VAKTOR-FAKTOR RISIKO YANG MEMPENGARUHI KEMDIAN PENYAKIT DEMAM BERDARAH DENGUE (DBD) SERTA JENiS INFEKS1 VIRUS DI KOTA BALIKPAI'AN

Abstract

Risk factors that influence the occurrence of dengue haemorrhagic fever disease (DUE) and type of viral infection at Balikpapan city" xviii + 118 pages + table + graph + picture + appendixes Background. Dengue haemorrhagic fever (DHF) is a communicable disease caused by a dengue virus and spreaded by Aedes sp especially Aedes aegypti. The ordinary sign and symptoms of DHF are fever for 2 — 7 days , bleeding tendency with at least one of these signs: tourniquet test positive, petekie, ochimosis or purpura, mukosa bleeding, gastrointestinal bleeding, injection spot or spot from other location of the body, hematemesis or melena, trombositopenia (< 100.000 cell per mm3) Case Fatality Rate of DHF decreases from 3,7 % (1997) to 0,65 % (1999) starting from the year of 2000, CFR tends to increase compared to CFR in the previous year. Objective. The objective of this study are : 1). To know the risk factors of DHF by calculating Odds Ratio (OR) ; 2). To know the types of DIE viral infection in Balikpapan . Methods. This is a case control study using 76 case and 152 controls. Control of non DI-IF patients found in hospital and in the community surrounding the case. Factors included in this study are environmental sanitation, vector control behavior. Multivariat logistic regression was used to analysis the data. Result. The study shows that the most of respondent are in the age group of 1 — 11 year-old (36,5 %), male (57,7 %). Risk factors of DHF found significant in Balikpapan city are Aedes aegypti (OR = 10,1; 95 % CI = 4,8 — 21,0; p = 0,0001), the present of plants around the house, (OR = 2,1 ; 95 % CI = 1,2 — 4,3; p=0,045), unclear yard of hawse every day (OR = 2,7 ; 95 % CI OR = 1,1 — 6,6 ; p = 0,027), the habit of hanging the clothes ( OR= 2,9 ; 95 % CI OR= 1,2 — 7,1; p = 0,023). DEN-4 type of virus is found in all of the types of DHF infections. Conclusion. The present of Aedes aegypti surrounding the house has the highest risk of infected by DHF (OR= 10,1), DEN-4 is the only type of DHF virus found in Balikpapan city. Suggestion. Case monitoring and entomological monitoring need to be intensified through cross program, cross sectoral collaboration and community participation have to be more active. Latar belakang.Penyakit Demam Berdarah Dengue (DBD) adalah penyakit menular yang disebabkan oleh virus dengue dan ditularkan nyamuk Aedes sp terutama Aedes aegypti. Gejala dan tanda umum DBD demam 2 — 7 hari, kecendrungan perdarahan sedikitnya dengan satu hal : uji tourniquet positif, petekie, ekimosis atau purpura, perdarahan dari mukosa, pendarahan saluran gastrointestinal, tempat injeksi atau lokasi lain, hematemesis atau melena, trombositopena (<100.000 sel per mm3) Terdapat penurunan CFR dari DBD tahun 1997 3,7 % , tahun 1999 0,65 %, namun pada tahun 2000 dan 2001 ada kecenderungan naik di banding tahun 1999. Tujuan. Mengetahui faktor risiko dan urutan besar faktor risiko serta jenis infeksi virus terhadap kejadian penyakit DBD di Kota Balikpapan. Metode. Desain penelitian yang digunakan kasus kontrol dengan 76 kasus dan 152 kontroL Kontrol terdiri dad tidak menderita penyakit DBD di rumah sakit dan di masyarakat sekitar penderita penyakit DBD. Faktor risiko yang tennasuk dalam penelitian ini sanitasi lingkungan, perilalaku pemberantasan vector. Analisis data multivariate dengan menggunakan regresi logistic. HasiL Umur terbanyak 1 — 11 tahun (36,5 %), laki-laki 30 (57,7 %). Faktor risiko DBD di kota Balikpapan hasil uji regresi logistic : jenis vektor OR = 10,1 (95 % CI OR= 4,8 — 21,0; p= 0,0001) , tanaman sekitar rumah OR = 2,1 (95 % CI OR = 1,2 — 4,3; p=0,045) , membersihkan halaman rumah OR = 2,7 (95 % CI OR = 1,1 — 6,6 ; p = 0,027) dan kebiasaan gantung pakaian OR= 2,9 (95 % CI OR= 1,2 — 7,1; p = 0,023) Kesimpulan. Aanya Aedes aegypti di sekitar rumah mempunyai risiko tinggi untuk tertular DBD. Jenis infeksi virus yang terbanyak di kota Balikpapan adalah DEN-4. Saran. Meningkatkan pengamatan kasus dan pengamatan entomologi, lintas program, lintas sektoral, menggerakkan peran aktif dan merubah perilaku masyarakat.