HUBUNGAN ANTARA FAKTOR LINGKUNGAN DAN PERILAKU DENGAN KEJADIAN HEPATITIS A PADA TARUNA AKADEMI KEPOLISIAN TAHUN 2008 STUDI DI AKADEMI KEPOLISIAN REPUBLIK INDONESIA SEMARANG

Abstract

Heptitis A merupakan salah satu penyakit endemis di beberapa daerah di dunia saat ini. Kejadian hepatitis A di Akpol merupakan bukti bahwa penyakit tersebut mudah menular dari orang ke orang lain. Jumlah kasus hepatitis A di Akpol (37 kasus) patut mendapatkan perhatian semua pihak khususnya pimpinan. Penularan hepatitis A di Akpol diduga terkait dengan kondisi lingkungan (air bersih, praktik pengelolaan makanan, personal hygiene Taruna). Penelitian ini bertujuan untuk mengkaji factor-faktor yang berkaitan dengan kejadian hepatitis A di Akpol Semarang. Penelitian ini merupakan penelitian observasional dengan rancangan case control. Subyek penelitian ini terdiri dari kelompok kasus (37 responden) dan kelompok kontrol (37 responden). Variabel bebas yang diteliti meliputi kondisi air bersih, sanitasi MCK, praktik personal hygiene Taruna, pengetahuan dan praktik penjamah makanan, kondisi populasi lalat. Pengumpulan data dilakukan dengan wawancara dan observasi langsung. Data hasil penelitian dianalisis secara deskriptif dan uji Chi-quare dengan alpha 0,05. Hasil penelitian menunjukkan bahwa kondisi air bersih dan sanitasi MCK di Akpol dalam keadaan baik dengan tersedianya kamar mandi dan WC pada setiap kamar Taruna/Taruni. Masih ditemukan lalat di tempat pengolahan makanan (dapur) walupun kepadtannta relative rendah.Titik kritis pengelolaan makanan terletak pada penampungan makanan masak sebelum diangkut ke ruang makan serta tempat simpan peralatan makan, serta kondisi dapur agak licin. Keberadaan vektor yang ditemukan adalah lalat dengan populasi di dapur dan tempat distribusi air minum perlu mendapat perhatian. Penjamah makanan sering menggaruk-garuk kepala saat memasak makanan dan tidak memakai tutup kepala. Personal hygiene Taruna/Taruni relatif baik, namun kebiasaan cuci tangan sebelum makan belum menjadi tradisi Taruna/Taruni sebagai bentuk perilkau hidup bersih dan sehat. Hasil analisis statistik menunjukkan bahwa belum cukup bukti untuk mengatakan kondisi air bersih, sanitasi MCK dan personal hygiene Taruna sebagai faktor risiko kejadian hepatitis A (p-value > 0,05). Penelitian ini menyimpulkan bahwa dimungkinkan kasus Hepatitis A terjadi di luar Akpol namum penyebaran dari Taruna satu ke yang lainnya terjadi di dalam Akpol. Para Taruna/Taruni perlu meningkatkan personal higienenya dengan membiasakan diri mencuci tangan sebelum makan. Pengedalian lalat di dapur tetap perlu dilakukan untuk mencegah paparan makanan dan lalat yang ada. Kata kunci: Hepatitis A, Sanitasi air bersih dan MCK, personal hygiene, Akpol Master of Environmental Health Diponegoro University, 2009 Concentration of Environmental Health Industry SETIJANI DWIASTUTI ABSTRACT THE RELATIONSHIP BETWEEN ENVIRONMENTAL AND BEHAVIOR FACTOR WITH HEPATITIS A INCIDENCE ON PILICE ACADEMY STUDENTS SEMARANG, YEAR OF 2008 xiv + 104 Pages + 25 Tabels + 12 figures + 50 appendices Hepatitis A is one of endemic diseases occurred worldwide. Hepatitis outbreak in Police Academy was one of evidence that hepatitis could transmit person to person easily. A number of 37 case of hepatitis A in Police Academy made someone should pay attention. The transmission of hepatitis might be related to environmental condition (water supply and sanitation). This study aimed to analyze factors related to hepatitis A incidence on Police academy students. It was an observational research using case control design. The subjects were devided into two groups namely cases (37 respondents) and control (37 respondents). Independent variables studied in this research include water supply and sanitary condition, personal hygiene practice of Police Academy Students, food handler’s knowledge and practice, and fly density. Data collection was conducted by interviewing and direct observation. Data would be analyzed descriptively and using Chi-square test at 0,05 level of significance. The result showed that water supply and sanitary facility was in good condition with the existence of bathing room and water closed for every bed room. Flies were still existed in the kitchen although in a low density. The critical point of food handling was at the collection point for cooked food and keeping of utensil. While cooking, food handler often hold their head and no cap. The personal hygiene of students were good, but hand washing was not still done routinely yet. Based on the statistical analysis, no variable had associated with hepatitis incidence (p>0,05). This research concluded that index case of hepatitis A might occurred out of Police Academy but transmission could be in It. It was suggested that Police Academy Students always increase their personal hygiene through hand washing intensively by using desinfection/soap before eating. Beside that, It was important to control fly density in the kitchen in other to reduce exposure between food and fly. Keywords: Hepatitis A, water and sanitation, personal hygiene, Academy Police.