FACTORS RELATED TO THE OCCURRENCE OF MALARIA IN DISTRICT PANYABUNGAN MANDAILING NATAL SUMATERA UTARA

ABSTRACT Panyabungan is one of the districts in Mandailing Natal regency which is an endemic area of malaria. The number of Malaria cases until 2013 reached 36.6 ‰ in 2879 positive cases. This study aimed to determine factors related to the malaria’s occurrence. This research was observational analytic study with case control design, analyzed by logistic regression.. The result of study indicated that the area of study was in the plateu, the average of temperature and humidity is 30.8 ° C and 66.7% during the day but the everage at night is on 27.2 ° C and 71.7. Factors which significantly associated with the occurence of malaria were the use of mosquito nets (p value: 0.000; OR: 3.573 ; 95% CI: 1.732 to 7.373), the use of anti-mosquito substance (p value: 0.029; OR: 2.719; 95% CI: 1.087 to 6.798), had activity outside of the house at night (p value: 0.01; OR: 3.254; 95% CI: 1.563 to 6.777), the use of long clothes (p value: 0.013; OR: 2.474; 95% CI: 1.205 to 5.076) and the presence of stagnant water (p value: 0.033; OR: 2.33; 95% CI: 1.06 to 5.118). The dominant risk factors was not using mosquito nets at night.Panyabungan merupakan salah satu kecamatan di Kabupaten Mandailing Natal dan termasuk daerah endemis malaria. Angka kesakitan malaria hingga tahun 2013 mencapai 36,6‰ dengan 2879 kasus positif. Penelitian ini bertujuan mengetahui faktor lingkungan dan perilaku yang berhubungan dengan kejadian malaria.Penelitian ini merupakan studi analitik observasional dengan desain case control, dan analisis data menggunakan analisis regresi logistik. Hasil penelitian menunjukkan daerah penelitian berada di daerah dataran, rata-rata suhu dan kelembaban pada siang hari 30,8 oC dan 66,7% sedangkan pada malam hari 27,2 oC dan 71,7 %. Faktor-faktor yang berhubungan secara signifikan dengan kejadian malaria yaitu penggunaan kelambu (p value: 0,000; OR: 3,573; 95% CI: 1,732-7,373), pemakaian obat anti nyamuk (p value: 0,029; OR: 2,719; 95% CI: 1,087-6,798), keluar rumah pada malam hari (p value: 0,01; OR: 3,254; 95% CI: 1,563-6,777), kerapatan pakaian (p value: 0,013; OR: 2,474; 95% CI: 1,205-5,076) dan genangan air (p value: 0,033; OR: 2,33; 95% CI: 1,06-5,118). Faktor risiko yang dominan terhadap kejadian malaria di Kecamatan Panyabungan adalah tidak menggunakan kelambu pada malam hari.Panyabungan is one of the districts in Mandailing Natal regency which is an endemic area. The number of Malaria cases until 2013 is still high. Malaria morbidity reached 36.6 ‰ in 2879 positive cases. This study aims to determine factors related to the occurrence malaria. Research was observational analytic study with case control design. The number of samples in case group of 66 people and a control group of 66 people. The result indicate that the area has the Annual Parasite Index (API) was in the plateu, the average of temperature and humidity is on 30.8 ° C and 66.7% during the day but the everage at night is on 27.2 ° C and 71.7. Factors that are significantly associated with the occurence of malaria is the use of mosquito nets (p value: 0.000; OR: 3.573 ; 95% CI: 1.732 to 7.373), use of anti-mosquito substance (p value: 0.029; OR: 2.719; 95% CI: 1.087 to 6.798), get out of the house at night (p value: 0.01; OR: 3.254; 95% CI: 1.563 to 6.777), the closed clothing (p value: 0.013; OR: 2.474; 95% CI: 1.205 to 5.076) and the puddle (p value: 0.033; OR: 2.33; 95% CI: 1.06 to 5.118). Analysis of logistic regression shows dominant risk factors on the occurence of malaria in panyabungan distric is not using mosquito nets at night, not using mosquito repellent at night, habit of getting out of the house at night, wearing closed cloting when getting out of the house at night and the presence of puddles around the house as a breeding place of Anopheles. Research conducted in the District Panyabungan showed that several environmental and behavioral factor are correlated to the incidence of malaria. Environmental and behavioral factors associated with the incidence of malaria consists of the use of mosquito nets, mosquito repellent use, out of the house at night, used clothing when outdoors the house as well as the presence of stagnant water. Keywords : Malaria, Environment, Behavior, Panyabungan