ANALISIS FAKTOR RISIKO, PETA KERENTANAN, DAN POLA PENYEBARAN RABIES PADA ANJING DI KABUPATEN BANGLI DAN KARANGASEM TAHUN 2019

SERLI EKA MELYANTONO, drh. Heru Susetya, M.P., Ph.D.; Dr. Prima Widayani, S.Si., M.Si.

2020 | Tesis | MAGISTER SAINS VETERINER

Rabies adalah penyakit ensefalitis progresif akut pada anjing yang bersifat zoonosis dan penularan melalui gigitan. Rabies masih bersiklus secara aktif di Bali. Bangli dan Karangasem merupakan kabupaten - kabupaten dengan status rabies bersiklus aktif. Pengungkapan faktor-faktor risiko, kerentanan wilayah, pola penyebaran rabies perlu dilakukan khususnya di Kabupaten Bangli dan Karangasem. Penelitian ini bertujuan untuk mengkaji faktor risiko, pemetaan kerentanan, dan pola penyebaran rabies serta mengukur jarak transmisi rabies di Kabupaten Bangli dan Karangasem. Penelitian ini menggunakan kajian case control (kasus kontrol) dengan jumlah kasus sebanyak 59 anjing berpemilik yang terkonfirmasi positif uji Fluorescent Antibody Technique (FAT) dan 177 anjing sehat berpemilik yang akan dipergunakan sebagai kontrol. Pengumpulan data dilakukan melalui wawancara kepada pemilik anjing, baik pemilik anjing kasus maupun kontrol dengan menggunakan kuesioner dan mengambil titik koordinat lokasi kasus rabies dengan menggunakan alat Global Positioning System (GPS) Essentials. Data kuisioner dianalisis menggunakan analisis univariat (deskriptif), analisis bivariat (Chi square, Odds Ratio, Estimasi Attributable Fraction, Population Attributable Fraction dan Estimasi Population Attributable Fraction) dan analisis multivariat (Regresi Logistik) untuk menentukan faktor-faktor yang berpengaruh terhadap rabies. Analisis tumpang susun (overlay) untuk pemetaan kerentanan. Data koordinat dipergunakan untuk mengetahui pola penyebaran penyakit menggunakan tools Average Nearest Neighbor (ANN) tools dan mengukur estimasi jarak transmisi rabies menggunakan tools Standart Distance dan Mean Center. Hasil penelitian menunjukkan bahwa faktor-faktor yang berpengaruh terhadap rabies Kabupaten Bangli dan Karangasem adalah umur anjing kurang dari sama dengan enam bulan (B = 3.40694;OR = 30,17; CI = 6,20-146,73), anjing tidak divaksin (B = 4.59585; OR = 99,07; CI = 22,70-432,42), anjing memiliki riwayat kontak dengan anjing lain (B = 2.20594; OR = 99,08; CI = 2,36-34, 93), anjing tidak diawasi penuh (B = 2.20594; OR = 34,38; CI = 3,16-374,09), pemilik tidak mengetahui informasi tentang rabies (B = 2.63250; OR = 13,91; CI = 2,34-82,60). Nilai overall classification table menunjukkan bahwa model yang diperoleh mempunyai akurasi cukup baik untuk memprediksi kejadian rabies pada anjing di Kabupaten Bangli dan Karangasem sebesar 92,8%; Pada peta kerentanan di Kabupaten Bangli dan Karangasem memperlihatkan bahwa faktor spasial atau kedekatan wilayah tidak berpengaruh terhadap kerentanan rabies; Pola penyebaran rabies di Kabupaten Bangli dan Karangasem adalah acak (random). Penyebaran rabies di Kabupaten Bangli memiliki pola menyebar (dispersed) secara signifikan dan masing-masing kecamatan di Bangli memiliki pola penyebaran rabies yaitu menyebar (dispersed). Kabupaten Karangasem memiliki pola penyebaran rabies adalah mengelompok (clustered) meskipun tidak signifikan dan masing-masing kecamatan di Karangasem memiliki pola penyebaran rabies yaitu menyebar (dispersed); Estimasi jarak transmisi rabies berbasis kecamatan adalah sejauh 3,81-5,18 km. Saran untuk pengendalian rabies di Kabupaten Bangli dan Karangasem adalah vaksinasi pada daerah padat penduduk, melakukan sosialisasi dan edukasi tata cara pemeliharaan anjing dengan pendekatan sosiokultural masyarakat Bangli dan Karangasem dan melakukan eliminasi atau sterilisasi anjing liar.

Rabies is the acute progressive encephalitis in dogs that are zoonotic and transmitted by bite. Rabies is still actively cycle in Bali. Bangli and Karangasem are the districts with active cycle rabies status. The disclosure of risk factors, regional vulnerability, distribution patterns of rabies is necessary especially in Bangli and Karangasem districts. This study aims to assess risk factors, vulnerability mapping, and distribution patterns of rabies and to measure rabies transmission distance in Bangli and Karangasem districts. This research used a case-control study with 59 cases of positive confirmed Fluorescent Antibody Test (FAT) and 177 proprietary healthy dogs which will be used as a control. The research data was collected by interviewing dog owners of both dog with case and also dog as control, by using the questionnaire, and taking coordinate location of rabies case by Global Positioning System (GPS) Essentials. Questionnaire data was analyzed using univariate analysis (descriptive), bivariate analysis (Chi square, Odds Ratio, Attributable Fraction Estimation, Population Attributable Fraction and Population Attributable Fraction Estimation) and multivariate analysis (Logistic Regression) to determine factors that affected rabies. Overlay analysis was used for vulnerability mapping. Coordinate data were used to determine the pattern of disease spread by using the Average Nearest Neighbor (ANN) tools and to measure the estimated distance of rabies transmission using the Standard Distance and Mean Center tools. The results showed that the influential factors of rabies in Bangli and Karangasem districts were the age of dogs less than or equal to six months (B = 3.40694;OR = 30,17; CI = 6,20-146,73), the dogs that were not vaccinated (B = 4.59585; OR = 99,07; CI = 22,70-432,42), the dogs that had a history of contact with other dogs (B = 2.20594; OR = 9,08; CI = 2,36-34, 93), the dogs that were not fully supervised (B = 2.20594; OR = 34,38; CI = 3,16-374,09), the owner who did not know the information about rabies (B = 2.63250; OR = 13,91; CI = 2,34-82,60). The value of overall classification table indicated that the model that was obtained had good accuracy in predicting the incidence of rabies in Bangli and Karangasem districts at 92.8%; On the vulnerability map in Bangli and Karangasem districts shows that spatial factors or proximity of the area do not affect rabies vulnerability; The pattern of rabies distribution in Bangli and Karangasem districts were random. The distribution of rabies in Bangli district had a significantly dispersed pattern, and each subdistrict in Bangli had a dispersed-distribution pattern of rabies. Karangasem district had a clustered-distribution pattern of rabies although it was not significant and each subdistrict in Karangasem had a dispersed-distribution pattern of rabies; The estimated distance for the rabies transmission was based on a sub-district was 3.81 - 5.18 km. The suggestions for rabies control in Bangli and Karangasem districts are vaccination in densely populated areas, conducting socialization and education on how to care for dogs with the sociocultural approach of the Bangli and Karangasem communities and conducting elimination or sterilization of stray dogs.

Kata Kunci : Rabies, Case Control, Average Nearest Neighbor