Analisis Spasial Kejadian Filariasi di Kabupaten Demak Jawa Tengah

Latar Belakang: Filariasis merupakan salah satu penyakit tular vektor yang kurang mendapatkan perhatian, termasuk kelompok Neglected Tropical Diseases (NTDs) . Kabupaten Demak merupakan salah satu wilayah di Propinsi Jawa Tengah yang merupakan daerah endemis filarisis (mf rate>1%). Kejadian filarisis di daerah ini diduga berkaitan dengan kondisi lingkungan fisik dan biologis (nyamuk) yang mempunyai peran penting dalam penyebaran penyakit filarisis. Penelitian ini bertujuan untuk menemukan adanya penderita baru, mengidentifikasi kondisi lingkungan fisik dan biologi yang berkaitan dengan sebaran filarisis di Kabupaten Demak. Matede: Penelitian ini merupakan penelitian observasional dengan rancangan cross-sectional . Sebanyak 30 kasus filariasis dijadikan indek kasus yang selanjutnya dipilih secara purposif sebanyak 140 yang tinggal di sekitar 30 kasus tersebut untuk dilakukan pengamblan darah jari. Observasi lingkungan dilakukan untuk mengidentifikasi kondisi lingkungan (breeding places dan resting places) dari yang diduga sebagai nyamuk vektor filariasis. Penangkapan nyamuk dilakukan di sekitar rumah penderita filariasis. Pengukuran koordinat kasus filariais dilakukan dengan pesawat Geographic Positioning System (GPS). Pemeriksaan darah jadi jari dilakukan di Laboratorium Kesehatan Daerah (LABKESDA) Propinsi Jawa Tengah. Sedang bedah nyamuk dilakukan di Balai Penelitian Vektor Penyakit Banjarnegara. Analisis data dlakukan secara deskriptif, analisis spasial dilakukan dengan software ArcGis 9.3. Hasil: Penelitian ini tidak menemukan penderita baru filarisis ( mf rate =0%). Sebanyak 129 ekor nyamuk telah dilakukan pembedahan dengan hasil semuanya negatip cacing filaria. Hasil identifikasi nyamuk menemukan spesies nyamuk Culex quinquefasciatus merupakan nyamuk yang dominan (72,86%) di lokasi penelitian.Terdapat breeding places (40%) berupa genangan air terbuka (SPAL) dan resting places (83,3%) berupa semak-semak di sekitar rumah penderita. Analisis spasial menunjukkan bahwa kasus filariasi hampir menyebar di seluruh wilayah Kaputaen Demak. Daerah cekungan aliran air nampaknya merupakan kondisi dimana kasus filariasis banyak terjadi. Simpulan: Kasus filariasis hampir menyebar di seluruh wilayah Kabupaten Demak dengan konsentrasi lebih banyak pada daerah cekungan aliran air Semarang-Demak. ABSTRACT Title: Spatial Analysis of Lymphatic Filariasis in Demak Dictric, Central Java Background: Lymphatic filarias is (LF) is one of ve c tor related diseaseswhich less attention from goverment, It was classified as Neglected T ro pical Diseases (NTDs). Demak District is one of area in Central Jawa which was endemic of LF (mf rate>1%). It may be related to the physical and biologycal environment condition which have important role in the spreading of LF. This research aimed to identify new cases, find mosquitoe vector , and asses the condition of physical and biologycal environment related to the distribuion of LF cases in Demak District. Methods: It was an observational research using cross-sectional design. As more as 30 LF cases defined as index case and then 140 persons living around index case were selected for blood testing of microfilaria. Observation was conducted to assess the presence of breeding and resting places for mosquitoes development. Mosquito collection was conducted around the houses the LF cases early in the morning. Site of LF cases were measured using Geographic Positioning System (GPS) Apparatus. Blood test for identifying microfilaria was performed at Province Health Labotatory of Centra Java. Mosquotoes dissection was performed at Research Institule of Disease Vector Banjarnegara. Data would be analyzed descriptively and spatial analysis was performed using ArcGis 9.3. Results: This rese a rch did’t find new cases of filariasis (mf rate=0%). As more as 129 mosquitoes had been dissected and all of them indicated negative of filarial worm. This research showed that Culex quinquefasciatus as dominant mosquitoe species with the proportion of 72,86%. Water puddle (40%) and small three (83,3%) were found as a good habitats located around the house of filariasis cases. Spatial analysis indicated that filari a sis cases spread in all over area of Demak Distirct, and It concentated in the area of undergroud water flow of Semarang-Demak Conclusion: Lymphatif Filariasis cases were nearly distributed all over area of Demak Distict and It was concentrated in area with underground water flow Semarang-Demak.