Background: Cervical cancer patients per hour has increased by 2.5 people. Women died because of cervical cancer are 1.1 per hours. Indonesia is the second country after Tiongkok with the largest number incidence of cancer. Pap smear is one of the screening programs to reduce the numbers of cervical cancer genesis. Moreover in Indonesia, the rates of screening Pap smear less than 5%. This study aimed to investigate path analyze of using pap smear with as early detection of cervical cancer by planned theory of behavior in women in Sewon 1 Public Health Center, Bantul. Subjects and Method: This was an observational analytic study with the direction cross sectional design. A total sample of 96 women with comprised 32 cases and 64 control with fixed-disease sampling method. Data analysis used path analysis. Results:The results show there is influence between intentions and screening Pap smear (p=<0.000), perceived behavioral control with Pap smear test (p=0.010). An indirectly interaction with the screening Pap smear through intention on attitudes (p=<0.001), subjective norms (p=0.036), and control behavior perceptions (p=0.034). Conclusion: from this study there are interactions directly and indirectly the uses of screening Pap smear based on planned of behavior theory.

Background: Leptospirosis a global public health issue, particullary in tropical and sub-tropical countries with high precipitation. WHO has estimated that the annual of Leptospirosis is 0.1 to 1 case/ 100,000 population in moderate non-endemic area, and 10 to 100 cases/ 100,000 population in humid and tropical endemic areas. Currently, Indonesia is a tropical country with the highest fatality rate of leptospirosis, ranging from 2.5% to 16.45% with an average of 7.1%. It places Indonesia as the third country with the highest mortality attibutable to Leptospirosis. This study aimed to analyze the risk factors of Leptospirosis in Klaten, Central Java. Subjects and Method: This was an analytic and observational study with case control design. The study was conducted in Klaten, Central Java, from October to November, 2017. A sample of 49 Leptospirosis cases and 101 non-diseased controls were selected for this study by fixed disease sampling. The independent variable were employment status, history of cuts, history of water excursion, use of personal protective equipment (PPE), house condition, environmental condition, presence of mouse or cattle, history of rain or flood. The dependent variable was Leptospirosis. The data were collected by questionnaire and analyzed by path analysis. Results:The risk of Leptospirosis increased with history of cuts (b= 1.64; CI 95%= 0.40 to 2.87; p= 0.009), history of water excursion (b= 1.98; CI 95%= 0.52 to 3.43; p= 0.008), poor house condition (b= -1.92; CI 95%= -3.08 to -0.77; p= 0.001), and poor environmental condition p<0.001). History of cuts increased with cattle-related work (b= 1.79; CI 95%= 0.86 to 2.72; p<0.001) and absence of PPE (b= -2.54; CI 95%= -3.49 to -1.60; p<0.001). Conclusion:The risk of Leptospirosis increases with history of cuts, history of water excursion, poor house condition, and poor environmental condition. History of cuts increases with cattlerelated work and absence of PPE.

Background: Dengue Hemorrhagic Fever (DHF) is an infectious disease transmitted by mosquitoes that carry dengue virus (DV). This disease is endemic in more than 100 countries. Nganjuk district, East Java, is a DHF endemic area with sharp increase in DHF incidence by 286% from 2014 to 2015, of which 9 cases died. This study aimed to examine biological, physical, social, and environmental factors associated with dengue hemorrhagic fever in Nganjuk, East Java. Subjects and Method: This study was observational analytic with case control design. It was conducted in Nganjuk District, East Java, from May to June, 2017. A sample of 120 children aged less than 15 years old were selected for this study by fixed disease sampling. This sample consisted of 40 children with DHF selected as cases and 80 neighboring children without DHF selected as controls. The independent variables were the existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control (PSN), and activity of larva monitoring cadre. The dependent variable was DHF cases. The data were collected by a set of pre-tested questionnaire and observation with a checklist. Logistic regression was employed for data analysis. Results: Incidence of DHF case was determined by the existence of bush surrounding the house (OR=2.14; 95% CI =0.99 to 4.6; p=0.052), existence of mosquito larvae (OR=14.94; 95% CI =5.91 to 37.73; p<0.001), still water (OR=11.42; 95% CI= 4.68 to 27.89; p<0.001), hung clothes (OR=4.31; 95% CI =1.92 to 9.70; p<0.001), mosquito breeding place control (OR=0.06; 95% CI= 0.02 to 0.15; p<0.001), and activity of larva monitoring cadre (OR=0.14; 95% CI= 0.06 to 0.32; p<0.001). Conclusion: Existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control, and activity of larva monitoring cadre, are the determinants of DHF incidence.

Background: Dengue Hemorrhagic Fever (DHF) causes not only epidemic but also social and economic impacts. Environmental sanitation, water reservoirs, and community behavior can influence the incidence of DHF. This study aimed to examine sanitation-related behavior, container index, and their associations with dengue hemorrhagic fever incidence. Subjects and Method: This was an analytic observational field study using case control design. The study was conducted in sub-districts with the highest and lowest DHF cases in Karanganyar, Central Java, from May to July, 2017. A total sample of 120 study subjects was selected for this study using fixed disease sampling, including 40 people with DHF and 80 people without DHF. The dependent variable was DHF. The independent variables were age, education level, family income, container index, and sanitation behavior. The data were measured by a set of questionnaire and examined using path analysis. Results: Sanitation behavior (b=1.50; 95% CI= 0.57 to 2.42, p=0.001) and Container Index (b=0.90; 95% CI= 0.03 to 1.84; p=0.057) were directly and positively associated with DHF incidence. Container Index was associated with sanitation behavior (b=2.09, 95% CI = 1.21 to 2.97, p<0.001). Age (b=-0.76, 95% CI = -1.60 to 0.08, p=0.074), education level (b=-1.02, 95% CI = -1.87 to -0.17, p=0.019), and family income (b=-0.70, 95% CI= -1.60 to 0.19, p=0.122) were associated with sanitation behavior. Conclusion: DHF incidence is directly and positively associated with sanitation behavior, and container index. DHF incidence is indirectly associated with age, education level, and family income.

Context:Data regarding the distribution of Human Leukocyte Antigen (HLA)-E alleles and their association with blood-borne pathogen infections/co-infections are limited for many populations, including Indonesia.Aims:The aim of this study was to analyze the association between HLA-E allelic variants and infection with blood-borne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), hepatitis D virus (HDV), torque teno virus (TTV), GB virus C (GBV-C), and Toxoplasma gondii (T. gondii) in Indonesian Javanese human immunodeficiency virus (HIV) patients.Settings and Design:A total of 320 anti-HIV-positive blood samples were analyzed for HBV, HCV, HDV, TTV, GBV-C, and T. gondii infection status and its association with HLA-E allelic variants.Materials and Methods:Nucleic acid was extracted from plasma samples and used for the molecular detection of HBV DNA, HCV RNA, HDV RNA, TTV DNA, and GBV-C RNA, whereas hepatitis B surface antigen, anti-HCV, immunoglobulin M and G (IgM and IgG) anti-T. gondii were detected through serological testing. The blood samples were genotyped for HLA-E loci using a sequence-specific primer-polymerase chain reaction.Statistical Analysis Used:Either the Chi-square or Fisher's exact test was performed to analyze the frequency of HLA-E alleles and blood-borne pathogen infections in the population. Odds ratios (ORs) were calculated to measure the association between the antibodies found and the participants’ possible risk behaviors. A logistic regression analysis was used to assess the associations.Results:HLA-E*101/0101 was associated with HCV/TTV co-infection (adjusted OR [aOR]: 3.5; 95% confidence interval [CI]: 1.156-10.734; P = 0.027) and IgM/IgG anti-Toxo positivity (aOR: 27.0; 95% CI: 3.626-200.472; P = 0.001). HLA-E*103/0103 was associated with TTV co-infection (aOR: 2.7; 95% CI: 1.509-4.796; P = 0.001).Conclusions:HLA-E alleles in Indonesian Javanese HIV patients were found to be associated with HCV, TTV, and toxoplasma co-infections.