Main Disease (Filariasis)- 2012

7/21/2019 Main Disease (Filariasis)- 2012

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AGNITUDE OF FILARIASIS

PROBLE IN INDONESIA

• Filariasis is health problem in tropical and sub

tropical region in the world.

• Prevalence estimate in the world 120 million

filariasis infection.

• Population at risk in the world 1 billion cases,

distributed in tropic/sub tropical countries• Two filariasis : F. brancofti dan F.brugia

• !uchereria brancofti infection "#0$% and

&rugia mala'i ( &.timori "10$%.




PROBLE IN INDONESIA

•

)ndonesia is endemic of filariasis and prevalenceof F.brugia *0$.

• !+ Program : Global Programme to Eliminate

Lympatic Filariasis elimination target for 2020

•-i )ndonesia disesuian dengan )ndonesia ehatdan Paradigma ehat.




PROBLE IN INDONESIA

• )ndonesia prevalence 0.1#.*$ "mean prevalensi :

.1$%, variation in province and region, high prevalence

in di 3TT dan 3angroe 4ceh -arusalam• 5esult of epidemiological surve' 6an 2007 : 2*2

district are endemic

• Total number case is 10.8 persons chronical

filariasis distributed in man' region district andaprovince.

• &rugia spesies is high prevalence "& mala'i in umatra

s/d 9ep.aluu &.timori in east )ndnesia 3TT, ver'

hihg in Timor, Flores, 4lor dan 5ote%.



EMERGING INFECTIOUS DISEASESIN INDONESIA : VECTOR BORNE

DISEASE FILARIASIS : Transmitted by many

vectrs : C!"e# $ati%ans& Mansni&

An'(e"es and Aedes ms)ites* Unti" A!%!st +,,- in Indnesia& it .as

$!nd //*/01 cases $ c"inica" c(rnic2"ariasis s'read n 3-0 m!nici'a"s .it('reva"ence rate avera%e 4M$ rate , 5/1&-0 67



DEFINITION

Fi"ariasis : C(rnica" in$ecti!s diseaseca!sed by micr2"aria 42"aria" nematdes7in (!man * 8ym'(atic 2"ariasis cc!rs'rimari"y d!rin% ad!"t(d and nt

c(i"d(d r in$ancy*Beca!se disease d!e t "ym'(atic 2"ariasisis c(aracteri9ed by dis2%!rement $ t(e

"imbs 4e"e'(antiasis7 and %eneta"ia4(ydrc"es and t(er anatmica" c(an%es int(e ma"e %eneta"ia7& it is $ten 'erceived as(avin% adverse ecnmic and 'syc(ssia"

eects as .e"" as medica" cnse)!ences



TRANSMISSION

8ym'(atic $i"ariasis can be transmitted inany re%in $ t(e .r"d .(ere t(ea''r'riate ms)!it vectr breeds* Inc!rrent"y is a si%ni2cant (ea"t( 'rb"em in

tr'ica" A$rica& Asia and Indians!bcntinent& may is"and $ t(e .esternand s!t(ern >aci2c and $ca" areas $ "atinAmerica*

In any '"aces in Indnesia& main"y in <ava?Ba"i'reva"ence is @& (.ever in t(er '"aces& is (i%('reva"ence 4 4 /,67& in r!ra" area and sta!secnmic is ".*

Di'er;ira;an se;itar ,,, daera( ;antn%



MORBIDIT CONTRO8

Daera( endemis 2"ariasis tersebar di +/'r'insi di "!ar <a.a?Ba"i& yan% masi('tensia" men!"ar;an dan menyebar;an'enya;it* Ter!tama 'ara 'endatan% bar!

4transmi%ran7 yan% datan% ;e daera(endemis& risi; terseran% 'enya;it "ebi(m!da( dibandin%;an 'end!d!; as"i& ;arenabe"!m mem'!nyai daya im!nitas*

Vectr Cntr" a"ami (ambatan&men%in%at tia' =enis nyam!; mem'!nyaibinmi berbeda yan% be"!m di;eta(!i&

'enyem'rtan tida; da'at disera%am;an



C8INICA8 DIAGNOSIS

Di Indnesia di=!m'ai 3 =enis 2"ariasisyait! Fi"ariasis bancr$ti 4Wuchereriabancrofti), F.malayi (Brugia malayi) danF*timri 4Br!%ia timri7*

Ac!te sym'tm are $ever& "ym(adenitis&"ym(an%itis 4$ten re"a's7& ber!"an%& da'at timb!"tia' b!"an& ter!tama bi"a be;er=a berat* Demamber"an%s!n% +? (ari& ta; =aran% timb!" abses 'ada

;e"* dan sa"!ran "im$e& !";!s yan% ber"an%s!n%bebera'a min%%!* Ge=a"a a;!t ini banya;ditem!;an 'ada in$e;si B*ma"ayi dan B*timri*

Ge=a"a ;rni; ter=adi 'er"a(an& 'asca %e=a"a

a;!t a%a; "ama& td* "im$edema& (idr;e"&



C8INICA8 DIAGNOSISMetda 'ra;tis sam'ai saat ini bar! di!'aya;an

!nt!; mene%a;;an dia%nsis dini* anya seba%ian;eci" 4/?+67 %e=a"a a;!t terdia%nsisH Um!mnyadia%nsis bar! dite%a;;an sete"a( 'enya;itber;emban% se"ama ? b!"an& yait! ditem!;annya

mi;r2"aria 'ada dara( te'i& y% seba%ian besartida; men!n=!;;an %e=a"a ;(as& bai; a;!t ma!'!n;rni;& se(in%%a 'enderita ta; 'erna( merasa;anterseran% 2"ariasis*

Cacin% 2"aria tin%%a" di da"am sa"!ran "im$e&

beredar da"am dara( "im$e ;e"!ar t!b!(man!sia me"a"!i %i%itan nyam!; se"an=!tnya"arva t!mb!( da"am t!b!( nyam!; dan men%a"ami'er!ba(an bent!; dit!"ar;an ;emba"i ;e



8ABORATORICDIAGNOSIS Ditem!;annya cacin% 2"aria 4mi;r2"aria7

di da"am dara( te'i& yan% diambi" daridara( =ari antara =am +,*,, ? +J*,,*

Sete"a( dit!s!; den%an "anset diambi" +,mm3 b!at a'!san dara( teba" /+ =am;em!dian dara( di(em"isis dan di2;sasi&di.arnai den%an Giemsa 'eri;sa di(it!n% =!m" mi;r2"aria di ba.a(

mi;rs;'*Di sam'in% it! seba%ian 'end!d!;di"a;!;an 'em*dara( secara %anda yait!den%an dara( teba" dan =!%a den%an 2"trasinucleopore ter(ada' dara( vena / m"*



E>IDEMIO8OGIC DIAGNOSIS

Unt!; menent!;an dera=at endemisitas

s!at! daera( den%an 'emeri;saan s!rveidara( =ari& s!rvei ve;tr dan s!rvei 'en!"ar"ainnya*

S!rvei dara( =ari men%ambi" sam'e" /,6 =!m"a( 'end!d!; desa endemis& yan%ditent!;an MF-rate (microlaria rate).

Tanda %e=a"a ;"ini; a;!t ;rni; da'at dicari

besarnya an%;a A! (Acute isease rate7 dan "!("hronic isease rate7 ata! #! (#lephatiasis rate).

MF-rate $ %& dan A! '& 'en%enda"ian

sera( ?;an >!s;esmas setem'at& #"(ietilarbamasin) se"e;ti$ * MF-rate + %&



E>IDEMIO8OGIC FACTORS

Agent Cacin% 2"aria termas!; $ami"i

Fi"arridae& 'arasit da"am sistem 'eredarandara(& "im$e& tt& =arin%an i;at* Bent!;cacin% se'erti benan%& .arna '!ti(?;e;!nin%an& 'an=* +?-, cm 4betina =antan7*

Ti%a s'esies : B*bancr$ti& B*ma"ayi B*timri& yan% secara e'idemi"%i;

di'isa(;an men=adi =enis 4/7 K*bancr$tidi daera( 'er;taan& 4+7 K* bancr$ti di'edesaan& 437 B*ma"ayi yan% 'eridi; 4yan%tLda'at dit!"ar;an 'd (e.an7 4J7B*ma"ayi

yan% s!b'eridi; 4da'at dit!"ar;an 'd




Agent "ycle life

Micr2"aria yan% terte"an nyam!; bersama dara(

yan% di(isa' mas!; ;e da"am tt nyam!;t!mb!( se"ama ?+, (ari& "arva ;e"!ar dari tt&den%an menimb!";an ;er!sa;an berat dan

ber%era; ;e 'rsbscis*

8arva in$e;ti$ yan% ;e"!ar dari 'rsbscis ;e ;!"it(s'es bar! me"a"!i "!;a %i%itan& "arvamener!s;an 'er=a"anan ;e sa"!ran "im$e& sam'aide.asa da"am .a;t! sat! ta(!n*

Cacin% de.asa timb!";an 'eradan%an ;e" dansa"*"im$e in%!ina" e'ididym!s 4"a;i?+7 dan

;e"*"abi!m 4.anita7* Micr2"aria menin%%a";ancacin% ind!;& menemb!s dindin% 'emb*"im$e ;e




ost enitif (uman )

>rinsi' tia' ran% da'at ter;ena in$e;si2"ariasis H K*bancr$ti dan B*ma"ayi seba%ai(st de2niti$ t!n%%a"& sedan%;an B*timri

"ebi( bersi$at 9nti;* Fa;tr?+ yan% ber'en%ar!( a"* !m!r&;e;eba"an& se;s& =enis 'e;er=aan& imi%rasi'end!d!;& $a;tr "in%;!n%an dan 'eri"a;!'end!d!;*

Fre;!ensi menin%;at se=a"an den%an'er;emban%an !sia& ana; ter;eci" yan% 'erna(

ditem!;an !sia b!"an* Banya; di=!m'ai 'ada"a;i?+ ;aitan den an e;er aan di "!ar r!ma( *




ost ntermediate (Mosuitos )

8ebi( +3 s'esies nyam!; di"a'r;an seba%ai

ve;tr 2"ariasis di Indnesia& yan% be"!m di;eta(!ibinmi masin%?masin% ve;tr*

K*bancr$ti daera( ;ta : C!"e# )!in)!e$aciat!s&daera( 'edesaan : An*acnit!s& An*bancr$ti&An*mac!"at!s& An*s!ndaic!s& An*"eti$er&An*.(artni& dan An*;"iensis& di sam'in% it! =!%adi"a'r;an =enis C!"e#& Aedes '"inesiensis dan

Mansnia*

B*ma"ayi y% 'eridi; : An*barbirstris seba%aive;tr& s!b'eridi; s'esies Mansnia : M*indiana&M*!ni$rmis& M*ann!"i$era& M*an!"i'esH tem'atber;emban% di ra.a+ S!matra& ;a"imantan dan



E>IDEMIO8OGICFACTORS #n/ironment

8in%;!n%an yan% dima;s!d ada"a( "in%;!n%an

2si;& yan% ber'en%ar!( t(d ;e(id!'an "arvama!'!n nyam!; de.asa seba%ai ve;tr*

antn%?;antn% daera( endemis : dataranrenda(& bera.a& yan% di;e"i"in%i "e( sema;be"!;ar dan (!tan daera( tsb 'tensia" ba%i'er;emban%an dan tem'at istira(at ve;tr*Sedan%;an 'ada C!"e# )!e$asciat!s biasa

membia; da"am air yan% di;tri air %t ba(anr%ani; y% memb!s!;& yan% ter;aitan den%an;e'adatan 'end!d!; dan ;ebersi(an ;!ran% di'er;taan*

Transmi%ran : Banya; yan% 'enem'atan di de;at



CONTRO8 OF FI8ARIASIS

T!=!an Um!m Cntr" Me"ind!n%i

'end!d!; dari men!r!nnya daya ;er=a&(i"an%nya =am ;er=a dan mence%a(timb!"nya cacat a;ibat 'enya;it

T!=!an (!s!s : 4/7 Men!r!nnya ADR 5 ,64+7 Men!r!nnya M$?rate @ 6 dan 437Mem'erta(an?;an CDR sam'ai ,6*

Daera( 'riritas : 4a7 Daera( endemis yan%

berde;atan den%an da*transmi%rasi bar! 4b7Daera( 'rd!;si den%an endemisitas tin%%i 4c7Daera( yan% te"a( dica;!' 'ada ta(!n sebe"!mnyadan b!t!( tera'i !"an%*

Indi;atr an%;a 'en!"aran : 4/7 A! (&) 0 Acute-



CONTRO8 OF FI8ARIASIS

4/7 Memberantas s!mber 'en!"aran :

Men%bati 'enderita seba%ai 'embrantarasan=an%;a 'ende; !nt!; men%!ran%i infection rate dan disease rate* DECFi"arsan& tab"et .arna (i=a!&rasa asam& m!da( "ar!t da"am air disera' "e(!s!s dan se%era da"am 'eredaran dara(& yan%

bere$e; ++J =am& memb!n!( micr2"aria d"mdara( dan memb!n!( cacin% de.asa d"m sa"!ran"im$e steri" tL'rd!;si te"!r* Dsis 3 # +m%%BB (ari sd tta" -+ m%%BB* 4a"ternati$

Medicated salt 7

E$e; sam'in% 47 : se$a"%ia& demam& men%%i%i"&m!a"& sa;it ttt!"an%& %ata"&;e"!ar cacin% darisa"!ran cernaH da'at diatasi den%an ana"%eti;&

anti'ereti; dan anti(istamin*



CONTRO8 OF FI8ARIASIS 4+7 >embrantasan Ve;tr Nyam!; : >embrantasan tsb (ar!s di;eta(!i =enis s'esies

nyam!;& distrib!si& ;ebiasaan istira(at danmen%%i%it serta ;erentanan e$e;tivitas ter(ada'inse;tisida*

4a7 Nyam!; de.asa den%an residual indoorspraying t(d An'e"es den%an DDT$enitrtinata! nyam!; Aedes den%an aireal spraying men%%!na;an ma"at(in*

4b7 8arva nyam!; : C!"e# den%an ba(an ;imia&minya; tana( di 'erm!;aan air %t& cmberan*An'e"esAedes ditab!r;an serb!; Abate SG/6 ;eda"am ;ntainer saran% nyam!; se;itar r!ma(*Mansnia : me"enya';an tanaman air&

men%erin%;an ata! menimb!n ra.a* U'aya



CONTRO8 OF FI8ARIASIS 437 Ed!;asi ese(atan : Sasaran

'eny!"!(an ada"a( 'enderita& an%%ta ;e"!ar%a&

tetan%%a dan sem!a 'end!d!; daera( endemis*

Materi 'eny!"!(an : 'enyebab& nyam!; 'en!"ar&rantai 'en!"aran& tanda dan %e=a"a dan caramence%a(nya*

Si;a' yan% di(ara';an& 'end!d!; : 4/7Memeri;sa;an diri bi"a ada ;e"!(an ses!ai 4+7Bersedia di'eri;sa dara( =ari 'ada ma"am (ari 437Bersedia min!m bat Fi"arsan yan% diberi;an'et!%as secara terat!rH demam sete"a( min!mbat mer!'a;an rea;si y% tLb"e( seba%ai a"asan!nt!; men%(enti;an min!m bat 4J7 Ber!sa(asecara a;ti$ men%(indar;an diri dari %i%itan

nyam!; 4;e"amb!& bat nyam!;& d""* 47 >en!"aran



CONTRO8 OF FI8ARIASIS 4J7 Bite;n"%i : Tara$ 'ene"itian& yan%

sedan% di;emban%;an ada"a( 'en%%!naan

te;n"%i d"m (a" im!n"%i !nt!; mema(ami'at(%enesis 'enya;it& im!ndia%nsis dandete;si ve;tr di "a'an%an*

47 Eva"!asi : Men%eta(!i ;ema=!an (asi";e%iatan 'embrantasan yan% te"a( di"a;!;an& yi:E* 'erasina"& dan E*;"ini;?e'idemi"%i;*

E*'erasina" : Men=a.ab 'ertanyaan terca'ainya

4/7 Sasaran 'emeri;saan ;"inis 4+7 Sasaran'emeri;saan dara( 437 Sasaran 'en%batan 4J7Sasaran 'emberantasan nyam!; 'en!"ar 47Sasaran 'eny!"!(an 47 Ada;a( 'er!ba(an'eri"a;! 4-7 A'a (ambatan 'erasina"

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Main Disease (Filariasis)- 2012

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