ANALISIS SPASIAL DAN TEMPORAL DEMAM BERDARAH DENGUE DI KOTA TANJUNGPINANG TAHUN 2016

Abstract

Latar Belakang: Demam Berdarah Dengue/Dengue Haemorrhagic Fever (DHF) merupakan masalah dalam kesehatan masyarakat, dengan kecenderungan berdasarkan moilitas dan kepadatan penduduk yang mengikuti pola siklus kasus. Kasus Demam Berdarah Dengue di Kota Tanjungpinang pada tahun 2014 sebanyak 559 kasus (Incidence Rate= 27,98 per 10.000 penduduk dan case fatality rate= 0,17%), Incidence rate mengalami penurunan menjadi 17,5 dari total kasus 358 pada tahun 2015 namun case fatality rate mengalami peningkatan yaitu 0,83%. Pada tahun 2016 kasus sebanyak 306 kasus Demam Berdarah Dengue dan Case Fatality Rate= 0,32%. Penelitian ini bertujuan untuk melakukan analisis spasial kejadian Demam Berdarah Dengue berdasarkan faktor-faktor klimatis (suhu, curah hujan, dan kelembaban), demografi (kepadatan populasi, jumlah bangunan), program pengendalian DBD (larva-free number), dan peruntukkan lahan. Metode: Penelitian ini merupakan analisis deskriptif yang menggunakan rancangan penelitian potong lintang (cross-sectional), dimana variabel penelitian diperiksa pada waktu yang sama dari keseluruhan populasi. Pendekatan spasial temporal digunakan untuk menganalisa distribusi kasus-kasus dan untuk mengamati perubahan iklim yang mempengaruhi kejadian demam berdarah dengue. Penelitian menggunakan Global Positioning System (GPS), data dikumpulkan untuk menentukan koordinat dari lokasi pasien. Hasil: Hasil dalam penelitian ini menunjukkan bahwa distribusi kasus DBD tertinggi di Kota Tanjungpinang pada tahun 2016 adalah di Kecamatan Tanjungpinang Timur, yakni sebanyak 117 kasus dengan Incidence Rate sebesar 40,5 per 100.000 penduduk, sementara kasus DBD terendah ada di Kecamatan Tanjungpinang Barat, yakni 19 kasus dengan Incidence Rate sebesar 9,2 per 100.000 penduduk. Sebagian besar kasus (34,2%) terjadi pada anak usia 5 sampai 9 tahun. Dalam hubungannya dengan peruntukkan lahan di Kota Tanjungpinang, sebagian besar area permukiman terletak di Kecamatan Tanjungpinang Timur. Kesimpulan: Pola-pola spasial yang beragam dalam aksesibilitas populasi juga menyebabkan distribusi kasus DBD yang beragam, mengikuti mobilitas dari kegiatan manusia. Pola-pola distribusi dari kasus DBD sangatlah dipengaruhi oleh jumlah bangunan, kepadatan penduduk, Angka Bebas Jentik dan peruntukkan lahan yaitu melihat populasi yang saat ini sangat sulit untuk diprediksi dengan indikator yang tidak terencana (jumlah gedung, kepadatan populasi, penggunaan lahan pemukiman). Kasus DHF sangat dipengaruhi oleh peubahan-perubahan dalam lingkungan fisik, demografis dan topografi. Kata Kunci: Demam Berdarah Dengue, Distribusi Spasial, Sistem Informasi Geografis, Kota Tanjungpinang Introduction: Dengue haemorrhagic fever (DHF) has emerged as an important public health problem, with an extensive incline, following an increase in mobility and population density following the cycle pattern of cases. In Tanjungpinang City, there were a total of 168 DHF cases in 2013 (the Incidence Rate = 8.52 per 10.000 inhabitants and the case fatality rate = 0.59%), which in 2014 increased into 559 cases (the Incidence Rate = 27.98 per 10.000 inhabitants and the Case Fatality Rate = 0.17%), the incidence rate decreased into 17.5 from a total of 358 cases in 2015, while the case fatality rate increased into 0.83%. In 2016, there were a total of 306 DHF cases with the case fatality rate by 0.32%. This research aimed to do spatial temporal approach analysis of the incidence of DHF which was then related to the spatial temporal scope like climatic factors (temperature, rainfall, and humidity), demography (population density, the number of buildings), DHF alleviation programs (the larva-free number), and land use patterns. Method: This is descriptive analytic survey research using a cross-sectional research design, where the research variables were inspected at the same time from the whole population. A spatial temporal approach was used to analyze distribution of the cases and to observe climate change retrospectively that affect the form of the dengue incidence and the analysis pattern. Using the Global Positioning System (GPS), data were collected to determine the coordinates of patients’ location. Results: Results of this research suggest that the highest distribution of DHF patients in Tanjungpinang City in 2016 was in East Tanjungpinang Subdistrict, namely by 117 cases with the IR (Incidence Rate) equal to 40.5 per 100.000 inhabitants, while the lowest one was found in West Tanjungpinang Subdistrict, namely by 19 cases with the IR (Incidence Rate) by 9.2 per 100.000 inhabitants. Most cases (33.8%) took place at the age of 5 to 9 years old. In relation to land use in Tanjungpinang City, most residential areas are situated in East Tanjungpinang Subdistrict. Discussion and Conclusions: Understanding the spatial characteristics of dengue haemorrhagic fever (DHF) incidence is highly crucial for governmental agencies to implement effective disease control strategies. Various spatial patterns in the population accessibility also bring a varied distribution of DHF cases, following the mobility of human activities. The distribution patterns of DHF cases are affected by the patterns of number of buildings, population density, and larve free rate that are currently difficult to be predicted with unplanned settlements (number of buildings, population density, settlement land use). DHF cases are strongly influenced by changes in physical environment, demographics, and topography. Keywords: Dengue Haemorrhagic Fever, Spatial Distribution, Geographical Information System, Tangjungpinang City