THE RELATIONSHIP OF FAMILY CHARACTERISTICS AND

ENVIRONMENTAL CHARACTERISTICS AGAINST MALARIA OCCURRENCE

IN TANJUNG TIRAM, BATUBARA 2016

Tiurma Rosdiana Simanjuntak1, Lambok Siahaan2, Deryne Anggia Paramita3, Wisman

Dalimunthe4, Tina Christina L.Tobing4
1
College Student of Faculty of Medicine University of North Sumatera
2
Lecturer of Department of Parasitology Faculty of Medicine University of North Sumatera
3
Lecturer of Department of Dermatology and Venereology Faculty of Medicine University of
North Sumatera
4
Lecturer of Department of Child Health Sciences Faculty of Medicine University of North
Sumatera

ABSTRACT

Malaria is disease infection parasite caused by Plasmodium attacking eritrosite (red

corpuscle) and marked with finding asexual form in blood. Sub District of Tanjung Tiram,
District of Batubara Povince is a malaria-endemic areas with the incidence of malaria per 1000
population in 2013 was 2.70. The incidence of malaria caused by human contact with mosquitoes
and malaria is influenced by family characteristics and environmental characteristics.
The purpose of this study was to determine the relationship characteristic of family and
environmental characteristics on the incidence of malaria in the district of Tanjung Tiram,
Batubara 2016
This type of research is an analytic study with cross sectional study design. The sample
size in this study using simple random sampling and data collection through interviews and
observations. The total sample of 100 heads of families. The research data were statistically
tested by Chi Square with a 95% CI.
The results obtained that there is a relationship between family characteristics: the
number of family members (p = 0.045), income (p = 0.019) and environmental characteristics:
thicket (p = 0.023) on the incidence of malaria.
The conclusion of this research are there is a significant relationship between the number
of family members, income, and thickets on the incidence of malaria, and there is no significant
relationship between age, education, occupation, and puddles on the incidence of malaria in the
sub district of Tanjung Tiram, District of Batubara.

Keyword : family characteristics, environmental characteristics, malaria.

INTRODUCTION
Malaria is an infectious
disease caused by the parasite
Plasmodium which invade
erythrocytes and is marked by the
discovery of a form of asexual
reproduction in the blood. 1.2 Malaria
is a disease that is completely
preventable and handled when the
current recommended intervention
has been fully applied starting from
the control of the vector until
treatment with antimalarial drugs
accordingly.3
According to the report of the
World Health Organization (WHO)
in 2011 found 216 million cases of
malaria in the world and estimated
death as much as 655,000 cases.
Nationally the number of pain,
malaria during the 2005-2014 tend to
decrease from 4.1 per 1000
population at risk in 2005 to 0.99 per
1000 population at risk in 2014.
While the Ministry of health strategic
plan targets for numbers of pain,
malaria (fire/Annual Parasite
Insidence) 2014 1 per 1000
population < risky. Thus the scope of
the FIRE reaching the target of 2014
strategic plan 2014. The three
provinces with the highest population
per 1000 API namely Guinea
(29,57), West Papua (20,85), and
East Nusa Tenggara (12,81).4
Based on data obtained from
North Sumatra Health Office in 2011
as much as 67,314 in North Sumatra
found positive citizens suffer from
malaria, to areas that are most widely
found malaria sufferers include Nias
with the number of cases, Deli
Serdang 14,165 9,124 cases,
Mandailing Natal (Madina) 7,011
METHODS
This type of research is an
analytic study with cross sectional
study design.. Research and data
collection will be carried out during
the months of August to November
2016. Great samples on this research
using a simple random sampling
Padang Lawas case with 6,942 cases,
Labuhan Batu 6,263 South Nias
4,692 case, case, case 4,340 Coal,
Tapanuli Tengah (Tapteng) 3,416
case , and Padang Lawas (Paluta) as
much as 2,622 cases.5 In the
meantime, for malaria incidence per
1000 inhabitants in Coal County in
2013 is 2, 70.6
Biological environment,
physical environment and socio-
cultural community is a factor that
affects the process of spreading of
malaria. In the characteristics of the
family, the family as the smallest
unit of society has a very important
role in tackling malaria, especially
cut the chain of transmission of the
disease. Families can be represented
by the characteristics of the head of
the family.
The purpose of this study was
to determine the relationship
characteristic of family and
environmental characteristics on the
incidence of malaria in the district of
Tanjung Tiram, Batubara 2016
techniques and data collection was
conducted through interviews and
observations. The number of samples
as many as 100 heads of families.
Study data statistically tested by Chi
Square with a 95% confidence
Interval.
RESULTS

A. Family Characteristics
Table.1 Distribution of Family Characteristics
Age N %
≤ 26 2 2,0.
> 26 98 98,0.
Education N %
No School 0 0
Elementary School 61 61,0.
Junior High School 24 24,0.
Senior High School 14 14,0.
Undergraduate 1 1,0.
Jobs N %
Farmer 0 0
Fisherman 51 51,0.
Employees 5 5,0.
Self employed 31 31,0.
Civil Servants 2 2,0.
Does not work 11 11,0.
The number of family
members N %
≤4 34 34,0.
>4 66 66,0.
Total 100 100,0.
Income N %
≤ 1.000.000 82 82,0.
> 1.000.000 18 18,0.
History of malaria N %
Ever 63 63,0.
Never 37 37,0.
Total 100 100,0.
Based on Table.1 Distribution education last as many as 61 people
of Family Characteristics, on (61%), on the characteristics of the
characteristics age, number of head work, i.e. the most heads of families
of the family is at most age > 26 with employment of fishermen as
years namely as much as 98 people much as 51 people (51%), on the
(98%), on the characteristics of characteristics of the number of
education, i.e. the most heads of family members, the largest number
families with ELEMENTARY of families by having the number of
family members as much as 66 4 > 1.000.000 people ≤ (82%), and for a
people (66%) on the characteristics, history of malaria, the most that have
income, amount of most families ever suffered from malaria by as
with incomes as much as 82 much as 63 people (63%).

B. Environmental Characteristic
Table.2 Distribution of Environmental Characteristics
Puddle N %
There is 88 88,0.
There is no 12 12,0.
Thickets N %
There is 90 90,0.
There is no 10 10,0.
Total 100 100,0.
Based on Table 2 distribution 88 (88%), and on the characteristics
of the characteristics of the of the thickets, the largest number of
environment, on the characteristics households with environmental
of the puddle, the largest number of conditions have thickets as much as
households with environmental 90 (90%).
conditions have a puddle as much as

C. 3 The relationship of Family Characteristics against Malaria Incidence. Keluara

degan Malaria
Kjadia n

Tabel 3. The Relationship of Family Characteristics against Malaria

Incidence

Characteristic Malaria Incidence

Total p
No of the age Ever Never Value
N % n % Total %

1 Age ≤ 26 0 0 2 2 2 2
0,135
2 Age > 26 63 63 35 35 98 100
Total 63 63 37 37 100 100
 Characteristics Malaria Incidence
Total p
No of the Ever Never
Value
Education n % n % Total %
1 No School 0 0 0 0 0 0
Elementary
2 school 40 40 21 21 61 61
Junior High
3 School 16 16 8 8 24 24 0,959
Senior High
4 School 6 6 8 8 14 14
5 Undergraduate 1 1 0 0 1 1
Total 63 63% 37 37% 100 100%
Malaria Incidence
Characteristics Total p
No Ever Never
of the Jobs Value
n % n % Total %
1 Farmer 0 0 0 0 0 0
2 Fisherman 32 32 19 19 51 51
3 Employees 4 4 1 1 5 5
4 Self employed 17 17 14 14 31 31 0,993
5 Civil Servants 1 1 1 1 2 2
6 Does not work 9 9 2 2 11 11
Total 63 63 37 37 100 100
The number of Malaria Incidence
family Total p
No Ever Never
members Value
n % n % Total %
1 ≤4 26 26 8 8 34 34
2 >4 37 37 29 29 66 66 0,045
Total 63 63 37 37 100 100
Malaria Incidence
Characteristics Total p
No Ever Never
of the Income Value
n % n % Total %
1 ≤ 1.000.000 56 56 26 26 82 82
2 > 1.000.000 7 7 11 11 18 18 0,019
Total 63 63 37 37 100 100

Based on table 3, it can be seen with malaria incidence using the

that the results of the analysis of the
relationship of the age of the
respondents with the genesis of
malaria using Chi-Square test
obtained p value = 0.135 (p > 0.05),
the results of the analysis of the
relationship of education respondents
Kolmogorov-Smirnov test obtained p
value = 0.959 (p > 0.05), results
analysis of the relation of the work of
the respondents with the incidence of
malaria using the Kolmogorov-
Smirnov test obtained p value =
0.993 (p > 0.05), so that it can be
concluded that there is no
relationship between the age of the
respondents against the incidence of
malaria While the results of the
analysis of the relationship of the
number of family members with
malaria incidence respondents using
test Chi Square value obtained p =
0.045 (p < 0.05), and the results of
the analysis of the relationship of
income respondents with malaria
incidence using the Chi Square test is
obtained a value of p = 0.019 (p 0.05
<) so that it can be concluded that
there is a relationship between the
income of the respondent against the
incidence of malaria.

D. The relationship of Environmental Characteristics against Malaria

Incidence.
Kega dengan Kejadian Malaria
Tabel 4. The Relationship of Environmental Characteristics against
Malaria Incidence
Malaria Incidence
Characteristics Total p
No Ever Never
of Puddle Value
n % n % Total %
1 There is 56 56 32 32 88 88
2 There is no 7 7 5 5 12 12 0,721
Total 63 63 37 37 100 100
Malaria Incidence
Characteristics Total p
No Ever Never
of Thickets Value
n % n % Total %
1 There is 60 60 30 30 90 90
2 There is no 3 3 7 7 10 10 0,023
Total 63 63 37 37 100 100

Based on table 4, it can be seen that
the results of the analysis of the
relationship of the puddle in the
environment respondents with Gen.
Chi Square test for malaria using the
retrieved value p = 0.721 (p 0.05 >)
so that it can be concluded that there
is no relationship between the puddle
against the incidence of malaria and
the results of the analysis of the
relationship of the thickets in the
neighborhood of the respondents
with the incidence of malaria using
the Chi Square test p value = 0.023
obtained (p 0.05 <) so that it can be
concluded that there is a relationship
between the thickets against the
incidence of malaria.
DISCUSSION
Based on the results of the
analysis of the relationship of the age
of the respondents with the genesis
of malaria using Chi-Square test
obtained p value = 0.135 (p 0.05 >)
so that it can be concluded that there
is no relationship between the age of
the head of the family against the
occurrence of malaria. In line with
research conducted by Rofiqoh
(2013) showed that there is no
meaningful relationship between age
and the incidence of malaria in this
study said that malaria can attack the
whole age group of men.7 But in
contrast to research Mühlberger et al.
(1999), who found that the Case
Fatality Rate and increased disease
risk weight may increase due to age,
such as decreased immunity due to
aging which resulted in system
response to infectious agents being
not defensive.8
Based on the results of the
analysis of the relationship of
education respondents with malaria
incidence using the Kolmogorov-
Smirnov test obtained p value =
0.959 (p 0.05 >) and it can be
concluded that there is no significant
difference so that there is no
relationship between the education of
respondents against the incidence of
malaria. This means that although a
person included in the respondent's
education level is low, the
respondent's conduct is not
necessarily less well to tackling
malaria.9 In accordance with research
of Lario (2016) in statistical tests
conducted obtained rating p = 0,840
In this study the majority of the
respondents are in the low and
medium educated groups but seen
from the knowledge of the
respondents interviewed that most
already know or understand the
description of malaria prevention
through counselling and guidance-
but the attitude and behavior of a
society that still less do.10
Based on the results of the
analysis of the relationship of the
respondent's employment with the
incidence of malaria using the
Kolmogorov-Smirnov test obtained p
value = 0.993 (p 0.05 >) and it can be
concluded that there was no
significant difference between the
work of the respondents against the
incidence of malaria. This shows that
although the respondents worked on
areas that are prone to malaria
(fishermen) or not working on
vulnerable areas (civil servants,
labourers and traders) do not
influence the respondent towards
tackling malaria. This can be
influenced by the knowledge and
behavior of individual prevention
itself.11
The results of this research contrasts
with research results Ernawati et al.
(2011), By staying or are at work at
the time of biting Anopheles
mosquito hours from early morning
until 18:00 hours, then the Group of
respondents who worked as
fishermen (on the ocean)/farmer
pond/plantation/forest at higher
risk.12
Based on the results of the
analysis of the relation of the number
of family members with malaria
incidence respondents using test Chi
Square value obtained p = 0.045 (p
0.05 <) so that it can be concluded
that there is a relationship between
the number of family members of the
respondent against the occurrence of
malaria. It can be influenced by
household habits which does nothing
to prevent the occurrence of
mosquito bites such as wearing
mosquito net in his house because of
the socio-economic conditions
affected. This is in accordance with
the research Priyandina (2011) that
another reason that respondent filed
is any home shared only one
mosquito net for 2 adults by Clinics,
while family members residing in the
House more, so mosquito nets
distributed is insufficient.13 In
addition, according to research
Ngambut and Sila (2013), in which
case the use of mosquito nets, the
reasons presented respondents who
do not use bed nets on a regular basis
is the use of netting a hassle during
sleep, and sometimes a bit of heat.
So that it can directly affect the
family members in the family
environment have the risk to be
bitten mosquitoes.14
Based on the results of the analysis
of the relationship of income
respondents with malaria incidence
using the Chi Square test is obtained
a value of p = 0.019 (p 0.05 <) so
that it can be concluded that there is
a relationship between the income of
the respondent against the incidence
of malaria. This indicates that the
higher the income the better the
respondents will then also the
behavior of the respondents in
tackling malaria risk factor towards
reducing the incidence of malaria. 15
According the study Wahyudi
(2012), community with the level of
low income have limitations to gain
access to medical services.16
Based on the results of the
analysis of the relationship of the
puddle in the environment
respondents with Gen. Chi Square
test for malaria using the retrieved
value p = 0.721 (p 0.05 >) so that it
can be concluded that there is no
relationship between This is in
accordance with the research
Priyandina (2011) that standing
water does not affect the incidence of
malaria because puddles directly
exposed to the rays of the Sun
resulting in a temperature and
humidity are not appropriate for the
development of the mosquito larva,
so could hinder or stop the breeding
of mosquitoes, and does not affect
the incidence of malaria.13
Based on the results of the
analysis of the relationship of the
bushes in the neighborhood of the
respondents with the incidence of
malaria using the Chi Square test p
value = 0.023 obtained (p 0.05 <) so
that it can be concluded that there is
a relationship between the bushes
against the incidence of malaria. The
majority of respondents House
adjacent to the bushes. The bushes
around the House of malaria
sufferers make place for resting
(resting place) for mosquitoes during
the day that causes malaria sufferers
environment highly preferred by
mosquitoes. This is in accordance
with the research Priyandina (2011)
that someone with a residence in the
surroundings there are bushes has the
risk to be exposed to malaria
amounted to 5.1 times. 13
CONCLUSION AND SUGGESTIONS
Family related characteristics
against malaria incidence is the
number of a family member (p =
0,045), as well as income (p = 0.019)
and unrelated incident against
malaria is age (p = 0,135), education
(p = 0,959), and occupation (p =
0,993). Environmental characteristics
of events associated with malaria are
bushes (p = 0,023) and unrelated
incident against malaria was a puddle
(p = 0,721).
As for the advice that
required the presence of an
additional health counseling to the
community especially about malaria,
And for the community, pay more
attention to the cleanliness of the
environment by performing mutual,
use protectors themselves while
moving at night, are expected to
wear long-sleeve shirts and long
pants when out of the House at night,
and the whole family using mosquito
nets while sleeping, doing
larvaciding Anopheles mosquitoes at
the site such as swamps, trenches and
ponds which are dormant.

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