Objectives
To describe and quantify spatiotemporal trends of dengue fever at district level in Sumatra and Kalimantan, Indonesia in relation to forest cover and climatic factors.
Methods
A spatial ecological study design was used to analyse monthly surveillance data of notified dengue fever cases from January 2006 to December 2016 in the 154 districts of Sumatra and 56 districts of Kalimantan. A multivariate, zero‐inflated Poisson regression model was developed with a conditional autoregressive prior structure with posterior parameters estimated using Bayesian Markov chain Monte Carlo simulation with Gibbs sampling.
Results
There were 230 745 cases in Sumatra and 132 186 cases in Kalimantan during the study period. In Sumatra, the risk of dengue fever decreased by 9% (95% credible interval [CrI] 8.5–9.5%) for a 1% increase in forest cover and by 12.2% (95% CrI 11.9–12.6%) for a 1% increase in relative humidity. In Kalimantan, dengue fever risk fell by 17.6% (95% CrI 17.1–18.1%) for a 1% increase in relative humidity and rose by 7.6% (95% CrI 6.9–8.4%) for a 1 °C increase in minimum temperature. There was no significant residual spatial clustering in Sumatra after accounting for climate and demographic variables. In Kalimantan, high residual risk areas were primarily centred in North and East of the island.
Conclusions
Dengue fever in Sumatra and Kalimantan was highly seasonal and associated with climate factors and deforestation. Incorporation of climate indicators into risk‐based surveillance might be warranted for dengue fever in Indonesia.
Introduction: Diarrhea incidence in children under five increases by 11% in Indonesia during 2013 - 2018 that could be driven by poor environmental sanitation. This study examined the relationship between environmental sanitation with diarrhea incidence in children under five. Methods: This study was an observational study with a cross-sectional design and used a total sampling technique of 81 underfive children. Primary data were collected by conducting interviews with parents using a structured questionnaire guideline and observation, including the source of drinking water, availability of healthy latrine, floor condition, and lighting. A Chi-square test (α = 0.05) was conducted to analyse the relationship between variables. Results and Discussion: There was a significant correlation between household sanitation and diarrhea incidence in under-five children (p = 0.040; PR = 1.202 [95% CI 0.987 – 1.463]). Conclusion: Poor household sanitation can be a driving factor in diarrhea incidence in under-five children, where households categorised as good sanitation have 1.2 times lower risk than poor sanitation
Dengue Fever (DF) incidence in Bali has been the highest in Indonesia for decades. This study describes the annual distribution of DF and analyzes its association with population density, number of rainy days, and average humidity during 2010-2018 at the district level. The choropleth maps and Poisson regression were employed to provide geographical distribution and quantify the association. The P, 95% confidence interval (CI), and Akaike Information Criterion (AIC) were adopted to assess the significance and the goodness of the association. During 2010-2018 there were 55 215 new DF cases notified. The annual incidence of dengue cases in Bali increased with IRR: 1.000186 (95% CI:1.0000183:1.000189) for every increment of population density per kilometers square and increased by IRR: 1.01043 (95% CI: 1.01019: 1.01078) for every additional one rainy day annually. The dengue cases also increased with IRR 1.0172 (95% CI: 1.0137: 1.0208) for every 1% increase in average humidity. Population density and climate factors are positively associated with dengue cases incidence in Bali from 2010 to 2018. The results underline the urgency of integrating population dynamics and climatic determinants into the DF control program and customizing the intervention program based on local characteristics.
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