ANALISIS

SPASIAL

Dian Sidik Arsyad, SKM. MKM.

Sistem Informasi
Geografis Bidang
Kesehatan
Masyarakat

OUTLINE PRESENTASI
TEORI (PENGANTAR)
Definisi dan Konsep Analisis Spasial
Sejarah GIS dan Analisis Spasial Bidang Kesehatan
Potensial Implementasi GIS dan Analisis Spasial
Bidang Kesmas
Spatial Analysis Framework
Teknik analisis spasial berdasarkan jenis data spasial
Contoh Pemetaan dan Analisis Spasial Bidang
Kesehatan
Studi Kasus Kusta di Pulau Terpencil di Indonesia
PRAKTEK

DEFINISI DAN KONSEP ANALISIS

SPASIAL
Thefirst law of geographyaccording toWaldo
Tobleris "Everything is related to everything else,
but near things are more related than distant
things.
Defenisi:
Spatial Analysis: The study of the locations and shapes of geographic
features and the relationships between them (Earth Systems Research
Institute, 1996).
Analisis spasial adalah suatu inferensi visual dalam bentuk peta yang
merupakan gabungan dari data spasial dan data atribut.

Konsep dasar dari analisis spasial adalah kewilayahan dan

aspek lokasional (space & location)
Istilah istilah lain Medical geography, Spatial

DEFINISI DAN KONSEP ANALISIS

SPASIAL
Fakta : berbeda lokasi di muka bumi berkaitan
terhadap perbedaan profil lokasi seperti physical,
biological, environmental, economic, social,
cultural, yang jelas memberikan pengaruh
terhadap masalah kesehatan, penyakit serta
pelayanan kesehatan.
Profil wilayah ini serta hubungannya terhadap
kondisi dan masalah kesehatan juga berubah
seiring dengan berjalannya waktu Konsep
Spatial dan Temporal Epidemiology.

SEJARAH DAN
PERKEMBANGAN
Konsep bahwa lokasi mempengaruhi kesehatan Abad ke 3 SM
oleh Hippocrates, beliau mengamati bahwa penyakit-penyakit
tertentu hanya terjadi di lokasi tertentu saja, dan tidak di tempat
lain.
1854 di Outbreak / Wabah Kolera di London menjadi tonggak
sejarah berkembangnya GIS dan analisis spasial, yang di
motori oleh Dr. John Snow
Beliau memetakan setiap penderita dan kematian karena
kolera dimana Outbreak terjadi
Kejadian Kolera saat itu terpusat (clustered) di sekitar pompa
air Broad Street milik Southwark and Vauxhall Water Company
Rekomendasi Beliau Melepas handle pompa
Menghentikan transmisi.
Dengan menggunakan peta untuk mengamati dan

PETA DR. JOHN SNOW

(DAN BEBERAPA REPLIKASI)

POTENSIAL IMPLEMENTASI GIS DAN

ANALISIS SPASIAL BIDANG KESMAS
Communicable Disease Control
Environmental Health Research, Planning and Operations
Nutrition and Physical Activity
Child and Youth Health
Health Promotion
Chronic Disease Prevention
Alcohol, Tobacco and Other Drugs Service (ATODS) provision
Injury
Mental Health
Vector

Referensi :Spatial Analysis, GIS, and Remote Sensing Applications in

Control
the
Health Sciences, 2000

JOURNAL INTERNATIONAL
Journal yang berkaitan dengan GIS & analisis spasial di
bidang kesehatan :
Health & Place (An International Journal)

http://www.journals.elsevier.com/health-and-place
International Journal of Health Geographics

http://www.ij-healthgeographics.com/
Spatial And Spatio-Temporal Epidemiology

http://
www.journals.elsevier.com/spatial-and-spatio-temporal-epidemiol
ogy

Geospatial Health

http://www.geospatialhealth.net/index.php/gh
International Journal of Applied Geospatial Research (IJAGR)

CONTOH ARTIKEL
PENELITIAN
Laura Bissonnette, et all, Neighbourhoods and potential access to health care: The role
of spatial and aspatial factors, Health & Place, Volume 18, Issue 4, July 2012.
ZariaTatalovich, et all., Geographic disparities in late stage breast cancer incidence:
results from eight states in the United States, International Journal of Health
Geographics201514:31
YoshiharuFukuda, et all., Variations in societal characteristics of spatial disease
clusters: examples of colon, lung and breast cancer in Japan, International Journal of
Health Geographics20054:16
Rosenberg MS, et all.,Spatial autocorrelation of cancer in Western Europe.Eur J
Epidemiol1999,15:1522.
Tha Han, et all., Impact of tobacco outlet density and proximity on smoking cessation:
A longitudinal observational study in two English cities, Health & Place, Volume 27, May 2014.
Jiachen Zhou, et all., Determinants and spatial patterns of adult overweight and
hypertension in a high HIV prevalence rural South African population, Health & Place,
Volume 18, Issue 6, November 2012.

CONTOH ARTIKEL
PENELITIAN

AlexisJComber, et al. A spatial analysis of variations in health access: linking geography,

socio-economic status and access perceptions, International Journal of Health
Geographics201110:44
Marcia Caldas de Castro et all., Spatial patterns of malaria in the Amazon: Implications for
surveillance and targeted interventions, Health & Place, Volume 13, Issue 2, June 2007
Britton A. Gibson,et all., Accessibility and utilization patterns of a mobile medical clinic
among vulnerable populations, Health & Place, Volume 28, July 2014
Ruben Brondeel,et all., Use of healthcare services in the residence and workplace
neighbourhood: The effect of spatial accessibility to healthcare services, Health & Place,
Volume 30, November 2014
BambangParmanto, et al., Spatial and multidimensional visualization of Indonesia's village
health statistics, International Journal of Health Geographics20087:30
JosephRSharkey, et al., Association between proximity to and coverage of traditional
fast-food restaurants and non-traditional fast-food outlets and fast-food consumption
among rural adults, International Journal of Health Geographics201110:37
Lukar E Thornton, et al., Does the choice of neighbourhood supermarket access measure
influence associations with individual-level fruit and vegetable consumption? A case

SPATIAL ANALYSIS
FRAMEWORK
Vector
Attribute
data

GIS

Point
Feature
data

Databases

Line
Polygon

Raster
Maps

Visualization

Describe
patterns

Exploration

Test
hypotheses

Modelling

GIS
DBMS

Statistical
Software

* GIS = Geographic Information

Systems
** DBMS = Database Management
Systems

Conceptual framework of spatial epidemiological data analysis (Spatial Analysis in Epidemiology,

KLUSTER PENYAKIT
(DISEASE CLUSTERING)
Definisi Kluster Penyakit : Kluster penyakit
merupakan pengelompokkan spasial atau spacetime suatu penyakit yang signifikan secara statistik.
Clustered Pola penyebaran secara global / umum
Clustering Pola penyebaran mengikuti faktor lain
(faktor risiko/determinan)
Pada awalnya mendeteksi kluster sangat sulit,
dengan adanya teknologi informasi serta aplikasi GIS
maka semakin mudah mendeteksi pola penyebaran
pnyakit.

METODE DETEKSI CLUSTER

PENYAKIT
Metode Deteksi Kluster terbagi menjadi dua :
Global Detection test Mendeteksi pola
penyebaran penyakit dan mendeteksi ada tidaknya
kluster terjadi di dari seluruh wilayah penelitian
tanpa menetukan letak lokasi kluster terjadi.
Local Detection test Mendeteksi pola
pennyebaran penyakit, ada tidaknya terjadi kluster
serta menentukan dimana (dan kapan) lokasi
kluster terjadi (mendeteksi hotspot)

Deteksi kluster bisa dilakukan untuk data

BENTUK SPASIAL
PENYEBARAN PENYAKIT

TEHNIK ANALISIS SPASIAL

BERDASARKAN JENIS DATA SPASIAL

METODE STATISTIK DETEKSI

CLUSTER
Data spasial Point (titik)
Global Test
Ripleys K Function (dan variannya)
Local Test
Kernel Density Estimation
Kuldorffs Spatial Scan Statistic
Data spasial polygon (area)
Global test
Morans I
Local test
Local Morans I
Kuldorffs Spatial Scan Statistic

Hipotesis null (H0) pada

semua analisis spasial
dalam mendeteksi
Cluster :
Risiko terjadinya penyakit
sama pada seluruh
wilayah studi (RR=1)
Tidak ada pengelompokan
/ kluster yang terjadi pada
wilayah studi (Log

SPATIAL & TEMPORAL

CLUSTER

Spatio-Temporal Diffusion Pattern and Hotspot Detection of Dengue in Chachoengsao Province, Thailand

CONTOH IMPLEMENTASI
DETEKSI KLUSTER
MENGGUNAKAN SATSCAN
PADA STUDI
LEPROSY STUDY ON REMOTE

KIT Biomedical
Research
www.kit.nl
31/01/2007

Background information on study

General aims of the project:

1. To study the epidemiology of leprosy
2. To study the effect of prophylactic treatment of contacts on various
determinants of leprosy

Spatial research questions:

Is leprosy clustered on these islands
Are persons with IgM antibodies against M.leprae clustered
Do contacts of patients have an increased risk of being seropositive
and is there a difference between types of patients

Background info on study area

Data collected in 2000

5 isolated islands
Number of in habitants: 250-2400 per island
Number of houses: 50-550 per island
24 hours by boat from Makassar
Available map: 1:250,000

Study area

Transportation to islands

Flat, sandy, coconut trees and coral

DATA COLLECTION
Population census (registration of
all inhabitants per house with age
and sex)
Active screening of whole
population for symptoms of leprosy
Serum collection for antibody
detection among population above
5 years
Collection of clinical samples from

PREPARATION OF MAPS
Numbered all houses and prepared hand-drawn
maps indicating location of all houses
Measured latitude and longitude of about every
5th house using GPS
Situated houses without lat/long between georeferenced houses in Arcview
Calculated lat/long of every house
Joined SPSS file with demographic and health
data using the house-variable

Part of hand-drawn map

map

map
Football

Mosques

Health
centre

Schools

Disease mapping

PERFORMING SATSCAN
Purely spatial
Bernoulli model (used when there are cases and
non-cases; people with or without a disease)

Cases=leprosy patients per house

Controls=examined persons without leprosy
per house
Coordinates=lat and long of every house

hotspots of patients identified by

SATSCAN

PERSIAPAN PRAKTEK
ANALISIS SPASIAL

PERSIAPAN YANG DILAKUKAN

Memahami pertanyaan penelitian yang sesuai
dengan spasial Pelajari artikel penelitian
yang menggunakan metode analisis spasial
Menyiapkan data yang sesuai untuk analisis
spasial Panduan SatScan
Menginstal aplikasi GIS untuk visualisasi peta
dan analisis spasial QGIS - SatScan

SATSCAN 9.4 (STATISTIC &

ANALYSIS)
Analyzes spatial, temporal and spatio-temporal data
through a scan statistic
Quick assessment of potential clusters
Developed by Martin Kuldorff for the National Cancer
Institute
Freely available from www.satscan.org
User guide available from http://
www.satscan.org/cgi-bin/satscan/register.pl/SaTSca
n_Users_Guide.pdf?todo=process_userguide_download

QUANTUM GIS

(HTTP://QGIS.ORG/ID/SITE/)

QGIS mulai dikembangkan pada tahun 2002 oleh Gary

Sherman

Awalnya hanya bisa digunakan di OS Linux / Unix

Versi pertama 0.0.1 Alpha (July 2002)

Versi 2.8.2 Wien (February 2015)

Versi 2.10 .... (Juni 2015)

Versi terakhir 2.12 Lyon (Oktober 2015)

Merupakan salah satu opensource GIS terbesar dari sisi

jumlah pengguna

Fasilitas yang cukup lengkap dan Mudah digunakan