Statistics and Probability Commons^™

Risk Of Gastrointestinal Bleeding Associated With Oral Anticoagulants: Population Based Retrospective Cohort Study, Hsien-Yen Chang, Meijia Zhou, Wenze Tang, G. Caleb Alexander, Sonal Singh

Epidemiology Faculty Publications

Objectives To determine the real world safety of dabigatran or rivaroxaban compared with warfarin in terms of gastrointestinal bleeding.

Design Retrospective cohort study.

Setting Large administrative database of commercially insured people in United States from 1 October 2010 through 31 March 2012.

Participants Enrollees with a prescription of warfarin, dabigatran, or rivaroxaban between 1 October 2010 and 31 March 2012, who were aged 18 years or older, had continuous enrollment and no oral anticoagulant use during the six months before the entry date, with known age and sex, and with no gastrointestinal bleeding for at least six months before the …

Association Between Respiratory Syncytial Virus Activity And Pneumococcal Disease In Infants: A Time Series Analysis Of Us Hospitalization Data., Daniel M. Weinberger, Keith P. Klugman, Claudia A. Steiner, Lone Simonsen, Cécile Viboud

Epidemiology Faculty Publications

BACKGROUND:

The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV.

METHODS AND FINDINGS:

We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and >16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal …

A History Of Undergraduate Education For Public Health: From Behind The Scenes To Center Stage., Richard Kenneth Riegelman, Susan Albertine, Randy Wykoff

GW Biostatistics Center

No abstract provided.

Scaling Down To Scale Up: A Health Economic Analysis Of Integrating Point-Of-Care Syphilis Testing Into Antenatal Care In Zambia During Pilot And National Rollout Implementation., Katharine D. Shelley, Éimhín M. Ansbro, Alexander Tshaka Ncube, Sedona Sweeney, Colette Fleischer, Grace Tembo Mumba, Michelle M. Gill, Susan Strasser, Rosanna W. Peeling, Fern Terris-Prestholt

GW Biostatistics Center

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, …

Treatment-Induced Changes In Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion In The Diabetes Prevention Program Cohort., Kieren J. Mather, Qing Pan, William C. Knowler, Tohru Funahashi, George A. Bray, Et Al.

GW Biostatistics Center

BACKGROUND AND OBJECTIVES: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

DESIGN, SETTING, PARTICIPANTS AND METHODS: We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) …

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William H. Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Skin Collagen Advanced Glycation Endproducts (Ages) And The Long-Term Progression Of Sub-Clinical Cardiovascular Disease In Type 1 Diabetes, Vincent M. Monnier, Wanjie Sun, Xiaoyu Gao, David R. Sell, Patricia Cleary, John M. Lachin, Saul Genuth, The Dcct/Edic Research Group

GW Biostatistics Center

BACKGROUND:

We recently reported strong associations between eight skin collagen AGEs and two solubility markers from skin biopsies obtained at DCCT study closeout and the long-term progression of microvascular disease in EDIC, despite adjustment for mean glycemia. Herein we investigated the hypothesis that some of these AGEs (fluorescence to be reported elsewhere) correlate with long-term subclinical cardiovascular disease (CVD) measurements, i.e. coronary artery calcium score (CAC) at EDIC year 7-9 (n = 187), change of carotid intima-media thickness (IMT) from EDIC year 1 to year 6 and 12 (n = 127), and cardiac MRI outcomes at EDIC year 15-16 (n …

Quality Control Measures Over 30 Years In A Multicenter Clinical Study: Results From The Diabetes Control And Complications Trial / Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Study., Gayle M Lorenzi, Barbara H Braffett, Valerie L Arends, Ronald P Danis, Lisa Diminick, Kandace A Klumpp, Anthony D Morrison, Elsayed Z Soliman, Michael W Steffes, Patricia A Cleary

GW Biostatistics Center

No abstract provided.

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Pregnant And Postpartum Women’S Experiences And Perspectives On The Acceptability And Feasibility Of Copackaged Medicine For Antenatal Care And Pmtct In Lesotho, Michelle M. Gill, Heather J. Hoffman, Appolinaire Tiam, Florence M. Mohai, Mokone Majoalane, Anthony Isavwa, Laura Guay, +4 Additional Authors

Epidemiology Faculty Publications

Objective. To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women.

Methods. Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013.

Results. 290 HIV-negative women and 437 HIV-positive women (n=727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were …

Clinical Significance Of Left Atrial Anatomic Abnormalities Identified By Cardiac Computed Tomography, Ara V. Vehian, Brian G. Choi, Satinder Rekhi, Heather A. Young, Raman S. Dusaj, Robert K. Zeman

Epidemiology Faculty Publications

Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouchings, i.e., the left atrial appendage, have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients undergoing CT with embolic events and arrhythmia.

Methods: 242 patients (mean age 56 SD 12 years, 41% female) were selected who had CT coronary angiography performed with 64-row MDCT between 2007 and 2012 if complete …

Parity And Diabetes Risk Among Hispanic Women From Colombia: Cross-Sectional Evidence, Pablo Cure, Heather J. Hoffman, Carlos Cure-Cure

Epidemiology Faculty Publications

Objective

The association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia.

Research design and methods

Herein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3–5, 6 or > births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find …

Implementation Of Point-Of-Care Diagnostics Leads To Variable Uptake Of Syphilis, Anemia And Cd4+ T-Cell Count Testing In Rural Maternal And Child Health Clinics., Caroline De Schacht, Carlota Lucas, Nádia Sitoe, Rhoderick Machekano, Patrina Chongo, Laura Guay, Et Al.

Epidemiology Faculty Publications

INTRODUCTION: Anemia, syphilis and HIV are high burden diseases among pregnant women in sub-Saharan Africa. A quasi-experimental study was conducted in four health facilities in Southern Mozambique to evaluate the effect of point-of-care technologies for hemoglobin quantification, syphilis testing and CD4+ T-cell enumeration performed within maternal and child health services on testing and treatment coverage, and assessing acceptability by health workers.

METHODS: Demographic and testing data on women attending first antenatal care services were extracted from existing records, before (2011; n = 865) and after (2012; n = 808) introduction of point-of-care testing. Study outcomes per health facility were compared …

A Systematic Review And Meta-Regression Analysis Of Lung Cancer Risk And Inorganic Arsenic In Drinking Water., Steven H. Lamm, Hamid Ferdosi, Elisabeth K. Dissen, Ji Li, Jaeil Ahn

Epidemiology Faculty Publications

High levels (> 200 µg/L) of inorganic arsenic in drinking water are known to be a cause of human lung cancer, but the evidence at lower levels is uncertain. We have sought the epidemiological studies that have examined the dose-response relationship between arsenic levels in drinking water and the risk of lung cancer over a range that includes both high and low levels of arsenic. Regression analysis, based on six studies identified from an electronic search, examined the relationship between the log of the relative risk and the log of the arsenic exposure over a range of 1-1000 µg/L. The …

Reassessment Of Risk Genotypes (Grn, Tmem106b, And Abcc9 Variants) Associated With Hippocampal Sclerosis Of Aging Pathology, Peter T. Nelson, Wang-Xia Wang, Amanda B. Partch, Sarah E. Monsell, Otto Valladares, Sally R. Ellingson, Bernard R. Wilfred, Adam C. Naj, Li-San Wang, Walter A. Kukull, David W. Fardo

Pathology and Laboratory Medicine Faculty Publications

Hippocampal sclerosis of aging (HS-Aging) is a common high-morbidity neurodegenerative condition in elderly persons. To understand the risk factors for HS-Aging, we analyzed data from the Alzheimer’s Disease Genetics Consortium and correlated the data with clinical and pathologic information from the National Alzheimer’s Coordinating Center database. Overall, 268 research volunteers with HS-Aging and 2,957 controls were included; detailed neuropathologic data were available for all. The study focused on single-nucleotide polymorphisms previously associated with HS-Aging risk: rs5848 ( GRN ), rs1990622 ( TMEM106B ), and rs704180 ( ABCC9 ). Analyses of a subsample that was not previously evaluated (51 HS-Aging cases …

Developments In Nonparametric Regression Methods With Application To Raman Spectroscopy Analysis, Jing Guo

Theses and Dissertations--Epidemiology and Biostatistics

Raman spectroscopy has been successfully employed in the classification of breast pathologies involving basis spectra for chemical constituents of breast tissue and resulted in high sensitivity (94%) and specificity (96%) (Haka et al, 2005). Motivated by recent developments in nonparametric regression, in this work, we adapt stacking, boosting, and dynamic ensemble learning into a nonparametric regression framework with application to Raman spectroscopy analysis for breast cancer diagnosis. In Chapter 2, we apply compound estimation (Charnigo and Srinivasan, 2011) in Raman spectra analysis to classify normal, benign, and malignant breast tissue. We explore both the spectra profiles and their derivatives to …

Nonlinear Hierarchical Models For Longitudinal Experimental Infection Studies, Michael David Singleton

Theses and Dissertations--Epidemiology and Biostatistics

Experimental infection (EI) studies, involving the intentional inoculation of animal or human subjects with an infectious agent under controlled conditions, have a long history in infectious disease research. Longitudinal infection response data often arise in EI studies designed to demonstrate vaccine efficacy, explore disease etiology, pathogenesis and transmission, or understand the host immune response to infection. Viral loads, antibody titers, symptom scores and body temperature are a few of the outcome variables commonly studied. Longitudinal EI data are inherently nonlinear, often with single-peaked response trajectories with a common pre- and post-infection baseline. Such data are frequently analyzed with statistical methods …

The Distribution Of Type 1 Diabetes Onset In The United States By Demographic Factors, Margaret Beckstrand

Walden Dissertations and Doctoral Studies

Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene …

Mediation Analysis Of Gestational Age, Congenital Heart Defects, And Infant Birth-Weight, Adane F. Wogu, Christopher A. Loffredo, Ionut Bebu, George Luta

GW Biostatistics Center

Background

In this study we assessed the mediation role of the gestational age on the effect of the infant’s congenital heart defects (CHD) on birth-weight.

Methods

We used secondary data from the Baltimore-Washington Infant Study (1981–1989). Mediation analysis was employed to investigate whether gestational age acted as a mediator of the association between CHD and reduced birth-weight. We estimated the mediated effect, the mediation proportion, and their corresponding 95% confidence intervals (CI) using several methods.

Results

There were 3362 CHD cases and 3564 controls in the dataset with mean birth-weight of 3071 (SD = 729) and 3353 (SD = 603) …

Access To Hiv Prevention And Care For Hiv-Exposed And Hiv-Infected Children: A Qualitative Study In Rural And Urban Mozambique, Caroline De Schacht, Carlota Lucas, Caterina Mboa, Michelle Gill, Eugenia Macasse, Stelio A. Dimande, Emily A. Bobrow, Laura Guay

Epidemiology Faculty Publications

Background Follow-up of HIV-exposed children for the delivery of prevention of mother-to-child transmission services and for early diagnosis and treatment of HIV infection is critical to their survival. Despite efforts, uptake of postnatal care for these children remains low in many subSaharan African countries. Methods A qualitative study was conducted in three provinces in Mozambique to identify motivators and barriers to improve uptake of and retention in HIV prevention, care and treatment services for HIV-exposed and HIV-infected children. Participant recommendations were also gathered. Individual interviews (n=79) and focus group discussions (n=32) were conducted with parents/caregivers, grandmothers, community leaders and health …

Prognostic Value Of Lymphocyte Vascular Density And E-Cadherin In Inflammatory Breast Cancer, Paul H. Levine, Heather J. Hoffman, Audra Macneil, Salman Hashmi, Sherry X. Yang, Stephen Hewitt, Kenneth L. Van Golen, Sandra M. Swain

Epidemiology Faculty Publications

Background: We recently evaluated four laboratory assays, vascular endothelial growth factor D (VEGF-D), E-cadherin, lymphatic vessel density (LVD) measured by podoplanin, and intra-lymphatic tumor emboli (ILTE), which showed notable differences between inflammatory breast cancer (IBC) and non-inflammatory locally advanced breast cancer (LABC). In this study we investigated the potential of the three most quantitatively measured markers, E-cadherin, LVD and VEGF-D, to predict survival in the IBC patients.

Materials and Methods: This study involved the 100 cases identified in the Inflammatory Breast Cancer Registry (IBCR) whose tumors were previously evaluated for the four assays noted above. Living patients were recontacted and …

The Effectiveness Of Teleglaucoma Versus In-Patient Examination For Glaucoma Screening: A Systematic Review And Meta-Analysis, Sera-Melisa Thomas, Maya M Jeyaraman, Maya Jeyaraman, William G Hodge, Cindy Hutnik, John Costella, Monali S Malvankar-Mehta

Epidemiology and Biostatistics Publications

BACKGROUND: Glaucoma is the leading cause of irreversible visual impairment in the world affecting 60.5 million people worldwide in 2010, which is expected to increase to approximately 79.6 million by 2020. Therefore, glaucoma screening is important to detect, diagnose, and treat patients at the earlier stages to prevent disease progression and vision loss. Teleglaucoma uses stereoscopic digital imaging to take ocular images, which are transmitted electronically to an ocular specialist. The purpose is to synthesize literature to evaluate teleglaucoma, its diagnostic accuracy, healthcare system benefits, and cost-effectiveness.

METHODS: A systematic search was conducted to help locate published and unpublished studies. …

Identifying Change Points In A Covariate Effect On Time-To-Event Analysis With Reduced Isotonic Regression, Yong Ma, Yinglei Lai, John M. Lachin

GW Biostatistics Center

Isotonic regression is a useful tool to investigate the relationship between a quantitative covariate and a time-to-event outcome. The resulting non-parametric model is a monotonic step function of a covariate X and the steps can be viewed as change points in the underlying hazard function. However, when there are too many steps, over-fitting can occur and further reduction is desirable. We propose a reduced isotonic regression approach to allow combination of small neighboring steps that are not statistically significantly different. In this approach, a second stage, the reduction stage, is integrated into the usual monotonic step building algorithm by comparing …

Assessing The Social And Ecological Factors That Influence Childhood Overweight And Obesity, Katie Callahan

Electronic Theses and Dissertations

The prevalence of childhood overweight and obesity is increasing at an alarming rate in the United States. Currently more than 1 in 3 children aged 2-19 are overweight or obese. This is of major concern because childhood overweight and obesity leads to chronic conditions such as type II diabetes and tracks into adulthood, where more severe adverse health outcomes arise. In this study I used the premise of the social ecological model (SEM) to analyze the common levels that a child is exposed to daily; the intrapersonal level, the interpersonal level, the school level, and the community level to better …

Pengaruh Rejimen Terhadap Ketidakpatuhan Berobat Tuberkulosis, Rizka Nur Fadila, Pandu Riono

Kesmas

Beban tuberkulosis di Indonesia termasuk lima tertinggi di dunia. Temuan kasus dan pengobatan adalah pilar utama program penanggulangan tuberkulosis. Survei nasional menunjukkan peningkatan penggunaan rejimen tidak standar dari 16,8% (2010) menjadi 55,6% (2013). Peningkatan penggunaan rejimen tidak standar diduga berpengaruh terhadap ketidakpatuhan berobat. Penelitian ini bertujuan untuk mempelajari ketidakpatuhan berobat pada orang dengan tuberkulosis yang menerima rejimen tidak standar dan rejimen standar. Penelitian menggunakan data sekunder Riset Kesehatan Dasar 2010. Analisis logistik multivariabel dilakukan pada sampel 971 orang dengan tuberkulosis yang selesai mendapatkan pengobatan. Hasil penelitian menunjukkan ada kecenderungan orang dengan tuberkulosis yang menerima rejimen tidak standar memiliki ketidakpatuhan berobat …

Annual Parasite Incidence Malaria Di Kabupaten Banyumas, Dwi Sarwani Sri Rejeki, Ruthi Armita Sari, Nunung Nurhayati

Kesmas

Kabupaten Banyumas merupakan kabupaten endemis malaria di Provinsi Jawa Tengah. Data Dinas Kesehatan Kabupaten Banyumas tahun 2008 - 2013 menunjukkan angka annual paracite incidence (API) yang selalu mengalami fluktuasi. Dari 27 kecamatan, 22 di antaranya termasuk dalam kategori medium case incidence (MCI) dan low case incidence (LCI). Faktor lingkungan, perilaku, sosial ekonomi, dan iklim berdampak pada tinggi rendahnya kejadian malaria. Tujuan penelitian adalah mengetahui faktor yang berhubungan dengan API di Kabupaten Banyumas. Data dikumpulkan dari Januari 2011 - Desember 2013 menggunakan penelitian analitik dengan rancangan penelitian potong lintang dan menggunakan data sekunder dari Dinas Kesehatan, Dinas Pertanian, dan Badan Pusat …

Riwayat Pemberian Air Susu Ibu Dengan Penyakit Infeksi Pada Balita, Abidah Nur, Nelly Marissa

Kesmas

Riset Kesehatan Dasar tahun 2013 menyebutkan angka insiden diare pada balita di Indonesia sebesar 6,7%. Aceh merupakan provinsi dengan insiden diare tertinggi, mencapai 10,2%. Profil Kesehatan Aceh menunjukkan bahwa secara umum terjadi peningkatan penyakit infeksi seperti influenza, tuberkulosis, dan diare dalam kurun waktu tujuh tahun (2006 - 2012). Penyakit tersebut dapat dicegah dengan pemberian ASI yang berperan dalam peningkatan kekebalan tubuh. Penelitian ini dilakukan untuk mengetahui hubungan riwayat pemberian ASI dengan penyakit infeksi pada balita. Penelitian ini menggunakan data sekunder dari Badan Pusat Statistik Provinsi Aceh, yaitu data Survei Sosial dan Ekonomi Nasional tahun 2012 dengan jumlah sampel 3.486 balita. …

Analisis Risiko Karakteristik, Sosial Ekonomi, Perilaku Dan Kondisi Lingkungan Rumah Terhadap Kejadian Malaria, Susy Sriwahyuni Sukiswo, Rinidar Rinidar, Sugito Sugito

Kesmas

Malaria merupakan penyakit menular yang menjadi perhatian global. Kecamatan Arongan Lambalek merupakan daerah rawan malaria di Kabupaten Aceh Barat dengan kategori Medium Incidence Area dengan nilai Annual Parasite Incidence (API) 3,67 per 1000 penduduk masih di atas target API Nasional pada fase eliminasi API kurang dari 1 per 1000 penduduk tahun 2013. Penelitian ini bertujuan menganalisis karakteristik, sosial ekonomi, perilaku, dan kondisi lingkungan rumah yang berpengaruh terhadap kejadian malaria di Kecamatan Arongan Lambalek, Kabupaten Aceh Barat. Jenis penelitian ini adalah observasional analitik dengan pendekatan kasus kontrol dengan metode penarikan sampel yaitu purposive sampling. Jumlah sampel dalam penelitian ini terdiri 33 …

Mutu Pelayanan Puskesmas Perawatan Yang Berstatus Badan Layanan Umum Daerah, Putu Ayu Indrayathi, Rina Listyowati, Ni Made Sri Nopiyani, Luh Putu Sinthya Ulandari

Kesmas

Kebijakan pusat pelayanan kesehatan masyarakat (puskesmas) sebagai Badan Layanan Umum Daerah (BLUD) diimplentasikan untuk meningkatkan kualitas pelayanan kesehatan dasar. Kebijakan BLUD puskesmas telah diterapkan di Kabupaten Gianyar sejak tahun 2010 dan berlaku pada puskesmas perawatan maupun nonperawatan. Pelaksanaan BLUD puskesmas tidak selalu meningkatkan mutu layanan. Penelitian ini bertujuan mengetahui gambaran mutu pelayanan puskesmas perawatan yang berstatus BLUD di Kabupaten Gianyar. Penelitian ini merupakan penelitian potong lintang dengan pendekatan kuantitatif dan kualitatif. Tempat dan waktu penelitian ini dilakukan di Kabupaten Gianyar, Agustus hingga Desember 2013. Data kuantitatif dikumpulkan melalui penyebaran kuesioner kepada 105 pengguna layanan di empat puskesmas yang dipilih dengan …

Kondisi Kesehatan Lingkungan Pesantren Dan Perilaku Hidup Bersih Dan Sehat Siswa Dengan Kejadian Hepatitis, Ii Sumarni, Dewi Susanna

Kesmas

Kejadian luar biasa hepatitis A di Kabupaten Ciamis telah terjadi beberapa kali, satu di antaranya terjadi di Pondok Pesantren X. Penelitian ini bertujuan untuk menganalisis kondisi kesehatan lingkungan serta perilaku hidup bersih dan sehat dengan kejadian hepatitis A siswa/siswi di Pondok Pesantren X Kabupaten Ciamis. Rancangan penelitian menggunakan desain kasus kontrol dengan jumlah kasus 40 orang dan kontrol 80 orang, total sampel 120 orang. Populasi penelitian adalah siswa/siswi madrasah tsanawiyah dan madrasah aliyah negeri yang tinggal di asrama pondok pesantren. Data kasus merupakan data sekunder yang diperoleh dari Tim Surveilans Kabupaten Ciamis, dengan hasil pemeriksaan serologis positif. Sedangkan kontrol berdasarkan …