BERBAGAI FAKTOR RISIKO KECACATAN KUSTA TINGKAT II (STUDI DI KABUPATEN NAGAN RAYA PROVINSI ACEH)

Abstract

Latarbelakang: Kecacatan tingkat II merupakan suatu kelainan pada mata, tangan dan kaki. Kabupaten Nagan Raya terdapat 41% daerah endemis, prevalensi 4,33 per 10.000 penduduk dengan angka kecacatan sebanyak 5%. Berbagai faktor risiko kecacatan kusta tingkat II sudah diketahui, namun terdapat beberapa faktor risiko yang belum diketahui di Kabupaten Nagan Raya, seperti karakteristik individu, sosial budaya dan pengobatan tradisional. Penelitian ini bertujuan untuk membuktikan beberapa faktor host dan environment merupakan faktor risiko kecacatan kusta tingkat II. Metode: Penelitian ini menggunakan pendekatan observasional dengan desain kasus kontrol terhadap variabel jenis kelamin, umur saat diagnosis, tingkat pendidikan, tingkat pengetahuan, jenis pekerjaan, kecepatan diagnosis, keteraturan minum obat, sosial ekonomi, perawatan diri, tipe kusta, jumlah lesi, dukungan keluarga, pengobatan tradisional, dan stigma kusta. Jumlah subyek sebanyak 84 responden, terdiridari 42 kasus (cacat kusta tingkat II) dan 42 kontrol (kusta tanpa cacat), dipilih secara consecutive sampling dengan memperhatikan kriteria inklusi dan eksklusi. Pengumpulan data dilakukan dengan metode wawancara. Analisis data secara bivariat dengan uji chi-square dan multivariat dengan uji regresilogistik. Hasil : Terdapat lima variabel yang merupakan faktor risiko terhadap kecacatan kusta tingkat II, yaitu umur saat diagnosis > 15 tahun (OR=8,4, 95% CI=1,1-63,3, p=0,039), diagnosis dini lambat (OR=5,4, 95%, CI=1,5-19,6, p=0,011), mendapat stigma kusta (OR=4,9, 95% CI=1,6-15,1, p=0,006), tipekusta MB (OR=3,9, 95%, CI=1,3-12,1, p=0,015) dan tingkat pendidikan rendah (OR=3,4, 95% CI=1,1-10,9, p=0,038). Simpulan : Beberapa faktor host dan environment terbukti berisiko terhadap kecacatan kusta tingkat II adalah umur saat diagnosis > 15 tahun, diagnosis dini lambat, mendapat stigma kusta, tipe kusta MB dan tingkat pendidikan rendah, dengan probabilitas sebesar 99,96%.Penderita diharapkan tidak menutup diri terhadap informasi dan program pengawasan yang dilakukan petugas kesehatan, serta masyarakat tidak mengucilkan penderita kusta. Kata Kunci:Risiko kusta, kecacatan kusta tingkat II, host, environment, sosial budaya. Background: Level II disability is an abnormality in the eyes, hands, and feet in people with leprosy. Forty one percent of Nagan Raya Regency is endemic area with the prevalence of 4.33 per 10.000 people with the number of disability around 5%. Various risk factors of leprosy-related disability level II is already known, however there are some variables still unknown, those are characteristic of the individual, social cultural and tradisional medicine. This research aims to prove some host and environment factors that become the risk factors of disability for level II leprosy. Method: This research used observasional case-control design approach with the variable of sex, age during diagnosis, regularity of taking medicine, socio-economic condition, self treatment, type of leprosy, family support, traditional medicine, and stigma. The subjects of this research are 84 respondents with 42 cases of level II leprosy and 42 controls (leprosy without disability). The samples were selected with consecutive sampling by considering the criteria of inclusion and exclusion. The data gathering was conducted with interview method. The data were analyzed with bivariate with chi square test and logistic regression test. Result: Five variables that had the risk towards leprosy level II disability were age at the diagnosis time > 15 years (OR=8.4, 95% CI=1,1-63.3, p=0.039), too late to do early (OR=5,4, 95%, CI=1,5-19,6, p=0,011), getting negative stigma of leprosy (OR=4,9, 95% CI=1.6-15.1, p=0.006), type of leprosy MB (OR=3.9, 95%, CI=1,3-12,1, p=0.015), and low level of education (OR=3.4, 95% CI=1,1-10.9, p=0.038). Conclusion: Some factors of host and environment that were proven to have risk towards leprosy disability of level II are the age at the time of diagnosis > 15 years, slow early diagnosis, getting negative stigma about leprosy, kind of leprosy MB and low level of education with the probability of 99.96 %.The patients should openly share information and be cooperative with supervision program from medical service. In addition, the community must not isolate and discriminate the poeple with leprosy. Keywords: leprosy risk, leprosy, leprosy disability level II, host, environment, socio cultural