Relationship Between Environmental Sanitation and Dengue Hemorrhagic Fever Incidents
Abstract
Purpose of the study: The purpose of this study was to analyze the relationship between environmental sanitation and the incidence of Dengue Hemorrhagic Fever in the Unidad de Salud Work Area.
Methodology: The study employed an analytical design using a survey method with a retrospective case-control approach. A total of 50 respondents were purposively sampled, comprising 25 Dengue Hemorrhagic Fever patients and 25 neighbors within ±10 meters who had no history of Dengue Hemorrhagic Fever. Data collection utilized a validated questionnaire (Cronbach's α = 0.803) focusing on environmental sanitation and vector control practices. Data analysis included univariate analysis for descriptive statistics and bivariate analysis using the chi-square test at a 95% confidence level to determine significant associations between risk factors and Dengue Hemorrhagic Fever incidence.
Main Findings: The results of the study showed that there was a significant relationship between the independent variables, namely there was a relationship between house conditions and the incidence of Dengue Hemorrhagic Fever (p-value = 0.023), there was a relationship between water reservoir conditions and the incidence of Dengue Hemorrhagic Fever (p-value = 0.010), and there was a relationship between the waste disposal system and the incidence of Dengue Hemorrhagic Fever (p-value = 0.005) in the Unidad de Salud Work Area.
Novelty/Originality of this study: This study offers a comprehensive approach to identify significant environmental determinants in influencing dengue incidence, which can form the basis for developing community-based interventions to improve the effectiveness of vector control.
References
A. Virgolino et al., “Towards a global perspective of environmental health: Defining the research grounds of an institute of environmental health,” Sustain., vol. 12, no. 21, pp. 1–24, 2020, doi: 10.3390/su12218963.
P. Asfian, R. N. Halik, N. Hidayat, S. Dwiyanti, S. Nurhaliza, and K. Amalia, “Relationship between Climate Change and Prevalence of Environmentally Based Diseases in Coastal Fishing Communities in Sambuli Village , Nambo District,” J. Epidemiol. Heal. Sci., vol. 2, no. 1, pp. 83–92, 2025.
L. W. Riley, “Differentiating Epidemic from Endemic or Sporadic Infectious Disease Occurrence,” Microbiol. Spectr., vol. 7, no. 4, pp. 1–16, 2019, doi: 10.1128/microbiolspec.ame-0007-2019.
G. Dharmarajan et al., “The Animal Origin of Major Human Infectious Diseases: What Can Past Epidemics Teach Us About Preventing the Next Pandemic?,” Zoonoses (Ireland), vol. 2, no. 1, pp. 1–13, 2022, doi: 10.15212/ZOONOSES-2021-0028.
I. Restiaty, Z. Maharani, R. Rojali, W. Darmawan, and B. Y. D. Yanti, “Relationship of Water Temperature and Air Humidity with Aedes Sp. Manggarai Tebet Village South Jakarta in 2022,” ADI J. Recent Innov., vol. 4, no. 1, pp. 102–109, 2022, doi: 10.34306/ajri.v4i1.780.
M. Khairulbahri, “Understanding the Dynamics of Dengue Haemorrhagic Fever (DHF) in Indonesia and its Sustainable Solution: a Qualitative Perspective,” Sci. Technol. Asia, vol. 27, no. 2, pp. 217–226, 2022, doi: 10.14456/scitechasia.2022.38.
C. L. S. Lessa, K. V. S. Hodel, M. de S. Gonçalves, and B. A. S. Machado, “Dengue as a Disease Threatening Global Health: A Narrative Review Focusing on Latin America and Brazil,” Trop. Med. Infect. Dis., vol. 8, no. 5, pp. 1–21, 2023, doi: 10.3390/tropicalmed8050241.
R. Dehghani and H. Kassiri, “A review on epidemiology of dengue viral infection as an emerging disease,” Res. J. Pharm. Technol., vol. 14, no. 4, pp. 2296–2301, 2021, doi: 10.52711/0974-360X.2021.00406.
A. de Souza, M. C. Abreu, and J. F. Oliveira-Júnior, “Impact of Climate Change on Human Infectious Diseases: Dengue,” Brazilian Arch. Biol. Technol., vol. 64, pp. 1–14, 2021, doi: 10.1590/1678-4324-2021190502.
N. Yadav and R. K. Upadhyay, “Global Effect of Climate Change on Seasonal Cycles, Vector Population and Rising Challenges of Communicable Diseases: A Review,” J. Atmos. Sci. Res., vol. 6, no. 1, pp. 21–59, 2023, doi: 10.30564/jasr.v6i1.5165.
S. J. Coates and S. A. Norton, “The effects of climate change on infectious diseases with cutaneous manifestations,” Int. J. Women’s Dermatology, vol. 7, no. 1, pp. 8–16, 2021, doi: 10.1016/j.ijwd.2020.07.005.
M. I. Nasir, U. Usman, and I. Hussain, “The Societal Economic Burden of Dengue and Awareness Impact,” J. Law Soc. Stud. 2023 J. Law Soc. Stud., vol. 5, no. 1, pp. 52–68, 2023, doi: 10.52279/jlss.05.01.01.5268.
S. R. Mishra et al., “Transforming health in Nepal: a historical and contemporary review on disease burden, health system challenges, and innovations,” Heal. Res. Policy Syst., vol. 23, no. 1, pp. 1–20, 2025, doi: 10.1186/s12961-025-01321-z.
N. Nurdin, Y. I. Siregar, M. Mubarak, and W. Wijayantono, “Environmental Factors linked to the Presence of Aedes aegypti Larvae and the Prevalence of Dengue Hemorrhagic Fever,” Open Access Maced. J. Med. Sci., vol. 10, no. E, pp. 475–480, 2022, doi: 10.3889/oamjms.2022.8533.
L. Pascoe, T. Clemen, K. Bradshaw, and D. Nyambo, “Review of Importance of Weather and Environmental Variables in Agent-Based Arbovirus Models,” Int. J. Environ. Res. Public Health, vol. 19, no. 23, pp. 1–24, 2022, doi: 10.3390/ijerph192315578.
O. R. Pinontoan, O. J. Sumampouw, J. H. V. Ticoalu, J. E. Nelwan, E. C. Musa, and J. Sekeeon, “The variability of temperature, rainfall, humidity and prevalance of dengue fever in Manado City,” Bali Med. J., vol. 11, no. 1, pp. 81–86, 2022, doi: 10.15562/bmj.v11i1.2722.
J. M. Gurevitz, J. G. Antman, K. Laneri, and J. M. Morales, “Temperature, traveling, slums, and housing drive dengue transmission in a non-endemic metropolis,” PLoS Negl. Trop. Dis., vol. 15, no. 6, pp. 1–22, 2021, doi: 10.1371/journal.pntd.0009465.
D. K. Yosef, A. S. Ismail, B. S. Awil, H. A. Hassan, and M. A. Hassan, “Epidemiology of dengue fever in Somaliland: clinical features, and serological patterns from a retrospective study,” BMC Infect. Dis., vol. 25, no. 1, p. 179, 2025, doi: 10.1186/s12879-025-10558-6.
M. A. Nurjana et al., “Water containers and the preferable conditions for laying eggs by Aedes mosquitoes in Maros Regency, South of Sulawesi, Indonesia,” J. Water Health, vol. 21, no. 11, pp. 1741–1746, 2023, doi: 10.2166/wh.2023.270.
T. Prameswarie et al., “Aedes Aegypti Hatchability and Larval Development Based on Three Different Types of Water,” Maj. Kesehat. Indones., vol. 4, no. 1, pp. 27–32, 2023, doi: 10.47679/makein.2023124.
M. T. Khan et al., “Personal protective equipment (PPE) disposal during COVID-19: An emerging source of microplastic and microfiber pollution in the environment,” Psychiatry Res., vol. 14, no. 4, pp. 1–14, 2020.
F. Dzul-Manzanilla et al., “Identifying urban hotspots of dengue, chikungunya, and Zika transmission in Mexico to support risk stratification efforts: a spatial analysis,” Lancet Planet. Heal., vol. 5, no. 5, pp. 277–285, 2021, doi: 10.1016/S2542-5196(21)00030-9.
N. I. Hawa, E. Antriyandarti, D. N. Martono, and R. A. Maulana, “Improvement of Environmental, Social, and Cultural Attributes in the Slum Settlements on the Riverbanks of Yogyakarta City under the Sultan’s Rule,” Sustain., vol. 15, no. 11, pp. 1–14, 2023, doi: 10.3390/su15118974.
P. Kumar, S. Srivastava, A. Banerjee, and S. Banerjee, “Prevalence and predictors of water-borne diseases among elderly people in India: evidence from Longitudinal Ageing Study in India, 2017–18,” BMC Public Health, vol. 22, no. 1, pp. 1–11, 2022, doi: 10.1186/s12889-022-13376-6.
M. A. F. Mahmud et al., “The application of environmental management methods in combating dengue: a systematic review,” Int. J. Environ. Health Res., vol. 33, no. 11, pp. 1148–1167, 2023, doi: 10.1080/09603123.2022.2076815.
R. M. N. U. Rajapaksha, C. Abeysena, and A. Balasuriya, “Health seeking behaviours, dengue prevention behaviours and community capacity for sustainable dengue prevention in a highly dengue endemic area, Sri Lanka,” BMC Public Health, vol. 23, no. 1, pp. 1–9, 2023, doi: 10.1186/s12889-023-15404-5.
M. S. Rahman, F. Mehejabin, M. A. Rahman, and R. Rashid, “A case-control study to determine the risk factors of dengue fever in Chattogram, Bangladesh,” Public Heal. Pract., vol. 4, no. June, p. 100288, 2022, doi: 10.1016/j.puhip.2022.100288.
J. Khan et al., “A cross-sectional study to assess the epidemiological situation and associated risk factors of dengue fever; knowledge, attitudes, and practices about dengue prevention in Khyber Pakhtunkhwa Province, Pakistan,” Front. Public Heal., vol. 10, pp. 1–18, 2022, doi: 10.3389/fpubh.2022.923277.
S. Abdullah, J. Islam, M. Hasan, D. Sarkar, S. Rana, and S. S. Das, “Impact of Waste Management on Infectious Disease Control : Evaluating Strategies to Mitigate Dengue Transmission and Mosquito Breeding Sites – A Systematic Review,” Angiotherapy, vol. 8, no. 8, pp. 1–12, 2024.
W. N. F. M. Wan, N. C. Dom, R. Dapari, S. Abdullah, and S. Y. Agyemang-Badu, “Profiling of Aedes Mosquito Breeding Sites at Residential Construction Sites in Malaysia,” Malaysian J. Med. Heal. Sci., vol. 19, no. 6, pp. 234–241, 2023, doi: 10.47836/mjmhs.19.6.31.
I. R. Abubakar et al., “Environmental Sustainability Impacts of Solid Waste Management Practices in the Global South,” Int. J. Environ. Res. Public Health, vol. 19, no. 19, pp. 1–26, 2022, doi: 10.3390/ijerph191912717.
J. M. Chisholm et al., “Sustainable waste management of medical waste in African developing countries: A narrative review,” Waste Manag. Res., vol. 39, no. 9, pp. 1149–1163, 2021, doi: 10.1177/0734242X211029175.
J. R. Pratiwi, F. F. Wulandari, I. D. Aprilya, and I. Salsabila, “Education on the effectiveness of sugar-based mosquito traps in controlling dengue fever vectors,” ABDIMAS J. Pengabdi. Masy. Univ. Merdeka Malang, vol. 10, no. 374, pp. 59–69, 2025.
L. F. Rauf and S. Prasetyo, “Problem Based Learning ( PBL ) Model for Science Material on Prevention of Dengue Fever for Elementary School,” Basica J. Prim. Educ., vol. 5, no. 1, pp. 57–74, 2025, doi: 10.37680/basica.v5i1.5433.
G. Berihun et al., “Access to and challenges in water, sanitation, and hygiene in healthcare facilities during the early phase of the COVID-19 pandemic in Ethiopia: A mixed-methods evaluation,” PLoS One, vol. 17, no. 5 May, pp. 1–15, 2022, doi: 10.1371/journal.pone.0268272.
N. P. Tseole, T. Mindu, C. Kalinda, and M. J. Chimbari, “Barriers and facilitators to Water, Sanitation and Hygiene (WaSH) practices in Southern Africa: A scoping review,” PLoS One, vol. 17, no. 8, pp. 1–17, 2022, doi: 10.1371/journal.pone.0271726.
A. Debie, R. B. Khatri, and Y. Assefa, “Successes and challenges of health systems governance towards universal health coverage and global health security: a narrative review and synthesis of the literature,” Heal. Res. Policy Syst., vol. 20, no. 1, pp. 1–17, 2022, doi: 10.1186/s12961-022-00858-7.
T. O. Kolawole, A. Y. Mustapha, A. O. Mbata, B. O. Tomoh, A. Y. Forkuo, and M. C. Kelvin-agwu, “Evaluating the Effectiveness of Community-Based Health Education Programs in Preventing Non-Communicable Diseases,” IRE Journals, vol. 7, no. 3, pp. 779–794, 2023.
S. Syarifuddin and W. Samosir, “Relationship Between Health Behaviors and Incident of Dengue Fever and Dhf in Theworking Area of Singosari Pematang Siantar Health Center,” Medalion J. Med. Res. Nursing, Heal. Midwife Particip., vol. 3, no. 2, pp. 38–43, 2022, doi: 10.59733/medalion.v3i2.17.
Yulianti and W. R. Hidayani, “The Relationship between Environmental Sanitation and the Incidence of Dengue Hemorrhagic Fever (DHF) in Indonesia,” J. Public Heal. Sci., vol. 1, no. 02, pp. 71–88, 2022, doi: 10.56741/jphs.v1i02.83.
U. Thisyakorn et al., “Epidemiology and costs of dengue in Thailand: A systematic literature review,” PLoS Negl. Trop. Dis., vol. 16, no. 12, pp. 1–21, 2022, doi: 10.1371/journal.pntd.0010966.
Y. Chen et al., “Measuring the effects of COVID-19-related disruption on dengue transmission in southeast Asia and Latin America: a statistical modelling study,” Lancet Infect. Dis., vol. 22, no. 5, pp. 657–667, 2022, doi: 10.1016/S1473-3099(22)00025-1.
Y. Chang and X. Li, “Climate Change on Environmental Health and The Spread of Infectous Diseases,” Int. J. Educ. Technol. Artif. Intell., vol. 3, no. 2, pp. 86–93, 2024.
C. N. Olumba, E. J. Ihemezie, and C. C. Olumba, “Climate change perception, adaptation strategies, and constraints amongst urban farmers in Anambra Metropolis, Nigeria,” Clim. Dev., vol. 16, no. 4, pp. 311–320, 2024, doi: 10.1080/17565529.2023.2221685.
H. Taherdoost, “What are Different Research Approaches? Comprehensive Review of Qualitative, Quantitative, and Mixed Method Research, Their Applications, Types, and Limitations,” J. Manag. Sci. Eng. Res., vol. 5, no. 1, pp. 53–63, 2022, doi: 10.30564/jmser.v5i1.4538.
A. Althubaiti, “Sample size determination: A practical guide for health researchers,” 2023. doi: 10.1002/jgf2.600.
C. X. Y. Sutton, E. Carrazana, C. Mitchell, J. Viereck, K. K. Liow, and A. Ghaffari-Rafi, “Identification of associations and distinguishing moyamoya disease from ischemic strokes of other etiologies: A retrospective case-control study,” Ann. Med. Surg., vol. 78, no. May, p. 103771, 2022, doi: 10.1016/j.amsu.2022.103771.
F. Nyimbili and L. Nyimbili, “Types of purposive sampling techniques with their examples and application in qualitative research studies,” Br. J. Multidiscip. Adv. Stud., vol. 5, no. 1, pp. 90–99, 2024.
K. R. Subedi, “Determining the Sample in Qualitative Research,” Sch. J., vol. 4, no. December, pp. 1–13, 2021, doi: 10.3126/scholars.v4i1.42457.
L. R. Maulidah, I. Thohari, F. Rokhmalia, H. Suryono, N. Narwati, and A. D. Imami, “Article Analysis of the Relationship between Residential Environmental Sanitation and the Risk of Dengue Fever (DHF) Incidence in the Moropelang Health Centre Working Area , Lamonga , East Java,” Public Heal. Res. Dev. eISSN, vol. 1, no. 2, pp. 69–76, 2024.
N. Siyam et al., “Eco-health survey effort to diagnose readiness for sustainability dengue prevention and control,” Int. J. Public Heal. Sci., vol. 12, no. 2, pp. 898–908, 2023, doi: 10.11591/ijphs.v12i2.22797.
T. Nguyen-Tien et al., “Risk factors of dengue fever in an urban area in Vietnam: a case-control study,” BMC Public Health, vol. 22, no. 1, pp. 1–13, 2022, doi: 10.1186/s12889-022-13361-z.
S. Islam, C. E. Haque, S. Hossain, and J. Hanesiak, “Climate variability, dengue vector abundance and dengue fever cases in dhaka, bangladesh: A time-series study,” Atmosphere (Basel)., vol. 12, no. 7, pp. 1–21, 2021, doi: 10.3390/atmos12070905.
F. A. Lubis, P. A. Siregar, and Salamudin, “The Conditions Environmental Sanitation 3M Behavior and The House Indexwith The Event Of Dengue Dengue Fever (DHF),” Int. Arch. Med. Sci. Public Heath, vol. 2, no. 1, pp. 89–97, 2021.
A. H. M. Chastonay and O. J. Chastonay, “Housing Risk Factors of Four Tropical Neglected Diseases: A Brief Review of the Recent Literature,” Trop. Med. Infect. Dis., vol. 7, no. 7, pp. 1–15, 2022, doi: 10.3390/tropicalmed7070143.
U. Agustine, P. Belarminus, A. T. Ora, and G. F. Boa, “Home Environmental Conditions With Dengue Hemorrhagic Fever Incidence In West Sumba Regency,” J. EduHealth, vol. 15, no. 02, pp. 1563–1574, 2024, doi: 10.54209/eduhealth.v15i02.
A. R. R. Ramadhan, N. Hidayah, and M. Husni, “The Characteristics Probabilities and Risks Prediction of Containers as Potential Breeding Sites for Aedes Aegypti Mosquitoes,” J. Berk. Kesehat., vol. 8, no. 2, p. 149, 2022, doi: 10.20527/jbk.v8i2.14718.
A. Sutriyawan, K. Wirawati, and S. Suherdin, “The Presence of Aedes Aegypti Mosquito larvae in Bandung City in 2021,” Dis. Prev. Public Heal. J., vol. 16, no. 2, pp. 70–77, 2022, doi: 10.12928/dpphj.v16i2.5121.
M. Nanda, adinda A. R. Sibarani, A. A. Rizki, D. A. Natasya, and N. N. Syahputri, “The Relationship Between Sanitation Facilities and Dengue Fever Incidents on Jl. Aman, Tanjung Balai City, Simardan Island,” J. Heal. Sci. Vol, vol. 9, no. 2, pp. 38–45, 2016.
I. N. Chazanah and A. Bayu Dani Nandiyanto, “Literature of Waste Management (Sorting Of Organic And Inorganic Waste) Through Digital Media In Community,” Int. J. Res. Appl. Technol., vol. 2, no. 1, pp. 114–123, 2022, doi: 10.34010/injuratech.v2i1.6731.
A. A. Noman, I. M. Rafizul, S. M. Moniruzzaman, E. Kraft, and S. Berner, “Assessment of municipal solid waste from households in Khulna city of Bangladesh,” Heliyon, vol. 9, no. 12, p. e22446, 2023, doi: 10.1016/j.heliyon.2023.e22446.
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