Analisis spasial infeksi Cryptosporidium spp. terhadap penggunaan sumber air bersih pada balita stunting di Kabupaten Jember

https://doi.org/10.22146/mgi.93422

Wiwien Sugih Utami(1*), Ahmad Yudho Hadi Pangestu(2), Azham Purwandhono(3), Achmad Maududie(4), Yunita Armiyanti(5), Bagus Hermansyah(6)

(1) Fakultas Kedokteran, Universitas Jember, Jember, Indonesia
(2) Fakultas Kedokteran, Universitas Jember, Jember, Indonesia
(3) Fakultas Kedokteran, Universitas Jember, Jember, Indonesia
(4) Fakultas Ilmu Komputer, Universitas Jember, Jember
(5) Fakultas Kedokteran, Universitas Jember, Jember, Indonesia
(6) Fakultas Kedokteran, Universitas Jember, Jember, Indonesia
(*) Corresponding Author

Abstract


Abstrak. Cryptosporidium spp. adalah parasit intestinal yang secara global ditularkan melalui air (waterborne diseases), dengan banyak kejadian wabah di dunia yang dilaporkan terkait dengan sumber air konsumsi. Mayoritas penyakit ini tidak bergejala (asimptomatis) pada orang dewasa dengan rute penularan dari orang-ke-orang, hewan-ke-orang, melalui air dan makanan. Namun infeksi ini menyebabkan diare kronis hingga malnutrisi pada kelompok rentan yaitu balita dan merupakan faktor risiko terjadinya stunting.  Salah satu media transmisi Cryptosporidium spp. adalah air bersih yang dikonsumsi dan digunakan sehari-hari. Tujuan penelitian adalah untuk menganalisis risiko sumber air bersih yang digunakan sehari-hari terhadap infeksi Cryptosporidium spp. pada balita stunting secara spasial di Kabupaten Jember. Penelitian ini dilakukan pada populasi balita stunting di Kecamatan Kaliwates, Panti, Rambipuji dan Sukorambi Kabupaten Jember menggunakan desain cross sectional. Analisis spasial moran index dan nearest neigbor index (NNI) digunakan untuk mengetahui pola persebaran infeksi Cryptosporidium spp. terhadap suatu wilayah. Uji chi-square dilakukan untuk mengetahui hubungan faktor risiko sumber air  bersih  dengan infeksi Cryptosporidium spp. Hasil penelitian menunjukkan bahwa 18 dari 528 (3,41%) balita stunting diketahui terinfeksi Cryptosporidium spp. Nilai moran index menunjukkan adanya pola persebaran mengelompok (clustered) dengan autokorelasi positif di Kecamatan Sukorambi sedangkan daerah lainnya memiliki pola yang acak (random). Hasil NNI di Kecamatan Sukorambi menunjukkan pola yang acak, sedangkan 3 kecamatan lain menunjukkan pola menyebar (dispersed). Jenis sumber air bersih menunjukkan korelasi terhadap infeksi Cryptosporidium spp. Pola spasial infeksi Cryptosporidium spp. di Kecamatan Sukorambi dan korelasinya dengan jenis sumber air bersih ini menunjukkan bahwa pola infeksi ini cenderung mengelompok (clustered) karena penggunaan sumber air bersih yang sama pada penduduk di kecamatan ini yaitu sumber mata air alami yang digunakan bersama-sama seluruh warga, meskipun jarak antar penggunanya tidak berdekatan atau acak sesuai hasil NNI. Di 3 kecamatan lain, pola spasial cenderung menyebar (dispersed) karena penggunaan sumber air yang berbeda dan tidak digunakan secara bersama-sama. Kesimpulan, infeksi Cryptosporidium spp. cenderung meningkat pada sumber air bersih yang digunakan secara bersama-sama. Perlu edukasi pada kelompok masyarakat agar mengolah dulu air yang digunakan sebelum dikonsumsi untuk mengurangi risiko penyebarannya.


Abstract. Cryptosporidium spp . are intestinal parasites that are transmitted worldwide by water(waterborne disease), with many of the reported outbreaks in the world associated with sources of drinking water. Most cases of the disease are asymptomatic in adults, and transmission is person-to-person, animal-to-person, waterborne, and foodborne. However, the infection causes chronic diarrhea and malnutrition in vulnerable children under the age of five and is a risk factor for stunting. One of the modes of transmission of Cryptosporidium spp . is through clean water, which is consumed and used daily. The study aimed to spatially analyze the risk of daily clean water sources on Cryptosporidium spp. infection among stunted children in Jember Regency. This study was conducted on a population of stunted young children in Kaliwates, Panti, Rambipuji and Sukorambi sub-districts of Jember Regency using a cross-sectional design. The Moran and NNI index were used to determine the distribution pattern of infection in a region. Chi-squared test was conducted to determine relationship between risk factors of clean water source and Cryptosporidium spp. It was found that 18 out of 528 (3.41%) stunted infants were known to have Cryptosporidium spp. infection. The Moran index value shows a clustered distribution pattern with positive autocorrelation in the Sukorambi sub-district, while the other areas show arandom pattern. The results of the NNI in Sukorambi sub-district show a random pattern, and 3 other sub-districts show adispersed pattern. The spatial pattern of Cryptosporidium spp . infection in Sukorambi subdistrict and its correlation with the type of clean water source shows that this infection pattern tends to cluster because the population in this subdistrict uses the same clean water source, natural springs, which are shared by all residents, although the distance between users is not close or random according to NNI results. In the other three sub-districts, the spatial pattern tends to be more dispersed due to the use of different water sources that are not shared. In summary, there is a tendency for the incidence of Cryptosporidium spp. to increase in shared water supplies. There is a need to educate community groups to treat the water they use prior to consumption in order to reduce the risk of its spread.


Submitted: 2024-01-22  Revisions:  2024-09-11 Accepted: 2024-09-25 Published: 2024-09-25



Keywords


Stunting;Infeksi Cryptosporidium spp.;Analisis Spasial;Moran Index;Nearest Neighbor Index



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DOI: https://doi.org/10.22146/mgi.93422

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