Biopsychosocial Determinants of Hepatitis A Outbreaks in Pacitan, East Java

Sugeng Retyono1), Setyo Sri Rahardjo2), Bhisma Murti3)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret



Background: Little studies have examined biopsychosocial factors associated with Hepatitis A. The purpose of this study was to biopsychosocial determinants of hepatitis a outbreaks in Pacitan, East Java.

Subjects and Method: A case-control study was conducted in Pacitan, East Java, from January to February 2020. A sample of 200 adults was selected by fixed disease sampling, including (1) 50 Hepatitis A patients (case), and (2) 150 non Hepatitis A patients (control). The dependent variable was Hepatitis A. The independent variables were age, education, income, history of Hepatitis A vaccination, hand wash behavior, eating behavior, clean water availability, and latrine availability. The data were collected by questionnaire and analyzed by a multiple logistic regression.

Results: The risk of Hepatitis A decreased with age ≥40 years old (b= -2.89; 95% CI= -4.46 to -1.31; p<0.001), high education (b= -1.95; 95% CI= -3.56 to -0.33; p= 0.018), high income (b= -1.93; 95% CI= -3.60 to -0.26; p= 0.023), and had Hepatitis A immunization (b= -2.60; 95% CI= -5.03 to -0.17; p= 0.036). The risk of Hepatitis A increased with poor washing hands behavior (b= 1.66; 95% CI= 0.28 to 3.05; p= 0.019), unhygienic eating behavior (b= 2.27; 95% CI= 0.88 to 3.66; p= 0.001), poor sanitation water (b= 3.12; 95% CI= 1.70 to 4.54; p<0.001), and latrine availability (b= 1.56; 95% CI= 0.35 to 2.78; p= 0.012).

Conclusion: The risk of Hepatitis A decreases with age ≥40 years old, high education, high income, and had Hepatitis A immunization. The risk of Hepatitis A increases with poor washing hands behavior, unhygienic eating behavior, poor sanitation water, and latrine availability.

Keywords: biopsychosocial determinants, Hepatitis A

Correspondence: Sugeng Retyono. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Utami 36A, Surakarta 57126, Central Java. Email: Mobile: +6287758732030.


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