DINAMIKA KEJADIAN DEMAM BERDARAH DENGUE DENGAN PENDEKATAN SPASIO-TEMPORAL DI KECAMATAN MARITENGNGAE, KABUPATEN SIDENRENG RAPPANG, PROVINSI SULAWESI SELATAN TAHUN 2008-2009

I Made Swastika, dr. Tribaskoro Tunggul Satoto, M.Sc., Ph.D.

2011 | Tesis | S2 Kesehatan Masyarakat/EL

Latar Belakang: Demam berdarah dengue (DBD) menempatkan 40% populasi dunia berisiko tertular, tiap tahun menginfeksi 50 juta orang dengan 24.000 orang diantaranya meninggal. Angka insiden di Indonesia khususnya di Kecamatan Maritengngae, Kabupaten Sidenreng Rappang (Sulawesi Selatan) meningkat sehingga perlu dikendalikan. Persebaran penyakit belum terdokumentasi secara kewilayahan. Dinamika kejadian berupa karakteristik penderita, keadaan lingkungan, kerentanan nyamuk penular akibat penggunaan insektisida dan infektifitasnya secata transovarial serta pola kejadiannya belum diketahui. Tujuan: Mengetahui dinamika kejadian DBD dengan pendekatan spasiotemporal, meliputi jenis kelamin, umur, kebiasaan membersihkan tempat penampungan air, kepadatan rumah dan tempat penampungan air dalam radius 100 meter dari rumah penderita, resistensi nyamuk dan transmisi transovarial virus dengue. Metode: Studi observasional cross sectional. Subyek penelitian penderita DBD di Kecamatan Maritengngae. Analisis menggunakan chi-square, uji-T independent, retrospective space-time, standar deviasi absorban value (AV) dan indeks transmisi transovarial (ITT) . Hasil: Distribusi kejadian DBD tahun 2008-2009 untuk jenis kelamin tidak berbeda (p=1.000), umur <15 tahun berbeda dengan umur ≥15 tahun (p=0,016 dan 0,013), kepadatan rumah dan tempat penampungan air di sekitar rumah penderita dalam radius 100 meter tidak berbeda (p=0,829 dan 0,538). Kebiasaan membersihkan bak air di rumah penderita sebesar 43,84%. Nyamuk Aedes aegypti mengalami resisten sedang 1,94% dan mengandung virus dengue (ITT=33,33%). Kesimpulan: Tidak ada perbedaan distribusi jenis kelamin, kepadatan rumah dan tempat penampungan air di sekitar tumah penderita, tetapi terdapat perbedaan kelompok umur pada kejadian DBD tahun 2008-2009. Baru sebagian terdapat kebisaaan membersihkan bak air di rumah penderita. Terdapat resistensi insektisida dan transmisi transovarial virus dengue pada nyamuk Aedes aegypti.

Background: Dengue Hemorrhagic Fever (DHF) causes 40% of world population at risk for infection and every year 50 million people get infected and as many as 24,000 die. Incidence rate in Indonesia, particularly at subdistrict of Maritengngae, District of Sidenreng Rappang, Sulawesi Selatan is increasing, so that neet to controlled. Disease distribution has not been documented regionally. The dynamics of the incidence that comprises characteristics of the patient, environmental condition, susceptibility of mosquitoes by use of insecticide consequence, transovarial ineffectiveness and the incidence pattern are unknown. Objective: To identify the incidence of DHF through spatio-temporal approach, comprising gender, age, the habit of keeping water container clean, house density and the availability of water container within the radius of 100 meters from the house of the patient, resistance of the mosquito and transovarial tranmission of dengue virus. Method: The study was observational with cross sectional design. Subject of the study were DHF patients. Analysis used chi square, independent T-test, retrospective space-time, absorbent value (AV) deviation standard and transovarial transmission index (TTI). Result: Incidence distribution in 2008-2009 for gender showed no difference (p=1.000), age <15 years differed from age ≥15 years (p=0.016 and 0.013), house density and availability of water container around the house of the patient showed no difference (p=0.829 and 0.538). The habit of cleaning water container at the house of the patient was 43.84%. Aedes aegypti had medium resistance (1.94%) and contained dengue virus (TTI=33.33%). Conclusion: There was no difference in the distribution of gender and house density and availability of water container around the house of the patient, but there was difference in age group in the incidence 2008-2009. Only a part of the patient house with habit of cleaning water container. There were insecticide resistance and transovarial tranmission of dengue virus in Aedes aegypti mosquito.

Kata Kunci : Dinamika, dengue, spasio-temporal, Aedes aegypty.