Strategi Penanggulangan Penyakit Malaria dengan Pendekatan Faktor Risiko di Daerah Endemis Kabupaten Aceh Utara Provinsi Nanggroe Aceh Darussalam Tahun 2007

Abstract

Malaria is still a problem of community health in Indonesia as well as Nanggroe Aceh Darussalam (NAD). The Annual Malaria Jncidens (AMI) at 2006 in NAD was 32,12 %0 of the population with 12 deaths. Matang Kuli and Nisam subdistricts are two of the 13 malaria endemic subdistricts in Aceh Utara district. Based on the AMI indicators, malaria case in Aceh Utara district within the period of 2004 to 2006 ware 3,55 %0, 4,36 %0 and 3,67 %0 within the period of 2004 to 2006 in Matang Kuli subdistrict ware 31,4 %0, 26,8 %0 and 19,3 %0 and in Nisam subdistrict ware 29,8 %0, 23,5 %0 and 16, 7 %0 resprectively. To obtain a model for malaria control through the risk-factor approach in the malaria endemic areas in Aceh Utara district, an observational study with control case design was conducted to the citizens of 14 to 60 years old. The samples consisted of 95 persons suffering from clinical malaria and 95 person who, based on their health history, never suffer from malaria but all of them are of the same characteristics in the terms of age, sex and address. The result of bivariate analysis ( Chi-Square test) shows that there is a significant relationship with p value < 0,05 in the habitat Anopheles spp, the environmental, human and vector factor. Based on the result of multivariate test (Logistic regretion), several variables are included to be model candidate (predictor variable) such as the existence of pond (OR=97,7), marshes (OR=22,8), mosquito resting place (OR=30,9), house with many mosquitoes (OR=0,02), poor action (OR=0,03), the existence oflarva (OR=30,5), and Anopheles spp (OR=183,3). The conclution of this study is that several factors such as the existence of vector habitat/multiplying site, environmental condition, the existence of Anopheles spp and its larva are statistically significant in giving a dominant contribution to the incidens of malaria and a fit model to control malaria that can predict the increase or decrease of malaria incidens rate in the malaria endemic areas in Aceh Utara district has been invented. Through this malaria control model, a more directed and integrated intervention activity can be implemented in Aceh Utara district, specially in its malaria endemic areas.