Abstrak: Prediabetes merupakan golden period dalam menunda terjadinya diabetes melitus tipe 2 karena pada periode ini perjalanan penyakit masih bisa dihentikan.Penelitian ini bertujuan untuk mengetahui dampak stres pada konversi prediabetes menjadi diabetes melitus tipe 2 pada orang dewasa. Penelitian ini menggunakan desain kohort retrospektif. Data yang digunakan adalah data sekunder dari Studi Kohort Faktor Risiko untuk Penyakit Tidak Menular di Bogor, Indonesia. Pengumpulan data pada penelitian ini dilakukan sejak 2011 hingga 2015 dengan total populasi 5.890. Berdasarkan kriteria eksklusi dan inklusi, total subjek penelitian adalah 1059. Selama 5 tahun pengamatan, di antara subjek usia dewasa prediabetik ada 169 subjek yang dikategorikan sebagai T2DM dan 219 subjek dikategorikan sebagai stres. Analisis bivariat menunjukkan bahwa stres dan usia pada awal merupakan faktor risiko pada konversi pradiabetes menjadi T2DM (p <0,05). Model akhir pada analisis multivariat, menunjukkan hazard rasio stres sebesar 1,815 (95% CI: 1,307 - 2,520) dengan p <0,05. Temuan ini, diharapkan dapat digunakan sebagai informasi dan motivasi dalam upaya melakukan pencegahan dan pengendalian T2DM. Terutama pada individu dengan prediabetes yang menderita stres karena memiliki pengaruh terhadap konversi prediabetes menjadi T2DM.
Kata kunci: Diabetes melitus tipe 2, prediabetes, stres, dewasa

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Prediabetes is a golden period in delaying the occurrence of type 2 diabetes mellitus because in this period the course of the disease can still be stopped. The study aim was to knowing the impact of stress on the conversion of prediabetes to type 2 diabetes mellitus in adults. This study used retrospective cohort design. The data used are secondary data from the Cohort Study of Risk Factors for Non-Communicable Diseases in Bogor, Indonesia. Data collection in this study was carried out since 2011 until 2015 with a total population of 5890. Based on the exclusion and inclusion criteria, the total of study participants were 1059. During 5 years of follow-up, among prediabetic adults there were 169 subjects categorized as T2DM and 219 subjects categorized as stressed. Bivariate analysis shows that stress and age at baseline is a risk factor on the conversion of prediabetes to T2DM (p < 0,05). Final model on multivariate analysis, shows the hazard ratio of stress was 1.815 (95% CI: 1.307 - 2.520) with p < 0.05. This findings, expected to be used as information and motivation in an effort to make prevention and control of T2DM. Especially in individuals with prediabetes who suffer from stress because it has an impact with conversion of prediabetes to T2DM.
Key words: Type 2 diabetes mellitus, prediabetes, stress, adults

Abstrak: Pendahuluan : Indonesia menduduki posisi ketiga dengan jumlah kasus tuberkulosis terbanyak. Rata-rata 90% dari yang terinfeksi M.tuberkulosis menimbulkan kekebalan karena imunitas yang baik akan tetapi 10% berkembang menjadi tuberkulosis aktif dalam hitungan beberapa bulan atau tahun setelah terjadi infeksi (WHO, 2018). Diabetes menyerang 382 juta pada tahun 2013 dan diproyeksikan akan meningkat menjadi 592 juta pada tahun 2035. Ketika diabetes menyebar, itu akan menyebabkan semakin banyak penduduk yang terinfeksi tuberkulosis (Lönnroth, 2014). Prevalensi diabetes mellitus meningkat berdasarkan umur terutama pada populasi di atas 40 tahun yang dikarenakan perkembangan intoleransi glukosa. Oleh karena itu perlu dilakukan penelitian untuk mengetahui besar risiko diabetes mellitus terhadap kejadian tuberkulosis paru pada penduduk 40-65 tahun dengan mempertimbangkan faktor-faktor contributory (potential confounder) yang juga berhubungan terhadap kejadian tuberkulosis maupun diabetes mellitus.
Metode : Penelitian ini menggunakan disain cross-sectional. Sebanyak 26.301 Penduduk 40-65 tahun menjadi sampel pada penelitian ini. Data diperoleh dari Mandat Litbangkes RI dan dianalisis menggunakan uji Regresi Logistik.
Hasil : Risiko TB Paru 4,8 kali lebih besar pada penduduk 40-65 tahun yang memiliki riwayat diabetes mellitus dibandingkan dengan tidak memiliki riwyat diabetes mellitus (POR=4,8 : 95% CI 2,2-10,6).
Kesimpulan : Kolaborasi antar layanan termasuk didalamnya skrining (Diabetes Mellitus dan TB Paru) diperlukan untuk mengurangi prevalensi dari kedua penyakit dengan didukung penyusunan peraturan/pedoman standard antar layanan di FKTP serta pertimbangan pemberian profilaksis PP INH pada penderita diabetes mellitus perlu dipertimbangkan

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Introduction : Indonesia is the third rank of the highest number cases of tuberculosis. On average 90% of those infected with M and only 10% develop active tuberculosis after infection (WHO, 2018). Diabetes attacked 382 million in 2013 and will be predicted increase to 592 million by 2035. When diabetes spreads, it will cause more people infected tuberculosis (Lönnroth, 2014). The prevalence of diabetes mellitus increases with age, especially in populations over 40 years due to the development of glucose intolerance. Therefore, it is necessary to do research to determine the risk of diabetes mellitus against pulmonary tuberculosis in the population of 40-65 years by considering the contributory factors (potential confounder) which are also related to the prevalence of tuberculosis and diabetes mellitus.
Method: This study used cross-sectional design. Sample were 26,301 respondents of 40- 65 years. Data was obtained from the Indonesian Litbangkes and analyzed using the Logistic Regression.
Result : The risk of pulmonary TB was 4,8 times greater in the population of 40-65 years who had a history of diabetes mellitus compared to not having a diabetes mellitus (POR = 4,8 : 95% CI 2,2-10,6).
Conclusion : Collaboration both health services including screening (Diabetes Mellitus and Pulmonary TB) is needed to reduce the prevalence of both diseases and profilaxis program of PP INH need to be considered

Abstrak: Prevalensi DM di Kota Bogor yakni sebesar 2,1% hal ini masih lebih tinggi dibandingkan dengan prevalensi DM di Indonesia menurut data Riskesdas 2013 yakni sebesar 2,0%. Tujuan penelitian ini adalah untuk mengetahui pengaruh aktivitas fisik terhadap kontrol kadar Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Menurut uji Log-rank survival berdasarkan aktivitas fisik tidak berbeda bermakna dengan nilai signifikansi 0,941. Bahwa survival antara kelompok aktivitas fisik cukup dan kurang tidak berbeda survival-nya terhadap event kontrol glukosa darah buruk. Penderita DM tipe 2 yang cukup beraktivitas fisik memiliki HR sebesar 0,788 kali (95%CI: 0,456-1,360) dengan p value 0,392. Artinya, penderita DM tipe 2 yang cukup beraktifitas fisik maupun yang kurang tidak menunjukkan perbedaan yang bermakna terhadap kontrol glukosa darah. Tidak ditemukan pengaruh aktivitas fisik terhadap kontrol Glukosa darah penderita diabetes mellitus tipe 2 pada studi kohort PTM di Kota Bogor tahun 2011-2016. Hal ini dikarenakan banyak terjadi sensor dan lost to follow up juga titik pengamatan yang cukup jauh rentangnya yakni 2 tahun. Diperlukan upaya promosi kesehatan yang berkelanjutan dan bagi peneliti lain dapat melakukan studi dengan titik pengamatan.
Kata kunci: Aktivitas fisik, kontrol glukosa darah, diabetes mellitus

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The prevalence of DM in Bogor City which is equal to 2.1%, this is still higher than the prevalence of DM in Indonesia according to Riskesdas 2013 data which is equal to 2.0%. The purpose of this study was to determine the effect of physical activity on blood glucose level control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. According to the Log-rank survival test based on physical activity there was no significant difference with a significance value of 0.941. That survival between groups of physical activity is sufficient and the survival of the blood glucose control event is not different. Patients with type 2 DM who have enough physical activity have HR of 0.788 times (95% CI: 0.456-1.360) with p value 0.392. That is, patients with type 2 diabetes who have sufficient physical activity or those who do not show significant differences in blood glucose control. There was no effect of physical activity on blood glucose control in patients with type 2 diabetes mellitus in the PTM cohort study in Bogor City in 2011-2016. This is because there are a lot of sensors and lost to follow-up as well as a far enough observation point, which is 2 years. Continuous health promotion efforts are needed and other researchers can conduct studies with observation points with a shorter time span so that the effects of physical activity on blood glucose control in patients with type 2 diabetes can be measured more precisely.
Key words: physical activity, diabetes mellitus, blood glucose control

Abstrak: ABSTRAK Hubungan obesitas dan merokok terhadap kejadian hipertensi sudah banyak diketahui namun masih jarang dilakukan penelitian untuk melihat efek gabungan obesitas dan merokok dalam menyebabkan hipertensi derajat 1. Penelitian ini bertujuan untuk mengevaluasi efek gabungan obesitas dan merokok dalam menyebabkan hipertensi derajat 1. Penelitian ini menggunakan desain cross-sectional menggunakan data Indonesian Family Life Survey-5 (IFLS-5) tahun 2014. Sampel yang dianalisis pada penelitian ini berjumlah 13.487 setelah memenuhi kriteria inklusi dan eksklusi. Analisis multivariat menggunakan uji cox regresi digunakan untuk mengetahui besar risiko obesitas dan merokok dalam menyebabkan hipertensi derajat 1. Hasil penelitian didapatkan prevalensi hipertensi derajat 1 sebesar 23,50%. Analisis multivariat menunjukkan bahwa orang yang obesitas dan merokok memiliki risiko 2,86 kali untuk mengalami hipertensi derajat 1 (PR=2,86), orang obesitas dan tidak merokok memiliki risiko 1,64 kali untuk mengalami hipertensi derajat 1 (PR=1,64), orang tidak obesitas dan merokok memiliki risiko 1,32 kali untuk mengalami hipertensi derajat 1 (PR=1,32). Risiko untuk mengalami hipertensi derajat 1 meningkat 48% akibat interaksi obesitas dan merokok. Perlu adanya adanya skrining lebih ketat untuk mencegah hipertensi terutama pada orang obesitas dan merokok pada umur ≥18 tahun misalnya dengan pengkuran tekanan darah secara rutin di rumah. Selain itu perlu adanya peningkatan kualitas pelaksanaan Posbindu PTM dari pemerintah untuk pemantauan faktor risiko serta deteksi dini PTM. Kata kunci: Efek gabungan, obesitas, merokok, hipertensi derajat 1, Indonesia ABSTRACT The relationship of obesity and cigarette smoking to the incidence of hypertension was well known, but study is still rare to see the joint effects of obesity and smoking in causing hypertension grade 1. This study aimed to evaluate the joint effect of obesity and cigarette smoking on causing hypertension grade 1. This study used a crosssectional design using data from Indonesian Family Life Survey-5 (IFLS-5) in 2014. The samples analyzed in this study amounted to 13,487 after fulfilling the inclusion and exclusion criteria. Multivariate analysis using the cox regression test was use to determine the risk of obesity and smoking in causing hypertension grade 1. The results showed that the prevalence of hypertension grade 1 is 23.50%. Multivariate analysis showed that people who were obese and smoking had a risk of 2.86 times for having hypertension grade 1 (PR = 2.86), obese and non-smoking people have a risk of 1.64 times to have hypertension grade 1 (PR = 1.64), people who were not obese and smoking have a risk of 1.32 times for having hypertension grade 1 (PR = 1.32). The risk of developing hypertension grade 1 increased by 48% due to the interaction of obesity and smoking. There needs to be more rigorous screening to prevent hypertension, especially in obese and smoking people at age ≥18 years, for example by measuring blood pressure regularly at home. In addition, there is a need to improve the quality of the implementation of NCDs Integrated Development Post (Posbindu) from the government for risk factor monitoring and early detection of NCDs. Key words: Joint effect, obesity, smoking, hypertension grade 1, Indonesia

Abstrak: Hypertension or high blood pressure is a global health problem, including in Indonesia because of its high prevalence. Hypertension does not provide typical complaints and symptoms so many sufferers do not realize it. Therefore hypertension is called the silent killer, the prevalence of hypertension in Indonesia in 2013 is 25.8%, in 2015 23.8%, in 2016 30.9%. Prevalence in women is 32.9%, men 28.7%, in urban areas 31.7%, rural areas 30.2% and the number 3 cause of death in Indonesia. This study aims to determine the relationship between consumption patterns of fast food, soft drinks and meat with the incidence of hypertension in the adult population in Indonesia in 2014 using IFLS-5 data. The design of the study in this study was analytic observational with a cross-sectional study design, this study was conducted in October-November 2018 in Depok City. The results of the study were the prevalence of hypertension in the adult population (≥ 18 yrs - 101 yrs) of 18.91%, people who consumed fast food, age> 30 years, with female gender, low education and suffering from diabetes mellitus were at risk for hypertension by 1 , 47 times to experience hypertension compared to people who do not consume fast food, PRadj 1.47 (95% CI: 1.16 - 1.86) P-value 0.001. People who consume soft drinks, age> 30 years, are female, with low education and suffer from diabetes mellitus at a risk of 1.63 times compared to people who do not consume PRadj soft drinks; 1.63 (95% CI; 1.37 - 1.95) P-value 0,000. People who consume meat, age> 30 years in female sex, low education, smoke and suffer from diabetes mellitus are not associated with the incidence of hypertension PRadj 1.00 (95% CI: 0.92 - 1.09) P-value 0.885. It is recommended to the public to consume foods that contain balanced nutrition, take measurements of blood pressure at least 1 time / month, to the Health Office to conduct counseling or healthy food campaigns that contain balanced nutrition, to the Ministry of Health, promote the consumption pattern of 4 perfectly healthy 5.
Keywords: Hypertension, Fast Food, Soft Drink, Meat and IFLS-5.

Abstrak: Persalinan yang dilakukan di fasilitas pelayanan kesehatan, terbukti bisa menekan risiko kematian ibu. Persalinan di fasilitas pelayanan kesehatan di Puskesmas Lamunti tahun 2017 masih rendah yaitu 16,8%. Penelitian ini bertujuan untuk mengetahui determinan dan alasan pemanfaatan persalinan di fasilitas pelayanan kesehatan oleh ibu bersalin di wilayah kerja Puskesmas Lamunti Tahun 2017. Metode penelitian menggunakan metode gabungan kuantitatif dan kualitatif. Analisis bivariat menunjukkan tiga faktor yang berhubungan yaitu kepemilikan jaminan kesehatan, pelayanan antenatal dan komplikasi kebidanan. Analisis multivariate menunjukkan dua faktor yang berhubungan yaitu pelayanan antenatal dan komplikasi kebidanan. Faktor komplikasi kebidanan merupakan faktor yang paling dominan berhubungan dengan pemanfaatan persalinan di fasilitas pelayanan kesehatan. Hasil kualitatif ditemukan bahwa masih banyak masyarakat yang belum mempunyai kartu BPJS, standar pelayanan antenatal di desa kurang dari 10 T, adanya komplikasi kebidanan menjadi alasan ibu melahirkan di fasilitas pelayanan kesehatan. Diperlukan komitmen/kebijakan yang mendukung persalinan di fasilitas pelayanan kesehatan; pelatihan ANC terintegrasi; pemberdayaan masyarakat (pelaksanaan program perencanaan persalinan dan pencegahan komplikasi, kelas ibu hamil, desa siaga dan PIS-PK).
Kata kunci: Determinan, Fasilitas pelayanan kesehatan, Metode gabungan, Persalinan

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Childbirth performed in health care facilities has been proven to reduce the risk of maternal death. Childbirth in health care facilities at Lamunti Health Center in 2017 is still low at 16.8%. This study aims to know the determinants and reasons for the use of childbirth in health care facilities by maternity in the working area of Lamunti Health Center 2017. The research method uses quantitative and qualitative combined methods. Bivariate analysis showed three related factors namely health insurance ownership, antenatal care and obstetric complications. Multivariate analysis showed two related factors, namely antenatal care and obstetric complications. Obstetric complications are the most dominant factor associated with the use of childbirth in health care facilities. The qualitative results found that there were still many people who did not yet have a BPJS card, the standard of antenatal care in the village was less than 10 T, the existence of obstetric complications was the reason for the mother giving birth in a health care facility. Commitments / policies are needed to support childbirth in health care facility; integrated ANC training; community empowerment (implementation of childbirth planning programs and prevention of complications; classes of pregnant women; alert villages and PIS-PK).
Keywords: Determinants, Health care facilities, Combined methods, Childbirth

Abstrak: ABSTRAK Infeksi menular seksual dapat menimbulkan beban morbiditas dan mortalitas terutama di negara sedang berkembang. Berdasarkan data STBP di Indonesia, kelompok LSL memiliki prevalensi HIV meningkat tajam 2,5 kali dibandingkan hasil STBP sebelumnya. Tujuan penelitian ini untuk menganalisis jenis pasangan seksual dengan konsistensi penggunaan kondom pada LSL di 6 kota di Indonesia. Penelitian ini menggunakan metode penelitian Cross Sectional. Jumlah sampel yang diteliti sebanyak 827 orang. Hasilnya LSL yang mempunyai pasangan waria (44%) paling konsisten dalam menggunakan kondom, LSL yang mempunyai pasangan lakilaki (39,5%) merupakan kelompok LSL yang tidak konsisten dalam penggunaan kondom, dan LSL yang mempunyai pasangan wanita paling banyak yang tidak pernah menggunakan kondom (51,5%). LSL yang mempunyai pasangan laki-laki 8,06 kali lebih konsisten dalam penggunaan kondom dibandingkan pasangan wanita.LSL yang mempunyai pasangan waria 8,58 kali lebih konsisten dalam penggunaan kondom dibandingkan pasangan wanita. Variable confounding pengetahuan, penggunaan pelumas, akses, dan sumber informasi (teman sebaya, konselor, pertunjukan, media social, dan internet) memiliki hubungan yang bermakna terhadap penggunaan kondom secara konsisten. Saran dari penelitian inii yaitu memaksimalkan pelaksanaan program pencegahan HIV yang sudah ada dan penggunaan media massa dan pendekatan yang inovatif. Kata Kunci: LSL, Konsistensi penggunaan kondom ABSTRACT Sexually transmitted infections can cause a burden of morbidity and mortality, especially in developing countries. Based on STBP data in Indonesia, MSM have a HIV prevalence that has risen sharply 2.5 times compared to the previous STBP results. The purpose of this study was to analyze the types of sexual partners with the consistency of condom use in MSM in 6 cities in Indonesia. This study uses the Cross Sectional research method. The number of samples studied was 827 people. The result is MSM who have a transgender partner (44%) are most consistent in using condoms, MSM who have male partners (39.5%) are MSM groups who are inconsistent in condom use, and MSM who have the most female partners who have never use condoms (51.5%). MSM who had male partners 8.06 times were more consistent in condom use than female partners. LSL who have a transgender partner were 8.58 times more consistent in condom use than female partners. Variable confounding knowledge, use of lubricants, access, and sources of information (peers, counselors, shows, social media, and the internet) have a significant relationship to consistent condom use. Suggestions from this research are maximizing the implementation of existing HIV prevention programs and the use of mass media and innovative approaches. Keywords: MSM, Consistency of condom use

Abstrak: Tesis ini membahas remaja Indonesia yang saat ini sedang mengalami perubahan sosial yang cepat dari masyarakat tradisional menuju masyarakat modern, yang juga mengubah norma-norma, nilai-nilai dan gaya hidup mereka. Perilaku seksual di kalangan remaja yang belum menikah cenderung meningkat. Penelitian ini bertujuan untuk mengetahui adakah hubungan pengetahuan agama dengan perilaku seks pranikah remaja sekolah menengah (MAN 2 dan MAS Darussalam) di kota Bengkulu tahun 2018. Desain penelitian ini adalah cross sectional. Populasinya adalah Remaja kelas X dan XI di MAN 2 dan MAS Darussalam Kota Bengkulu, besar sampel 135 responden yang diambil dengan menggunakan purposive sampling. Variabel independen adalah pengetahuan agama dan variabel dependennya adalah perilaku seks pranikah remaja. Instrumen pada penelitian ini menggunakan kuesioner dan dianalisa dengan uji chi square dengan tingkat kesalahan p value < 0,05 Hasil penelitian menunjukkan sebagian besar pengetahuan agama adalah kategori tinggi MAN 2 78,6% dan MAS Darussalam 84,6% dan sebagian kecil perilaku seks pranikah pada remaja adalah kategori beresiko( MAN 2 21,4% dan MAS Darussalam 30,8%). Setelah dilakukan uji statistik chi square nilai p value= 0,002 (MAN 2) dan p value=0,001 (MAS Darussalam) yang artinya ada hubungan antara pengetahuan agama dengan perilaku seks pranikah pada remaja. Pada model akhir, pengaruh teman sebaya (p value= 0,022) dan paparan media pornografi (p value=0,001) berhubungan dengan perilaku seks pranikah remaja (MAN 2) dan paparan media pornografi (p value=0,019) di MAS Darussalam. Kesimpulan yang dapat diambil dari penelitian ini adalah ada hubungan pengetahuan agama dengan perilaku seks pranikah pada remaja. Melihat hasil penelitian ini maka pengetahuan agama sangat penting untuk mengurangi perilaku seks pranikah tersebut. Remaja diharapkan agar lebih meningkatkan pengetahuan tentang keagamaannya dalam menjalankan kehidupan agar terhindar dari perilaku yang tidak sesuai dengan agama seperti perilaku seksual pranikah. Kata kunci: Pengetahuan agama; Perilaku Seks Pranikah; Remaja This thesis discusses Indonesian adolescents who are currently experiencing rapid social change from traditional societies to modern societies, which also change their norms, values and lifestyles. Sexual behavior among unmarried teenagers tends to increase. This study aims to determine whether there is a relationship between religious knowledge with premarital sexual behavior of middle school adolescents (MAN 2 and MAS Darussalam) in the city of Bengkulu in 2018. The design of this study was cross sectional. The population is Adolescents of class X and XI in MAN 2 and MAS Darussalam in the City of Bengkulu, a sample of 135 respondents taken using purposive sampling. The independent variable is religious knowledge and the dependent variable is premarital sexual behavior of adolescents. The instrument in this study used a questionnaire and was analyzed by the chi square test with an error rate of p value <0.05 The results showed that the majority of religious knowledge was in the high category of MAN 2 78.6% and MAS Darussalam 84.6% and a small proportion of premarital sex in adolescents was at risk category (MAN 2 21.4% and MAS Darussalam 30.8%). After chi square statistical tests, the value of p value = 0.002 (MAN 2) and p value = 0.001 (MAS Darussalam), which means there is a relationship between religious knowledge and premarital sexual behavior in adolescents. The conclusion that can be drawn from this study is that there is a relationship between religious knowledge and premarital sexual behavior in adolescents. Seeing the results of this study, religious knowledge is very important to reduce premarital sexual behavior. Adolescents are expected to increase their knowledge of religion in carrying out life in order to avoid behavior that is not in accordance with religion such as premarital sexual behavior. Key words: Adolecent; Primatal Sex Behavior; religious Knowlwdge

Abstrak: Malaria is a disease caused by the Plasmodium parasite and is transmitted by the Anopheles mosquito. Malaria is one of the health problems faced by Indonesia and the world. So that efforts to eradicate malaria are included in one of the goals of the Sustainable Development Goals (SDGs). This study aims to determine the relationship of environmental and population factors to the incidence of malaria in Kapuas District. This study used ecological methods carried out in 17 sub-districts in Kapuas District in 2013 - 2017. The data used in this study were secondary data obtained from relevant agencies, namely the Kapuas District Health Office, Kapuas Regency Central Bureau of Statistics and BMKG Palangkaraya. The independent variables in this study were topography, rainfall, water area, distribution of bed nets, and population density. For the dependent variable is the incidence of malaria. The results of the analysis show that environmental variables, namely topography, rainfall, water area, and population distribution and population variables, namely population density are significantly associated with malaria incidence in Kapuas District in 2013-2017 (p value <0.1). The results of the analysis also showed positive relationships between the topographic, water, and netting distributions with the incidence of malaria. While the rainfall and population density variables showed a negative relationship to the incidence of malaria. Preventive efforts need to be made to prevent the incidence of malaria in the Kapuas Regency, such as maximizing the distribution of mosquito nets to spray in transmigrant homes, providing larvacides and strengthening malaria baseline data by mapping.
Key words: Malaria, Environmental Factors, Demography Factor