1418 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No.

Effect of Schistosomiasis Control Program Performance

on Schistosomiasis Incidence Rate in Sigi Regency, Central
Sulawesi, Indonesia

Reni Septiana1, Auli Fisty Noor Azizah2

1
Master of Health Administration and Policy Students, Faculty of Public Health, Airlangga University, Surabaya, 2
Master of Health Administration and Policy, Faculty of Public Health, Airlangga University, Surabaya

Abstract
Schistosomiasis is a zoonotic disease based on transmission transmission classified in the metazoonosis
group. Based on data from the Central Sulawesi Provincial Health Office on the prevalence of schistosomiasis
cases, it shows that schistosomiasis cases continue to increase from year to year to above the WHO standard
of 1%. The purpose of this study was to determine the effect of schistosomiasis control program performance
on the incidence of schistosomiasis in Sigi Regency, Central Sulawesi, Indonesia. This research was an
observational study with cross sectional design. The sample size was 122 people. The results showed that the
factors that influenced the incidence of schistosomiasis were the IEC of Officers while the treatment program
did not directly influence the incidence of schistosomiasis. Recommendations to improve the performance of
schistosomiasis control programs include making regular outreach programs where puskesmas staff provide
IEC about schistosomiasis in the community. Providing space for puskesmas to make special programs
related to the control of schistosomiasis which so far have been centralized in the Sigi District Health Office.
Coordinate with related parties such as the Department of Hygiene and Green Open Space to create a snail
eradication program as a vector of Schistosomiasis disease.

Keywords: Schistosomiasis, Performance, Control, Prevalence

Introduction national world. But until now the program has not found
a bright spot related to the resolution of schistosomiasis
Schistosomiasis is a zoonotic disease based on
cases. Schistosomiasis is endemic in 76 low income
transmission classified in the metazoonosis group.
countries, namely in rural and suburban areas. More than
Metazoonosis is a zoonosis with a transmission cycle
700 million people worldwide are at risk of infection,
that requires vertebrates and involves invertebrates
with more than 207 million people infected with
to perfect the life cycle of disease-causing agents.
schistosomiasis, 85% of whom live in Africa.3
Schistosomiasis is an obligatory metazoonosis in which
humans or vertebrates must be one of the hosts in their This disease control activity has existed since 1982.
life cycle.1 At the beginning of the activity focused on human
activities, namely the treatment of the population. It is
In infected cases, an estimated 120 billion people
also supported by counseling activities, procurement
show symptoms of schistosomiasis, and 20 billion
of environmental health facilities, examination of
people have serious complications. In 2011 reported by
population feces, inspection of snails of transmitters and
WHO, there were 243 million people requiring treatment
rats on a regular and regular basis.4,5
for schistosomiasis, with the number of people reported
having been treated for schistosomiasis in 2011 of 28.1 Schistosomiasis in Indonesia is only found in Central
million.2 Sulawesi Province. This case is found in 2 regencies
/ cities in Central Sulawesi which are endemic areas,
Schistosomiasis control programs have been very
namely Sigi Regency and Poso Regency. Sigi Regency
widely implemented and applied by the international and
 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1419

precisely in Lindu Valley and Poso Regency precisely in
Napu Valley, Besoa Valley and Bada Valley.6,7
Data from the last 3 years released by the Central
Sulawesi Provincial Health Office on the prevalence of
schistosomiasis cases shows that schistosomiasis cases
continue to increase from year to year to above the WHO
standard of 1%. This is closely related to schistosomiasis
control programs in Central Sulawesi.8,9
The prevalence of schistosomiasis in 2014-2016 has
increased, the lowest prevalence in 2014 was 1.66%, and
the highest prevalence in 2016 was 1.86%.6 There are two
areas that are endemic to schistosomiasis cases, namely
Lengkeka, Poso Regency and Lindu, Sigi Regency. The
following is case data and prevalence in both districts.
The prevalence of Poso Regency from 2014 to 2016
has decreased. Whereas in Sigi Regency the prevalence
of schistosomiasis has increased and is still above the
national target (<1%). Therefore, this study is focused
in Sigi Regency because the prevalence of cases is
still quite large and has increased, where the condition
is not in accordance with the target of schistosomiasis
treatment programs. The purpose of this study was to
determine the effect of schistosomiasis control program
performance on the incidence of schistosomiasis in Sigi
Regency, Central Sulawesi, Indonesia.
Research Methods
Research using cross sectional design. The study was
conducted in the working area of the ​​ Lindu Community
Health Center. Data collection and processing will be
conducted from April to May 2019.10,11 The population
in this study is the entire community in the area of​​
Lindu Health Center, Sigi Regency, Central Sulawesi
(2579 people). The sample in this study were residents
with a history of schistosomiasis and residents who had
never experienced schistosomiasis. The sample size
for the community analysis unit was 122 people. The
community as a research sample will be interviewed
regarding the schistosomiasis control program that has
been conducted by Lindu Community Health Center
staff.12,13 Variables that will be examined include the
IEC officer, the stability of the treatment program in the
working area of ​​the Lindu Community Health Center, and
also the incidence of schistosomiasis in the community.
IEC officers and treatment programs are indicators of the
performance of schistosomiasis control programs in the
work area of the
​​ Lindu Community Health Center, Sigi
Regency, Central Sulawesi, Indonesia.14,15,16

Result
Table 1 Identification of Officer IEC

Score

Statement (1) (2) (3) (4)

n % n % n % N %
Have received information about
9 7,4 11 9,0 45 36,9 57 46,7
Schistosomiasis from Puskesmas staff

Motivated to take medication when

10 8,2 21 17,2 43 35,2 48 39,3
experiencing schistosomiasis by officers

Obtain information about the mode of

transmission of schistosomiasis from 25 20,5 31 25,4 32 26,2 34 27,9
officers

Obtain information about symptoms of

11 9,0 27 22,1 54 44,3 30 24,6
schistosomiasis from officers
 1420 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7

Cont .... Table 1 Identification of Officer IEC

Score

Statement (1) (2) (3) (4)

n % n % n % N %

Getting information about the source of

schistosomiasis transmission from the 17 13,9 25 20,5 25 20,5 55 45,1
officer

It is recommended by officers to use

footwear and hand protection when 18 14,8 20 16,4 44 36,1 40 32,8
working

It is recommended by officers to defecate

21 17,2 20 16,4 41 33,6 40 32,8
defecation

Average 15,9 13,0 22,1 18,1 40,6 33,3 43,4 35,6

Most of the respondents considered that the puskesmas staff had conducted IEC, as evidenced from around 69%
of respondents who answered that they often and always did IEC to the community related to schistosomiasis. This
means that basically IEC officers are already good, but it needs to be improved in IEC related information about
the way of transmitting schistosomiasis because there are still more than 40% included in the category of IEC poor
officers with rare and never criteria.

Table 2 Identification of Treatment Programs

Score

Statements (1) (2)

n % N %

know that there is always treatment at the Puskesmas for Schistosomiasis

7 5,7 115 94,3
sufferers

always get treatment when coming to the health center when experiencing
5 4,1 117 95,9
schistosomiasis

Average 6 4,9 116 95,1

It shows that the majority of respondents considered that the treatment program at the puskesmas was always
available (94.3%) and always received treatment (95.9%). This means that the majority of respondents assume that
the treatment program has been running and is routine.
 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7 1421

Table 3 Effect of Schistosomiasis Control Program Performance on the Occurrence of Schistosomiasis

Occurrence of Schistosomiasis
Total
Indicator Yes No P Exp (B)

N % n % n %

1. Officer IEC

a. Poor 34 89,5 4 10,5 38 100,0 0,000 17,944

b. Good 27 32,1 57 67,9 84 100,0

2. Treatments Program

a. Poor 4 66,7 2 33,3 6 100,0 0,411 -

b. Good 57 49,1 59 50,9 116 100,0

From the table it can be seen that the direct effect
on the incidence of schistosomiasis is the IEC of officers
(p = 0,000 and exp (B) = 17,944) while the treatment
program does not affect the incidence of schistosomiasis.
This means that officials need maximum efforts to carry
out IEC on the community so that the incidence of
schistosomiasis can be reduced.
Discussion and Conclusions
The implementation of the Schistosomiasis Disease
Control Program in Sigi Regency which aims to reduce
the prevalence of Schistosomiasis to below 1% requires
several roles including the role of related agencies
that have been appointed to move in an integrated
team to control Schistosomiasis.17,18 The role of the
Schistosomiasis laboratory which serves as the discovery
of sufferers, the discovery of habitat from snails and
treatment of patients with Schistosomiasis, the role
of the Lindu Community Health Center in increasing
knowledge and changes in community behavior and the
participation of the community itself, in this discussion
is the community of the Lindu Community Health
Center.19,20
The government in implementing infectious
disease prevention programs can form work units /
implementing units. Based on the prevalence / incidence
of illness and characteristics of infectious diseases, the
target of communicable disease control programs can be
through elimination. Elimination is an effort to reduce
the disease on an ongoing basis in certain regions so
that the disease morbidity rate can be reduced as low as
possible so that it does not become a health problem in
the area concerned.
Based on the results of the study, it is known that
the majority of IEC officers are good, as is the treatment
at the puskesmas where the majority of the community
knows that there is treatment for schistosomiasis at the
puskesmas and the majority of the population receives
the treatment at the puskesmas.21
Efforts to find cases of schistosomiasis require active
participation from the community. Public awareness to
check themselves into the health center is crucial to the
discovery of schistosomiasis cases. The active role of
cadres in helping Puskesmas to report schistosomiasis
is urgently needed. The low participation of the
community and cadres can hamper the discovery of cases
of schistosomiasis. This is due to the busyness of the
community itself and minimal community knowledge
related to the case of schistosomiasis which must be
resolved by maintaining the health of the community
itself.22
The discovery of the case of schistosomiasis
requires strong motivation from health workers, where
officers have a strong desire and feel attached to their
organizations so that they voluntarily and try hard to
achieve organizational goals. In line with this, researchers
also found that there were still unprofessional health
workers working on the program because the incentives
obtained were still far from expectations.
 1422 Indian Journal of Public Health Research & Development, July 2020, Vol. 11, No. 7
Make regular outreach programs where puskesmas
staff provide IEC about schistosomiasis in the
community. IEC is very important because IEC officers
influence community factors and environmental factors,
also directly affect the incidence of schistosomiasis. From
this IEC, it is expected to increase public knowledge,
especially in the context of improving environmental
conditions so that people do not get too much exposure
to the vector of schistosomiasis.
Conflict of Interest: The authors declare that there
is no conflict of interest regarding the publication.
Ethical Clearance: This research has been approved
by the Health Research Ethics Committee Faculty of
Nursing Universitas Airlangga with Ethical Approval
Number: 1767-KEPK published in 9th September 2019.
Source of Funding: This research was funded by
self funding.
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