Outbreak of Diarrhea in Pondok Duta Elementary School, Depok, 2018

Introduction: Diarrhea is an endemic disease in Indonesia. Diarrhea in Pondok Duta Elementary School, Depok was determined as an outbreak in 2018. The purpose of this study is to define the factor associated with diarrheal incidence and provide a recommendation for the outbreak prevention in the future. Method: This study is used retrospective cohort design, Chi square test andCox regression Proportional Hazard Regression Model. Results: 335 students(50,2%) were reported diarrhea in October 2018. Bivariate analysis showed that diarrhea was significantly associated with snack behaviour (RR=1.58,95% CI=1.32-1.89,p=0.000), drinking refilled water (RR=1.3,95%CI=1.11-1.52,p=0.003), use of water from old well (RR=1.24,95%CI=1.06- 1.45,p=0.010) and cutting nail (RR=1.21,95% CI=1.02-1.44,p=0.038). In final cox regression model, diarrhea was significantly associated with snack behavior (RR=1.70,95%CI=1.34-2.17,p=0.000)and use of water from anew well (RR=0.70,95%CI=0.53-0.93,p=0.010).Coliform and E.Coli were detected in the refilled water samples. Discussion: There was a great risk of infectious diarrhea among the students for two weeks. Snack behavior was the strongest factor in students diarrhea. Use of water from a new well was considered to be protective against the incidence of diarrhea. Improvement in providing healthy food at the canteen including maintaining the strict food hygiene, sanitation regulation and practices were essential. This recommendation needs to be followed up by the school administrators and local authorities.