HUBUNGAN SANITASI LINGKUNGAN DENGAN KEJADIAN DIARE PADA BALITA DI KABUPATEN BOYOLALI

wAHYU HUDOYOKO, Dra. Susi Iravati, Apt, Ph.D

2014 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Penyakit diare saat ini masih menjadi masalah kesehatan masyarakat di dunia, kejadian kasus diare sekitar 4 miliar per tahun, dengan kematian sebesar 2,2 juta. Di Indonesia diare menjadi penyebab kematian bayi tertinggi yaitu 42 %. Pada balita 25,2 % kasus kematian disebabkan diare. Kecenderungan kasus diare di Kabupaten Boyolali terus meningkat meningkat dari tahun 2010 dengan IR 1,5/100 penduduk menjadi 1.9/100 penduduk pada tahun 2012. KLB diare terjadi setiap tahunnya dan kondisi sanitasi lingkungan yang kurang memadai diantaranya cakupan SPAL memenuhi syarat 48.6%, sumber air PDAM 10.7%, tidak mempunyai jamban 11%, dan penggunaan air hujan sebagai sumber air bersih sebanyak 3.2%. Tujuan Penelitian: Untuk membuktikan bahwa sarana sanitasi lingkungan yang tidak baik beririsiko meningkatkan kejadian dare pada balita. Metode: Penelitian ini merupakan penelitian analitik dengan pendekatan observasional menggunakan rancangan kasus kontrol. Jumlah sampel sebanyak 220 yang terdiri 110 kasus dan 110 kontrol. Pengambilan kasus dengan menggunakan teknik stratified random sampling, yaitu proportionate stratifield random sampling. Analisa data secara bivariabel menggunakan uji chi-square dan multivariabel menggunakan uji regresi logistik. Hasil: Pada hasil analisis multivariabel, variabel yang terbukti meningkatkan kejadian diare pada balita adalah tidak mempunyai sarana pembuangan sampah (OR=3,31; 95% CI: 1,41-7,73, p=0,006), keberadaan peternakan sapi di dekat tempat tinggal (OR=3,01; 95% CI: 1,55-5,84, p=0,001), sarana air bersih yang tidak memenuhi syarat (OR=1,93; 95% CI: 1,06-3,49 p=0,030), dan pendidikan ibu (OR=2,20; 95% CI: 1,21-3,99, p=0,009). Kesimpulan: Tidak adanya sarana pembuangan sampah, adanya peternakan sapi yang dekat dengan tempat tinggal, sarana air bersih yang tidak memenuhi syarat dan pendidikan ibu yang rendah berisiko meningkatkan kejadian diare pada balita. Sarana pembuangan tinja yang tidak memenuhi syarat dan tidak adanya sarana pembuangan air limbah tidak berisiko meningkatkan kejadian diare pada balita di kabupaten Boyolali

Background: Diarrhea still remains a public health problem currently in the world, diarrhea incidences was about 4 billions annually, with mortality about 2.2 millions. In Indonesia, diarrhea become the highest infant mortality that was 42%. In Indonesia, diarrhea become the highest infant mortality cause that was 42%. In underfive, 25.2% of mortality was caused by diarrhea. The tendency of diarrhea incidence in Boyolali Regency have been increasing, in 2010 with IR= 1.5/100 population to 1.9/100 population in 2012. Diarrhea extraordinary incidence (KLB) was occurred every year and the environmental sanitation condition that was not sufficient was the cause such as the coverage of SPAL (sewage pipeline) that is meet the requirement was only 48.6%, clean water source from PDAM was only 10.7%, have no latrine was 11% and using rainwater as the source for clean water was 3.2%. Objective: To prove that environmental sanitation facilities that are not fine have risk to increase the diarrhea incidence in underfive. Methods: This is analytic study by observational approach, using case control design. The sample size was 220 that is consist of 110 in case group and 110 in control group. The sampling was done by stratified random sampling, that is proportionate stratified random sampling. Data was analyzed by bivariable approach by Chi Square test and by multivariable approach by logistic regression test. Results: In multivariable analysis, the variable which was proved increased the diarrhea incidence in underfive were; had no waste container (OR=3,31; 95% CI: 1,41-7,73, p=0,006), the location of cattle husbandry near the residence (OR=3,01; 95% CI: 1,55-5,84, p=0,001), clean water facilities that are not meet the health conditions (OR=1,93; 95% CI: 1,06-3,49 p=0,030), and woman’s education background (OR=2,20; 95% CI: 1,21-3,99, p=0,009. Conclusion: Have no waste container, the cattle husbandry near the residence, clean water facilities that are not meet health conditions, and education background of the mother that is low, had been increasing the diarrhea in cadence in underfive. Latrine facilities that are not meet the health condition and had no sewage facility did not made risk increasing the diarrhea incidence in underfive in Boyolali Regency.

Kata Kunci : sanitasi lingkungan, diare balita, Kab. Boyolali