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Epidemiology and Society Health Review| ESHR 
 

Vol 2 No1 2020 
 

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Research Article 
 
Comparative Analysis the Coverages of Filariasis Mass 
Prevention Drug (POPM) in Central Java Year 2018: Case 
Study in Grobogan, Semarang, and Wonosobo 
 
Setya Ningrum1, Rokhmayanti Rokhmayanti1*, Mieng Nova Sutopo2 
  
1 Faculty of Public Health, Ahmad Dahlan University, Yogyakarta, Indonesia 
2 Center for Environmental Health Engineering and Disease Control, Yogyakarta, Indonesia 
 
*Correspondence: rokhmayanti@ikm.uad.ac.id. Tel: +6281229517992 
Received 10 February 2020; Accepted 31 March 2020; Published 01 April 2020 
 

ABSTRACT  

Background: Filariasis is a disease caused by filarial worms and transmitted by mosquitoes 
that contain filarial worms. Pemberian Obat Pencegahan Masal (POPM) filariasis or Mass 
Prevention Drug is a program aimed to reduce the number of filariasis. The Survey of POPM 
in Grobogan, Semarang, and Wonosobo, shows there are different coverages of 65% and 
85%. The purpose of this study is to compare the survey coverage of POPM filariasis. Seek 
the reason not to participate, and the characteristics of the respondents who did not take 
filariasis medicine in Grobogan, Semarang, and Wonosobo. 
Methods: Descriptive quantitative study was used in this study by collecting secondary data 
of POPM survey coverage in Grobogan, Semarang, and Wonosobo year 2018. Descriptive 
and comparative analysis was applied to respondent characteristics, filaria POPM coverage, 
and elaborate the unconformity to the filaria medication.   
Results: Grobogan coverage is low compared to Semarang and Wonosobo. The respondent 
said about traveling, don't know, and age as the reason to not take the filariasis medication. 
Conclusions: Among the three districts, Grobogan is the district with low filariasis medication 
coverage compared to Semarang and Wonosobo. 

Keywords: Filariasis, POPM, Grobogan, Semarang, Wonosobo 

 

INTRODUCTION 

Filariasis is a chronic infectious disease caused by the filarial worms and transmitted by 
mosquitoes that contain filarial worms in their body. The worm grows into an adult in the human 
body and settles in the lymphatic tissue, causing swelling in the feet, legs, breasts, arms, and 
genital organs (1). Currently, globally there are 1.3 billion people at risk of transmitting the 
filariasis that spreads in more than 83 countries, and 60% of cases are in Southeast Asia (2). 

In Indonesia, found three species of filarial worms: Wuchereria bancrofti, Brugia malayi, and 
Brugia timori (3). From 2014-2018, 2014 was the highest filariasis case, recorded 14,932 
cases during that year, and declined in 2018 with 10,681 cases. Filariasis in Indonesia spread 
across 34 provinces. Five provinces with the most cases of chronic filariasis are Papua, East 
Nusa Tenggara, West Java, West Papua, and Aceh (2). In Central Java, in 2018, there were 
439 cases of chronic filariasis that mostly found in nine districts/cities that became endemic 



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areas: Pekalongan, Pekalongan, Brebes, Wonosobo, Semarang, Grobogan, Blora, Pati and 
Demak (4). 

Indonesia Minister of Health leads the filaria control program under the regulation No. 94 the 
Year 2014 about filariasis elimination. This regulation states about the main activity on the 
elimination is implementing a POPM (Filariasis Mass Prevention Drug) program. Filaria 
elimination goal is reducing the microfilariae number to less than 1% in each district. Surveys 
of the program implementation can identify filariasis POPM coverage.  

The POPM filariasis coverage survey was conducted for all people living in endemic filariasis 
areas. The subject of this survey is divided into two groups, namely POPM target, and non-
POPM target respondents. POPM target is each residence who aged 2-70 years in all 
education levels. Non POPM target respondents are every residence outside the target group, 
such as pregnant women, people with chronic illness, aged less than 2 years, and above 70 
years. POPM filariasis coverage is measured by two categories: 65% coverage and 85% 
coverage. 65% coverage is the ratio of the number of respondents taking the drug, with the 
total number of respondents multiplied by 100%. High coverage for this standard means the 
proportion of taking medication is above 65% for all respondents. 85% coverage is the ratio of 
the number of respondents taking the drug with the number of target respondents multiplied 
by 100%. 85% coverage can be called as high if the proportion of taking filaria drugs is above 
85% of the target respondents (5)-(7). 

65%	/	85%	𝑐𝑜𝑣𝑒𝑟𝑎𝑔𝑒 =
𝑁𝑢𝑚𝑏𝑒𝑟	𝑜𝑓	𝑟𝑒𝑠𝑝𝑜𝑛𝑑𝑒𝑛𝑡	𝑡𝑎𝑘𝑒𝑠	𝑓𝑖𝑙𝑎𝑟𝑖𝑎	𝑑𝑟𝑢𝑔

𝐴𝑙𝑙	𝑟𝑒𝑠𝑝𝑜𝑛𝑑𝑒𝑛𝑠 𝑥	100% 

In 65% target coverage, Grobogan, Semarang, and Wonosobo are stand in 81%, 84%, 83%, 
respectively. When in 85% target coverage, they stand in 85%, 91%, and 91%, respectively 
(5)(6)(7). This study aims to compare the coverage of POPM filariasis and people's motivation 
not to participate, include their characteristics in Grobogan, Semarang, and Wonosobo.  

 

METHODS 

Descriptive quantitative design was applied to illustrate the comparative results POPM 
filariasis coverage in Grobogan, Semarang, and Wonosobo year 2018. The table and graphics 
were used to display the result. Secondary data (POPM coverage filariasis) was collected from 
BBTKLPP Yogyakarta from 5-31 August 2019. This data based on the BBTKPLPP survey 
year 2018. The population of this research was all people aged 2-70 years living in Grobogan, 
Semarang, and Wonosobo, they are not pregnant, not sick, aged not less than two years and 
not more than 70 years were included in this study. In three districts (Grobogan, Semarang, 
and Wonosobo), we included 1,115; 1,242 and 1,170 respondents, respectively. The analysis 
was performed using descriptive and comparative analysis. 
 

RESULTS 

Comparisons of filariasis medication compliance in Grobogan, Semarang and 
Wonosobo year 2019 
According to the data, Grobogan, Semarang, and Wonosobo have reached the national target 
(65% and 85%) (Figure 1). Filaria POPM coverage in three districts was categorized as high 
both for 65% and 85 % measure. On 65% target, Semarang is the district with the highest 



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coverage (84%), and in 85% target, Semarang and Wonosobo have similar coverage (91%). 
This result implies in Semarang and Wonosobo, POPM targets have high conformity to take 
filaria drugs compared to Grobogan.  

 
               Source: BBTKLPP Yogyakarta, 2018 

Figure 1. Results of Drinking Drug Coverage Filariasis in Grobogan, Semarang 
and Wonosobo 2018 

The reason to not comply with filariasis medication in Grobogan, Semarang and 
Wonosobo year 2018 

Among the three districts, Grobogan has the highest number of not conforming people to 
filariasis medication (208 people) compared to Semarang and Wonosobo, with 204 people 
each of them. However, the differences among them are not significant.  Non-POPM targets 
said about pregnant, sick, and age reason to not adhere to the program. While for POPM 
target they said refuse, don't know, travel and other specific reasons (Table 1) 

Table 1. The motivation of people to not comply with filariasis medications 
in Grobogan, Semarang and Wonosobo 2018 

No. Reason Number of people 
Grobogan Semarang Wonosobo 

1 Not POPM Target    
 Pregnant 11 13 16 
 Sick 16 28 46 
 Age 44 62 53 
Amount 71 103 115 
2 POPM Target    
 Refuse 25 18 7 
 Do not know 28 49 9 
 Travel 64 32 54 
 Other: Breastfeeding, do not have 

an ID card, forget to drink, without 
explanation 

20 2 19 

Amount 137 101 89 
Total 208 204 204 

   Source: BBTKLPP Yogyakarta, 2018 

 

 

81
84 83

86

91 91

75

80

85

90

95

Grobogan Semarang Wonosobo

Pe
rc

en
ta

ge

Cakupan 65% Cakupan 85%65% coverage target 85% coverage target 



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Characteristics of POPM Target Who Not Take Filariasis Drugs in Grobogan, Semarang 
and Wonosobo year 2018 

Table 2 shows that Grobogan is the district with people's POPM target but not comply with the 
program. In three districts, most of the respondents are aged 16-70 years, hold primary school, 
and the majority of them are male (Table 2). 

Table 2. Characteristics of POPM Target Who Not Take Filariasis Drugs in 
Grobogan, Semarang and Wonosobo year 2018 

No. Characteristics Number of Respondents (People) 
Grobogan Semarang Wonosobo 

1 Age group (Yo)    
 3-5 14 3 3 
 6-15 11 14 7 
 16-70 112 84 79 
Amount 137 101 89 
2 Level of education    
 Pre-School 15 12 4 
 Basic School (Primary and 

Junior High School) 
88 49 59 

 Advance School (Senior 
High School and 
University) 

34 40 26 

Amount 137 101 89 
3 Gender    
 Male 75 61 46 
 Female 62 40 43 
Amount 137 101 89 

Source: BBTKLPP Yogyakarta, 2018 

 

DISCUSSIONS 

Grobogan is the district with low coverage of POPM. Some factors are influencing the low 
coverage of POPM filaria. For example, the information does not meet the target due to 
geographic conditions, inadequate communication facilities, people not in place when the 
program held, farming, schooling, insufficient knowledge and awareness of the community to 
take medicine. On the other hand, the POPM low coverage shows the weak performance of 
POPM staff. While the little POPM coverage compared to the target presents the unsuccessful 
of the medication (8). 

The geographical conditions of Grobogan may be the reason for this situation. The various 
geographic area: plains, hills, and plateau could be a barrier for POPM staff to deliver 
information about POPM filariasis. Another reason, this district consists of mostly by 
productive age group (15-64 years), which is most of them do the activity away from they 
reside, such as schooling, laboring in other places. Accordingly, they are not in place when 
POPM was held. These results are consistent with research Harfaina et al. (2019), which 
stated there is a significant relationship between job by taking medicine filariasis (9). 

Knowledge among the community in Grobogan is categorized as high indicated from the level 
of education in general. Unfortunately, it is in contrast with the low level of awareness on taking 
filaria medication. This is in line with research Nurlaila et al. (2017), who stated that there is a 
significant relationship between knowledge versus the conformity on medication filariasis (10). 



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A similar result was found by Rusmini and Suryawan (2014), who said there is no significant 
relationship between education versus filariasis medication. A busy person might neglect to 
take the filariasis drug (11). However, a person with good knowledge will have better health 
awareness, such as they comply with taking filaria medications because he knows the benefits 
of the drug compared to those who are not knowledgeable. Indeed, education was influencing 
the acceptance of health information, but education does not directly influence people to 
decide on to participate in the health program (12). 

Semarang obtains the highest coverage compared to other districts. It demonstrates the high 
public awareness of the Semarang District to participate in taking medicine filariasis. This 
achievement shows high awareness among the Semarang population and the high 
performance of the health staff. On the other hand, indeed, the mobility of Semarang people 
is low compared to Grobogan due to the industrial setting in Semarang (13). Accordingly, 
people easy to meet with the POPM staff when the program held because they are in place. 
In addition, the high coverage of POPM filariasis is influenced by community participation on 
the take the drug, funding efficiency in socialization (14). 

Increasing public knowledge about filariasis and the importance of taking medication is 
necessary for people who live in areas with filariasis endemic. Finding the way out for working 
people that also need to take medicine is essential to avoid the failure medication among 
them. If community participation on the POPM filaria program is excellent, it is expected the 
incidence of filariasis in Grobogan, Semarang, and Wonosobo can be reduced (15). 

In the three districts, people as POPM targets have a similar reason for their unconformity to 
filaria medication. Most of them said about children less than 2 years or more than 70 years. 
It is following the program that targeting people in 2-70 years. Some of them talked about the 
side effect of the filaria drug, such as fever, headache, muscle aches, nausea, and dizziness. 
Another reason for the unconformity is the lack of information about the program that due to 
people's activities such as working, studying, or temporarily not living in the area. So, when 
health staff conducts socialization, they not in place. In addition, they talked about 
breastfeeding and the difference in address between the current location and what is written 
on the national identity card (KTP) (16). 

Indonesian government uses DEC dan Albendazole on the filaria program. According to the 
national guidelines, DEC is allowed to be given to pregnant women but not allowed to children 
under 2 years. While Albendazole, totally prohibited for children under 2 years, pregnant 
woman, and sick person (17). The regulation considers the side effect of the two drugs. For 
example, Albendazole can cause alopecia or hair loss in high consumption of this drug 
(800mg/day). A pregnant woman is not the POPM target because Albendazole is embryogenic 
or embryo growth problem. In children aged under two, the safety is unknown, so the allocation 
of this drug is prohibited. While at people aged more than 70 years, the forbidden on using 
this drug-related decreased organ performance in the elderly (18). 

Another reason to not participate in the POPM program is not in place or traveling for many 
purposes, such as work or schooling. In Semarang for POPM target said that don't know or 
lack of POPM information as to their reason for not participating in the program. This is in line 
with research Astuti, et al. (2014), which states that there is a significant relationship between 
the socialization of health workers to take medication POPM filariasis (19). In this case, the 
lack of health promotion on POPM may lead the inadequate coverage of filariasis. 

The characteristics of POPM filariasis respondents in Grobogan, Semarang, and Wonosobo 
year 2018 mostly the same: aged 16-70 years, have primary education and are male. People 
who are holding primary school are the high proportion who not comply with the medications. 



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According to Alam and Marlina (2016), education is not related to filariasis medication; 
however, knowledge has an association with filariasis medication (20). 

In this study, males mostly un-conform with filariasis medication. This is in line with the results 
of research Isabella, et al. (2018), which states that there is a significant relationship between 
the sex by taking medicine filariasis. Female found more conform to taking filaria medicine 
than the male. This is because the majority of men are working while most women are staying 
at home. As a result, most of the man does not take the medication for his absence related 
work (21). 

 

CONCLUSIONS 

Grobogan coverage is low compared to Semarang and Wonosobo. The respondent said about 
traveling, don't know, and age as the reason to not take the filariasis medication. 
 

Authors’ Contribution 

SN contributed to the data collection, data analysis, and report writing and manuscript 
publication, RR contributed to licensing, data analysis, and report writing. MN participated as 
a provider of data and information, data analysis, and report writing. 

Funding 

This research has not received external funding 

Acknowledgments 

Thanks to the Center for Disease Control Environmental Health Engineering (BBTKL PP) 
Yogyakarta, which has provided the data and information in the study. 

Conflict of Interest 

There is no conflict of interest in this research. 

 

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