Kurnia Dwi Artanti

Background: Pneumonia remains a leading cause of infection-related mortality in children under five worldwide. In Indonesia, pneumonia was the second leading cause of death among children under five, accounting for 9.40% in 2021. Jember Regency ranked eighth in East Java Province in 2022, with 3,134 pneumonia cases among children under 5, most of which occurred in the Sumbersari Health Center area. Purpose: To examine the relationship between exposure to cigarette smoke, exclusive breastfeeding, and completeness of basic immunization with pneumonia among children under five. Methods: This study employed a case-control design involving 92 respondents, consisting of 46 cases and 46 controls selected using simple random sampling from medical records at Sumbersari Health Center in 2022. The independent variables were exposure to cigarette smoke, exclusive breastfeeding, and completeness of basic immunization. Primary data were collected through interviews with caregivers and validated, reliable questionnaires. Data were analyzed using univariate and bivariate analyses with chi-square and contingency coefficient tests. Result: Pneumonia was most prevalent in children aged 0–1 years (67.39%) and predominantly occurred in males (65.21%). Among cases, 93.47% were exposed to cigarette smoke, 45.65% did not receive exclusive breastfeeding, and 34.78% had incomplete basic immunization. Statistical analysis showed that exposure to cigarette smoke (p<0.001; OR=10.09; 95% CI: 2.72–37.36) and incomplete basic immunization (p0.05). Conclusion: Exposure to cigarette smoke and incomplete basic immunization are significantly associated with pneumonia among children under five in this study.

Background: Menstrual problems affect an estimated 500 million people worldwide, with reported prevalence among schoolgirls and female university students ranging from 23% to 76.60%. In Indonesia, the prevalence has been reported as 11.70%. Academic pressure may contribute to stress and insomnia, which in turn may increase the risk of menstrual irregularities. Purpose: Analyze the direction and strength of the relationships between stress, insomnia, and menstrual irregularities among midwifery students at the Faculty of Medicine, Airlangga University. Methods: This observational analytic study used a cross-sectional design. Data were collected from 109 respondents selected through simple random sampling using validated and reliable questionnaires. Data normality was assessed using the Kolmogorov-Smirnov test, and associations between variables were examined using Spearman’s rank correlation test. Results: Among the respondents, 34% reported regular menstrual cycles, while 66% experienced menstrual irregularities. The normality test indicated that all variables were not normally distributed (menstrual irregularity p<0.01; stress level p=0.01; insomnia level p=0.01). Spearman’s rank correlation analysis showed significant positive correlations between stress and menstrual irregularities (p=0.00; r=0.48) and between insomnia and menstrual irregularities (p=0.00; r=0.32). These findings indicate that higher levels of stress and insomnia were associated with greater menstrual irregularities. The association was moderate for stress and weak for insomnia. Conclusion: Stress and insomnia were significantly associated with menstrual irregularities among midwifery students. These findings highlight the importance of stress reduction, sleep management, and regular reproductive health screening in this population.

Introduction: Effective disaster management requires an integrated approach based on community and school entities, encompassing preparedness, response, and recovery. This study aims to develop an integrated model for community and school-based disaster surveillance information systems. Method: This research was operational research that employs a mixed method, utilizing document study for obtaining quantitative data also Focus Group Discussions for obtaining qualitative data. Those identifying data and information needed to develop integrated disaster surveillance information system model. Results: The findings highlight the critical role of community-based interventions, from pre, during, and post disaster. Strategic data surveillance consists of disaster risk factors, preparedness, mitigation, early warning system, emergency, rapid health assessment, also community-based rehabilitation, and reconstruction. School identifications, infrastructures, contingency plan, risk map, and disaster preparedness team are also obtained in this disaster surveillance information system model. Information consists of disaster risk indicators, such as hazard, vulnerability, capacity, risk, high risk area, and trend of disaster risk factors are also acquired in each area as well as educational institution. Conclusion: The study demonstrates that integrated and participatory approaches to disaster management strengthen disaster contingency plan. Policymakers and practitioners are urged to prioritize routine disaster surveillance data collection to contribute to policymaking.

Introduction: Stunting in Indonesia, caused by nutritional deficiencies from pregnancy until the age of two, remains above the WHO target despite a decrease in prevalence from 37.2% in 2017 to 21.6% in 2022. The detrimental impact of stunting on child development and the high rates in Indonesia underscore the importance of improving maternal and child nutrition to reduce this prevalence. Objective: The objective of this study was to analyze the effect of feeding patterns on the incidence of stunting in toddlers in the Ponorogo District. Methods: This research is an analytical observational study with a case‐control study design. The sample size was calculated using the case‐control sample size formula with a 1:1 ratio, resulting in 44 cases and 44 control samples. The case samples consist of children aged 1–5 years who experience stunting in the North Ponorogo Community Health Center area. The control samples consist of children aged 1–5 years who do not experience stunting in the same area. The sampling method used is simple random sampling. Risk factor analysis uses the odds ratio (OR) value and a 95% confidence interval (CI). Results: There is an association between feeding patterns and the incidence of stunting, with an OR value of 14.54 (95% CI = 3.11 < OR < 67.86). There is no association between immunization completeness status and the incidence of stunting, with an OR value of 0.42 (95% CI = 0.14 < OR < 1.25). Conclusions: Based on the conducted research, it can be concluded that there is a significant relationship between feeding patterns and the incidence of stunting in the North Ponorogo Community Health Center area. Inadequate feeding patterns significantly increase the risk of stunting.

Background: Tuberculosis remains a major public health problem in Indonesian. The Indonesian TB control program for the 2020–2024 period aims to accelerate the achievement of national TB elimination by 2030 and contribute to ending the global TB epidemic by 2050, aligning with the WHO's End TB Strategy. As part of this national strategy, the government has implemented various interventions, including the provision of Tuberculosis Preventive Therapy (TPT) to high-risk groups and improvements in the Treatment Success Rate (TSR). Objectives: This research aims to analyze the trends and the correlation between TPT and TSR with the incidence of tuberculosis, measured through the Case Notification Rate (CNR) at the provincial level during 2021-2023. Methods: This research is an ecological study using quantitative methods. The data in this research are based on tuberculosis prevention reports from the Directorate of Disease Prevention and Control, Ministry of Health of Indonesia, from 2021 to 2023. The variables analyzed in this research are TPT coverage and TSR with CNR in 2021-2023. Results: The study results show an increasing trend in CNR in Indonesian provinces for three consecutive years. Furthermore, TPT coverage has also increased, although it remains relatively low, and TSR shows variation across provinces. Spearman's analysis indicates a correlation between TPT, TSR, and CNR. However, the correlations are weak and mostly negative. Conclusion: TPT coverage and TSR in Indonesia showed improvement during 2021–2023, although disparities remained between provinces. The weak correlations between TPT, TSR, and incidence rates indicate that prevention and treatment interventions have not yet fully impacted the reduction of new cases. Strengthening case detection, enhancing contact tracing, and expanding TPT are needed to accelerate the decline in TB incidence nationally.

This study aimed to analyze the factors related to the incidence of hypertension among Hajj pilgrims from Banjarmasin Indonesia in 2025. This study used a quantitative approach with a cross-sectional study design. The sampling technique used total sampling with secondary data, as many as 1050 prospective Hajj pilgrims. Data analysis was carried out using SPSS software. The variable of age range with a p-value of <0.001 and adjusted PR was 6.23 with 95% CI (5.27-8.13). Age 41 to 60 years old had adjusted PR was 3.46 with 95% CI (2.38-5.22). The variable of of diabetes mellitus had a p-value of <0.001 and adjusted PR of 1.74 with 95% CI (1.44-1.95). The variable of hyperlipidemia had a p-value of <0.001 and adjusted PR of 1.36 with 95% CI (1.28-1.59). The variable of heart disease/heart failure with p-value <0.001 and obtained adjusted PR of 1.28 with 95% CI (1.20-1.47). The variable of family history of hypertension with p-value <0.001 and obtained adjusted PR of 1.72 with 95% CI (1.62-1.94). The study concluded that the factors related to hypertension incident in Hajj pilgrims of Banjarmasin Indonesian in 2025, were age range, diabetes mellitus, hyperlipidemia, heart disease/heart failure, and family history of hypertension.

Background: Diabetes Mellitus (DM) is a chronic disease characterized by elevated blood glucose levels and can lead to serious health complications if not properly managed. HbA1c measurement is an accurate method for assessing glycemic control over the past 2–3 months and evaluating long-term blood glucose levels. Objectives: To analyze the description of HbA1c levels in patients with DM at Husada Utama Hospital Surabaya. Methods: A descriptive design with a cross-sectional approach was used. The sample consisted of 118 patients with DM who had checked their HbA1c, selected using the accidental sampling method. Secondary data were obtained from the patient's medical records recorded at Husada Utama Hospital. Results: The results showed that 73.7% of the respondents had uncontrolled HbA1c levels (≥6.5%) with an average HbA1c value of 8.18%. The majority of uncontrolled HbA1c levels were found in the elderly (62.1%), female patients (70.1%), patients who had suffered from diabetes mellitus for ≥5 years (57.5%), and those using a combination of oral antidiabetic drugs (39.1%). Conclusion: Based on the findings, it can be concluded that most respondents with uncontrolled HbA1c levels were elderly, female, had been living with DM for ≥5 years, and were using a combination of oral antidiabetic drugs. This indicates that diabetes management still needs improvement.

Background: Imbalanced nutritional status in adolescents can affect the menstrual cycle. In 2018, the WHO stated that as many as 80% of women in the world have irregular menstrual cycles. More specifically, this condition is experienced by 11.70% of adolescents aged 15-19 years and 14.90% of women in urban areas. Purpose: To analyze the effect of body mass index (BMI) on the menstrual cycle in adolescents at Junior High School State 19 Surabaya. Methods: This quantitative research employed an observational analytic method with a case-control design at SMP Negeri 19 Surabaya. As many as 104 participants (52 cases with irregular menstrual cycles and 52 controls with regular cycles) were randomly selected in a 1:1 ratio. Data collection occurred from February to May 2024, and bivariate analysis was conducted using the Chi-square test. Results: This study showed that overall BMI had a significant effect on menstrual cycle regularity (p = 0.001). Students with normal BMI have a greater chance of experiencing regular menstruation than overweight/obese (OR = 4.694; 95% CI = 1.536 - 14.344; p = 0.007). Meanwhile, the categories of very thin (OR = 0.985; 95% CI = 0.235 - 4.127; p = 0.983) and underweight (OR = 0.433; 95% CI = 0.072 - 2.622; p = 0.363) did not show a significant influence on menstrual regularity (p > 0.05). Conclusion: Body mass index affects menstrual cycle regularity in adolescents. Maintaining nutritional status is important to minimize the risk of menstrual cycle disorders and ensure reproductive health.

The World Health Organization Bulletin data show that Indonesia's compliance score for non-smokers' protection efforts was 0.1 in 2016. This research aims to analyze the need for data, information, and indicators to support the implementation, monitoring and evaluation of Smoke Free Area (SFA) in Indonesia through system analysis. This is an operational research study using the Focus Group Discussion (FGD) and document methods. The research series at early stage in the development of an evaluation and monitoring system, utilizing a system develop-ment cycle approach. Data is collected by the SFA task force and the community based on system components. The results of this study show that the entity responsible for conducting the monitoring and evaluation of SFA is the Task Force and community. The new potential data and information that has not been existed in the previous system are community as the potential data source of monitoring SFA, strategic data for SFA including the existence of self-service machines for selling cigarettes, and socialization of SFA regulation, monitoring and evaluation as a strategic activity to improve the result of SFA regulation, institution status of SFA and changes in smoking behavior. The information generated by the monitoring and evaluation system includes the SFA status of the institutions which is used for decision making to support the SFA program and the tobacco control program. Continuous monitoring and evaluation are important to ensure policy effectiveness, identify components for improvement or expansion of policies, and increase stakeholder and public support to strengthen or develop SFA policies.

Background: Various factors motivate couples of childbearing age to use long-term contraceptive methods (MKJP), despite their effectiveness and efficiency being 20 times higher than non-MKJP types. One of them is the husband's support factor. Validity and reliability tests ensure that a research instrument for data collection complies with the rules. In validity testing, the test method often involves comparing the score of each statement item with the total score. Reliability testing often employs the Cronbach's alpha test. Objectives: This research aims to test the validity and reliability of the questionnaire with the variable husband's support on barriers to using MKJP among active multipara acceptors in Surabaya. Methods: This research was carried out with a quantitative analysis research design with the Great Surabaya Cadre analysis unit in Kenjeran District, which has active multipara acceptor status. Data were collected using convenience sampling from 30 Great Surabaya Cadres, Kenjeran District, by administering a questionnaire containing 10 statements about a husband's support with a measurement scale. Results: The results of the study stated that the husband's support questionnaire was valid and reliable, with a calculated Pearson r correlation value (0.469–0.748) > r table (0.361) and a Cronbach's alpha value of 0.809. Conclusion: Based on the results and discussion, a conclusion can be drawn, namely that the husband's support questionnaire regarding barriers to the use of MKJP among active multipara acceptors in Surabaya is declared valid and reliable.