Perbedaan faktor-faktor risiko yang mempengaruhi keberadaan jentik vektor dengue (Aedes aegypti dan Aedes albopictus) antara desa endemis dan sporadis Kecamatan Banguntapan Kabupaten Bantul

WATI DP, Nur Alvira Pasca, dr. Tribaskoro TS., M.Sc., Ph.D

2009 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang: Penanggulangan penyakit DBD mengalami masalah yang cukup kompleks karena hasil survei Dinkes Kabupaten Bantul (2007) menyatakan bahwa partisipasi masyarakat Bantul dalam melaksanakan PSN dan pengelolahan sampah rumah tangga untuk memutus rantai penularan nyamuk masih belum memuaskan karena nilai ABJ belum dapat mencapai target yang ditetapkan Kabupaten Bantul sebesar 80% dan masih jauh dari harapan nasional sebesar 95%. Kecamatan Banguntapan menjadi salah satu penyumbang 80% kasus DBD di Kabupaten Bantul dan menempati urutan pertama pada tahun 2005 dan urutan ke dua tahun 2006 dan 2007, sebagai kasus tertinggi dan sebagai daerah yang paling padat. Di Kecamatan tersebut, terdapat 2 desa yang memiliki beberapa kesamaaan baik dari segi kondisi geografis maupun kepadatan penduduk dan jarak antar desa yang tidak terlalu jauh, tetapi memiliki tingkat endemisitas yang berbeda. Tujuan: Untuk mengetahui perbedaan faktor-faktor risiko yang mempengaruhi keberadaan jentik vektor dengue (Aedes aegypti dan Aedes albopictus) antara desa endemis dan sporadis Kecamatan Banguntapan Kabupaten Bantul. Metode: Penelitian ini merupakan penelitian observasional rancangan “Cross Sectional”. Unit analisis adalah individu dan rumah sebanyak 406 sampel (secara proportional to population size) di Desa Baturetno dan Potorono. Variabel bebas meliputi: lingkungan fisik, lingkungan sosial budaya, dan upaya pemberantasan vektor program dinas, sedangkan variabel terikatnya adalah status endemisitas. Hasil: Analisis kondisi tempat potensial perkembangbiakan jentik vektor dengue berbasis MI (p: 0,0000 dan OR: 11,46), pengelolahan sampah rumah tangga (p: 0,0000), penggunaan insektisida rumah tangga (p: 0,004), kepadatan jentik berbasis CI dan BI (p: 0,0000 dan p: 0,039), serta kunjungan tim Gertak PSN (p: 0,003), mempengaruhi perbedaan status endemisitas sedangkan faktor pengetahuan, sikap, perilaku PSN, kepadatan jentik berbasis HI dan kunjungan jumantik tidak menunjukkan adanya perbedaan yang signifikan. Kesimpulan: Faktor lingkungan sosial budaya (praktik pengelolahan sampah rumah tangga dan penggunaan insektisida rumah tangga), lingkungan fisik (kondisi tempat potensial perkembangbiakan jentik vektor dengue berbasis MI, kepadatan jentik berbasis HI dan MI), serta program pengendalian vektor (kunjungan tim Gertak) merupakan faktor risiko yang mempengaruhi perbedaan status endemisitas di Desa Baturetno dan Potorono Kecamatan Banguntapan Kabupaten Bantul.

Background: The eradication of hemorrhagic dengue fever experiences complicated problems. Based on the survey result of Bantul District Health Office in 2007, it was stated that the participation of people in Bantul in implementing to reduce mosquito breeding sites (PSN) and the management as well as the management of household waste to break down the chain of disease transmission due to mosquitoes has not been satisfying because the score of larvae free rate does not yet achieve the target determined by Bantul District, that is 80%, and is still far from the national target, that is 95%. In fact, Banguntapan sub-district contributes 80% of dengue fever cases in Bantul District. This subdistrict was in the first rank in 2005 and in the second rank in 2006-2007 of the highest cases of dengue fever and the densest area in Bantul District. In Banguntapan sub-district, there are two villages that have some similarities both in geographic condition and in population density. Those two villages are considered near but have the difference of endemic level. Objective: To investigate the differences of risk factors that affect the existence of the larva of dengue vectors, which are Aedes aegypti and Aedes albopictus between the endemic and sporadic villages in Banguntapan sub-district, Bantul district. Method: This was an observational study with cross sectional study design. The analysis unit was individuals and houses as many as 406 samples (proportional to population size) in Baturetno and Potorono villages. The independent variables included physical environment, socio-cultural environment, and the health office effort of vector eradication. Meanwhile, the dependent variable was endemic status. Results: Results: Analysis showed that the factors that affected the status differences of endemic was, the Maya Index (MI)-based (potential places for the larva of dengue vector to proliferate (p: 0.0000), the management of household (p: 0.0000), the use of household insecticide (p: 0.004), Container Index (CI) and Breteau Index (BI)-based larva density (p: 0.0000 and p: 0.039), and the visit of unison activation-PSN team (p: 0.003), however, the factors of knowledge, attitude, behavior or habit of to reduce mosquito breeding sites, HI-based larva density and the visit of surveyor for mosquito larvae did not show significant differences. Conclusion: The factor of social and culture (the management of household and the use of household insecticide), physical environment (the MI-based potential places for the larva of dengue vector to proliferate, Container Index (CI) and Breteau Index (BI)-based larva density) with vektor programe control (the visit of unison activation-PSN team) form risk factor that affected the status differences of endemic in Baturetno and Potorono villages, Banguntapan sub-district, Bantul district.

Kata Kunci : Pengelolaan sampah,Insektisida rumah tangga,MI,Jentik vektor dengue,Management of household,household insecticide,MI,larvae vektor dengue,endemic status