FAKTOR-FAKTOR RISIKO KEJADIAN DEMAM BERDARAH DENGUE (DBD) DAN PEMETAAN RESISTENSI NYAMUK AEDES AEGYPTI DI KECAMATAN WONOGIRI KABUPATEN WONOGIRI TAHUN 2010

Purnama Magdalena Simanullang, dr. Tribaskoro Tunggul S., M.Sc., Ph.D.

2011 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Demam berdarah dengue masih merupakan masalah di negara tropis dan sub tropis. Di Kabupaten Wonogiri pada tahun 2009, IR kasus DBD sebesar 3,64 per 10.000 penduduk dengan CFR 0,52% tersebar di 13 kecamatan dan 48 desa endemis DBD. Kecamatan Wonogiri merupakan kecamatan endemis DBD. IR kasus DBD di Kecamatan Wonogiri tahun 2009 sebesar 14, 86 per 10.000 penduduk dengan CFR 1,43%. Faktor risiko kejadian DBD, kerentanan nyamuk Aedes aegypti terhadap insektisida yang digunakan untuk pengendalian DBD serta pola sebaran kasus belum diketahui. Tujuan: Memperoleh gambaran pola sebaran penderita DBD serta mengetahui faktor-faktor risiko yang berhubungan dengan kejadian DBD di Kecamatan Wonogiri Kabupaten Wonogiri tahun 2010, meliputi: tingkat pendidikan, pekerjaan, maya index dan resistensi nyamuk. Metode Penelitian: Penelitian ini adalah observational analitik dengan rancangan penelitian kasus kontrol (1:1). Analisis menggunakan Mc Nemar, conditional logistic regression, standar deviasi absorban value (AV) dan nearest neighbour analysis. Hasil : Analisis multivariabel menunjukkan bahwa tingkat pendidikan bukan merupakan faktor resiko kejadian DBD (p value > 0,05). Status tidak bekerja (p value = 0,0017, OR = 4,8; 95%CI = 1,64 – 14,16), maya index tinggi (p value=0,000, OR= 4,3; 95%CI 2,08-9,26) merupakan faktor risiko kejadian demam berdarah dengue. Nyamuk Aedes aegypti telah mengalami resistensi tinggi (17,51%), resistensi sedang (57,77%) dan sensitif (24,72%). Pola sebaran kasus mengelompok (cluster) di area pemukiman. Kesimpulan: Status tidak bekerja, mempunyai tempat penampungan air dengan maya index tinggi, resistensi nyamuk dan tinggal di daerah padat pemukiman merupakan faktor risiko kejadian demam berdarah dengue.

HF Background: Dengue hemorrhagic fever is a problem in tropical and sub tropical countries. In Wonogiri District, the IR of DHF cases in 2009 was 3.64 per 10,000 population with CFR of 0.52%, distributing in 13 sub districts and 48 villages having DHF endemics. Wonogiri sub district is a D endemic with IR of the cases in 2009 was 14.86 per 10,000 population with CFR of 1.43%. The factors of DHF incidences, the resistance of Aedes aegypti on insecticide used for DHF controlling and case dispersion pattern which is not yet known. ces Objective: To obtain a description on dispersion pattern of DHF patients and to find out risk factors that were related to DHF inciden in Wonogiri sub district in 2010 that included educational level, occupation status, Maya index, and mosquito resistance. ir - Method: This was an observational-analytical study with pa matched case-control study design. Quantitative data analyses used univariable analysis with frequency distribution, bivariable analysis with chi-square (χ 2 ) test according to McNemar, multivariable analysis with conditional logistic regression, insecticide resistance with standard deviation of Absorbance Value (AV) and cluster with nearest neighbour analysis. T here was not a signi Result: ficant relationship between educational level and DHF incidences (p value > 0.05). Unemployed (p value = 0,0017, OR = 4,8; 95%CI = 1,64 – 14,16), maya index which was high (p value=0,000, OR= 4,3; 95%CI 2,08-9,26) were risk factor in DHF incidence. Aedes aegypti had experienced levels of resistance which were high (17.51%), moderate (57.77%), and sensitive (24.72%). Clusters of incidence were found in residence areas. Unemployed, Conclusion: High Maya index, mosquito resistance and residing in dense area are risk factors of dengue hemorrhagic fever.

Kata Kunci : Demam berdarah dengue, analisis spasial, pemetaan resistensi, maya index.