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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.

The present study aimed to analyse molecular epidemiological data from hepatitis A virus (HAV) outbreaks in two affected areas. The association between the knowledge of hepatitis A and incidence of infection was also determined. Serum samples were obtained from 88 individuals with clinical manifestations of acute hepatitis in Lamongan (n=54) in January 2018 and Bangkalan (n=34) in March 2018. The outbreak investigation was started one day after the outbreaks were reported by the Public Health Offices in Lamongan and Bangkalan. Anti-HAV immunoglobulin M (IgM) and PCR amplification products of the VP1 capsid protein-P2A protease and VP1-VP3 junctions were analysed. Positive PCR products were sequenced, and a phylogenetic tree was constructed using Molecular Evolutionary Genetics Analysis X software. The control group comprised healthy students and staff members from the two affected areas. Thus, 172 responses from the control and hepatitis A case groups were analysed to assess the association between the students' knowledge level and the incidence of HAV infection. A total of 32 (59.25%) of the 54 individuals from Lamongan and 19 (55.9%) of the 34 participants from Bangkalan were positive for anti-HAV IgM; 26 PCR tests were positive in the VP3-VP1 and/or VP1-P2A junction, which were identified as HAV subgenotype IA. The subtype of HAV in the two areas was IA, similar to those identified previously, but the viruses did not originate from the same strain, as identified by multiple alignment. The knowledge level of the students and staff members in Lamongan studying and working at a half-day school exhibited a significant association with the incidence; however, no association was observed among the students in Bangkalan studying at a full-day school with a dormitory.

Leptospirosis is a zoonotic disease that globally spreads and has the potential to become an epidemic. In Indonesia, the incidence of leptospirosis tends to increase with case fatality rate ranged from 5-12%. Ponorogo is one regency in Province of East Java, Indonesia that has high incidence of leptospirosis. The objective of this study was to identify sociodemographic, behavioral, and environmental factors associated with incidence of leptospirosis in highlands of Ponorogo regency. The study used case control design conducted in 15 villages in the highlands of Ponorogo regency. The sample was composed of 28 cases of leptospirosis and 112 nonleptospirosis. The variables of this study were sociodemographic, behavioral factors, environmental factors, and incidence of leptospirosis. Data was collected by interview using questionnaire and observation of environmental conditions. Data was analyzed using chi square and logistic regression. The result showed that factors associated with the incidence of leptospirosis were education (p = 0.019), occupation (p = 0.003), health practice (p = 0.007), house density (p = 0.013), livestock ownership (p = 0.004), distance from house to cowshed (p = 0.024), cow ownership (p = 0.010), and the presence of rats in the house (p = 0.050). The result of logistic regression analysis showed that the variables dominantly associated with the incidence of leptospirosis were livestock ownership, education (low), house density (crowded), and distance from house to cowshed (less than 10 meters). In conclusion, sociodemographic, behavioral, and environmental factors were associated with the incidence of leptospirosis in highlands of Ponorogo Regency.

Background: Indonesia is one of the countries where 35% of the population lives in areas with a high risk of malaria infection. Trenggalek is one of the malaria-endemic regions in East Java. Purpose: This study aimed to identify the malaria cases in Trenggalek based on the epidemic triangle and identify the vulnerability status of Anopheles vagus mosquito against Permethrin 0.75% in Pandean Village, Trenggalek. Methods: This study is a type of descriptive observational study. The data used in this study is secondary data obtained from the The Center of Environmental Health and Disease Control Agency Surabaya. The data consists of characteristics of malaria cases in Trenggalek and Anopheles vagus resistance test data against Permethrin 0.75% in Pandean Village, Trenggalek. Results: Trenggalek is considered as low malaria endemicity area, with malaria incidence dominated by imported malaria cases, because recently there is no cases of autochthonous malaria have been found. Data on malaria case trends in 2014-2017 tended to fluctuate, the majority of malaria patients were male group counting of 97.34% which consist of farmers (59.88%) and private sector worker (29.79%). The Anopheles vagus was found 100% death in one hour of the treatment, but there was no death incidence in the control group. Conclusion: Most malaria patients dominated by male, migrant workers, and most of them work as farmers and the private sector which have a high potential for the emergence of autochthonous malaria. Anopheles vagus is still susceptible to Permethrin 0.75% in Pandean Village, Trenggalek

Background: Hepatitis A outbreaks were reported by the Lamongan District Health Office to the Surabaya Center for Environmental Health and Disease Control Engineering on January 16, 2018, indicated by an increase in hepatitis A cases in of G and S areas, B village. One of initial sufferer was students in High School X.. Purpose: This study aims to identify the epidemiological characteristics of hepatitis A outbreaks that occur in High School X and the risk factors. Methods: The investigation was carried out in an observational manner with a cross sectional approach. Data were collected by structured interviews, hepatitis A antibodies in blood samples assay, environmental observation, and water samples assay. Data were collected with purposive determination of respondents. Results: Hepatitis A outbreaks at High School X in Lamongan District take place from November 2017 to january 2018, with a target group of 33 students. The epidemic cased tends to be extend common source. Risk factors are contact history with patients, eating habits together in same place, mutual exchange and sharing same eating utensils, the lack of hygiene habit (such as washing hands with soap for students and food handlers), lack of hand washing facilities, bad sanitation, bad food hygiene management, and inadequate clean and hygienis water source. Conclusion: The outbreaks of hepatitis A was extended with the most important risk factors, i.e. lack of personal hygiene and sanitation of water sources.