PERBANDINGAN STATUS ENTOMOLOGI VEKTOR DENGUE DI DAERAH ENDEMIS URBAN DAN DAERAH ENDEMIS RURAL DI KABUPATEN KULON PROGO

SITI ZAINATUN WASILAH, DR. drh. Sitti Rahmah Umniyati, SU; dr. Tri Baskoro Tunggul Satoto, M.Sc, PhD

2015 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Latar Belakang: Penyakit Demam Berdarah Dengue (DBD) merupakan salah satu masalah kesehatan utama di Indonesia, karena menyebabkaan kematian, selain itu bersifat endemis, timbul sepanjang tahun disertai dengan Kejadian Luar Biasa (KLB). Jumlah kasus yang terjadi di kabupaten Kulon Progo menunjukkan bahwa penyakit demam berdarah masih menjadi masalah kesehatan yang perlu penanganan.Kasus-kasus DBD yang telah dilaporkan terbanyak merupakan penduduk yang tinggal di Kecamatan Wates (daerah endemis urban) dan Kecamatan Sentolo (daerah endemis rural) karena kedua kecamatan tersebut masih berstatus sebagai daerah endemis DBD. Tujuan: Penelitian ini secara umum bertujuan untuk mengetahui perbedaan kepadatan populasi vektor Dengue, kondisi lingkungan sebagai resiko perkembangbiakan larva Ae.aegypti dengan indikator Maya Index (MI), perbedaan nyamuk Ae.aegypti jantan dan betina yang terinfeksi virus Dengue, serotipe virus Dengue yang dominan serta perbedaan status kerentanan larva nyamuk Ae.aegypti di daerah endemis urban dan daerah endemis rural. Metode: Jenis penelitian yang digunakan adalah penelitian observasional deskribtif analitik dengan desain cross sectional. Survei di daerah endemis urban (Gadingan, Wates) dan daerah endemis rural (Dusun Siwalan, Sentolo) dimulai dari rumah yang pernah terdapat kasus DBD dalam kurun waktu 6 bulan terakhir sebagai titik awal, kemudian dipilih rumah secara berselang sampai radius 100 m ke arah barat,utara, timur, dan selatan. Status entomologi yang diperiksa yaitu kepadatan populasi vektor, Parameter Maya Index (MI), deteksi virus Dengue yang diperiksa dengan metode imunositokimia menggunakan antibody monoclonal DSSE 10 dan serotipe virus pada nyamuk Ae. aegypti jantan dan betina stadium imago ditentukan dengan metode Reverse Transcriptase-Polymerase Chain Reaction menggunakan primer Lanciotti. Status kerentanan nyamuk Ae. Aegypti terhadap insektisida organofosfat (temefos) diperiksa dengan uji hayati dan uji biokimia. Hasil: Kepadatan populasi vektor Dengue dengan indikator Angka Bebas Jentik di daerah endemis rural sebesar 40,28% lebih tinggi dibandingkan dengan daerah endemis urban yakni sebesar 35,85%. Nilai House Index, Container Index, Breteau Index, Pupa Index, Ovitraps Index di daerah endemis urban berturut-turut sebesar 64,15%; 21,61%; 96,23%; 87; 44,81% lebih tinggi dibandingkan dengan daerah endemis rural yakni 59,72%; 21,43%; 83,33%; 78; 38,89%. Status Maya Indeks di daerah endemis urban dapat diketahui bahwa proporsi rumah dengan kategori MI rendah: 94,33% (100 rumah),MI sedang: 4,71% (5 rumah) MI tinggi 0,94% (1 rumah), sedangkan di daerah endemis rural kategori MI rendah : 97,22% (70 rumah), MI sedang: 1,38% (1 rumah) MI tinggi 1,38% (1 rumah). Nyamuk Ae.aegypti yang terinfeksi virus (transmisi transovarial) di daerah endemis urban sebesar 11,43% lebih tinggi dibandingkan dengan daerah endemis rural yakni 4,89%. Serotipe Virus daerah endemis urban dan rural adalah DEN-2 dan DEN-3. Status kerentanan dengan insektisida organofosfat (temefos) di daerah endemis urban menunjukkan status toleran dan daerah endemis rural menunjukkan status rentan. Kesimpulan: Ada perbedaan kepadatan populasi vektor DBD di daerah endemis urban (Gadingan, Wates) yakni lebih tinggi dibandingkan daerah endemis rural (Dusun Siwalan, Sentolo) di Kabupaten Kulon progo.Ada perbedaan status Maya Index (MI) rendah di daerah endemis urban yakni lebih rendah daripada daerah endemis rural. Ada perbedaan nyamuk yang terinfeksi virus dari daerah urban dan rural; Tidak ada perbedaan nyamuk jantan yang terinfeksi virus dari daerah urban dan rural; ada perbedaan nyamuk betina yang terinfeksi virus dari daerah urban dan rural. Serotipe virus Dengue yang dominan di daerah endemis urban dan daerah endemis rural adalah sama yaitu Den-2 dan Den-3. Ada perbedaan status kerentanan larva Ae.aegypti terhadap insektisida organofosfat (temefos) di daerah endemis urban menunjukkan status toleran dan daerah endemis rural menunjukkan status rentan.

Background: Dengue Hemorrhagic Fever (DHF) is one of the major health problems in Indonesia because it causes death. In addition, it is endemic, occurring throughout the year along with outbreak. The number of cases occurring in Kulon Progo Regency indicates that dengue fever is still a health problem that needs handling. DHF that cases have been reported are mostly residents who live in Wates Subdistrict (urban endemic area) and Sentolo Subdistrict (rural endemic areas) because the status of both subdistricts is still endemic areas. Objective: This research is in general aimed at identifying the differences of dengue vector population density, environmental conditions as the risk of reproduction of Ae.aegypti larvae with an indicator of Maya Index (MI), the differences between male and female Ae.aegypti mosquitoes infected with dengue virus, dominant dengue virus serotypes and the differences in vulnerability status of Ae.aegypti mosquito larvae in urban endemic areas of and rural endemic areas. Methods: This research belongs to is analytic descriptive observational research with cross sectional design. The survey in endemic urban area (Gadingan, Wates) and rural endemic area (Siwalan Hamlet, Sentolo) started from the house where there was cases of DHF fever within the last 6 months as a starting point, then houses were chosen in a criss-cross manner until a radius of 100 m to the west, north, east, and south. The examined entomological status consisted of vector population density, Parameter of Maya Index (MI), dengue virus detection examined with immunocytochemistry method using monoclonal antibody DSSE10 and virus serotypes in male and female Ae. aegypti of imago stage determined with the method of Reverse Transcriptase-Polymerase Chain Reaction using primers by Lanciotti. The vulnerability status of Ae. Aegypti to organophosphate insecticides (temephos) was examined with bioassay and biochemical tests. Results: Dengue vector population density with an indicator of Larva Free Rate in rural endemic areas was 40.28%, higher than that in urban endemic area (35.85%). The values of House Index, Container Index, Breteau Index, Pupa Index, Ovitraps Index in endemic urban areas were for 64.15%, 21.61%, 96.23%; 87; 44.81% respectively, higher than those of in endemic area rural (59.72%; 21.43%; 83.33%; 78; 38.89%). The status of Maya Index in urban endemic area indicated that the proportion of house with categories of low MI: 94.33% (100 houses), medium MI: 4.71% (5 houses), high MI: 0.94% (1 house), while in rural endemic areas indicated categories of low MI: 97.22% (70 houses), medium MI: 1.38% (1 house) high MI 1.38% (1 house). Ae.aegypti mosquito infected with the virus (transovarial transmission) in urban endemic area was 11.43%, higher than that in rural endemic area (4.89%). The virus serotypes of urban and rural endemic areas were DEN-2 and DEN-3. The vulnerability status to organophosphate insecticides (temephos) in urban endemic areas indicated tolerant status and in rural endemic areas indicated vulnerable status. Conclusion: The vector population density of DHF in urban endemic area (Gadingan, Wates) is higher than that of rural endemic areas (Siwalan Hamlet, Sentolo) in Kulon Progo Regency. Low Maya Index (MI) Status in urban endemic areas was lower than that in rural endemic areas. There were differences in virus-infected mosquitoes in urban and rural areas; There were no differences in virus-infected male mosquitoes in urban and rural areas; There were no differences in virus-infected female mosquitoes in urban and rural areas. The serotypes of dominant dengue virus in urban endemic areas and rural endemic areas were the same, namely Den-2 and Den-3. The vulnerability status of Ae.aegypti larvae to organophosphate insecticides (temephos) in urban endemic areas indicated tolerant status and in rural endemic areas indicated vulnerable status.

Kata Kunci : Ae.aegypti, status entomologi, urban, rural