Nutritional Epidemiology Commons^™

Characterizing How Food Advertising And Genetic Obesity Risk Factors Affect Neural Reward Reactivity And Eating In The Absence Of Hunger In Children, Dabin Yeum

Dartmouth College Ph.D Dissertations

The complex and multifactorial etiology of obesity involves the interaction of numerous risk factors. Assessing the gene-environment interaction of pediatric obesity can provide valuable insights for the characterization of key factors contributing to obesity and identification of potential points of intervention. The data used in this thesis comes from a single sample of young children recruited from the communities surrounding Dartmouth College. The primary objective of this thesis is to assess the impacts of complicated gene-environment interaction on pediatric obesity. First, we assessed the dynamic and static advertising of food cues to examine they lead to differential neural reward responsivity. …

Ramadan Fasting Did Not Lessen Vegetable And Fruit Consumption, Sleep Duration, And Physical Activity On Adolescents In Universitas Al-Azhar Indonesia, Afradina Septiasari, Elma Alfiah, Andi Mukramin Yusuf, Amalina Ratih Puspa

Indonesian Journal of Public Health Nutrition (IJPHN)

Muslims do Ramadan fasting for around 12 hours (between dawn and sunset). Apart from changing meal times, Ramadan fasting also has the potential to change sleep duration due to sahoor (before the dawn) activities that must be done. The ideal amount and frequency of vegetables and fruit consumption in the national guideline were illustrated by the three main meals a day. The different conditions occurred when doing Ramadan fasting, which was predicted to have less vegetable and fruit consumption than the normal days, especially Muslim adolescents. This research analyzed the difference between the consumption of vegetables and fruit, sleep duration, …

Peer Influence As The Dominant Factor In Coffee Drink Consumption Among Non-Health Major University Of Indonesia Students In 2023, Patrisha Ramadhiani, Triyanti Triyanti, Sandra Fikawati

Indonesian Journal of Public Health Nutrition (IJPHN)

Coffee drinks are sugar-sweetened beverages made from coffee powder, sugar, and water through heating. High consumption of coffee drinks is associated with sugar content, which can increase the risk of obesity. The aim of this study was to determine the differences in coffee drink consumption levels based on individual characteristics and environmental factors among non-health undergraduate students at the University of Indonesia in 2023. This quantitative study used a cross-sectional design with a sample of 181 active undergraduate non-health students in 2023. Data were collected in June 2023 through a self-administered questionnaire. The results showed that 52.5% of the respondents …

The Differences In Nutritional Status Based On The Use Of Online Food Delivery (Ofd) Services Among The Universitas Indonesia’S Non-Health Science Cluster Students In 2023, Muhammad Aulia Rizky, Asih Setiarini, Sandra Fikawati, Fajrinayanti Fajrinayanti

Indonesian Journal of Public Health Nutrition (IJPHN)

Uncontrolled use of Online Food Delivery (OFD) can increase food intake and affect the incidence of overweight/obesity. This study aims to examine the differences in the proportion of nutritional status based on the use of OFD services among UI non-health science cluster students. This study involved 136 respondents using a purposive sampling method and cross-sectional study design. Data were collected through anthropometric measurements, Google Form, and direct interviews to be analyzed by Chi-Square test and multiple logistic regression. The results showed significant differences in the proportion of nutritional status based on the duration of consumer loyalty, pocket money, and energy …

Relationship Between Muscle Dysmorphia And Other Factors With Supplement Consumption Among Selected Gym Members In Jakarta, Mohammad Rafid Billy Ramadhan, Anna Fitriani

Indonesian Journal of Public Health Nutrition (IJPHN)

Ergogenic supplements can enhance exercise performance. However, many gym members use them without consulting professionals such as nutritionists/dietitians, increasing the risk of adverse effects. This study investigates the consumption of ergogenic supplements and factors associated with them among members of selected fitness centers in Jakarta. This cross-sectional study was conducted on 116 participants from 3 fitness centers in Jakarta. The independent variables studied were Muscle Dysmorphia, Exercise Addiction, self-esteem, body image, age, gender, exercise duration, exercise experience, exercise intensity, and social media exposure. Data was collected via interviews based on a prepared questionnaire. Results showed that 67.2% of the respondents …

The Difference Of Ultra-Processed Food Consumption Based On Individual Characteristics And Other Factors Among Non-Health Undergraduate Students In Universitas Indonesia In 2023, Adeline Vashtianada, Asih Setiarini, Ratu Ayu Dewi Sartika

Indonesian Journal of Public Health Nutrition (IJPHN)

Ultra-processed food/UPF is a product that undergoes a series of industrial techniques and processes, also has low nutritional value. Overconsumption of UPF can increase the risk of overweight and obesity. The purpose of this study is to determine the differences in the proportion of UPF consumption based on individual characteristics, environmental factors, and lifestyle factors among non-health undergraduate students in Universitas Indonesia in 2023. A cross sectional study design conducted on 149 samples. The data was collected using a self-administered online questionnaire. The data was analyzed using univariate and bivariate (chi-square) analyses. The results showed that 50.3% of the students …

Sugary Food And Beverages Consumption, Family History, And Primary Dysmenorrhea In Undergraduate Students, Faculty Of Public Health, Universitas Indonesia, Raihani Ramadhan, Wahyu Kurnia Yusrin Putra, Diah Mulyawati Utari, Khoirul Anwar

Indonesian Journal of Public Health Nutrition (IJPHN)

Primary dysmenorrhea is the most common gynecological problem experienced by women of reproductive age and can interfere with daily activities. Therefore, the aim of this study was to determine the prevalence and differences in the proportion of primary dysmenorrhea based on individual factors (duration of menstrual bleeding, family history, physical activity, stress) and diet (breakfast habits, frequency of saturated fat consumption, omega-3 consumption, iron consumption, frequency of consumption of dairy products, caffeine consumption, and frequency of consumption of sugary foods and beverages). This study used a cross-sectional design and involved 150 regular undergraduate students in the 2019-2022 batch of the …

Health And Nutritional Status Among Internally Displaced Children Under Five Years, During The Civil War: Sri Lankan Experience, Madhuka Ambagahage

Indonesian Journal of Public Health Nutrition (IJPHN)

Around the globe, 1 in 6 children become vulnerable to grave physical and mental violence, hunger, sexual assaults, and exploitation of human rights due to war. These adversities are multi-dimensional, synergistic, and often subtle. This study attempted to evaluate the health and nutritional status of children aged under five years and living in the war zone of Sri Lanka, in view of improving the health services delivered to them. The study used a descriptive cross-sectional design. The study sample, 400, was based on probability proportionate and then systematic sampling drawn from IDP camps located in the Vavuniya district. Validated instruments …

The Effectiveness Of Nem (Nutrizone Educational Media) Compared With Knowledge And Attitudes In Early Adults In The West Jakarta Region, Daniel Hartanto, Laras Sitoayu, Lintang Purwara Dewanti, Harna Harna, Mertien Sa’Pang

Indonesian Journal of Public Health Nutrition (IJPHN)

Metabolic syndrome is a disease that often occurs in early adulthood. Maintaining a good lifestyle to prevent non-communicable diseases is very important to maintain a good quality of life. In early adulthood, most of them are still not exposed to information related to metabolic syndrome, so it is necessary to provide interventions associated with it. This study uses the Nutrizone gameboard intervention media. Good early adults’ knowledge and attitude about Metabolic Syndrome may lead to a good lifestyle that prevents them from suffering from NCDs. An intervention media may improve their knowledge and attitude. The research design used was pre-experimental …

Dietary Determinants Of Stunting And Underweight In Under- Five Years Children In Pengasinan Health Center's (Puskesmas) Working Area, Depok, West Java, Muthia Syifa Rahmadina, Ratih Qamara Dewi, Arif Hidayat, Satria Yudistira, Fadila Wirawan

Indonesian Journal of Public Health Nutrition (IJPHN)

Stunting and underweight are public health problems, especially in under-five children. This study aims to explore the dietary determinants of stunting and underweight. Participants were 52 under-five children who visited Posyandu in Pengasinan and Bedahan, Depok. Body weight for age z-score (WAZ) and height for age z-score (HAZ) were measured with standardized measurement tools by trained operators. Questionnaires were administered to determine sociodemographic, maternal, and child health history, sanitation, disease history, and exclusive breastfeeding history. Data on food intake was obtained through the semi-quantitative Food Frequency Questionnaire and 24-hour recall. There was a significant correlation between the mother’s income with …

Factors Related To The Incidence Of Diarrhea Of Children Aged 24-59 Months In Karangkamulyan Village, Cihara District, Lebak Regency In 2020, Hafshah Farah Fadhilah, Kusharisupeni Djokosujono, Ratu Ayu Dewi Sartika

Indonesian Journal of Public Health Nutrition (IJPHN)

Diarrhea remains a major issue in developing countries, including Indonesia, and is a leading cause of malnutrition and death. Banten is one of the provinces with a high incidence of diarrhea. In 2019, the district with the highest number of diarrhea cases for all ages in Banten was Lebak with a total of 50,270 cases. The age group with the greatest number of diarrhea cases was toddlers with over 14,000 cases. This study aimed to investigate the relationship between the incidence of diarrhea and the characteristics of toddlers and their parents, personal hygiene, and environmental sanitation. The study used secondary …

Analysis Of Energy Balance In Obese Healthcare Workers, Nani Cahyani Sudarsono, Ria Lestari, Tiffany Georgine T’Sidkenu Widjaja

Indonesian Journal of Public Health Nutrition (IJPHN)

Obesity is a global health challenge that seriously affects developing countries, including Indonesia. It is important to discover the energy balance calculated from energy intake and energy expenditure in obese individuals, especially in obese healthcare workers. This study aimed to analyze the balance of energy intake and expenditure, body composition, and physical activity level in obese healthcare workers at the Exercise Center of Indonesia Medical Education and Research Institute (IMERI FKUI). A cross-sectional study was held at Exercise Center IMERI FKUI. Total sampling was the sampling method utilized in the study. Study participants (aged above 18 years) were screened by …

Associated Food Parenting Practices And Other Factors With Fruit And Vegetable Consumption In Students In Jakarta, Indonesia, Gina Amalia Chaerunnisa, Triyanti Triyanti

Indonesian Journal of Public Health Nutrition (IJPHN)

The increased risk of non-communicable diseases is still a problem in Indonesia, one of which is the lack of consumption of fruits and vegetables. The available data shows that although fruits and vegetables have a protective/protective effect on the incidence of non-communicable diseases but in real life, the average consumption of fruits and vegetables is still below the recommended intake. Thus, the protective effect cannot be seen clearly. This study aims to describe the consumption of fruits and vegetables and determine the factors of food parenting practices and other factors related to the consumption of fruits and vegetables in students …

Analysis Of The Relationship Between Children's Characteristics, Family Characteristics, Food Intake, Eating Habits, And Disease History With Nutritional Status Of Under-Five Children Based On The Composite Index Of Anthropometric Failure In Karangkamulyan Village, Cihara District, Lebak Regency, Indonesia In 2020, Ayu Anisadiyah, Ratu Ayu Dewi Sartika

Indonesian Journal of Public Health Nutrition (IJPHN)

The Composite Index of Anthropometric Failure (CIAF) is an indicator of composite nutritional status assessment (BB/U, PB/U, and BB/PB) to describe all under-five children’s nutritional problems. In 2020, malnutrition, unemployment, and poverty in Banten Province were high, and the population's income tends to be low. Karangkamulyan Village is an underdeveloped village with mining areas. This study aims to determine the factors related to the nutritional status of under-five children based on CIAF in Karangkamulyan Village in 2020. The study used a cross-sectional study design and a systematic random sampling technique. The research sample was 141 under-five children aged 24-59 months. …

Factors Associated With High Fat, Salt, And Sugar Food Selection On Online Food Delivery Service Among Students Of Sman (State High School) 47 Jakarta, Indonesia, In 2022, Arifiana Arifiana, Kusharisupeni Djokosujono, Wahyu Kurnia Yusrin Putra, Nina Muziana

Indonesian Journal of Public Health Nutrition (IJPHN)

In the use of Online Food Delivery Service (OFDS), an online service applying a smartphone to make it easier for users to get food quickly, it was found that the foods selected tend to be unhealthy and may increase the risk of being overweight. The aim of this study was to determine predominant and other factors that differ in food selection in OFDS among students at SMAN (State High School) 47 Jakarta in 2022. This study applied a cross-sectional study design with 112 subjects. Data were taken through a questionnaire and analyzed by using an X²- test and multiple logistic …

The Association Between Feeding Practices And History Of Diarrhea With Nutritional Status Of Toddlers, Lulu Indria Setyani, Khoirul Anwar

Indonesian Journal of Public Health Nutrition (IJPHN)

The age of 0-59 months is a phase of basic life formation that is vulnerable to nutritional problems—causes such as infectious diseases and parenting. This research aims to analyze the relationship between feeding practices and a history of diarrhea with the nutritional status of children under five. This study used a cross-sectional design. Samples were taken by purposive sampling of as many as 96 toddlers. Data were collected by direct measurement of weight scales, stature meters, and interviews using the main questionnaire and the modified CFQ questionnaire. The statistical tests used were the chi-square test and fisher's exact test. A …

Sleep Quality And Affecting Factors Among Elderly Living In A Nursing Home In East Nusa Tenggara Indonesia, Asyifa Robiatul Adawiyah, Kusharisupeni Djokosujono, Jumiati Lelu Sanga

Indonesian Journal of Public Health Nutrition (IJPHN)

Sleep is one of the processes that greatly affects aging, It is essential for mental, physical, and maintenance of physical health. A research study was conducted in a public nursing home in Kupang East Nusa Tenggara Indonesia. This study aimed to analyze the sleep quality and the factors affecting sleep quality, among old age living in the nursing home. The research design was cross-sectional with primary data on 103 elderly living in nursing homes. There was a relationship between age, gender, marital status, spouse, educational background, have a chronic disease, living arrangement, anxiety, and depression with sleep quality (p

Availability Of Sugar-Sweetened Beverages At Home As The Dominant Factor Related To Its Consumption Among Students Of Sman (State High School) 47 Jakarta, Indonesia, In 2022, Nadhira Winindya Sari, Kusharisupeni Djokosujono, Diah Mulyawati Utari, Neni Rohayati

Indonesian Journal of Public Health Nutrition (IJPHN)

Sugar-sweetened beverages (SSBs) are drinks added with simple sugar, which can increase the energy because of calorie-dense and high in sugar, but low in other nutrients. Excessive consumption of SSBs can cause nutritional problems, such as increasing the risk of overweight and obesity. This study aims to determine the relationship between SSBs consumption and various factor and the dominant factor of SSBs consumption among students of SMAN (State High School) 47 Jakarta in 2022. The cross-sectional study was conducted from November 2021 to June 2022 with 120 respondents. Primary data was taken using questionnaires and analyzed by univariate, bivariate (chi-square …

Assessing The Influence Of Food Insecurity And Retail Environments As A Proxy For Structural Racism On The Covid-19 Pandemic In An Urban Setting, Rachael D. Dombrowski, Alex B. Hill, Bree Bode, Kathrybn A. G Knoff, Hadis Dastgerdizad, Noel Kulik, James Mallare, Kibibi Blount-Dorn, Winona Bynum

Urban Studies and Planning Faculty Research Publications

A collaborative partnership launched the Great Grocer Project (GGP) in March 2021 in Detroit, Michigan where health inequities, including deaths due to COVID-19, have historically been politically determined and informed by socially entrenched norms. Institutional and structural racism has contributed to a lack of diversity in store ownership among Detroit grocers and limited access to high-quality, affordable healthy foods as well as disparate food insecurity among Detroit residents. The GGP seeks to promote Detroit’s healthy grocers to improve community health and economic vitality through research, programs, and policies that have the potential to advance health equity. A cross-sectional design was …

Emotional Eating Among Final Year Undergraduate Female Students Of Faculty Of Public Health Universitas Indonesia During Covid-19 Pandemic In 2021, Adinda Safira Salsabiela, Wahyu Kurnia Yusrin Putra

Indonesian Journal of Public Health Nutrition (IJPHN)

Emotional eating is defined as the tendency to excessively consuming food which often high in sugar, salt, and fat levels in response to negative emotions. Uncontrolled emotional eating will increase the risk of eating disorders such as bulimia nervosa and binge-eating disorder, obesity, cardiovascular diseases, and type II diabetes. This study aims to find out about the relationship between perceived stress, anxiety, academic stressors, social media engagement, COVID-19 infection history in respondent and their family members, and mindfulness with emotional eating among 106 final year undergraduate female students of the Faculty of Public Health Universitas Indonesia during the COVID-19 pandemic …

Current Intake And Infection Status Were Not Good Predictive Factors Of Stunting Among Children Aged 6-59 Months In Babakan Madang Sub-District, Bogor District, West Java, Indonesia, Ruth Desinta Purnamasari, Ratu Ayu Dewi Sartika, Trini Sudarti

Indonesian Journal of Public Health Nutrition (IJPHN)

This study aims to discover the prevalence of stunting and determine the associations between the history of pulmonary tuberculosis disease with the prevalence of stunting among children under five years of age (6-59 months) in Babakan Madang Sub-District, Bogor District 2019. This study uses a cross-sectional design with a quantitative approach. The sample in this research was 194 children under five obtained by cluster sampling. Data collection was conducted through May 2019. The data collection process includes anthropometric measurements using calibrated microtoise and digital length board, dietary assessment using 1 x 24-h food recall, and a self-administered questionnaire. Data analyses …

Nutrition Analysis Of Wood Apple (Limonia Acidissima), Yuliana Noor Setiawati Ulvie, Hapsari Sulistya Kusuma, Erma Handarsari

Indonesian Journal of Public Health Nutrition (IJPHN)

Wood apple or Limonia acidissima contains fruit acid, vitamins, and minerals. The dry fiber of the fruit contains 15% citric acid, potassium, calcium, and iron salt. The seed and pulp contain fats and protein. The fats consist of palmitic acid, oleic acid, linoleic acid, and linolenic acid, despite palmitoleic and stearic acid traces. β-sitosterol, β-Amirin, lupeol, and stigmasterol are from the unsaponifiable matter of seed oil. It was descriptive research that employed a laboratory experiment approach to determine the composition of total carbohydrate, total protein, total fats, water, ash content, and the crude fiber of wood apple. The research found …

Carbohydrate Intake Is Associated With Learning Concentration Among High School Students In Jember Regency, East Java Province, Indonesia, Nadya Parahita Handini, Triyanti Triyanti, Kusharisupeni Djokosujono

Indonesian Journal of Public Health Nutrition (IJPHN)

Low learning concentration will have impact on low academic performance. This study aims to determine the relationship between learning concentration and several factors and to find the most dominant factor in the students of SMAN 1 Jember. In this study, learning concentration was the dependent variable, while breakfast habits, nutrient intake (energy, carbohydrates, protein, fat, iron, zinc, vitamin B12, vitamin C), sleep quality, and physical activity were independent variables. This research is a quantitative study with cross-sectional design. This study conducted in June 2021 at SMAN 1 Jember with a total of 200 respondents who were selected using the quota …

Effect Of Health And Nutrition Education On Blood Pressure, Knowledge And Compliance Among Hypertensive Patients In Bogor District, Indonesia: A Control Quasi-Experiment, Nurul Dina Rahmawati, Hasbullah Thabrany, Ratu Ayu Dewi Sartika

Indonesian Journal of Public Health Nutrition (IJPHN)

With a high prevalence of hypertension (25.8% in 2013 and 34.1% in 2018), Indonesia currently deals with a tremendous health economic burden with the implementation of National Health Insurance (JKN). Hypertension is known to lead to severe complications and productivity loss. This study aimed to evaluate the effect of health and nutrition education on blood pressure knowledge and compliance among hypertension patients. The study was conducted over a period of 6 months in Bogor District. A total of 179 patients (64%) completed the study (intervention n = 88, control n = 91). Compared to the control group, patients in the …

The Risk Factors For Self-Monitoring Of Blood Glucose Among Individuals Diagnosed With Type 2 Diabetes In Saudi Arabia, Mohammed Abdulrahman Alsuliman, Qi Zhang, Shelley Mishoe, Praveen K. Durgampudi

Community & Environmental Health Faculty Publications

Background: Lack of self-monitoring of blood glucose (SMBG) is a known risk factor for controlling type 2 diabetes mellitus (T2DM). Nevertheless, little research has been conducted on SMBG among Saudis with T2DM.

Aim: The study aimed to investigate personal and cognitive-perceptual factors for SMBG among Saudis with T2DM guided by Health Promotion Model.

Methods: A cross-sectional study was conducted with a sample size of 808 Saudi adults with T2DM utilizing secondary data from the Saudi Health Interview Survey for 2013.

Statistical Analysis: Bivariate and multivariate logistic regressions were applied to examine the risk factors for SMBG among Saudis with T2DM. …

Internalization Of Appearance Ideals And Not Religiosity Indirectly Impacts The Relationship Between Acculturation And Disordered Eating Risk In South And Southeastern Asian Women Living In The United States, Sonakshi Negi, Erik M. Benau, Megan Strowger, Anne Claire Grammer, C. Alix Timko

Psychology Faculty Publications

Objective: Studies that examine disordered eating in samples of Asian individuals living in the United States frequently combine all individuals of Asian descent into a single group, which can obscure important differences between groups and their experiences of acculturation. The goal of the present study was to establish the relation of acculturation, internalization of appearance ideals, and religiosity as predicting body dissatisfaction and disordered eating in women of South and Southeast Asian (SSEA) descent.

Method: Women of SSEA descent (N = 112) aged 18–51 years (M = 23.10, SD = 6.4) completed a battery of questionnaires that inquire about these …

Breastfeeding Media Coverage And Beliefs During The Covid-19 Pandemic In Mexico: Implications For Breastfeeding Equity, Mireya Vilar-Compte, P. Gaitán‐Rossi, E. C. Rhodes, V. Cruz‐Villalba, R. Pérez‐Escamilla

Department of Public Health Scholarship and Creative Works

Background: Because breastfeeding offers short- and long- term health benefits to mothers and children, breastfeeding promotion and support is a public health priority. Evidence shows that SARS-CoV-2 is not likely to be transmitted via breastmilk. Moreover, antibodies against SARS-CoV-2 are thought to be contained in breastmilk of mothers with history of COVID-19 infection or vaccination. WHO recommends direct breastfeeding as the preferred infant feeding option during the COVID-19 pandemic, even among women with COVID-19; but conflicting practices have been adopted, which could widen existing inequities in breastfeeding. This study aims to describe how information about breastfeeding was communicated in Mexican …

Factors Determining Successful Exclusive Breastfeeding Among Working Mothers In Indonesia: An Exploration By Using Positive Deviance Concept: Analysis Of Secondary Data Of Demographic Health Survey Indonesia 2017, Melinda Mastan, Endang Laksminingsih Achadi

Indonesian Journal of Public Health Nutrition (IJPHN)

Despite the fact that exclusive breastfeeding brings a lot of benefits for infants and mothers, breastfeeding rates in Indonesia remain low, at 42% of all infants aged 0-5 months in 2012. This study aims to apply the positive deviance concept to explore the factors determining the success of exclusive breastfeeding among mothers in a high-risk group in Indonesia. The study used the cross-sectional, DHS 2017 data of 1.178 mothers with 0-5 months old infants in Indonesia. Chi-square and multiple logistic regression tests with 95% confidence intervals are used in identifying the factors associated with exclusive breastfeeding. Maternal working status is …

The Effect Of The Provision Of Bagea Enriched With Sea Urchin Gonads On Weight Gain In Toddlers Of The Bajo Ethnic, La Banudi, Suriana Koro, M. Anas Anasiru, Nurmiaty Nurmiaty

Indonesian Journal of Public Health Nutrition (IJPHN)

Cassava starch extract and sea urchin gonads can be used as ingredients for making various kinds of food formulas. This study aimed to develop cassava starch extract as a formula for making bagea added with sea urchin gonads which are rich in nutrients to make it good for child. This study was aimed at analyzing the effect of the provision of bagea enriched by sea urchin gonads on weight gain in toddlers of the Bajo community. In making the formula of bagea, the researchers used a quasi-experimental design. After the data were collected, they were then checked for feasibility, coded, …

Relationship Of Age, Gender, And History Of Comorbid Diseases In Tb Patients Toward Self-Stigma Tb In Surakarta, Ignes Widowati, Balgis Balgis, Sri Mulyani

Indonesian Journal of Public Health Nutrition (IJPHN)

Tuberculosis (TB) infection in Indonesia has not been completely eradicated. It is challenging for those who suffer from TB to be away from self-stigma. This study aimed to determine the relationship between age factors, gender, and a history of comorbid diseases related to self-stigma. This was a cross sectional study using a Tuberculosis Stigma Assessment questionnaire. Total 50 respondents were obtained by purposive sampling technique. Inclusion criteria are TB patients or former patients aged 18 years to the elderly, male and female, without or having a history of comorbidities (HIV & DM). Quantitative-qualitative analysis, univariate and bivariate tests using Pearson …