Journal of Epidemiology and Public Health
type: channel
description: e-ISSN: 2549-0273 Publisher: Masters Program in Public Health, Sebelas Maret University Jl. Ir Sutami 36A, Surakarta 57126, Central Java, Indonesia Editor in Chief: Vitri Widyaningsih, dr., M.S., Ph.D Universitas Sebelas Maret, Solo, Indonesia Aim and Scope The Journal of Epidemiology and Public Health (JEPH) is an open-access, peer-reviewed international journal dedicated to advancing knowledge and research in the fields of epidemiology and public health. Established on June 2, 2015, JEPH publishes high-quality original research articles, systematic reviews, and meta-analyses on a quarterly basis. Our mission is to contribute to the global improvement of population health by disseminating rigorous scientific evidence that informs public health policy, practice, and education. The journal seeks to highlight innovative research that addresses contemporary health challenges, with a particular emphasis on health disparities, disease prevention, health promotion, and health systems strengthening. JEPH welcomes contributions from researchers around the world and is particularly committed to amplifying the voices of scholars from low- and middle-income countries (LMICs). We encourage submissions that tackle regionally relevant health issues, apply robust epidemiological methods, and propose evidence-based solutions to pressing public health problems. Key areas of interest include, but are not limited to: Epidemiological studies of communicable and non-communicable diseases Social determinants of health and health inequalities Health systems research and policy evaluation Public health interventions and health promotion Environmental and occupational health Global health and health equity Biostatistics and methodological advances in epidemiological research Pandemic preparedness and response JEPH is officially accredited by the Ministry of Research, Technology, and Higher Education, Government of Indonesia, under decree No. 10/C/C3/DT.05.00/2025. The journal holds SINTA 2 …
publisher: Masters Program in Public Health
language: en
publication name: Journal of Epidemiology and Public Health
issn: 2549-0273
items: Determinants of Type 2 Diabetes Mellitus among Adults in Urban and Rural Areas of Sragen Regency, Central Java, Indonesia
items: Health Belief Model Predictors of Tertiary Preventive Behavior and HbA1c Levels among Patients with Type 2 Diabetes Mellitus
items: Factors Associated with Pulmonary Tuberculosis in Yogyakarta, Indonesia: A Matched Case-Control Study
items: Household Drinking Water Source, Treatment, Storage, and Weather Conditions in Relation to Drinking Water Quality in Klaten District, Indonesia
items: Multilevel Analysis of District- and City-Level Contextual Factors Influencing Hypertension Risk Among Adults: An Analysis of Indonesian Health Survey Year 2023
items: Determinants of Tuberculosis Incidence Among Children Under Five in Karanganyar, Central Java, Indonesia
items: Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study
items: Association Between Screen Time Duration and Attention- Deficit/Hyperactivity Disorder Symptoms Among Children Aged 4–6 Years
items: Scalable Forecasting Geoanalytics for Epidemic Dengue Risk in East Java
items: Clinical Indicators of Robotic Assisted versus Conventional Spine Surgery: A Systematic Review
items: Implementation of Theory of Planned Behavior on Behavior Change and Outcomes in Type 2 Diabetes Mellitus Patients in Surakarta, Central Java, Indonesia
items: Analysis of Risk Factors Associated with Rabies Cases in South Timor Tengah Regency, East Nusa Tenggara, Indonesia
items: The Influence of Social Trust, Income Inequality, and Employment Status on the Risk of Depression
items: The Influence of Gender, Body Mass Index, Work Fatigue and Noise Exposure on Blood Pressure among Manufacturing Industry Workers
items: The Relationship between the TCF7L2 rs7903146 Gene Polymorphism and Anthropometric Parameters and Muscle Mass among Patients with Type 2 Diabetes Mellitus at Puskesmas Waruroyom, Cirebon
items: Maternal Death Review Through the Maternal Perinatal Death Notification Surveillance System: An Aggregate Analysis at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
items: A Review of Solid Medical Waste Management in Indonesian Hospitals
items: Factors Associated with Post-Sternotomy Wound Infection: A Meta-Analysis
items: Unveiling the Drivers of Anemia: A Multifactorial Analysis
items: Patient Safety and Hospital-Based Health Promotion in Preventing Infections and Their Impact on Childhood Stunting: A Systematic Review

Determinants of Type 2 Diabetes Mellitus among Adults in Urban and Rural Areas of Sragen Regency, Central Java, Indonesia
type: item
description: Background: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with increasing prevalence in both urban and rural areas. Differences in sociodemographic characteristics and health behaviors between urban and rural populations are suspected to influence the clinical profile and demographic characteristics of T2DM patients. This study aims to analyze differences in T2DM patient characteristics in adults in urban and rural areas of Sragen Regency, Indonesia, and identify the most dominant factors differentiating these two groups. Subjects and Method: This was a comparative observational analytical study with a cross-sectional design conducted in six health centers in Sragen Regency representing urban and rural areas. Research subjects were adult patients with T2DM who met inclusion criteria. Variables examined included age, sex, educational level, income, occupation, and physical activity. Data were collected using structured questionnaires and medical records. Bivariate analysis was performed using the Chi-square test, while multivariate analysis used binary logistic regression. Results: Significant differences were found between T2DM patients in urban and rural areas based on age (p=0.035), educational level (p=0.007), income (p=0.011), occupation (p=0.016), and physical activity (p=0.005). No significant difference was found in sex distribution between the two areas (p=0.078). Binary logistic regression analysis showed that physical activity was the most dominant factor differentiating T2DM patient characteristics in urban and rural areas (OR=2.326; p=0.007). Patients with low physical activity had 2.326 times higher odds of residing in urban areas compared to those with moderate or high physical activity. Conclusion: Physical activity is the most dominant factor differentiating T2DM patient characteristics between urban and rural areas. Area-specific T2DM prevention and control stra­tegies should prioritize physical activity improvement with approaches t…
subject: Articles
  topic: section
subject: type 2 diabetes mellitus
  topic: keywords
subject: urban and rural
  topic: keywords
subject: physical activity
  topic: keywords
subject: health determinants
  topic: keywords
creator: Novia Erliana Wandansari
creator: Ika Sumiyarsi Sukamto
creator: Setyo Sri Rahardjo
creator: Erindra Budi Cahyanto
creator: Revi Gama Hatta Novika
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 197
ending page: 209
doi: 10.26911/jepublichealth.2026.11.02.07

Health Belief Model Predictors of Tertiary Preventive Behavior and HbA1c Levels among Patients with Type 2 Diabetes Mellitus
type: item
description: Background: Type 2 diabetes mellitus (T2DM) remains a major public health challenge worldwide. This study applied the Health Belief Model (HBM) to examine its association with tertiary preventive behavior and HbA1c levels among patients with T2DM. The study aimed to analyze the effects of HBM constructs on tertiary preventive behavior and their impact on HbA1c levels in patients with T2DM. Subjects and Method: A quantitative study with a cross-sectional design was conducted among 210 patients with T2DM receiving outpatient care at UNS Hospital. Data were collected between September and October 2025. The independent variables included perceived susceptibility, perceived severity, perceived benefits, self-efficacy, and cues to action. The dependent variables were tertiary preventive behavior and HbA1c levels. Data were analyzed using univariate analysis, bivariate analysis with simple logistic regression, and multivariate analysis using path analysis in STATA 13. Results: Self-efficacy (b = 0.190; 95% CI = 0.029 to 0.350; p = 0.020), perceived benefits (b = 0.162; 95% CI = 0.021 to 0.301; p = 0.023), and cues to action (b = 0.294; 95% CI = 0.122 to 0.465; p = 0.001) had direct and significant effects on tertiary preventive behavior. Tertiary preventive behavior (b = −0.183; 95% CI = −0.307 to −0.085; p = 0.004), age (b = 0.134; 95% CI = 0.005 to 0.263; p = 0.041), duration of diabetes (b = 0.164; 95% CI = 0.035 to 0.295; p = 0.014), and family history of diabetes (b = 0.228; 95% CI = 0.104 to 0.351; p < 0.001) had direct and significant effects on HbA1c levels. Sex had direct but non-significant effects on both tertiary preventive behavior and HbA1c levels. Perceived susceptibility and perceived severity exerted indirect but significant effects on tertiary preventive behavior through perceived benefits. Conclusion: Self-efficacy, perceived benefits, cues to action, and sex directly influenced tertiary preventive behavior, whereas perceived susceptibility and perceived…
subject: Articles
  topic: section
subject: Type 2 diabetes mellitus
  topic: keywords
subject: health belief model
  topic: keywords
subject: tertiary preventive behavior
  topic: keywords
creator: Anindya Wahyu Utami
creator: Dono Indarto
creator: Erindra Budi Cahyanto
creator: Vitri Widyaningsih
creator: Eti Poncorini Pamungkasari
creator: Bhisma Murti
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 108
ending page: 126
doi: 10.26911/jepublichealth.2026.11.02.01

Factors Associated with Pulmonary Tuberculosis in Yogyakarta, Indonesia: A Matched Case-Control Study
type: item
description: Background: Tuberculosis (TB) remains a public health problem in Indonesia, including in the city of Yogyakarta. The incidence of TB is influenced by various socioeconomic factors, individual characteristics, behavior, and the physical conditions of the home environment. Given these influences, this study aims to analyze the determinants of pulmonary tuberculosis incidence in Yogyakarta, Indonesia. Subjects and Method: This was a matched case-control study. Cases were patients with pulmo­nary tuberculosis, matched 1:2 by age, sex, and health center area to non-TB controls. Among 168 respondents (56 cases and 112 controls). The study involved 18 community health centers in Yogyakarta, Indonesia, from April to May 2026. Variables included family income, knowledge, attitudes, nutritional status, smoking history, diabetes mellitus, household and close contact history, and housing characteristics. Data were analyzed using bivariate tests and multivariate conditional logistic regression. Results: Family income below the Yogyakarta regional minimum wage (aOR= 0.30; 95% CI= 0.10–0.93), poor tuberculosis knowledge (aOR = 0.27; 95% CI= 0.08–0.95), history of diabetes mellitus (aOR= 0.07; 95% CI= 0.01–0.82), and a confirmed history of close contact with a tuberculosis patient (aOR= 5.12; 95% CI= 1.00–26.09) were independently associated with pulmo­nary tuber­culosis. Respondents who were unaware of their close contact history also had higher odds of tuber­culosis (aOR= 3.67; 95% CI= 0.82–16.30), although this association did not reach statistical significance. Conclusion: The incidence of pulmonary tuberculosis in Yogyakarta is significantly associated with family income, tuberculosis-related knowledge, history of diabetes mellitus, and close contact with TB patients. These findings highlight the importance of strengthening active TB case finding through systematic contact investigation not only among household contacts but also in workplaces and industrial settings to facilit…
subject: Articles
  topic: section
subject: contact investigation
  topic: keywords
subject: education
  topic: keywords
subject: knowledge
  topic: keywords
subject: tuberculosis
  topic: keywords
creator: Ardyawati Wira Oktaviana
creator: Setyo Sri Rahardjo
creator: Vitri Widyaningsih
creator: Nur Hafidha Hikmayani
creator: Arsita Eka Prasetyawati
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-08-07
publication date: 2026-08-07
doi: 10.26911/jepublichealth.2026.11.03.04

Household Drinking Water Source, Treatment, Storage, and Weather Conditions in Relation to Drinking Water Quality in Klaten District, Indonesia
type: item
description: Background: Safe drinking water remains a major public health challenge in Indonesia, where contamination continues to contribute to diarrheal disease burden. Household drinking water quality surveillance coverage in Klaten District remains far below the national target. This study analyzed the association between water source protection, household water treatment, water storage conditions, and climatic factors with household drinking water quality in Klaten District. Subjects and Methods: A cross-sectional study was conducted among 390 households from 26 subdistricts in Klaten District, selected via equal-allocation subsampling from the 2025 National Household Drinking Water Quality Surveillance Program (SKAMRT) using two-stage cluster sampling (15 households/subdistrict). Drinking water quality was classified as safe or unsafe based on five parameters (E. coli, Total Dissolved Solids, pH, nitrate, nitrite) per Ministry of Health Regulation No. 2/2023. Associations were assessed using Chi-square and Fisher's exact tests, followed by multiple logistic regression with backward stepwise elimination (α = 0.05). Results: Of 390 households, 202 (51.8%) had unsafe drinking water. Unprotected water sources were the only significant determinant of unsafe water quality (Adjusted OR = 1.61; 95% CI: 1.05–2.47; p = 0.029). Water treatment, storage type, and weather conditions showed no statistically significant association. Spatial analysis identified five subdistricts with very high risk (>80% non-compliant): Polanharjo (93.3%), Wonosari (86.7%), Bayat, Tulung, and Klaten Tengah (80.0% each). Model calibration was adequate (Hosmer-Lemeshow p = 0.741). Conclusion: Unprotected water sources represent an independent determinant of unsafe household drinking water quality in Klaten District. Interventions should prioritize water source protection, household water safety education, and expansion of SKAMRT surveillance coverage to support SDGs 6.1 achievement by 2030.
subject: Articles
  topic: section
subject: drinking water
  topic: keywords
subject: household water
  topic: keywords
subject: water quality
  topic: keywords
subject: source protection
  topic: keywords
subject: water treatment
  topic: keywords
creator: Desy Vidi Kurniasari
creator: Arsita Eka Prasetyawati
creator: Hafi Nurinasari
creator: Siti Khoiriyah
creator: Cynthia Permata Sari
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-07-16
publication date: 2026-07-16
starting page: 241
ending page: 251
doi: 10.26911/jepublichealth.2026.11.03.03

Multilevel Analysis of District- and City-Level Contextual Factors Influencing Hypertension Risk Among Adults: An Analysis of Indonesian Health Survey Year 2023
type: item
description: Background: Hypertension remains a major public health challenge in Indonesia, with prevalence continuing to rise across different population groups. The burden of hypertension varies across settings, including urban and rural areas, socioeconomic levels, and regional contexts. This study aimed to examine how district- and city-level contextual factors influence the risk of hypertension among adults in Indonesia. Subjects and Method: A cross-sectional study included a sample of 48,878 adults who participated in the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia). The data were analyzed using multilevel multiple linear regression. Results: Multilevel analysis showed that the risk of hypertension increased among individuals aged ≥60 years (b= 4.12; 95% CI= 3.76 to 4.48; p < 0.001), compared with those aged <20 years. Senior high school or higher education (b= –0.40; 95% CI= –0.48 to –0.31; p <0.001) was associated with a lower risk of hypertension compared with individuals with no formal education. Higher BMI was associated with an increased risk of hypertension among individuals with BMI 18.5–25 kg/m² (b= 0.19; 95% CI= 0.09 to 0.30; p < 0.001) and BMI ≥25 kg/m² (b= 0.92; 95% CI= 0.82 to 1.03; p < 0.001). Female sex (b= 0.21; p < 0.001), urban residence (b= 0.06; p= 0.021), and high Gini Ratio (b = 0.17; p < 0.001) increased the risk of hypertension, whereas high physical activity and higher provincial minimum wage reduced the risk. The ICC of 0.37% indicated low variation across districts/cities. Conclusion: Hypertension risk among Indonesian adults is mainly driven by individual factors, while income inequality is the only contextual factor with a significant effect. These results emphasize the need for interventions targeting both personal health behaviors and socioeconomic disparities.
subject: Articles
  topic: section
subject: hypertension
  topic: keywords
subject: systolic blood pressure
  topic: keywords
subject: multilevel analysis
  topic: keywords
subject: Indonesian Health Survey
  topic: keywords
creator: Anindhita Saviorel Rivaldy
creator: Bhisma Murti
creator: Setyo Sri Raharjo
creator: Vitri Widyaningsih
creator: Eti Poncorini Pamungkasari
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 147
ending page: 160
doi: 10.26911/jepublichealth.2026.11.02.04

Determinants of Tuberculosis Incidence Among Children Under Five in Karanganyar, Central Java, Indonesia
type: item
description: Background: Tuberculosis (TB) remains a major infectious disease and a leading cause of mortality worldwide, with 10.8 million cases and 1.25 million deaths reported in 2023. Indonesia is classified as a high-burden TB country, with 78,566 cases reported among children under five years of age. Young children are particularly vulnerable due to their immature immune systems. In Karanganyar Regency, Central Java, Indonesia, 137 cases of TB among under-five children were recorded in 2023. This study aimed to analyze the risk factors associated with TB incidence among children under five in Karanganyar Regency. Subjects and Method: This study employed an analytic observational design using a case-control approach. A total of 200 children under five were randomly selected, comprising 50 TB cases and 150 non-TB controls. Data were analyzed using simple logistic regression and path analysis to examine direct and indirect relationships among variables. Results: The incidence of TB among children under five increased with a history of contact with TB patients (b = 0.18; 95% CI = 0.10–0.26; p < 0.001) and living in homes with high humidity (b = 0.09; 95% CI = 0.01–0.17; p = 0.019). Conversely, TB incidence decreased with good lighting (b = -0.11; 95% CI = -0.19 to -0.03; p = 0.005), presence of bedroom windows (b = -0.41; 95% CI = -0.51 to -0.31; p < 0.001), living room windows (b = -0.31; 95% CI = -0.41 to -0.22; p < 0.001), and residence in highland areas (b = -0.13; 95% CI = -0.21 to -0.06; p < 0.001). Nutritional status was negatively affected by TB (b = -0.30; 95% CI = -0.43 to -0.15; p < 0.001) and positively influenced by family income (b = 0.17; 95% CI = 0.03–0.31; p = 0.016), with income exerting both direct and indirect effects through TB. The path analysis model demonstrated good fit (Chi-square p = 0.068; RMSEA = 0.052; CFI = 0.981; TLI = 0.960). Conclusion: The risk of TB among children under five increases with exposure to adult TB cases and living in humid housi…
subject: Articles
  topic: section
subject: childhood tuberculosis
  topic: keywords
subject: nutritional status
  topic: keywords
subject: tuberculosis
  topic: keywords
subject: contact history
  topic: keywords
subject: housing environment
  topic: keywords
creator: Ninik Hartini
creator: Bhisma Murti
creator: Setyo Sri Rahardjo
creator: Sumardiyono
creator: Yulia Lanti Retno Dewi
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-01-16
publication date: 2026-01-16
starting page: 68
ending page: 79
doi: 10.26911/jepublichealth.2026.11.01.06

Pathways to Depression: A Multidimensional Composite Analysis of Socioeconomic Inequalities in a Population-Based Study
type: item
description: Background: Socioeconomic factors are recognized as key contributors to the risk of depression among adults and older populations. However, socioeconomic status (SES) is often measured using single indicators, which may not capture its multidimensional nature. Moreover, the mechanisms through which socioeconomic conditions influence depression remain insufficiently explored. This study aimed to examine the pathways linking socioeconomic inequalities to depression using a multidimensional composite measure of SES. Subjects and Method: A cross-sectional analysis was conducted using data from the 2023 Indonesian Health Survey, a nationally representative population-based survey. SES was constructed using principal component analysis (PCA) based on wealth index, education level, employment status, participation in government social protection programs, and provincial-level income inequality (Gini index). Path analysis was performed to assess direct and indirect relationships between SES, physical activity, comorbidity, and depression. All analyses were conducted using STATA 17. Results: Higher SES was associated with a lower risk of depression. Significant pathways were observed from SES to depression both directly (β= -0.06; 95% CI= -0.07 to -0.06; p <0.001) and indirectly through comorbidity (β= -0.03; 95% CI= -0.03 to 0.02; p <0.001). Conclusion: Socioeconomic inequalities play a critical role in shaping depression risk through multiple pathways.
subject: Articles
  topic: section
subject: depression
  topic: keywords
subject: socioeconomic inequalities
  topic: keywords
subject: gini index
  topic: keywords
subject: household wealth index
  topic: keywords
subject: social protection program
  topic: keywords
subject: principal component analysis
  topic: keywords
creator: Wahyu Tri Sudaryanto
creator: Wahyuni
creator: Firmansyah
creator: Afif Ari Wibowo
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-07-16
publication date: 2026-07-16
doi: 10.26911/jepublichealth.2026.11.03.02

Association Between Screen Time Duration and Attention- Deficit/Hyperactivity Disorder Symptoms Among Children Aged 4–6 Years
type: item
description: Background: The rapid increase in screen time among children has raised urgent public health concerns due to its potential link with Attention- Deficit/ Hyperactivity Disorder (ADHD)-related symptoms. Emerging evidence suggests that excessive and early exposure to digital media may contribute to inattention, impulsivity, and behavioral dysregulation. This study aimed to examine the association between the duration of gadget use and ADHD symptoms in children aged 4–6 years. Subjects and Method: A cross-sectional study was conducted at four early childhood education institutions in Kartasura, Central Java, Indonesia. A total of 87 children aged 4–6 years were included. Screen time duration was assessed using a 7-day parent-reported observation sheet. ADHD symptoms were measured using the ADHD Rating Scale-5 (ADHDRS-5). The association between screen time duration and ADHD symptoms was analyzed using Pearson’s correlation test. Results: There was a statistically significant positive correlation between screen time duration and ADHD symptoms (r = 0.35; p = 0.001). Conclusion: Longer screen time duration is associated with higher levels of ADHD symptoms among children aged 4–6 years.
subject: Articles
  topic: section
subject: attention deficit hyperactivity disorder
  topic: keywords
subject: screen time
  topic: keywords
subject: preschool-aged children
  topic: keywords
creator: Adnan Faris Naufal
creator: Anida Azkia Fitri
creator: Arif Pristianto
creator: Laura Kirana
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-07-16
publication date: 2026-07-16
doi: 10.26911/jepublichealth.2026.11.03.01

Scalable Forecasting Geoanalytics for Epidemic Dengue Risk in East Java
type: item
description: Background: Current methods for managing Dengue Hemorrhagic Fever (DHF) in East Java often separate temporal and spatial analyses, hindering proactive public health interventions. To address this limitation, this study develops an integrated spatio-temporal framework that combines multi-model forecasting and geospatial analysis to create localized dengue projections and risk maps. Subjects and Method: An ecological spatio-temporal design was conducted across 38 districts/ cities in East Java using secondary data from 2013–2023. The dependent variable was annual dengue incidence, while independent variables comprised natural factors (e.g., rainfall, humidity) and social factors (e.g., population density, poverty). Data were analyzed using Geographically Weighted Regression (GWR) for spatial modeling. Time series forecasting for the 2024–2028 period was conducted using Trigonometric seasonality, Box-Cox transformation (TBATS), Auto­regressive Integrated Moving Average (ARIMA), Prophet, and Neural NETwork AutoRegression (NNETAR) models, evaluated by Root Mean Square Error (RMSE). Results: Rainfall demonstrated the strongest natural association (R²=0.49; p=0.022), followed by humidity (R²=0.26; p<0.001). Epidemiologically, population density emerged as the key social determinant (R²=0.50; p=0.005). TBATS achieved the highest forecasting accuracy with the lowest RMSE (47.657), outperforming ARIMA (202.980), Prophet (172.809), and NNETAR (157.653). Spatial risk mapping revealed that high-risk social clusters are heavily concentrated in the eastern 'Tapal Kuda' region and northern coastal metropolitan corridors. Conclusion: Dengue incidence in East Java is significantly driven by climatic factors and spatially varying social vulnerabilities. The integration of TBATS forecasting and GWR spatial modeling provides a robust framework for anticipating future case burdens and identifying priority inter­vention areas, thereby supporting highly targeted public health planning.
subject: Articles
  topic: section
subject: dengue
  topic: keywords
subject: forecasting
  topic: keywords
subject: spatial analysis
  topic: keywords
subject: population density
  topic: keywords
creator: Budi Fajar Supriyanto
creator: Ikha Nurjihan
creator: Nesa Ayu Murthisari Putri
creator: Elsa Tursina
creator: Andi Mulyanti Suhartini
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-07-16
publication date: 2026-07-16
starting page: 271
ending page: 283
doi: 10.26911/jepublichealth.2026.11.03.05

Clinical Indicators of Robotic Assisted versus Conventional Spine Surgery: A Systematic Review
type: item
description: Background: Spine surgery has technological breakthrough of robotic assistance systems. The objective of this review is to explore clinical outcome indicators employed for comparison of out-comes of robotic assisted surgery to conventional spine surgery under the framework of evidence-based practice. Subjects and Method: Based on guidelines issued by PRISMA, we systematically searched multi-ple sources, including PubMed, Scopus, and Science Direct databases. Studies comparing robotic assisted and conventional spine surgery were screened and analysed. Clinical indicators were collected and categorized according to surgical, functional, and safety concerns. Results: The 24 review papers reviewed were all published during 2017 – 2025. The study design studies included three RCTs, nineteen RC studies, one prospective controlled study and one PSMC study pointing to the recent incorporation of robotic technologies in spinal surgery. This has revealed five categories of clinical indicators: accuracy benchmarks, operative parameters, safety and complications, functional outcomes, recovery and hospitalization. The most often reported indicator was the precision of the placement of the pedicle screw, followed by time of operation and intraoperative blood loss. Radiation exposure is a very important measure of occupational health and safety. The goal of this comprehensive clinical framework is to identify a method whereby an evidence-based clinical practice framework for efficient application of technological adoption becomes possible which is in favour of sustainable use can help to guide fiscally responsible adoption. Conclusion: The current review establishes a composite framework of clinical indicators of clinical considerations towards robotic versus conventional spine surgery across robotic versus conventional spine surgery, a comprehensive evaluation paradigm. This framework provides a foundation upon which future studies can proceed.
subject: Articles
  topic: section
subject: robotic
  topic: keywords
subject: conventional
  topic: keywords
subject: spine surgery
  topic: keywords
subject: clinical indicators
  topic: keywords
creator: Hanny Ayu Soegihwangi
creator: Masyitoh Basabih
creator: I Made Esa Sadana Yoga
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 172
ending page: 196
doi: 10.26911/jepublichealth.2026.11.02.06

Implementation of Theory of Planned Behavior on Behavior Change and Outcomes in Type 2 Diabetes Mellitus Patients in Surakarta, Central Java, Indonesia
type: item
description: Background: The Theory of Planned Behavior (TPB) can serve as a conceptual framework for improving healthy behaviors among patients with type 2 diabetes mellitus (T2DM). The application of TPB is essential for predicting both behavioral patterns and health outcomes in individuals with T2DM. This study aimed to assess the implementation of TPB on behavioral change and outcomes in T2DM patients Subjects and Method: This cross-sectional study was conducted in Surakarta, Indonesia. There was 200 type 2 DM patients selected by purposive sampling. The dependent variables were HbA1c and behavior. The independent variables were behavioral belief, outcome evaluation, normative belief, motivation, control belief, control power, attitude, subjective norm, perceived behavioral control, and intention. Data were collected using a set of questionnaires and analyzed using path analysis. Results: HbA1c ≥6.5% was directly reduced by strong behavior, but it was statistically non signi­ficant (b= -0.22; 95%CI= -0.15 to 1.08; p= 0.745). Behavior was directly and significantly increased by strong intention (b= 1.66; 95% CI= 1.03 to 2.30; p<0.001) and high perceived behavior control (b= 0.87; 95% CI= 0.23 to 1.50; p= 0.007). Conclusion: The Theory of Planned Behavior can be used to predict healthy behavior among patients with type 2 DM.
subject: Articles
  topic: section
creator: Burhannudin Ichsan
creator: Bhisma Murti
creator: Revi Gama Hatta Novika
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2025-10-16
publication date: 2025-10-16
starting page: 566
ending page: 576
doi: 10.26911/jepublichealth.2025.10.04.12

Analysis of Risk Factors Associated with Rabies Cases in South Timor Tengah Regency, East Nusa Tenggara, Indonesia
type: item
description: Background: Rabies is a zoonotic infectious disease that can be directly transmitted to humans and is fatal, leading to death in South Timor Tengah Regency. Rabies has been officially declared an outbreak in this region. This study aimed to analyze the effects of selected risk factors on rabies cases in South Timor Tengah Regency, East Nusa Tenggara Province, Indonesia. Subjects and Method: This study used primary data and employed an analytic observational design with a case–control approach. A total of 200 participants were included, consisting of 100 rabies cases and 100 controls, drawn from a population of 4,749 cases and controls using random sampling across 32 subdistricts in South Timor Tengah Regency. The dependent variable was rabies case status. The independent variables included community knowledge, history of contact with dogs, vaccination status of pet dogs, age, sex, stray dog bites, and stray dog population density. Data were collected using a questionnaire that had been tested for validity and reliability. Path analysis was conducted using STATA version 13. Results: The study found significant associations between rabies cases and community knowledge (OR= 0.06; 95% CI= 0.03–0.16; p < 0.001), stray dog population density (OR= 2.72; 95% CI= 1.30–5.70; p= 0.008), stray dog bites (OR = 4.59; 95% CI= 1.97–10.69; p < 0.001), age (OR= 0.97; 95% CI= 0.95–0.99; p= 0.008), and sex (OR= 0.33; 95% CI= 0.16–0.71; p = 0.005). In contrast, history of contact with dogs (OR= 1.30; 95% CI= 0.62–2.71; p= 0.487), vaccination of pet dogs (OR= 0.89; 95% CI= 0.37–2.13; p = 0.796), and educational level (OR = 1.31; 95% CI= 0.54–3.15; p= 0.553) were not statistically significant. Conclusion: High stray dog population density and stray dog bites increase the risk of rabies, while higher community knowledge, female sex, and age ≥35 years serve as protective factors against rabies in the population of South Timor Tengah Regency.
subject: Articles
  topic: section
subject: rabies
  topic: keywords
subject: rabies vaccination
  topic: keywords
subject: stray dog bites
  topic: keywords
subject: outbreak
  topic: keywords
creator: Lucitania Floreca Mokos
creator: Setro Sri Rahardjo
creator: Bhisma Murti
creator: Yulia Lanti Retno Dewi
creator: Nur Hafidha Hikmayani
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2025-10-16
publication date: 2025-10-16
starting page: 555
ending page: 565
doi: 10.26911/jepublichealth.2025.10.04.11

The Influence of Social Trust, Income Inequality, and Employment Status on the Risk of Depression
type: item
description: Background: Depressive disorders are among the most common and complex mental health problems worldwide, including in Indonesia. The determinants of depression are closely linked to social and economic factors. This study aimed to estimate the effects of social trust, income inequality, and employment status on the risk of depression. Subjects and Method: An observational study with a cross-sectional design utilized the fifth wave of the Indonesia Family Life Survey (IFLS5). The dataset includes more than 29,716 individuals across 13 provinces. The sample was selected using a purposive sampling method. Results: The risk of depression increased significantly among individuals who were unmarried (b = 0.97; 95% CI: 0.84 to 1.07; p < 0.001), female (b = 0.16; 95% CI: 0.06 to 0.26; p = 0.002), unemployed (b = 0.25; 95% CI: 0.14 to 0.35; p < 0.001), and living in provinces with higher income inequality (b = 0.32; 95% CI: 0.21 to 0.42; p < 0.001). Conversely, the risk of depression decreased significantly with higher social trust (b = -0.18; 95% CI: -0.29 to -0.08; p < 0.001), good sleep quality (b = -0.20; 95% CI: -0.21 to -0.19; p < 0.001), older age (b= -0.81; 95% CI: -0.99 to -0.63; p < 0.001), and higher education level (≥senior high school) (b= -0.36; 95% CI: -0.46 to -0.25; p < 0.001). Conclusion: The risk of depression increases with unmarried, female, unemployed, and living in provinces with higher income inequality. The risk of depression decreases with higher social trust, good sleep quality, older age, and education ≥senior high school.
subject: Articles
  topic: section
subject: kepercayaan sosial
  topic: keywords
subject: ketimpangan pendapatan
  topic: keywords
subject: risiko depresi
  topic: keywords
creator: Dhina Nur Irfani
creator: Bhisma Murti
creator: Yulia Lanti Retno Dewi
creator: Revi Gama Hatta Novika
creator: Ika Sumiyarsi Sukamto
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2025-10-16
publication date: 2025-10-16
starting page: 547
ending page: 554
doi: 10.26911/jepublichealth.2025.10.04.10

The Influence of Gender, Body Mass Index, Work Fatigue and Noise Exposure on Blood Pressure among Manufacturing Industry Workers
type: item
description: Background: Noise in the work environment can exceed a set threshold and have an impact on workers' health, including increased blood pressure. In addition to noise, other factors such as work fatigue, body mass index, and gender also contribute to the risk of hypertension. Preliminary studies show that exposure to high noise and manual work activities is at risk of causing fatigue, so it requires further analysis of the influence of these factors on the blood pressure of industrial workers. Subjects and Method: The study design was a cross-sectional study. The study was conducted in Karanganyar Regency, Central Java in February-April 2025. Sampling in this study was conducted using the Fixed Exposure Sampling method, involving 200 worker samples from a herbal medicine factory and a fireworks factory in Karanganyar Regency, Central Java. The method used to collect data in this study was analytical observations with a cross-sectional approach. The analysis used in this study was path analysis. The dependent variable was blood pressure. The independent variables were noise exposure, fatigue, body mass index, and gender. Results: Blood pressure increased with high fatigue (b= 0.15; 95% CI <0.01 to 0.29; p= 0.038), noise exposure (b= 0.15; 95% CI= 0.02 to 0.28; p= 0.020). Blood pressure in female workers was lower than in men (b= -0.14; 95% CI= -0.28 to -0.01; p= 0.034). Blood pressure was indirectly affected by body mass index. Conclusion: This study shows that noise exposure and work fatigue have a direct effect on increasing blood pressure; women have lower blood pressure than men, while body mass index has an indirect effect on increasing the blood pressure of workers.
subject: Articles
  topic: section
subject: blood pressure
  topic: keywords
subject: noise, work fatigue
  topic: keywords
subject: body mass index
  topic: keywords
subject: gender
  topic: keywords
creator: Nurvita Eka Rizky
creator: Bhisma Murti
creator: Sumardiyono
creator: Setyo Sri Rahardjo
creator: Revi Gama Hatta Novika
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2025-10-16
publication date: 2025-10-16
starting page: 539
ending page: 546
doi: 10.26911/jepublichealth.2025.10.04.09

The Relationship between the TCF7L2 rs7903146 Gene Polymorphism and Anthropometric Parameters and Muscle Mass among Patients with Type 2 Diabetes Mellitus at Puskesmas Waruroyom, Cirebon
type: item
description: Background: Polymorphism of the TCF7L2 gene (rs7903146) is involved in glucose homeostasis and has been strongly associated with type 2 diabetes mellitus (T2DM). However, its relationship with anthropometric characteristics, particularly by glycemic control status, remains unclear. Subjects and Method: This cross-sectional study included 75 patients with type 2 diabetes mellitus (T2DM) in the working area of Puskesmas Waruroyom, Cirebon. The target population comprised all registered T2DM patients, and total sampling was applied through screening. Subjects were classified into controlled (n = 37; 49.3%) and uncontrolled (n = 38; 50.7%) groups based on glycemic status. TCF7L2 rs7903146 genotypes (CC, CT, TT) were identified, and anthro­pometric parameters (height, body weight, BMI, waist circumference, and muscle mass) were analyzed using chi-square or Fisher’s exact tests, with additional analyses for continuous variables. Results: The most frequent genotype was CT (69.3%), followed by TT (25.3%) and CC (5.3%). No significant differences were observed in anthropometric parameters across TCF7L2 rs7903146 genotypes in both controlled and uncontrolled groups, including BMI (p= 0.580 and p= 0.830), waist circumference (p= 1.000 and p= 0.760), and muscle mass (p= 1.000 and p= 0.420), respectively. Conclusion: The TCF7L2 rs7903146 polymorphism was not associated with anthropometric profiles among patients with T2DM, regardless of glycemic control status. This suggests that the influence of TCF7L2 is more strongly related to metabolic regulation through insulin signaling pathways rather than to determinants of body composition.
subject: Articles
  topic: section
subject: anthropometry
  topic: keywords
subject: diabetes mellitus
  topic: keywords
subject: glycemic control
  topic: keywords
subject: TCF7L2 polymorphism
  topic: keywords
creator: Muhammad Ajmalunnas
creator: Yuni Susanti Pratiwi
creator: Tiar Masykuroh Pratamawati
creator: Donny Nauphar
creator: Edhyana Sahiratmadja
creator: Leonardo Lubis
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 161
ending page: 171
doi: 10.26911/jepublichealth.2026.11.02.05

Maternal Death Review Through the Maternal Perinatal Death Notification Surveillance System: An Aggregate Analysis at Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
type: item
description: Background: Maternal mortality remains a major concern in Indonesia, particularly in referral hospitals that manage high-risk pregnancies. This study aimed to examine maternal deaths and assess contributory factors at Universitas Airlangga Hospital in 2024 using the maternal perinatal death notification (MPDN) system. Subjects and Method: A retrospective-descriptive study was conducted, including all maternal deaths recorded from January to December 2024. Quantitative data were analyzed descriptively, and factors contributing to maternal mortality were classified using the Three Delays Model. A mixed method with multidisciplinary hospital staff provided qualitative insights into clinical and institutional gaps. Results: A total of 11 maternal deaths occurred during the study period, resulting in an MMR of 557 per 100,000 live births. Most deaths occurred in women over 35 years (81.8%) and during the third trimester (81.8%). Non-obstetric complications were the leading cause (40%), followed by pregnancy-related infections (20%) and hypertensive disorders (10%). First, delay factors, particularly socio-cultural barriers, were present in 36.4% of cases, while third, delay factors, including delayed diagnosis and treatment, were identified in 45.5%. FGDs highlighted gaps in emergency preparedness, blood availability, and interprofessional communication. Conclusion: These findings highlight the combined role of clinical complexity and systemic delays, emphasizing the need to strengthen referral readiness, rapid multidisciplinary response, and decision-making to reduce preventable maternal deaths.
subject: Articles
  topic: section
subject: maternal death
  topic: keywords
subject: referral hospital
  topic: keywords
subject: maternal perinatal death notification
  topic: keywords
subject: EmOC
  topic: keywords
creator: Muhammad Ardian Cahya Laksana
creator: Nurani Zulfa Zakiya
creator: Nur Sahila
creator: Ayu Dyah Primaningrum
creator: Asti Alya Rahmahdia
creator: Dinda Zhafira
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-01-16
publication date: 2026-01-16
starting page: 46
ending page: 57
doi: 10.26911/jepublichealth.2026.11.01.04

A Review of Solid Medical Waste Management in Indonesian Hospitals
type: item
description: Background: Hospitals generate hazardous medical waste that threatens both environmental sanitation and human health. Common challenges include a lack of awareness, insufficient training, inadequate disposal infrastructure, and limited resources. Proper management is essential to minimize ecological impacts and prevent hospital-acquired infections (HAIs) at every stage—collection, segregation, transport, and storage. This study systematically evaluates global hospital waste management practices. Subjects and Method: This study is a systematic review literature review conducted on selected databases (PubMed, Science Direct, Google Schoolar) with a publication year between 2020 and 2025. Literature uses Indonesian and English. The literature included was literature with qualitative and quantitative method. The quality assessment of the literature was carried out using the JBI Critical Appraisal. Results: The research results from nine (9) articles related to solid medical waste management in Indonesia show that the process of sorting, transportation, temporary storage and final disposal in the management of medical waste from several hospitals has met the requirements in accordance with applicable regulations. Conclusion: While segregation and temporary storage show high compliance, final disposal remains a critical challenge due to incinerator licensing issues and third-party dependency. Addressing this requires practical staff training, routine audits, and a transition to alternative technologies like autoclaving. Strengthening contract governance and cost-benefit analysis between internal investment and outsourcing is essential for sustainable waste management in Indonesia.
subject: Articles
  topic: section
subject: Solid
  topic: keywords
subject: Medical Waste
  topic: keywords
subject: Management
  topic: keywords
subject: Hospital
  topic: keywords
creator: Anggreini Beta Citra Dewi
creator: Aurina Firda Kusuma Wardani
creator: Ervansyah Wahyu Utomo
creator: Siti Rachmawati
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-01-16
publication date: 2026-01-16
starting page: 16
ending page: 30
doi: 10.26911/jepublichealth.2026.11.01.02

Factors Associated with Post-Sternotomy Wound Infection: A Meta-Analysis
type: item
description: Background: Sternal wound infection is a serious complication following cardiac surgery, contributing to increased morbidity, mortality, and length of hospital stay. Obesity, diabetes mellitus, smoking habits, and re-operation are suspected to contribute to the incidence of post-sternotomy wound infections. This study aimed to estimate the magnitude of the influence of obesity, diabetes, smoking, and re-operation as risk factors for post-sternotomy wound infections. Subject and Method: This study is a systematic review and meta-analysis. Articles were obtained from databases including PubMed, Google Scholar and ScienceDirect, limited to publications from 2015 to 2025. The keywords and MeSH terms used were: “sternotomy, AND sternal wound infection OR deep sternal wound infection OR surgical site infection, AND “obesity OR body mass index, AND diabetes mellitus OR hyperglycemia AND smoking OR tobacco use AND re-operation AND cardiac surgery”. Article selection was based on eligibility criteria defined using the PICO model: P = patients post-sternotomy; I = obesity, diabetes, smoking, re-operation; C = non-obese, non-diabetic, non-smokers, no re-operation; O = post-sternotomy wound infection. Only full-text articles with a cross-sectional study design were included. Data were analyzed using RevMan version 5.3. Results: A total of 16 articles were included in this meta-analysis, originating from Finland, Denmark, Australia, Saudi Arabia, Colombia, Italy, France, China, Pakistan, Brazil, and United States. The meta-analysis showed that the risk of post-sternotomy wound infection was significantly increased in patients with obesity (aOR = 1.50; 95% CI: 1.31–1.72; p < 0.001), diabetes (aOR = 2.02; 95% CI: 1.26–3.25; p = 0.004), smoking (aOR = 2.44; 95% CI: 1.36–2.27; p = 0.05), obstructive sleep apnea (aOR = 1.76; 95% CI: 1.36–2.27; p < 0.001), and re-operation (aOR = 2.90; 95% CI: 1.49–5.64; p = 0.002). All findings were statistically significant. Conclusion: Risk of ster…
subject: Articles
  topic: section
subject: obesity
  topic: keywords
subject: diabetes
  topic: keywords
subject: smoking
  topic: keywords
subject: re-operation
  topic: keywords
subject: sternal wound infection
  topic: keywords
subject: sternotomy
  topic: keywords
creator: Aris Widiyanto
creator: Sri Iswahyuni
creator: Krisnanda Aditya Pradana
creator: Perdana Prabasari Putri Ichsani
creator: Rina Tri Handayani
creator: Hakim Anasulfalah
creator: Ahmad Syauqi Mubarok
creator: Joko Tri Atmojo
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-01-16
publication date: 2026-01-16
starting page: 1
ending page: 15
doi: 10.26911/jepublichealth.2026.11.01.01

Unveiling the Drivers of Anemia: A Multifactorial Analysis
type: item
description: Background: Anemia remains a major public health concern, particularly in developing countries, due to its multifactorial causes and negative impact on individual productivity and quality of life. Identifying the determinants of anemia is essential for improving prevention strategies and targeted interventions. This study aimed to analyze factors associated with anemia among adult outpatients. Subjects and Method: The cross-sectional analytic study was conducted at Primary Health Care Ronowijayan, Ponorogo, Indonesia. The study population consisted of adult outpatients aged ≥18 years who visited the health center during the study period. A total of 100 participants were selected using an incidental sampling technique. The dependent variable was anemia, defined as hemoglobin level <12 g/dL in women and <13 g/dL in men, measured using a standardized spectrophotometric method. The independent variables included age, gender, body mass index (BMI), and economic status. BMI was calculated based on measured weight and height, while economic status was classified according to the regional minimum wage. Data were analyzed using Chi-square tests for bivariate analysis and multiple logistic regression for multivariate analysis, with a significance level of α = 0.05. Results: Most participants were aged <40 years (59.0%), female (54.0%), underweight (59.0%), and of low economic status (82.0%). Bivariate analysis showed that only economic status was significantly associated with anemia (OR = 4.87; p = 0.004). Multivariate analysis confirmed that economic status (OR = 6.77; 95% CI = 1.98–23.10; p= 0.002) and BMI (OR = 1.45; 95% CI = 0.78–2.68; p = 0.035) were significantly associated with anemia, while age (OR = 0.87; 95% CI = 0.27 to 1.24; p = 0.792) and gender (OR = 2.65; 95% CI = 0.07 to 0.33; p = 0.064). Conclusion: Low economic status was significantly associated with an increased risk of anemia among adult outpatients, while body mass index also showed a significant associa…
subject: Articles
  topic: section
subject: anemia
  topic: keywords
subject: determinants
  topic: keywords
subject: factors
  topic: keywords
creator: Eky Okviana Armyati
creator: Sugeng Mashudi
creator: Nurul Sri Wahyuni
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2026-04-16
publication date: 2026-04-16
starting page: 137
ending page: 146
doi: 10.26911/jepublichealth.2026.11.02.03

Patient Safety and Hospital-Based Health Promotion in Preventing Infections and Their Impact on Childhood Stunting: A Systematic Review
type: item
description: Background: Child stunting is influenced by nutrition, recurrent infections, and the quality of health services. Patient safety and hospital-based health promotion play key roles in preventing infections that increase stunting risk. This study aimed to analyze the role of patient safety and hospital-based health promotion in infection prevention and its impact on childhood stunting. Subjects and Method: A systematic review was conducted following the PRISMA guidelines and the PICO framework. The Joanna Briggs Institute (JBI) Checklist was used for quality assessment. Articles were collected from Scopus, ScienceDirect, ProQuest, SpringerLink, Google Scholar, Nature, JSTOR, and Emerald Insight, covering publications from 2020 to 2025. The keywords used were: “patient safety” AND “hospital-based health promotion” AND “infection prevention” AND “childhood stunting”, and “hospital governance” AND “infection control” AND “child growth”. Boolean operators and Medical Subject Headings (MeSH) were applied to each database. Results: This systematic review consisted of 10 articles that met the inclusion criteria. The studies, published between 2020 and 2025, originated from Indonesia, Ethiopia, Southeast Asia, and other developing regions. The findings showed that patient safety programs and infection control effectively reduced neonatal and childhood infections. Health promotion interventions, such as caregiver education and cadre training, improved hygiene and preventive behavior. Integration of hospital governance and policy strengthened infection prevention and service quality. Across the reviewed evidence, exposure to infection during the first 1,000 days of life was consistently linked to an increased risk of stunting (OR=1.85; 95% CI=1.42–2.37; p=0.001). Conclusion: Patient safety and hospital-based health promotion are crucial for preventing infections and reducing stunting. Strengthening hospital governance through integrated infection prevention strategies is essenti…
subject: Articles
  topic: section
subject: stunting
  topic: keywords
subject: patient safety
  topic: keywords
subject: hospital-based health promotion
  topic: keywords
subject: hospital governance
  topic: keywords
creator: Jasmin Ambas
creator: Yasinta Indah Widyaningsih
rights: Copyright (c) 2026 Journal of Epidemiology and Public Health
date: 2025-10-16
publication date: 2025-10-16
starting page: 513
ending page: 524
doi: 10.26911/jepublichealth.2025.10.04.07