| dc.description.abstract | Lymphatic filariasis being a global health problem and the second leading
cause of disability globally. Indonesia is a country with filariasis endemic status.
In 2016, the disease were reported endemic in 29 provinces and 239 districts/cities
of Indonesia, with an estimated 102.279.739 people at risk of being infected with
filariasis. Bogor Regency was an endemic filariasis area with the discovery of
clinical filariasis patients continuing to grow from year to year since 2004 until
now. Until the end of 2018, there were 117 people with clinical filariasis in Bogor
Regency. The control of filariasis in Bogor Regency has focused on administering
drugs to patients and preventing and limiting disability. Attention to mosquitoes
as vektors was still minimal, entomological studies based on mosquito bioecology
have not been carried out, so that this control effort still leaves problems in the
field. In addition, data and information about the factors that influence filariasis
are not widely known. In connection with this, to control filariasis, Bogor
Regency must pay attention to all aspects that can affect the incidence of filariasis,
including vektors, the environment, humans, agents, and the role factors of health
institutions. Based on these problems, it is necessary to research filariasis both on
an agent, environmental, vektor, human factors, and the role of health institutions
as primary data that can be used to develop an integrated filariasis control strategy
in Bogor District.
The study was carried out for 10 (ten) months, namely June-July 2019,
September 2019-February 2020 and August-September 2021. Collection of adult
mosquitoes, observation of mosquito larvae habitats and measurements of
community behaviour were carried out in two villages, namely Tamansari Village
and Cimanggis Village. Epidemiological studies, program evaluations and the role
of health institutions were carried out in 46 Puskesmas in Bogor Regency and the
Bogor District Health Office. Adult mosquitoes are collected every two weeks for
six months using the human landing collection (HLC) and resting collection
methods for 12 hours of observation (18.00-06.00). Mosquito larvae were
collected in various habitat types every month for six months. Dissection
technique and polymerase chain reaction (PCR) carried out the detection of
filarial in the mosquito body. They were measuring community behaviour using
interview questionnaires with a sample size of 157 respondents in Tamansari
Village and 369 in Cimanggis Village. Epidemiological studies and evaluation of
the filariasis program were carried out by analyzing secondary data from the
Bogor District Health Office. Study of the role of health institutions using a
monitoring and evaluation questionnaire at the health centre level and in-depth
interviews with key informants at the Bogor District Health Office level.
Distribution of filariasis in Bogor District with dominant sufferers in women
(59.8%) and productive age (36-45 years). The chi-square test results showed a
significant difference between the age groups with the incidence of filariasis from
year to year (p<0.05). In contrast, the relationship between gender and theincidence of filariasis from year to year did not show a significant difference
(p>0.05). Sub-districts with filariasis sufferers increased from 55% in 2015 to
77,5% in 2018. The implementation of POPM includes treatment achievement
rates (> 65%) and treatment success rates (> 85%) from 2015 to 2018 has
exceeded the national target.
There were six species of mosquitoes in Cimanggis Village, namely Culex
quinquifasciatus, Cx. visnhui, Cx. tritaeniorhynchus, Aedes aegypti, Armigeres
kesseli, Ar. subalbatus. In Tamansari Village, eight mosquito species were found,
six species were the same as in Cimanggis Village, and two additional species
were Ae. albopictus and Mansonia annulata. The highest dominance was found in
Cx. quinquefasciatus both in Tamansari Village (90.46) and in Cimanggis Village
(95.67). The mosquito diversity index was low in Tamansari Village (H'=0.444)
and Cimanggis Village (H'=0.238). In general, mosquito-biting behaviour prefers
to suck blood inside the house (endophagic) with a peak density of 23.00-04.00.
Cx. quinquefasciatus is very dominant due to very supportive environmental and
habitat conditions. The potential habitat in Cimanggis Village consists of ribs,
ditches/gullies and used tires, while in Cimanggis Village, the most potential
habitats are ditches/gullies. The mosquito density per person per night (man biting
rate-MBR) in Tamansari and Cimanggis villages mostly had no significant
correlation with rainfall, temperature and humidity.
The parity rate of mosquitoes collected in Tamansari and Cimanggis
villages was very high (>80%). The microscopic observation didn’t detect the
presence of worm larvae, as well, the Ssp I PCR test didn’t detect the presence of
Wuchereria bancrofti larvae in the thorax and heads of mosquitoes.
The knowledge of respondents in Tamansari Village, in general, is low
(52.8%), and in Cimanggis Village, they have moderate knowledge (55.3%). The
attitude of respondents in Tamansari Village and Cimanggis Village, in general,
has neutral attitude while the general practice is good. Education has a significant
relationship with knowledge and attitudes in Cimanggis Village, meaning that the
better the education of the respondents, the better their knowledge and attitudes.
Practices do not have a significant relationship with the characteristics of
respondents in Tamansari and Cimanggis villages, meaning that the characteristics
of gender, age, education and occupation do not influence the practices carried out
by the community. Spearman's correlation test between knowledge, attitude and
practice found only attitudes and practices that had a significant relationship in
Cimanggis Village, meaning that the better respondent’s attitude, the better their
practice. There are significant differences knowledge, attitudes and practices in
rural (Tamansari Village) and urban (Cimanggis Village) areas about filariasis.
The role of health institutions in controlling filariasis was quite good in
several aspects, and there were still shortcomings in other aspects. There were
(8.7%) health center that do not have a filariasis treatment program. The mass
prevention mass drug administration program (MDA), clinical management and
establishment of medicine man have been quite good but the formation of cadres
and vector control was still low. There were adequate health personnel at the
health center involved in the filariasis program, but the presence of entomology
personnel was very low at only 13% of all health center. The healt center have
very well carried out the patient survey and counseling activities while the
activities that were still very low were knowledge, attitude, and pratice (KAP)surveys, mosquito larvae habitat surveys, evaluation surveys for filariasis
transmission, and microfilaria evaluation surveys after MDA. The health center
have received quite good supervision, guidance, monitoring, and health
department evaluation. The health center have also received infrastructure
support, but it was still lacking from the support of Non Goerment Organiations
(NGOs). Assessment of the health department level shows that policy, budget,
cooperation, and human resources were still very lacking. The budget given was
minimal and cross-sectoral cooperation was not yet running. Human resources
owned were very low both in quantity and quality. Facilities and infrastructure
were considered sufficient to support filariasis prevention programs and activities.
Based on the results of the strengths, weakness, opportunities, and threats
(SWOT) analysis of the data and information obtained, the selected strategies and
steps that can be developed for filariasis control strategies based on entomological
studies and evaluation of the role of health institutions are as follows: increasing
understanding and comprehensive vector control, empowering communities and
personnel health in the scope of the health center, comprehensively increasing
public information and knowledge about filariasis, and support for strengthening
regulations and cooperation in controlling filariasis. | id |
