GEOSPATIAL LEARNING IN COMBATING DENGUE FEVER PROJECT

STUDY SITE: THE CITY OF YOGYAKARTA

Aji Putra Perdana 1, *, Hilmi Ardiansyah 2, Humam Zarodi1

1
GIS and Data Management Unit Assistant, Tahija Foundation, Project Dengue,
Project office: Jl. Pandega Sakti 159 Kaliurang Street KM 6, 2 Yogyakarta 55281, Indonesia. -
ajiputrap@gmail.com, humam_kpj@yahoo.com
2
Team Leader GIS and Data Management Unit, Tahija Foundation, Project Dengue,
Project office: Jl. Pandega Sakti 159 Kaliurang Street KM 6, 2 Yogyakarta 55281, Indonesia. -
hilmi_a@yahoo.com

ABSTRACT:

Dengue fever and Dengue Hemorrhagic Fever (DHF) is already endemic in 45 Kelurahan in the City of Yogyakarta
yet is the most densely populated. A two years combating dengue fever project started in 2007, the strategy is targeted
Aedes aegypti breeding source control using the insect growth regulator. This project involved 262 local peoples and
32 surveyors; they are the main actors in geospatial learning. GIS, Satellite Images and GPS are part dengue fever
project in the City of Yogyakarta. This paper described Geospatial Learning in Combating Dengue Fever in
Indonesia Phase II Project (study site: The City of Yogyakarta).

KEY WORDS: Geospatial, Dengue Fever, GIS, Satellite Images, GPS

1. INTRODUCTION intersectoral coordination with many surveillance

methods are used. Source reduction is still the main
1.1 Background emphasis in the control of DF/DHF.
Dengue cannot be spread directly from person
Vector borne diseases are the most common
to person, but the spread of disease is unavoidably spatial
worldwide health hazard and represent a constant and
(Holmes, 1997). Epidemiologists, public health
serious risk to a large part of the world's population.
professionals, medical geographers have traditionally
Among these, dengue fever especially is sweeping the
used maps when analyzing associations between
world in majority of the tropical and arid zones. It is
location, environment, and disease. Geographic
transmitted to the man by the mosquito of the genus
Information Systems (GIS) is particularly well suited for
Aedes and exists in two forms: the Dengue Fever (DF) or
studying these associations because of its spatial analysis
classic dengue and the Dengue Haemorrhagic Fever
and display capabilities. GIS and the value of maps used
(DHF), which may evolve into Dengue Shock Syndrome
in public health have a very long history. Dr John Snow
(DSS) (Nakhapakorn, K. et al, 2005).
is the pioneer in the field. John Snow's now classic maps
Dengue Fever (DF) and Dengue Haemorrhagic
of cholera cases in relation to the Broad Street pump are
Fever (DHF) has become a major international public
a good example.
health concern. Many countries/areas in Asia have been
Recently, Geographic Information Systems
experiencing unusually high levels of dengue/dengue
(GIS) and Remotely Sensed data has been used in the
haemorrhagic fever activity in 1998. Since
surveillance and monitoring of vector-borne diseases. A
2004 Indonesia reports the highest number of cases from
pilot project based on implementation of result from
the South East Asia region. In 2006 57 % of the cases
Dengue Project Phase I study site in The City of
were reported from Indonesia alone (Nakhapakorn, K. et
Yogyakarta had been conducted by the Tahija
al, 2005; Perdana, Aji P. et al, 2009).
Foundation (Indonesia) collaborated with Gadjah Mada
Until today, In Indonesia DF/DHF is still the
University. This project was known as Combating
main concern in public health problems on the
Dengue Pilot Project Phase II proposed targeted source
responsibility of The Indonesian Ministry of Health.
reduction strategy/control strategy for dengue control
Many efforts and strategies to control dengue have being
used Geographic Information Systems (GIS) and
conducted by the government, Non-Government
Remotely Sensed data.
Organization, and society. Strategies to control dengue,
is largely through source reduction, health education and

* Corresponding author.
 The combating dengue fever project needs rukun tetangga (RT), the smallest administrative unit
geospatial data of the city of Yogyakarta as treatment composed of approximately 50-80 residences.
area and also three Villages in Sleman District and three
villages in Bantul District as control areas; the Base
Maps (Municipality, Villages, Administrative
Boundaries, River, Roads) and Satellite Images for
determine of working area, survey, distribution and
monitoring activities. But there was geospatial data
problem related to the needs of geospatial data until
Rukun Warga (RW)/Rukun Tetangga (RT) or
neighbourhood’s level. It causes several changes in the
strategies of collecting the tabular data from the field.
GIS and Data Management Unit, which has
responsibility in geospatial data management was
suggested the project to use GPS and printed Quickbird
Images to do participatory mapping.
This project involved 262 field workers called
Pemantau DBD was recruited from 2523 Jumantik’s RT
Figure 1. Map of the Municipality of Yogyakarta
by Dinas Kesehatan Kota Yogyakarta and 32 surveyors
from Faculty of Medicine, Gadjah Mada University.
The City of Yogyakarta is the fourth largest
They are the main actors in collecting data from the field
(32.5 km2) kabupaten in DIY yet is the most densely
to be linked in to geospatial data. Geospatial training
populated (ca. 16,000 per square kilometre); this
was given to them in order to get the right coding in
variability in density explains much of the variability in
field-collected data, which will be linked into the Map
the incidence for severe dengue within the Province. At
Layers in GIS. Geospatial learning of the field workers
an incidence rate (IR) of 17.7 cases per 10,000, the City
and surveyors in this project helps us in combating
has twice- to three-times higher incidence than that
dengue fever in the City of Yogyakarta.
neighbouring Sleman (7.6) or Bantul (6.3). Dengue fever
and Dengue Hemorrhagic Fever (DHF) is already
1.2 Aims
endemic in 45 Kelurahan in the City of Yogyakarta.
The aim of this paper is to describe and seeks to
show how geospatial learning from field workers and Table 1. Population size, number and incidence rate (IR,
surveyors during the combating dengue fever project in per 10,000) of dengue cases by kabupaten for the
the City of Yogyakarta. The paper also aims to see the Province of Yogyakarta in 2006.
potential and the limitations of geospatial learning with
GPS training and participatory mapping as a method to Popu- No.
Kabupaten Residences IR
extract information for the combating dengue fever lation cases
project. This case study will be the basis for a more Yogyakarta 506,000 105,417 888 17.7
general discussion on how the method might be applied Sleman 826,558 172,200 626 7.6
and improved for the future when it comes to be
Bantul 780,177 162,537 493 6.3
continued in the next phase.
Kulonprogo 443,819 92,462 71 1.6
Gunung
746,457 155,512 106 1.4
2. THE CITY OF YOGYAKARTA, DENGUE, Kidul
CONTROL METHOD, AND GEOSPATIAL DATA Totals 3,303,011 688,127 2,184 6.6

2.1 The City of Yogyakarta and Dengue

Source: Focks, Dana A., 2007

Yogyakarta, a city of about 506-522 thousand 2.2 Control Method

people, is the provincial capital of the Province or
Special Region (Daerah Istimewa Yogyakarta, or DIY) of
Yogyakarta located in south central Java. The Province
is divided into 5 administrative districts with each
district divided into progressively smaller units
beginning with sub-districts (Fig. 1), and these, in turn,
divided into kelurahans, and further divided into rukun
warga (RW, ca. 250 residences each), and finally into
A two years combating dengue fever project
started in 2007, the strategy was targeted Aedes aegypti
breeding source control using an insect growth regulator
(IGR), pyriproxyfen (Fig. 2) that prevents successful
emergence of adult mosquitoes from the pupal stage.
Distribution and monitoring of the insect growth
regulator being conducted by 262 Pemantau DBD’s,
each day 20-25 houses coordinated by Operational units.
Independently assessment of the prevalence of IGR in
targeted water container by 32 Surveyors from Quality
Control Research & Serology (QCRS) Unit. This team
was also had two main activities, namely Serology and
Entomology.
© Dengue Project Documentations Copyright 2008
Figure 2. An insect growth regulator (IGR),
pyriproxyfen in three kinds of sachet
Based on dengue IR, serosurvey and
entomologic surveys was conducted only in 12
kelurahans, 6 in the City and 3 each in Sleman and
Bantul on the basis of similar dengue incidence rates
(IRs). Serology used to measure of the impact of dengue
control effort. Entomologic surveys consist of pupal
counts and emergence, adult aspirations,
pupal/demographic surveys to determine the reduction of
Ae. aegypti populations due to targeted intervention.
Knowledge, attitudes, and practices (KAP)
regarding targeting, the utility and safety of the insect
growth regulator being conducted in sampling area. We
also used case reported from Dinas Kesehatan of the
Municipality of Yogyakarta to monitor the suppression
of dengue cases.
All project data compiled in Data Management
Unit, which has responsibility to create and maintain the
repository of all project data that is spatially explicit,
conversion of paper-based data from the other Units into
digital data (data entry) and also summarizing data and
creating maps.
2.3 Geospatial Data
Starting dengue control project requires
information about the condition of the study area and for
the determination of cluster area (treatment and control
area), so that the existence of spatial data are absolutely
needed. Tahija Foundation in collaboration with Faculty
of Geography, Gadjah Mada University as Spatial Data
Provider since the Dengue Control Phase I and also for
this project phase II. Geospatial data included satellite
images (Quickbird, Ikonos, and Digital Aerial Photos
from previous project) and base maps Layer.
Dengue control project need to be able to
effectively use information, manage project information,
combined with spatial dataset to build data integration
for the purposes of supporting the dengue project. In this
project, GIS facilitate the integration of geospatial data
and all data collected into Geodatabase. The dengue
project geodatabase contains three primary dataset types
are shown below:
- Feature classes: Base Map Layers;
Municipality, Villages, Administrative
Boundaries, River, Roads, Survey Location
(GPS measurements), etc.
- Raster datasets: Quickbird Imagery, Ikonos
Imagery, digital aerial photos
- Tables: Dengue Cases Report, Demographic
Data, IGR Distribution and Monitoring Data,
pupal counts and emergence, adult aspirations,
pupal/demographic surveys, serology surveys.
There were limitations in spatial data and
tabular data, such as the smallest mapping unit is
villages, we have no baselines, the exact or detailed data
related to the number of houses, targeted water container
in the City of Yogyakarta, etc. Therefore, we needed the
participation from the field for gathering those
information and learned how to combating dengue fever
with geospatial data.
3. GEOSPATIAL LEARNING IN COMBATING
DENGUE FEVER PROJECT
Geospatial learning was also part of the capacity
building and enriches local knowledge in order to think
spatially, do more effective and efficient in their survey,
distribution and monitoring activities.
3.1 Human Resources
Human resources of geospatial learning in this
project consist of core team, data entry persons, field
workers, and surveyor team. In the core team, three
persons as GIS and data management who deals with
geospatial information and data management. Data entry
persons (25-30 persons) helped GIS and data
management unit in conversion of paper-based data into
digital data. The main actors are 262 field workers and
32 surveyors, because they learned about the use of
geospatial data for themselves and also this project.
On daily based, the field workers were
distribution IGR, monitoring the prevalence of IGR,
checked larvae and pupal in the targeted water container,
reported data on paper-based form and submitted to the
office. They were working in the City of Yogyakarta;
especially in their own neighbourhoods for more than 5
RT and it’s depended on the numbers of RT and
Pemantau DBD in their own villages. But, the surveyors
conducted entomologic surveys only in 12 kelurahans, 6
in the City and 3 each in Sleman and Bantul. Sometimes
the surveyor also met with the field worker when
conducted survey in 12 Kelurahans in the City of
Yogyakarta (Fig. 3).
The field workers and surveyors had capacity
building of geospatial learning in order to collect
information from field to be correlated to geospatial data.
3.2.2 Satellite Images: Satellite images in this dengue
project were Quickbird, Ikonos, and Digital Aerial
Photos from previous project (only for Terban and
Klitren). All images were covered 45 Kelurahan in the
City of Yogyakarta and 3 kelurahan each in Sleman and
Bantul. At first project plan that satellite images would
be used as basic data to determining the locations for
surveys and as guidance also dividing working area for
Pemantau DBD.

3.2.3 Maps: Creating maps was one of the

responsibilities GIS and Data Management Unit. Input
for maps were from Dinas Kesehatan for dengue cases,
principal investigator for determined cluster area, but the
most important things; information from field workers
and surveyors. That was why they should knew about
what is map and how important the information they
were collected and to be coded in the right way in order
to be linked into geospatial data.

3.3 The GPS application and Participatory Mapping

© Dengue Project Documentations Copyright 2008
3.3.1 The GPS Application: Use the GPS Garmin
Figure 3. Surveyors QCRS and Pemantau DBD 76csx was easy operating, the surveyors should marked
the visited houses in coded number. Even though, all
surveyors were trained in using GPS usually only one or
3.2 GPS, Satellite Images, and Maps two persons that used the GPS. Without surveyor'
participation in the application GPS in mapping the
Geospatial learning in this project were
visited houses, the accuracy cannot always be assured on
conducted with training method; learn by doing and do
the one hand, while on the other, the information cannot
by learning. GIS and Data Management Unit in
be properly utilized.
coordination with other units conducted several training
for the field workers and surveyors. Introduction about
GPS only for the surveyors, but geospatial training about
the use of satellite images, tabular data, and maps for
this project were conducted for both of them.

3.2.1 GPS (Global Positioning System): A

constellation of twenty-four satellites, developed by the
United States Department of Defence, that orbit the earth
at an altitude of 20,200 kilometres (10,900 nautical
miles, 12,544 miles). Each satellite orbits the earth
every 12 hours and transmits radio signals that allow a
GPS receiver anywhere on earth to calculate its location.
Exact location is determined by trilateration
(determining the position of a point by measuring the
distance between three points). That introduction was
given to the surveyors in training. GPS receivers are © Dengue Project Documentations Copyright 2008
relatively easy to operate, many users are not aware of
the technology's complexities. We were used 6 GPS Figure 4. Surveyor marked house location with GPS
Garmin 76csx for 32 surveyors divided into six groups.
3.3.2 Participatory Mapping: The use of participatory
mapping with the first aim was in order to get RT/RW
level boundaries from 45 Kelurahan in the City of
Yogyakarta. Printed Quickbird images were distributed
for Pemantau DBD and also 45 Kelurahan. Since
participatory mapping was new method in combating
dengue fever, the reactions of the peoples involved from
the field are an important part. They were learned to see
images that captured houses from the sky, to know their
own location, survey and try to delineate the boundaries
until RW/RT level, the roads, and rivers (Fig. 5).
© Dengue Project Documentations Copyright 2008
Figure 5. Pemantau DBD prepared for participatory
mapping
Their results then digitized by GIS and Data
Management Unit into several layers (Fig. 6) and edited
using GIS software to be display, visualize and also for
analysis needs.
Figure 6. Administrative Map (RT Boundaries) of
Kelurahan Terban, the City of Yogyakarta
3.4 Lesson Learned
Geospatial activities have been conducted by the
field workers and surveyors made both of them as the
main actors of geospatial learning in combating dengue
fever in the City of Yogyakarta.
Geospatial capacity-building lesson-learned
Surveyors were learned new knowledge, geospatial data
and tools and increase their skill or capacity, namely:
1. Ability to read satellite images maps for survey
activities
2. Generally able to interpret the information in
the maps and try to match with the real world
(field condition), such as: building schools,
mosques, houses.
3. They know and get the benefits of using GPS
and Maps for entomology survey
4. They can use and operate GPS Handheld;
waypoint, track and route.
5. Understand and know their working area
spatially
Pemantau’s DBD were learned geospatial knowledge
and also increases their skill or capacity, namely:
1. Learned about Maps: how to make map from
delineate boundaries, roads, rivers, creating
legend for the map; reading the map, etc.
2. Understand the importance of Maps in
monitoring their activities in the working area.
3. At the beginning, maybe they only knew their
nearest neighbourhood, but now they knew
more than before and think spatially in their
work activities, such as determine visited area.
4. Generally able to interpret the information in
the maps and try to match with the real world
(field condition), such as: building schools,
mosques, houses.
Based on lesson learned from geospatial
learning in dengue control, Geographic Information
Systems (GIS) and Remotely Sensed data has been used
effectively to get the information needed for the project
goal. The GIS needs assessment was a critical initial step
in the capacity-planning process.
4. CONCLUSION
The geospatial learning in combating dengue
fever still needs improvement. Meanwhile, we can
conclude that combating Dengue Fever (DF) and Dengue
Haemorrhagic Fever (DHF) in the City of Yogyakarta
with geospatial learning to get geospatial understanding
for the team and also community is very important,
because the disease spread is unavoidably spatial.
GIS, Satellite Images and GPS are part dengue
fever project in the City of Yogyakarta and geospatial
learning. These lessons learned will be valuable as the
centre moves to next phase project to build Geospatial
capacity.
For the future project, we need to explore the
potential of participatory mapping as a tool to be used in
order to capture the local perspectives on public health in
combating dengue fever. The possibility to integrate
participatory mapping with consultations or
empowerment of the locals of the combating dengue
process are also interesting issues for future research.
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