Dengue is a major mosquito-borne viral disease and an important public health problem. Identifying which factors are important determinants in the risk of dengue infection is critical in supporting and guiding preventive measures. In South-East Asia, half of all reported fatal infections are recorded in Indonesia, yet little is known about the epidemiology of dengue in this country. Hospital-reported dengue cases in Banyumas regency, Central Java were examined to build Bayesian spatial and spatio-temporal models assessing the influence of climatic, demographic and socio-economic factors on the risk of dengue infection. A socio-economic factor linking employment type and economic status was the most influential on the risk of dengue infection in the Regency. Other factors such as access to healthcare facilities and night-time temperature were also found to be associated with higher risk of reported dengue infection but had limited explanatory power. Our data suggest that dengue infections are triggered by indoor transmission events linked to socio-economic factors (employment type, economic status). Preventive measures in this area should therefore target also specific environments such as schools and work areas to attempt and reduce dengue burden in this community. Although our analysis did not account for factors such as variations in immunity which need further investigation, this study can advise preventive measures in areas with similar patterns of reported dengue cases and environment. Dengue has been detected in Indonesia and transmission is progressively rising to account for half of all fatal dengue cases recorded in South-East Asia. However, little is known about the epidemiology of the virus, which may hamper the effectiveness of preventive strategies carried out in the country. Identifying local risk factors is critical in assuring preventive measures are efficiently targeted. In this study we carried out a spatial, long-term analysis of all hospital-reported dengue cases in the 329 villages of the Banyumas Regency of Central Java, Indonesia between 2000 and 2013. We determined which variables, including environmental factors, geography, socio-economic status, and access to health services, significantly impacted the village-level risk of dengue infection between 2000 and 2013. Our data give a large scale overview of dengue risk factors in this Regency and to our knowledge is the first study of such scale in Indonesia. Our findings have the potential to guide targeted preventive planning locally as we identify intervention points in the socio-economic make up of this Regency. The outcomes of this study need to be confirmed in other affected areas of Indonesia.

Background: Acute otitis media (AOM) is the most common disease in young children requiring antibiotic treatment. Information on AOM-related determinant risk factors in primary school children is still limited, particularly in Indonesia. This study aims to identify risk factors related to AOM in primary school children in Banyumas Regency, Central Java, Indonesia. Design and methods: This is an analytical study with a casecontrol design in Banyumas Regency, Indonesia. 3574 children from 6 regions of the Banyumas Regency were recruited for the screening of AOM detection, and confirmation of AOM diagnosis was determined by Otolaryngologist. One hundred and twentyfive cases and 125 control were involved in this study. Data collection was carried out using a structured questionnaire focusing on several variables such as household cooking fuel, house environment, smoking exposure, knowledge of parents, and nutrition status. Univariate, bivariate using chi-square and multivariate with regression logistic was conducted for data analysis. Results: This study highlights the risk of household firewood use (p=0.003), poor nutritional status (p=0.009), and a family history of ear infections (p=0.015) with an increased risk of otitis media. Conclusions: Household firewood use, poor nutritional status and family history of ear infection are factors associated with the occurrence of acute otitis media. It is necessary to provide public health education to prevent exposure to fuel at risk for children and to improve their nutritional status.

Background: Diabetes mellitus (DM) is a non-communicable disease that remains a significant health concern in Indonesia. The disease is more prevalent in urban areas due to lifestyles, socioeconomics level and lack of physical activity. Currently, DM has begun occured also in rural areas. The purpose of this study is to identify the risk factors associated with Type II DM incidence in rural areas. Method: This is analytical study with a case-control design, located in Community Health Centre 1, Wangon, Banyumas Regency. There are 65 people in case group and 65 people in control group involved in this study. Variables included personal characteristics, dietary habit, physical activity and exposure to cigarette smoke. Data was obtained by structured questionnaire and analyze using univariate, bivariate (chi-square test) and multivariate analysis (logistic regression test). Results: The results showed that the dietary habit (OR = 11,824; 95% CI = 4,988-28,032) and physical activity (OR = 2,608; 95% CI = 1,116–6,095) had influenced on the incidence of DM type II. Whilst the exposure of cigarette smoking did not influenced the incidence of DM type II. It is suggested that consume foods with balanced nutrition and doing physical activities should be conducted routinely in accordance with WHO recommendations.

Introduction: Diarrhoea due to water borne diseases is still prevalent in Indonesia and this environmental health problem could triggered outbreaks in multiple regions. Objectives: The aim of this study was to determine the correlation of environmental factors, behavior and quality of water to the incidence of diarrhea in densely populated settlements in Rasanae Barat District, Bima City. Method: This study used cross sectional design and the data was obtained by survey and interview using questionnaire. The population in the study was all residents who lived permanently in the Rasanae Barat District of Bima City. The sample size is 192 which determined by formula for testing the proportion of a single population. Variables of this study were environmental factors (distance of clean water facilities with latrines (septic tanks) and waste bins facilities), behavioral factors (knowledge, and attitude) and water quality (total coliform). Data analysis was carried out includes univariate, bivariate by chi-square statistical test. and multivariate analysis by multiple logistic regression. Results and Discussion: Based on the results of the study, it showed that the variables associated with the incidence of diarrhea were water quality (total coliform) (p=0,000), and knowledge (p= 0.003). Conclusion: Since the variables that have significant association to diarrhea were water quality and knowledge, so it is important for community to build septic tank with requirement standard to overcome the land limitation. Health institution also need to conduct periodic water quality checks and also increase community knowledge about water quality and diarrhea prevention. This study could provide valuable input for diarrhea prevention and control program.

Background: The implementation of the COVID-19 vaccination is still being carried out in Indonesia to enhance immunity against SARS Cov-2 infection. However, the information about vaccination service satisfaction is still very limited. This study aims to assess how satisfied Covid-19 vaccination service users are in Indonesia. Design and methods: This is an analytic study with a cross-sectional design was conducted through an online survey in the third week of June 2022. People with a minimum age of 17 years, having received at least one COVID-19 vaccination, and residing in Indonesia were allowed to participate in this study. We used the SERVQUAL model as an instrument, measuring five aspects covering tangibility, responsiveness, reliability, assurance, and empathy. The analysis carried out included univariate analysis and bivariate test using chi-square statistical test. Results: A total of 509 respondents were included in this study. The findings of this study revealed that there was not much of a difference between the satisfied (50.1%) and dissatisfied categories (49.9%) of vaccination users. Of the five dimensions measured, the highest level of dissatisfaction is in tangibility particularly on facility (48.7%), while the highest level of satisfaction is in reliability (the vaccination service following applicable procedures; 59.7%). We find out that vaccination location ( p = 0.038), provision of refreshment/reward/incentives ( p = 0.001), providing emergency contact post-vaccination ( p = 0.000), and observation time post-vaccination ( p = 0.000) were associated with the satisfaction of users. Conclusion: Many respondents in this study are still dissatisfied with the COVID-19 vaccination services, so it is necessary for taking continuous efforts to raise the quality of vaccination services to increase user satisfaction.

Background: Tuberculosis (TB) in childreen is still considered as important public health problems in various countries, including Indonesia. Risk factors related to childhood tuberculosis is crucial to identify in order to conduct prevention effort effectively. The purpose of this research is to determine the effect of environmental health in house, contact history and nutritional status toward childhood tuberculosis. Methods: This research is an analytical observational study using case-control design, with 35 samples of the case and 35 samples of the control. Several variables such as house environment, contact history and nutritional status were obtained by questionnaire and observation in house of respondents. Data analysis was conducted using Logistic Regression test to determine correlation between independent and dependent variables. Results: This research highlighted that contact history and nutritional status were correlated with childhood tuberculosis. While house environment variables such as lighting level, floor type, house occupancy density were not related to the incidence of tuberculosis in children. Conclusions: Contact history and nutritional status were the factors which determined childhood tuberculosis in Banyumas. It is important for parents to maintain good nutritional status of their children and to avoid them from contact with tuberculosis patients.