Lingkungan fisik rumah dan pneumonia balita di wilayah kerja Puskesmas Argamakmur Kabupaten Bengkulu Utara

FATARANI, Agus Suwarni, SKM, M.Kes

2009 | Tesis | S2 Ilmu Kesehatan Kerja

Latar belakang : Rumah atau tempat tinggal yang kumuh dapat mendukungm terjadinya penularan penyakit dan gangguan kesehatan, di antaranya infeksi saluran pernapasan akut, seperti common cold, TBC, influenza, campak, batuk rejan, dan sebagainya, Penyakit pneumonia Balita di wilayah kerja Puskesmas Argamakmur cenderung mengalami peningkatan selama 2 (dua) tahun terakhir secara berturut-turut, tahun 2006 sebanyak 47 kasus, dan tahun 2007 jumlah pneumonia 52 kasus (4,14%) dari 1254 Balita dan kondisi lingkungan fisik rumah dilokasi penelitian masih banyak yang tidak memenuhi syarat kesehatan perumahan berdasarkan Keputusan Menteri Kesehatan Republik Indonesia Nomor 829/MENKES/SK/VII/1999 tentang Persyaratan Kesehatan Perumahan. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan lingkungan fisik rumah panggung, semi permanen, dan permanen dengan kejadian pneumonia Balita di wilayah kerja Puskesmas Argamakmur. Metode: Jenis penelitian adalah observasional dengan rancangan antara studi kasus dan kontrol (case control study). Subjek penelitian 52 orang pada kelompok kasus dan 52 orang kelompok kontrol yang bertempat tinggal di wilayah kerja Puskesmas Argamakmur. Adapun distribusi antara kasus dan kontrol berdasarkan lingkungan fisik bentuk rumah antara lain: pada rumah panggung 36 orang; 40 orang pada rumah semi permanen; dan 28 orang pada rumah permanen. Analisis data menggunakan analisis regresi logistik dengan α=0,05 yang dilanjutkan dengan odds ratio (OR). Hasil: Penelitian menunjukkan bahwa, faktor risiko lingkungan fisik terhadap masing-masing bentuk rumah yang dapat menyebabkan terjadinya pneumonia Balita yaitu (1). rumah panggung luas ventilasi < 10% luas lantai dengan nilai p=0,047 dan OR=7,857, letak dapur nilai p=0,028 dan OR=5,200, dan kepadatan hunian rumah < 10 m2 per orang dengan nilai p=0,015 dan OR= 7,857; (2) rumah semi permanen, ventilasi nilai p=0,043 dan OR= 6,926; letak dapur nilai p=0,031 dan OR= 4,889; kebersihan perabotan rumah nilai p=0,028 dan OR=7,429; dan kepadatan hunian nilai p=0,026 dan OR= 7,000; (3) rumah permanen, ventilasi nilai p=0,042 dan OR= 6,600; kebersihan perabotan rumah nilai p=0,035 dan OR=8,000; dan kepadatan hunian nilai p=0,042 dan OR= 6,600. Kesimpulan: (1) ada hubungan yang bermakna lingkungan fisik rumah panggung: ventilasi, letak dapur, dan kepadatan hunian; (2) ada hubungan yang bermakna lingkungan fisik rumah semi permanen: ventilasi, letak dapur, kebersihan perabotan rumah dan kepadatan hunian; dan (3) ada hubungan yang bermakna lingkungan fisik rumah permanen: ventilasi, kebersihan perabotan rumah, dan kepadatan hunian dengan kejadian pneumonia Balita di wilayah kerja Puskesmas Argamakmur.

Background: A dirty house or residence can trigger the incidence of disease infection and health problem, such as acute respiratory tract infection like common cold, tuberculosis, influenza, measles, whooping cough, and so on. Pneumonia among underfives at the working area of Argamakmur Health Center tends to increase; 47 cases in 2006 and 52 cases in 2007 (4.14% out of 1,254 underfives). The condition of house physical environment of the location of the study largely does not meet health requirements of housing based on the decree of the Ministry of Health No. 829/MENKES/SK/VII/1999 about Housing Health Requirements. Objective: The study aimed to identify the association between physical environment of scaffolded houses, semi permanent houses and permanent houses and the incidence of pneumonia in underfives at the working area of Argamakmur Health Center, District of Bengkulu Utara. Method: The study was observational with case control study design. Subject consisted of 52 in the case group and 52 in the control group of underfives that lived in the working area of Argamakmur Health Center. The distribution of the case and control group was based on the house physical building; 36 respondents in scaffolded houses; 40 in semi permanent houses; and 28 in permanent houses. Data analysis used logistic regression with α=0.05 and Odds Ratio (OR). Result: Risk factor of the environment in relation to physical type of houses could cause the incidence of pneumonia in underfives; i.e. (1) scaffolded houses with ventilation < 10% of floor width had score of p = 0.047 and OR = 7.857; location of the kitchen p = 0.028 and OR = 5.200; and house population density < 102 per person p = 0.015 and OR = 7.857; (2) semi permanent houses with ventilation had score of p=0.043 and OR=6.926; location of the kitchen p=0.031 and OR=4.889; hygiene of house furniture p=0.028 and OR=7.429; and population density p=0.026 and OR=7.000; (3) permanent houses with ventilation had score of p=0.042 and OR=6.600; hygiene of house furniture p=0.035 and OR=8.000; and population density p=0.042 and OR=6.600. Conclusion: 1) There were significant association between physical environment of scaffolded houses (ventilation, location of the kitchen and population density); 2) there was significant association between physical environment of semi permanent houses (ventilation, location of the kitchen, and population density); and 3) there was significant association between physical environment of permanent houses (ventilation, physical hygiene of furniture and population density) and the incidence of pneumonia in underfives at the working area of Argamakmur Health Center, District of Bengkulu Utara.

Kata Kunci : Lingkungan fisik rumah,Kejadian pneumonia,Balita, physical environment of houses, pneumonia