In Indonesia, leptospirosis often causes outbreaks. Three important sources of transmission of leptospirosis are the environment contaminated with leptospira, the presence of rats and presence of livestock as reservoirs. This study aims to determine the reservoir that plays a role in the leptospirosis transmission in increased case areas of leptospirosis in the Pagedangan Ilir Village, Kronjo Sub-district, Tangerang. Rat traping was done twice. Each trapping was done two times, in consecutive days. Livestock sampling was also conducted in the study area. Rat and livestock serum specimens were collected for leptospirosis detection using MAT, while rat kidneys were collected for PCR test. Leptospirosis detection was performed by PCR and MAT. The results of the first and second rat traping showed relative density of 17% and 20% in the houses, as well as 14% and 10% in outdoor area. Rat traped consist of two species, Rattus norvegicus and Rattus tanezumi. The prevalence of pathogenic leptospira in rat (with PCR assay) was 33% in the first trap and 26% in the second trap. The MAT test showed a positive 14% on R. norvegicus in the first trap, but negative in the second trap. While livestock did not show PCR positive, but one serological positive sample (by MAT) with low titers (1:20) was found against the serovar Robinsoni
Abstract
Leptospirosis cases in Klaten Regency in 2016-2018 have increased. An assessment action to describe the knowledge and behavior of the community regarding leptospirosis incidence in Gantiwarno District was carried out as input in efforts to control leptospirosis. The research location was in Towangsan Village, using a cross-sectional design. Data was collected in October-November 2018 through a survey among 32 residents around the case house and indepth interviews with five staff of district health office and Gantiwarno public health center. Most respondents have correct knowledge about first symptoms, health assistance facilities for leptospirosis treatment, mode of transmission, leptospirosis prevention, and carcasses handling. The community already knew about early symptoms, but didn’t see the necessity of the second visit in health facilities nor given information to medical staff about exposure history or risk factors. Qualitatively, farmers' groups are susceptible to leptospirosis because some communities still throwing rat carcasses into paddy fields, minimum use of PPE, and handwashing behavior. Health Office was recommended to educate the community about the importance of repeated visits to health facilities and providing risk factor information to health workers related to leptospirosis. Counseling leptospirosis prevention in farmer groups is carried out through cross-sectoral collaboration between the regency health office and regency agriculture office.
Abstrak
Kasus leptospirosis di Kabupaten Klaten tahun 2016-2018 mengalami peningkatan. Kegiatan assessment dilakukan untuk mendeskripsikan pengetahuan dan perilaku masyarakat pada peningkatan kasus leptospirosis di Kecamatan Gantiwarno. Rancangan penelitian adalah cross sectional. Lokasi penelitian di Desa Towangsan, Kecamatan Gantiwarno, dengan waktu pengumpulan data pada bulan Oktober-November 2018. Survei pengetahuan dilakukan pada 32 orang penduduk di sekitar rumah kasus dan wawancara mendalam dilakukan pada 5 orang staf dinas kesehatan dan puskesmas. Sebagian besar responden telah memiliki pengetahuan yang benar tentang gejala awal, pemanfaatan fasilitas pelayanan kesehatan untuk pengobatan leptospirosis, cara penularan dan pencegahan leptospirosis, serta cara menangani bangkai. Masyarakat mengetahui gejala awal leptospirosis, namun belum mengetahui perlunya kunjungan ulang ke sarana kesehatan dan menginformasikan riwayat faktor risiko untuk membantu penegakan diagnosis. Secara kualitatif, kelompok petani rentan terhadap penularan leptospirosis karena adanya perilaku masyarakat membuang bangkai tikus ke sawah dan rendahnya penggunaan APD serta perilaku cuci tangan dengan sabun setelah bekerja. Dinas kesehatan direkomendasikan memberikan edukasi ke masyarakat tentang pentingnya kunjungan ulang ke sarana kesehatan dan memberikan informasi faktor risiko ke tenaga kesehatan apabila memiliki gejala awal leptospirosis. Penyuluhan edukasi pencegahan leptospirosis pada kelompok petani dilakukan melalui kerjasama lintas sektor antara dinas kesehatan dengan dinas pertanian.
Rats are animal reservoirs and harbours of several zoonotic pathogens diseases in humans. At least, there are 68 viruses of zoonotic agents that can be transmitted by rats. Two common types of viruses attackinghumans are Hepatitis E virus (HEV) and Hantavirus. Early detection of those viruses is fundamentally required in order to prevent disease transmissions to humans. The aim of the study was to detect and count the percentage of rats infected by HEV and Hantavirus in Kendal and Klaten Districts, Central Java Province. The research design used in this study was descriptive design with cross-sectional approach. The target population was rats distributed in Klaten and Kendal Districts. In addition, the research subject was trapped rats. Detection of Hantavirus was carried out using ELISA method and detection of HEV was conducted using nested reverse transcription PCR (nested RT-PCR). A total of 73 rats was successfully captured consisting of 2 genus and 4 species e.g. Rattus novergicus, R. tanezumi, R. tiomanicus and Bandicota indica. The trapped rats infected by HEV were 3.7% and 41.3% for Klaten and Kendal, respectively. However, the seropositive of Hantavirus was only found in Kendal District (20.5%). Rat control is necessary to prevent transmission of HEV and Hantavirus.
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