FAKTOR RISIKO DAN DISTRIBUSI SPASIAL KEJADIAN DIARE AKUT PADA BALITA DI KECAMATAN KEPIL KABUPATEN WONOSOBO PROVINSI JAWA TENGAH

JAMALUDDIN, Prof. dr. Muhammad Juffrie, Dr.Ph., Sp.AK.

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Angka insidensi, prevalensi dan mortalitas diare masih cukup tinggi di Indonesia, khususnya pada anak balita. Menyebabkan 25,2% kematian bayi dan balita. Angka kejadian diare di Kabupaten Wonosobo terus meningkat yaitu 11.074 (33,62 %), IR 14/1000 penduduk tahun 2007, menjadi 13,566 (43,25 %), IR 17,77/1000 penduduk pada tahun 2011, dengan KLB terjadi setiap tahun. Tujuan Penelitian: Untuk mengetahui faktor risiko kejadian diare akut pada balita terhadap sikap ibu, vitamin A, imunisasi campak, sanitasi sarana air, kualitas air bersih (total koliform), status gizi, status ekonomi dan distribusi spasial di Kecamatan Kepil Kabupaten Wonosobo. Metode: Jenis penelitian yang digunakan adalah penelitian analitik observasional, rancangan kasus kontrol. Jumlah sampel sebanyak 150 yang terdiri dari 75 kasus dan 75 kontrol. Pengambilan sampel dengan cara non probability sampling (consecutive sampling). Analisis data secara bivariabel (chi-square) dan analisis multivariabel (regresi logistik) metode stepwise serta distribusi spasial. Hasil: Hasil uji multivariabel, variabel sanitasi sarana air bersih (OR=3,709 95% CI 1,801-7,640 p=0,000) dan status ekonomi (OR=3,352 95% CI=1,650-6,807, p=0,001) merupakan faktor risiko diare akut pada balita yang dominan dan bermakna secara statistik. Distribusi spasial menujukkan kasus diare pada balita tidak mengelompok pada satu wilayah tertentu saja, tapi menyebar rata di hampir semua desa wilayah puskesmas Kecamatan Kepil. Kesimpulan: Sanitasi sarana air bersih dan status ekonomi merupakan faktor risiko kejadian diare akut pada balita di Kecamatan Kepil. Probabilitas anak yang diare dengan status ekonomi rendah dan sanitasi sarana air bersih dengan pencemaran tinggi, berpeluang terkena diare sebesar 53%.

Background: The rate of incidence, prevalence and mortality of diarrhea remain high in Indonesia, especially in children under five years and caused 25.2% of deaths of infants and children under five years. The incidence of diarrhea in Wonosobo District kept increasing, specifically 11,074 (33.62 %), IR 14/1,000 population in 2007, to 13,566 (43.25%), IR 17.77/1,000 population in 2011, where outbreaks occurred every year. Objectives: To determine risk factors of acute diarrhea in children under five years on maternal attitudes, vitamine A, measles immunization, sanitation clean water facilities, clean water quality (total coliform) and spatial distribution in Wonosobo District. Methods: This is analytical research using observational approaches with casecontrol design. A total sample of 150 consisted of 75 cases and 75 controls. The sample was collected using non-probability sampling (consecutive sampling). The data were analyzed using bivariable analysis through Chi-Square test and multivariable analysis through logistic regression test and spatial distribution. Results: From the multivariable analysis, the variable of sanitation clean water facilities OR=3.709 95% CI 1.801-7.640 p=0.000) and economic status (OR=3.352 95% CI=1.650-6.807, p=0.001) are the most dominant and statistically significant risk factors of acute diarrhea cases occurred in children under five years. The spatial distribution indicated that cases of diarrhea in children under five years were not clustered in a particular region, but they spread evenly in almost all villages in the areas of primary health care of Kepil Sub District. Conclusion: Sanitation clean water facility and economic status are risk factors for the onset of acute diarrhea in children under five years in Kepil Sub District. The probability of children with diarrhea with low economic status and sanitation clean water facilities with high contamination by 53%.

Kata Kunci : Diare akut, balita, spasial, air bersih, Wonosobo