Analisis kondisi sanitasi lingkungan penderita Ascariasis dan richuriasis anak Sekolah Dasar di Kota Yogyakarta :: Studi kasus

ISTIQOMAH, Siti Hani, Prof.Dr.dr. Soebijanto

2007 | Tesis | S2 Ilmu Kesehatan Kerja (Ilmu Kesehatan Lingkungan

Indonesia termasuk negara yag beriklim tropis, sehingga parasit dapat berkembang dengan baik dan menyebabkan infeksi pada manusia, selain itu didukung oleh sanitasi lingkungan dan hygiene perseorangan yang buruk, serta keadaan sosial ekonomi yang rendah. Penyakit kecacingan disebabkan oleh Ascaris lumbricoides dan Trichuris trichiura masih merupakan masalah kesehatan masyarakat di Indonesia prevalensinya sekitar 60-80% yang diderita anak sekolah. Berdasarkan hasil pemeriksaan tinja oleh Dinkes Kota Yogyakarta dan PKBI DIY jumlah penderita Ascariasis dan Trichuriasis sebanyak 197 siswa. Penelitian ini bertujuan untuk menganalisis kondisi sanitasi lingkungan rumah dan sekolah. Penelitian ini merupakan studi kasus dengan jenis penelitian kuantitatif dan kualitatif dengan rancangan penelitian Cross-Sectional. Alat ukur yang digunakan berupa checklist untuk observasi sanitasi lingkungan rumah, sekolah dan panduan wawancara mendalam untuk memperoleh data kondisi siswa yang berkaitan dengan penyakit Ascariasis dan Trichuriasis. Analisis menggunakan Independent Sample Test dengan tingkat kepercayaan 95%. Hasil uji Independent Sample Test kondisi sanitasi lingkungan rumah (p=0,817) dan sub variabel meliputi pembuangan tinja(p=0,537), penyediaan air bersih(p=0,571), pembuangan limbah rumah tangga(0,682), sanitasi makanan dan minuman(p=0,473), vektor penular penyakit(p=0,418), kebersihan rumah dan halaman(0,624) dan kondisi sanitasi lingkungan sekolah(p=0,144). Hasil penelitian menunjukkan bahwa tidak ada perbedaan antara kondisi sanitasi lingkungan rumah, sekolah dengan penyakit Ascariasis dan Trichuriasis yang kondisinya baik, cukup dan rendah. Analisis deskriptif menyimpulkan kondisi sanitasi rumah dari 164 penderita terdapat 79 rumah (48,17%) kategori cukup dan 57 rumah (34,76%) kategori kurang, sedangkan sanitasi lingkungan sekolah dari 164 penderita terdapat 60 (36,59%) kategori cukup dan 63(38,41%) kategori kurang. Secara kualitatif hygiene pribadi siswa rendah seperti kuku pendek/panjang kotor sebesar 60,04%, agak kotor 32, 32%, penderita menyatakan lebih sering bermain diluar rumah 93,90%, bermain tanah secara lansung 56,10% dan masih ada penderita yang pembuangan tinjanya di sungai 26,22%. Disimpulkan bahwa kondisi sanitasi lingkungan rumah, sekolah dan hygiene pribadi siswa merupakan faktor risiko terhadap kejadian Ascariasis dan Trichuriasis. Disarankan perlunya pengendalian secara kombinasi antara sanitasi dan hygiene anak melalui pendidikan, training toilet, keberadaan tempat cuci tangan dan sabun baik di sekolah maupun rumah.

Background: Indonesia is a tropical country whereby parasites can grow well and cause infection among people due to poor environmental sanitation and individual hygiene and low social economic condition. Disease caused by Ascaris lumbricoides and Trichuris trichiura are public health problems in Indonesia of which 60 – 80% of their prevalence occurs among school children. According to the result of faeces examination by the Health Office of Yogyakarta Municipality and Indonesian Family Planning Asociation of Yogyakarta Special Territory there are 197 children suffering from Ascariasis and Trichuriasis. Objective: The objective of the study was to analyze the environmental sanitation condition of home and school. Method: This was a case study of qualitative and quantitative type. Research instruments used were checklist for the observation of environmental sanitation of home and school and indepth interview guide to obtain data of children's environmental sanitation condition related to Ascariasis and Trichuriasis diseases. Analysis used Independent Sample Test at significance level 95%. The result of the Independent Samples Test for environmental sanitation condition of home was p=0.817 and of school was p=0.144. The result of the pearson Correlation for environmental sanitation condition of home was p= 0,045 and at school was p=0,022. Result: There was correlation between environmental sanitation condition of home and of school in Ascariasis and Trichuriasis diseases. The result of descriptive analysis showed that there were 15 houses (39%) of 38 Ascariasis sufferers which had poor home sanitation condition; Out of 126 Trichuriasis sufferers there were 64 houses (51%) which had adequate home sanitation condition and 42 houses (33%) which had poor home sanitation condition. The condition of school environment sanitation of Ascariasis sufferers 18 children (47%) belonged to adequate category and the condition of school environment sanitation of Trichuriasis sufferers 52 children (41%) belonged to poor category. Qualitatively the children's individual hygiene was low; i.e. dirty short / long nail (60.04%), slightly dirty short / long nail (32.3%), sufferers often played outdoor (93.90%), had direct contact with soil (56.10%) and excreted on rivers (26.22%). Conclusion: The condition of environmental sanitation of home, school and children's individual hygiene were risk factors of Ascariasis and Trichuriasis prevalence. Suggestion: There should be integrated control between children's sanitation and hygiene through health education, toilet training, adequate household waste disposal, place for hand washing both at home and at school.

Kata Kunci : Kesehatan Lingkungan,Sanitasi,Penderita Ascariasis dan Trichuriasis, Ascariasis, Trichuriasis, environmental sanitation, individual hygiene