Typhoid Fever in Ngemplak

ENVIRONMENTAL SANITATION AND PERSONAL HYGIENE AND THE INCIDENCE OF TYPHOID FEVER AT SUBDISTRICT OF NGEMPLAK DISTRICT OF BOYOLALI 2010

Zulfikar1, Adi Heru Sutomo2, Susi Iravati2

ABSTRACT

Background: Typhoid fever is a disease caused by Salmonella typhi bacterial infection. The disease is still a public health problem particularly in developing countries. It is closely related with unhealthy environmental sanitation condition and poor practice of personal hygiene. In Indonesia, the disease is very endemic and occurs throughout the year in all regions. Subdistrict of Ngemplak is a subdistrict at the District of Boyolali that has the highest cases, i.e. 656 cases in 2009 or nearly 44% of all cases at the district with mortality as much as 9.26 per 1,000 population. This figure is higher than the overage rate of typhoid fever incidence in Indonesia; i.e. 5 per 1.000 population a year.

Objective: To analyze association between environmental sanitation and personal hygiene and the incidence of typhoid fever.

Method: This observational study used a case control study design. Subject of the study consisted of 134 people comprising 67 people as cases and 67 as control. The study was undertaken at Subdistrict of Ngemplak, District of Boyolali. Data analysis used chi square test with α=0.05, OR calculation and logistic regression test.

Result: The result of multivariate analysis showed variables significantly associated with the incidence of typhoid fever were quality of toilet (OR=3.438; 95% CI=1.573-7.513; p=0.002), hand washing before eating (OR=2.915; 95% CI=1.333-6.375; p=0.007); history of typhoid fever disease of the family (OR=2.961; 95% CI=1.115-7.861; p=0.029) and habit of eating out (OR=2.350; 95%CI=1.036-5.332; p=0.041).

Conclusion: Toilet that met sanitation requirement, handwashing using soap before eating, habit of eating out and history of typhoid fever disease in the family had significant association with the incidence of typhoid fever. Clean water facilities that met the requirement and habit of toiletting had no significant association with the incidence of typhoid fever.

Keywords: typhoid fever, environmental sanitation, personal hygiene

1. Health Polytechnic, Banda Aceh
2. Graduate Program in Environmental Health, Faculty of Medicine, Gadjah Mada University