STUDI MAKRO EPIDEMIOLOGI KEJADIAN MALARIA
DENGAN PENDEKATAN SPASIAL DAN TEMPORAL TERKAIT TATA GUNA LAHAN DAN METEOROLOGIS DI KECAMATAN BINTAN UTARA
KABUPATEN BINTAN PROVINSI KEPULAUAN RIAU
MACROEPIDEMIOLOGY STUDY ON THE INCIDENCE OF MALARIA USING SPATIAL AND TEMPORAL APPROACHES IN RELATION TO LANDUSE MANAGEMENT AND METEOROLOGY AT SUBDISTRICT OF BINTAN UTARA, DISTRICT OF BINTAN, PROVINCE OF KEPULAUAN RIAU
Muslim1, Sugeng Juwono Mardihusodo2, Hari Kusnanto3
Background : Malaria is an infectious disease caused by blood protozoa, Plasmodium sp. and transmitted by Anopheles sp. Factors affecting malaria infection includes direct factors such as number of mosquito bites, mosquito density, duration of sporogonic cycle, age of mosquitoes and number of parasite carriers as well as indirect factors, namely land use management and meteorology. Clinical malaria incidence in 2006 and 2007 at District of Bintan increased from 125,3/1000 people in 2006 to 127,2/1000 people in 2007, whereas Annual Parasite Incidence (API) decreased from 16,4/1000 people to 9,6/1000 people in 2007. Meanwhile, at Subdistrict of Bintan Utara Annual Malaria Incidence (AMI) increased and API did not increase. API cases increased from 586 to 1.006 in Subdistrict of Bintan Utara, a malaria endemic area at District of Bintan.The research problem is whether malaria incindence at Subdistrict of Bintan Utara is related to land use management and meteorology.
Objective : To get an overview of malaria macroepidemiology in relation to land use management and climatic factors using spatial approach and trend in malaria incidence using temporal approach based on morbidity data 2005-2007 at Subdistrict of Bintan Utara, District of Bintan, Province of Kepulauan Riau.
Method : The study was an analytic cross sectional survey with observational design. Subject consisted of 248 postive malaria patients according to the report of laboratory registry at Tanjung Uban Health Center during 2007. The dependent variable was malaria incidence and the independent variables were land use management and meteorology. Spatial data analysis used clustering, space time permutation model (Likehoold Ratio Test) and trend analysis.
Result : There was significant relationship between land area and malaria incidence (p=0.0440940). There was no significant relationship between areas for plantation, dwelling, swamp, deserted sand mining, temperature, humadity and rainfall and malaria incidence (p>0.05).
Conclusion : Forest area was cause for malaria incidence because cutting down trees in forest areas could cause the emergence of increased mosquito breeding places that accelerated reproduction of Anopheles maculatus and the process of infection to human. Plantation, swamp, dwellings, and sand mining were not cause for malaria incidence. Climatological aspect such as temperature, humadity and rainfall were not could cause for malaria incidence either. There was increasing trend of malaria incidence in 2005-2007 and there was evidence of local transmission that enable the emeregence of most likely clusters at Kelurahan Tanjung Uban Selatan and secondary clusters at Kelurahan Tanjung Uban Kota.
Keywords: malaria cases, spatial analysis, temporal analysis, geographic information system
1. Health Office, District of Bintan, Province of Kepulauan Riau.
2. Graduate Program in Tropical Medicine, Faculty of Medicine, Gadjah Mada University.
3. Graduate Program in Health Informatin and Management System, Gadjah Mada University.