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UPAYAPENANGGULANGANKASUS DBD DI WILAYAHKERJA PUSKESMAS
AMBACANG TAHUN2011
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Bab IPendahuua
n
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La!a" Bea#an$
Pen%a#&! De'a' Be"da"ah
Den$ue (DBD) 'e"u*a#an+aah +a!u 'a+aah #e+eha!an'a+%a"a#a! *en!&n$ d&
Ind,ne+&a dan +e"&n$'en&'bu#an +ua!u e!u+anKejadian Luar Biasa (KLB)den$an kematian
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KASUS DBD DI IND-NESIAMENURUT TAHUN
2002 200. 200/ 2000
10
20
.0
/0
0
0
0
30
40
C,u'n2
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200 200 20005
15
15
25
25
.5
Chart Title
C6R
Ta"$e!Presentase
CASE 6ATALITY RATE
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KASUS P-SITI6 DBD DI PUSKESMASAMBACANG
2003 2004 2010 20110
2
/
3
10
12
1/
C,u'n2
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1.2 Rumusan Masalah
6a#!," 7 8a#!," a*a +a9a %an$'en%ebab#an !&n$$&n%a an$#a #a+u+DBD :&a%ah #e"9a Pu+#e+'a+
A'ba;an$ Ku"an9& *ada !ahun 2011 15
TNI> 25
a&n?a&n> 135
Ma!a Pen;aha"&an Pendudu# A'ba;an$
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Ju'ah Tena$a Ke+eha!anNo Jenis Ketenaaan Pendidikan Jumlah
1 D,#!e" U'u' S 1 /
2 D,#!e" G&$& S 1 .
! A*,!e#e" S 1 ?
" Sa"9ana Ke+eha!an Ma+%a"a#a! S 1 .
# Pe"a:a! Ah& S 1 ?
$ Pe"a:a! Ah& Mad%a D . .
% Nu!"&+&,n&+ S 1 1
& Pe"a:a! Ke+eha!an SPK .
' B&dan Ah& Mad%a D . 11
1 B&dan SPK ( @ )
11 anitarian *! !
12 Pe"a:a! $&$& SPRG 21! P"ana!a Lab,"a!,"&u' Ke+= SMAK 1
1" A+&+!en A*,!e#e" SM6 .
1# S,*&" SLTP 1
1$ Pen9a$a Maa' SLTP ?
Ju'ah /
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S!"u#!u"-"$an&+a+&
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Bab III
T&n9auanPu+!a#a
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Den&+&
De'a'
dengue(D6)
Pen%a#&!8eb"&+?&"u+a#u!
Tanda +a#&!#e*aa"ua'
eu#,*en&an%e"& !uan$+end& a!au
,!,!
De'a'be"da"ahden$ue
(DengueHaemoragic
kFrever/DHF)
!anda de'a' !&n$$&8en,'ena he',"a$&
+e"&n$ den$an
he*a!,'e$a& dan*ada #a+u+ be"a!
d&+e"!a& !anda ? !anda#e$a$aan +&"#ua+&=
Keb,;,"an
Pa+'a
sindromsyock
dengue
(DSS)
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E!&,,$&
/ Se",!&*e A"b,&"u+1= Den$ue !&*e 1 d&&+,a+& ,eh Sab&n
2= Den$ue !&*e 2 d&&+,a+& ,eh Sab&n
.= Den$ue !&*e . d&&+,a+& Sa!he"
/= Den$ue !&*e / d&&+,a+& Sa!he"
Yan$ !e"ban%a# d& Ind,ne+&a adaah den$ue !&*e 2 dan.
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Penua"an
N,amuk Penular - edes e,/ti Da+a" h&!a' den$an b&n!?b&n! *u!&h *ada ba$&an
badan #a#& dan +a%a*n%a Men$$&$&! b&a+an%a *a$& (*u#u 04=00?10=00) +a'*a&
*e!an$ ha"& (1=00? 1=00) Te'*a! h&n$$a* %an$ d&+enan$& adaah benda?benda
%an$ !e"$an!un$ dan b&a+an%a d& !e'*a! %an$ a$a#$ea* dan e'bab
Tem/at Potensial Bai Penularan *B*
W&a%ah %an$ ban%a# #a+u+ DBD (Ende'&+)
Se#,ah RSF *u+#e+'a+ dan +a"ana *ea%anan #e+eha!an
a&nn%a= Te'*a! u'u' a&nn%a +e*e"!& h,!e *e"!,#,an
*a+a" "e+!,"an !e'*a! &badah dan a&n?a&n=
Pe'u#&'an ba"u d& *&n$$&" #,!a
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Mekanisme Penularan
&"u+ den$ue d& da"ah *ende"&!a DBD(*,+&!&8) a!au ;a"&e"
Darah dihisap nyamuk virus dilambung nyamuk
&"u+ be"#e'ban$ b&a# d& be"ba$a&9a"&n$an !ubuh n%a'u#
!e"'a+u# d& a&" &u" n%a'u#
1 '&n$$u #e'ud&an n%a'u# 'en9ad&&n8e#!&8
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0amaran Klinis *emamBerdarah *enue
De'a'
Man&8e+!a+& Penda"ahan (*!e;h&ae
*u"*u"a e#&',+&+ e*&+!a#+&+)
He*a!,'e$a&
Sh,;#
Ge9aa a&n (an,"e#+&a 'ua'un!ah d&a"e a!au #,n+!&*a+& dan
#e9an$)
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*ianosis *emam Berdarah*enue.
De'a' !&n$$&'endada# !an*a+ebab %an$ 9ea+
be"an$+un$ !e"u+?'ene"u+ +ea'a 2?
Man&!e+!a+&Pe"da"ahan
T,'b,+&!,*en&a %a&!u9u'ah !",'b,+&!d&ba:ah 10=000F''.
b&a+an%a d&!e'u#anan!a"a ha"& #e .? +a#&!
He',#,n+en!"a
+& %a&!u'en&n$#a!n%a
he'a!,#"&!=
Kenaan H! 20=
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/a,a
PemerantasanPen,akit *emam
Berdarah *enuedi 3ndonesia
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Pe"&a#u Pendudu#
Pe"an Tena$a Ke+eha!an
S&+!e' Pe"&n$a!an D&n&
Re+&+!en+& N%a'u# !e"hada*In+e#!&+&da
4aktor54aktor ,anMem/enaruhi
KeerhasilanPemerantasan *B*
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Keijakan
PenanulananPen,akit *B*Pen&n$#a!
an*e"&a#udaa'h&du*
+eha! dan
#e'and&"&an'a+%a"a#
a!!e"hada*
*en%a#&!DBD
Men&n$#a!#an
*e"&ndun$an
#e+eha!an
'a+%a"a#a!
!e"hada**en%a#&!
DBD
Men&n$#a!#an &'u
*en$e!ahuan dan
!e#n,,$&*",$"a'*e'be"an
!a+anDBD dan
Me'an!a*#an
#e"9a+a'a
&n!a++e#!,"F&n!a+
*",$"a'=
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tratei dalam PelaksanaanKeijakan
Pe'be"da%aan 'a+%a"a#a! Pen&n$#a!an Ke'&!"aan Be":a:a+an
Beba+ da"& Pen%a#&! DBD Pen&n$#a!an P",8e+&,na&+'e Pen$e,a
P",$"a' De+en!"a&+a+& Pe'ban$unan Be":a:a+an Ke+eha!an
L&n$#un$an=
Pe'be"an!a+an &n!en+&8 *en%a#&!De'a' Be"da"ah d& De+a #eu"ahanende'&+ De'a' Be"da"ah Den$ue
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Proram P25*B* di
3ndonesiaPen%e&dan E*&de'&,,$&Pene'uan dan *e"!,,n$an
*ende"&!aAba!&+a+& See#!&8 (AS)
6,$$&n$ 6,;u+ (66)
Pe'e"+aan Jen! be"#aaPe'ben!u#an Ke,'*,# Ke"9a
(P-KJA)Pen$$e"a#an PSN (Pe'be"an!a+an Sa"an$N%a'u#)
Pen%uuhanPea!&han
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kema Penelolaan *B*
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Monitorin dan 67aluasi
Inda!,"*e'e"a!aan
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Inda!," E8e#!&&!a+ Pe"&ndun$an
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Inda!," E+&en+& P",$"a'
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Bab IPe'baha+an
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a= Iden!a+& Ma+aah
1=Te"da*a!n%a ',"!a&!a+ dan !&n$$&n%a
an$#a #e9ad&an DBD d& Pu+#e+'a+A'ba;an$ Ku"an9&
3 ,"an$ *,+&!&8 DBD 2 ,"an$ 'en&n$$a dun&a
Tahun
2003 12 ,"an$ *,+&!&8 DBD T&da# ada %an$ 'en&n$$a
dun&a
Tahun2004
. ,"an$ *,+&!&8 DBD T&da# ada %an$ 'en&n$$a
dun&aTahun2010
,"an$ *,+&!&8 DBD 2 ,"an$ 'en&n$$a dun&a
Tahun
2011
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2=Men&n$#a!n%a Ka+u+ G&$&!an He:anPenua" Rab&e+ d& Pu+#e+'a+ A'ba;an$
Ku"an9& #a+u+ $&$&!an he:an
*enua" "ab&e++eban%a# 11 #a+u+=
Da"& ha+& *e'e"+aan
!&da# d&!e'u#an adan%a*a+&en %an$ *,+&!&8'ende"&!a "ab&e+=
Tahun
2010 #a+u+ $&$&!an he:an
*enua" "ab&e+
+eban%a# 2. #a+u+= Da"& ha+& *e'e"+aan
!&da# d&!e'u#an adan%a*a+&en %an$ *,+&!&8'ende"&!a "ab&e+=
Tahu
n2011
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.=Rendahn%a *ene'uan #a+u+ ba"u TB Pa"uBTA *,+&!&8 (Case Detection ate ! CDR)d&
:&a%ah #e"9a Pu+#e+'a+ A'ba;an$ Ku"an9&=
*ene'uan *a+&en ba"uBTA *,+&!&8 (CDR)'en;a*a& .35=
Tahu
n2010
!"&:uan I 'en;a*a& 22 5 !"&:uan II 'en;a*a& /2
5 !"&:uan III 'en;a*a& 1
5 %an$ !en!un%a 9auh da"& !a"$e! %an$
d&!e!a*#an %a&!u 05=
Tahun
2011
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/=Beu' !e";a*a&n%a !a"$e! DFS d&Pu+#e+'a+ A'ba;an$ Ku"an9&
#eu"ahanA'ba;an$015
#eu"ahan
Andu"&n$ /3/5 #eu"ahan
Lubu# L&n!ah/34 5
#eu"ahan
a'*an$/5
Be"da+a"#an da!a!ahun2010
*en;a*a&an DFSadaah
4 2 5=
Ta"$e! %an$ ha"u+ d&;a*a&adaah 5=
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b= P"&,"&!a+ Ma+aah
Kriteria Urgensi Intervensi Biaya Mutu Total Rank
Terdapatnya mortalitas dan tingginya
angka kejadian DBD di Puskesmas
Ambacang Kuranji5 4 4 5 18 I
eningkatnya Kasus !igitan "e#an
Penular $abies di Puskesmas Ambacang
Kuranji
% & & 4 1% I'
$enda(nya penemuan kasus baru TB
Paru BTA positi) (Case Detection Rate =
*D$)di #ilaya( kerja Puskesmas
Ambacang Kuranji
4 % 4 5 1+ III
Belum tercapainya target D,- di
Puskesmas Ambacang Kuranji4 4 4 5 1. II
Belum terlaksananya P/-BI0D di
#ilaya( kerja Puskesmas Ambacang
Kuranji 4 & % 4 1% '
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8. nalisis
eakiat
Masalah
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Peta Kasus DBD di Wilayah Kerja
Puskesmas Ambaang
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!ra"ik #$ Angka kematian akibat DBD di
%uskesmas Ambaang
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6a#!," *en%ebab
Manu+&a
a= Ma+%a"a#a!
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Masala
h1= Ma+&h
"endahn%a*en$e!ahuan
'a+%a"a#a!!en!an$
*en%a#&!;a"a
*enua"an
*en$,ba!andan
*en;e$ahanDBD
Tolak
kur
Kue+&,ne"
Keteran
an
4 5
Tahu
.15 T&da# !ahu
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Masal
ah2=
Ma+%a"a#a!d&
#eu"ahanbeu'
'ea#+ana#an $e"a#an. M +e;a"a
,*!&'aun!u#
'en;e$ahDBD
Tolak
kur
Kue+&,ne"
Keteran
an
62,5%
37.5%
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Masala
h.= Beu'
,*!&'an%a
#&ne"9a#ade" %an$be"*e"anbe"*e"an+eba$a&
9u'an!(9u"u*e'an!au
9en!)
Tolak
kurWa:an;a"a
den$an*enan$$un$
9a:ab*",$"a' DBD
dan*enan$$un$
9a:ab*",$"a'
*",'#e+ +e"!a:a:an;a"aden$an
'a+%a"a#a!
+e!e'*a!=
Ketera
nanTe"da*a! 20 ,"an$#ade" %an$ !e"+eba"
d& 23 P,+%andu=Se!&a* #ade"
be"!an$$un$ 9a:abun!u# *ea#+anaan
+e'ua *",$"a' %an$ada d& Pu+#e+'a+!e"'a+u# un!u# DBD
#hu+u+n%a 9u"u*e'an!au 9u'an!=
Te!a*& *a"a #ade" &n&!&da# ,*!&'a daa'
*ea#+anaan
!u$a+n%a &n& !e"bu#!&den$an *ea#+anaan*e'an!auan 9en!be"#aa %an$ han%a
+a!u #a& +ea'a!ahun 2011 ha"u+n%a
d&a#u#an +e!&a* .buan=
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6a#!," *en%ebab
Manu+&a
b= T,#,h Ma+%a"a#a!
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Masal
ah
1= Beu',*!&'an%a
*e"an +e"!a RTdan RW daa''en$h&'bau'a+%a"a#a!
un!u#'ea#+ana#an$,!,n$ ",%,n$+e;a"a !e"a!u"
Tola
kkur
Kue+&,ne"
Keteranan
90%
10%
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6a#!," *en%ebab
Manu+&a
;= Tena$a Ke+eha!an
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Masalah
Ku"an$,*!&'an%a*e"an +e"!a
*e!u$a+*u+#e+'a+
un!u#*en&n$#a!an
*e'be"an!a+an 9en!n%a'u# d&
"u'ah :a"$a
Tolak
kur
Kue+&,ne"
Ke!e"an$
an
90%
10%
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6a#!,"*en%ebab
Ma!e"&a
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Masala
h
Ku"an$n%a*e'an8aa!an
'ed&a
&n8,"'a+&+e*e"!& *a*an
&n8,"'a+&*,+!e"
*a'e! daneae! !en!an$
*en%a#&! DBDdan u*a%a*en;e$ahann%a d& !e'*a!?
!e'*a! u'u'=
Tolak
kur
1= Da!aP",'#e+
'en$ena&*en%uuhanua" $edun$%an$ beu'
'en;a*a&!a"$e!=
Keteran
an
Ku"an$
d&'an8aa!#ann%a *a*an*en$u'u'an
ba &!u d&*u+#e+'a+a!au*un d&*,+%andu
+e"!a d&!e'*a!?
!e'*a! u'u'
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Masala
h
Ku"an$n%a
*e'an8aa!an'ed&a &n8,"'a+&+e*e"!& *a*an
&n8,"'a+& *,+!e"*a'e! dan
eae! !en!an$*en%a#&! DBD
dan u*a%a*en;e$ahann%ad& !e'*a!?!e'*a!
u'u'=
Tolak
kur
2=Kue+&,ne"
Ketera
nan
87.50%
12.50%
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6a#!,"*en%ebab
Me!,de
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Masala
h
A= Beu',*!&'an%a*en%uuhan#e+eha!an'en$ena&
DBD d&'ana*en%uuhanua" $edun$
han%a!e"ba!a+ d&*,+%andudan #an!,"u"ah +a9a
Tolak
kur
1=Wa:an;
a"aden$an*&'*&nan
*u+#e+'a+dan
*e'e$an$*",$"a'
P2M
Keteran
anPada !ahun
2011 &n&*en%uuha
n ua"$edun$!eah
d&a#u#an+eban%a#
/2 #a& !a*&!e"ba!a+
*ada*,+%andudan #an!,"
u"ah
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Masala
h
Tolak
kur
2=Kue+&,ne"
Keteran
an
62,5%
37,5 %
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Masala
hB= Ku"an$
be"9aann%a#e"9a+a'a
&n!a+ *",$"a'an!a"a ba$&anP2M Ke+&n$
P",'#e+ +e"!aPe'b&na
:&a%ah daa'
*en;e$ahandan*enan$$uan$
an *en%a#&!DBD
Tolak
kur
Wa:an;aa"
a den$an*&'*&nan
*u+#e+'a+dan
*e'e$an$
*",$"a'P2M
Keteran
anPenan$$uan
$an #a+u+DBD 'a+&h
d&a#u#an*",$"a'!e"#a&! !e!a*&
beu'!e"&n!e$"a+&
ha &n&
da"ena#an#e!&da#;,;,#an daa''en%u+un
9ad:a
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Ma+aah
C= = Beu'be"9aann%a*e'e"+aan
9en!
be"#aa
T,a#
U#u"
1=Pe'e"+aan9en!
ha"u+n%ad&a#+ana#an
1. buan!e!a*& !&da#!e"a#+ana
Ke!e"an
$anPe'e"+aanJen!Be"#aahan%a
d&a#u#ana*ab&a!e"9ad& #a+u+DBD +ea'a!ahun 2011!e"da*a! #a+u+ DBD
han%a 1 #a&d&a#u#an
*e'e"+aan9en!
be"#aa=
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Masala
h
Tolak
kur
2=Kue+&,ne"
Ketera
nan
90 %
10 %
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Masala
h
D= Beu',*!&'an%a *",$"a'8,$&n$ dan
+a+a"an*",$"a'8,$&n$
Tolak
kur
1=:a:an;a"a den$an*&'*&nan
*u+#e+'a
Ketera
nan6,$$&n$
8,#u+&dean%a
d&a#u#an+e!&a* ada#a+u+ DBD
da"&
#a+u+ DBDba"u 1 #a&d&a#u#an8,$$&n$8,#u+=
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Masala
h
Tolak
kur
2=Wa:an;a"a %an$d&a#u#an#e*ada
'a+%a"a#a!
Ketera
nan
8,$$&n$han%a
!e"ba!a+*ada !e"a+
"u'ah
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Masala
h
Tolak
kur
!.Kuesio
ner
Ketera
nan
37,5 %
62,5 %
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Masala
h
6. Beu',*!&'an%a
*ea#+anaan $,!,n$
",%,n$
Tolak
kur
Kue+&,ne"
Ketera
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D&a$"a' I+ha:a
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$ManusiaMasyarakat
Masih rendahnya pengetahuan masyarakat tentang
penyakit, cara penularan, pengobatan dan pencegahan
DBD Masyarakat dikelurahan belum melaksanakan gerakan
3M secara optimal Belum optimalnya kinerja kader yang berperan sebagai
jumatik
Tokoh Masyarakat Belum optimalnya peran serta RT/ RW dalam
menghimbau masyarakat untuk berprilaku hidup bersih
dan sehat seperti program 3M+
Tenaga Kesehatan Kurang optimalnya peran serta petugas kesehatan
untuk peningkatan pemberantasan jentik nyamuk
MetodeBelum optimalnya penyuluhan kesehatan mengenai
penyakit DBD, cara penularan dan pencegahannya
khususnya penyuluhan luar gedung hanya terbatas di
posyandu dan kantor lurah saja.
Kurang berjalannya kerjasama lintas program antara ,
bagian P2M, Kesling Promkes serta Pembina wilayah
dalam pencegahan dan penanggulangan penyakit DBD
Belum berjalannya pemeriksaan jentik berkala
Tidak optimalnya program foging dan sasaran program
foging untuk pencegahan penyakit DBD
Tidak dilaksanakannya gotong royong bersama untuk
membersihkan lingkungan sekitar
MaterialKurangnya pemanfaatan media informasi seperti papan
informasi, poster, pamflet, dan leaflet tentang penyakit DBD
dan upaya pencegahannya di tempat-tempat umum.
LingkunganLingkungan kurang bersih dan tidak sehat
T&n$$&n%a An$#aKa+u+ DBD d&
Pu+#e+'a+A'ba;an$ Ku"an9&Tahun 2011
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d.
lternati9Peme8ahan
Masalah
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Manu+&a
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Pen%eba"a
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MATERIAL
Pen%eba"an eae!
dan
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MET-DE
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L&n$#un$an
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Bab Ren;anaPea#+anaan
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Taha* Pe"+&a*an
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Ke$&a!an
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Ke$&a!an
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Ke$&a!an
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Ke$&a!an
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Bab IPenu!u*
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Ke+&'*uan
PENYEBAB TINGGINYA KASUS DBD
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Ma+&h "endahn%a *en$e!ahuan 'a+%a"a#a! !en!an$*en%a#&!;a"a *enua"an *en$,ba!an dan *en;e$ahanDBD
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Ku"an$ be"9aann%a #e"9a+a'a &n!a+ *",$"a'an!a"a ba$&an P2M Ke+&n$ P",'#e+ +e"!a Pe'b&na:&a%ah daa' *en;e$ahan dan *enan$$uan$an*en%a#&! DBD=
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2 SARAN
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=2 SARAN
A$a" P-A &n& da*a! d&a#+ana#an den$an'e"ea&+a+an a!e"na!&8 *e'e;ahan 'a+aah dan
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TERIMAKASIH=
