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Background: Anemia is a condition characterized by low levels of hemoglobin (Hb) from normal limits. Anemia is still a public health problem. Data states that the prevalence of anemia in Indonesia in 2013 was 21.7%, with the number of sufferers known to be higher in women than men. The prevalence of anemia in the age range 15 to 24 years was 18.4%. Nutritional status shows the balance of nutrients due to the consumption, absorption, and use of nutrients that come from food in the body. A person's nutritional status can be said to be deficient if the body lacks intake of one or more essential nutrients for the body. One of the indicators for assessing a person's nutritional status is the Body Mass Index (BMI). Inadequate nutritional status will affect the nutritional status of iron in a person' s body so that it can be interpreted that nutritional status is one of the factors of anemia. Consuming foods with good nutritional value, especially foods that contain high iron will also affect the nutritional status of these adolescents so that the risk of suffering from anemia will decrease. Objective: This study aims to analyze the relationship between body mass index and anemia among young women in Indonesia. Methods: This study is a cross-sectional study. The data used are secondary data from the Indonesian Family Life Survey (IFLS) 5. The population of this study was all Indonesians who participated in IFLS 5. The sample used in this study amounted to 3,525 respondents. IInclusion criteria of this study included female, aged 10-18 years, unmarried, having complete data regarding body weight, height and hemoglobin measurement results. If data related to the measurement results of hemoglobin, body weight, height are incomplete, they will be excluded.The statistical test was used is a chi-square test. Results: There was a relationship between Body Mass Index (BMI) and anemia among young women in Indonesia (p = 0.034

Tuberculosis (TB) can infect all age groups, even children. Three provinces in Indonesia namely West Java (14%), Papua (13%), and Bangka Belitung provinces (11%) have the highest proportion of children with TB disease. Some previous research reveals that there is a relationship between exclusive breastfeeding and BCG immunization status of children with TB disease. This current study identified the increasing trend of children (aged 0-14 years) with TB disease in Bangka Belitung province based on the coverage of exclusive breastfeeding and BCG immunization. It was observational research with a cross-sectional design. Data were retrieved from seven districts/cities in Bangka Belitung province in 2015-2017. The unit of analysis was the number of overall TB cases, the percentage of BCG immunization coverage, and exclusive breastfeeding. The data were analyzed using the Health Mapper application version 4.3.0.0 with product version 4.03. The number of children (aged 0-14 years) with TB disease increased from 2015-2017, and BCG immunization coverage and exclusive breastfeeding decreased in 2015-2016 only, but swelled in 2016-2017. The number of TB cases was still high despite the high coverage of exclusive breastfeeding and BCG immunization. Several factors such as the quality of vaccines and exclusive breastfeeding might influence the prevalence of TB in children. Future studies should employ more variables to garner more references.

Diphtheria is an acute disease that attacks the airways and causes deaths. The risk factors for diphtheria are low Diphtheria-Pertussis-Tetanus (DPT) immunization coverage and an unhealthy home environment. One effort to control diphtheria is by providing information in the form of the patient's location that makes it easier to determine the target group of people intervened. The city of Surabaya experienced an increase of 50 diphtheria cases from 2017 to 2018. This study aimed to map and analyze diphtheria cases based on DPT immunization and healthy homes from 2017 to 2018 in the city of Surabaya. This study was classified descriptive analytic and used an ecological design. This study used the Pearson's correlation coefficient statistical test to analyze secondary data from the Surabaya City’s Health Profile of 2017 to 2018. This study employed the Health Mapper 4.3.0.0 application and SPSS software version 23. The study variables were diphtheria cases, DPT immunization coverage, and the percentage of healthy homes in 2017 and 2018 in Surabaya. The results of the statistical test indicated that there was a moderate relationship between DPT basic immunization coupon with the number of diphtheria cases in 2018 (p = 0.007; OR = 0.471); while the percentage of healthy homes and the number of diphtheria cases in 2018 showed a strong correlation (p = 0.002; OR = 0.544). The city experienced an increase in the number of diphtheria cases from 2017 to 2018, as well as the rise in DPT immunization coverage and the percentage of healthy homes, which tended to be stagnant. DPT immunization coverage and the percentage of healthy homes based on the 2018 data were related to the number of diphtheria cases in Surabaya. Counseling for the people in the city should be conducted to ensure that their children get DPT immunization and maintain environment cleanliness for a healthy home.

Early Awareness of Extraordinary Events of Dengue Hemorrhagic Fever (DHF) was asked to community (n= 130). Precautions were measured based on community knowledge, attitudes, and behavior. Knowledge, attitude, and behavior are constructs (in the form of a composite variable) from an early awareness of DHF outbreak. The result showed that the knowledge related to the transmission factor and the proliferation of dengue disease was quite good (72.3%). The DHF risk control was also good (93.9%) while the dengue fever eradication was still poor (67.7%). However, the attitude showed that it is still not ready to act on the basis of consciousness. Meanwhile, the results of the data analysis identified that the model of the early awareness measurement on DHF outbreak which consisted of construct variables (knowledge, attitude, and action) were a perfect fit. Based on the measurement model, the level of community awareness on DHF disease can be measured. This showed that the level of early awareness of DHF disease was good 76.2% and only 3.8% were less alert. This means although the less alert percentage is quite small, if people have an attitude of indifference to the prevention of DHF then the impact will affect a wider community.

Background: The program for finding pneumonia cases as an effort to prevent and control infectious diseases in Jombang is getting better. Risk factors for pneumonia in infants include complete basic immunization (IDL) status and nutritional status in infants. Complete basic immunization coverage in Jombang has met the Ministry of Health Strategic Plan 2015-2019 target of 80%, however pneumonia cases continue to occur and have continued to increase for the past 3 years. Objectives : Observing the trend between complete basic immunization coverage and cases of malnutrition with the incidence of pneumonia in children under five in Jombang Regency during 2015, 2016, 2017 and describe the distribution of cases in the form of maps. Methods: This type of research is descriptive by describing in the form of a map. The population in this study were all children under five in Jombang. Data was taken from the Jombang health profile in 2015, 2016 and 2017. Data management uses the Health Mapper application version 4.3.0.0 with product version 4.03. Results: The trend of the incidence of pneumonia with IDL coverage in Jombang in 2015-2017 shows, an increase in pneumonia cases in infants accompanied by a decrease in IDL coverage. This incident occurred in 19.04% in Jombang, specifically in Mojoagung, Sumobito, Ploso and Plandaan. While the increase in pneumonia was accompanied by an increase in cases of malnutrition occurred in 23.8% of the districts namely Ngoro, Mojowarno, Bareng, Sumobito and Plandaan. Conclussions: During 2015, 2016 and 2017 the incidence of pneumonia tends to increase followed by a decrease in IDL coverage and an increase in cases of malnutrition. ABSTRAK Latar Belakang: Progam penemuan kasus pneumonia sebagai upaya pencegahan dan pengendalian penyakit menular di Jombang semakin membaik. Faktor risiko dari pneumonia pada balita diantaranya adalah status imunisasi dasar lengkap (IDL) dan status gizi pada balita. Cakupan IDL di Kabupaten Jombang telah memenuhi target Renstra Kementrian Kesehatan tahun 2015-2019 sebanyak 80%, namun demikian kasus pneumonia tetap terjadi serta terus mengalami peningkatan selama 3 tahun tersebut. Tujuan: Melihat kecenderungan antara cakupan IDL dan kasus gizi buruk dengan kejadian pneumonia pada balita di Kabupaten Jombang selama tahun 2015, 2016, 2017 serta menggambarkan persebarannya dalam bentuk peta. Metode: Jenis penelitian ini adalah peneltian deskriptif dengan menggambarkan dalam bentuk peta. Populasi dalam penelitian ini adalah seluruh balita di Kabupaten Jombang. Data diambil dari profil kesehatan Jombang pada 2015, 2016 dan 2017. Manajemen data menggunakan aplikasi Health Mapper versi 4.3.0.0 dengan versi produk 4.03. Hasil: Kecenderungan kejadian pneumonia dengan cakupan IDL di Jombang pada tahun 2015-2017 menunjukkan terjadi peningkatan kasus pneumonia pada balita disertai dengan penurunan cakupan IDL. Kejadian ini terjadi di 19,04% kecamatan di Jombang tepatnya kecamatan Mojoagung, Sumobito, Ploso dan Plandaan. Sedangkan peningkatan pneumonia disertai dengan peningkatan kasus gizi buruk terjadi di 23,8% kecamatan yaitu Kecamatan Ngoro, Mojowarno, Bareng, Sumobito dan Plandaan. Kesimpulan: Selama tahun 2015, 2016 dan 2017 kejadian pneumonia cenderung mengalami peningkatan yang diikuti dengan penurunan cakupan IDL serta peningkatan kasus gizi buruk.

Background: A large proportion of cancer deaths are caused by patient delay in accessing hospital treatment. One of the causes of such delays is the use of alternative medicine. Purpose: This research is conducted to determine the characteristics and factors related to the behavior of seeking treatment in the form of alternative medicine among cancer patients at the Indonesian Cancer Foundation (Yayasan Kanker Indonesia). Methods: This research is a quantitative descriptive research with a cross-sectional study design. The target of the research is all patients who temporarily stayed at the Yayasan Kanker Indonesia from February–April 2020, a total of 45 patients aged ≥ 17 years who had been diagnosed with cancer. The data was obtained via questionnaires and interviews. The variables examined are the predisposition factors (sex, age, education, occupation, stage of cancer, time ranges for accessing health services after symptom onset, prior illness, family history), enabling factors (distance to health services, income, health insurance), and reinforcing factors (family support and information resources). Analysis of research data was conducted using frequency tables and Chi-Square or Fisher's Exact test. Results: The factors related to the behavior of seeking treatment via alternative medicine in cancer patients at Yayasan Kanker Indonesia are the stage of cancer (p=0.04), the time span between symptom onset and checking into health services (p=0.02), and length of illness (p=0.03). Conclusion: Alternative treatment search behavior is influenced by several factors, namely the stage of cancer, the time span between symptom onset and checking into health services, and the length of illness.

Latar Belakang: Tuberkulosis (TB) masih terus menjadi endemik di berbagai wilayah di dunia, termasuk di India, penilaian klinis, pengujian, pelacakan kontak, konfirmasi diagnosis dengan rejimen pengobatan yang diawas. Pemberantasan yang efektif menjadi salah satu penyakit yang penanggulangannya menjadi komitmen global dalam SDGs. M enunjang keberhasilan program penanggulangan TB diperlukan adanya data epidemiologi penyakit TB yang dapat diperoleh melalui kegiatan surveilans epidemiologi TB . Tujuan : mengetahui gambaran dan evaluasi komponen system dan atribut surveilans TB di Dinas Kesehatan Kabupaten Blitar tahun 2018. Metode : penelitian ini merupakan penelitian kualitatif dengan rancang studi evaluasi. Evaluasi sistem surveilans di Dinas Kesehatan Kabupaten Blitar di lakukan dari April – Juni 2018 dan data. Evaluasi system surveilans program TB dilakukan dengan wawancara untuk memperoleh informasi. Hasil: Berdasarkan komponen sistem surveilans diperoleh bahwa Pengumpulan data yang dilakukan petugas kesehatan dianggap mudah mulai dari alur pengumpulan data, pengisian formulir hingga alur pelaporan walaupun dalam pengiriman laporan masih ada Puskesmas yang terlambat dalam proses pengiriman ke aplikasi SITT . Proses analisis hanya dilakukan ditingkat Dinas Kesehatan, sedangkan ditingkat Puskesmas tidak dilakukan analisis. Pada komponen output, umpan balik yang dilakukan Dinas Kesehatan Kabupaten adalah dengan melakukan monitoring mengenai pengumpulan data serta pengiriman laporan melalui aplikasi Whatssapp dan melakukan miniloka setiap 3 bulan . Kesimpulan: Sistem surveilans TB di Kabupaten Blitar masih memerlukan perbaikan dalam pelaksanaannya dalam hal pengumpulan data, analisis data, ketersediaan pedoman surveilans TB hingga pengetahuan petugas terkait dengan surveilans TB .

The number of cases of breast cancer is increasing every year and it’s a serious health problem in the world, including in Indonesia. Breast cancer is type of cancer that is most dominant in Indonesia. High estrogen exposure is one of factor that can increase the risk of breast cancer in women. This study was conducted to determine the relationship of estrogen exposure through the use of hormonal contraceptives and age of menarche with breast cancer incidence in women. Type of this study is observational analytic and use case control design. All of women breast cancer patients of Dr. Soetomo Hospital in 2013 were the population of case. All of woman non breast cancer patients who done breast examination at Dr Soetomo Hospital in 2013 were the population of control. The number of respondents in this study were 90 respondents were drawn from population using simple random sampling method. The variables studied were the use of hormonal contraceptives and age of menarche. The results of the analysis used binary logistic regression (α = 5%) indicated that the use of hormonal contraceptives (p = 0,028; OR = 3,266) and age of menarche (p =0,031; OR = 3,492) has an significant correlation with incidence of breast cancer in women at Dr. Soetomo Hospital in 2013. It is expected that the community can be more accurate in determining the duration of hormonal contraception usage and avoid lifestyle can accelerate the occurrence of menarche.Keywords: breast cancer, risk factor, hormonal contraceptives, age of menarche, estrogen

Background: According to the World Health Organization (WHO), Indonesia is one of the ten countries with the most significant number of measles cases in the world. Immunization coverage in Trenggalek Regency has reached the target of prevention of measles in the elimination stage, namely measles immunization coverage> 95%, the incidence of measles persists and increases in the last three years, from 2013 to 2015. Purpose : This study aim ed to evaluate the trends between measles immunization status and the provision of vitamin A with the incidence of measles in Trenggalek Regency. Method s : This type of research is an observational study with a cross-sectional study design. The sample population is consist of 14 sub-districts in Trenggalek Regency. Data was taken from the health profile of Trenggalek Regency in 2013, 2014, and 2015. In this study, data processing were analysed by Health Mapper application version 4.3.0.0 with product version 4.03 to determine data descriptively. Results: Distribution of measles incidence with immunization coverage in Trenggalek Regency in 2013, 2014, and 2015 showed that measles incidence tended to increase followed with the decreasing number of measles immunization coverage each year. Ironically, the distribution of measles incidence with vitamin A administration in 2013, 2014, and 2015 showed the incidence of measles had increased because of the inconsistent amount of vitamin A administration. Conclusion: Measles incidence tends to occur in low immunization coverage areas and has decreased from the previous year. Giving vitamin A does not prevent the occurrence of measles, but serves to reduce compilation.

Traffic accidents are a health problem in both developed and developing countries including Indonesia. Number of traffic accidents each year has increased and traffic accidents in Indonesia is considered by WHO as the third biggest killer after coronary heart disease and tuberculosis. Most traffic accidents involving motorcyclists and the current junior high school students are also involved as a perpetrator of the accident. This study was conducted to determine the relationship of knowledge, the use of traffic lane and the driving speed with the incidence of traffic accidents in junior high school students motorcyclists. Type of research is analytic observational cross-sectional study design. The study population was all junior high school students in Wonokromo Surabaya in 2015. The number of respondents in this study of 100 respondents drawn from the population by using two stage cluster random sampling. The variables studied were knowledge, the use of traffic lane and the driving speed. Results of analysis using chi square test (α = 5%) indicate that knowledge (p = 0,027; RR = 1,966), the use of traffic lane (p = 0,005; RR = 1,894) and the driving speed (p = 0,017; RR = 1,941) has a significantly relationship to the incidence of traffic accidents to junior high school students motorcyclists in Wonokromo sub-district Surabaya 2015. Especially under age children of junior high school student are encouraged to not ride a motorcycle before age sufficient and have a driver’s licence. Beside that, the role of parents to prevent underage motorcyclists is needed to support the efforts of the police and schools in minimizing the number of accident to reduce the number of junir high school student involved in a motorcycle accident.Keywords: traffic accident, risk factors, knowledge, traffic lane, speed

P r eeclampsi a is a hypertensive disorder in pregnancy which is accompanied by edema and proteinuria. This study aimed to analyze the characteristic of mothers, ANC visits and compliance maternity care of preeclampsia in dr. Mohamad Soewandhie Surabaya. This study is using case control with quantitative approach. Samples are 70 people who were taken by simple random sampling method with the distribution of samples 35 cases and 35 controls. The independent variables were age, history of hypertension, history of preeclampsia, primigravida, ANC and compliance of maternity care (provision of preeclampsia information, sources of information, advisory and compliance to suggestions). Data analysis was performed using Chi-Square test. The results showed that the variables are age-related (p = 0.014; OR 5.167), history of preeclampsia (p = 0.000), compliance of maternity care which includes the provision of preeclampsia information (p = 0.000), resources (p = 0.000; OR 0.045 ), provision of advice (p = 0.000; OR 0.015) and compliance of mother to advice (p = 0.000; OR 0.028). Unrelated variables is a history of hypertension (p = 0.198; OR 5.667), primigravida (p = 0.791; OR 0.755), and ANC (p = 0.733; OR 1.603). To reduce the occurrence of severe preeclampsia health workers are expected to be motivating mothers to provide relevant health education and knowledge relevant to the prevention of preeclampsia on the safe age to get pregnant and give birth, how to maintain their health with proper diet, adequate rest, regular medication given, examination timetable next ANC and other suggestions which is may help prevent or reduce the risk of preeclampsia. Keywords: preeclampsia, age, history of preeclampsia, compliance

Osteoarthritis represent disease at most found in the world, including in Indonesia. This disease cause pain in bone and disability at patient so disturb everyday activity. One of removed occurrence of knee Osteoarthritis was obesity. Other factors like age, gender, physical activity, and habit smoke were risk factors of knee Osteoarthritis . This research was the relationship of obesitas and individuals factors with occurrence knee osteoarthritis at Surabaya Islamic Hospital. The methods of this research was an observation with case control design. Level of sampel was 64 which consist of 32 case group and 32 control group from incomed patient to radiology unit Islamic Hospital Surabaya for X-Ray photo. The dependent variable was occurence of knee osteoarthritis . The independent variables were obesity, gender, age, physical activity, habit smoke. The instrument used was a questionnaire and form BMI measurement. Data analysis used Chi-Square test with α=0,05 and to know oods ratio (OR) used statclac. The results showed significant relationship between occurence of knee osteoartritis with obesity (p=0,001,OR=7,20), age (p=0,012,OR=3,67) , gender (p=0,005,OR=4,69). For the characteristic of habit smoke (p=0,268,OR=0,56) and physical activity (p=0.919,OR=0,71) were’nt associated with occurence of knee Osteoarthritis at Surabaya Islamic Hospital. The conclusion there is relationship between obesity with knee osteoarthritis at Surabaya Islamic Hospital. Risk factor knee osteoarthritis like gender and age also there were relation with occurence of knee osteoarthritis , for the risk factor of physical activity and habit smoke were’nt relation with occurence of knee osteoarthritis. Keyword : Knee osteoarthritis, obesity, individual factors

Human Immunodeficiency Virus (HIV) is a virus that may degrade human immune system. This is resulting from interaction between agent, host, environment. Viewed from year to year, case of HIV-AIDS on all parts of world is keep increasing, therefore this disease become health problem feeling concerned about to the society, because beside the vaccine and drug for the prevention of this not yet been found, this disease not generate symptom during its natural history. The objectives of this research were to analyze high risk sexual behavior causing HIV to the drivers of public transportation in Sub-Province Sidoarjo Those were sexual couple during last month, frequency of intercourse with another during last one mont, and usage of condom when doing intercourse with another. This was cross sectional study with the population were all drivers of public transportation who come to follow Voluntary Counseling and Testing (VCT) examination. There were 62 respondents who came to follow it. Data collection was conducted through interview, admission filling of questionnaire and observation. The results than studied by using existing theory. The result of this research showed that any 5% of drivers with positive result of HIV, with risk behavior 22,8% doing intercourse with wife and whore, 4,8% with whore only, 62,9% of them were not use condom while doing intercourse. to reduce risk exposed to HIV, it is recommended to increase their knowledge and give motivation about contagious risk of HIV.Keywords: Human Immunodeficiency Virus (HIV), the number of couple, sexual frequency, condom utilization, public transportation driver

The rapid progress of development in Indonesia have an impact on increasing life expectancy thus increasing the number of elderly. Elderly is the final stage of life so often experienced various changes and disturbances, one of which is a sleep disorder or Insomnia. The prevalence of insomnia in the elderly is quite high, more than 60% but the appearance of this disorder is often overlooked. This study was conducted observational case-control study design. Research sites in the Pelayanan Sosial Lanjut Usia Jombang and performed on 40 elderly people. The study population was divided into 2, 20 people population cases and 20 people population control. The variables studied were depression, chronic disease, sleep hygiene and Insomnia. Most of the elderly suffering from Subtreshold Insomnia with Difficulty Initiating Sleep symptoms are severe. Early Morning Awakening is the least symptom experienced by the elderly. Depression (OR = 22,667), chronic disease (OR = 6.926) and sleep hygiene (OR = 11,000) showed a significant association with Insomnia. The conclusion that can be drawn is perpetuating factors (chronic disease) and precipitating (sleep hygiene) plays a role in the emergence of insomnia in the elderly. The advice given is to take action to control chronic diseases and more attention on sleep disorders experienced by the elderly. In addition, the need for action to improve and enhance sleep hygiene.Keywords: depression, sleep hygiene, chronic disease, insomnia, elderly

Malaria is a public health problem that can affect infant mortality, under five, pregnant women and can reduce productivity. The annual parasite incidence from 2008 antil 2011showed malaria morbidity in Sumbawa district remain high. The Purpose of this study was to describe the implementation of Malaria Surveillance System at the District Health Office Lombok Sumbawa Besar. This study used a descriptive survey method. Subjects were malaria surveillance officer in district Health office, health centers, and hospitals. Research object is a document epidemiological surveillance report of malaria in 2013. Variables of this study is the implementation of malaria surveillance system (input, process, output) and surveillance system attributes. Data obtained from interviews and observations were analyzed descriptively. The results showed that the data type on input stage was not yet complete, the quantity of labor was complete but insufficient quality of human resources, facilities and sufficient funds were available. At stage of the data collection process employed W2 weekly report format and monthly report format, report formats and reporting lines were simple, completeness and monthly reports 100% W2, W2 reporting time liness was > 80% and monthly reports was > 90%, Analysis and interpretation of the data was done However the analysis of relationshif was conducted by 20% of primary health care. The resulting output is a description of endemicity areas, API and SPR are presented in tabular form, graph and maps. Dissemination of information is done in the form of reports, workshops and profiles. Feedback is done each month through coordination meeting, regular meetings and regular supervision. Surveillance evaluation system based on attributed surveillance showed its simplicity and acceptability, however sensitivity can not be assessed yet, low NPP 1.75%, report punctuality was > 80%. It is necessary the existence of expert epidemiologists (S2) and skilled epidemiologists (S1), training officer, coordination, and the role of public institutions and budgetary surveillance of malaria increased in all areas Sumbawa district health offices.Keywords: malaria surveillance systems, evaluation, surveillance attributes