Setyo Sri Raharjo
Pharmacology Laboratory, School of Medicine, Sebelas Maret University, Surakarta

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Path Analysis on the Determinants of Adherence to Anti Tuberculosis Drug Treatment in Kaur District, Bengkulu, Indonesia Hamidi, Surahman; Raharjo, Setyo Sri; Wijaya, Mahendra
Journal of Epidemiology and Public Health Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Drug treatment compliance was the behavior of patients to take medication and undergo treatment according to the rules determined by professional health personnels. Many factors influenced the compliance with treatment for tuberculosis patients. This study aimed to examine determinants of drug treatment compliance among tuberculosis patients.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted at 16 community health centers in Kaur Regency, Bengkulu, Indonesia, from January to February 2019. A sample of 206 study subjects was selected by purposive sampling. The dependent variable was drug treatment adherence. The indepen­dent variables were age, gender, education, income, knowledge, role of drug taking supervisor, side effect of drug treatment, distance to health service, drug availability, family support, and tenure. The data were collected by questionnaire and analyzed by path analysis.Results: Adherence to anti tuberculosis treatment was directly and positively affected by age (b= 2.96; CI 95%= 1.12 to 4.79; p= 0.002), gender (b= 1.48; CI 95%= 0.02 to 2.95; p= 0.047), education (b= 2.18; CI 95%= 0.24 to 4.11; p= 0.027), income (b= 0.85; CI 95%= 0.76 to 2.45; p= 0.031), knowledge (b= 2.27; CI 95%= 0.32 to 4.22; p= 0.023), the role of drug taking supervisor (b= 3.46; CI 95%= 1.57 to 5.36; p<0.001), drug availability (b= 0.04; CI 95%= -6.07 to 6.16; p= 0.989), and family support (b= 2.97; CI 95%= 1.30 to 4.64; p<0.001). It was negatively affected by the side effects of the drug (b= -3.07; CI 95%= -4.90 to -1.24; p= 0.001), distance to health service (b= -1.86; CI 95%= -3.61 to -0.11; p= 0.037), and tenure (b= -2.16; CI 95%= -3.95 to -0.38; p= 0.017). Adherence to anti tuberculosis treatment was indirectly affected by income, knowledge, and role of drug treatment supervisor.Conclusion: Adherence to anti tuberculosis treatment is directly and positively affected by age, gender, education, income, knowledge, the role of drug taking supervisor, drug availability, and family support. It is negatively affected by the side effects of the drug, distance to health service, and tenure.Keywords : treatment adherence, tuberculosis, determinants, path analysisCorrespondence: Surahman Hamidi. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: surahmanhamidi@student.uns.ac.id. Mobile: 085267­456713.Journal of Epidemiology and Public Health (2019), 4(3): 205-214https://doi.org/10.26911/jepublichealth.2019.04.03.08
The Effects of Exclusive Breastfeeding and Contextual Factor of Village on Stunting in Bontang, East Kalimantan, Indonesia Sugiyanto, Joko; Raharjo, Setyo Sri; Dewi, Yulia Lanti Retno
Journal of Epidemiology and Public Health Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Basic Health Research Results of 2018 stated that 30.8% of Indonesian children experienced Stunting. Stunting problems describe the existence of chronic nutritional problems, which can be influenced by a variety of interrelated factors. This study aimed to examine the determinants of stunting Bontang, East Kalimantan, Indonesia.Subjects and Method: This was an analytic observational study with a case control design. It was conducted at 15 sub-districts in Bontang, East Kalimantan, from February to April 2019. A sample of 225 children was selected by purposive sampling. The dependent variable was stunting. The independent variables were exclusive breastfeeding, history of infection, low birth weight (LBW), economic status, maternal education, maternal height, basic sanitation, and Community Based Total Sanitation (CBTS) urban village status. The data were collected by questionnaire and analyzed by a multilevel multiple logistic regression.Results: The risk of stunting decreased with maternal height ≥150 cm (b = -1.37; 95% CI= -2.41 to -0.32; p = 0.010), maternal education ≥senior high school (b = -1.83; 95 % CI= -2.79 to -0.87; p<0.001), exclusive breastfeeding (b= -1.67; 95% CI= -3.28 to -0.06; p= 0.042), and high economic status (b= -1.33; 95% CI= -2.23 to -0.41; p= 0.004). It was increased with number of family members >4 (b= 1.32; 95% CI= 0.41 to 2.22; p= 0.004), history of infectious disease (b= 2.23; 95% CI= 1.32 to 3.14; p<0.001), poor environmental sanitation (b= 1.83; 95% CI= 0.64 to 3.02; p= 0.003), and LBW (b= 1.30; 95% CI= 0.04 to 2.56; p= 0.043). Subdistricts had neglected contextual effect on the incidence of stunting with ICC <1%.Conclusion: The risk of stunting decreases with maternal height ≥150 cm, maternal education ≥senior high school, exclusive breastfeeding, and high economic status. It is increased with number of family members >4, history of infectious disease, poor environmental sanitation, and LBW. Subdistricts has neglected contextual effect on the incidence of stunting.Keywords: stunting,exclusive breastfeeding, multilevel analysisCorrespondence: Joko Sugiyanto. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: jksgnt@gmail.com.Mobile: 081254261020Journal of Epidemiology and Public Health (2019), 4(3): 222-233 https://doi.org/10.26911/jepublichealth.2019.04.03.10