Background: Dengue Hemorrhagic Fever (DHF) is still reported to be one of the

health problems in Indonesia, and continues to be reported in the city of Bandung.

This retrospective descriptive study aims to see the distribution the incidence of
DHF pattern compared to annual rainfall and population density, as well as
dengue prevention program in the district with the highest incidence of dengue
fever in Bandung period of 2008-2011.
Methods: The data used in this study are gotten from Dinas Kesehatan Kota
Bandung and Laboratorium Penelitian dan Pengabdian Pada Masyarakat Faculty
of Medicine, University of Padjadjaran.
Results: The highest incidence of dengue fever in the period 2008-2011 occurred
in 2009 (276.6 / 105). The incidence of dengue increased in January-February and
declined at the end of the year. An increase of rainfall occured in the end of the
year and having a reduction in the mid-year. Population density in the district with
the highest incidence of dengue, has a population density below the average
population density of Bandung. Kecamatan Coblong is the district with the
highest implementation of fogging program. Angka Bebas Jentik (ABJ) in districts
with the highest incidence are not all below 95%. There are still districts with ABJ
below 95%.
Conclusions: The incidence of dengue increased after months of high rainfall.
The pattern of distribution of the entire district and compared to the fluctuating
population density present a hand in hand. Fogging program showed a good
response. The high number of ABJ is not always accompanied by a low incidence
of dengue.
BACKGROUND
Dengue Hemorrhagic Fever (DHF) is a public health problem that has reached
into an international health problem. The spread of dengue has been vastly

expanded since last 30 years. Back in 1970, it was only nine countries which
reported the cases of dengue, but currently, it estimated that arround 100 countries
with tropical and sub-tropical climate known as endemic areas. Approximately,
40% of the world's population are at risk for dengue virus. From the total
population in Southeast Asia, an estimated 87% are at risk of dengue.
Indonesia is a country in Southeast Asia that includes in the dengue endemic
areas. In 2006, Indonesia has the highest incidence in Southeast Asia. Since the
first discovered in 1968 in Surabaya, Indonesia's dengue fever cases have been
increasing. All provinces in Indonesia have reported dengue cases. Based on the
reports of the Ministry of Health of the Republic of Indonesia, in 2009, it was
noted that the province of West Java was the region with the highest number of
dengue cases.
Based on the report of Riset Kesehatan Dasar (RISKESDAS) of West Java
province in 2007, the prevalence of dengue in Bandung, which is the capital of
West Java province, is above average prevalence provinces. Climatic factors and
population density in Bandung may affect the presence of mosquito-borne dengue
vector.
Several factors which affect the increase and spread of dengue cases are the high
rate of population growth, unplanned and uncontrolled urbanization, and the lack
of effectiveness mosquito vector control in endemic areas. Morbidity and
mortality from viral infection is also influenced by other factors such as host
immunity, the density of vector mosquitoes, dengue virus virulency, and local
geographical conditions. Pattern outbreak of dengue virus infection is also
influenced by the climate and humidity, where the hot temperatures (28-32 degree

Celcius) and high humidity is an intermediate vector of dengue virus in order to

stay alive. DHF patients is expected to continue to grow, especially post-floods
and climatic changes which caused many water reservoirs as in toren water,
bathtub, bottles, cans and other water reservoir which is close to settlement. This
kind of unmoved water storage is a good place mosquito-borne dengue vector
breeding.
Dengue fever continue to be reported every year in the city of Bandung and
remains a health concern. Based on the idea, the researchers wanted to see how
the incidence and spread of dengue fever in every district in Bandung during the
period of 2008 to 2011.
Research Objectives. Analyzing patterns of dengue incidence associated with
rainfall patterns; analyze the distribution pattern of dengue disease associated with
population density, and knowing dengue prevention program in the district with
the highest incidence rate in Bandung during the period of 2008 to 2011.
METHODS
The research design that used in this study was descriptive retrospective by using
secondary data which obtained from Dinas Kesehatan Kota Bandung and
Laboratorium Penelitian dan Pengabdian Pada Masyarakat, Faculty of Medicine,
University of Padjadjaran. Objects studied in this research are the DHF patients
recorded data which are routinely reporting in every health center (Puskesmas) in
all districts in Bandung during January 2008 - December 2011 with the inclusion
criteria, new cases of dengue fever patients who live in Bandung.
The variables in this study consisted of DHF incidence, annual rainfall (mm),
location of residence DHF (in districts), population density (population/km2), the
implementation of fogging and larvae-free number (ABJ). Then, the data was

processed using Ms. Excel 2010 and Arc View 3.3 to obtain results in the form of
tables, graphs, and mapping based on the district. In mapping, each year is divided
into 3 areas based on the incidence of dengue fever, the red region: high
incidence, yellow regions: moderate incidence and green areas: low incidence.
The determination of this region obtained from the calculation of the incidence
rate of dengue fever across districts per year with the highest and lowest value,
then divided into 3 groups.