The Relationship Between Handwashing, Fly Density and Sewerage on the Incidence of Diarrhea in Toddlers in Serdang Bedagai District in 2020
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International Journal of Science and Healthcare Research Vol.6; Issue: 1; Jan.-March 2021 Website: ijshr.com Research Paper ISSN: 2455-7587 The Relationship between Handwashing, Fly Density and Sewerage on the Incidence of Diarrhea in Toddlers in Serdang Bedagai District in 2020 Ayu Handayani1, Nurmaini2, Irnawati Marsaulina3 1,2,3Universitas Sumatera Utara, Indonesia Corresponding Author: Ayu Handayani ABSTRACT The World Health Organization states that diarrheal disease is a disease that Diarrhea is an environmentally based disease can basically be prevented by using or and occurs in almost all geographic areas in the consuming safe drinking water sources, as world. The problem of diarrhea in Indonesia well as adequate sanitation and hygiene often occurs in the form of extraordinary events (World Health Organization, 2016). (KLB). This study aims to determine the relationship between handwashing, fly density, Diarrhea is in the second rank as the and sewerage on the incidence of diarrhea in cause of death in children under five, both toddlers in Serdang Bedagai District in 2020. preventable and treated. Every year diarrhea This type of research is descriptive analytical causes the death of two billion children in using a cross-sectional design with a total the world, where as many as 525,000 cases sample size 61 respondents. The instruments of death are among children under five. used in this research were questionnaire and fly Diarrhea in the under five group is the most grill. The data obtained in this study were vulnerable group and results in death if not analyzed by bivariate analysis. The results of the treated seriously. The highest incidence of bivariate analysis showed that there was a diarrhea cases occurs in the first two years significant relationship between handwashing of life and will decrease with increasing age (p=0.001), fly density (p=0.002), sewerage (p=0.018) on the incidence of diarrhea in (World Health Organization, 2017). toddlers in Serdang Bedagai District in 2020. The problem of diarrhea in Indonesia often occurs in the form of Keywords: Handwashing, Fly Density, extraordinary events (KLB). Diarrhea Cases Sewerage, Incidence of Diarrhea In 2014 there were 6 diarrhea outbreaks in 5 provinces with 2,549 sufferers and 29 INTRODUCTION deaths (CFR 1.14%), in 2015 there were 21 Diarrhea is an environmentally diarrhea outbreaks in 13 provinces with based disease and occurs in almost all 1,213 sufferers and deaths. 30 people (CFR geographic areas in the world. 2.47%), in 2016 there were 3 outbreaks of Diarrhea is the discharge of stool diarrhea in 3 provinces, 3 districts, with 198 that is more fluid than usual with a sufferers and 6 deaths (CFR 3.04%), in frequency of more than three times a day or 2017 there were 21 outbreaks of diarrhea occurs more often than usual in a person, spread over 12 provinces, 17 regencies/ which is generally a symptom of a digestive cities. Polewali Mandar, Pohuwato, Central tract infection caused by microorganisms Lampung and Merauke districts each had 2 from food, drinking water, or directly from outbreaks. The number of sufferers was people; the result of lack of sanitation 1,725 and 34 people died (CFR 1.97%), in (World Health Organization, 2016) 2018 there were 10 cases of diarrhea International Journal of Science and Healthcare Research (www.ijshr.com) 210 Vol.6; Issue: 1; January-March 2021 Ayu Handayani et.al. The relationship between handwashing, fly density, and sewerage on the incidence of diarrhea in toddlers in Serdang Bedagai District in 2020. outbreaks in 8 provinces, 8 districts/cities. Factors that increase the risk of Tabanan Regency and Buru Regency each diarrhea in children under five are occurred 2 outbreaks. The number of environmental factors including latrines, sufferers was 756 people and death was 36 waste management, sewage channels, and people (CFR 4.76%) (Kementerian water sources. Uncovered latrines will be Kesehatan, 2019). accessible to vectors that cause diarrhea. Diarrheal disease is a disease whose Improper processing of garbage and sewage morbidity and mortality are still high until can cause diarrhea in toddlers. This is now, this disease is still considered a health because the fly vector lands on the trash or problem that has not been resolved by waste and then lands on the food. In developing countries such as in Indonesia, addition, diarrhea can occur if someone uses on average children under 3 years of age in water that is already polluted from the developing countries experience three source. In addition, the habit of washing episodes of diarrhea per year (Syah et al., hands when cooking food or after defecating 2017). (BAB) will allow direct contamination Diarrhea can cause loss of nutrition (Widoyono, 2011). needed by children during their infancy and Factors related to the incidence of is the biggest cause of death among children diarrhea in children under five are agent, under five in Indonesia. In Indonesia, host, environment, health care and behavior diarrheal disease is the number two killer of factors. Host factors that cause increased children under five after acute respiratory vulnerability to diarrhea, including not infection (ISPA) and every year 100,000 giving exclusive breast milk (ASI), children under five die from diarrhea. One malnutrition, the emergence of hereditary of the factors causing diarrhea disease is infectious diseases, etc. The most dominant improper management at home and health environmental factors are clean water facilities. The results of the household facilities, the presence of vectors, waste health survey (SKRT) in Indonesia in the handling, and feces disposal. These factors Ministry of Health of the Republic of will interact with human behavior and the Indonesia, diarrhea is the second leading quality of health services so that they have cause of death in children under five, the potential to cause diarrhea. number three in infants and number five for Theoretically, the incidence of all ages (Rahman et al., 2016). diarrhea can be caused by environmental Personal hygiene or personal factors, maternal knowledge, socioeconomic hygiene is a person's effort to maintain their factors, infectious factors, malabsorption own hygiene and health in order to obtain factors, infectious factors, psychological physical and psychological well-being. The factors and dietary factors. habit of not washing hands with soap after Poor environmental conditions are defecating is a habit that endangers toddlers, one of the factors in increasing the especially when they are about to eat. incidence of diarrhea due to the health status Cleanliness in everyday life is very of an environment which includes housing, important and must be considered because sewage disposal and clean water supply. cleanliness will affect one's health. Someone This can cause major environmental health experiences illness, usually hygiene problems because it can lead to outbreaks of problems are not paid attention to, this diarrhea disease and affect public health happens because they think that personal conditions (Fiestai et al., 2012). hygiene problems are trivial problems, even Diarrheal disease is an though if this is allowed to affect general environmentally based disease. Several health, it can cause diseases such as diarrhea factors are related to the incidence of (Tarwoto, 2012). diarrhea, namely inadequate supply of clean water, water contaminated with feces, lack International Journal of Science and Healthcare Research (www.ijshr.com) 211 Vol.6; Issue: 1; January-March 2021 Ayu Handayani et.al. The relationship between handwashing, fly density, and sewerage on the incidence of diarrhea in toddlers in Serdang Bedagai District in 2020. of hygiene facilities (unhygienic disposal of is divided into 17 sub-districts with 237 feces), personal hygiene and bad villages and 6 sub-districts. Geographically, environment, preparation of undercooked Serdang Bedagai Regency is located at the food and storage of cooked food at room position 3˚01'2.5 "North Latitude - 3˚46'33" temperature that is not should. North Latitude and 98˚44'22 "East There are many factors that directly Longitude - 99˚19'01" East Longitude with or indirectly drive diarrhea, namely agent, an altitude ranging from 0 - 500 meters host, environment and behavior factors. above sea level. Serdang Bedagai Regency Environmental factors are the most in the north is bordered by the Malacca dominant factors, namely clean water Strait, to the south with Simalungun supply facilities and feces disposal, these Regency, to the east with Batu Bara two factors interact together with human Regency and Simalungun Regency, and to behavior. If environmental factors are not the west with Deli Serdang Regency. healthy because they are contaminated with Serdang Bedagai Regency has 24 rivers diarrhea germs and accumulate with where the longest rivers are the Padang and unhealthy human behavior, then diarrhea Bah Hilang rivers which are 25,000 m² transmission can easily occur. each, while the Mendaris and Sei Rampah This study aims to determine the rivers are the shortest rivers, each of which relationship between handwashing, fly is 5000 m². Serdang Bedagai Regency has a density, and sewerage on the incidence of tropical climate where the climatic diarrhea in toddlers in Serdang Bedagai conditions are almost the same as Deli District in 2020. Serdang Regency as the main district. The average humidity per month is around 83%, RESEARCH METHODS rainfall ranges from 78 to 297 mm per This type of research is descriptive month. The average wind speed ranges from analytical using a cross-sectional design, 2.4 m/s with an evaporation rate of about namely to analyze the relationship between 3.9 mm/day. Minimum temperature per personal hygiene and environmental month is 23.7 ˚ C and maximum 33.1 C. sanitation with the incidence of diarrhea in which all independent variables and Demographic State dependent variables were measured at the The total population of Serdang same time at the time of the study.