Spatial Cluster Change of Schistosoma japonicum Transmission Foci in Indonesia During the Schistosomiasis Elimination Program

PURPOSE

The Government of Indonesia committed to eliminating schistosomiasis by 2025. Collaboratively snail control became one of the crucial strategies to ensure that the prevalence of Schistosoma japonicum in Oncomelania hupensis lindoensis reaches zero by the end of the program. This research investigated the spatial cluster change of S. japonicum transmission foci in Indonesia between 2017 and 2021.

METHODS

We mapped the snail foci, collected the snails, and calculated the snail density. We also conducted laboratory tests to detect the existence of cercariae in the snails. Identified infected snails were used to calculate the infection rate (IR) or snails' prevalence of schistosome cercariae among freshwater snails. We then analysed the spatial cluster using the Getis-Ord Gi* statistic to identify the hot and cold spots.

RESULTS

The 5-year schistosomiasis elimination program successfully declined 18.84% of the snail foci and reduced 40.37% of the infected snail foci. Local spatial autocorrelation of snail density and infection rate identified that in 2017 and 2021, the number of cold spots decreased by 53.91% and 0%, while hot spots increased by 2.63% and 56.1%. The presence of more hot spots suggests a rise in the number of foci with high snail density and infection rates. The implementation of snail control was not optimal, and the parasite transmission through domestic animals still existed, causing the spatial cluster of hot spots to change during this period. Most hotspots have been observed near settlements, primarily in cocoa plantations, developed and deserted rice fields, grassland, and bush wetlands.

CONCLUSION

During the schistosomiasis elimination program, the number of hot spots increased while cold spots decreased, and there were notable changes in the geographical distribution of hot spots, indicating a shift in the clustering pattern of schistosomiasis cases. The findings become essential for policymakers, particularly in selecting priority areas for intervention. In the Discussion section, we demonstrated the selection process based on the existence of hot and cold spots. Furthermore, we proposed that enhancing cross-sector integration is crucial, particularly in connection with the management of S. japonicum transmission through domestic animals.

Pengaruh Pengobatan dan Prevalensi Infeksi Cacing Usus pada Anak Sekolah Dasar di Kecamatan Dampelas dan Kecamatan Banawa, Kabupaten Donggala, Sulawesi Tengah

ABSTRACT Soil-Transmitted Helminths infection is still remain become a health problem in tropical and sub-tropical countries, one of which is Indonesia. The aim of the study was to determine the STH infection in Banawa and Dampelas sub-districts, Donggala district, Central Sulawesi Province. The study was conducted in February - November 2017 on 153 elementary school students. The collected feces were examined by the direct examination method. The results found infections of Ascaris lumbricoides, hookworm, and Trichuris trichiura. We also found Enterobius vermicularis and mixed infections. However, the logistic regression test showed there was no relationship between taking deworming medication and the incidence of worms in school childrenin Donggala Regency (p-value > 0,05). Based on the results it can be concluded that the prevalence of STH infection in both locations is still high. It is necessary to make efforts to treat school children and counseling on clean and healthy living behavior. ABSTRAK Infeksi Soil Transmitted Helminths masih menjadi masalah kesehatan di negara tropis dan sub tropis, termasuk di Indonesia. Tujuan penelitian adalah untuk menentukan tingkat infeksi STH pada siswa sekolah dasar (SD) wilayah Kecamatan Banawa dan Dampelas, Kabupaten Donggala, Provinsi Sulawesi Tengah. Penelitiandilakukan pada bulan Februari - November 2017 dengan jumlah sampel 153. Tinja yang terkumpul diperiksa dengan metode pemeriksaan langsung. Hasil penelitian ditemukan infeksi cacing gelang (Ascaris lumbricoides) cacing tambang (Hookworm), dan cacing cambuk (Trichuris trichiura). Selain itu ditemukan infeksi Enterobius vermicularis dan infeksi ganda. Namun uji logistic regression menunjukkan bahwa tidak ada hubungan antara minum obat cacing dengan kejadian kecacingan pada anak sekolah di Kabupaten Donggala (p-value > 0,05).Berdasarkan hasil penelitian dapat disimpulkan bahwa prevalensi infeksi STH di kedua lokasi masih tinggi. Perlu dilakukan upaya pengobatan anti cacing pada anak sekolah serta penyuluhan perilaku hidup bersih dan sehat.

Peran Pengelolaan Limbah Rumah Tangga Terhadap Kejadian Diare Pada Balita di Indonesia (Analisis Data Riskesdas 2018)

Waste with a certain concentration and quantity has a negative impact on the environment, especially for human health. Dominant environmental factors such as excreta disposal, drinking water sources, household waste water disposal channels, waste management play a role in the spread of diarrhea germs in toddlers. Diarrhea is one of the main causes of morbidity and mortality in children under five. The purpose of this study was to determine the relationship between household waste management and the incidence of diarrhea. The design of this research was cross sectional, by utilizing data from the 2018 Riskesdas activity, this was in accordance with the approval letter for the use of data issued by the Health Research and Development Agency Number: 11062001-118 dated June 22, 2020. Analysis of the relationship between waste management and the incidence of diarrhea in children under five had been carried out using logistic regression. The samples analyzed were 93,448 toddlers from Riskesdas 2018 data. The results of the analysis showed that the factors related to the incidence of diarrhea in toddlers in Indonesia were the majority male, the age of toddlers over two years old, handling and RT trash bins, and waste disposal sites. Handling household waste is the most dominant factor with the incidence of diarrhea in toddlers. Handling household waste is carried out in an environmentally friendly way by dumping it in a landfill, stockpiling or making compost, it is necessary for households to do so as not to be infested with flies which can be a source of transmission of diarrhea in children under five. Abstrak Limbah dengan konsentrasi dan kuantitas tertentu berdampak negatif terhadap lingkungan terutama bagi kesehatan manusia. Pengelolaan limbah rumah tangga merupakan pilar yang menentukan dalam kejadian diare pada balita. Faktor lingkungan yang dominan seperti pembuangan tinja, sumber air minum, saluran pembuangan air limbah rumah tangga, pengelolaan sampah,berperan dalam penyebaran kuman diare pada balita. Diare merupakan salah satu penyebab utama kesakitan dan kematian pada balita. Tujuan kajian ini untuk mengetahui hubungan pengelolaan limbah rumah tangga terhadap kejadian diare. Desain penelitian ini adalah cross sectional, dengan memanfaatkan data hasil kegiatan Riskesdas 2018, hal ini sesuai dengan surat persetujuan penggunaan data yang dikeluarkan oleh Badan Penelitian dan Pengembangan Kesehatan Nomor : 11062001-118 tanggal 22 Juni 2020. Analisis hubungan pengelolaan limbah dengan kejadian diare pada balita telah dilakukan dengan regresi logistik. Sampel yang dianalisis sebanyak 93.448 balita dari data Riskesdas 2018. Hasil analisis menunjukkan bahwa faktor yang berhubungan dengan kejadian diare pada balita di Indonesia yaitu mayoritas berjenis kelamin laki-laki, umurbalita di atas dua tahun, penanganan dan tempat sampah rumah tangga, serta tempat pembuangan tinja balita. Penanganan sampah rumah tangga merupakan faktor yang paling dominan dengan kejadian diare pada balita. Penanganan sampah rumah tangga dilakukan dengan cara yang ramah lingkungan dengan membuang di TPA, menimbun, atau membuat kompos perlu dilakukan rumah tangga agar tidak dihinggapi lalat yang dapat menjadi sumber penularan diare pada balita.

Implementasi Model Bada dalam Pengendalian Schistosomiasis di Desa Lengkeka, Kecamatan Lore Barat, Kabupaten Poso, Sulawesi Tengah

Abstract Schistosomiasis in Indonesia has been found in three endemic areas of Central Sulawesi Province and its control program has long been implemented for more than 35 years, but the transmission has remained unchanged. A new integrated and community based strategy, namely “Bada”was implemented in Lengkeka Village.in 2019. The study aimed to determine the impact of the implementation of Bada model to control schistosomiasis using mixed methods. The Bada model consisted of four actions, namely design of village regulations, formation of schistosomiasis control team, the improvement of capacity for several key persons and integrated schistosomiasis control with various sectors. The results showed the increase of stool collection coverage from 54.59% in 2018 to 71.92% in 2019 and the mass drug administration coverage, from 53% in 2018 to 86.04% in 2019. The snail focci areas were reduced from five to three areas. The schistosomiasis prevalence in human was 0% in 2019. The study also found the increasing of the knowledge, attitude, and practice about schistosomiasis and its prevention of people in the study area.. Based on the results, the Bada model can be considered to be implemented in other schistosomiasis endemic areas, with regard to the local wisdom. Keywords: Schistosomiasis, community empowerment, development of Bada model, Lengkeka, Poso Abstrak Schistosomiasis di Indonesia ditemukan di Provinsi Sulawesi Tengah dan upaya pengendalian sudah dilakukan selama lebih dari 35 tahun terakhir, tetapi sampai saat ini penularan masih terjadi. Sebuah strategi baru pengendalian schistosomiasis terintegrasi dan berbasis masyarakat, yang disebut pengembangan model “Bada” diimplementasikan di Desa Lengkeka tahun 2019. Penelitian dilakukan dengan mixed methods Pengembangan tersebut terdiri atas empat kegiatan, yaitu penyusunan peraturan desa, pembentukan tim pengendalian Schistosomiasis desa/Tim Peda’, peningkatan kapasitas dalam pengendalian schistosomiasis melalui beberapa tokoh masyarakat dan program pengendalian Schistosomiasis terintegrasi lintas sektor. Hasil implementasi menunjukkan terjadi penurunan kasus schistosomiasis pada manusia dan hewan mamalia ternak menjadi nol, meningkatkan cakupan pengumpulan tinja manusia, dari 54,59% menjadi 71,92%, juga meningkatkan cakupan pengobatan dari 53% pada tahun 2018 menjadi 86,04% pada tahun 2019. Pengembangan Model Bada dapat menurunkan jumlah daerah fokus dari 5 menjadi 3 daerah fokus, juga menambah pengetahuan, sikap dan perilaku masyarakat secara signifikan. Berdasarkan hasil tersebut Pengembangan Model Bada dapat dipertimbangkan untuk diimplementasikan di daerah endemis schistosomiasis lain di Provinsi Sulawesi Tengah, dengan tetap mempertimbangkan kearifan lokal masingmasing desa. Kata kunci: Schistosomiasis, pemberdayaan masyarakat, pengembangan model Bada, Lengkeka, Poso.

Program Pengendalian Filariasis di Kabupaten Donggala, Sulawesi Tengah

Abstract Donggala district had successfully conducted Transmission Assesment Survey–1 despite two children found positive for Brugia malayi. This study aimed to determine the progress of the filariasis program in Donggala District, Central Sulawesi. It was conducted in Kabonga Kecil, Banawa Sub-District and Sabang, Dampelas Sub-District from February to November 2017. Data collection included finger blood surveys, detection of Brugia malayi DNA, mosquito surveys, and in-depth interviews. From 638 people tested for finger blood survey, none of them were positive for microfilaria. Twenty children were tested for Brugia malayi DNA and  the results were negative. A total of 2.978 mosquitoes were caught from mosquito surveys which identified as Aedes, Anopheles, Armigeres, Culex, Mansonia, Aedomyia, Uranotaenia, and Coquillettidia. PCR examination results showed all mosquito negative for Brugia malayi. A comprehensive and integrated surveillance strategy with other programs that are cost-effective and sustainable must continue to be carried out therefore the elimination of filariasis in the Donggala district can be achieved. Abstrak Kabupaten Donggala lulus Transmission Assesment Survey-1 meskipun  masih ditemukan dua anak positif antibodi Brugia malayi. Penelitian ini bertujuan untuk mengetahui capain program filariasis di Kabupaten Donggala, Provinsi Sulawesi Tengah. Dilaksanakan di Kelurahan Kabonga Kecil, Kecamatan Banawa dan Desa Sabang, Kecamatan Dampelas pada bulan Februari – November 2017. Kegiatan meliputi survei darah jari, deteksi DNA Brugia malayi, survei nyamuk dan wawancara mendalam. Sebanyak 638 masyarakat diperiksa darahnya hasilnya seluruhnya negatif microfilaria. Sebanyak 20 anak diambil sampel darah untuk diperiksa deteksi DNA Brugia malayi hasilnya negatif. Nyamuk tertangkap sebanyak 2.978 nyamuk dari genus Aedes, Anopheles, Armigeres, Culex, Mansonia, Aedomyia, Uranotaenia, dan Coquillettidia. Hasil pemeriksaan PCR menunjukkan seluruh nyamuk negatif Brugia malayi. Strategi surveilans yang comprehensif dan terintegrasi dengan program lain yang cost-effective dan berkesinambungan harus terus dilakukan agar eliminasi filariasis di kabupaten Donggala dapat tercapai.  

The Potential of Rats and Bats as Reservoirs of Leptospirosis and Japanese Encephalitis (JE) in Muna Region, Southeast Sulawesi Province, Indonesia

BACKGROUND: Small mammals such as rats and bats are important animal reservoirs of various zoonotic diseases of public health importance. The potential of rats and bats as a reservoir of leptospirosis and Japanese Encephalitis (JE) in Muna Regency remains unknown. This study aimed to determine the presence of Leptospira spp and JE virus (JEV) in rats and bats in Muna Regency, Southeast Sulawesi Province. METHODS: A cross-sectional survey was carried out in three districts, namely Kabawo, Batalaiworu, and Katobu. Bats and rats were caught in six ecosystems spread across the three districts. Serological (Microscopic Agglutination Test, MAT) and molecular examinations (Polymerase Chain Reactions, PCR) were performed to detect Leptospira spp. and JEV in rats and bats, respectively. RESULTS: A total of 137 rats from seven species were successfully caught, namely Mus sp., Rattus argentiventer, R. nitidus, R. exulans, R. hoffmanni, R. norvegicus, and R. tanezumi. Of which, six species were confirmed positive for Leptospira spp by PCR, with the highest prevalence was found in R. argentiventer (50%) and R. tanezumi (36.4%). Meanwhile, a total of 86 bats were also successfully captured. The JEV antibody was detected in D. viridis, R. celebensis and S. wallacei. CONCLUSION: Rats and bats are the potential reservoirs of leptospirosis and JE in Muna Regency. Most importantly, the study provides the first evidence of JE reservoirs (R. celebensis and S. wallacei) in Sulawesi. Surveillance of leptospirosis and JE are recommended.