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Journal of Epidemiology and Public Health
Published by Universitas Sebelas Maret
ISSN : 25490273     EISSN : 25490273     DOI : -
Core Subject : Health,
Public Health
Background: Increased blood pressure for a long time can increase the risk of kidney failure, co­ronary heart disease, brain damage, and other di­seases. In 2019, it is estimated that hyper­tens­ion is experienced by 1.13 billion people in the world with most (two thirds) living in low and mid­­dle income countries. Other study also shows that the police and military are at risk of develop­ing hypertension due to a number of factors such as low know­led­ge about healthy and nutritious food, co-workers who are smokers, and consum­ing alco­hol. This study aimed to analyze the risk factors for hypertension in the police and military in the world using meta analysis. Subjects and Method: This was a meta-ana­lysis and systematic review. The articles used we­re obtained from Google Scholar, Springer Link, Pro­­Quest, and Science Direct databases. Selected arti­cles published from 2000 to 2020. Keywords to search for articles are as follows: hypertension po­lice personnel and military, or hypertension po­lice personnel and military. The articles studi­ed are 3 full text articles with cross sectional stu­dy designs and 1 full text articles with case cont­rol study design. Articles are col­lect­ed using PRI­S­­­MA diagrams, and analy­zed us­ing the Re­vi­ew Ma­nager application 5.3. Results: Overweight (aOR= 1.42; 95% CI = 1.01 to 2.00; p= 0.04), alcohol consumption (aOR­=­ 1.­55; 95% CI= 1.12 to 2.12; p= 0.007), ciga­rette con­­­­sumption (aOR= 1.45 ; 95% CI= 1.06 to 1.97; p= 0.020) is a risk factor for hyper­­­tension in the po­­­lice and military. Conclusion: Overweight, alcohol consump­tion, and cigarette consump­tion, are risk fac­tors for hypertension in po­lice and military personnel.
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Effect of Boiled Carica Papaya Leaf on Death of Aedes Aegypti Larvae Aji, Rustam
Journal of Epidemiology and Public Health Vol 2, No 3 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: In its life cycle Aedes aegypti larvae develop to become mosquito. Then the masquito develops to become vector of dengue haemorrhagic fever transmission. The life cycle of Aedes aegypti vector can be interrupted by killing Aedes aegypti larvae. The killing of Aedes aegypti larvae has been undertaken by fogging or abate powder administration. However, these methods can cause environmental pollution. Carica papaya leaf has long been recognized to have the potential to become an effective and safe larvacide since it contains papain enzyme. The effect of papain protease can kill Aedes aegypti larvae. This study aimed to determine the effect of boiled Carica papaya leaf on death of Aedes aegypti larvae.Subjects and Method: This was an analytic experimental study using randomized control trial design. The study was conducted in Curup Tengah village, Bengkulu Province. Study sample included 36 water containers containing Aedes aegypti larvae. These containers were divided into 2 groups: papain enzyme group and no papain enzyme (control) group. The data on the percentage of killed Aedes aegypti larvae were then compared and tested by Chi Square test. The effect of Carica papaya leaf was indicated by Odds Ratio.Results: Boiled Carica papaya leaf had an effect on the death of Aedes aegypti larvae. Carica papaya leaf that was administered on the larvae increased the risk of death among Aedes aegypti larvae four times as many (OR= 4.10; p= 0.043).  Conslusion: Carica papaya leaf is effective to increase the risk of death among Aedes aegypti larvae.Keyword : Carica papaya leaf, Aedes aegypti larvae.Correspondence: Rustam Aji. Study Program in Nursing, Curup School of Health Polytechnics, Bengkulu. Email: adjieroestamadjie@gmail.com.Journal of Epidemiology and Public Health (2017), 2(3): 236-240https://doi.org/10.26911/jepublichealth.2017.02.03.05
Multilevel Analysis on the Social Determinants of Cervical Cancer in Yogyakarta Sari, Heni Elmiani; Mudigdo, Ambar; Demartoto, Argyo
Journal of Epidemiology and Public Health Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: There are 527.600 new cases of invasive cervical cancer. Cervical cancer is caused by infection with the Human Papilloma Virus (HPV) 16 and 18 study was conducted in the city of Yogyakarta. This study aimed to analyze the social determinants on cervical cancer by multilevel analysis in Yogyakarta.Subjects and Methods: This was an observational analytic study with case control design. This was conducted on March 31 to May 4, 2016. A total of 120 samples were selected by fixed disease sampling with a ratio 1:3. The data collected was using a questionnaire and analyzed with Logistic Regression.Results: The risk of cervical cancer with a positive effect on family income (OR = 3.45 95% CI = 0.26 to 45.45 p = 0.346), age of first sexual intercourse (OR = 8.54 95% CI = 1.17 to 62.41 p = 0.034), number of sexual partners (OR = 14.60 95% CI = 2.93-72.66 p = 0.001), oral contra­ceptives (OR = 1.85 95% CI = 0:37 to 9:20 p = 0452), nutritional status (OR = 5.69 95% CI = 1.36 to 23.82 p = 0.017), hygiene genitalia (OR = 9:23 95% CI = 1.76 to 48.35 p = 0.009), and an effect reversed by education (OR = 0:14 95% CI = 0:09 to 2:08, p = 0.155). ICC value of 40.68% indicating the risk of cervical cancer in women varies and a variation of 40.68% at the level of environmental sanitation home.Conclusion: There is a positive effect of family income, age of first sexual intercourse, number of sexual partners, nutritional status, hygiene genitalia, and sanitary home environment, on the risk of cervical cancer. There is an inverse effect of education on the risk of cervical cancer. The society  is expected to be aware of cervical cancer.Keywords: multilevel analysis, social determinants, cervical cancer.Correspondence: Heni Elmiani Sari. School of Midwifery (AKBID) Kutai Husada, Tenggarong, Indonesia. Email: henyelmiani@gmail.comJournal of Epidemiology and Public Health (2016), 1(2): 100-107https://doi.org/10.26911/jepublichealth.2016.01.02.03
Risk Factors of Dengue Fever: Application of PRECEDE – PROCEED Model Ayuningtyas, Kanthi Devi; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 4, No 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Dengue infection is one of the main health problems in more than 100 tropical and subtropical countries. This study aims to analyze the factors that play a role in the occurrence of dengue fever cases by applying the PRECED - PROCEED model.Subjects and Method:This was an analytic observational study with a case control design. The study was conducted at 8 sub-districts in Sukoharjo, Central Java, from May to July 2018. A sample of 200 study subjects was selected for this study by fixed disease sampling, comprising 50 peoples with dengue fever and 150 peoples without dengue fever. The dependent variables were dengue fever. The independent variables were intention, attitude, education, dengue fever prevention, family income, and sanitation. The data were collected by questionnaire and analyzed by path analysis run on Stata 13.Results: The risk of dengue fever was directly reduced by good environmental sanitation (b= -1.32, 95% CI= -2.09 to -0.54, p= 0.001) and good prevention behavior (b= -2.61, 95% CI= -3.55 to -1.67, p<0.001). The risk of dengue fever was indirectly affected by intention, attitude, education, and family income.Conclusion: The risk of dengue fever is directly reduced by good environmental sanitation and good prevention behavior. The risk of dengue fever is indirectly affected by intention, attitude, education, and family income.Keywords: dengue fever, preventive behavior, environmental sanitation, PRECEDE-PROCEED modelCorrespondence: Kanthi Devi Ayuningtyas. School of Health Sciences Patria Husada, Blitar. Jl. Sudanco Supriyadi No 168, Blitar, East Java. Email: kanthideviayuningtyas@gmail.com. Mobile: 08125266956.Journal of Epidemiology and Public Health (2019), 4(1): 37-46https://doi.org/10.26911/jepublichealth.2019.04.01.05
Geographical Satellite and Survey Data for Prediction of Dengue Cases in Sukoharjo, Indonesia Kusumawati, Dyah; Prayitno, Adi; Dharmawan, Ruben
Journal of Epidemiology and Public Health Vol 1, No 1 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Dengue fever is a disease based on environment and still a health problem. Problems related to the dengue fever vector distribution factor in terms of the spread of vector space with the use of geographic data and survey data in order to predict the incidence of dengue in the region.Subjects and Methods: This study used analytic observational with cross sectional approach using modeling Geographical Information Systems (GIS). The sampling technique in this research is saturated sampling of secondary data Sukoharjo District Health Profile in 2011-2014, population data and data Geographic, then all the data were analyzed using multiple linear regression.Results: There is a positive relationship between the area per Km2 with the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.01 - 0:02; p = 0.310). There is a positive relationship between population density per soul / Km2dengan number of new cases of dengue fever, a significant relationship between population density with DHF cases. (B = <0:01; CI <0:01 to 0:01; p = 0.013). There is a negative relationship between topography per masl by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.02 - 0:01; p = 0.335). There is a positive correlation between rainfall per mm / yr with the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI <0:01 to 0:01; p = 0101). There is a positive relationship between river flow per ha by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = 0:02; CI -0.01 - 0:03; p = 0318). There is a negative correlation between% Non Flick figure by the number of new cases of dengue fever, although the relationship was not statistically significant. (B = <0:01; CI -0.02 - 0:01; p = 0764).Conclusions: The increase in land area, population density, rainfall, river flow is predicted to affect the increase in dengue cases, whereas the increase ABJ predicted topography and affecting the decline of dengue cases in the district of Sukoharjo in 2011-2014.Keywords: geographical data and survey data, prediction of dengue casesCorrespondence: Dyah Kusumawati. Academy of Health Analyst 17  Agustus 1945, Semarang, Indonesia. Email: dyahkusumawatiwinarno@yahoo.co.id. Mobile: 085876563978Journal of Epidemiology and Public Health (2016), 1(1): 11-17https://doi.org/10.26911/jepublichealth.2016.01.01.02
Path Analysis: Psychososial and Economic Factors Affecting Diarrhea Incidence in Children Under Five in Jayapura, Papua Tungga, Tersia Marentiva; Dewi, Yulia Lanti Retno; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Diarrhea is a major cause of malnutrition and death in children under five. Studies have shown that there are some factors contributing to the incidence of diarrhea in infants. This study aimed to examine the psychosocial and economic factors affecting diarrhea incidence in children under five in Jayapura, Papua.Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in North Jayapura Subdistrict, Papua, in February 2018. A sample of 200 children under five was selected for this study by fixed disease sampling, consisting of 100 children with diarrhea and 100 children without diarrhea. The dependent variable was diarrhea. The independent variables were maternal education, family income, exclusive breastfeeding, nutritional status, personal hygiene, and environmental sanitation. The data were collected by questionnaire. Path analysis was employed for data analysis in Stata 13.Results: The risk of diarrhea increased with poor personal hygiene (b= -1.04; 95% CI= -1.75 to -0.33; p= 0.004), poor environmental sanitation (b= -1.90; 95% CI= -2.59 to -1.21; p<0.001), poor nutritional status (b= -1.27; 95% CI= -2.02 to -0.52; p= 0.001). The risk of diarrhea was indirectly affected by exclusive breastfeeding, maternal education, and family income.Conclusion: The risk of diarrhea increases with poor personal hygiene, poor environmental sanitation, poor nutritional status, and indirectly affected by exclusive breastfeeding, maternal education, and family income.Keywords: psychosocial factor, economic factor, diarrhea, children under fiveCorrespondence: Tersia Marentiva Tungga. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami No. 36 A, Surakarta 57126, Central Java. Email: tersiatungga@gmail.com. Mobile: +6285244754188.Journal of Epidemiology and Public Health (2018), 3(3): 331-341https://doi.org/10.26911/jepublichealth.2018.03.03.04
Biopsychosocial Factors Associated with Child Growth at Ngembal Kulon Community Health Center, Kudus Setyaningrum, Th. Catur Wulan; Murti, Bhisma; Indarto, Dono
Journal of Epidemiology and Public Health Vol 2, No 2 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: The first five years of life is widely acknowledged as a sensitive period for child growth. Any interruption exposing during this period may cause problems in child growth. Various internal and external factors can affect child growth. This study aimed to analyze the effects of biopsychosocial factors associated with child growth with life course perspective.Subjects and Method: This was an observational analytic study with cross-sectional design. It was conducted at Ngembal Kulon community health center, Kudus, Central Java, from December 2016 to February 2017. A total sample of 160 children aged 1 to 5 years old and their mothers were selected for this study by purposive sampling. The dependent variable was child growth as measured by weight for age (WAZ) and height for age (HAZ). The independent variables were birth weight, body length at birth, maternal height, number of children, and family income. The data was collected by a set of questionnaire. Child and maternal heights were measured by microtoise. Data on birthweight and body length at birth were obtained from maternal and child health book. Multiple linear regression was used for data analysis.Results: Child growth (WAZ) was associated with family income (b= 0.36; 95% CI= 0.22 to 0.49; p<0.001), birthweight (b= 0.42; 95% CI= 0.25 to 0.58; p<0.001), and number of children (b= -0.25; 95% CI= -0.42 to -0.08; p=0.004). Child growth (HAZ) was associated with family income (b= 0.26; 95% CI= 0.12 to 0.39; p<0.001), body length at birth (b=0.21; 95% CI= 0.12 to 0.30; p<0.001), and maternal height (b= 0.43; 95% CI= 0.27 to 0.58; p<0.001).Conclusion: Child growth (WAZ) is associated with family income, birthweight, and number of children. Child growth (HAZ) is associated with family income, body length at birth, and maternal height. Life course influences were demonstrated in this study.Keywords: child growth, WAZ, HAZ, birthweight, body length at birth, number of children, maternal height, family incomeCorrespondence: Th. Catur Wulan Setyaningrum. Academy of Midwifery Mardi Rahayu, Kudus. Email: theresia.akmr@yahoo.com. Mobile: 085641897987.Journal of Epidemiology and Public Health (2017), 2(2): 130-140https://doi.org/10.26911/jepublichealth.2017.02.02.04
Multilevel Analysis on the Biological, Social Economic, and Environmental Factors on the Risk of Pneumonia in Children Under Five in Klaten, Central Java Luthfiyana, Nurul Ulya; Rahardjo, Setyo Sri; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Pneumonia is one of the leading causes of death in children under five in the world, particularly in the developing countries including Indonesia. Imbalance between host, agent, and environment, can cause the incidence of pneumonia. This study aimed to examine the biological, social economic, and environmental factors on the risk of pneumonia in children under five using multilevel analysis with village as a contextual factor.Subjects and Method: This was an analytic observational study with case control design. The study was conducted in Klaten District, Central Java, from October to November, 2017. A total sample of 200 children under five was selected for this study by fixed disease sampling. The dependent variable was pneumonia. The independent variables were birth weight, exclusive breastfeeding, nutritional status, immunization status, maternal education, family income, quality of house, indoor smoke exposure, and cigarette smoke exposure. The data were collected by questionnaire and checklist. The data were analyzed by multilevel logistic regression analysis.Results: Birth weight ≥2.500 g (OR=0.13; 95% CI= 0.02 to 0.77; p= 0.025), exclusive breastfeeding (OR= 0.15; 95% CI= 0.02 to 0.89; p= 0.037), good nutritional status (OR=0.20; 95% CI= 0.04 to 0.91; p= 0.038), immunizational status (OR= 0.12; 95% CI= 0.02 to 0.67; p= 0.015), maternal educational status (OR= 0.18; 95% CI= 0.03 to 0.83; p= 0.028), high family income (OR= 0.25; 95% CI= 0.07 to 0.87; p= 0.030), and good quality of house (OR= 0.21; 95% CI= 0.05 to 0.91; p= 0.037) were associated with decreased risk of pneumonia. High indoor smoke exposure (OR= 8.29; 95% CI= 1.49 to 46.03; p= 0.016) and high cigarette smoke exposure (OR=6.37; 95% CI= 1.27 to 32.01; p= 0.024) were associated with increased risk of pneumonia. ICC= 36.10% indicating sizeable of village as a contextual factor. LR Test p= 0.036 indicating the importance of multilevel model in this logistic regression analysis.Conclusion: Birth weight, exclusive breastfeeding, good nutritional status, immunizational status, maternal educational status, high family income, and good quality of house decrease risk of pneumonia. High indoor smoke exposure and high cigarette smoke exposure increase risk of pneumonia.Keyword: pneumonia, biological, social economic, environmental factor, children under fiveCorrespondence: Nurul Ulya Luthfiyana, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: ulya.luthfiyana@gmail.com.Journal of Epidemiology and Public Health (2018), 3(2): 128-142https://doi.org/10.26911/jepublichealth.2018.03.02.03 
Effect of Locus of Control, Self-Efficacy, and Personality Type on the Quality of Life among Caregivers of Schizophrenia Patient in Godean Sub-District, Yogyakarta -, Mulyanti; Adriani, Rita Benya; Rahardjo, Setyo Sri
Journal of Epidemiology and Public Health Vol 2, No 1 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Caregivers of schizophrenia patients have an important role in fulfiling the need of patients. This task implicates on care burden and physological problems on the caregivers. The quality of life of the caregivers may have important impact on the caring process. This study aimed to examine effect of locus of control, self-efficacy and personality type on the quality of life among caregivers of schizophrenia patient.Subjects and Method: This study was analytic observational with cross-sectional design.  It was carried out at Godean Sub-District, Yogyakarta, from March to April 2017. A sample of 102 caregivers of schizophrenia patient were selected for this study by fixed diseases sampling. The dependent variable wa quality of life. The independent variables were age, gender, personality type, locus of control, self-efficacy, family concern, family income. The data was collected by questionnaire, and analyzed by path analysis.Results: Higher quality of life of caregivers was affected by self-efficacy (b=0.46; SE=0.15; p<0.001), extrovert personality (b=0.21; SE=0.10; p=0.01), and higher family income (b=0.18; SE=0.05; p=0.02). Self-efficacy was affected by better family concern (b=0.22, SE=0.16; p=0.02) and extrovert personality (b=0.33; SE=0.06; p<0.001).Conclusion: Higher quality of life of caregivers was directly affected by self-efficacy, extrovert personality, and higher family income. Higher quality of life of caregivers was indirectly affected by better family concern and extrovert personality.Keywords: quality of life, locus of control, self-efficacy, schizophrenia, caregiverCorrespondence: Mulyanti. Masters Program in Public Heath, Sebelas Maret University, Surakarta. Email: kalilaputri2811@gmail.com. Mobile: +6285868823105.Journal of Epidemiology and Public Health (2017), 2(1): 20-31https://doi.org/10.26911/jepublichealth.2017.02.01.03 
Risk Factors of Leptospirosis in Klaten, Central Java Sofiyani, Maya; Dharmawan, Ruben; Murti, Bhisma
Journal of Epidemiology and Public Health Vol 3, No 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Leptospirosis a global public health issue, particullary in tropical and sub-tropical countries with high precipitation. WHO has estimated that the annual of Leptospirosis is 0.1 to 1 case/100,000 population in moderate non-endemic area, and 10 to 100 cases/100,000 population in humid and tropical endemic areas. Currently, Indonesia is a tropical country with the highest fatality rate of leptospirosis, ranging from 2.5% to 16.45% with an average of 7.1%. It places Indonesia as the third country with the highest mortality attibutable to Leptospirosis. This study aimed to analyze the risk factors of Leptospirosis in Klaten, Central Java.Subjects and Method: This was an analytic and observational study with case control design. The study was conducted in Klaten, Central Java, from October to November, 2017. A sample of 49 Leptospirosis cases and 101 non-diseased controls were selected for this study by fixed disease sampling. The independent variable were employment status, history of cuts, history of water excursion, use of personal protective equipment (PPE), house condition, environmental condition, presence of mouse or cattle, history of rain or flood. The dependent variable was Leptospirosis. The data were collected by questionnaire and analyzed by path analysis.Results: The risk of Leptospirosis increased with history of cuts (b= 1.64; CI 95%= 0.40 to 2.87; p= 0.009), history of water excursion (b= 1.98; CI 95%= 0.52 to 3.43; p= 0.008), poor house condition (b= -1.92; CI 95%= -3.08 to -0.77; p= 0.001), and poor environmental condition (b= -2.35; CI 95%= -3.48 to -1.23; p<0.001). History of cuts increased with cattle-related work (b= 1.79; CI 95%= 0.86 to 2.72; p<0.001) and absence of PPE (b= -2.54; CI 95%= -3.49 to -1.60; p<0.001).Conclusion: The risk of Leptospirosis increases with history of cuts, history of water excursion, poor house condition, and poor environmental condition. History of cuts increases with cattle-related work and absence of PPE.Keywords: risk factor, LeptospirosisCorrespondence: Maya Sofiyani. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, 57126, Central Java, Indonesia. Email: mayasofiani@rocketmail.com.Journal of Epidemiology and Public Health (2018), 3(1):  11-24https://doi.org/10.26911/jepublichealth.2018.03.01.02 
Path Analysis on the Determinants of Neonatal Asphyxia at Dr. Saiful Anwar Hospital, Malang Lestary, Dewy Indah; Sulaeman, Endang Sutisna; Suryani, Nunuk
Journal of Epidemiology and Public Health Vol 1, No 2 (2016)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Neonatal asphyxia is one of the main causes of neonatal mortality. Many factors may have caused neonatal mortality. This study aimed to investigate the determinants of neonatal asphyxia at Dr. Saiful Anwar Hospital, Malang.Subjects and Method: This was an analytic observational study using case control design. The study was conducted at Dr. Saiful Anwar, Malang, East Java, in June 2016. A total of 53 newborn babies with asphyxia (cases) and 159 newborn babies without asphyxia (controls) were selected by fixed disease sampling for this study. There were three exogenous variables: prematurity, maternal age, and parity. The endogenous variables were birthweight and neonatal asphyxia. The data were collected by a checklist. The data were analyzed by path analysis model.Results: Low birthweight had positive direct effect on the risk of neonatal asphyxia (b=1.61; 95% CI= 0.86 to 2.37; p<0.001). Prematurity (b=0.93; 95% CI= 0.13 to 1.74; p<0­.02­3)­, maternal ages <20 years or ≥35 years (b=0.97; 95%CI = 0.05 to 1.87; p<0.034), and parity primipara or ≥4 parity (b=1.00; 95% CI = 0.155 to 1.85; p<0.021), had positive indirect effects on the risk of neonatal asphyxia via low birthweight.Conclusion: Low birthweight had positive direct effect on the risk of neonatal asphyxia. Prematurity­, maternal ages <20 years or ≥35 years, and parity primipara or ≥4 parity, had positive indirect effects on the risk of neonatal asphyxia via low birthweight.Keywords: neonatal asphyxia, low birth weight, prematurity, maternal age, parity.Correspondence: Dewy Indah Lestary. Academy of Midwifery Wijaya Kusuma, Malang, East Java. Email: dewylestary86@gmail.comJournal of Epidemiology and Public Health (2016), 1(2): 140-147https://doi.org/10.26911/jepublichealth.2016.01.02.08 

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