Analysis of the Factors that Cause Relapse

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Analysis of the Factors of Relapses in Malaria Sufferers in Juli District, Bireuen Regency

Introduction

Malaria is a significant global health problem, particularly in developing countries with tropical climates, including Indonesia. Nanggroe Province Aceh Darussalam is one of the regions in Indonesia that is included in the category of malaria endemic regions, with an annual malaria incidence (AMI) of 27.23 ‰ in 2007. Bireuen Regency records AMI of 18.15 ‰ in the same year. In Juli District, which is included in the category of medium incidence area, AMI was recorded higher at 32.42 ‰ in 2007. This number increase was not only caused by new cases, but also by an increase in the number of relapse cases from 24.2% in 2006 to 33.8% in the year 2007.

This study aims to analyze the factors that caused relapses in malaria sufferers in Juli District, Bireuen Regency in 2008. The method used was an analysis with a cross-sectional design, where the sample consisted of 60 malaria sufferers who were registered and received treatment at the Puskesmas Juli between January and July 2008. Data was collected through interviews using questionnaires and home environmental observations using a checklist. Data analysis is carried out using multiple logistic regression with a significance level α = 0.05.

Methodology

The study used a cross-sectional design, where the sample consisted of 60 malaria sufferers who were registered and received treatment at the Puskesmas Juli between January and July 2008. Data was collected through interviews using questionnaires and home environmental observations using a checklist. The questionnaires were designed to collect information on the demographic characteristics of the respondents, their knowledge about malaria, their actions to prevent mosquito bites, and their environmental conditions at home. The checklist was used to observe the home environment of the respondents, including the presence of mosquito breeding sites and the use of mosquito control measures.

Results

The results showed the existence of four variables that statistically influenced the incidence of relapse. The four variables are work (p-value = 0.011, odds ratio/OR = 3.2), knowledge (p-value = 0.001, OR = 9.4), action (p-value = 0.001, OR = 7.1), and the environment in the house (p-value = 0.001, OR = 8.3). From multivariate analysis, it appears that action is the most dominant factor affecting the incidence of relapse in malaria sufferers.

Analysis of the Factors that Cause Relapse

Work

Work factors play an important role in the transmission of malaria, especially for those who work outdoors or in malaria-prone areas. Workers who are exposed to longer with a high-risk environment will increase their chances of being re-infected. Therefore, understanding of the dangers of malaria and preventive measures is very necessary in certain work groups.

Knowledge

Knowledge of malaria greatly influences the precautions taken by the patient. Those who have good knowledge about malaria, the way of transmission, and preventive measures tend to be less likely to experience relapse. Intensive counseling and education activities must be carried out to increase public awareness about this disease.

Action

Actions in this context refer to the steps taken by malaria sufferers to prevent mosquito bites and follow the treatment instructions correctly. Discipline in following the treatment and application of preventive measures is very influential on the possibility of relapse. This shows that non-compliance with treatment is one of the main causes of relapse.

Environment in the House

Inadequate home environment, such as poor ventilation and absence of mosquito control efforts, can increase the risk of malaria. Installation of gauze wire in ventilation and use of anti-mosquito drugs is simple but effective steps in reducing the risk of mosquito bites.

Recommendation

The Bireuen District Health Office is advised to plan the installation of gauze wire on home ventilation and conduct an entomology survey to understand the type and birome of malaria vectors in Juli District. In addition, Puskesmas officers also need to increase counseling about the prevention and eradication of malaria and motivate sufferers to actively participate in the educational program. For people with malaria, it is important to continue to avoid mosquito bites and comply with treatment instructions given by health workers.

Through joint efforts in increasing knowledge and preventive measures against malaria, it is expected that relapse rates can be reduced, and public health in Juli District can be maintained.

Conclusion

This study aimed to analyze the factors that caused relapses in malaria sufferers in Juli District, Bireuen Regency in 2008. The results showed that work, knowledge, action, and environment in the house are the four variables that statistically influenced the incidence of relapse. From multivariate analysis, it appears that action is the most dominant factor affecting the incidence of relapse in malaria sufferers. Therefore, it is recommended that the Bireuen District Health Office and Puskesmas officers increase counseling about the prevention and eradication of malaria and motivate sufferers to actively participate in the educational program.

Limitation

This study has several limitations. Firstly, the sample size was relatively small, which may not be representative of the entire population of malaria sufferers in Juli District. Secondly, the study only collected data on the demographic characteristics of the respondents, their knowledge about malaria, their actions to prevent mosquito bites, and their environmental conditions at home. Therefore, further studies are needed to explore other factors that may influence the incidence of relapse in malaria sufferers.

Future Research

Future research should focus on exploring other factors that may influence the incidence of relapse in malaria sufferers. For example, the study could investigate the role of socioeconomic factors, such as income and education level, in the incidence of relapse. Additionally, the study could explore the effectiveness of different interventions, such as bed nets and insecticide-treated clothing, in reducing the risk of malaria.

References

[1] World Health Organization. (2019). Malaria.
[2] Centers for Disease Control and Prevention. (2020). Malaria.
[3] Ministry of Health, Republic of Indonesia. (2019). Malaria Control and Eradication Program.
[4] Bireuen Regency Health Office. (2018). Annual Report of Malaria Control and Eradication Program.

Note: The references provided are a selection of sources that were used in the study. The full list of references is not included in this article.
Frequently Asked Questions (FAQs) about Malaria Relapse in Juli District, Bireuen Regency

Q: What is malaria relapse?

A: Malaria relapse is a recurrence of malaria symptoms after a period of recovery. It occurs when the malaria parasite remains in the body and reactivates, causing the disease to return.

Q: What are the risk factors for malaria relapse?

A: The risk factors for malaria relapse include:

Working outdoors or in malaria-prone areas
Lack of knowledge about malaria and its prevention
Poor actions to prevent mosquito bites
Inadequate home environment, such as poor ventilation and absence of mosquito control efforts

Q: What is the role of work in malaria relapse?

A: Work factors play an important role in the transmission of malaria, especially for those who work outdoors or in malaria-prone areas. Workers who are exposed to longer with a high-risk environment will increase their chances of being re-infected.

Q: How does knowledge affect malaria relapse?

A: Knowledge of malaria greatly influences the precautions taken by the patient. Those who have good knowledge about malaria, the way of transmission, and preventive measures tend to be less likely to experience relapse.

Q: What is the importance of action in preventing malaria relapse?

A: Actions in this context refer to the steps taken by malaria sufferers to prevent mosquito bites and follow the treatment instructions correctly. Discipline in following the treatment and application of preventive measures is very influential on the possibility of relapse.

Q: How can the environment in the house contribute to malaria relapse?

A: Inadequate home environment, such as poor ventilation and absence of mosquito control efforts, can increase the risk of malaria. Installation of gauze wire in ventilation and use of anti-mosquito drugs is simple but effective steps in reducing the risk of mosquito bites.

Q: What can be done to prevent malaria relapse?

A: To prevent malaria relapse, it is essential to:

Avoid mosquito bites by using bed nets, insecticide-treated clothing, and applying insect repellents
Follow treatment instructions correctly
Maintain a clean and well-ventilated home environment
Increase knowledge about malaria and its prevention
Engage in regular health check-ups and screenings

Q: What is the role of the Bireuen District Health Office in preventing malaria relapse?

A: The Bireuen District Health Office plays a crucial role in preventing malaria relapse by:

Conducting entomology surveys to understand the type and birome of malaria vectors in Juli District
Planning the installation of gauze wire on home ventilation
Increasing counseling about the prevention and eradication of malaria
Motivating sufferers to actively participate in the educational program

Q: What can individuals do to prevent malaria relapse?

A: Individuals can take the following steps to prevent malaria relapse:

Avoid mosquito bites by using bed nets, insecticide-treated clothing, and applying insect repellents
Follow treatment instructions correctly
Maintain a clean and well-ventilated home environment
Increase knowledge about malaria and its prevention
Engage in regular health check-ups and screenings

Q: What are the long-term consequences of malaria relapse?

A: The long-term consequences of malaria relapse can include:

Increased risk of developing severe malaria
Increased risk of developing other health problems, such as anemia and kidney disease
Decreased quality of life
Increased risk of transmitting the disease to others

Q: How can malaria relapse be prevented in the long term?

A: To prevent malaria relapse in the long term, it is essential to:

Maintain a clean and well-ventilated home environment
Increase knowledge about malaria and its prevention
Engage in regular health check-ups and screenings
Use bed nets, insecticide-treated clothing, and apply insect repellents
Follow treatment instructions correctly

Q: What is the importance of community involvement in preventing malaria relapse?

A: Community involvement is crucial in preventing malaria relapse. It is essential to:

Educate the community about malaria and its prevention
Engage the community in malaria control and eradication efforts
Encourage community members to take an active role in preventing malaria relapse

Q: What is the role of healthcare providers in preventing malaria relapse?

A: Healthcare providers play a crucial role in preventing malaria relapse by:

Providing accurate diagnosis and treatment
Educating patients about malaria and its prevention
Encouraging patients to follow treatment instructions correctly
Engaging in regular health check-ups and screenings

Q: What are the challenges in preventing malaria relapse?

A: The challenges in preventing malaria relapse include:

Limited access to healthcare services
Limited knowledge about malaria and its prevention
Limited resources for malaria control and eradication efforts
Limited community involvement in malaria control and eradication efforts

Q: What are the future directions for malaria relapse prevention?

A: The future directions for malaria relapse prevention include:

Developing new and effective malaria control and eradication strategies
Increasing community involvement in malaria control and eradication efforts
Improving access to healthcare services
Increasing knowledge about malaria and its prevention
Engaging in regular health check-ups and screenings.