Analisis Spasial Faktor yang Memengaruhi Kasus Malaria pada Daerah Pra Eliminasi Kabupaten Bireuen Tahun 2012-2013

Abstract

The Government of Indonesia has been committed to achieve malaria elimination by 2030, however, there are still 323 districts/ city categorized as malaria endemic area (2011). Bireuen District of Aceh Government territory (2013) has entered the pre-elimination phase (API <1 / %, 16 positive cases), but the malaria cases hasn't registered into the GIS. The objective of this study was to analyze spatially the determinant of malaria cases and media communication of public awareness in the community.

This study was an analytical by age and sex matched pairs case-control design in Bireuen District. The data were collected from September 2013 10 July 2014, of a total sampling (2012-2013) 106 samples (53 cases and 53 controls), were interviewed regarding socio-demographics, habits of outdoor activities at night and observed bet nets usage. All geographic coordinates of Malaria cases, mosquito breeding sites and cattle sheds were collected with GPS Garmin Etrek-10, spatial analysis by Quantum-GIS, Chi-square test and multiple logistic regression.

Comparing the cases and control group respondent, the result shows educational background was predominantly in elementary school (52.8% vs 41,5%), more work a risk (71,7% vs 7,5%), no use bet nels (73,6% vs 11,3%), habits of outdoor activities at night (38,7% vs 75,5%), close to the breeding places (81,1% vs 30.2%), far from the cattle sheds (79,2% vs 56.6%). Spatial analysis showed that malaria cases were located along the plains and coastal area, forming a clusters with the breeding places of Anopheles sp. within the area of 2 m, meaning local (indigenous) transmission has occurred in Bireuen District. Bivariate analysis showed there were association among risky jobs, behaviour of bednets usage, mosquito breeding places, and the location of big cattle sheds with Malaria cases (p <0.05). Multivariate analysis showed three factors influencing malaria cases such as risky job especially gold mining and working in the forest [OR = 17 (95% CI: 3.7 to 77.8)]. the availability of breeding places of Anopheles sp. [OR = 10.6 (95% CI: 2.6 10 42.7)]. and did not use mosquito nets when sleeping at night [OR = 9 (95% CI 2.3 10349]

It is suggested to improve knowledge of community members to prevent/ control Malaria by sending "text message” through mobile phone and direct promotion through the local wisdom specific forum, " learning Islamic together in Meunasah or small mosque”.