Malaria masih merupakan masalah kesehatan masyarakat yang penting di Indonesia, khususnya di daerah transmigrasi dan daerah endemis malaria yang didatangi penduduk baru dari daerah non-endemik. Sering terjadi letusan atau wabah yang banyak menimbulkan kematian. Kecamatan Kemuning Kabupaten Indragiri Hilir Propinsi Riau merupakan kecamatan pemekaran dan daerah transmigrasi, sehingga sering terjadi pembukaan lahan baik oleh perusahaan maupun perorangan termasuk masyarakat tempatan.
Penelitian ini bertujuan untuk mengetahui hubungan lamanya tinggal di ladang berpindah dengan kejadian malaria di Kecamatan Kemuning Kabupaten Indragiri Hilir Propinsi Riau.
Rancangan penelitian adalah kasus kontrol. Kasus dan kontrol adalah subjek yang tinggal di ladang berpindah berturut-turut minimal 9 (sembilan) hari dan maksimal 3 (tiga) bulan terakhir yang berkunjung ke pelayanan kesehatan dalam wilayah Kecamatan Kemuning. Kasus disertai gejala klinis malaria (demam panas, sakit kepala dan menggigil secara berkala) dengan pemeriksaan sediaan darah plasmodium di laboratorium hasilnya positif. Kontrol tanpa gejala klinis malaria (demam panas, sakit kepala dan menggigil secara berkala) dengan pemeriksaan sediaan darah plasmodium di laboratorium hasilnya negatif,
Hasil penelitian dengan alpha 5% terdapat perbedaan bermakna antara rata-rata lama tinggal di ladang berpindah dengan kejadian malaria. Nilai OR hasil analisis multivariat 14,26 (95% CI, 6,72 - 22,40), maka responden yang lebih lama tinggal di ladang berpindah lebih dari 26 hari akan terinfeksi malaria 14,26 kali dibanding yang tinggal kurang dari 26 hari setelah dikontrol variabel pemakaian repellent. Persamaan regresi logistik ganda menunjukkan peluang sebesar 19% yang lebih lama tinggal di ladang berpindah dan tidak memakai repellent terkena malaria.
Disarankan kepada petugas kesehatan melakukan penyuluhan upaya pencegahan penularan penyakit malaria. Disarankan kepada masyarakat saat tidur di ladang selalu memakai kelambu dan bila keluar pada malam hari menggunakan repellent secara teratur. Bagi yang mempunyai ternak hendaknya membawa dan mengkandangkan ternaknya di ladang berpindah.
Penanggung jawab program dapat kiranya membuat dan merencanakan kegiatan pemberantasan nyamuk malaria dengan program pemolesan kelambu dengan insektisida yang sesuai dan stimulan pengadaan dan penggunaan repellent.
The Relationship of Living in The Shifting Cultivation Lands and Malaria Infected in The Sub District of Kemuning Indragiri Hilir Regency in The Province of Riau In 2002Malaria still acts as one of crucial public health problems in Indonesia, especially in transmigration areas and other endemic areas malaria, which or inhabited by the new comers from non-endemic areas which often suffer this disaster. That has caused much mortality. Kemuning is a new sub-district and a transmigration area. The opening of new lands either by the company or individuals including by the local people often occurred here.
This study aimed to measure the relation of living period in the shifting cultivation lands and malaria incidents in The Sub District of Kemuning Indragiri Hilir Regency in The Province of Riau.
The design of the study was a case control design. The cases and control were subjects living in the shilling cultivation lands recently and continuously for at least 4 (four) days, and at length 3 (three) months who visited the Kemuning sub-district's area health services. Cases with malaria clinical symptoms (high fever, headache and periodic cold), and whose availability of plasmodium blood were positive after the checking up at the laboratory. The controls without malaria clinical symptoms (high fever, headache and periodic cold), and whose availability of plasmodium blood were negative after the checking up at the laboratory.
The result of the study by using alpha was 5% of significant difference between average living lengths in the shifting cultivation lands to be infected by the malaria. The OR value result of multivariate analysis showed that was 14.26 (95% CI, 6,72 - 22,40), therefore the respondent with length of living ? 26 days in the shifting cultivation lands could be infected by the malaria for 14.26 times in the comparison with the one whose length period of living < 26 days with the malaria incidents after being would controlled by the variable of using repellent. The equation of multiple logistic regression showed that the probabilities was 19% in the shifting cultivation lands and not using repellent would be infected by malaria, in contrast only 1.85% would be infected by malaria and using repellent.
It is suggested to the health personal to provide guidance to the people about the importance of malaria preventive. It is suggested that as steeping to use mosquito bed net during night staying in the land, if going out at night use the repellent routinely. To this people who owned livestock could take their animals with them and encage in the land.
The program coordinator should make and plan the activities of malaria mosquito controls by of the polishing the mosquito bed net with the appropriate insecticides and the stimulant using repellent programs.