Analisis Spasial Distribusi Demam Berdarah Dengue Berdasarkan Host dan Lingkungan di Kota Pematangsiantar

Abstract

Dengue Hemorrhagic Fever (DHF) is an infectious disease that is a public health problem in Indonesia, including in Pematangsiantar City. In 2024, there were 315 cases with a CFR of 1,59 percent in this city. This study aims to analyze the spatial distribution of DHF cases based on host and environmental factors to provide recommendations for effective prevention and control strategies. This study is an observational analytical epidemiological study with a case-control design using a spatial approach. The study sample consisted of 78 cases and 78 controls spread across all sub-districts in Pematangsiantar City. Data were analyzed using the chi- square test and multiple logistic regression, as well as spatial mapping using a Geographic Information System (GIS) with ArcGIS. The results of the multivariate analysis illustrate that gender (p=<0,001; OR=11,662; 95% CI: 3,476-39,119), education (p=0,039; OR=0,084; 95% CI: 0,008-0,886), occupation (p=0,016 OR=4,355; 95% CI: 1,323-14,342), knowledge (p=0,004; OR=0,205; 95% CI: 0,071–0,596), type of water reservoir (closed/open) (p<0.001; OR=0,101; 95% CI: 0,030–0,339), frequency of landfill emptying (p=0,004; OR=5,622; 95% CI: 1,746-18,099), use of mosquito repellent (p=0,040; OR=0,325; 95% CI: 0,111-0,949), installation of mosquito nets (p=0,002; OR=5,377; 95% CI: 1,808-15,992), length of stay (p=0,002; OR=7,769; 95% CI: 2,121-28,458), and residential density (p=0,019; OR=4,530; 95% CI: 1,287-15,942) had a statistically significant effect on the incidence of dengue fever (p < 0,05). Spatial distribution indicates a concentration of cases (hotspots) in Siantar Martoba District, with the NNA value indicating a clustered distribution of dengue cases. Dengue cases are more common in areas with high residential density and relatively long distances from health facilities. The conclusion of this study indicates that dengue distribution in Pematangsiantar City is influenced by a combination of spatially significant host and environmental factors. Focused interventions in hotspot areas and increased public education on dengue prevention behavior are needed.