Epidemiologi dan faktor penularan Schistosoma japonicum di dataran tinggi Napu Kabupaten Poso Sulawesi Tengah

ROSMINI, Prof. Dr. dr. Soeyoko, DTMH, SU

2009 | Tesis | S2 Ilmu Kedokteran Tropis

Latar Belakang : Penularan schistosomiasis masih berlangsung di Dodolo dan Mekarsari, Dataran Tinggi Napu, Kabupaten Poso. Selain ditemukan kasus, juga masih ditemukan hospes perantara, keong Oncomelania hupensis lindoensis yang positif cercaria dan hospes resevoir yaitu tikus yang positif mengandung cacing Schistosoma japonicum. Secara epidemiologi penularan schistosomiasis berhubungan dengan pekerjaan dan perilaku manusia yang selalu kontak dengan air yang terinfeksi parasit Schistosoma. Tujuan Penelitian : Penelitian ini bertujuan untuk mengetahui epidemiologi dan faktor risiko terjadianya schistosomiasis di Dataran Tinggi Napu. Metode Penelitian : Penelitian ini merupakan penelitian observasional dengan rancangan cross sectional. Pengumpulan data dilakukan dengan survei tinja, survei keong, survei tikus dan wawancara. Pemeriksaan tinja menggunakan metode Kato-Katz dan pembedahan tikus untuk mengetahui prevalensi schistosomiasis pada manusia dan tikus, pemeriksaan keong dengan metode crushing untuk mengetahui infection rate keong dan wawancara menggunakan kuesioner terhadap 196 responden yang dipilih dengan simple random sampling untuk mengetahui faktor risiko penularan schistosomiasis. Hasil : Hasil penelitian menunjukkan prevalensi schistosomiasis pada manusia dan tikus (Rattus exulans) dan infection rate keong O.h. lindoensis di Desa Dodolo yaitu 6,9%, 8,3%, 2,8% dan di Desa Mekarsari yaitu 6,1%, 10%, 2,6%. Hasil penelitian ini juga menunjukkan bahwa tidak ada hubungan pekerjaan dengan kejadian schistosomiasis (p=0,137). Perilaku yang berhubungan dengan kejadian schistosomiasis yaitu kebiasaan mandi dan mencuci di sungai (p=<0,001), selalu bepergian ke daerah focus (p=0,04), pemanfaatan sumber air sumur (p=0,001), mencuci kaki ataupun tangan di sungai (p=<0,001) dan berenang (p=0,007). Simpulan : Penularan schistosomiasis masih berlangsung di Desa Dodolo dan Mekarsari, Dataran Tinggi Napu. Kejadian schistosomiasis berhubungan dengan perilaku masyarakat yaitu kebiasaan mandi dan mencuci di sungai, bepergian ke daerah fokus, pemanfaatan sumber air sumur, mencuci kaki ataupun tangan di sungai dan berenang.

Background : The transmission of schistosomiasis is still ongoing in Dodolo and Mekarsari Villages of Napu Highland, Poso District. The people who infected Schistosoma japonicum, intermediate host, Oncomelania hupensis lindoensis snails that infected by cercaria, infective stage of S. japonicum and reservoir host, rats, which infected by S. japonicum were still found. According to the previous study, the infection of schistosomiasis is related with occupation and human behaviour in the schistosomiasis endemic area. Objective : The purpose of this study was to identify epidemiology and infection risk factors of schistosomiasis at Napu Highland. Method : The epidemiological investigation was analyzed using observational study with cross sectional design. Data collections were conducted, including stool, snail and rat surveys. The risk factors data were obtained, were available. Stool samples were examined by the Kato-Katz method and rats were dissected to identify prevalence rate of schistosomiasis in human and rats. Snails were examined using crushing method to identify the infection rate of the snails. Interviewes were conducted in among 196 respondents using simple random sampling to identify infection risk factors of schistosomiasis. Result : Prevalence rate of schistosomiasis in human and rats (Rattus exulans) and infection rate O.h. lindoensis snails in Dodolo were 6,9%, 8,3%, 2,8% and in Mekarsari were 6,1%, 10% 2,6% respectively. The result also showed that occupation of farmer was no significant association with infection of schistosomiasis (p=0,137) and schistosomiasis infection was related to the human behaviour of taking a bath and washing in the river (p value=<0,001), always going to the focus area (p=0,04), utilizing water resources from well (p=0,001), washing legs or hand in the river (p=<0,001) and swimming (p=0,007). Conclusion : The transmission of schistosomiasis is still ongoing in Dodolo and Mekarsari Villages of Napu Highland. Schistosomiasis infection was related to the human behaviour of taking a bath and washing in the river, always going to the focus area, utilizing water resources from well, washing legs or hand in the river and swimming

Kata Kunci : Schistosomiasis,S japonicum,oh lindoensis,Pekerjaan,Perilaku, Schistosomiasis, S. japonicum, O.h. lindoensis, occupation, behaviour