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Malaria hampir ditemukan di seluruh bagian dunia, terutama di negara-negara yang beriklim tropis dan sub tropis, dan penduduk yang berisiko terkena malaria 2,3 milyar atau 41% dari jumlah penduduk dunia. Penyakit ini hampir tersebar di seluruh kepulauan di Indonesia dengan jumlah kesakitan sekitar 70 juta atau 35% penduduk Indonesia. Malaria di Propinsi Kepulauan Bangka Belitung cukup tinggi, tergambar dari Annual Malaria Incidence (AM!) 27,7% tahun 2004 dan meningkat pada tahun 2005 menjadi 37,59%o. Dibandingkan dengan target AMI nasional 25%0 (2004) dan 22,5%0 (2005) ternyata masih di atas AMI nasional dengan kategori Mediun Incidence Area (MIA). Kejadian malaria di Kota Pangkalpinang pada tiga tahun terakhir meningkat terus secara berturut-turut AMI 25,2%0 (2002), 25,7%0 (2003) dan 29,5%0 (2004). Dari sebanyak 6531 sampel darah yang diperiksa tahun 2005 diperoleh Slide Positive Rate (SPR) 46,5% dimana 50,85% diantaranya Plasmodim falsiparum positif, terjadi peningkatan 8,7% bila dibandingkan dengan tahun 2004. Tujuan penelitian ini, untuk mengetahui peran tempat perindukan nyamuk dan pengaruh faktor-faktor risiko lainnya (kovariat) terhadap kejadian malaria falsiparum di Kota Pangkalpinang. Desain penelitian adalah studi kasus kontrol, menggunakan data primer. Jumlah sampel keseluruhan 434, jumlah kasus dan kontrol masing-masing 217 (perbandingan 1:1). Kasus adalah penduduk yang berkunjung ke Puskesmas berusia 15-55 tahun dengan gejala klinis malaria; demam, menggigil secarn berkala, berkeringat, mengeluh sakit kepala, dan basil pemeriksaan sediaan darah positif Plasmodim falsiparum dan bertempat tinggal di wilayah Kota Pangkalpinang lahun 2006, sedangkan kontrol mempunyai kondisi yang sama dengan kasus tetapi basil pemeriksaan sediaan darahnya negatif semua jenis Plasmodim malaria Pengumpulan data dilakukan pada bulan Maret hingga Mei 2006. Variabel penelitian adalah kejadian malaria falsiparum (dependen), dengan tempat perindukan nyamuk sebagai variabel independen utama dan delapan variabel kovariat (pemeliharaan binatang temak, dinding rumah, kebersihan lingkungan, pemasangan kawat kasa, pemakaian kelambu, penggunaan obat nyamuk, kebiasaan pembersihan lingkungan dan perilaku tokoh masyarakat. Hasil uji bivariat terdapat 8 (delapan) variabel berhubungan secara bermakna dengan kejadian malaria falsiparum (p-value<0,05), hanya satu variabel yang tak berhubungan secara statistik yaitu; variabel dinding rumah (p-value>0,05). Setelah dilakukan analisis multivariat, variabel yang berhubungan dengan kejadian malaria falsiparum hanya enam variabel yaitu; tempat perindukan nyamuk, pemeliharaan binatang ternak, kebersihan lingkungan, pemasangan kawat kasa, pemakaian kelambu, penggunaan obat nyamuk, dan kebiasaan pembersihan lingkungan. Peran tempat perindukan nyamuk setelah dikontrol (adjust) dengan kelima variabel lain yang berpengaruh terhadap kejadian malaria falsiparum diperoleh p-value =0,000 dan OR ad1=3, 506. Pada dasarnya tempat perindukan nyamuk sebagai variabel independen utama berperan panting untuk terjadinya malaria falsiparum. Efek atau risiko oleh adanya tempat perindukan nyamuk tersebut tetap tinggi walaupun sudah dikontrol oleh variabel lainnya (OR adj=3,506, 95%CI:2,285-5,378). Variabel lain yang ternyata ikut berperan untuk terjadinya infeksi malaria falsiparum adalah pemeliharaan binatang ternak, kebersihan lingkungan, pemasangan kawat kasa, pemakaian kelambu, dan penggunaan obat nyamuk. Dan penelitian ini dapat disarankan adalah memasyarakatkan Gerakan Jum'at Bersih, penyuluhan kesehatan masyarakat untuk memberdayakan tokoh masyarakat dan lembaga swadaya masyarakat (LSM), menjalin kemitraan dengan stakeholder serta merancang program pencegahan dan pemberantasan malaria yang berbasis wilayah dan masyarakat dengan dikukuhkan dalam bentuk peraturan daerah (Perda) Kota Pangkalpinang.
Malaria is almost found in all over the world, especially in countries which have tropical climate and sub tropical, and population which have a malaria risk, they are 2,3 billions or 41% of world population number. This disease almost spread over in all of archipelago in Indonesia with morbidity rate are 70 millions or 35% of population in Indonesia. Malaria rate is highest in province of Kepulauan Bangka Belitung, It showed by an Annual Malaria Incidence (AMI) is 27,7% in 2004 and it is increasingly to be 37,59% in 2005. Compared to a national purpose of Annual Malaria Incidence is 25% (2004) and 22,5% (2005), it indicated above a national Annual Malaria Incidence with Medium Incidence Area (MM) category. Malaria occurrence at Pangkalpinang in the last three years increased by an Annual Malaria Incidence (AMI) is 25,2°Imo (2002), 25,7°Imo (2003), 29,5°I. (2004). From 6531 blood samples checked in 2005 are obtained Slide Positive Rate (SPR) are 46,5% and 50,85% of them are positive Plasmodium falciparum, increased 8,7% compared in 2004. This research purpose is to know role of a mosquitos breeding place and effect of other risk factors (covariate) to malaria falciparum occurrence at Pangkalpinang. This research used a control case study design with a primary data. All samples number are 434, each cases and controls number are 217 (comparison 1:1). Cases are population who visited to primary health care with 15-55 years old by a symptom of a clinic malaria: fever, trembling periodically, sweating, headache and examination result indicated a positive blood preparation of Plasmodium falciparum who lived at Pangkalpinang in 2006, while controls have the same condition as cases but its result of blood preparations for all types of Plasmodium malaria are negative. Data collected from March-May 2006. Research variable is malaria falciparum occurrence (dependent), with a mosquito breeding places as a main independent variable and eight covariate variables (breed animal conservancy, house wall, hygienic environment, wire netting installation, usage of mosquito net, usage of mosquito prevention, hygienic environment practice, and public figure behavior. There are eight variables from bivariate test result which have a meaning correlation with malaria ,falciparum occurrence (p-value<0,05), only one variable which do not correlate statistically, it is a house wall variable (p-value>0,05). After multivariate analysis, there are only six variables which related to malaria occurrence, such as mosquitos breeding place, breed animal conservancy, hygienic environment, wire netting installation, usage of mosquito net, usage of mosquito prevention, hygienic environment practice. Role of mosquitos breeding places after controlled (adjust) with other fifth variables which have effect to malaria falciparum occurrence obtained p-value=0,000 and ORadj=3,506. Basically, mosquitos breeding places as a main independent variable, has played the important role to malaria falciparum occurrence. The existence of mosquitos breeding places has a highest risk although it has been controlled with other variable (CRad1=3,506, 95%Cl: 2,285-5,378). The other variables which have important roles of malaria falciparum infection are breed animal conservancy, hygienic environment, wire netting installation, usage of mosquito net, and usage of mosquito prevention. From this research can be suggested by socializing of "Gerakan Jum'at Bersih ", counseling of public health to give a change for public figure and non government organization, making a relationship with stakeholder as a partner and planning a prevention and eradication of malaria program based on district and community confirmed in the form of a district regulation of Pangkalpinang.
For hospital patients, quality health services are not only felt by recovering from physical illness but also regarding patient satisfaction with the attitudes, knowledge and skills of health workers in providing services and the availability of adequate facilities and infrastructure. Patients will be satisfied if the service they receive at least equals or exceeds patient expectations. Meanwhile, the patient feels dissatisfied if the service he receives does not match the patient's expectations. Based on the achievement data of quality indicators at Bakti Timah Mentok Hospital in 2022, there are several quality indicators that have not reached the target. In addition, the number of JKN patient visits at the outpatient installation at Bakti Timah Mentok Hospital in 2020-2022 has also decreased. The purpose of this study was to describe patient satisfaction and interest in revisiting JKN patients at the outpatient installation at Bakti Timah Mentok Hospital in 2023. The study design was cross sectional with a sample size of 120 people. Statistical analysis using Chi Square test or Fisher Exact test. Based on statistical tests to see the relationship between the characteristics of the respondents and the interest in repeat visits, it was found that all of the characteristics of the respondents had p value > 0.05, which means that there was no significant relationship between the characteristics of the respondents and the interest in repeat visits. While the results of statistical tests between respondents' satisfaction on the Tangibles dimension and intention to revisit, it is known that p value > 0.05, which means that there is no significant relationship between respondent's satisfaction on the Tangibles dimension and intention to revisit. And the results of statistical tests between respondents' satisfaction on the dimensions of Reliability, Responsiveness, Assurance and Empathy with interest in repeat visits are known to be p value ≤ 0.05, which means that there is a significant relationship between respondents' satisfaction in the dimensions of Reliability, Responsiveness, Assurance and Empathy with interest in repeat visits. The relationship between patient satisfaction as a whole resulted in p value ≤ 0.05, which means that there is a significant relationship between patient satisfaction and interest in repeat visits. The results of the mapping of service elements in the Cartesian diagram show that 5 (five) service elements are in quadrant A, which means they are a top priority for improvement efforts. The five elements of service are the condition of the patient's waiting room, the availability of medical devices, the availability of types of laboratory examinations, the availability of drugs in the hospital pharmacy installation and the presence of doctors according to the service schedule. Therefore, the Bakti Timah Mentok Hospital must pay more attention to service elements that have not provided maximum satisfaction to patients.