Abstract

Sampai dengan tahun 2013 dilaporkan ada 13 kasus leptospirosis di Kabupaten Banyumas.Terjadinya peningkatan kasus selama dua tahun terakhir perlu mendapat perhatian dari berbagai pihak agar kasus leptospirosis bisa segera ditangani. Tujuan penelitian ini adalah memetakan kasus leptospirosis dan menganalisis faktor risiko lingkungan dan perilaku yang memengaruhi leptospirosis. Penelitian ini menggunakan desain studi observasional kasus kontrol. Pengumpulan data dilakukan dengan wawancara, observasi, dan pengukuran. Analisis data menggunakan analisis spasial, analisis univariat, dan bivariat. Kasus adalah penderita leptospirosis berjumlah 13 orang dan kontrol adalah tetangga kasus yang tidak menderita leptospirosis berjumlah 52 orang. Hasil pemetaan menunjukkan kasus leptospirosis di Kabupaten Banyumas termasuk daerah aliran sungai dengan radius 600 meter ke sungai; seluruh kasus dekat dengan sawah (jarak < 1 km); sebagian besar memiliki vegetasi ³ 3 jenis dan berada di daerah dengan curah hujan tinggi. Faktor lingkungan yang terbukti berhubungan dengan leptospirosis adalah kondisi jalan yang buruk sekitar rumah (OR = 4,90; CI 95% = 1,35 - 17,10). Faktor perilaku yang berhubungan dengan leptospirosis adalah kebiasaan mandi/mencuci di sungai (OR = 4,35; 95% CI = 1,21 - 15,60), riwayat peran serta dalam kegiatan sosial yang beresiko (OR = 12,00; 95% CI = 1,45 - 99,09) dan penggunaan alat pelindung diri (OR = 7,50; 95% CI = 1,00 - 62,18). There were 13 Leptospirosis cases in Banyumas in 2013. The increasing incidents in last 2 years should get an attention from all institutions. The study conducted was to map incidence of leptospirosis and analyze the environmental and behavior risk factors which associated leptospirosis case. This research was observational by case-control approach. The data was collected through interviews, observation and test. For analyzing the data, the researcher applied spatial analysis, univariate, and bivariate analysis. It was 13 leptospirosis cases and 52 people as the controls; they are the neighbors who are free from leptospirosis.The mapping showed that leptospirosis cases in Banyumas were along the riverin 600 meters radius, all cases with the distance of 0 - 1 km into the rice field, had vegetation 3 species and those were in areas with high rainfall intensity. Environmental risk factor associated with leptospirosis was a bad road conditions around the house (OR = 4,90; CI 95% = 1,35 - 17,10). Behavior risk factors werethe bathing/washing habit in the river (OR = 4,35; 95% CI = 1,21 - 15,60, a history of participation in social activities (OR = 12,00; 95% CI = 1,45 - 99,09)and the use of personal protective equipment (OR = 7,50; 95% CI = 1,00 - 62,18).

References

1. Widiyono. Penyakit tropis. Epidemiologi, penularan, pencegahan dan pemberantasannya. Jakarta: Erlangga; 2008 2. Kementerian Kesehatan Republik Indonesia. Profil data kesehatan Indonesia Tahun 2012 [online]. 2012 [diakses tanggal 21 Maret 2013]. Diunduh dalam: http://www.depkes.go.id. 3. Rejeki, DSS. Faktor risiko lingkungan yang berpengaruh terhadap kejadian leprospirosis [Tesis]. Semarang: Universitas Diponegoro; 2005. 4. Febrian F, Solikhah. Analisis spasial kejadian leptospirosis di Kabupaten Sleman Propinsi Daerah Istimewa Yogyakarta Tahun 2011. Kesmas Jurnal Kesehatan Masyarakat Nasional. 2011; 7 (1): 7-14. 5. Sunaryo. Sistem informasi geografis untuk pemetaan dan penentuan zona kerawanan leptospirosis di Kota Semarang. 2009 [diakses tanggal 2 November 2013]. Diunduh dalam: http://eprints.undip.ac.id/19202/- 1/1OR04-Sunaryo-GIS-Leptospirosis.pdf. 6. Renato BR, Ribeiro SG, Felzemburgh MDR, Santana SF, Mohr S, Mendelez OTXA, et al. Impact of environment and social gradient on leptospira infection in urban slums. Plos Neglected Tropical Disease [serial on the internet]. 2008; [cited 2013 Nov 20]; 2 (4). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2292260. 7. Faria MT, Calderwood MS, Athanazio DD, McBride AJA, Hartskeerl RA, Pereira MM, et al. Carriage of leptospira interrogans among domestic rats from an urban setting highly endemic for leptospirosis in Brazil. Acta Tropica [serial on the internet]. 2008 [cited 2013 Nov 30]; 108 (1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/- PMC2596941. 8. Felt AS, Wasfy OM, El-Tras FW, Samir A, Rahman AB, Boshra M, et al. Cross-species surveillance of leptospira in domestic and peri-domestic animals in Mahalla City. Am J Trop Med Hyg [serial on the internet]. 2011 [cited 2013 Nov 28]; 84(3): 119-129 . Available from: http://- www.ncbi.nlm.nih.gov/pubmed/21363980. 9. Sugunan AP, Vijayachari P, Sharma S, Roy S, Manickam P, Natarajaseenivasan K, et al. Risk factors associated with leptospirosis during an outbreak in middle Andaman India. Indian J Med Res [serial on the internet]. 2009 [cited 2013 Nov 30]: 130. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19700804 10. Victoriano AF, Smythe LD, Barzaga NG, Cavinta LI, Kasai T, Limpakarnjanarat K, et al. Leptospirosis in the Asia Pacific Region. Biomed Infect Dis [serial on the internet]. 2009 [cited 2013 Nov 10]; 9 (47). Available from: http://www.biomedcentral.com/1471-2334/9/- 147/. 11. Ullmann, Langoni. Interactions between environment, wild animals an human leptospirosis. J Venomous Anim Toxins Trop Dis [serial on the internet]. 2011 [cited 2013 Nov 30]; 17 (2). Available from: http://www.scielo.br/scielo.php?pid=S1678-91992011000200 002&script=sci_arttext. 12. Bhardwaj P, Kosambiya KJ, Desai KV. A case control study to explore the risk factors for acquisition of leptospirosis in Surat City after flood. Ind J Med Sci [serial on the internet]. 2008 [cited 2013 Nov 10]; 62 (11). Available from:http://www.ncbi.nlm.nih.gov/pubmed/19265232. 13. Anies, Hadisaputro S, Sakundarno AM, Suhartono. Lingkungan dan perilaku pada kejadian Leptospirosis. Media Medika Indonesia. 2009; 43 (6): 306-311 14. Brockmann S, Piechotowski I, Hensley OB, Winter C, Oehme R, Zimmermann S, et al. Outbreak of leptospirosis among triathlon participants in Germany, 2006. BioMed Central Infect Dis [serial on the internet]. 2010 [cited 2013 Nov 30]; 10 (91). Available from: http://- www.biomedcentral.com/1471-2334/10/91. 15. Dinas Kesehatan Kabupaten Banyumas. Profil Kesehatan Kabupaten Banyumas. Banyumas 16. Robertson C, Nelson TA, Stephen C. Spatial epidemiology of suspected clinical leptospirosis in Sri Lanka. Epidemiol Infect [serial on the internet]. 2012 [cited 2013 Nov 30]; 140. Available from: http ://www. search.proquest.com. 17. Davis S, Calvet E, Leirs H. Fluctuating rodent populations and risk to humans from rodent-borne zoonoses. Vector-Borne Zoonotic Dis [serial on the internet]. 2005; 5 [cited 2013 Nov 5]. Available from: http://- www.ncbi.nlm.nih.gov/pubmed/1641742. 18. Tassinari WS, Pellegrini DC, Sa CB, Reis RB, Ko Al, Carvalho MS. Detection and modeling of case clusters for urban leptospirosis. Trop Med Hygiene [serial on the internet]. 2008 [cited 2013 Nov 30]; 13. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18312472. 19. Dassanayake D, Harith W, Suneth BA, Veranja CL, Thibbotumunuwe ACLP, Bimba LG. Evaluation of surveillance case definitions in the diagnosis of leptospirosis, using the microscopic agglutination test. BMC Infect Dis [serial on the internet]. 2009 [cited 2013 Nov 5]; 9 (48). Available from: http://www.biomedcentral.com/1471-2334/9/48. 20. Riyaningsih, Hadisaputra S, Suhartono. Faktor risiko lingkungan terhadap kejadian leptospirosis di Jawa Tengah (studi kasus di Kota Semarang, Kabupaten Demak dan Pati). Jurnal Kesehatan Lingkungan. 2012; 11(1): 87-94. 21. Svircev Z, Markovic MJ, Vukadinov J, Mikic SS, Ruzic M, Doder R, et al. Leptospirosis distribution related to freshwater habitats in the Vojvodina Region (Republic of Serbia). Sciences in China Series: Life Sciencs [serial on the internet]. 2009 [cited 2013 Nov 30]; 52 (10). Available from:http://www.ncbi.nlm.nih.gov/pubmed/19911133.

Share

COinS