Biological, Physical, Social, and Environmental Factors Associated With Dengue Hemorrhagic Fever in Nganjuk, East Java

Abstract

Background: Dengue Hemorrhagic Fever (DHF) is an infectious disease transmitted by mosquitoes that carry dengue virus (DV). This disease is endemic in more than 100 countries. Nganjuk district, East Java, is a DHF endemic area with sharp increase in DHF incidence by 286% from 2014 to 2015, of which 9 cases died. This study aimed to examine biological, physical, social, and environmental factors associated with dengue hemorrhagic fever in Nganjuk, East Java. Subjects and Method: This study was observational analytic with case control design. It was conducted in Nganjuk District, East Java, from May to June, 2017. A sample of 120 children aged less than 15 years old were selected for this study by fixed disease sampling. This sample consisted of 40 children with DHF selected as cases and 80 neighboring children without DHF selected as controls. The independent variables were the existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control (PSN), and activity of larva monitoring cadre. The dependent variable was DHF cases. The data were collected by a set of pre-tested questionnaire and observation with a checklist. Logistic regression was employed for data analysis. Results: Incidence of DHF case was determined by the existence of bush surrounding the house (OR= 2.14; 95% CI= 0.99 to 4.6; p= 0.052), existence of mosquito larvae (OR= 14.94; 95% CI= 5.91 to 37.73; p<0.001), still water (OR=11.42; 95% CI= 4.68 to 27.89; p<0.001), hung clothes (OR= 4.31; 95% CI =1.92 to 9.70; p<0.001), mosquito breeding place control (OR=0.06; 95% CI= 0.02 to 0.15; p<0.001), and activity of larva monitoring cadre (OR= 0.14; 95% CI= 0.06 to 0.32; p<0.001). Conclusion: Existence of bush surrounding the house, existence of mosquito larvae, still water, hung clothes, mosquito breeding place control, and activity of larva monitoring cadre, are the determinants of DHF incidence.

Multilevel Analysis on the Contextual Effect of Village on the Incidence of Hemorrhagic Dengue Fever in Grobogan, Central Java

“…This study supported the research of Sukowinarsih and Cahyati in Semarang which stated that the larvae at the water reservoir (TPA) can affect the incidence of dengue by 3.38 times greater for experiencing DHF (Sukowinarsih and Cahyati, 2010). The results of research conducted by Nurrochmawati, et al (2017) showed that there was a relationship of the presence of WR with no cover that have the potential to became a place for mosquitoes to breed that was 11.42 times more likely to suffer from HDF. The presence of WR played an important role in the density of the Aedes aegypti mosquito vector, because more and more WR sites would increase the breeding places and would be more densely populated by the Aedes aegypti mosquito (Dash et al, 2012).…”

“…Just as the habit of hanging clothes can increase the number of mosquitoes in the house because mosquitoes prefer to perch on hanging clothes. Based on research conducted by Nurrochmawati (2017) in Nganjuk, it showed that the people who have hanging clothes were more likely to have HDF than subjects who did not have hanging clothes inside their houses.…”

“…Based on a study done by Nurrochmawati (2017) it showed that there was an effect of mosquito larvae on the incidence of HDF which was statistically significant in bivariate and multivariate tests. The result showed that in the environment where mosquito larvae were found, it has a higher likelihood of DHF.…”

“…This was in line with a study done by Ananda and Hidayatullah (2015) which stated that MNE has a positive correlation with mosquito larva, therefore, it minimized the incidence of HDF. According to a study done by Nurrochmawati (2017) there was an effect of continuity of HDF MNE with the incidence of HDF if the eradication of mosquito nests was conducted, and it was less likely to be affected by HDF. The result of a study done by Al-Dubai et al (2013) stated that MNE affected the incidence of HDF in Malaysia.…”

“…Environmental factors, include the biological, physical and socio-economic environment that support mosquitoes breed (Sarfraz et al, 2014). Environmental factors that influence the spread of dengue cases include: physical environmental factors are the existence of a Water Shelter (TPA), the presence of clothes hanging, the presence of houses; Biological environmental factors are the existence of farm land, the existence of mosquito larvae, and the existence of ponds; socioeconomic environmental factors are continuity of PSN, education, and employment (Nurrochmawati, et al, 2017;Francisco, et al, 2017;Diaz-Quijano et al, 2018;Phuong et al, 2008).…”