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All Journal International Journal of Public Health Science (IJPHS) INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Journal of Public Health Research and Community Health Development (JPH RECODE) Public Health and Preventive Medicine Archive

Dewa Nyoman Wirawan

Department Of Community And Preventive Medicine Faculty Of Medicine Udayana University

Author-ID : 5329904

Health Professions Medicine & Pharmacology Public Health

Published : 57 Documents Claim Missing Document

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SUBTIPE HIV-1 DI BEBERAPA DAERAH DI INDONESIA DAN PERANNYA SEBAGAI PETUNJUK DINAMIKA EPIDEMI HIV Parwati Merati, Tuti; Ryan, Claire; Turnbul, Shannon; Wirawan, DN; Otto, Brad; Bakta, I Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 2, No. 2 Mei 2008
Publisher : Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.901 KB)

Subtipe HIV-1 dapat ditentukan dengan melakukan analisis sekuens nukleotida dari gen selubung luar HIV-1, dengan mengekstrak DNA proviral dari sampel pasien, dan memakainya dalam PCR khusus untuk envelope HIV-1. Kemudian ini di sekuens dan dianalisis dengan memakai rujukan sekuens dari bank gen LANL (Los Alamos National Library) untuk menentukan subtipe. Distribusi geografi subtipe HIV-1 bersifat dinamis. Sampai sekarang terdapat 9 subtipe HIV dan 34 circulating recombinant forms (CRFs). Penelitian terdahulu mendapatkan ada dua subtipe HIV-1 yang beredar di Indonesia, Subtipe B dan CRF01_AE. Dengan mengetahui subtipe HIV-1 dapat membantu penelusuran arah epidemi dan memberikan informasi untuk merencanakan pencegahan HIV demikian juga memberikan informasi yang diperlukan dalam pembuatan vaksin. Oleh karena itu sangat penting dilakukan penelitian mengenai subtipe HIV di Indonesia.Rancangan penelitian adalah cross-sectional analytic yang dilakukan di Klinik Pelayanan AIDS di Denpasar, Bali dan Panti Rehabilitasi Narkoba di Bogor, Jawa Barat. Responden adalah odha dewasa yang memenuhi kriteria inklusi (odha dewasa dan bersedia ikut dalam penelitian) dan responden dipilih secara non probability sampling sampai memenuhi jumlah sampel yang dibutuhkan. Dengan memakai rumus 16.4 Sastroasmoro S. and Ismael S. (2002), jumlah sampel minimal dihitung sebesar 65. Untuk hipotesis 1, melihat perbedaan Subtipe HIV-1 dengan cara transmisi virus, analisis data menggunakan uji statistik Chi-Square. Untuk hipotesis 2, membandingkan Subtipe HIV-1 dengan derajat penyakit, analisis data menggunakan uji statistik Fisher’s Exact test, sedangkan untuk analisis data epidemiologi kasus dikerjakan secara deskriptif. Hasil disajikan dalam bentuk tabel, gambar pohon phylogenetic dan narasi.Dari penelitian ini didapatkan empat jenis subtipe di Indonesia, yaitu Subtipe B, CRF01_AE, C dan G (A/G). Semua pengguna narkotika suntik (penasun) terinfeksi oleh Subtipe CRF01_AE, dan hubungan ini terbukti secara statistic bermakna (Chi-square test with continuity correction value 7,951 p = 0,005) (Tabel 5.3.1). Subtipe HIV-1 tidak berhubungan secara bermakna dengan derajat penyakit, akan tetapi terdapat kecenderungan CRF01_AE mempunyai lebih banyak kasus dengan derajat penyakit berat dibandingkan dengan NonCRF01_AE. Prevalensi kasus dengan performance yang terganggu pada CRF01_AE adalah 30,3% sedangkan pada Non CRF01_AE 14,3%. Perbedaan ini secara statistic tidak bermakna (Fisher’s-Exact test p = 0,3445 (Tabel 5.11). Dari analisis Phylogenetic didapatkan bahwa transmisi HIV pada populasi risiko tinggi di Indonesia bersifat dinamis, dan epidemi yang terjadi tidak terpisah diantara populasi dengan faktor risiko yang berbeda.Kesimpulan dari penelitian adalah: CRF01_AE merupakan subtipe yang paling banyak didapatkan dan tersebar disebagian besar wilayah. CRF01_AE didapatkan pada populasi penasun, heteroseksual, penjaja seks komersial dan pelanggannya. Karena prevalensi HIV pada penasun sangat tinggi, baik di Bali maupun daerah lainnya di Indonesia (50%), maka ada kemungkinan penasun merupakan episentrum epidemi HIV di Bali dan beberapa daerah di Indonesia, yang akan menyebar ke populasi umum melalui kelompok heteroseksual risiko tinggi yaitu PSK dan pelanggannya. Sedangkan Subtipe B, C dan G (AG) terdapat baik pada homoseks dan heteroseks, namun tidak ada penasun. Data tersebut didukung oleh gambaran pohon phylogenetic (Gambar 5.3). Pemakaian DBS dalam penelitian ini cukup praktis dan aman, walaupun keberhasilannya masih rendah (44,9%). Sekarang sudah ada kertas saring yang lebih baik dan sesuai untuk dipakai pada penelitian yang akan datang.Saran dari penelitian ini adalah, dalam program harm reduction bagi penasun hendaknya juga menekankan pemakaian kondom secara konsisten dengan pasangan seksualnya. Disamping itu disarankan perlunya melakukan pemeriksaan subtipe HIV secara periodik karena distribusi subtipe HIV bersifat dinamis.

Perceptions dynamics about antiretroviral treatment among HIV patients in Bali Anak Agung Sagung Sawitri; I Nyoman Sutarsa; Tuti Parwati Merati; Made Bakta; Dewa Nyoman Wirawan
International Journal of Public Health Science (IJPHS) Vol 10, No 3: September 2021
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v10i3.20917

Perceptions of people living with HIV and AIDS (PLHIV) about antiretroviral treatment (ART) is crucial for improving adherence. This study aims to examine the dynamics of perceptions during the early phase of ART. A longitudinal study involving newly diagnosed PLHIV was conducted. Interviews were carried out at the time of HIV diagnosis and at three months after ART initiation. Data were analyzed by comparing proportion of good perception across the continuum of HIV diagnosis, ART initiation and threemonths follow-up, and were tested using Chi-square. From 170 PLHIV participated in the study, 81.76% had initiated ART and 73.4% remained on ART at three-months of follow-up. Several positive perception items were significantly decreased: ability to take ART at work and ability to continue treatment if experiencing side effects, effectiveness of ART, confidentiality, unwanted disclosure, and level of support from outreach workers. Ability to follow instruction from physician was significantly increased, and negative attitudes toward ART were decreased across the continuum. Adherence to ART is a continuous process, and is influenced by the dynamics perceptions among PLHIV. Understanding these dynamics is crucial to formulate strategies that can promote and maintain positive attitudes toward ART as well as living with HIV more broadly.

DETERMINAN SOSIAL KERENTANAN PEREMPUAN TERHADAP PENULARAN IMS DAN HIV Desak Made Sintha Kurnia Dewi; Luh Putu Lila Wulandari; D.N. Wirawan
Journal of Public Health Research and Community Health Development Vol. 2 No. 1 (2018): Oktober
Publisher : Sekolah Ilmu Kesehatan Dan Ilmu Alam (SIKIA), Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jphrecode.v2i1.16250

Kasus HIV - AIDS meningkat pada perempuan dan menjadikannya salah satu kelompok rentan. Perempuan memiliki kemungkinan tertular IMS - HIV dua kali lebih besar dibandingkan laki-laki dan berdampak pada meningkatnya jumlah infeksi pada anak. Tujuan penelitian ini untuk menggali determinan sosial yang mempengaruhi kerentanan perempuan tertular IMS - HIV. Penelitian ini menggunakan design studi kualitatif pada 21 informan yang dipilih secara purposive yaitu terdiri dari klien, provider, konselor. Informan yang terpilih adalah pernah atau saat ini mengalami IMS atau HIV (klien), memiliki pengalaman menangani klien IMS atau HIV (provider/konselor). Proses rekrutmen dilakukan dengan melibatkan petugas layanan. Penelitian dilaksanakan pada April – Juni 2012 di tiga tempat layanan di Denpasar. Pengumpulan data dilakukan melalui wawancara mendalam menggunakan pedoman wawancara semi terstruktur, kemudian direkam dan ditranskrip. Analisis dilakukan secara tematik dan triangulasi melalui member checking dan peer debriefing. Hasil penelitian menunjukkan bahwa determinan sosial yang mempengaruhi kerentanan perempuan terhadap penularan IMS -HIV antara lain kurangnya pengetahuan, perilaku seksual berisiko perempuan dan pasangan, tekanan ekonomi mendorong perempuan terlibat dalam pelacuran, ketergantungan ekonomi membatasi akses ke layanan, stigma terhadap kondom dan HIV, pengaruh ketimpangan gender, nilai perempuan di masyarakat menempatkan perempuan sebagai pihak yang dipersalahkan, posisi tawar rendah dalam menegosiasikan hubungan seksual, motivasi, dan perilaku petugas yang kurang mempengaruhi kualitas layanan dan menimbulkan ketidakpercayaan klien. Determinan sosial tersebut mempengaruhi kerentanan perempuan terhadap penularan IMS - HIV secara holistik, dapat dilihat dari faktor individu perempuan dan di luar individu seperti lingkungan keluarga, masyarakat dan budaya. Diperlukan upaya komprehensif berbagai pihak untuk meningkatkan pengetahuan, pemberdayaan perempuan, pelatihan komunikasi dan konseling pasangan bagi petugas kesehatan.

Predictor of muscle dysmorphia among members of fitness centers in Denpasar City, Bali, Indonesia Vennesa Vitari Maureen Susanto; Dewa Nyoman Wirawan; I Putu Adiartha Griadhi
Public Health and Preventive Medicine Archive Vol. 8 No. 1 (2020)
Publisher : Universitas Udayana

Background and purpose: Muscle dysmorphia is one of the most common forms of body dysmorphic disorder. It is part of the obsessive-compulsive disorders, wherein sufferers believe that the body is too small or not muscular enough. The purpose of this study was to determine the predictors of muscle dysmorphia among fitness center members. Methods: A cross-sectional study was conducted at five fitness centers with 117 respondents. Several scales were applied including: 1) 4th edition Sociocultural Attitudes Towards Appearance Scale (SATAQ) to measure self-internalization, family, peer, and media pressures; 2) Physical Appearance Comparison Scale (PACS) to measure social comparison; 3) Body Esteem Scale for Adolescents and Adults (BESAA) to measure respondents’ satisfaction with their bodies and 4) The Muscle Dysmorphic Disorder Inventory (MDDI) to measure muscle dysmorphia. Meanwhile, weight was measured with Kris EB9-4A Series digital scales, height with GEA microtoise and body fat percentage with a digital HBF-306 body fat monitor. Spearman’s Correlation test was performed for the bivariate analysis and multiple linear regression for the multivariate analysis. Results: The prevalence of muscle dysmorphia among fitness center members was 43.6% (95%CI=33.99:53.20) in the total sample based on MDDI cut-off score. Bivariate analysis shows that six variables including body fat percentage, total physical activity, thin/low body fat internalizations, muscular/athletic internalizations, peer pressure, media pressure associated with muscle dysmorphia. In the multivariate analysis, only four variables were significantly associated with muscle dysmorphia, namely: muscular/athletic internalization (β=0.369, 95%CI=0.296:0776, p<0.001), media pressure (β=0.277, 95%CI=0.167:0.595, p<0.001), body fat percentage (β=-0.262, 95%CI=-0.301:-0.067, p=0.002) and body dissatisfaction (β=-0.224, 95%CI=-0.245:- 0.050, p=0.003). Conclusion: The prevalence of muscle dysmorphia in Denpasar City is relatively high. Muscular/athletic internalization, media exposure, body fat percentage and body satisfaction are associated with increase chance of having muscle dysmorphia.

Determinants of anemia in women of reproductive age in Indonesia: Secondary data analysis of the 2018 Indonesia Basic Health Research Putu Sri Utami; Luh Seri Ani; Dinar Saurmauli Lubis; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 8 No. 2 (2020)
Publisher : Universitas Udayana

Background and purpose: Anemia in women is a public health concern that is prevalent in developing countries. Women of reproductive age (WRA) frequently suffer from anemia, which can contribute to morbidity and mortality of mothers and their infants. The purpose of this study was to determine the prevalence and factors associated with anemia among women of reproductive age (WRA) in Indonesia. Methods: This study uses secondary data from the 2018 Indonesia Basic Health Research or Riset Kesehatan Dasar (Riskesdas) which was conducted in 34 provinces in Indonesia. The number of samples analyzed was 3,677 women aged 15-49 years who had data from interviews, measurements of height, weight, results of malaria\ tests, and hemoglobin levels. Data analysis was performed using multivariate logistic regression to determine the relationship between anemia and individual characteristics, nutritional and health status as well as environmental conditions and healthservice accessibility. Results: The prevalence of anemia among WRA in Indonesia was 25.3% (95%CI: 23.9-26.7). Factors which found to be associated with the prevalence of anemia in WRA were age <20 years (AOR=3.44; 95%CI: 2.22-5.35; p<0.001), underweight (AOR=1.48;95%CI: 1.08-2.05; p=0.017), obesity (AOR=0.68; 95%CI: 0.56-0.81; p<0.001) and the use of hormonal contraception (AOR=0.53;95%CI: 0.44-0.64; p<0.001). Conclusion: Based on the prevalence, anemia among WRA inIndonesia is categorized as a moderate public health concern and the most common risk factor for anemia was WRA aged <20 years and underweight. To reduce the incidence of anemia in WRA, interventions should be targeted at WRA aged <20 years and underweight

Husband’s behavior and early marriage as risk factors for hepatitis B virus infection among pregnant women in Karangasem, Bali, Indonesia I.N. Adnyana Surapathi; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 9 No. 1 (2021)
Publisher : Universitas Udayana

Background and purpose: Indonesia is categorized as a country with moderate level of hepatitis B virus (HBV) infection, where the majority of HBV transmissions occur from mother to child, horizontal transmission during childhood and adulthood, and transmission in health services. This study aims to determine factors associated with HBV infection among pregnant women. Methods: A case control study was conducted among 80 pregnant women with sero-positive HBsAg as cases and 80 pregnant women with sero-negative HBsAg as controls. The sources of cases and controls were the registers of pregnant women at 12 public health centers (PHCs) and Karangasem District Hospital from June 2017 to December 2018. Cases were selected by systematic random sampling from 129 pregnant women with sero-positive HBsAg and controls were selected through the same method from 1,408 pregnant women with sero-negative HBsAg. They were then matched based on village or residence. Data collected were including history of marriage, pregnancy, childbirth and abortion, history of health services relevant to HBV infection, use of contraception, mobility, permanent tattoos and history of injecting drug use. Data collection was carried out from June to August 2019 through face-to-face interviews with pregnant women as respondents in their respective homes using a pre-tested questionnaire. Bivariate data analysis was conducted with chi square test and multivariate analysis with logistic regression. Results: The case and control groups were similar in terms of age, number of pregnancy and parity. Risk factors which found to be significantly associated with HBV infection in pregnant women were age at first marriage <19 years with AOR=2.51 (95%CI: 1.13-5.60), history of husband’s mobility with AOR=3.07 (95%CI: 1.13-8.34), husband has a permanent tattoo with AOR=2.77 (95%CI: 1.04-7.44) and low level of maternal education with AOR=2.47 (95%CI: 1.06-5.73). Conclusion: Young marital age, low education, husband’s mobility and husband with permanent tattoos increase the likelihood of HBV infection among pregnant women. The coverage of HBV examination among pregnant women and early detection of HBV among husbands ought to be increased, especially among those with associated risk factors.

Determinants of caesarean section among women of childbearing age in Indonesia: Secondary data analysis of the 2017 Indonesia Demographic Health Survey Desak Nyoman Purniati; Dewa Nyoman Wirawan; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 8 No. 2 (2020)
Publisher : Universitas Udayana

Background and purpose: The caesarean section (CS) trendcontinues to increase throughout the world, including Indonesia. Indonesia is one of the countries where the proportion of CS exceeds the WHO recommendation. CS on medical indications can save the mother and baby, but if the CS is performed without any medical indication it will affect the welfare and health of both. This study was conducted to determine the factors associated with CS deliveries in women of childbearing age (WCA) in Indonesia. Methods: This study is a secondary data analysis using the 2017Indonesia Demographic and Health Survey (IDHS) data. The data analyzed in this study were CS deliveries in the last 5 years and predictors variables which were collected via interviews. The number of samples in this analysis were 14,533 respondents from the total sample size of the 2017 IDHS as many as 50,730 female respondents aged 15-49 years. Data analysis was performed using multivariate logistic regression with backward method. Results:The proportion of CS among women aged 15-49 years in Indonesia was 17.7% (95%CI: 17.4-18%). The risk factors for CS were age >35 years with AOR=2.35 (95%CI: 1.61-3.44), primiparity with AOR=2.03 (95%CI: 1.54-2.68), multiparity with AOR=1.53 (95%CI:1.18-1.99), low infant weight with AOR=1.71 (95%CI: 1.45-2.03),maternal high education level with AOR=2.15 (95%CI: 1.79-2.59), husband’s middle education level with AOR=1.41 (95%CI: 1.231.62), urban areas of residence with AOR=1.28 (95%CI: 1.15-1.41), high family wealth index with AOR=1.87 (95%CI: 1.64 2.13), hasa health insurance with AOR=1.54 (95%CI: 1.41–1.70), delivered the baby at a private health facility with AOR=1.18 (95%CI: 1.07-1.31), number of ANC visits ≥4 times with AOR=1.87 (95%CI: 1.42-\2.32), and have been exposed to information media with AOR=2.01(95%CI: 1.02-3.97). Conclusion: The proportion of CS delivery in Indonesia remains relatively high. Education for mothers and families about the impact of unnecessary CS delivery needs to be increased so that mothers and families are able to make appropriate and rational decisions. Interventions should be focused on mothers and husbands who are more educated, have higher socioeconomic status, live in urban areas and have chosen delivery in private health facilities

Willingness to pay for dengue vaccine among parents of elementary school students in Denpasar Ni Luh Astri Indraswari; Dewa Nyoman Wirawan; Made Pasek Kardiwinata,; Pande Putu Januraga
Public Health and Preventive Medicine Archive Vol. 9 No. 2 (2021)
Publisher : Universitas Udayana

Background and purpose: The incidence of Dengue Hemorrhagic Fever (DHF) in Bali, especially in Denpasar, remains high. Efforts to eradicate mosquito nests have been carried out but did not give a significant reduction in the incidence number. The dengue vaccine is now available and can be a way of prevention. The dengue vaccine has not been included in the mandatory immunization program by the government so people who want to get vaccinated have to pay for it by themselves. This study aims to determine the relationship between socio-demographic factors and perceptions with the willingness to pay for the dengue vaccine among parents of elementary school students in Denpasar. Methods: This study used a cross sectional design involving 100 mothers of students from grade 3 to grade 6 at Dauh Puri 5 Elementary School and Dauh Puri 6 Elementary School who were selected with systematic random sampling. Data collected included education level, income, respondents’ perceptions and willingness to pay for dengue vaccine. Data were collected by interview using a questionnaire, the results were analyzed using a multivariate logistic regression. Results: The average willingness of parents to pay for the dengue vaccine per dose was IDR 131,170. Percentage of respondents who were willing to pay for the dengue vaccine was 31%. The results of analysis showed that variables associated with parents’ willingness to pay for the dengue vaccine were education level (OR=4.06; 95%CI: 1.19-13.76), perceived susceptibility (OR=1.59; 95%CI: 0.58-4.37) and perceived benefits (OR=2.60; 95%CI: 1.00-6.81). Conclusion: Parents’ willingness to pay for the dengue vaccine remains very low compared to the current price of vaccine per dose. The government needs to provide subsidies so that the dengue vaccine can be included in the national immunization program and be accessed by all people. Further research is needed with a broader scope and more varied population’s characteristics to obtain a willingness to pay value that can represent society in general.

Training program for tuberculosis (TB) patients to improve referrals of presumptive TB cases and sputum in Denpasar, Bali, Indonesia Putu Ayu Merry Antarina; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 8 No. 2 (2020)
Publisher : Universitas Udayana

Background and purpose: Tuberculosis (TB) is a global healthproblem and one of the top ten causes of deaths in the world. TB case finding is an important component of TB control. In Indonesia, most case findings were done passively so that the referral coverage for TB sputum was lower than the target. This study aims to determine the effectiveness of training for TB patients as volunteers to increase the active referral of presumptive TB cases. Methods: The pretest-posttest design intervention study was conducted in five public health centers (PHCs) which had the highest number of TB patients in Denpasar. The intervention was carried out for seven weeks (February May 2020). A total of 35 TB patients, who were currently undergoing treatment at the PHCs, met the study criteria and willing to volunteer, were trained through meetings, discussions and demonstrations about the risk of TB transmission, contact investigations and how to collect sputum samples. Before and after the interventions, data on volunteers’ knowledge, the number of presumptive TB and sputum referrals by volunteers were collected through interviews and daily records. A regular reminder was sent in the form of a WhatsApp message once a week. Bivariate data analysis was performed with Chi-square and Wilcoxon Signed Rank Test. Results: Volunteers’ knowledge scores increased significantly after training, with a median score of 13.0 to 15.0 (p<0.001), and there was a significant difference in knowledge improvement amongthose who actively responded to regular reminders compared to those who were less active (p=0.002). A total of 31 presumptive TB cases were successfully referred during the study period (7 weeks). Volunteers managed to refer as many as 30 sputum preparations with good quality, but no positive sputum was found. Conclusion: Recruitment and training of TB patients as volunteers can increase the knowledge and skills of volunteers to identify and refer presumptive TB cases and quality sputum samples. More TB patients should be trained as volunteers with a longer observation time to increase TB patient detectio

The role of information sources and characteristics of children in the acceptance of Japanese encephalitis (JE) mass immunization in Bali Province Nyoman Suardani; Dewa Nyoman Wirawan; Anak Agung Sagung Sawitri
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p02

Background and purpose: Japanese encephalitis (JE) is a public health issue that can be prevented by immunization programs. Indonesia began the JE immunization campaign in Bali through simultaneous immunization for children aged 9 months to 15 years. Although information dissemination has been carried out, knowledge, perceptions and characteristics of mother and child can influence the acceptance and uptake of immunization for children. This study aims to determine the factors that influence acceptance of JE mass immunization in Bali Province. Methods: Secondary data analysis was performed on the results of the JE Supplementary Immunization Activities (SIA) Udayana University survey which consisted of 1,284 mothers and 2,107 children. The survey was conducted from June-August 2018 in nine districts/cities in Bali Province. The association between knowledge, perception and respondents’ characteristics with acceptance of JE mass immunization was analyzed with chi square test and multivariate analysis was conducted using logistic regression. Results: The proportion of children who received immunization was 93.9% (95%CI: 92.8-94.9). The results of the bivariate analysis showed that there was a significant association between acceptance of JE mass immunization with the child’s age, sex, educational status, complete basic immunization history, mother’s perception of severity, benefits, barriers, knowledge and sources of information (p<0.05). Multivariate analysis shows that the variables which significantly increase JE mass immunization acceptance are information from a combination of media and face to face education (AOR=3.95; 95%CI: 2.01-7.77), schooling children (AOR=2.43; 95%CI: 1.23-4.79), living outside of Denpasar City (AOR=2.32; 95%CI: 1.49-3.62), children who have received complete basic immunization (AOR=2.22; 95%CI: 1.42-3.49), face to face information only (AOR=2.11; 95%CI: 1.21-3.70) and girls (AOR=1.68; 95%CI: 1.15-2.46). Conclusion: Information disseminated via a combination of media and face to face is the strongest variable influencing JE mass immunization acceptance. Providing appropriate information through a combination of media and face to face education by health or non-health workers needs to be considered.

Co-Authors A.A.A.A. Candrawati Anak Agung Gede Agung Anak Agung Ngurah Gede Dharmayuda Brad Otto Claire Ryan Desak Nyoman Purniati Desak Nyoman Widyanthini Desak Putu Yulita Kurniati Dewa Ayu Ketut Sri Abadi Dewa Suyetna Dewi, Desak Made Sintha Kurnia Dinar Lubis Dinar Lubis Emily Rowe Emily Rowe Fonny Silfanus Gusti Ayu Satriani I Gusti Agung Trisna Windiani I Gusti Lanang Sidiartha I Ketut Duara I Ketut Subrata I Made Ady Wirawan I Made Bakta I Nyoman Sudiatmika I Nyoman Sutarsa I Putu Adiartha Griadhi I Wayan Gede Artawan Eka Putra I.N. Adnyana Surapathi Ida Ayu Dwi Astuti Minaka Ida Ayu Putri Widhiastuti Ifa Nurhasanah Irma Rubianti Jacinta dos Santos Guterres K Tangking Widarsa Kadek Dwi Ariesthi Kadek Tresna Adhi Kenyem Subagia Ketut Suarjana Ketut Tuti Parwati Merati Komang Ayu Kartika Sari Lina Anggaraeni Dwijayanti Lisa Sutiasih Luh Nyoman Sumiati Luh Pitriyanti Luh Putu Lila Wulandari Luh Putu Sri Armini Luh Putu Wulandari Luh Seri Ani Made Pasek Kardiwinata Made Suarjaya Mangku Karmaya Mangku Karmaya Musrifa Ni Kadek Ayu Dwi Utami Ds Ni Kadek Ethi Yudiastuti Ni Ketut Arniti Ni Luh Astri Indraswari Ni Luh Dea Kumala Sari Karang Ni Luh Putu Suariyani Ni Luh Putu Sudiasih Ni Made Ari Febriyanti Ni Putu Diwyami Ni Wayan Arya Utami, Ni Wayan Arya Ni Wayan Sri Rahayuni Nyoman Suardani Pande Putu Januraga Putri Pidari Putu Ayu Merry Antarina Putu Ayu Ratna Darmayanti Putu Ika Farmani Putu Sri Utami Putu Sukma Megaputri Rini Hendari Rizki Yulia Purwitaningtyas Sawitri, Anak Agung Sagung Shannon Turnbul Sri Juharni Vennesa Vitari Maureen Susanto Widya Aryati Widya Dwijayanti

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