ANALISIS SPASIAL KEJADIAN MALARIA DAN HABITAT LARVA NYAMUK Anopheles spp di WILAYAH KERJA PUSKESMAS WINONG KABUPATEN PURWOREJO

RESIANY NABABAN, Dr.drh.Sitti Rahmah Umniyati, SU.

2017 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Malaria merupakan penyakit yang disebabkan oleh Plasmodium sp dan ditularkan melalui gigitan nyamuk Anopheles spp betina. Di Purworejo kasus malaria mengalami peningkatan dari API 0,98 (2013) menjadi API 1,98 (2015).Tahun 2016 jumlah kasus sebanyak 423 kasus. Tujuan : Menganalisis faktor-faktor risiko dengan kasus malaria, memetakan distribusi spasial kasus malaria dan mengetahui tipe habitat larva nyamuk Anopheles spp di wilayah kerja Puskesmas Winong Kabupaten Purworejo. Metode Penelitian : Penelitian ini merupakan penelitian observasi analitik dengan rancangan penelitian case control. Variabel bebas adalah faktor cuaca, faktor lingkungan rumah dan faktor sosial budaya, sedangkan variabel terikat adalah kejadian (kasus) malaria. Hubungan variabel bebas dan terikat dianalisis dengan menggunakan uji korelasi Pearson dan Chi square, uji regresi logistik dan analisis spasial. Hasil : Analisis bivariat dengan uji korelasi Pearson menunjukan variabel suhu, kelembaban dan curah hujan tidak memiliki hubungan dengan kejadian malaria. Uji Chi square menunjukan ada hubungan kejadian malaria dengan keberadaan breeding site (p=0,02;OR 2,5 ), kondisi dinding rumah (p=0,004; OR 0,29) dan kebiasaan keluar malam hari (p=0,01;OR 3,6 ), sedangkan keberadaan hewan ternak, jarak breeding site, kebiasaan memakai kelambu, penggunaan kawat kasa, pemakaian anti nyamuk dan kebiasaan mengunjungi daerah endemis tidak memiliki hubungan dengan kejadian malaria. Berdasarkan uji regresi logistik kebiasaan keluar malam hari merupakan faktor risiko yang paling tinggi berhubungan dengan kejadian malaria. Pada analisis spasial terbentuk 3 cluster kejadian malaria dengan hasil buffering kebanyakan kasus berada pada buffer zone radius 1000 m dari habitat larva nyamuk Anopheles spp. Kesimpulan : Tidak ada hubungan faktor cuaca dengan kejadian malaria. Ada hubungan antara keberadaan habitat perkembangbiakan larva, kondisi dinding rumah dan kebiasaan keluar malam hari dengan kejadian malaria. Terdapat 3 cluster di wilayah kerja Puskesmas Winong dan kebanyakan kasus berada di area buffer zone pada radius 1000 meter.

Background: Malaria is a disease caused by Plasmodium sp and is transmitted through the bite of Anopheles spp female mosquito. In Purworejo cases of malaria has increased from API 0.98 (2013) to 1,411 cases (API 1,98 ) in 2015. In 2016 number of cases as many as 423 cases. Objective: To analyze risk factors with malaria case, to map the spatial distribution of malaria cases and to know the habitat of Anopheles spp mosquito larvae in Puskesmas Winong Purworejo District. Method: This study is an analytical observation research with case control. Independent variable are climate factors, home environment factors and sociocultural factors, while the dependent variable is the incidence (case) of malaria. Relation of independent and dependent variable was analyzed by using Pearson correlation and Chi square test, logistic regression test and spatial analysis. Result: Bivariate analysis with Pearson correlation test showed that temperature, humidity and rainfall variables have no correlation with malaria incidence. Chi square test showed that there was correlation between malaria incidence with the existence of breeding habitat (p value = 0,02, OR 2,5), house wall condition (p value = 0,004; OR 0,29) and nighttime habit (p value = 0.01; OR 3.6), whereas the presence of livestock, breeding site distance, the habit of wearing mosquito nets, the use of wire mesh, the use of mosquito repellent and the habit of visiting endemic areas have no relationship with malaria incidence. Multivariate analysis with logistic regression test showed that night out habits (p value = 0.01, adjOR 4,8) were the highest risk factors associated with malaria incidence. In spatial analysis, 3 clusters of malaria incidence and most cases are in buffer zone area 1000 m distance from Anopheles spp mosquito larvae. Conclusion: There is no correlation between weather factor and malaria incidence. There is a relationship between the presence of larvae breeding habitat, the condition of the wall of the house and the habit of going out at night with the incidence of malaria. There are 3 clusters in the work area of Puskesmas Winong and most cases are in the buffer zone area 1000 m distance. Keywords: Background: Malaria is a disease caused by Plasmodium sp and is transmitted through the bite of Anopheles spp female mosquito. In Purworejo cases of malaria has increased from API 0.98 (2013) to 1,411 cases (API 1,98 ) in 2015. In 2016 number of cases as many as 423 cases. Objective: To analyze risk factors with malaria case, to map the spatial distribution of malaria cases and to know the habitat of Anopheles spp mosquito larvae in Puskesmas Winong Purworejo District. Method: This study is an analytical observation research with case control. Independent variable are climate factors, home environment factors and sociocultural factors, while the dependent variable is the incidence (case) of malaria. Relation of independent and dependent variable was analyzed by using Pearson correlation and Chi square test, logistic regression test and spatial analysis. Result: Bivariate analysis with Pearson correlation test showed that temperature, humidity and rainfall variables have no correlation with malaria incidence. Chi square test showed that there was correlation between malaria incidence with the existence of breeding habitat (p value = 0,02, OR 2,5), house wall condition (p value = 0,004; OR 0,29) and nighttime habit (p value = 0.01; OR 3.6), whereas the presence of livestock, breeding site distance, the habit of wearing mosquito nets, the use of wire mesh, the use of mosquito repellent and the habit of visiting endemic areas have no relationship with malaria incidence. Multivariate analysis with logistic regression test showed that night out habits (p value = 0.01, adjOR 4,8) were the highest risk factors associated with malaria incidence. In spatial analysis, 3 clusters of malaria incidence and most cases are in buffer zone area 1000 m distance from Anopheles spp mosquito larvae. Conclusion: There is no correlation between weather factor and malaria incidence. There is a relationship between the presence of larvae breeding habitat, the condition of the wall of the house and the habit of going out at night with the incidence of malaria. There are 3 clusters in the work area of Puskesmas Winong and most cases are in the buffer zone area 1000 m distance.

Kata Kunci : kejadian malaria, case control, analisis spasial, Kabupaten Purworejo, malaria incidence,case control, spatial analysis, Purworejo district