Relationship of Knowledge, Attitude and Infrastructure Means with Community Behavior in the Eradication Dengue Hemorrhagic Fever in Port of Padangbai Karangasem

Dengue hemorrhagic fever (DHF) is a disease that is still a problem in Indonesia, including Bali. The Padangbai Karangasem port area is one of the entrances to countries that are not yet free from dengue fever cases, because there are still reported cases of dengue fever. The number of House of Aedes Flicking Index is still more than 1%. Based on Minister of Health Decree number 431 of 2007 Port Buffer Area <1%. The implementation of the Mosquito Nest Eradication through 3M Plus is the most effective effort to prevent the transmission of Dengue Hemorrhagic Fever.The purpose of this study was to determine the relationship between knowledge, attitudes and infrastructure with the behavior of implementing the Eradication of Dengue Hemorrhagic Fever Nests. The research design was quantitative with a cross sectional design. This research was conducted in the Padangbai Karangasem Port Area, Bali. Data collection used a questionnaire about Knowledge, Attitudes,facilities and infrastructure and Behavior for Eradicating Dengue Hemorrhagic Fever Eradication. The number of samples of 89 respondents was taken proportional random sampling. The results showed that Knowledge, Attitudes and Infrastructure were significantly related to the eradication behavior of dengue fever mosquitoes due to the value of p<α=0.,05. The most dominant variable associated with the implementation behavior of Eradication of Dengue Hemorrhagic Fever Eradication is Knowledge Variable because the highest OR value is 4.287 compared to Attitudes and infrastructure.

House index (HI) and Container Padangbai Port Buffer Area Index (CI) for 2016 -2017 has never reached <1%, According to Minister of Health Decree Number 431 concerning Environmental Health Risk Control in Ports / Airports / Cross-Border Posts for Quarantine Health Figures House Index (HI ) Aedes aegypti in the buffer region is less than 1% and the mosquito population in the port environment is pressed as low as possible. Mosquito Nest Eradication (PSN) is the most effective and easy way to control mosquito vector or effort to break the chain of transmission of dengue.
The Denpasar Class I Port Health Office has socialized to the public about DHF vector control efforts that can be carried out independently by the community at home. A program known as Eradication of Mosquito Nests by Closing, Draining and Recycling Plus (3M Plus PSN). PSN 3M Plus provides an explanation of the behavior of removing DHF vector mosquito nests and steps to reduce the contact or bite of Aedes mosquitoes. Considering that there are many Aedes mosquito nests inside the house so that this action is considered necessary by the community to reduce the incidence of DHF. The successful program of the Eradication of Mosquito's Nest Plus 3 Movement is strongly influenced by the behavior of individuals and society. The better the behavior of the people, the better the success rate of the 3 M Plus Mosquito Nest Eradication Movement Program. According to Green (2000) Some factors that influence the formation of individual and community behavior are: 1) Predisposing factors include: knowledge, attitude, 2) Enabling factors include the availability of infrastructure, affordability at health facilities. 3) Strengthening Factors / Reinforcing factors include health care, community leaders and decision makers.
This research was conducted to find out the relationship between knowledge, attitudes and infrastructure with the behavior of the community in the Eradication of Dengue Hemorrhagic Fever (PSN-DBD) in port of Padangbai Karangasem Bali.

Methodology:
The research design was quantitative with a cross sectional design.

Univariate Analysis of Dependent Variable
The results showed that the majority of respondents behaved less as much as 57 people (64%), while those who behaved well were 32 people (36%), as shown in table 1 below

Relationship between Facilities and Marketing and Respondents' Behavior in Eradicating Nest of Dengue Hemorrhagic Fever (PSN-DBD)
Based on the results of the study found that respondents who have good facilities and infrastructure with good behavior as many as 18 people (20.2%) while respondents who have facilities and infrastructure are lacking with less behavior as many as 40 people (44.9%). Based on the results of bivariate analysis, it is known that the p value = 0.014 <α (0.05) means that H0 is rejected or there is a relationship between Facilities and Infrastructure with Community Behavior in the Eradication of Dengue Hemorrhagic Fever (PSN-DBD) at Padangbai Karangasem Sea Harbor,Bali . Can be described in the following table 5:

Multivariate Analysis Results:
Multivariate analysis aims to obtain the dominant factor in the behavior of respondents in PSN-DBD. At this stage an analysis of several factors related to the behavior of respondents in PSN-DBD was carried out together, namely the level of knowledge, attitudes, and facilities and infrastructure. The stages:

Selection of candidate models
The first step is to determine the variables that will be included in the modeling with a value of p value <0.25. In this study there were 3 independent variables related to the behavior of respondents in PSN-DBD. Variables that have a value of p <0.25 are included in the multivariate model as shown in the following table:

Selection of Multivariate Models
The 3 independent variables included in the multivariate model were then analyzed by considering the valuation of the disposal of the variable with the highest p-valuation value then processed again by excluding variables with the highest p-valuation value, until the loglikerhood ratio was obtained (p <0.05), the final result of choosing a multivariate model as shown in the following table: Application (Application). When the respondent knows and understands that dengue fever is a disease that can cause death that is transmitted through the Aedes Aegepty mosquito vector and can be prevented by routinely conducting dengue PSN, the respondent will have the Behavior to do prevention by routinely conducting dengue PSN. This can be seen in the bivariate test, there are 15 people (16.5%) respondents who have good Knowledge and Behavior of PSN. The results of this study prove that Notoatmodjo's theory states that behavior is influenced by 2 factors, namely internal factors and external factors. Internal factors include: knowledge, intelligence, perception, emotion, motivation and so on which function to process stimuli from the outside. While external factors include the surrounding environment, both physical and non-physical such as: climate, human, socio-economic, culture, and so on The results of the multivariate analysis of the three independent variables were found that the knowledge variable had the strongest relationship to the behavior of the implementation of PSN-DBD. This condition can be seen from the odds ratio (OR) of the knowledge variable is 4,287, meaning that respondents who have good knowledge have an opportunity of 4,298 times to implement the Eradication of DHF Mosquito Nests According to Notoatmodjo (2003) research has shown that behavior based on knowledge will be more lasting than behavior that is not based on knowledge. Therefore providing health education interventions regarding PSN-DHF needs to be done to improve public knowledge about DHF and efforts to prevent dengue disease in the form of counseling or training in the formation of jumantik cadres at the community level. The results of Argina (2011) research show that there is an increase in public knowledge about DHF, so that it can improve the quality of behavior in preventing DHF.
Based on the description above, it can be concluded that there is a relationship between knowledge and behavior of DHF mosquito nest eradication, so this research is in accordance with the concepts of Notoatmodjo and green. Furthermore, it can be explained through the knowledge possessed about dengue fever, how to eradicate what must be done with 3M (drain, close and bury) the reservoir, so the respondents tend to have the desire to implement 3M. This desire arises from the background of his desire not to contract dengue fever. If you see the level of relationship including the strongest category, it means that the better the knowledge These results indicate that respondents who are positive and respondents who behave negatively have differences in the implementation of PSN. This might happen because the more positive a person's attitude or view of things, for example attitudes toward dengue disease, the better the actions taken to prevent the disease are by doing PSN. Someone who knows about DHF and knows the consequences that will be experienced if they do not take preventive action, then it will bring someone to think and try to avoid the disease. In the process of thinking there are components of emotion, motivation and confidence so that in the end someone has a positive attitude towards prevention efforts, namely by doing PSN. This is in accordance with what was stated by Notoatmodjo (2005). That behavior is based on knowledge, awareness, and a positive attitude, then the behavior will be long lasting. Attitudes related to individual motivation to do something, thus in this case a positive attitude will motivate individuals to carry out PSN activities According to Mar'at (1984) states that attitude is a product of a socialization process, where a person will react according to the stimulation he receives. In relation to this attitude is very closely related to the knowledge gained both from own experience and from the environment.
According to Sarwono (1993) where attitudes are a tendency to respond positively and negatively to an object through persuasion, role models from someone or from a social group. This is consistent with what Green found in Notoatmodjo (2003) that a person's behavior is influenced by knowledge, attitudes, beliefs and others. Thus a positive public attitude will affect their own behavior towards PSN. Although a person's behavior is influenced by attitudes but not always attitudes will automatically manifest in an action, because to be able to realize an attitude to become a real force needed supporting factors include facilities, support from other parties and experience, environment and motivation (Azwar 2008) In this study the results of the multivariate analysis of attitude variables were ranked second after knowledge, in getting the odds ratio (OR) attitude variable of 3.29, meaning that respondents with good attitudes had an opportunity of 3.29 times eradicating behavior DBD mosquito nests were compared who have a lack of attitude. So an increase in attitude is needed in order to improve the eradication behavior of Aedes aegypti mosquito nests. This is in accordance with the research conducted by Dewi, Nila. 2015. With the title Factors relating to the eradication of the family nest of dengue fever mosquitoes in the village of Mulyoharjo, Jepara Subdistrict, Jepara District, this study found that there was a significant relationship between family knowledge and attitudes towards the practice of eradicating dengue mosquito nests

Relationship between Facilities and Infrastructure and Respondents' Behavior in the Implementation of Eradication of Dengue Hemorrhagic Fever Nests (PSN-DBD)
Based on the results of bivariate analysis it is known that the value of p value = 0.014 <α (0.05) means that H0 is rejected or there is a relationship between Facilities and Infrastructure with Community Behavior in the Implementation of Eradication of Dengue Hemorrhagic Fever (PSN-DHF) at Padangbai Sea Port Karangasem Bali. The majority of the people in Padangbai Karangasem Port of Bali have less behavior regarding the Eradication of Dengue Hemorrhagic Fever (PSN-DHF), which is 57 people (64%).
The results of data collection on PSN facilities and infrastructure during the study revealed that limited warehouse ownership questions have the tendency to store used items such as bottles because they are sold where stacked used goods have the potential to become water reservoirs / mosquito breeding grounds. In addition, people tend to have water reservoirs that are not equipped with covers. The community feels that with the cover disturbing comfort in water use activities.
This result is in accordance with Green in Notoatmodjo (2003) which reveals facilities and infrastructure is a factor that will support the community to do or behave well in health, meaning that with supporting factors (facilities and infrastructure), the community will carry out real activities in nest eradication Ades aegypti mosquito. Thus the role of facilities and infrastructure is to support the PSN-DBD activities, especially in terms of the availability of abate which requires good planning in fulfilling abate needs for the implementation of PSN-DBD so as to achieve the PSN-DBD target, as the researchers found in terms of access to obtain abate powder it is sufficient but abate obtained by the community is not used properly. Because the community thinks it has an impact on water clarity. This condition shows that the public's understanding of the use of abate needs to be improved through PSN socialization / counseling which focuses on the procedures for using abate.
Another condition found in the field, namely the availability of clean water in this case sourced from the PDAM, is still limited (scheduled) so that people tend to hold water for> 2 days. This condition has the potential to become a breeding place for mosquitoes if it is not equipped with a cover and application of 3 M specifically "M" (Drain). 2. For Village Devices and traditional institutions in the Padangbai Port area, the relevant agencies are expected to provide motivation to the community to be able to carry out independent eradication activities not dependent on visits from health workers. It can also be done through empowerment through the establishment of larva monitoring (JUMANTIK) cadres from residents of each hamlet. Other activities can be through the joint cleaning work movement every holiday or week to foster community motivation.
3. For relevant agencies, it is expected to always provide information about the implementation of PSN and use abate to the community so that the community better understand and respond to PSN properly, so that the implementation of the appropriate PSN is created. Periodic control of the environment is also carried out, and invites the public to actively participate in prevention of dengue and reporting of cases that occur. Activating community participation in the implementation of PSN by forming cadres involving sub-village level equipment, schools, customary institutions.
5. For other researchers, it is expected to examine further about other factors such as behavioral relationships with a difference in the index of genetics, behavior of Ae mosquitoes. aegypty for dengue incidence, as well as people's behavior in accommodating water against larvae indexes.