Analysis of the Contextual Effect of Village Characteristics and Other Determinants of Diarrhea in Children Under Five, Banjarnegara, Central Java
Abstract
Background: Diarrheal disease is the leading cause of child death and illness in the world. Diarrhea is one of the most potent endemic diseases in Indonesia. Children under five were the most affected group by this disease. This study aimed to determine the effect of nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation on the incidence of diarrhea in children under five in Banjarnegara District, Central Java, using multilevel analysis.
Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted in Banjarnegara, Central Java, from January to February 2018. A total of 25 villages was selected using stratified random sampling, based on village stratification criteria. A sample of 250 children under five was selected for this study by fixed disease sampling, consisting of 125 children with diarrhea and 125 healthy children. The dependent variable was diarrhea. The independent variables at level 1 were nutritional status, information exposure, prevention behavior, income, social capital, and environmental sanitation. Village stratification was used as the contextual factor at level 2. The data were collected by a set of pre-tested questionnaire and analyzed by multilevel logistic regression analysis using Stata 13.
Results: Poor nutritional status (b= 1.33; 95% CI= -0.14 to 2.82; p= 0.077), poor prevention behavior (b= 1.52; 95% CI= 0.81 to 2.24; p<0.001), low income (b= 1.52; 95% CI= 0.80 to 2.25; p<0.001), weak social capital (b= 1.80; 95 % CI= 1.04 to 2.56; p<0.001), and poor environmental sanitation (b= 1.12; 95% CI= 0.39 to 1.85; p= 0.003) increased the risk of diarrhea. Exposure to information (b= 0.90; 95% CI= 0.17 to 1.64; p= 0.015) decreased the risk of diarrhea. The village stratification showed a strong contextual effect on the incidence of diarrhea with intra-class correlation (ICC)= 15.78%.
Conclusion: Poor nutritional status, poor personal hygiene, low income, weak social capital, and poor environmental sanitation increase the risk of diarrhea.
Keywords: determinant, diarrhea, children under five, multilevel analysis
Correspondence:
References
Agustina, R. Sari TP, Satroamidjojo S, Bovee Oudenhoven IMJ, Feskens EJM, Kok FJ (2013). Association of food hygiene practices and diarrhea prevalence among Indonesian young children from low socioeconomic urban areas. BMC Public Health. BMC Public Health, 13(1): 1. doi: 10.1186/1471245813977.
Asfaha KF, Tesfamichael FA, Fisseha GK, Misgina KH, Weldu MG, Welehaweria NB, Gebregiorgis YS (2018). Determinants of childhood diarrhea in Medebay Zana District, Northwest Tigray, Ethiopia: A community based unmatched casecontrol study. BMC Pediatrics. BMC Pediatrics, 18(1): 1
Azage M, Kumie A, Worku A, Bagtzoglou AC (2016). Childhood diarrhea in high and low hotspot districts of Amhara Region, northwest Ethiopia: a multilevel modeling. Journal of Health, Population and Nutrition. Journal of Health, Population and Nutrition. 1
Beaugerie L, Sokol H (2013). Diarrh
Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A (2017). Severe childhood malnutrition. Nature Reviews Disease Primers, 3: 17067. doi: 10.1038/nrdp.2017.67.
Bisung E, Elliott SJ, Schuster Wallace CJ, Karanja DM, Bernard A (2014). Social capital, collective action and access to water in rural Kenya. Social Science and Medicine. Elsevier Ltd, 119: 147
Bitew BD, Woldu W, Gizaw Z (2017). Childhood diarrheal morbidity and sanitation predictors in a nomadic community. Italian Journal of Pediatrics. Italian Journal of Pediatrics, 43(1): 1
Budhathoki SS, Bhattachan M, Yadav AK, Upadhyaya P, Pokharel PK (2016). Ecosocial and behavioural determinants of diarrhea in underfive children of Nepal: a framework analysis of the existing literature. Tropical Medicine and Health. Tropical Medicine and Health: 1
Tickell KD, Pavlinac PB, John Stewart GC, Denno DM, Richardson BA, Naulikha JM, Kirera RK, et al. (2017). Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea. The American Journal of Tropical Medicine and Hygiene, 97(5): 1337
Dinkes Kab Banjarnegara (2017) Dinkes dalam Angka Tahun 2017. Banjarnegara: DinkesKab Banjarnegara.
Dinkes Provinsi Jateng (2017) Profil 2016. Available at: http://www.dinkesjatengprov.go.id/v2015/dokumen/profil2016/mobile/index.html#p=1.
_____ (2011) Pedoman penentuan strata desa/kelurahan siaga aktif Provinsi Jawa Tengah. Edited by indiyah widiastuti. Semarang: Dinkesprop Jateng.
Diouf K, Tabatabai P, Rudolph J, Marx M (2014). Diarrhoea prevalence in children under five years of age in rural Burundi: an assessment of social and behavioural factors at the household level. 1
Ejemot Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA (2015). Hand washing promotion for preventing diarrhoea. Cochrane Database of Systematic Reviews, 2015(9). doi: 10.1002/14651858.CD004265.pub3.
Hill PS, Goeman L, Sofiarini R, Djara MM (2014). "Desa SIAGA
Irianto (2014). Epidemiologi Penyakit Menular dan tidak menular : panduan Klinis. Bandung: Alfabeta.
Islam M, Ayse E, Sania A, Rahman M, Shoab AK (2018). Unsafe disposal of feces of children <3 years among households with latrine access in rural Bangladesh: Association with household characteristics, fly presence and child diarrhea. Plos One. Edited by K. A. Dearden. Public Library of Science, 13(4): e0195218. doi: 10.1371/journal.pone.0195218.
Kamara JK, Galukande M, Maeda F, Luboga S, Renzaho AMN (2017). Understanding the challenges of improving sanitation and hygiene outcomes in a community based intervention: A crosssectional study in rural Tanzania. International Journal of Environmental Research and Public Health, 14(6): 1
Kemenkes RI (2010) Kepmenkes Nomor 1529/Menkes/SK/X/2010 Tentang Pedoman Umum Pengembangan Desa dan Kelurahan Siaga Aktif.
_____ (2011a). Panduan Sosialisasi Tatalaksana Diare Pada Balita. Jakarta.
_____ (2011b). Situasi diare di Indonesia. Jurnal Buletin jendela data & informasi kesehatan, 2: 1
_____ (2013) Riset Kesehatan Dasar Indonesia. Edited by Badan Penelitian Dan Pengembangan Kesehatan.Jakarta: kemenkes RI.
_____ (2017) 5 Pilar Kurangi Penyakit Berbasis Lingkungan. Available at: http://www.depkes.go.id/article/view/17032100003/5pilarkurangipenyakitberbasislingkungan.html.
Lawrence JJ, YeboahAntwi K, Biemba G, Ram PK, Osbert N, Sabin LL, Hamer DH (2016). Beliefs, Behaviors, and Perceptions of CommunityLed Total Sanitation and Their Relation to Improved Sanitation in Rural Zambia. 94(3): 553
Levison MM, Elliott SJ, Karanja DM, SchusterWallace CJ, Harrington DW (2011). You cannot prevent a disease; you only treat diseases when they occur: knowledge, attitudes and practices to waterhealth in a rural Kenyan community. East African journal of public health, 8(2): 103
Ma C, Wu S, Yang P, Li H, Tang S, Wang Q (2014). Behavioural factors associated with diarrhea among adults over 18 years of age in Beijing , China. 14(1): 1
Murti B (2010). Determinan sosioekonomi, modal sosial, dan implikasinya bagi kesehatan masyarakat. Guru Besar Ilmu Kesehatan Masyarakat. Available at: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Determinan+sosioekonomi,+modal+sosial,+dan+implikasinya+bagi+kesehatan+masyarakat#0.
Narzah NA (2016). Path Analysis FaktorFaktor Yang Berhubungan Dengan Kejadian Diare Pada Bayi (6 - 12 Bulan) di Wilayah Kerja Puskesmas Karanganyar Kabupaten Purbalingga. Universitas Sebelas Maret.
Nieminen T, Pr
Pang J, Chua SWJL, Hsu L (2015). Current knowledge, attitude and behaviour of hand and food hygiene in a developed residential community of Singapore: a cross sectional survey. BMC Public Health. BMC Public Health: 1
Pr
Sevilimedu V, Pressley KD, Snook KR, Hogges JV, Politis MD, Sexton JK, et al. (2017). Genderbased differences in water, sanitation and hygienerelated diarrheal disease and helminthic infections: a systematic review and metaanalysis. Transactions of The Royal Society of Tropical Medicine and Hygiene. doi: 10.1093/trstmh/trw080.
Soebagyo (2008) Diare akut pada anak. I. Surakarta: UNS Press.
Sulaeman ES, Murti B, Waryana (2015). Aplikasi Model Pada Perencanaan Program Pemberdayaan Masyarakat Bidang Kesehatan Berbasis Penilaian Kebutuhan Kesehatan Masyarakat The Application of PRECEDEPROCEED Model in Community Empowerment Planning in Health Sector Based on the Need Assessment of
Susilo S (2016). Peran Modal sosial dalam pertumbuhan ekonomi Indonesia Tahun 1980-2013. Universitas Sebelas Maret.
Sutisna E, Karsidi R, Murti B, Kartono DT, Waryana W, Hartanto R (2006). Model Pemberdayaan Masyarakat Bidang Kesehatan, Studi Program Desa Siaga Community Empowerment Model in Health Sector, Study on Village Preparadness Program. Jurnal Kesehatan Masyarakat Nasional, 7(36): 186
Tarwoto and wartonah (2011) Kebutuhan Dasar Manusia Dan Proses Keperawatan. Jakarta: Salemba Medika.
Tauso SA, Azizah R (2013). Hubungan Sanitasi Dasar Rumah dan Perilaku Ibu Rumah Tangga dengan Kejadian Diare pada Balita di Desa Bena Nusa Tenggara Timur. Jurnal Kesehatan Lingkungan, 7(1): 1
UNICEF (2010) Penuntun Hidup Sehat. Jakarta: Pusat Promosi Kesehatan Kemenkes RI.
WHO/UNICEF (2017). Safely managed drinking water thematic report on drinking water 2017: 1
Widoyono (2011) Penyakit Kronis : Epidemiologi, penularan, pencegahan dan pemberantasannya. Jakarta: Penerbit Erlangga.
Woldu W, Bitew BD, Gizaw Z (2016). Socioeconomic factors associated with diarrheal diseases among underfive children of the nomadic population in northeast Ethiopia. Tropical Medicine and Health. Tropical Medicine and Health, 44(1): 7
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Published
2018-07-12
Issue
Vol. 3 No. 3 (2018)
Section
Articles
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