Penerapan metode survei Pupa-Demografi untuk menilai intensitas penularan dengue di Kota Gorontalo Propinsi Gorontalo

MUSTAPA, Jefri, dr. Tribaskoro Tunggul Satoto, MSc., Ph.D

2010 | Tesis | S2 IKM-Epidemiologi Lapangan

Latar Belakang: DBD masih menjadi masalah kesehatan di Indonesia. Disepakati bahwa cara pencegahan yang efektif hanya dengan menurunkan populasi vektor. Selama ini indeks stegomya seperti: HI, 81, dan Cl masih diandalkan untuk memantau populasi vektor. Padahal indeks-indeks ini tidak bisa mengukur kepadatan vektor apalagi menilai risiko penularan. Survei pupa/demografi disebut-sebut lebih handal untuk mengukur kepadatan vektor, menilai risiko penularan sekaligus mencari premis dan kontainer kunci. Metode ini diajukan untuk menilai risiko penularan sekaligus mencari kontainer kunci di dua kelurahan yang berbeda endemisitasnya di Kota Gorontalo, pembandingnya adalah indeks stegomya. Perangkat PCI (Premise Condition Index) juga dinilai efektif untuk mencari premis kunci. Dua variabel diajukan menjadi prediktor risiko penularan, yakni jumlah kontainer kunci dan skor PC I. Tujuan: Mengkaji kemungkinan menerapkan strategi PSN bertarget di daerah Gorontalo berbasis metode pupa/demografi. Metode: Penelitian ini adalah penelitian analitik observasional, rancangan cross sectional, sampel 1 00 premis per kelurahan. Anal isis deskriptif, uji korelasi Spearman, uji t dan uji Mann Whitney digunakan untuk membandingkan kemampuan indeks pupa/orang dan indeks stegomya. Regresi logistik ganda digunakan untuk menganalisis variabel-variabel untuk memprediksi indeks pupa/orang. Hasil: lndeks stegomya tidak konsisten, tidak berkorelasi satu sama lain, dan kurang informatif dalam menilai risiko penularan. lndeks pupa/orang berkorelasi positif dengan semua indeks stegomya dan bisa secara jelas memutuskan bahwa dua wilayah yang diteliti sama-sama berada diatas ambang penularan. Selanjutnya, kontainer kunci dan skor PCI terbukti bisa dipakai untuk memprediksi risiko penularan. Kesimpulan: Survei pupa/demografi efektif diterapkan di Kota Gorontalo Kata Kunci: pupa/orang, premise condition index, kontainer kunci

Background : DHF was still a public health problem in Indonesia. There was an agreement that significant reduction of Ae. aegypti populations is an effective and proven method for disease prevention. Stegomya indexes, such as 81, Cl and HI have been used most widely all this time for monitoring vector population. But, in fact, they could not figure vector population densities nor risk of infection. Pupa/person index was said to be more reliable for assessing risk of infection as well as looking for key premises and containers. This survei method was proposed for assessing risk of dengue infection as well as looking for key containers in two areas with different endemicity of Gorontalo City, and stegomya indexes were used as comparison. The PCI tool (Premise Condition Index) was also mentioned to be effective for finding key premises. Two variables were proposed in searching for a predictor of transmission risk, i.e. number of key container and PCI score. Objective: To study the possibility to apply a targeted control strategy of mosquito breeding places (PSN) at Gorontalo region based on pupa/demography survey method. Method : This is an observational analytic study, with cross sectional design and 100 premises sampled per village. Descriptive analysis, test of correlation (Spearman test ) and test of comparison (t-test and Mann Whitney test ) were used in comparing the capacity of pupa/person index and stegomya indexes. Whereas, multiple logistics regression was used in analyzing variables for predicting pupa/person index. Result: Stegomya indexes were not consistent nor correlated to each other and less informative in assessing risk of transmission. Pupa/person index was correlated with all stegomya indexes and could clearly stated that both of the surveyed region were above the transmission threshold. Furthermore, number of key container and PCI score were proved to be applicable for predicting risk of transmission. Conclusion : Pupa/demography survey was effective to be applied at Gorontalo City. Key word : Pupa/person, premise condition index , key container

Kata Kunci : Pupa,orang,Premise condition index,Kontainer kunci