PENDIDIKAN DOKTER FAKULTAS KEDOKTERAN

UNIVERSITAS AIRLANGGA

SURABAYA 2007

Kuntaman

Ilmu Kedokteran TropisPenyakit tropis

Tropical diseases

M-03, 2 SKS, 1/1, Sem IV

TUJUAN INSTRUKSIONAL UMUM

• Setelah menyelesaikan modul ini mahasiswa S1

FK diharapkan mengetahui, memahami dan bisa

menjelaskan terjadinya penyakit tropis; Serta

mengetahui dan memahami penanggulangan

penyakit tropis

TUJUAN INSTRUKSIONAL KHUSUS

• Konsep dasar muncul & menyebarnya penyakit tropis

• Mengetahui, memahami dan bisa menjelaskan faktor

lingkungan

• Mengetahui, memahami dan bisa menjelaskan faktor

genetik

• Mengetahui, memahami dan bisa menjelaskan faktor

perilaku dan sosio-budaya;

• Mengetahui dan memahami beberapa penyakit tropis

yang banyak di Indonesia maupun Negara lain;

• Mengetahui dan memahami prinsip dasar mengendalikan

muncul dan menyebarnya penyakit tropis

DESKRIPSI SINGKAT

• Prevalensi penyakit: Tropis ≠ Non-tropis

• Indonesia: Tropis, Luas, multi etnik, genetik,

sosio-budaya

• Penyakit Tropis/infeksi: Interaksi inang, agen dan

lingkungan; dipengaruhi: genetik, perilaku-sosial

budaya dan lingkungan.

• Penyakit tropis: penyakit infeksi & Non-infeksi

• Pengendalian penyakit tropis: Komprehensif,

dasar faktor2

introduction

• Concept of TD

• Area

• Framework

• Examples

• Concept of Disease control

Bangkok School of Tropical Medicine, Faculty of Tropical Medicine, Mahidol University

“ … …… of Science in Tropical Medicine …..the

program focuses on tropical diseases and enriches

student understanding of the biological,

epidemiological, and social dimension of tropical

disease particularly in the South east Asia “

Institute of Tropical Medicine, Nagasaki University

“….. The institute of Tropical Medicine , Nagasaki University

aim to : overcome tropical disease, particularly infectious

disease and various health problem associated with them,

in cooperation with related institution, for excelence in the

following area :

1. research in the tropical medicine and international health

2. Global contribution through disease control and health

tropics by applying the fruit of the research promotion in

the tropics by applying the fruit of research

3. Cultivation of the researchers and specialists in the above

fields

Dominant determinant factors in tropical disease

medical genetic

tropical disease

tropical environment sosio cultural

Development of tropical disease

Inang

AgentsEnvironment

Tropical Disease

Mengetahui, memahami dan bisa menjelaskanmuncul dan menyebarnya penyakit tropis (PT)

Menjelaskan muncul dan menyebarnya PT dari aspekgenetik, lingkungan dan perilaku–sosio budaya

Mengetahui dan memahami interaksiH, A, E sbg penyebab munculnya PT

Menjelaskan faktor genetik terhadap munculnya PT

Menjelaskan faktor perilakusbg penyebab muncul dan

menyebarnya PT

Mampu menjelaskan faktorlingkungan, thd munculdan menyebarnya PT

Tropical Diseases

Lingkungan Agent

ParasitMikroba

Agen lain/fisik/kimia

Host

Sifat Genetik

Status Imunologi

Status Nutrisi

Kharakter Genetik

Perubahan genetik

Evolusi genetikBudayaSosio-antropol/

Perilaku

Env.Genetic

Socio-Culture

Dominant factors to be discussed in

Tropical Medicine

1. Primary care: provision of promotive, preventive, curative,

and rehabilitative

a) Disease control programmes

b) Nutritional supplementation

c) Clean and safe water supply

2. Epidemiology of Dis.:

a) Distribution and determinant of TD

b) Focus on six deadly diseases: pneumonia, diarrhoeal

illness, malaria, measles and HIV/AIDS. BUT also

others high fatality rates cases: Ebola, Hantavirus,

Nipah Virus

Dominant factors to be discussed in

Tropical Medicine

3. Traditional medicine healers:

a) Frequently the first point of contact for Pts in the Tropic

b) Play a significant role in access to health care

c) Have an important role in the framework in the

treatment of common tropical illness.

4. Genetics:

a) Pattern of autosomal and sex linked inheritance

b) Deversity of human genome

c) Selective pressure of human genome

(~haemoglobinopathy)

d) Genetic constribution to common disease (i.e.: HLA

type that confer resistance or susceptibility)

Dominant factors to be discussed in

Tropical Medicine

5. Immunological aspect of TD:

a) Host factor

b) Illustrate the delicate balance involving the host and

invading pathogens

c) Mechanisms involved in host susceptibility and

parasite evasion

6. Economic and financing:

a) Focuses on the effects of poverty and inadequate

resources

b) Most developing countries (mostly in the tropic) have

an inability to reduce the burden of diseases, due to

economic reasons

c) Poverty is underlying factor for poor health in tropic

d) Poor people are more vulnerable to disease (TD)

Diminished food-Absorbtion-Intake-Micronutrient store

Increase food-Requirements-Untilization

Diarrhoea

- Cell med immunity- humoral immunity- secretory IgA

- complement- neutrophil function- external barrier

malnutrition

infection

Produces reduces

increasesInduces

Tropical Disease

- The word of TROPICAL DISEASES is more convenient

than accurate

� Deseases peculiar to, and confined to, the tropics

� All diseases occuring in the tropics

� Medicine in the tropics OR Tropical medicine?

- Pathogenic microbes:

1973 Ebola Virus Acute haemorrh.fever

1977 Legionella pneu. Legionnaires’ dis

1981 Toxin S.aureus TSSyndrome

1982 E coli O157:H7 Haemorrh. Colitis

1983 HIV AIDS

1989 Hepatitis C Hepatitis

1993 Hanta virus Adult Resp Distress Syndr.

1996 nvCJD (Prion) Creutzfeldt-Jacob Dis

1997 H5N1 Influenzae

1999 Nipah Severe encedphalitis

Tropical Disease

- Vaccine preventable infectious diseases:

� Measles

� Hepatitis B

� Tetanus (neonatal)

- Emerging and resurgent diseases:

� Ebola

� Dengue fever

� Diphtheria

� CholeraNipah virus

� AI (Hongkong)

Malnutrisi

54%

Malaria

5% Campak

7%

Diare

19%

ISPA

18%

Perinatal

18%

Lain-lain

32%

Primary Health CarePrimary Health Care

Distribusi penyebab kematian balita disemuanegara berkembang, 1995 (WHO)

Kematian karenamalnutrisi, justru tinggi

Epidemiologi PenyakitEpidemiologi Penyakit

Perinatal

6%

Faktor Ibu

2%

Nutrisi

1%

Penyakit

menular

45%

Penyakit

tidak

menular

35%

Kecelakaan

11%

Estimasi, 1998, penyebab utama kematian dinegaraberpendapatan rendah, Asteng dan Afrika (WHO)

Tutorial Modul Integrasi

Kasus 1:

Separuh Kelompok

Tutorial 1Tutorial 2

Tutorial 3

Kasus 1 � Pleno Kasus 2

Kasus 2:

Separuh Kelompok

Jawablah pertanyaan ini?

1. Jelaskan makna penyakit tropis

2. Faktor apa yang mempermudah berkembangnya penyakit tropis

3. Apakah penyakit tropis itu penyakit infeksi?

4. Coba cari sosio-budaya etnis di Indonesia yang bisa mempermudah penyebaran penyakit tropis

5. Terangkan salah satu gangguan genetik yang bisa mencegah terjangkitnya penyakit tropis. Khususnya yang disertai kelainan morfologi sel darah merah.

Tropical Disease Center

TDC-UNAIR

Terima kasih

Manson’s Tropical Disease