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Malaria is an infectious disease transmitted by Protozoa of the genus Plasmodium through an infected female Anopheles mosquito. This study is conducted due to the high malaria incidence in Kab. Belu, East Nusa Tenggara, Indonesia, which presents itself as a public health threat. Study aims include analyzing and measuring the magnitude of the risk factors associated with malaria incidence. This study utilized a cross-sectional study design, and is part of a larger surveillance study by Sutanto et al in 2013, which conducts large-scale mass screening and selective treatment in Belu Regency, NTT, Indonesia. The number of samples included in the study were 1113 subjects, with statistical analysis using cox regression models with 5% significance level and 95% confidence interval. The results of multivariate analysis suggested that the the risk factors associated with the malaria incidence were (1) age PR 4.901 95% CI (3.093-7.766) p value 0.000, (2) occupation PR 3.838 95% CI (2.536-5.808) p value 0.000, (3) malaria drug use PR 0.448 95% CI (0.239-0.839) p value 0.012, and (4) village location. Therefore, malaria incidence in Belu District, East Nusa Tenggara Indonesia, were heavily influenced by age, occupation, consumption of antimalarial drugs, and strategic village position for malaria vector breeding grounds
Malaria masih merupakan masalah kesehatan msyarakat yang serius bagi umat manusia di dunia. Saat ini diperkirakan 2,5 milyar manusia hidup di wilayah-wilayah endemis malaria dengan ± 300 juta kasus dan -+ 1juta orang meninggal setiap tahun karena penyakit malaria. Di Indonesia pada periode tahun 2001-2004 mengalami penurunan Annual paracite incidence (API) di Jawa-Bali tahun 2001 (0,62%o), 2002 (0,47%0), 2003 (0,22%o) dan 2004 (0,15%0). Demikian pula annual malaria incidence (AMI) di War Jawa-Bali tahun 2001 (26,20%0), 2002 (22,30%0), 2003 (21,80960) dan 2004 (21,20%o), tetapi penyakit malaria masih menimbulkan KLB pada tahun 2004, di 5 propinsi pada 6 kabupaten dengan 1.959 penderita dan 33 penderita meninggal dunia_ Tujuan penelitian ini, untuk mengetahui hubungan antara faktor pelayanan kesehatan, perilaku dan lingkungan dengan kejadian malaria dalam upaya mengidentifikasi karakteristik populasi lokal spesifik. Desain penelitian adalah studi korelasi populasi, menggunakan data sekunder dari Depkes RI dan BPS Pusat. Besar sampel yang diperlukan dalam penelitian 108 namun dalam analisisnya menggunakan keseluruhan sampel yang berhasil dikumpulkan sebanyak 46. Kasus adalah kelompok penderita dengan gejala klinis malaria yang sudah didiagnosis oleh petugas kesehatan, tinggal di propinsi Indonesia dan tercatat di Sub Direktorat Malaria Direktorat Jenderal Penanggulangan Penyakit Menular dan Penyehatan Lingkungan Departemen Kesehatan Republik Indonesia tahun 2000-2004. Pengumpulan data dilakukan pada Bulan Juni 2006. Variabel penelitian adalah faktor pelayanan kesehatan (puskesmas), perilaku (kualitas sumber daya manusia) dan lingkungan (lingkungan sosial ekonomi, lingkungan tingkat rural, lingkungan sosial demografi dan lingkungan fisik) yang berhubungan dengan terjadinya efek yang diteliti (kejadian malaria di propinsi Indonesia tahun 2000-2004). Hasil penelitian menunjukkan ada hubungan sedang antara variabel puskesmas (1=0,335), sumber daya manusia (1=0,299), pemerataan (r=0,504), aspek lingkungan desa (r=-0,448), aspek pejamu desa (1=-0,493), kepadatan penduduk (1=-0,440) dan potensi perindukan nyamuk (r=-0,326) dengan kejadian malaria di Indonesia tahun 2000 sampai dengan 2004. Variabel yang paling besar berhubungan dengan kejadian malaria di Indonesia tahun 2000-2004 adalah variabel proporsi aspek lingkungan desa dengan model persamaan proporsi kejadian malaria = 2,316 + 0,628 (proporsi puskesmas) + 0,396 (proporsi sumber daya manusia) + 0,037 (proporsi pemerataan ) - 0,335 (proporsi aspek lingkungan desa) - 1,074 (proporsi potensi perindukan nyamuk). Dengan setiap puskesmas memiliki program P2 malaria yang secara aktif menjalankan tugasnya dalam penemuan kasus, pemberantasan, pencegahan dan penyuluhan malaria maka peningkatan faktor pelayanan kesehatan (variabel proporsi puskesmas) akan diikuti dengan penurunan proporsi kejadian malaria.
Malaria is still a serious health problem at society for human being in the world, because of a highest prevalence especially in development countries. Today it is estimated almost 2,5 billions people live at malaria endemic by 300 millions cases and 1 million people died because of malaria disease every year. It decreased in Indonesia at period of 2001-2004, Annual Paracite Incidence in Java - Bali in 2001 (0,62 0/00), in 2002 (0,47 °/oo), in 2003 (0,22 °/oo), and in 2004 (0,15 °/00). Furthermore, Annual Malaria Incident in Java-Bali in 2001, (26,20 0/oo, in 2002 (22,30 °/oo), in 2003 (21,80 °/oo), and in 2004 (21,20 0100). Malaria disease is still an extraordinary occurrence in 2004, 5 provinces, 6 sub-provinces, by 1.959 patients and 33 of them died. This research purpose is to know a relation between health services, behavior and environment factor with malaria occurrence in the effort of identifying a local population characteristic specifically. Research used a correlated population design with secondary data from Indonesia Ministry of Health and Indonesia Statistic Bureau. This research conducted to 108 samples but its analysis used all of samples which were success collected by 46 samples. Cases were patient groups with clinic symptom of malaria which have been diagnosed by a health worker, living in province of Indonesia and noted in Sub Directorate of Malaria, General Directorate of Infectious Disease Prevention and Environment Health, Indonesia Ministry of Health in 2000-2004. Data collecting was conducted on June 2006. Research variables are health service (primary health care), behavior (human resources quality) and environment (social economic, rural level, social demography and physic environment) related to the assessed effect (malaria occurrence in province of Indonesia, 2000-2004). Research result indicated that there was a medium relationship between primary health care (r=,335), human resources (r3,299), equity (r=0,504), district environment aspect (r),448), district host aspect (r),493), high population (r.1,440) and mosquito breeding places potency (r 0,326) variables with malaria occurrence in Indonesia, 2000-2004. The biggest variable related to malaria occurrence in Indonesia, 2000-2004 was proportion variable of district environment aspect with equity model of malaria occurrence proportion = 2,316 + 0,628 (proportion of primary health care) + 0,396 (proportion of human resources) + 0,037 (proportion of equity) - 0,335 (proportion of district environment aspect) -- 1,074 (proportion of mosquito breeding places potency). Each primary health care has a malaria eradication program which running their job actively on cases invention, eradication, prevention and counseling of malaria. Therefore, improvement of health service factor (proportion variable of primary health care) followed by proportion degradation of malaria occurrence.