ABSTRAK
Penyakit Demam Berdarah Dengue (DBD) merupakan penyakit menular yang disebabkan oleh virus dengue, ditularkan oleh nyamuk Aedes aegypti. Wilayah kerja Puskemas Helvetia merupakan daerah endemis DBD dengan Insidens Rate DBD sebesar 61/100.000 penduduk, diatas indikator nasional (<50/100.000 penduduk, tahun 2013). Tujuan penelitian adalah untuk menganalisis pengaruh lingkungan fisik (suhu, pencahayaan, kelembaban dan keberadaan jentik) dan perilaku (sikap, pengetahuan dan tindakan) terhadap kejadian DBD di wilayah kerja Puskesmas Helvetia Kota Medan Tahun 2013.
Metode penelitian adalah analitik observasional dengan desain case control. Sampel penelitian sebanyak 87 orang kasus dan 87 orang kontrol. Pengumpulan data melalui wawancara dan observasi. Analisis data dilakukan secara univariat, bivariat dengan menggunakan uji chi square, multivariat menggunakan uji regresi logistik berganda dan menghitung Population Attribute Risk.
Hasil analisis bivariat menunjukkan adanya hubungan dengan kejadian DBD adalah suhu Odss Ratio (OR)=2,962 (95%CI:1.598-5.490), Pencahayaan OR=2,717(95%CI;1,465-5,040), kelembaban OR=2.717 (95%CI:1.465-5.040), keberadaan jentik nyamuk OR = 2,190 (95% IC:1.175-4.081), dan tindakan OR= 3.464 (95% IC:1.852-6.478). Hasil analisis multivariat yaitu variabel yang paling dominan berpengaruh terhadap kejadian DBD di wilayah kerja Puskesmas Helvetia adalah suhu OR=3,464 (95%CI:1,693-7,090), kelembaban OR=2,304 (95%CI:1,120-4,741), keberadaan jentik nyamuk OR=5,009 (95%CI:2,380-10,544) dan tindakan OR=3,984 (95%CI:1,948-8,149). Probabilitas masyarakat untuk terkena DBD sebesar 91,7%. Faktor risiko dominan dapat diperbaiki sehingga mencegah terjadinya DBD sebesar 70,9%.
Keberadaan jentik nyamuk adalah variabel yang paling dominan mempengaruhi kejadian DBD maka disarankan kepada Pemda dan Puskesmas Helvetia untuk melaksanakan pemberantasan DBD dengan pemantauan jentik secara rutin dan fogging. Kepada masyarakat diharapkan ikut berperan serta dalam menjaga lingkungan rumah dengan melakukan pemberantasan sarang nyamuk.
Kata Kunci: Demam Berdarah Dengue, Lingkungan Fisik, Perilaku
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ABSTRACT
DHF (Dengue Hemorrhagic Fever) is a transmitted disease caused by dengue virus and transmitted by Aedes aegypti mosquitoes. The working area of Helvetia Public Health Center (PHC) in was the place of endemic DHF with theInsidence Rate DHF was 61/100,000 population, above the national indicator (<50/100,000 population, in 2013 ). The objective of the research was to analyze the influence of physical environment (temperature, lighting, moisture, and the existence of larvae) and behavior (attitude, knowledge, and practice) on the incidence of DHF in the working area of Helevtia PHC Medan, in 2013.
The research used analytic observational method with case control design. The samples consisted of 87 cases and 87 controls. The data were gathered by conducting interviews and observation and analyzed by using univatriate analysis, bivatriate analysis with chi squarte test, and multivatriate analysis with multiple logistic regression tests, and by counting Population Attribute Risk.
The result of the bivariat analysis an association the variables with the incidence of DHF were temperature Odss Ratio (OR) = 2.962 (95% CI:1.598-5.490), lighting OR=2,717(95%CI;1,465-5,040), moisture OR=2.190 (95% CI:1.175-4.081), the existence of larvae OR = 3,188 (95% IC:1.677-5.794), and practice OR = 3.464 IC:1.852-6.478). The result of the multivariat analysis association the variable which had the most dominant influence on the incidence of DHF in the working area of Helvetia PHC were temperature OR=3,464 (95% CI:1.693-7.090), moisture OR=2,304 (95% CI:1.120-4,741), the existence of larvae OR=5,009 (95%IC:2,380-10.554), and practice OR=3.984 (95%IC:1.948-8.140). The probability of people to be affected by DHF was 91.7%. Dominant risk factor could be corrected so that the incidence of DHF which could be avoided was 70.9%.
Existence of larvae is variable wich had the most dominant infuenced the incidence of DHF it is recommended that the City Administration and Helvetia PHC for implement of DHF the eradication by survei larvae and fogging regularly. People should also participate in keeping their home environment safe by destroying mosquito breeding places.
Keywords: Dengue Hemorrhagic Fever, Physical Environment, Behavior
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