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Download This PDF File FOKUS UTAMA Perilaku Penggunaan Kelambu dan Rumah Sehat Terhadap Kejadian Penyakit Tular Vektor (Malaria, Filariasis dan DBD) Pada Masyarakat di Provinsi Jambi Yulian Taviv* , Milana Salim*, Aprioza Yenny* *Loka Litbang Pemberantasan Penyakit Bersumber Binatang, Baturaja Jl. A. Yani KM. 7 Kemelak Baturaja Sumatera Selatan 32111 Abstract In Jambi Province, vector borne diseases (malaria, filariasis and dengue fever) is still a problem, this is known since 2006 in 10 regency in Jambi province as a malaria-endemic areas. This analysis aims to obtain the case of malaria, filaria and dengue fever and its relationship with environmental factors and behavior of the use of mosquito nets home in Jambi Province. The analysis is based on the results Riskesdas in 2007 where the population data analysis is the whole community Riskesdas Jambi Province. Sample analysis is selected households interviewed during Riskesdas 2007. In Jambi Province on the basis of further analysis Riskesdas known that vector borne diseases for the highest malaria cases compared with the filaria and dengue. The highest malaria cases in the Sarolangun Regency (8.9%) followed by Bungo and Tebo Regency, for cases of dengue fever in Bungo and Tebo Regency followed Tanjab Timur Regency, whereas filariasis in the Sarolangun and Bungo Regency. Based on this analysis found that 44.1% of Jambi people behave the use of mosquito net, insecticide treated bed net are known to have little chance of contracting malaria. Test Results Regretion Binary Logistic, sleep did not use mosquito net have 2.14 times greater chance of contracting malaria and did not use insecticides in the home have 1.37 times the chance of contracting malaria. To avoid outbreaks of vector borne diseases, for that we need to avoid self-contact with the capability of transmitting diseases such as malaria, filaria and dengue fever by using mosquito net, use of wire netting in the home and environmental sanitation. Key Words: Behavior, Mosquito Net, Healthy House, Jambi The Behavior of Using Mosquito Net and the Healthy House towards Vector Borne Diseases (Malaria, Filariasis and DBD) to the community in the Jambi Province Abstrak Di Provinsi Jambi, penyakit tular vektor (malaria, filariasis dan DBD) masih merupakan masalah, ini diketahuinya sejak tahun 2006 di 10 kabupaten yang ada di Propinsi Jambi sebagai daerah endemis malaria. Analisis ini bertujuan untuk mendapatkan gambaran kasus malaria, filaria dan DBD dan hubungannya dengan faktor lingkungan rumah dan perilaku penggunaan kelambu di Provinsi Jambi. Analisis yang dilakukan berdasarkan hasil Riskesdas tahun 2007 dimana populasi analisis data Riskesdas ini adalah seluruh masyarakat Provinsi Jambi. Sampel analisisnya adalah rumah tangga yang terpilih yang diwawancarai pada saat Riskesdas 2007. Di Provinsi Jambi berdasarkan hasil analisis lanjut Riskesdas diketahui bahwa penyakit tular vektor untuk malaria paling tinggi kasusnya dibandingkan dengan filaria dan DBD. Kasus malaria tertinggi berada di Kabupaten Sarolangun (8,9%) diikuti oleh Kabupaten Bungo dan Kabupaten Tebo, untuk kasus DBD berada di Kabupaten Bungo dan diikuti Kabupaten Tebo dan Kabupaten Tanjab Timur, sedangkan filariasis berada di Kabupaten Sarolangun dan Kabupaten Bungo. Berdasarkan analisis ini diketahui bahwa 44,1% masyarakat Jambi berperilaku penggunaan kelambu, diketahui kelambu berinsektisida mempunyai peluang kecil untuk terjangkit malaria. Hasil Uji Regretion Binary Logistic, tidur tidak menggunakan kelambu mempunyai peluang 2,14 kali besar terjangkit malaria dan yang tidak menggunakan insektisida di dalam rumah berpeluang 1,37 kali terjangkit malaria. Agar tidak terjangkitnya penyakit tular vektor, untuk itu perlu kita menghindari diri kontak dengan vektor penular penyakit seperti malaria, filaria dan DBD dengan cara penggunaan kelambu, pemakaian kawat kasa di rumah dan sanitasi lingkungan. Kata Kunci : Perilaku, Kelambu, Rumah Sehat, Jambi 30 PENDAHULUAN Angka kesakitan dan kematian malaria di Indonesia dalam kurun waktu lima tahun terakhir menunjukkan trend menurun. Walaupun demikian kemungkinan besar penyakit ini meningkat bahkan hingga mewabah, oleh karena itu pemerintah memandang malaria masih sebagai ancaman terhadap status kesehatan masyarakat.1 WHO melaporkan, setiap tahun di daerah tropis dan subtropis di seluruh dunia terdapat lebih dari 500 juta orang terkena dan lebih dari sejuta di antaranya meninggal akibat malaria. Penyakit ini ditemukan di lebih dari 90 negara, dan secara potensial mengancam keselamatan sekitar 2,5 miliar anggota masyarakat yang merupakan 40% penduduk dunia. Bagian terbesar korban kematian akibat malaria adalah anak-anak, wanita hamil, turis, pengungsi, atau pekerja yang tanpa kekebalan terperangkap di daerah endemis malaria. Malaria juga menyebabkan kehilangan pertumbuhan ekonomi tahunan hingga 1,3% di negara-negara dengan intensitas penularan yang tinggi.2 Sejak 1997 sampai Mei 2005 telah terjadi Kejadian Luar Biasa (KLB) malaria di 38 propinsi yang meliputi 47 Kabupaten/kota dengan jumlah kasus 32.987 penderita dan 559 kematian akibat malaria. Case Fatality Rate (CFR) malaria berat yang dilaporkan dari beberapa rumah sakit berkisar 10-15%. Pada tahun 2006 di 10 kabupaten yang ada di Provinsi Jambi diketahui sebagai daerah endemis malaria. Berdasarkan angka klinis malaria, tertinggi di Kabupaten Batang Hari dengan AMI 51,18‰ diikuti oleh Kabupaten Merangin dengan AMI 43,72‰ dan Kabupaten Sarolangun dengan AMI 34,41‰. Berdasarkan hasil pemeriksaan slide malaria, Slide Positif Rate (SPR) tertinggi di Kabupaten Bungo dengan API 90,84%, diikuti oleh Kabupaten Tebo dengan API 85,78% dan Kabupaten Kerinci dengan API 76,79% (Dinkes 2006). Bila dibandingkan dengan target yang ingin dicapai secara nasional pada tahun 2010, yaitu sebesar 5 per 1.000 penduduk, maka untuk wilayah Jambi dapat dikatakan masih jauh dari target Peningkatan insidens Malaria disebabkan oleh beberapa hal antara lain: (1) mobilitas penduduk yang tinggi ke dan dari daerah rawan Malaria, (2) pembu-kaan hutan untuk permukiman, (3) bertambahnya tempat perindukan nyamuk penular Malaria akibat perilaku masyarakat termasuk terbengkalainya tambak udang/ikan akibat krisis ekonomi, serta (4) kecenderungan resistensi parasit terhadap obat anti Malaria dan resistensi nyamuk penular Malaria terhadap insektisida. Keterbatasan informasi faktor-faktor perilaku beresiko kejadian malaria, dan lingkungan daerah endemis malaria tersebut menyebabkan belum diperoleh cara spesifik yang efektif dan efisien dalam pengendalian malaria. Penentuan strategi pemberantasan malaria perlu didukung dengan data epidemiologi dan faktor – faktor lingkungan yang mempengaruhi kejadian malaria dengan menganalisa variabel yang ada di data hasil riskesdas. Studi ini dilakukan untuk mendapatkan informasi tersebut di atas yang selanjutnya dapat digunakan sebagai bahan pertimbangan dalam menentukan intervensi program penanggulangan malaria di Provinsi Jambi. Masih tingginya kejadian malaria, filaria dan DBD di Provinsi Jambi diasumsikan berhubungan dengan perilaku penggunaan kelambu (Analisa Hasil Riskesdas 2007) dan rumah sehat (Susenas dan RKD) yang diakibatkan oleh lingkungan, yang merupakan alasan untuk dilakukan analisis lanjut ini. BAHAN DAN METODE Tempat dan Waktu Analisis perilaku penggunaan kelambu dan rumah sehat terhadap kejadian penyakit tular vektor (Malaria, Filaria dan DBD) dilaksanakan di Loka Litbang P2B2 Baturaja dan pengambilan data pendukungnya di Dinas Kesehatan Provinsi Jambi. Dilaksanakan pada bulan September sampai dengan bulan November 2008. 31 Tujuan umum Untuk mendapatkan gambaran kasus malaria, filaria dan DBD dan hubungannya dengan faktor lingkungan rumah dan perilaku penggunaan kelambu. Tujuan khusus 1. Untuk mengetahui distribusi frekuensi penderita malaria, DBD dan filariasis per kabupaten di Provinsi Jambi 2. Untuk mengetahui distribusi frekuensi penderita malaria, DBD dan filariasis berdasarkan kelompok umur per kabupaten di Provinsi Jambi 3. Untuk membuktikan adanya hubungan tingkat pekerjaan dengan kejadian malaria, DBD dan filariasis per kabupaten di Provinsi Jambi 4. Untuk membuktikan adanya hubungan sararana penampungan air dengan kejadian malaria, DBD dan filariasis per kabupaten di Provinsi Jambi 5. Untuk membuktikan adanya hubungan perilaku pengguna kelambu dengan kejadian malaria, DBD dan filariasis per kabupaten di Provinsi Jambi 6. Untuk membuktikan adanya hubungan perilaku pengguna kelambu berinsektisida dengan kejadian malaria, DBD dan filariasis per kabupaten di Provinsi Jambi 7. Untuk mengatahui faktor dominan terhadap kejadian malaria, filaria dan DBD per kabupaten di Provinsi Jambi Jenis Penelitian Jenis penelitian ini adalah analisis non intervensi yang merupakan analisis lanjut dari data Riskesdas. Desain penelitian adalah deskriptif analitik dengan pendekatan Cross Sectional. Populasi dan Sampel Populasi analisis data Riskesdas ini adalah seluruh masyarakat Provinsi Jambi. Sampel analisis adalah rumah tangga yang terpilih yang diwawancarai pada saat Riskesdas 2007 di Provinsi Jambi Cara Pengumpulan Data Instrumen yang digunakan adalah kuesioner rumah sehat berasal dari Susenas, sedangkan kuesioner perilaku pengguna kelambu dari kuesioner Riskedas. Data Riskesdas diperoleh dari Badan Litbang Kesehatan yang sebelumnya telah menjalani proses manajemen data. Prosedur Kerja Data Riskesdas yang diperoleh dari Badan Litbang Kesehatan yang sebelumnya telah menjalani proses manajemen data, di analisa berdasarkan kebutuhan sesuai dengan tujuan analisis lanjut Riskesdas. Data
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