strong>Background:</strong>&nbsp;Type 2 diabetes mellitus (T2DM) remains a major global public health concern, with its prevalence steadily increasing, including in Indonesia. While numerous studies have investigated modifiable risk factors such as obesity, smoking, and physical inactivity within primary healthcare settings, research on the influence of stress and dietary habits, particularly fruit and vegetable consumption remain limited. <strong>Purpose:</strong> This study investigated the association between stress, fruit and vegetable consumption, and other modifiable factors with T2DM occurrence among individuals under the supervision of Kalasan Public Health Center, Sleman, Yogyakarta. <strong>Methods:</strong> A cross-sectional study was conducted with a sample of 356 registered outpatients selected through purposive sampling. Stress levels were measured using the WHO Self-Reporting Questionnaire, while fruit and vegetable consumption were 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. <strong>Results:</strong> 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). <strong>Conclusion:</strong> Stress increased the probability of T2DM. Fruit and green leafy vegetable consumption 2-3 times per week was associated with a reduced likelihood of T2DM.&nbsp;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.</p> Solikhah Solikhah, Dedik Sulistiawan, Ratu Matahari, Widya Rahmawati, Dwi Sarwani Sri Rejeki Copyright (c) 2025 Solikhah Solikhah, Dedik Sulistiawan, Ratu Matahari, Widya Rahmawati, Dwi Sarwani Sri Rejeki https://e-journal.unair.ac.id/JBE/article/view/69915 Sat, 31 May 2025 00:00:00 +0700 THE ROLE OF OLFACTORY FUNCTION AND MULTIMORBIDITY IN COGNITIVE IMPAIRMENT https://e-journal.unair.ac.id/JBE/article/view/65169 <p><strong>Background:</strong> 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. <strong>Purpose:</strong> The goal of this research is to explore how multiple chronic diseases, sense of smell, and cognitive impairment are linked among the senior population. <strong>Methods:</strong> This study involves 128 individuals 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 were measured with the CERAD questionnaire, with a score below 52 indicating cognitive impairment. The analysis included chi-square tests at a 95% confidence level. <strong>Results:</strong> 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 significancy to support that certain disease pairs were more likely to lead to cognitive impairment. <strong>Conclusion:</strong> 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.</p> Kevin Kristian, Gennesia Vebriana, Nicholas Hardi, Yuda Turana, Yvonne Suzy Handajani Copyright (c) 2025 Kevin Kristian, Gennesia Vebriana, Nicholas Hardi, Yuda Turana, Yvonne Suzy Handajani https://e-journal.unair.ac.id/JBE/article/view/65169 Sat, 31 May 2025 00:00:00 +0700