Analysis Of Light Intensity, Ventilation Area, And Density Of Occupancy With Leprosy
Eliya Malika Oktavia1, Riza Tsalatsatul Mufida2,
Fakultas Kesehatan Masyarakat, Institut Ilmu Kesehatan Strada Indonesia
*Email: [email protected]
I. Introduction
Leprosy is a contagious and chronic disease. This disease is caused by the Mycobacterium leprae germ which is obligate intracellularly and occurs on the skin and peripheral nerves (Hadi &
Kumalasari, 2017). Based on the Data and Information Center of the Ministry of Health of the Republic of Indonesia in 2018, leprosy in Indonesia is ranked as the third largest in the world after India and Brazil. In 2017, East Java Province has a leprosy prevalence of 0.9 / 10,000 population, so that East Java province has achieved leprosy elimination status, but the number of new cases of leprosy in East Java in 2017 is still the largest number among other provinces with 3373 people. . Data collected by the East Java Provincial Health Office in 2019 states that the number of people with leprosy is at 0.9 percent, with the total number of leprosy sufferers in East Java reaching 2,610 cases with the highest leprosy sufferers in 8 districts in East Java. These eight districts are categorized as red areas, because the largest contributor to leprosy is in East Java. The eight districts are Pamekasan Regency with 65 cases, Tuban Regency with 92 cases, Probolinggo Regency with 125 cases, Lumajang Regency with 171 cases, Pasuruan Regency with 193 cases, Bangkalan Regency with 207 cases, Sampang Regency with 232 cases, and Sumenep Regency as many as 381 leprosy sufferers, therefore to prevent the emergence of new cases of leprosy, especially in areas where there are still high cases of leprosy it is necessary to make efforts to prevent leprosy.
ARTICLE INFO A B S T R A C T
Keywords:
Leprosy, home physical envirenment, lighting, ventilation, occupancy density
Background: The physical environment of the house such as lighting, ventilation and occupancy density that does not meet health requirements can be related/influence the growth of the Mycobacterium leprae bacteria that causes leprosy. Methods: Literature is sourced from the Google Schoolar, Spinger and ProQuest databases published in 2016-2020 with a regional scope in Indonesia, then the literature is selected and selected manually according to the research question. Results: Lighting, ventilation area, occupancy density do not meet the requirements of Ministerial Health Regulations RI No.1077/Menkes/Per/V/2011 concerning Guidelines for Indoor Air Sanitation, which includes a minimum lighting of 60 lux measured with a lux meter (assuming the lighting is as needed, not dim and dazzling ), a minimum ventilation area of 10% of the floor area, a minimum occupancy density of 8 m2, a maximum of 2 people, except for children under 5 years, can influence/relate to the incidence of leprosy and is a risk factor for the incidence of leprosy. Conclusion and Recommendation: Opening windows at least once a day during the day, installing glass tiles so that sunlight can enter the house and kill M.leprae germs within 2 hours, increasing ventilation due to lack of ventilation increases humidity so that M.leprae grows optimally at 40-70% humidity, grows fertile at temperatures of 250C-400C and optimum temperatures of 310C-370C, ventilation must be cross ventilation to maintain air flow, because lack of oxygen causes disease transmission, an average sufferer can infect 2-3 people in his house, regulating the number of family members who sleep one bedroom, separate sleeping with the patient because of repeated and continuous contact for 6 months with patients who are more at risk of contracting, increased public knowledge about the effects of the physical environment of the house by health workers.
Based on HL.Blum, genetic factors, health service factors, behavioral factors and environmental factors are four factors that contribute to a person's health status. Where the most dominant factors for the high and low degree of health are environmental factors and behavioral factors, besides that the environment is a determinant factor in introducing or transmitting a disease, both communicable and non-communicable diseases. (Hadi & Kumalasari, 2017)
According to (Wulansari, 2020) part of the physical environment where humans spend their time and function as a residence or place to live as well as a means of family development. Unhealthy and inadequate housing conditions can aggravate a disease and / or become a risk factor for the transmission of infectious diseases such as leprosy, tuberculosis, and ISPA. The physical conditions of the house that do not meet these health requirements include windows that are rarely opened, ventilation area does not meet the requirements, lighting does not meet the requirements, humidity and temperature do not meet the requirements, floor types and wall types do not meet the requirements, therefore researchers are interested in conducting a review. The journal deals with the analysis of light intensity, ventilation area and residential density of houses with the incidence of leprosy.
II. Method
Research question: Is there a relationship between light intensity, ventilation area and occupancy density with the incidence of leprosy? Key words: lighting, ventilation area, occupancy density, physical environment of the house, leprosy. The inclusion criteria in this study are literature relevant to titles published in 2016-2020. The exclusion criteria in this study were literature that was not relevant to titles published before 2016. The literature was obtained from the data base, namely:
Google Schoolar, Spinger and ProQuest. Each literature is selected, read carefully starting from the abstract, introduction, objectives, and research results to obtain information according to the title taken and keywords. The literature selection results obtained 11 research journals with all of them obtained through the Google Schoolar database, because the keywords that match this study were not found in the Spinger and ProQuest databases (the scope of the research area in Indonesia).
III. Results and Discussion
This review identified 11 journals that fit the inclusion criteria. All journals reviewed use this type of analytic observational research with a case control design, this is appropriate to determine the relationship between the independent variable (risk factor) and the dependent variable (an event / case) based on time travel retrospectively (looking at the past). simple random sampling so that research results can be generalized to the population and reduce the incidence of bias in the study.
Table 1. Journal review results Journal Review
No Author Journal Name Vol, No,
Year
Title Method
(Design, sample, Variable, Instrument,
Analysis)
Research result Conclusion
1 (Lathifah
&
Adriyani, 2020)
Journal of Health Research , Vol. 18, No. 1, January 2020
Relation ships Physical Environ ment Home And The presence of Mycoba cterium leprae Dna On Water
Design:
Observational analytic studies of case studies and controlsSample size:
12 case samples and 12 controls in a ratio of 1: 1. Total sample of 24 respondents.
sampling using simple random sampling method.
There is a relationship between the incidence of leprosy and the house temperature and respondents who do not have a house temperature according to the requirements are 33 times more at risk of leprosy than respondents who have a house temperature according to the requirements.
The physical environment of the house which includes
temperature, lighting, occupancy density, and ventilation is related to leprosy in Winongan District, Pasuruan Regency in 2018.
While humidity,
Resourc es With Leprosy Genesis Winonga n In District Pasuruan
The variables of this study are the physical environment of the house which includes:
lighting, temperature, occupancy density, ventilation, humidity, wall type, floor type, and the presence of M. Leprae DNA in water sources.
Research instruments:
thermometers and lux meter.
Data analysis: chi square and odss ratio
There is a relationship between house lighting and the incidence of leprosy and house lighting that is not in accordance with the requirements 22 times more risk of leprosy than respondents who have house lighting according to the requirements.
There is a relationship
between house
occupancy density and the incidence of leprosy and occupancy density
<4m2 per person, 10 times more likely to have leprosy than respondents who have house occupancy density> 4 m2 per person.
There is a relationship between ventilation and the incidence of leprosy and home ventilation that is not in accordance with the requirements 55 times more risk of leprosy than respondents who have house ventilation in accordance with the requirements There is no relationship between the type of house walls, floor of the house, humidity and leprosy.
M. leprae in water sources in Winongan District, Pasuruan Regency could not be analyzed.
wall type, floor type, and the presence of M.
leprae DNA in water sources are not related to leprosy in the Winongan District of Pasuruan Regency in 2018.
2 (Wulansa ri, 2020)
Echoes of the Environ mental Health Volume 18, No. 1, January 2020
Relation ship of Individu al Hygiene and Physical Conditio n of the House and Leprosy (Case Study in Tanjung Bumi Health
Design: observational analytic, with case control study.
The sample used in this study consisted of case and control samples with a ratio of 1: 1 ie 35 case samples and 35 control samples, with a total sample of 70 respondents. The sampling method uses simple random sampling.
The variables of this study are personal
There is a relationship between personal hygiene and the physical condition of the house with the incidence of leprosy p-value = 0.002 (p-value <α (0.05)).
There is a relationship between lighting and the incidence of leprosy p- value = 0.003 (p-value <α (0.05)).
There is a relationship between ventilation and the incidence of leprosy p-value = 0.016 (p-value
<α (0.05)).
There is a relationship between personal hygiene, lighting and ventilation with the incidence of leprosy and there is no relationship between temperature, humidity and occupancy density with the incidence of leprosy.
Center, Bangkal an Regency in 2019)
hygiene and physical condition of the house including: lighting, ventilation,
temperature, humidity and occupancy density.
Research instruments:
roll meter,
thermohygrometer and lux meter.
Data analysis using chi-square test.
There was no relationship between humidity and the incidence of leprosy in the case group (p value>
α (0.05)).
There was no relationship between humidity and the incidence of leprosy in the case group. P-value = 0.192 (p value> α (0.05)).
There is no relationship between occupancy density and the incidence of leprosy in the case group. p-value = 0.314 (p value> α (0.05)).
3 (Mahardi ka et al., 2019)
Proceedi ngs of the National Seminar on Health Poltekke s Kemenke s Surabaya , Volume 1, No 1, 9 Novemb er 2019
Factors Related to Leprosy
Design: observational analytic with case control study
Sample size: 28 case groups and 28 control groups (1:1) with a total sample of 56 people. Sampling technique: simple random sampling Research variables:
contact history,
gender, age,
education level, occupation,
temperature,
humidity, lighting, occupancy density and ventilation.
Research instruments:
measuring
instruments for temperature, humidity (thermohigrometer), occupancy density (roll meters) and lighting (lux meters).
Data analysis using chi square test and Odss ratio
There is a relationship history of contact with the incidence of leprosy and someone who has a history of physical contact at least 20 hours / week for a long period of time and continuously with people with leprosy has a 12,789 times greater risk of leprosy than someone who has no history of physical contact at least 20 hours / week for a long period of time and continuously with people affected by leprosy.
There is a sex relationship with the incidence of leprosy, the odds ratio (OR) of 9.615 means that a person who has a male gender is 9.615 times more likely to have a risk of leprosy than someone who has a female gender.
There is no relationship between age and the incidence of leprosy in the Jenu Public Health Center, Tuban Regency.
There is a relationship between the level of education and the incidence of leprosy and respondents who have a low level of education will be at risk of leprosy 20,250 times greater than respondents who have a high level of education.
There is a relationship between work and the
Factors related to and risk of the incidence of leprosy in the work area of the Jenu Public Health Center in Tuban in 2018 were contact history,
occupancy density, gender, education level, occupation, temperature, humidity, lighting
and house
ventilation conditions.
incidence of leprosy and respondents who have a job will be at risk 4.5 times greater than respondents who do not work
There is a relationship between occupancy density with the incidence of leprosy and a house with a humidity that does not meet the requirements has a risk of 7,222 times greater to the incidence of leprosy than a house with a humidity that meets the requirements.
There is a relationship between lighting and the incidence of leprosy and houses that have lighting that do not meet the requirements have a risk of leprosy 11,267 times greater to the incidence of leprosy than houses that have met the lighting requirements.
4 (Ratnawa ti, 2016)
Tunas Journal of Health Research Volume VI Number 3, August 2016
Factors Associat ed with Risk Leprosy (Morbus Hansen) e
Design: observational analytic with case control study
Sample size: case population 18 people, control 36 people.
The case and control ratio is 1: 2. The total sample was 54 people.
Research variables:
housing sanitation (roof condition, house wall condition, house floor condition, house window condition, house density, house ventilation, house lighting, clean water facilities, healthy latrines, waste water disposal facilities and waste disposal facilities) and community
characteristics (age, gender, education, occupation, income and contact history).
Research instruments:
questionnaire, roll
Housing sanitation has a significant relationship with the incidence of leprosy (p value <0.05), the OR value is 7.857 which means that housing sanitation is a risk factor associated with the incidence of leprosy and the chances of people living at home with unhealthy housing sanitation contracting leprosy 7,857 times greater than people living with healthy housing sanitation conditions.
The condition of the walls of the house has a significant relationship with the incidence of leprosy (p-value <0.05), the OR value of leprosy is 5,500 times greater than that of people living with healthy walls.
The condition of the house floor has a significant relationship with the incidence of leprosy and the condition
There is a relationship between housing sanitation
(condition of house walls and condition of the floor of the house) and community characteristics (education,
income and
contact history) with the incidence of leprosy in the working area of Bringin Public Health Center, Ngawi Regency.
meter,
thermohygrometer, and lux meter.
Analysis of data with the chi square test.
of the house floor is a risk factor for the incidence of leprosy and the chances of people living in houses with unhealthy floors of contracting leprosy are 8,846 times greater than people living with healthy floor conditions.
Healthy latrines have a significant relationship with the incidence of leprosy (p-value <0.05), the OR value is 5.179 which means that healthy latrines are a risk factor for the incidence of leprosy and the chance for people living in houses with unhealthy latrines to contract leprosy is 5.179 times more large compared to people living with healthy household latrines.
The level of education has a significant relationship with the incidence of leprosy and the level of education is a risk factor for the incidence of leprosy where people with low education are 4.375 times more likely to contract leprosy than people with higher education.
Income has a significant relationship with the incidence of leprosy and income is a risk factor for leprosy.
Contact history has a significant relationship with the incidence of disease and contact history is a risk factor for the incidence of leprosy and the chances of people who have a history of contact with people with leprosy contracting leprosy are 28,000 times greater than people who do not have a history of contact with lepers.
There is no relationship between the condition of the house windows, the
condition of the house windows, the condition of the roof of the house, house ventilation, house lighting, clean water facilities, waste water disposal facilities, waste disposal facilities, age, sex and occupation which are significant with the incidence of leprosy.
5 (Romdha ni &
Sulistyor ini, 2020)
Journal of Environ mental Health (Airlang ga) Volume 12 Number 1, January 2020
Leprosy Case Occupati on in Talango Commu nity Health Center in Sumene p Regency
Desain :
observasional analitik dengan study case control
Besar sampel : 25 kelompok kasus dan 25 kelompok kontrol dengan perbandingan kasus dan kontrol (1:1). Total sampel
sebnayak 50
responden.
pengambilan sampel dengan simple random sampling.
Variabel penelitian:
suhu, kelembaban, ventilasi, kepadatan hunian, pencahyaan alami, jenis dinding, dan jenis lantai ruang tidur responden dengan observasi.
Instrumen penelitian : kuesioner,
thermohygrometer dan roll meter Analisis
menggunakan uji chi squere
The results of this study indicate a significant association of BCG vaccination with an OR value of 4.13. humidity with an OR value of 2.64 and lighting with an OR value of 3.39. BCG vaccination is the most dominant risk factor for leprosy, while for variables of temperature (p = 1.00), humidity (p = 0.48), occupancy density (p = 1.00), type of wall (p
= 1.00) , and floor type (p
= 1,00) found no significant results.
BCG vaccination is the most dominant risk factor for leprosy.
Distribution of the incidence of leprosy spread (dispersed) in the
city of
Yogyakarta, Sleman, Bantul and Kulon Progo and only clustered in Gunung Kidul Regency, but overall in the Special Region of Yogyakarta is clustered. Most of the cases of leprosy are far
from the
puskesmas, far from roads and rivers, and predominantly
live in
mountainous areas
6 (Nisa Amira, 2016)
Journal of Health Research Volume 14, Number 3, Septemb er 2016.
The Influenc
e of
Physical Environ mental Factors of the House on the Incidenc
e of
Child Leprosy
Design: analytic observational with case control study The case sample size is 16 people and the control sample is 16 people comparison (1:
1) with a total sample of 32 respondents.
The variables of this study are the physical environmental factors of the house which include the area of ventilation of the child's room, type of wall, type of floor, temperature, house lighting, children's
There are two
independent variables that influence the incidence of child leprosy in Pasuruan
Regency. The
independent variables that affect the incidence of child leprosy in Pasuruan are the area of ventilation in the children's room and the density of the children's room. Children who sleep in a room with a ventilated area that does not meet the previous requirements have a risk of 9,297 times than a
There are two independent variables that influence the incidence of child
leprosy in
Pasuruan
Regency. The independent variables that
affect the
incidence of child
leprosy in
Pasuruan are the area of ventilation in the children's room and the density of the children's room.
room lighting, and humidity of the child's room.
The instrument uses a questionnaire, thermohygrometer, roll meter and lux meter
Analysis using chi square and Odd ratio
child who previously slept in a room with a ventilation area that meets the requirements.
Children who slept in overcrowded rooms previously had an 8,489 times risk than children who didn't sleep in overcrowded rooms previous.
Children who sleep in a room with a ventilated area that does not meet the previous requirements have a risk of 9,297 times than a child who previously slept in a room with a ventilation area that meets the requirements.
Children who
slept in
overcrowded rooms previously had an 8,489 times risk than children who didn't sleep in overcrowded rooms Previous.
The logistic regression analysis showed
that BCG
vaccination, humidity and lighting
contributed 17%
to the incidence of leprosy, while the remaining 83%
was caused by other risk factors.
BCG vaccination is the most dominant risk factor for leprosy 7 (Efrizal
et al., 2016)
BKM Journal Commun ity Medicine and Public Health, Volume 32 No.
10, 21 July 2016
Risk Factors and Distribut ion Patterns of Leprosy in Yogyaka rta
Design: analytic observational with case control study The sample size totaled 112 with a ratio of 1: 1, namely 56 cases and 56 control groups.
The variables of this study were BCG vaccination,
occupancy density, humidity and lighting Research
Instruments:
Questionnaire, Hygrometer, and Lux Meter
Data Analysis Using Chi-Squar Test with
The variable of BCG vaccination, as many as 51 people (91.07%) had no scar and as many as 5 people (8.93%) had scar.
Occupancy density variable, 50% of the population live in densely populated settlements.
Variable humidity, 55.36% of the population lives in areas with air humidity 40% to 70%, meanwhile,
The lighting variable in the house, there are 55.36% of the population who live with bad lighting (<60% lux).
The logistic regression analysis showed
that BCG
vaccination, humidity and lighting
contributed 17%
to the incidence of leprosy, while the remaining 83%
was caused by other risk factors.
BCG vaccination is the most dominant risk factor for leprosy
Logistic Regression Test, and Risk Through Odds Ratio 8 (Siswanti
&
Wijaya, 2018)
HIGEIA Journal Of Public Health Research And Develop ment, Volume 2, Number 3, Year 2018
Environ mental Risk Factors for Leprosy
Research design:
analytic observational case control study.
The sample of this study were 29 cases and 29 controls. The comparison of the case group and the control group was 1:
1, with a total sample of 55 respondents.
Research variables:
inundation distance, floor height, occupancy density, ventilation area, window opening habits, lighting level, humidity level, floor type, wall type, household contact history, and economic status.
Instruments:
questionnaire, roll meter,
thermohygrometer, and lux meter.
Analysis: using the chi-square test with univariate, bivariate and multivariate analysis
There is a relationship between the height of the house floor and the incidence of leprosy. a house floor height <20 cm has a 4.98 times greater risk of leprosy than respondents who have a floor height of
≥20 cm.
There is a relationship
between room
occupancy density and the incidence of leprosy.
Room occupancy density that does not meet the requirements has a 6.98 greater risk of getting leprosy than respondents who have meeting room occupancy density.
There is a relationship between the area of home ventilation and the incidence of leprosy.
House ventilation area
<10% floor area has a 4.71 times greater risk of leprosy than respondents who have a house ventilation area ≥ 10% of floor area.
There is a relationship between the habit of opening windows and the incidence of leprosy.
Respondents who do not regularly open their house windows every day have a 5.29 times greater risk of getting leprosy than respondents who have the habit of opening windows every day.
There is a relationship between the type of floor in the house and the incidence of leprosy.
Respondents who have a floor that is not waterproof have a 5.43 greater risk of getting leprosy than respondents who have a waterproof floor.
Floor height, room occupancy density,
ventilation area, window opening habits, floor type,
wall type,
household contact history and economic status are risk factors for leprosy in the Bandarharjo Health Center working area in 2018.
There is a relationship between the type of house wall and the incidence of leprosy.
Respondents who have non-waterproof type of house walls have a 5.83 times greater risk of getting leprosy than respondents who have a type of waterproof wall.
There is a relationship between household contact history and the incidence of leprosy.
Respondents who have a history of living with people with leprosy have a 6.98 times greater risk of getting leprosy than respondents who do not have a history of household contacts.
There is a relationship between economic status and the incidence of leprosy. Respondents who have a weak economic status have a risk of suffering from leprosy. 6.98 times greater than respondents with high economic status. There is no relationship between the distance of standing water from the house and the level of house lighting with the incidence of leprosy There is no relationship between the distance of standing water from the house and the level of lighting in the house with the incidence of leprosy.
9 0 (Aprizal et al., 2017)
Public Medicine News, Volume 33, Number 9 Year 2017
Risk factors for leprosy in Lamong an district
Research design:
analytic observational case control study Sample size: 85 cases and 85 controls taken by simple random sampling.
Comparison of case groups and control groups is 1: 1, with a total sample of 170 respondents.
Research variables:
economic status
The results of the bivariate analysis: family
income, BCG
vaccination, contact history, use of footwear during daily activities and soap when bathing (P
<α = 0.05 and OR = 3.1), the condition of the house, namely the condition of the house floor (P < α = 0.05 and OR = 2.8), occupancy density (P <α = 0.05 and
There is a relationship between economic status, BCG vaccination, contact history of the patient, bathing habits using soap, use of footwear,
occupancy density, condition of the floor of the house and sources
(family income), BCG vaccination, house conditions (floor conditions, occupancy density and clean water sources), individual behavior (contact time, bathing using soap and footwear).
Instruments:
questionnaire, roll meter
Bivariate data analysis using Kai-
square test,
multivariate analysis using, logistic regression test, the amount of risk using odds ratios.
OR = 3.2) and clean water sources (P <α = 0.05 and OR = 2.1) Of the 8 risk factors, there were 4 risk factors (family income OR = 3.1, BCG vaccination OR = 8.1, contact history OR = 6.2 and occupancy density OR = 3.2) which were statistically and biologically related to the incidence of leprosy . The results of the regression test (Odds Ratio): family income, BCG vaccination, contact history and occupancy density give an attributable risk of 79.4% to the incidence of leprosy cases. While the dominant risk factor for leprosy is BCG vaccination (P = 0.025, OR = 8.1 and CI = 1.3- 50)
of clean water to the incidence of leprosy. The dominant risk factor for the incidence of
leprosy in
Lamongan Regency is BCG vaccination
10 (Oktavia ni &
Nurmala, 2016)
World Journal of Public Health Volume 5, Number 3. July 2016
Risk Factors Associat ed with the Incidenc
e of
Leprosy in North Lampun g Regency 2014- 2016
Quantitative research design with case control study
The sample size is 38 cases and 38 controls with a sample ratio of 1: 1 with a total sample of 76 people.
Research variables:
water sources, occupancy density, personal hygiene, and house floors.
Instruments:
questionnaire, roll meter.
Data analysis using chi square, with a significance level of 95%
The results of the research in the case group where the use of water sources was not good were 13 (34.2%).
Whereas for the control group whose use of water sources was not good there were 4 (10.5%), respondents from the case group whose occupancy density did
not meet the
requirements were 6 (46.2%), the control group of respondents whose occupancy density did not meet the requirements contained as many as 7 (53.8%), respondents from the case group whose Personal Hygiene was not good were 28 (73.7%).
Meanwhile, for the
control group,
respondents from the case group whose personal hygiene were not good had leprosy as many as 15 (39.5%).
Furthermore, there were
There were as many respondents from case groups that used water sources as not good
13 (34.2%), while control 4 (10.5%).
The case group The occupancy density in the case group did not meet the requirements of 6 (46.2%) and the control group was 7 (53.8%).
Personal Hygiene for the bad case group was 28 (73.7%) and
control 15
(39.5%). The condition of the house floor does not meet the requirements in cases there are 25 (65.8%) and
control 15
(39.5%). There is a relationship between the use of water sources (p =
25 respondents from the case group whose floor conditions did not meet the requirements (65.8%). Whereas for the control group the floor of the house that did not meet the requirements was 15 (39.5%).
There is a relationship between water sources (p
= 0.028), Personal Hygiene (p = 0.005) and the incidence of leprosy in North Lampung Regency. There is no relationship between occupancy density (p = 1,000) with the incidence of leprosy in North Lampung Regency
0.028) and
personal hygiene (p = 0.005), the condition of the house floor (p = 0.012) with the incidence of leprosy in North Lampung
Regency in 2014- 2016. Meanwhile, there is no relationship between
occupancy density and the incidence of leprosy.
11 (Amsika n et al., 2019)
Journal Of Commun ity Health, Volume 1 Number 1, March 2019
Relation ship between Risk Factors and Leprosy in the City of Kupang in 2018
Analytical survey research design case control design Sample size: 23 groups and 46 control groups. The sample ratio is 1: 2 with a total sample of 69 people. The sampling technique uses simple random sampling technique.
Research variables:
Personal Hygiene, level of knowledge, room temperature, duration of contact, humidity, occupancy density.
Instruments:
questionnaire, thermohygrometer.
Analysis using the Chi Square statistical test and to find out the risk factors and the magnitude of the risk
followed by
calculating the odds ratio (OR) and presented in the form of tables, pictures and narratives.
There is a relationship
between room
temperature and the incidence of leprosy and an OR value of 0.095 There is no relationship between knowledge, personal hygiene, length of contact, humidity and the incidence of leprosy in Kupang City.
Room temperature has a significant relationship with the incidence of leprosy with a P value of 0.002 (P
<0.05), while knowledge, personal hygiene, length of contact, humidity,
occupancy density
have no
significant relationship with the incidence of leprosy.
IV. Discussion
The relationship between light intensity and incidence of leprosy
Of the 11 research journals that were the samples of this study, there were 8 journals that looked at the value of home lighting variables (Lathifah & Adriyani, 2020), (Wulansari, 2020), (Mahardika et al., 2019), (Romdhani & Sulistyorini, 2020), (Nisa Amira, 2016), (Efrizal et al., 2016) (Ratnawati, Riska, 2016) and (Siswanti & Wijaya, 2018).
Based on the results of a literature study that has been carried out, the results of research journals (Lathifah
& Adriyani, 2020), (Wulansari, 2020), (Mahardika et al., 2019), (Romdhani & Sulistyorini, 2020), (Nisa Amira, 2016), (Efrizal et al., 2016), that there is a relationship between house lighting and the incidence of leprosy, which means that house lighting is a risk factor for the incidence of leprosy. In addition, lighting is also a risk factor for the incidence of leprosy, according to a research review (Lathifah & Adriyani, 2020), it is stated that lighting does not meet the requirements, the risk is 22 times greater for the occurrence of leprosy compared to a room with good lighting. Research (Mahardika et al., 2019) that lighting does not meet the requirements has a risk of 11,267 times the risk of leprosy compared to a room with good lighting. Research (Romdhani & Sulistyorini, 2020) that lighting does not meet the risk requirements 3.39 times the risk of leprosy compared to rooms with good lighting, and research (Nisa Amira, 2016) that lighting does not meet the risk requirements 3.69 times greater for the occurrence of leprosy than with a well-lit room.
Meanwhile, 2 research journals (Ratnawati, Riska, 2016) and (Siswanti & Wijaya, 2018) obtained results, namely, home lighting has no significant relationship with the incidence of leprosy, which means that house lighting is not a risk factor for the incidence of leprosy. These results contradict the other 6 research journals that have been reviewed, possibly due to the long exposure time, because based on (Notoatmodjo, 2003 in Wijayanti, 2017) all light can basically kill germs, especially M. leprae, but it depends on the type and length of light. illuminates the room .
The lighting in this study is lighting that meets the requirements in accordance with the Regulation of the Minister of Health of the Republic of Indonesia Number 1077 / Menkes / Per / V / 2011 concerning Guidelines for Sanitary Air in Home Rooms, namely lighting with minimum light intensity requirements of 60 Lux with a measuring instrument, namely a lux meter. Where the 60 lux illumination is assumed to be suitable for the need to see the surrounding objects (not dim / dim and not dazzling).
The type of lighting here is natural light or sunlight according to literature (Hadi & Kumalasari, 2017) Mycobactorium leprae germs when exposed to sunlight will die within 2 hours and will thrive in environments with high humidity. Increased humidity is a good medium for pathogenic bacteria including those with a preferred temperature range, mesophilic bacteria that thrive in the 250C-400C range, but will grow optimally at 310C-370C. According to (Noerolandra, 2005 in Kusumaningsih, 2012) states that humidity is a risk of leprosy where the optimum humidity ranges from 40-70%.
The lack of light intensity in the house is influenced by several factors, namely: based on research (Romdhani & Sulistyorini, 2020), (Nisa Amira, 2016), and (Wulansari, 2020), (Efrizal et al., 2016), permanently closed ventilation, ventilation is rarely opened, there are no ventilation holes, respondents' habit of rarely opening curtains, non-standard ventilation area, and the absence of glass tiles. Such conditions cause access to sunlight is blocked, so that the room / room becomes damp and stuffy and has the potential to become a good place for M. leprae to breed, where the M. leprae bacillus that comes out of people with leprosy is through the skin and nasal mucosa. The nasal mucosa releases at most M. leprae, as many as 10 billion living organisms per day and is able to survive outside the human body for about 7-9 days in tropical areas.
This is in line with previous research (Faturahman, 2011) which was conducted on 70 samples in Cilacap Regency, that house lighting that does not meet the requirements has a 6 times greater risk of developing leprosthan rooms with good lighting. The level of lighting in the house of a leper, where sunlight cannot directly enter and illuminate the room, is because most houses have windows or ventilation that do not meet the requirements. The relationship between natural lighting in the house is at risk for 64.7% of them having risk ventilation too.
Therefore, it is necessary to carry out health efforts by fulfilling the requirements for room lighting intensity, namely at least 60 lux with: additional ventilation, standardization of ventilation area of at least 10% of the floor area, increasing public knowledge about leprosy, the importance of air circulation and the importance of home lighting, open habits. , installing glass tiles and windows during the day through outreach or outreach by local health officials.
The Relationship between Home Ventilation Area and Leprosy
Of the 11 research journals that were the samples of this study, only 7 journals analyzed the variable area of house ventilation (Lathifah & Adriyani, 2020), (Wulansari, 2020), (Mahardika et al., 2019), (Nisa Amira, 2016), ( Siswanti & Wijaya, 2018), (Ratnawati, Riska, 2016) and (Romdhani & Sulistyorini, 2020).
The results of the literature study showed that 5 research journals (Lathifah & Adriyani, 2020), (Wulansari, 2020), (Mahardika et al., 2019), (Nisa Amira, 2016), (Siswanti & Wijaya, 2018) show that there is a broad relationship. Home ventilation with the incidence of leprosy and ventilation are risk factors for leprosy in accordance with a journal review that has been conducted (Lathifah & Adriyani, 2020), the results of poor ventilation have a 55 times greater risk of leprosy compared to good ventilation. Nisa Amira, 2016) found that poor ventilation results have a 3.69 times greater risk of leprosy than good ventilation, and (Siswanti & Wijaya, 2018) it is found that poor ventilation results have a 4.71 times greater risk for leprosy compared to good ventilation.
Ventilation affects the incidence of leprosy because based on research results (Wulansari, 2020), (Lathifah & Adriyani, 2020), (Mahardika et al., 2019), (Romdhani & Sulistyorini, 2020), (Nisa Amira, 2016), most respondents Those who experience leprosy do not have adequate ventilation, ventilation does not meet the minimum requirement of 10%, of the floor area, does not cross ventilation, ventilation is closed by a curtain, and even does not have ventilation, only patented windows that cannot be opened.
While the research (Ratnawati, Riska, 2016) and (Romdhani & Sulistyorini, 2020), found that the area of house ventilation has no significant relationship with the incidence of leprosy. This contrasts with several previous studies, namely in research (Rismawati, 2014) which was conducted on 58 samples in Tugurejo Semarang, that there is a relationship between the area of house ventilation with the incidence of multibacillary leprosy and the area of house ventilation does not meet the requirements having a risk of 3.148 times greater. suffering from multibacillary leprosy compared to a house with a ventilation area was eligible.
(Siswanti & Wijaya, 2018) explained that ventilation is an absolute requirement for a healthy house because its function is very important. First, to keep the air flow in the house fresh. If the venethylation is lacking, the room will experience a lack of oxygen. Ventilation that does not meet the requirements has a bad impact, namely that the exchange of air or oxygen in the house is reduced so that it can cause diseases that can be transmitted through the air and are easily transmitted to people who share the same house with the sufferer.
Second, the increasing air flow can free indoor air from leprosy-causing bacteria. The existence of open ventilation during the day is one of the conditions that determines the quality of the air so that it is not stuffy and humid which causes the potential for microorganism to live because the presence or extent of ventilation of microorganisms in the air is an element of pollution as a cause of symptoms of various diseases including skin diseases. (Susanta, 2001 in Siswanti & Wijaya, 2018)
In addition, the area of house ventilation that does not meet the requirements results in blocking the process of entering sunlight into the house. As a result, leprosy germs cannot die and develop properly in the patient's body. This is also explained in a study (Cabral-Miranda et al., 2014) in the State of Bahia Brazil that the relationship between humidity and leprosy is also evidenced by the relationship between the incidence of leprosy and prevalence with a humid environment and proximity to water bodies and rivers. As evidenced in a cohort study in rural Malawi, Sterne et al. (1995) found that the incidence rate decreased with increasing distance from rivers or from the shore of lake Malawi. Higher rates were also found where drainage density and rainfall were higher. Desikan and Sreevatsa (1995) provide direct laboratory evidence that M. leprae has a better chance of survival in humid conditions. In Brazil, the five main groups occur in the Amazon region (Penna et al. 2009), where the environment is predominantly hot and humid. The high relative risk of Caatinga may weaken the hypothesis regarding the relationship of M. leprae to a humid environment. However, the high-risk clusters in Caatinga occur around large bodies of water where the water level is supposed to be higher, and is capable of providing sufficient moisture in the soil.
According to (Kusumaningsih, 2012) in Siswanti & Wijaya, 2018) the results of his research said that the environment where lepers lived had worse humidity than the living quarters of non-sufferers, this was due to inadequate lighting and no windows or ventilation so that the condition of the leprosy patient's room was very moist. This measurement is in accordance with the research conducted by Noerolandra (2005) which states that humidity is a risk of developing leprosy where the optimum humidity ranges from 40–70%. The humidity in the house here is the amount of water vapor in the air in the room which is measured using a thermohygrometer in the room where the respondent spends most of his time indoors.
Ventilation in this study is natural ventilation, where the standard area of ventilation is at least 10% of the floor area and is measured by comparing the area of ventilation and floor area of the house using a roll meter measuring instrument. This is explained in the Regulation of the Minister of Health of the Republic of Indonesia Number 1077 / Menkes / Per / V / 2011 concerning Guidelines for Sanitary Air in Home Spaces, it is explained that the risk factor for air sanitation in the house is that the house is not equipped with ventilation, at least 10% of the floor area with a cross ventilation system. , because the exchange of air that does not meet the requirements can lead to the growth of microorganisms, which results in disturbances to human health.
For this reason, it is necessary to make health efforts that can be done by regulating air exchange, among others by completing a house with ventilation, a minimum of 10% floor area and a cross ventilation system, the habit of opening windows during the day, and increasing public knowledge about leprosy about the importance of circulation. or the exchange of air and the importance of sunlight entering the house which is carried out through counseling or socialization by local health officers.
Relationship between occupancy density and the incidence of leprosy
Of the 11 research journals that were the samples of this research, all journals analyzed the occupancy density variable (Lathifah & Adriyani, 2020), (Mahardika et al., 2019), (Siswanti & Wijaya, 2018), (Aprizal et al., 2017), (Ratnawati, Riska, 2016), (Wulansari, 2020), (Romdhani & Sulistyorini, 2020), (Efrizal et al., 2016) (Nisa Amira, 2016), (Oktaviani & Nurmala, 2016) and (Amsikan et al. , 2019).
Based on the literature study, the results of 4 research journals (Lathifah & Adriyani, 2020), (Mahardika et al., 2019), (Siswanti & Wijaya, 2018), (Aprizal et al., 2017) show that there is a relationship between occupancy density and disease incidence. leprosy, and occupancy density are risk factors for the incidence of leprosy, namely in the study (Lathifah & Adriyani, 2020) that the room occupancy density does not meet the requirements and has a 10 times greater risk of suffering from leprosy, research (Mahardika et al., 2019) room occupancy density not meeting the requirements has a 7.22 times greater risk of suffering from leprosy, research (Siswanti & Wijaya, 2018) that the occupancy density of unqualified rooms has a 6.89 times greater risk of suffering from leprosy and research (Aprizal et al., 2017) occupancy density rooms that do not meet the requirements have a 3.2 times greater risk of suffering from leprosy.
Meanwhile, 7 other research journals (Ratnawati, Riska, 2016), (Wulansari, 2020), (Romdhani &
Sulistyorini, 2020), (Efrizal et al., 2016) (Nisa Amira, 2016), (Oktaviani & Nurmala, 2016) and (Amsikan et al., 2019) show that occupancy density does not have a significant relationship with the incidence of leprosy, which means that occupancy density is not a risk factor for leprosy. This is in contrast to research (Romero- Montoya et al., 2017) in Colombia that leprosy has a relationship with people who live one roof or the same house. Leprosy sufferers are not only a population at high risk of M. leprae infection, but also can act as carriers of M. leprae so that they become a source of infection. It may be contradicting that the length of exposure or the length of contact with a person with leprosy does not happen repeatedly and in a short time.
Because the length of exposure or duration of contact with the patient and living at home with the patient based on this study is at least 6 months.
Based on the Regulation of the Minister of Health of the Republic of Indonesia Number 1077 / Menkes /Per /V/ 2011 concerning Guidelines for Sanitary Air in Home Rooms, it is stated that the requirements for sleeping occupancy density are a minimum bedroom area of 8 meters and it is not recommended to use more than 2 people sleeping in one room, unless children under 5 years.
Research (Mahardika et al., 2019) explains that residential density is unhealthy because in addition to causing a lack of oxygen consumption, unqualified occupancy density will disrupt the exchange of clean air in the room so that the need for clean air is not met. The more the number of occupants in the room, the faster the room becomes contaminated with bacteria in the room and if one of the family members is infected with an infectious disease, especially leprosy, it will be easily transmitted to other family members, where an average patient can infect 2-3 people in his house.
In addition, other research also states that the same results were carried out by (Wijayanti, 2017) in South Tangerang City where the results of their research prove that occupancy density affects the incidence of leprosy, by looking at the effect of occupancy density and house temperature on the incidence of leprosy, based on the results of all respondents who have occupancy density at risk 64.3% of them have a house temperature that is at risk too (270C-300C). That means the density of the occupancy can cause the temperature to rise. . The occupancy density does not meet the requirements plus the optimal house temperature for the breeding of leprosy germs certainly increases the likelihood of new leprosy sufferers emerging and also the occurrence of leprosy transmission.
Based on several previous studies also explained that inadequate density is a risk factor for leprosy, the results of research (Patmawati & Setiani, 2015) in Polewali Mandar Regency stated that occupancy density has a relationship with the incidence of leprosy, and research (Rismawati, 2014) in Semarang also states that there is a relationship between room occupancy density and the incidence of multibasile leprosy with an odds ratio (OR) = 3.231, which means that respondents with room occupancy density not meeting the requirements have a 3.231 times greater risk of suffering from multibacillary leprosy when compared to respondents with meeting room occupancy requirements. .
Because it is expected to make efforts to control the prevention of leprosy transmission, by regulating the number of family members sleeping in one room according to the standards of a healthy home to avoid overcrowding, family members suffering from the disease should sleep separately from other family members, as well as increase in related knowledge. with leprosy and is a risk factor for leprosy by local health workers.
Based on the literature study, it was found that light intensity, ventilation area, and occupancy density were associated with leprosy and were risk factors for leprosy. In accordance with the Regulation of the Minister of Health of the Republic of Indonesia Number 1077/Menkes / Per / V / 2011 concerning Guidelines for Indoor Air Sanitation, namely the quality of indoor air can be influenced by physical quality which includes: temperature, lighting, humidity, air exchange (ventilation), and density. housing, where poor air quality in the house can have an impact on health problems, one of which is leprosy.
Therefore, it is recommended that the community performs indoor air sanitation to prevent the transmission of leprosy by meeting the physical quality requirements of indoor air, namely:
1. Minimum light intensity of 60 lux measured using a lux meter (lighting according to the need to see surrounding objects, not dim /dim and not dazzling)
2. Open windows every day in the morning and during the day so that light can enter the house, because ultraviolet light / sun can kill the mycobacterium leprae germs in 2 hours
3. Installation of glass tiles to add to home lighting
4. Increase ventilation with a minimum ventilation area of 10% of the floor area, because the area of ventilation that does not meet the requirements can increase the humidity of the room, so that mycobacterium leprae can grow optimally at 40-70% humidity. It thrives at temperatures of 250C-400C and optimum at 310C- 370C.
5. Every house must be equipped with cross-ventilation to keep the air flow in the house fresh, because inadequate ventilation can make the room lack oxygen so that it can cause airborne diseases that can be transmitted easily to people who share the same house with the sufferer.
6. Open windows or ventilation during the day, so that it is not stuffy and humid which causes the potential for microorganisms to live and sunlight can enter through the ventilation openings and windows that are opened. Because the optimum mycobacterium leprae bacteria at 40-70% humidity. It thrives at temperatures of 250C-400C and optimum at 310C- 370C.
7. Regulate the number of family members sleeping in one room according to the standard, namely the density of the occupancy with a bed area of at least 8 m2, a maximum of 2 people sleeping in one room, except for children under 5 years, because non-standard density causes lack of oxygen and leprosy is easily transmitted to other family members, where an average sufferer can infect 2-3 people in his house and the density of the occupancy can affect the temperature increase, where the temperature is at risk (270C-300 C), the temperature at which the mycobacterium leprae bacteria can grow optimally
8. Family members suffering from leprosy should sleep separately from other family members because repeated or continuous contact with leprosy sufferers is more likely to infect someone who lives at home with a contact duration of about 6 months.
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