Evaluasi Program Pengendalian Faktor Risiko Leptospirosis terhadap Perilaku Pencegahan pada Populasi Berisiko di Kabupaten Sleman Tahun 2022 - 2023

Setiyaningrum, dr. Riris Andono Ahmad, MPH, Ph.D; dr Vicka Oktaria, MPH, Ph.D

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Peningkatan kasus leptospirosis di Indonesia sejalan dengan peningkatan kasus di Sleman. Temuan bakteri leptospira positif pada tikus, air dan tanah di area persawahan Kapanewon Prambanan dan Minggir merupakan faktor risiko bagi petani. Pelibatan lintas sektor diperlukan dalam pengendalian faktor risiko leptospirosis. Tujuan utama dari penelitian ini adalah untuk mengevaluasi program pengendalian faktor risiko leptospirosis melalui pelibatan lintas sektor terhadap perilaku pencegahan pada populasi berisiko di Kabupaten Sleman. 

Metode: Penelitian ini terdiri dari tiga sub studi menggunakan pendekatan socio ecological model. Sub-studi analitik meneliti faktor yang mempengaruhi perilaku pencegahan pada populasi berisiko menggunakan desain studi cross sectional. Data dikumpulkan dari 400 responden dalam 40 cluster dianalisis secara univariat, bivariat dan multivariabel menggunakan logistic regression. Sub-studi evaluasi program pengendalian faktor risiko leptospirosis dengan desain studi deskriptif yang dilakukan melalui wawancara menggunakan kuesioner kepada 53 responden. Sub studi evaluasi surveilans leptospirosis dengan desain deskriptif melalui wawancara menggunakan kuesioner terstruktur kepada 36 responden.

Hasil: Pada sub-studi analitik diketahui bahwa variabel yang bermakna secara statistik yaitu sikap (aOR 1,78; 95% CI 1,123 – 2,837), pendidikan (aOR 2,03; 95% CI 1,204 – 3,422), pendapatan (aOR 2,35; 95% CI 1,225 – 4,510), dukungan keluarga (aOR 2,19; 95% CI 1,381 – 3,486) dan menerima 3-5 dukungan komunitas 2,74 (aOR 2,741; 95% CI 1,509 – 4,978). Fokus utama program termasuk penguatan kegiatan pemutusan alur transmisi, penyuluhan pada populasi berisiko serta penetapan indikator dan pada sistem surveilans difokuskan pada pencatatan dan pelaporan, analisis dan interpretasi data, kelengkapan dan keterwakilan wilayah. Regulasi diperlukan untuk mendukung pelaksanaan program dan surveilans melalui pelibatan lintas sektor .

Kesimpulan: Intervensi perilaku pencegahan pada populasi berisiko difokuskan  pada individu melalui edukasi serta peningkatan peran keluarga dan kelompok tani. Pelaksanaan program pengendalian faktor risiko di Sleman dapat dilakukan dengan dukungan regulasi dari pemerintah daerah dan pelaksanaan surveilans leptospirosis melalui pelibatan lintas sektor.

Background: The increase in leptospirosis cases in Indonesia is in line with the increase in cases in Sleman. The finding of positive leptospira bacteria in rats, water and soil in Kapanewon Prambanan and Minggir rice fields is a risk factor for farmers. Cross-sectoral involvement is needed in controlling leptospirosis risk factors. The main objective of this study was to evaluate the leptospirosis risk-factor control program through cross-sectoral involvement in preventive behavior in at-risk population in Sleman District.

Methods: This research consisted of three sub-studies using the socio-ecological model approach. The analytical sub-study examined factors influencing prevention behavior in at-risk populations using a cross-sectional study design. Data collected from 400 respondents in 40 clusters were analyzed univariately, bivariate and multivariable using logistic regression. The leptospirosis risk-factor control program evaluation sub-study with descriptive study design was conducted through interviews using questionnaires to 53 respondents. The leptospirosis surveillance evaluation sub-study was conducted with a descriptive study design through interviews using structured questionnaires with 36 respondents. 

Results: In the analytical sub-study, the statistically significant variables were attitude (aOR 1.78; 95% CI 1.123 - 2.837), education (aOR 2.03; 95% CI 1.204 - 3.422), income (aOR 2.35; 95% CI 1.225 - 4.510), family support (aOR 2.19; 95% CI 1.381 - 3.486) and receiving 3-5 community support (aOR 2.741; 95% CI 1.509 - 4.978). The main focus of the program included strengthening activities to eliminate the transmission route and health education to at-risk populations and indicator settings, while the surveillance system focused on recording and reporting, data analysis and interpretation, completeness and representativeness. Regulations are needed to support program implementation and surveillance through cross-sectoral engagement. elimination of transmission routes

Conclusion: Preventive behavioral interventions in at-risk populations focused on individuals through education and increasing the role of families and farmer groups. The implementation of risk-factor control programs in Sleman can be supported by regulations from the local government and leptospirosis surveillance through cross-sectoral involvement.

Kata Kunci : leptospirosis, lintas sektor, evaluasi surveilans, evaluasi program, petani