Kasus-Kasus Leptospirosis di Perbatasan Kabupaten Bantul, Sleman, dan Kulon Progo: Analisis Spasial

Abstract

Background: Leptospirosis is an important issue in Yogyakarta Province. Outbreak status had set in Sleman, Bantul, and Kulonprogo District. The border areas have the most cases. This study aims to analyze: distribution of the disease; cluster based on the buffer of distance from case's home to rice fields, rivers, and roads; determined clusters; as well as observed patterns of disease diffusion and frequency over time. Methods: This study was an observational study. 327 subjects obtained from all cases of Leptospirosis who were reported in District Health Office from 2009-2011 and living in seven sub-districts, namely Sedayu, Minggir, Moyudan, Godean, Sentolo, Nanggulan, and Kalibawang. We performed a descriptiveanalysis of leptospirosis distribution; a buffer analysis of distance between home and rice fields,riversandroads; cluster analysis; disease diffussion analysis and drawing curve of disease frequencyover time. Results:1)Most of thecasesweredistributedin the agricultural area, area drained by many riverstreams, and area with moderate rainfall(2000-2500 mm/year). There was nospecificdistribution patterninoverlay of cases map with mapsof population density, density ofpoor households, altitude, anddensity oflivestock. 2) Buffer analysis showed a cluster based on the distance between caseshomewithrice fields,rivers, androads. 3)All cases in the seven sub-district was one unit cluster. The area is the most widely drained by large and small rivers. Cluster scores are higher in areas with the highest deprivation scores and has the most widely watershed. We found some Leptospirosis clusters which were across-district, across sub districts, and across the river. 4)Disease diffusion of Leptospirosis cases was an infectious type of expansion diffusion. There was a seasonal pattern according to the planting season and the beginning of the rainy season. There was a trend of increase in Leptospirosis cases from year to year.Conclusion: Leptospirosis disease in the border of Bantul, Sleman, and Kulonprogo District were not spread through the river from one region to another, but very much related to the watershed. Research area which is a cluster is an area drained by many rivers, so it become moist soils and conducive for farming and supports the development and growth of Leptospira and harvest mouse. Cross-sectoral prevention measures must be carried out.