Background Geographical variation may likely influence the effectiveness of prevention efforts for malaria across Indonesia, in addition to factors at the individual level, household level, and contextual factors. This study aimed to describe preventive practices at individual and a household levels applied by rural communities in five provinces in eastern Indonesia and its association with the incidence of malaria among adult (�15 years) populations. Methods This study analyzed a subset of data of nationally representative community-based survey 2018 Riset Kesehatan Dasar (Riskesdas). Data for socio-demographic (age, gender, education and occupation) and preventive behaviors (use of mosquito bed nets while slept, insecticide-treated mosquito nets (ITNs), mosquito repellent, mosquito electric rackets, mosquito coil/electric anti-mosquito mats, and mosquito window screen) were collected. Data were analyzed using bivariate and multivariable logistic regression model.
Dengue fever threatens more than 200 million people in Indonesia. The disease has spread to over 400 of Indonesia's 497 districts, 26 of which have been declared hyper-endemic. These districts are all situated in West Java, the most densely populated province in the country. A study was conducted to detect clusters of dengue incidence during 2007-2013 in Cimahi City, which is situated in the Bandung metropolitan area in West Java. A temporal-spatial analysis based on population data from the local Bureau of Statistics, and monthly analysis of dengue incidence from the local Municipality Health Office, were performed using SaTScan™. This retrospective space-time analysis with a Poisson distribution model and monthly precision revealed 24 significant clusters (P<0.001) throughout the seven-year study period. The most likely cluster was detected in the centre of Cimahi City and followed as it moved to the northern part of the city. Several primary and secondary clusters were identified in villages surrounding Cimahi City over time, and our conclusion is that we identified a dynamic spread of dengue fever initiated from the city centre to surrounding areas during the study period. In general, clusters were more common in the first quarter of each year. An in-depth investigation to understand relevant risk factors in high-risk areas in Cimahi city is encouraged.
Latar belakang: Bandung memiliki daerah perkotaan dengan kualitas bangunan rumah yang memadai, namun masih memiliki kasus endemik Demam Berdarah Dengue (DBD) yang tinggi. Penelitian ini bertujuan untuk mengetahui karakteristik kejadian demam berdarah di tingkat rumah tangga.
Metode: Data dianalisis dari 781 rumah tangga yang terdiri dari 261 kasus dan 522 kontrol. Pemilihan sampel menggunakan metode kasus kontrol berpasangan dengan rasio 1:2. Tahapan penelitian terdiri dari pengamatan status rumah menggunakan form ceklis pemeriksaan dan wawancara menggunakan kuesioner tertutup. Analisis data korelasi pairwise spearmen, kemudian regresi logistik biner digunakan untuk prediksi faktor risiko.
Hasil: Faktor risiko usia produktif dan rendahnya tingkat pendidikan kepala keluarga, toilet yang kotor, dan status rumah tidak sehat memiliki pengaruh yang signifikan terhadap peningkatan kasus demam berdarah di Kota Bandung ((p<0.05). Faktor determinan adalah usia produktif kepala keluarga (31 - 60 tahun) dimana memiliki kemungkinan 2,53 (95%CI 1.34-4.78;p<0.05) kali lebih besar untuk memiliki anggota rumah tangga yang menderita DBD di Bandung.
Kesimpulan: Usia dan pendidikan kepala rumah tangga, kebersihan toilet dan status rumah sehat memilikiperan penting dalam mempengaruhi kejadian demam berdarah. Dengan demikian, petugas kesehatanperlu melakukan promosi kesehatan mengenai DBD secara intensif kepada kepala rumah tangga.
Kata kunci: Demam Berdarah Dengue (DBD), kepala rumah tangga, usia, sanitasi rumah, Kota Bandung
Abstract
Background: Bandung have urban areas with adequate housebuilding quality, yet still has high Dengue endemic cases. This study aims to investigate the characteristics of dengue incidence at the household level.
Methods: Data analyzed from 781 households consisted of 261 cases and 522 controls. We applied matched case-control samples with a ratio of 1:2 (case: controls). The stages of the research consisted of a house status observation using a form inspection checklist and interviews using a closed-ended questionnaire. The data analyzed by pairwise spearmen correlation and binary logistic regression for risk factor prediction.
Results: Risk factors for productive age and low level of education of family heads, dirty toilets, and unhealthy house status have a significant effect on the increase of dengue cases in Bandung (p<0.05). The determinant factor is the productive age of the head of the family (31 - 60 years), it means that the family who has a family head in a productive age is 2.53 (95% CI 1.34-4.78; p <0.05) times more likely to have a household member suffering from DHF in Bandung.
Conclusion: The age and the level of education of the household heads, toilet hygiene, and healthy home status have an essential role in influencing dengue fever. Therefore, health workers need to perform an intensive health promotion regarding DHF to the household heads.
Keywords: Dengue, head of household, ages, house sanitation, Bandung City
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