ANALISIS SPASIAL DISTRIBUSI VEKTOR DAN KASUS MALARIA DI WILAYAH KERJA PUSKESMAS BELANTING KECAMATAN SAMBELIA KABUPATEN LOMBOK TIMUR PROPINSI NUSA TENGGARA BARAT

MUNAWIR HARIS, dr. Tri Baskoro T. Satoto, M.Sc.,PhD

2016 | Tesis | S2 Ilmu Kedokteran Tropis

Latar Belakang. Malaria masih menjadi masalah kesehatan di sebagian wilayah Propinsi Nusa Tenggara Barat, salah satunya adalah di wilayah kerja Puskesmas Belanting Kecamatan Sambelia Kabupaten Lombok Timur.. Berbagai upaya telah dilakukan untuk mengurangi penyakit ini namun belum memberikan hasil yang memuaskan.Salah satu kendalanya adalah belum ada pemetaan sebaran vektor dan belum teridentifikasinya vektor malaria. Tujuan.Penelitian ini bertujuan untuk menganalisis secara spasial hubungan antara sebaran kasus malaria, vektor dan habitat. Metode.Penelitian ini merupakan penelitian analitik deskriptif dengan pendekatan cross sectional Hasil dan Pembahasan. Penderita malaria yang ditemukan di wilayah kerja Puskesmas Belanting sepanjang tahun 2007 sampai 2015 sebanyak 535 kasus yang terdiri dari 1,5% bayi, 7,7% balita, 27% usia 5-14 tahun dan 64% usia 15 tahun lebih, kasus terbanyak ditemukan di Desa Obel-obel (36,7%) sementara kasus terendah ditemukan di Desa Madayin (3,6%). Hasil penangkapan nyamuk Anopheles Sp ditemukan An. subpictus (90,5%), An vagus (6,3) dan An. indefinitus (3,2%). Sementara penangkapan jentik di tempat perkembangbiakan sebagian besar adalah An. subpictus. Jarak antara kasus yang terdekat atau kontak serumah (42%) dan terjauh 3.200 meter (1%) Pembahasan. Keberadaan malaria yang masih tinggi di Wilayah Kerja Puskesmas Belanting disebabkan adanya interaksi agen, host dan lingkungan yang saling mendukung.Agen penyebab langsung sudah tersebar dua jenis yakni Pl. falsiparum dan Pl.vivax, agen tidak langsung (vektor) yang terdiri dari 3 spesies (An. subpictus, An. vagus, An. indefinetus) sudah lama ada dan berkembangbiak di lingkungan yang cukup ideal serta perilaku masyarakat yang tidak terlalu memahami terhadap cara pencegahan dan pengendalian nyamuk. Kesimpulan.Distribusi malaria di wilayah Puskesmas Belanting menyebar ke semua desa dengan pola sebaran cenderung mengelompok (cluster) dan tempat perkembangbiakan nyamuk Anopheles tidak jauh dari pemukiman penduduk dan masih pada kisaran jangkauan terbang nyamuk Anoheles Sp.

Background. Malaria is still a public health concern in several parts of the West Nusa Tenggara province, one of which is in the Belanting Primary Health Facility working area, Sambelia district, East Lombok regency. Various attempts have been made to reduce the disease incidence, yet has not given satisfactory results. Among problems there are two major issues identified: there is no vector distribution mapping and there is unspecified vectors causing malaria. Objectives. This study aimed to analyze the spatial relationship between the spread of malaria, vector and habitat. Methods. This study was analytic descriptive with cross sectional design Results. The number of people found with malaria in Belanting Primary Health Facility working areas during 2007 to 2015 were as many as 535 cases, of which consist of 1.5% infants, 7.7% children, 27% aged 5-14 years and 64% aged older than 15 years. Most of the cases were found in the Village of Obel-Obel (36.7%), while the lowest cases were found in the Village of Madayin (3.6%). Malaria mosquito vector collection revealed Anopheles species of An. subpictus (90.5%), An. vagus (6.3%) and An. indefinitus (3.2%), while larvae collection in breeding sites showed predominantly of An. subpictus species. The closest distance between the cases or household contacts was (42%) and the farthest of 3,200 meters (1%). Discussion. The results showed that the existence of malaria is still high in Belanting Primary Health Facility working areas due to mutually supportive agent, host and environment interactions. Two types of direct causative agents of malaria have been spread, namely Pl. falciparum and Pl. vivax, while indirect agents, of which consists of three species (An. subpictus, An. vagus, An. indefinitus) have been long existed and multiplied in an environment that is quite ideal due to misleading people behavior and incorrect understanding towards mosquito control. Conclusion. Distribution of malaria in the Belanting Primary Health Facility working areas has spread into all villages with clustered distribution. Anopheles mosquito breeding sites are not far from residential areas and are still in the flying range of Anopheles Sp. mosquitoes.

Kata Kunci : Malaria, Anopheles Sp, spatial analysisngg