1418 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 Effect of Schistosomiasis Control Program Performance on Schistosomiasis Incidence Rate in Sigi Regency, Central ,

Reni Septiana1, Auli Fisty Noor Azizah2 1 Master of Health Administration and Policy Students, Faculty of Public Health, Airlangga University, Surabaya, 2 Master of Health Administration and Policy, Faculty of Public Health, Airlangga University, Surabaya

Abstract Schistosomiasis is a zoonotic disease based on transmission transmission classified in the metazoonosis group. Based on data from the Provincial Health Office on the prevalence of schistosomiasis cases, it shows that schistosomiasis cases continue to increase from year to year to above the WHO standard of 1%. The purpose of this study was to determine the effect of schistosomiasis control program performance on the incidence of schistosomiasis in Sigi Regency, Central Sulawesi, Indonesia. This research was an observational study with cross sectional design. The sample size was 122 people. The results showed that the factors that influenced the incidence of schistosomiasis were the IEC of Officers while the treatment program did not directly influence the incidence of schistosomiasis. Recommendations to improve the performance of schistosomiasis control programs include making regular outreach programs where puskesmas staff provide IEC about schistosomiasis in the community. Providing space for puskesmas to make special programs related to the control of schistosomiasis which so far have been centralized in the Sigi District Health Office. Coordinate with related parties such as the Department of Hygiene and Green Open Space to create a snail eradication program as a vector of Schistosomiasis disease.

Keywords: Schistosomiasis, Performance, Control, Prevalence

Introduction national world. But until now the program has not found a bright spot related to the resolution of schistosomiasis Schistosomiasis is a zoonotic disease based on cases. Schistosomiasis is endemic in 76 low income transmission classified in the metazoonosis group. countries, namely in rural and suburban areas. More than Metazoonosis is a zoonosis with a transmission cycle 700 million people worldwide are at risk of infection, that requires vertebrates and involves invertebrates with more than 207 million people infected with to perfect the life cycle of disease-causing agents. schistosomiasis, 85% of whom live in Africa.3 Schistosomiasis is an obligatory metazoonosis in which humans or vertebrates must be one of the hosts in their This disease control activity has existed since 1982. life cycle.1 At the beginning of the activity focused on human activities, namely the treatment of the population. It is In infected cases, an estimated 120 billion people also supported by counseling activities, procurement show symptoms of schistosomiasis, and 20 billion of environmental health facilities, examination of people have serious complications. In 2011 reported by population feces, inspection of snails of transmitters and WHO, there were 243 million people requiring treatment rats on a regular and regular basis.4,5 for schistosomiasis, with the number of people reported having been treated for schistosomiasis in 2011 of 28.1 Schistosomiasis in Indonesia is only found in Central million.2 Sulawesi Province. This case is found in 2 regencies / cities in Central Sulawesi which are endemic areas, Schistosomiasis control programs have been very namely Sigi Regency and Regency. Sigi Regency widely implemented and applied by the international and Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1419 precisely in Lindu Valley and precisely in Regency, Central Sulawesi, Indonesia. Napu Valley, Besoa Valley and Bada Valley.6,7 Research Methods Data from the last 3 years released by the Central Research using cross sectional design. The study was Sulawesi Provincial Health Office on the prevalence of conducted in the working area of the​​ Lindu Community schistosomiasis cases shows that schistosomiasis cases Health Center. Data collection and processing will be continue to increase from year to year to above the WHO conducted from April to May 2019.10,11 The population standard of 1%. This is closely related to schistosomiasis in this study is the entire community in the area of ​​ control programs in Central Sulawesi.8,9 Lindu Health Center, Sigi Regency, Central Sulawesi The prevalence of schistosomiasis in 2014-2016 has (2579 people). The sample in this study were residents increased, the lowest prevalence in 2014 was 1.66%, and with a history of schistosomiasis and residents who had the highest prevalence in 2016 was 1.86%.6 There are two never experienced schistosomiasis. The sample size areas that are endemic to schistosomiasis cases, namely for the community analysis unit was 122 people. The Lengkeka, Poso Regency and Lindu, Sigi Regency. The community as a research sample will be interviewed following is case data and prevalence in both districts. regarding the schistosomiasis control program that has The prevalence of Poso Regency from 2014 to 2016 been conducted by Lindu Community Health Center has decreased. Whereas in Sigi Regency the prevalence staff.12,13 Variables that will be examined include the of schistosomiasis has increased and is still above the IEC officer, the stability of the treatment program in the national target (<1%). Therefore, this study is focused working area of the​​ Lindu Community Health Center, and in Sigi Regency because the prevalence of cases is also the incidence of schistosomiasis in the community. still quite large and has increased, where the condition IEC officers and treatment programs are indicators of the is not in accordance with the target of schistosomiasis performance of schistosomiasis control programs in the treatment programs. The purpose of this study was to work area of the​​ Lindu Community Health Center, Sigi determine the effect of schistosomiasis control program Regency, Central Sulawesi, Indonesia.14,15,16 performance on the incidence of schistosomiasis in Sigi

Result Table 1 Identification of Officer IEC

Score

Statement (1) (2) (3) (4)

n % n % n % N % Have received information about 9 7,4 11 9,0 45 36,9 57 46,7 Schistosomiasis from Puskesmas staff

Motivated to take medication when 10 8,2 21 17,2 43 35,2 48 39,3 experiencing schistosomiasis by officers

Obtain information about the mode of transmission of schistosomiasis from 25 20,5 31 25,4 32 26,2 34 27,9 officers

Obtain information about symptoms of 11 9,0 27 22,1 54 44,3 30 24,6 schistosomiasis from officers 1420 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 Cont .... Table 1 Identification of Officer IEC

Score

Statement (1) (2) (3) (4)

n % n % n % N %

Getting information about the source of schistosomiasis transmission from the 17 13,9 25 20,5 25 20,5 55 45,1 officer

It is recommended by officers to use footwear and hand protection when 18 14,8 20 16,4 44 36,1 40 32,8 working

It is recommended by officers to defecate 21 17,2 20 16,4 41 33,6 40 32,8 defecation

Average 15,9 13,0 22,1 18,1 40,6 33,3 43,4 35,6

Most of the respondents considered that the puskesmas staff had conducted IEC, as evidenced from around 69% of respondents who answered that they often and always did IEC to the community related to schistosomiasis. This means that basically IEC officers are already good, but it needs to be improved in IEC related information about the way of transmitting schistosomiasis because there are still more than 40% included in the category of IEC poor officers with rare and never criteria.

Table 2 Identification of Treatment Programs

Score

Statements (1) (2)

n % N % know that there is always treatment at the Puskesmas for Schistosomiasis 7 5,7 115 94,3 sufferers always get treatment when coming to the health center when experiencing 5 4,1 117 95,9 schistosomiasis

Average 6 4,9 116 95,1

It shows that the majority of respondents considered that the treatment program at the puskesmas was always available (94.3%) and always received treatment (95.9%). This means that the majority of respondents assume that the treatment program has been running and is routine. Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1421 Table 3 Effect of Schistosomiasis Control Program Performance on the Occurrence of Schistosomiasis

Occurrence of Schistosomiasis Total Indicator Yes No P Exp (B)

N % n % n %

1. Officer IEC

a. Poor 34 89,5 4 10,5 38 100,0 0,000 17,944

b. Good 27 32,1 57 67,9 84 100,0

2. Treatments Program

a. Poor 4 66,7 2 33,3 6 100,0 0,411 -

b. Good 57 49,1 59 50,9 116 100,0

From the table it can be seen that the direct effect that the disease morbidity rate can be reduced as low as on the incidence of schistosomiasis is the IEC of officers possible so that it does not become a health problem in (p = 0,000 and exp (B) = 17,944) while the treatment the area concerned. program does not affect the incidence of schistosomiasis. Based on the results of the study, it is known that This means that officials need maximum efforts to carry the majority of IEC officers are good, as is the treatment out IEC on the community so that the incidence of at the puskesmas where the majority of the community schistosomiasis can be reduced. knows that there is treatment for schistosomiasis at the Discussion and Conclusions puskesmas and the majority of the population receives the treatment at the puskesmas.21 The implementation of the Schistosomiasis Disease Control Program in Sigi Regency which aims to reduce Efforts to find cases of schistosomiasis require active the prevalence of Schistosomiasis to below 1% requires participation from the community. Public awareness to several roles including the role of related agencies check themselves into the health center is crucial to the that have been appointed to move in an integrated discovery of schistosomiasis cases. The active role of team to control Schistosomiasis.17,18 The role of the cadres in helping Puskesmas to report schistosomiasis Schistosomiasis laboratory which serves as the discovery is urgently needed. The low participation of the of sufferers, the discovery of habitat from snails and community and cadres can hamper the discovery of cases treatment of patients with Schistosomiasis, the role of schistosomiasis. This is due to the busyness of the of the Lindu Community Health Center in increasing community itself and minimal community knowledge knowledge and changes in community behavior and the related to the case of schistosomiasis which must be participation of the community itself, in this discussion resolved by maintaining the health of the community is the community of the Lindu Community Health itself.22 Center.19,20 The discovery of the case of schistosomiasis The government in implementing infectious requires strong motivation from health workers, where disease prevention programs can form work units / officers have a strong desire and feel attached to their implementing units. Based on the prevalence / incidence organizations so that they voluntarily and try hard to of illness and characteristics of infectious diseases, the achieve organizational goals. In line with this, researchers target of communicable disease control programs can be also found that there were still unprofessional health through elimination. Elimination is an effort to reduce workers working on the program because the incentives the disease on an ongoing basis in certain regions so obtained were still far from expectations. 1422 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 Make regular outreach programs where puskesmas Pemerintah, Kinerja Serta Aktifitas Masyarakat staff provide IEC about schistosomiasis in the Dalam Pengendalian Schistosomiasis Di community. IEC is very important because IEC officers Kabupaten Poso. FKM Unair. Surabaya;2016 influence community factors and environmental factors, [9] Hafsah, Karakteristik Habitat Dan Morfologi also directly affect the incidence of schistosomiasis. From Siput Ongcomelania huspensi lindoensis this IEC, it is expected to increase public knowledge, Sebagai Hewan Reservoir Dalam Penularan especially in the context of improving environmental SchistosomiasisPada Manusia Dan Ternak Di conditions so that people do not get too much exposure Taman Nasional lore Lindu, Jurnal Manusia to the vector of schistosomiasis. Dan Lingkungan Vol.2 No.2, ;, (Cited 16 Desember 2014) avalaible from: jpe-ces.ugm. Conflict of Interest: The authors declare that there ac.id /ojs/ index.php /JML /aticle /view /44. is no conflict of interest regarding the publication. 2013 [10] Ivancevich, J.M., Konopaske, R. & Matleson, Ethical Clearance: This research has been approved M.TPerilaku dan Manajemen Organisasi, by the Health Research Ethics Committee Faculty of Jakarta: Penerbit Erlangga;2007. Nursing Universitas Airlangga with Ethical Approval [11] Muninjaya, G., Manajemen Kesehatan, Jakarta: Number: 1767-KEPK published in 9th September 2019. 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