FAKTOR—FAKTOR RISIKO KEJADIAN PENYAKIT CAMPAK DI KABUPATEN KENDAL TAKLA 2002

Abstract

Background : Measles still a public health problem in Kendal Regency. From 1999 to 2001, there were 4 times of outbreaks with 893 cases within the period. The average of measles immunization has achieved more than 85% for UCI, namely 91,3% (1999), 96,0% (2000) and 88,9% (2001). These conditions could have a relation to some risk factors such as ; un immunization status, malnutrition status, high-risk age, contact history, environment condition and social economic status. Objective : to verify the risk factors of measles disease. The total samples were 114 children under 15 years old, who visited to Hospital, Public Health Center and other health care facilities in Kendal. In this case, the children having the measles disease as cases and the not measles disease was not considered as the control. Method : an observational analytic research with case control study design. The data were gained through direct interview and focus group discussion. The hypotheseses were tested by statistic analysis. Result : it is statistically found (p<O, 25) that some risk factors have a relation with measles. There are major five factors that have a relation with measles incidence namely; high risk age (OR=4,9), bad community perception about measles (OR=3,9), malnutrition status (OR=4,9), contact history (OR=3, I) and housing density (OR=2,6). Due to that background, the risk that children will suffer from measles is of 94%. Conclusion : In Kendal Regency, measles have relation with high risk age, bad community perception about measles, malnutrition status, contact history and housing density of the patient, as risk factors. Suggestion : It is necessary to isolate the case and give additional immunization to children of high-risk age, as well as to improve their nutritional status. We must also give special attention to the atmosphere on condition of room in order to expose them to more sunshine; it is important to pay attention at the utility of house ventilation to decrease the risk of density. Report and record of measles case should be accurate, and dissemination of information to community is also useful. Latar belakang : Penyakit campak di Kabupaten Kendal masili menjadi masalah kesehatan masyarakat. Sejak tahun 1999 — 2001 terjadi 4 (empat) kejadian luar biasa (KLB) dengan angka kejadian 893 selama kurun waktu tersebut. Pencapaian cakupan imunisasi pada periode yang sama rerata tiap tahun sudah mencapai UCI (>85%), yaitu; 91,3% (1999), 96,0% (2000) dan 88,9% (2001). Kondisi ini mungkin berliubungan dengan beberapa faktor risiko, antara lain ; Status tidak imunisasi, status gizi yang kurang, umur rentan, kondisi lingkungan dan sosial ekomoni yang rendah. Tujuan penelitian : Membuktikan faktor-faktor risiko kejadian penyakit campak dengan melibatkan sampel sebanyak 114 anak usia kurang dari 15 tahun yang berkujung ke Rumah Sakit, Puskesmas dan sarana kesehatan lain di Kabupaten Kendal, dimana anak sakit campak sebagai kasus dan bukan campak sebagai kontrol. Bahan dan Cara : Penelitian analitik observasional dengan disain studi kasus kontrol. Data penelitian diperoleh dengan wawancara langsung dan diskusi kelompok terfokus (DKT) serta analisis statistik untuk menguji sejumlah hipotesis. HasiI : ditemukan cukup bukti secara statistik hubungan lima faktor risiko spesifik (pc0,25) dengan kejadian penyakit campak di Kabupaten Kendal tahun 2002, yaitu : umur rentan (OR=4,9), persepsi jelek tentang campak (OR=3,9), gizi kurang (OR=4,9), riwayat kontak (OR=3,1) dan kepadatan hunian (OR=2,6). Dengan latar belakang tersebut, besar peluang anak terkena sakit campak sebesar 94%. Kesimpulan : Kejadian penyakit campak di Kabupaten Kendal berhubungan dengan umur rentan, persepsi jelek masyarakat tentang campak, status gizi kurang, riwayat kontak dan kepadatan hunian. Saran : Isolasi tehadap kasus campak, pemberian imunisasi tambahan dan peningkatan gizi pada kelompok anak usia rentan. Pernanfaatan ventilasi rumah untuk mengurangi risiko kepadatan, pencatatan dan pelaporan kasus yang akurat dan penyuluhan masyarakat tentang penyakit campak.