Abstract
Background: Dengue Hemorrhagic Fever (DHF) is one of the main vector-borne diseases infecting humans. It remains a major public health problem in tropical and sub-tropical regions around the world. The poor physical and social environment are the leading cause of the increasing incidence of DHF. This study aimed to determine the effect of the physical and social environment on dengue incidence using multilevel analysis. Subjects and Method: This was an analytic a case-control study conducted in Bantul, Yogyakarta, Indonesia, from November to December 2018. A total of 250 study subjects were selected using the fix disease sampling method. The dependent variable was the incidence of DHF. The independent variables were Maya Index (MI), Density Figure (DF), household crowding, knowledge, mosquito nests eradication, and use of mosquito repellent. The data were collected using a questionnaire. The data were analyzed by using multilevel multiple logistic regression with Stata 13. Results: The incidence of dengue fever was increased with high Maya index (OR= 5.04; 95% CI= 2.38 to 10.67; p <0.001), high density figure (OR= 4.01; 95% CI= 1.90 to 8.44; p <0.001), high household crowding (OR= 1.90; 95% CI= 0.91 to 3.95; p= 0.870), low knowledge (OR= 2.94; 95% CI= 1.41 to 6.12; p= 0.004), poor mosquito nests eradication behavior (OR= 3.09; 95% CI= 1.47 to 6.49; p= 0.003), did not use insect repellent (OR= 3.06; 95% CI= 0.01 to 0.10; p <0.001). Village strata had contextual effect toward the incidence of DHF with Intra-Class Correlation (ICC) by 17.34%. Conclusion: Maya Index, density figure, household crowding, knowledge, mosquito nests eradication behavior, and the use of mosquito repellents affect the incidence of DHF. Village strata have a contextual effect on DHF incidence. Keywords: DHF , Maya Index, density figure , occupancy density, knowledge, mosquito nests eradication Correspondence: Nurkhairani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta, Indonesia. Email: anachristi19@gmail.com. Mobile: +6285229185896. Journal of Maternal and Child Health (2021), 06(02): 197-205 https://doi.org/10.26911/thejmch.2021.06.02.07
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