Containated water and Leptospirosis Infection on Society in Endemic Area Kabupaten Sampang Madura Repository - UNAIR REPOSITORY

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lnternational Journal of Epidemiology & lnfection
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Grffith University, Australia
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Dental Council of lndia, lndia
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Nova Southeastern University, USA
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Kazan Federal University, Kazan, Russia
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Department of Biotechnology, Jamia Millia lslamia Central University, lndia
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Brown University School of Public Health, Department of Biostatistics, Center for

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DOI: 10.12966/ijci.l

Ir crnational Iouusl ofEpidcmiotogy & Infcction
AAtdbrrion 3.0 Unportcd (CC BY 3 .0)

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-74

.m.7011

'

fffiirs

Contaminated \ilater and Leptospirosis Infection on Society in
Endemic Area Kabupaten Sampang Madura

il
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IXne F Roryedrr, Rustrmen RIhJ,

Xf

h Yudhestuflr,

Bubrug

G lrlentor,

Elri

ii

B Notobroto'

I

I

rEtrviroomtsl Hcslth Dcpstgrstr! hblic Hcalth Facllty, Airlauggr UniYGrsity SuEbcy.' lndooGir
lHcqlth Polytechnic Sur8bayr, Indmcri!
]H6lth St tiltico Drp'I!!co! Public Hcalrfi Faculty, Airlmgga Urivcrity Surrbryi, Iqd6E5i.

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ri

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fCorcspoodbg auttor (Emil: dina6rioarocya@yahoo.co.id)

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Abrtrrct - Th€ grcat climarc for lcptospin dcvelopslcDt is narm air md humid soil. Thir situation oaa bc formd commonly ir
tropical coutru'y, snch as Indoncsia- Ttis discas€ ia found in arca which is cootaminated by urinc from Lqt^cpim bactrrin

I

infectcd aairnat. Casc in Indoocsia is formd again on April 2013 until mid-2014 in Kabryatro Saryang Madura. From that
6!ding, SEopang is coofrmcd as cod€mic arca of leptospimsis, Thi! rcs€srch aiocd to aml)rzc thc influ€acc olcootaoilated t
watcr, bomc salitatioa and bealth bcluvior ol Lepuxpira infection ir society in l&bupat€o SaoDaag Madura Data rer€ I
collected tom laboratory cxamimtion on mouse oarrplc aod puddlg iattrvicw and obcsvation This rcscqcb sscd malytical
observational witt case cofirol dcsign. Tbe oumbet of sarplo wcre 7 crsc .rea and 2l colEol arca (l:3), cach of drEm used l0 I
inhsbitants. Dafa vcrc analyzed with univariste and multivariatc used logistic lrgr€ssim trsl Dominrnt faotm that influaced I
I
leptospimsis wos flood track.ecord (OR=2, 89; p4,001). Ervironm€ohl hcalth Esosgsrreot wi& ro&nt mnitorin& xrasc
program
plan
used
in
conuslling
lcptocPiroois
water pipclinc haadling wtich rclated to rainwater ars som efforts wtich can be
iu Kshryat€n Saqatrg Madura-

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Reyior.lt - t ptospirosi!, Endimic, Coorqninrtcd Wstar

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1.

Introduction

jI
i
I
Zooaoses are diseases that can natr:rally vsrtebmta h8&sfcarEd from animals to bumaos or furst!8d Lcptospirosis is an iofectious
!
Ciscase causcd by a bacrcrial pathogen called Leptospira, wtich b tr8osrtrifird dircctty or iDdirrctty fiom arisals to hrrmaos so it I
is included in momcfic diseascs. (VIHO, 2003) Th6 srea emund South East Asia w.s rspoficd ss leptoryirosis codemic arcas.
!
Countries bave rsportcd outbreaks record leptospirods cases uamely India, Indm€siq Sri Lekr ond Thailmd. Areas with I
specifc clirutc, E Ey populatioas end thc irceas€d coatact baweco humas and daorls (inftctcd witt Lrptospira bacteda)
coEtribulc to maiDtsidng thc high u-ansnission of lcptospirosis ill Sordtcad Asia- Data from &c Int€nrationsl Lcptospirosis
Socicty (ILS) statcs tbat lndoncsia is orrc ofthc topical cormtri€s with rclstivcly high leptospirodr dcrths, wLict rlaged beiweeu
2.5o/o - l6-45Y" ot u averagc of 7.10,4 aad including tkrc mDlcd in ttc world for mrality (lrvctt, 2001).
Bascd on thc Sampalg Hcalth Servics In April 2013, conccraing thc cxistrocc of casc6 of leAtospirmis h &c poet-Aood '
Saryang sincc April 2013 showcd a significatrt increarE iD thc uumber of cases md dc{ths hlve an i4oct occurs. Cas.
rediscovetd in 2014, there wqr 5l Gported plti€ds witt clinicsl syESoBs of l.pto6pirosi! s! trstrd to Saqang Hospial l
(BBTKL & Surabaya, 2013; Samparg Healtb Scrvice, 2014). Thc lapri of tk rcaa thd have a lot morc people with
lcPtospirosis in tbe vifhgcs those arc in the tow! of Saorydrg by ncig[borhood mostty &om Gunug Selor, Banyu Newer,
Kamoning, Ccut'al Rong Dalpcnag, Pot"g"n ald Acngsar&
Based on leptoqirosis onlbrcaks thnr bave occr:rrcd in Sarymg disricq thcc is a big pocoibrlity L?toapira bacttria prescnt
thc
in
cnvirumcat in tbe endemic areas. Esvircumcntal hlth rcscarch associatcd with tcfroryira baacria conuoinauoq ro ,
s/3!er puddles' bchavioral f.ctot8, horE saaitd'on fa.tors 8ad thc cxigcncc of ricc infcstcd witt the bsctcrium tretospin in
eodtmic arsra. Ery€sEd to bc us€ft| in sccing bow tte tnnd of lcptocpirmio carcs in 6c fitup firthcr coosidcr*ioo carly
aYmrctlcss prograE b leptospirosis cnscs to m8kc E c@trol of thc oanrgorr* of cuvimcrtat trcrtth,

r

Iatcrnatioaal Jownal of EpkLmiotogy & ln fccti on (2014) 7l'? 4

?1

2.

Reseirch Methods

Thig res€arch is an obs€ryational ar:alyic rtudy with case coatrol ddign- Tbc pqulatio urcd in thn *udy ii thc Populatioa of
c6es atrd cortsoh- Th€ casc population is a population casc Dkrict / Villagc ia Srtryang containcd lqtodpirosis patierts.
PopRrJati@ control is thc village / village in Sampang that 6cre wcrc no pcople wi6 tcptoapfuocis. Cootol ranplc ir the uban /
rural in Sampug wto tlo not have prople suffering from lepospirocfu. Tbc sanplc sizc ofthis sardy uring a compuison group of
cascs and cortsolr was l: 3. hrgc sarylc of cas€ was 7 Distict / Villago and coufol sarylc size ir 2l Dis8icd / Villagc so that
the sauplcs in this *udy were 2t District / Viltagr. Control saryld itr tiit rrs€arEt wcre 2l District / Village- Tbc saurple area
ofa Disuict / Village in thir sordy consisted ofrEsidetrt8 and bolH Es vEll Es wat r s3trIplcs tEkcn Aom scY€ral points in cacb
District / Villagc. ln thc variablc charactcristics of thc region, hooc sadtatio[ atrd hctlth bchwiors ware tskctr &ord cach Dshict
-v'illagc as 6e aamplc is 70 corco 8sd control
/ Vitlagc and housc I 0 pcople, so srrangB pcople and bousca rtprcccntiry Ditrict i
sarnplcs was 210 to weter saErples takeD cach 7 csscs cacb sarelc areas of pctrdld w8r!r ssryles and tbc contol samplc a'cas
w€rc 2l watrf sarplcs ateo from several poinls- In thc saEple of lat tsE ping rata pcrformd in some areas tbe numbcr of
l€piorpiroab cascs or paticaB thc most. Eacb rcspondear yas htcrvisw.d wi6 on tbc (o'nplc quBtionDrirc intcnricws and
obscrvatioos sanitation of ttcir home. Thc observation dsra itrchldas v.rrf qryply, typc of wastcwerrr dispoal, any trasbcaa
rnarts thc rat, gu6€r distancc to homc and tie presence of coqooen6 61ft6 6€iling in tbc housc in raqleg tatco rEt kidneys for
leprospircs laboratory tested Sanptee of watEr prddla md hdncys of nicc tcrted rsing potymtras€ chafu rcactiotr ms&od

3.

Results snd Discusslon

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pfft of tt€ island of Java Ovcralt Saryang Dirtrict h8s a total a.ca of
t23330 tm2. Thc lotal populatioo of Sampang is 1,008,799 peoplc. Thc numbcr of saoplcr &om 2E rcgioos coosisB of 2EO
respoadcrc. Data characteristics ofrcspondeats by cducation lart majrity wcre pimary rhool gra&ats (35.7%), the tDajority
of thc ftmalc gcndcr of rcspondcnt (53.9-ol.). Most respood.nts sged 3140 ycan (3a.6%) od j* mrjority of sclf-crnploycd
Sampang oo Madwa is a diskict th8t ic in thc north castcm

respoodcnts (85.7olo). Av€rage incomc ofrcspondents is Rp 600,00O/ month-

Tablc

l.

Cross-taNations variablc ofbc[avioral factorg the majority of th€ popoldion seitatiotr fectors
laboratory srrTlca ofrat! rd wstsr puddles with th€ typc ofclsc 0!d conrol rrgion

Vrrlrble

Reglon

-Pogitive

-Ncsstive
Flood track record
-Ever f,oodg
-Ncvcr floods
Uscd protcctor af home
-Nev€r

4lrays

(se/r)
t (6.3%)

6

(lm%)

)$qd

0 (0p,r)
7 (29.2yo)

6 (5V/.)

l5

2tas.ta)

4

-Never

0 (0ol.)
7

(58.3%)

(twc)

outdoor

0 (0olo)
7 (63.6%'t

16

-Batbroom
Placc to *ashing tablcworc
-Washirg di8h€r| in rhc kitchcE

-Ctdoor
Frrqu€nt prcscncc of rat
-Ycs
-No
HavinS p€ts

0 (ry/r)
7 (3s%)

0.000

0.389

0.533

17

(l00,/o) 1t.23

0.0ot

4 (36.4%

E ( 100./o)

2.t

o.t47

t3 {6sv")

7 (4t.z-A\
0 (oyo)

lo

(5E.E"/o)

I

l0e/6)

1 (25y")

2t (1sy)

0(o%)

rE.l01

(tooryo) 9.52E 0.002

Plac€ io balh

-River

O.O2'1

5 (41.7"/0 )

Working placc

-Indoor

4.861

t7 (70.8W

Used protcctor ia working habit

-Always

I

(93-89/0)

0 (0 /c)

I

0 (e/6)

of

p

G=1t)

L,eptospira mousc

6

regults

Control

Cerc
(n=-a

Wat6 conrq"ninrtioo and positive

Ydue

ad

4-043

0.044

2222

0.400

Iltrmeti(rril }rrruii

of

EpkHotog & Inftctio (mlq7l'74
2(t2.5%)

-Yca
-No

t4

?(

(n.syo) t.75

o.lE5

0.124

0.124

Frequeocy ofcontact wi& Puddlc

WelEr
-Scldom
-Onen
Wat€r Supply
-Wctls
-Local *atcr coqany
Type of wastc*atcr disposal
-There uras no
4psn waslewstcr disposal
{lose vastcwat€r disposal
-ADy Eashcar

1(28%)

tE ('tzvo)

o

3(t00zd

(t/.)

0(v/.)

7(rw

-No
-Ycs

Aay Marks of rals in homc

2l

(two)

a

(v/.)

I

(14.3o/o'

15 (1004,.0)
6 (E6.1"/o)

6

(lof/,

0 (V/a)

7
0

(|W/c)
(0/.)

0(ry,

2$.7m

-No
Any Ccilbg in tbc housc

5 ( 1007.)

-Yes

7

i

22.921

0.000

it

i

0 (oel,)

)

-Y€3

rl

?3.429

I
0.000

I

22.291

I

o.mo

I

2r (100./0)

{tftr/.}

I

i

2l (91.3o/c)
0(ry.)

l3;lt6

0.000

0(trn)

22.921

0.000

I

I

i

From thc Table I shows thc independcnt yariable lbat havc rclsvancc to tbc dcpdcd vrriablc in 6is sedy ar" Watsr I
contamilatioo and positivc l4tospirE m[sc, flood Ea.k r€conq used protcctor in lrorting babit xrc(kiDg placa, plac. to t
washing tablcrare, srpply watsr, t)?c ofc,a3texratrr dispocsl, any trashca4 atry marks ofratc io honc md atry csiling in hous€.

Tabh

Vrrhbcl

rffatcr coDt minirioq aad pogitive
L€ptcspirs mouse

Flood track rccord
Us€d protector in

aorkiry babit

Working place
Placc to u,ashiog tBblewarc
Supply

vstcr

I

2. Bivariate Tcst

oR

('lts% CD

p

l5

t.47 5.152.4

0.077

2..15

1.3934.325

0,m2

2.78

0.87&2.485

0.004

t6.24

0.E562.468

0.u2

L7E

r.378-5.633

0.074

1.34

0.752-2.380

0322

t6

o.7't2-l -734

0.46

Typc of wsstte'attr dispooal

l.

Atry Edshcar

2.69

1.4624.945

0.05t

1.54

0.821-2.900

0.t7E

2.69

t.452.1,94s

0.rl0l

Aay

metr

of rats ia homc

Aay cciliag in bousc

Frpm thc Tgble 2 shows the variablcg thai affcsr thc icidcncc of lepdospitosis in Sarymg are
positivc Lcptospira 8t Eousc, flood track rccol4 uscd protcctor in wuttiag habit aad wting placc.

watr contaminatioo

ii

and

Trblc 3. Multivariar. Test
OR

(95y.

p

L€ptospirE oouse

1.il

0.t7&3200

0.176

Flood track rrcord

2-69

1.4624.945

0.00I

Uscd protcct6 iD r.,o*iug hsbit

1.53

0.E23-2.EI0

0.1

Yy'orking

1.46

o.8784245

o.t42

Varlabel
Wstu contalrinrtiof, and posiiive

Fmm thc Tablc 3 showr thc moet variablcs in this rcscach ir flood Fack rccord Variablc rcnrlts oflaboratory
tcsts of watcr

i

Intcrncional Jotrrnal of

74

Epitffiolory & Io.fteicn (20i1) ii-71

and rata bavc a significatrt effcct (OR = 15.0) on thc occurrence of cascr of lcpo.ryirosir in tlr rcgiotr Saryaog. This indicatcs
the pres€oce of x/at{r csnaminaioE and .ricc infcct d by l.?tospira bacrsis inffucncc 6c surrrncc of caces of i?.oryirosisUrine of infected animrls catr codaminsrc the crvirmment and a8 I Stalting point I source of transmi:oion of lcptospirosis
(SWar ct sL, 2005; Toyokaws et aI., 201 l).
Th€ rEsul6 EhowEd tbat uea with as many as 16 cascr of lcptoepiroe is rat's mra than 50el6 po*itivc lcftospirosis. Typc micc
arc Suncua mr[iEus, R uowegicus, 8Dd taacami B8ndicot& Rat playr m iryortut rolc in ttr trrnsmission of l€Ptospiro8is
(Ristiyanto, 2008). Taaerni rat is knowlr a8 rat wholc ac'tivitiec erch c firding foo4 chcltct, md brceding in tbc housc. Rat
norvegicua rnors oftea occupy watcr*ays and are foond in orbaa arras wt€rs ir most areas of ttic rasesrch the casc of urban
areas in Sanpang (Okatili ct al., 2007; Raja a aL, 2012)- Fmm thc ki&rcyr, lepocpirca ars lxcretrd in thc urirc ard may tho

il
il

jl

I
I

contioate s:rfaoc water, stcams and yalcr, infection of animals or humm occrr &ou dirEti contact witt urirr or water I
tcrmina6d (Adla ct al., 2010). Cascs of l€ptospirosir in Saryang $4eortcd by 6c occurrncc of flmding (OR = 2.45). I
Reseach arta wer floding bas occurred El greatsr rist of lcptoflpirosis, wher€ s history of morc frequld flooding drrilg 6c
rainy season (Mandal et al., 201l). At tk timc of stagnant flood s'atr €o 8min8t€d witt Lcptoryira ridt (S{tff et al., 2002).
According to tbc history of tloodirog ir Sarpaog bavc a big tlood in April and May 2013 and occurrcd rgdn in hE 20t4 ud I
ca y this allows for tbc sprrad oflcptospira ad mice infoctcd with kptosPirosis in thc rcgim of the case. Whilc in 6c rcgion is I
not thc case of a nood nsvcr happ€ne4 so it c,aE not a cssc of lcplospimsis in thc rca drsPitt thc laitsry bous€ has more I
componenrs than the minimal region of thc urban area of 6e casc (Kusoiyad 2005). In this Ordy vrriablc alro have a
sigDificant elfcct oo the wear factor footsear a'td pcrsornl protcctive cquipment wficn wortiag ard thc type ofwod( that can bc
sharcd indoors or outdoors, usiog pcrsooal protcctivc equipoat whco mrtiog priDrrity pcrformed Qtdoors to mirimizc
contact n,ith cotrtsmimted ctrvirooo.ntal Ercdia risk L,tptoopira pooitivc rat urinc (Gamap et d., 2012).
Variable cutlery washing juaga is *ignificant €fu- Place O washing cating/tablcware coutaminatcd rat urinc can be risk if
donc outside thc hour gvcn tlre rats would b€ clos€r to tbe placc smellcd lftc food or uratcr' .hIrnel. thrt c&ricd &c rat {
R.nowegicus.
I

4.

i
Conclusion

$

ir

From thcsc results it was known that a potcntially bccomc codcmic r€gioos lc?to0pimsis in Sampons Madura was ceus€d I
dogtiraot frctor & history of flooding in the rcgion. to ncver flooded reas wilt potcqtisty E kc the spread of rat urinc in ouc
sDvironmcttal medium is puddle sBtcr. It was supportcd by fic positive ratE with txptospira. The mrmuoity was crpcctcd to '
usc persoml pmtectivc cquipmert in the wcaa of floodin& such as the u& of boots and glovcc in an attcryt to midEizc thc risk
of cootact with r8t urhc Loptospira positivc. Bcsides tbat it avoids tbc fic4rcacy of coatact wi6 dirty water whqo lloodi4 I
occlrs. Enviroment on thc other hand mdntaincd thsr tbc rod.nt docs not casily ft in thc hom €nvirotr rr€trt md rats moniloriry |
:

is nccd to detcrDinc thc condition of the

infusd

rats in

E

rcgion.

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Pacifu,loual of ftoplcal iladrca., p. tml-I0()6Olutini i{., Farwrnr R, & DjsjE M. L (20Or. Rclatioorhip of Etrvi!@tl F.ctdt .od Di!...c OcoEr! c! Charaarriaicr of iodividub A8riD,

srdpdf t{..ttt S.dic..

CnnrsB

C.

L,*to+irocir ir Jrkarr-Mzt n\ ltulrL, I I (l).11-21Rrji, S. & KtlitbdE ,\ (ml 2). I-+oqir! L Rc...rl! ruEc.ti(a h hdi!: Cyrtkr A'',fislt

Ar*ml} Md JNnd dMa*

al nd

I

lryltd ltfe

&iarc:. p.t3l-l{.
Sdflr, U- Nscim.ntq S. F., Beto.., R., f,tutirr, R., Ntr3vo, fL, Iohfooo.r t, & Ko, A t (20(r2I P@tlrtio+..cd c.ro{qEd irye*igdiE of
for L$o.piro.ir dtring.s rtfu qidas,ic- Tte ,l*rbotiotor,,, d tqbl ,iad.,,. drd hygtac, 6qt\@S4lo.
TqFlc** Tr ohi$i! nl., & xoiafri, N. (Ztr t ). Di.SE (i. of rd. t*qt,Ei*
W6id H..ftt Or8&i^ir em3). ttum- t4toqirtir Oriare fu Oieglrr., Sr'iEilbo. Ed C:6ol

!i* ict(r
i

I