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Introduction: A group of people in China were hospitalized with an initial diagnosis of pneumonia of unknown cause. The patients were linked to a wholesale wet seafood and animal market in Wuhan, Hubei Province, China. The disease has spread to other provinces in China, Thailand, Japan, and South Korea in less than a month. SARS-CoV-2 was found to originate from bats. Therefore, this research aims to analyze SARS-CoV-2 mutation in bats in Malang Karst, Indonesia. Methods: Other bat body parts used as research samples include the brain, liver, kidneys, intestines, pancreas, fetus, blood, lungs, and ectoparasites. The samples were taken separately and placed in a container containing 10% PBF. For further analysis, we used RNA Extraction, Real-Time PCR, Sequencing, and CoV Gisaid mutation analysis software to analyze the sequencing data. Then, EMBL software will be used to analyze the phylogenetically. Results and Discussion: There was 1 sample that showed a positive result for Covid-19, namely the intestine of the Cynoptera brachyotis species. There were differences between SARS-CoV-2 in bats in Malang Karst in Indonesia compared to SARS-CoV from 2000 to 2019. The spike protein's receptor binding domain (RBD) is the most variable part of the coronavirus genome. Conclusion: From the research results, one positive sample was obtained using Real-Time PCR, and based on mutation analysis, mutations were found in SARS-CoV-2 against the SARS-CoV virus from 2000-2019. Further research is needed, especially regarding SARS-CoV-2 as a vaccine.

Introduction: Water was a part of the environment that was very susceptible to contamination by various hazardous substances, both physical, chemical, and microbiological. Serious health problems might occur when humans consume contaminated drinking water and can cause infectious and non-infectious diseases. This study aimed to analyze the risk quotient of chemical hazard exposure in drinking water by depot refilling drinking water from 25 cities and regencies in East Java Province. Methods: This study was analytically observational with a cross-sectional research design. The sampling method used was porposive sampling, which took 25 from 38 cities and regencies in East Java province. There were three steps to analyze drinking water health risks: dose-response analysis, exposure path, and risk characteristics analyzed. Results and Discussion: The highest concentrations of each parameter parameter F (1.4132 mg/L), NO_3 (56.2780 mg/L), NO_2 (22,225 mg/L), Fe (0.3845 mg/L), Mg (4.54 mg/L), and Zn (0.4272 mg/L). Analysis of risk quotient > 1 for parameters NO_3 (1.2265), NO_2 (7,748), and Mg (1.1308) Indicates that drinking water in the area is not safe for consumption by people weighing 55kg as much as 2L/day for 350 days. Conclusion: Based on the results of studies conducted on those substances (F, NO_3, NO_2, Fe, Mg, and Zn) there are three substances in the water that have RQ value > 1, NO_3 (1.2265), NO_2 (7,748), and Mg (1.1308) this means that those substances are risking human health and needed to be addressed controlled.

Background: Pneumonia is the leading cause of infection-related death in children globally. East Java, Indonesia, is one of the provinces with the discovery achievement of pediatric pneumonia cases under 70%. Nganjuk Regency, located in East Java, has low discovery achievement of pediatric pneumonia cases (34.64%). Nganjuk Regency also requires an up-to-date study to determine the current state of pneumonia risk factors. Objective: This study aimed to examine the occurrence of pneumonia in toddlers and its risk factors in Nganjuk Regency East Java, Indonesia. Methods: The design of this study was a cross-sectional using a rapid survey. The participants of this study were 210 housewives or other adult household members having children under five in Nganjuk Regency. The study procedure began by collecting data from seven districts wherein each district comprised 30 houses that were chosen purposely. Data analysis was carried out using bivariate and multivariate analysis. The data were analyzed using the statistical software STATA. Results: This study revealed that 18 (7.96%) toddlers had developed pneumonia. The main risk factors for pneumonia among toddlers in Nganjuk Regency were the nutritional status of toddlers (OR=6.787; 95%CI=1.417-32.525; p=0.017), house cleaning (OR=3.381; 95%CI=1.160-9.851; p=0.026), and room occupancy density (OR=4.191; 95%CI=1.371-12.809; p=0.012). Conclusion: The incidence of toddler pneumonia can be reduced by educating mothers about pneumonia and its risk factors, monitoring toddler growth and nutritional status, and conducting routine surveillance of toddler pneumonia alongside sanitation inspections. Keywords:Children; Pneumonia; Risk Factors; Survey

Malaria is a tropical disease caused by the bite of the Anopheles mosquito. Malaria is an infectious disease that is of global concern. This disease still often causes extraordinary events. This disease can attack all individuals regardless of age and gender. Factors related to the incidence of malaria are the environment and community behavior. Clean and Healthy Living Behavior is a set of behaviors practiced based on awareness because of learning in the health sector, and it plays an active role in realizing public health. One effort to eradicate malaria is clean and healthy living behavior. This research analyzes the relationship between Healthy, Clean-Living Behavior and malaria incidence. Systematic Review (PRISMA) is used. All articles that pass the selection are then reviewed and summarized based on the purpose, author name, year published, instruments used, research results, and suggestions for further research. The results of this literature research aim to implement healthy and clean-living habits to avoid environments that cause malaria. It is also more optimal to build a clean environment by implementing clean and healthy living behaviors, which will ultimately have a good effect on health. Malaria is one of the infectious diseases that is still a public health problem in the world, including Indonesia.

Pemerintah telah mencanangkan Percepatan Target Program Sanitasi dan Air Minum Aman Tahun 2024 melalui Rencana Pembangunan Jangka Menengah Nasional (RPJMN) dan Sustainable Development Goals (SDGs) 2024–2030. Salah satu capaian SDGs 2030 yaitu meminimalisasi penyakit berbasis lingkungan. Dari total 21.829 Sarana Air Minum (SAM) di Indonesia, proporsi rumah tangga untuk keperluan minum menurut mata air tidak terlindungi adalah 2,5%. Kecamatan Karangrejo, Kabupaten Tulungagung memiliki satu mata air yang digunakan secara komunal dan berpotensi tercemar. Pencemaran air dapat berdampak pada kesehatan masyarakat, yaitu terjadinya penyakit bawaan air seperti diare. Penerapan teknologi tepat guna dapat menjadi salah satu teknik pengelolaan air untuk memenuhi standar mutu air bagi kebutuhan masyarakat. Penelitian ini bertujuan melakukan pemanfaatan teknologi tepat guna portable chlorinator pada sistem pengolahan air bersih komunal menjadi sehat dan aman bagi masyarakat. Penelitian ini merupakan penelitian terapan sebagai solusi pemecahan masalah yang ditemukan. Data yang dikumpulkan adalah pengambilan sampel air di lima titik pemantauan dan data pendukung berupa angka kejadian diare dan pemberdayaan masyarakat di Desa Sukodono sebelum dan sesudah pemasangan alat. Hasil penelitian menemukan adanya Coliform pada saat sebelum pemasangan alat, yaitu 20–41 MPN/100 ml. Setelahnya, alat mampu mendesinfeksi air dan menghasilkan 0 MPN/100 ml Total Coliform dan E. coli. Jumlah kasus diare pada kategori balita di Puskesmas Jeli mengalami kenaikan di tahun 2020. Hingga September 2021, kasus diare pada balita sebanyak 57,6% dari kasus diare pada semua umur. Kegiatan sosialisasi membuat masyarakat paham akan pentingnya air bersih dan salah satu upaya pencegahan penyakit waterborne disease melalui teknologi tepat guna.

Introduction: Anthrax was a zoonotic disease caused by the bacterium Bacillus anthracis in several regions of Indonesia. Transmission of anthrax in animals and humans occurred by direct contact with anthrax spores present in meat, soil, or plants. This study aimed to analyse the risk factors and recommend preventive action for anthrax transmission. Methods: This research used a descriptiveanalytic study to describing cases based on the case definition, primary data, and secondary data. The primary data were collected from the field observations and interviews with farmers and people in the community. The secondary data were obtained from the Pacitan District Health Office and Surabaya Technical Centre for Environmental Health and Disease Control. Data analysis of this study applied content analysis techniques that describe the actual situation of the community. Results and Discussion: Risk factors for anthrax transmission in Pacitan Regency included livestock traffic from endemic anthrax areas and lacked public knowledge about anthrax disease, rainfall, and topography. Conclusion: Anthrax disease control measurements include surveillance and investigation periodically, treatment of the suspected livestock, vaccination, disinfection, and socialisation. The government needs to control livestock traffic by providing proper regulation. Also, the public might improve knowledge and awareness with their livestock

Background: Understanding the health practice of Indonesian residents and its related factors during the COVID-19 pandemic is crucial, but such association necessitates clarity. Objective: To examine the health practices of the Indonesian citizens and their correlations with knowledge and health belief model (perceived susceptibility, barriers, benefits, severity, and self-efficacy) during the COVID-19 pandemic. Methods: A community-based online cross-sectional design was employed. The study was conducted from 10 July to 30 August 2020 among 552 citizens selected using convenience sampling. Sociodemographic characteristics, knowledge, health belief model, and health practices, including wearing a mask, social distancing, and washing hands, were measured using validated questionnaires. Adjusted odds ratios (AORs) and logistic regression were employed for data analysis. Results: The adjusted AORs (95% CIs) of a good level of health practices—wearing the mask, social distancing, and washing hands—were 3.24 (1.52~6.89), 2.54 (1.47~4.39), and 2.11 (1.19~3.75), respectively, in citizens with the high level of knowledge. Interestingly, respondents with positively perceived susceptibility exhibited significantly good practice in wearing the mask (4.91; 2.34~10.31), social distancing (1.95; 1.08~3.52), and washing hands (3.99; 2.26~7.05) compared to those with negatively perceived susceptibility. In addition, perceived barriers, benefits, severity, and self-efficacy also exhibited a significantly good all variables of health practice regarding COVID-19 pandemic after adjusting for confounding variables. Conclusion: Citizens with high levels of knowledge and positive levels of the health belief model had good practice of wearing masks, social distancing, and washing hands. The outcomes of this survey could encourage health professionals, including nurses, through management practices of nursing intervention based on the health belief model during the pandemic. Funding: This study was funded by the University of Kadiri, Kediri, Indonesia (106/P.1/LP3M/XII/2020).

Dengue Fever (DF) incidence in Bali has been the highest in Indonesia for decades. This study describes the annual distribution of DF and analyzes its association with population density, number of rainy days, and average humidity during 2010-2018 at the district level. The choropleth maps and Poisson regression were employed to provide geographical distribution and quantify the association. The P, 95% confidence interval (CI), and Akaike Information Criterion (AIC) were adopted to assess the significance and the goodness of the association. During 2010-2018 there were 55 215 new DF cases notified. The annual incidence of dengue cases in Bali increased with IRR: 1.000186 (95% CI:1.0000183:1.000189) for every increment of population density per kilometers square and increased by IRR: 1.01043 (95% CI: 1.01019: 1.01078) for every additional one rainy day annually. The dengue cases also increased with IRR 1.0172 (95% CI: 1.0137: 1.0208) for every 1% increase in average humidity. Population density and climate factors are positively associated with dengue cases incidence in Bali from 2010 to 2018. The results underline the urgency of integrating population dynamics and climatic determinants into the DF control program and customizing the intervention program based on local characteristics.

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.

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 to 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 m). 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.