MALARIA

S e j a r a h .....

• Malaria Mal-Area = Bad Air

• Demam -----> panas naik turun & menggigil

• Splenomegali -----> Limpa membesar &

mengeras
 PLASMODIUM
Plasmodium
4 Spesies ;
1. P. Vivax
2. P. Falcifarum Manusia
3. P. Malariae
4. P. Ovale

4 Spesies
1. P. Cynomolgi (1)
2. P. Knowlesi (2)
3. P. Rodhaini
KERA
4. P. brasilianum (3) (CHIMPANZEE)
 Daur hidup
1. Sporogoni seksual Anopheles
2. Skizogoni Aseksual hospes
Vertebrata

Aseksual:

1. Daur Eritrosit (Skizogoni Eritrosit)

2. Daur sel Parenkim hati = Stadium jaringan (Skizogoni
Eksoeritrosit)

a. Skizogoni Pra-eritrosit (Skizogoni Eritrosit - Primer)

Sporozoit Masuk ke dlm sel hati

b. Skizogoni eksoeritrosit sekunder.

 Penelitian Populasi
1. Sporozoit aktif Langsung Tumbuh
2. Sporozoit tidur dormant (Hipnozoit)

P. Falcifarum P. Vivax
P. Malariae P. Ovale

1 Siklus 2 Siklus
 Daur Hidup Malaria
Manusia Anopheles

Dalam hati Dalam kelenjar Liur

Sporozoit
Hipnozoit
Skizon
Skizon Ookista

Merozoit Dalam Lambung

Dalam Darah
Tropozoit

Skizon
Merozoit

Makrogametosit Makrogamet
Zigot = Ookinet

Mikrogametosit Mikrogamet
 Beberapa Istilah
• Patologi dan gejala klinis
- masa tunas instrinsik
- masa prapaten
- rekrudesensi (relaps jangka pendek)
- rekurens (relaps jangka panjang)
- splenomegali
- Penyebab Anemia (3)

• Diagnosis darah
Ada beberapa cara dan teknik diagnosa.
 KEKEBALAN
Nonspesifik spesifik

Bawaan/Alam didapat Didapat

(Natural)

Burung Dpt ditkn aktif pasif

Pengerat
Negro BCG alam buatan
Hb S + Hb F
 Obat Malaria
Secara umum digunakan :
• Klorokuin
• Sulfadoksin
• Kina
• Tetrasiklin ----> kombinasi
• Herbal Treatments
• Internal Applications
• Lemon – take the juice of 1 lemon and add 3 grams of lime. Mix
this with 60 ml of water. Take this mixture before you think an
attack is about to occur.
• Holy basil – mix 11 grams of holy basil leaf juice with 3 grams of
powdered black pepper to be taken in the cold stage of malaria.
This can check the severity.
• Datura – for Tertian Fever, use 2-1/2 freshly sprouted leaves.
Make these leaves into a pill by rubbing them with jiggery and
take them 2 hours before the next attack.
• Cinnamon – take a teaspoon of coarsely powdered cinnamon
and boil it in a cup of water and a pinch of pepper powder and
honey.
• Guarana - reputed to offer protection against malaria.
• Wormwood – the active constituent artemesinin in this plant is
very effective against malaria. Thought to be particularly useful
in treating drug resistant malaria.
• Garlic – a natural antibiotic, garlic has been used to treat malaria
as well as many other diseases. Take capsules as directed or
eat raw garlic cloves.
• Fenugreek – add the seeds to your diet to increase your
immunity and fight against the parasites.
 Klasifikasi Obat Malaria
1. Skizontosida jar. Primer
proguanil + pirimetamin
2. Skizontosida jar. Sekunder
primakuin
3. Skizontosida darah
Kina + klorokuin + amodiakuin +proguanil +
pirimetamin
4. Gametosida
Primakuin + kina + klorokuin + amodiakuin
5. Sporontosida
Primakuin + proguanil
Secara kimia ada 9 golongan :
1. Kina (alkaloid Cinchona)
2. Primakuin (8-aminokuinolin)
3. Mepakrin (9-aminoakridin)
4. Klorokuin /amodiakuin (4-aminokuinolin)
5. Proguanil/klorproguanil (biguanida)
6. Pirimetamin / trimetoprim
(diaminopirimidin)
7. Sulfon + Sulfonamid (sulfadoksin)
8. Antibiotika (Tetra+doksi+mino+klinda)
9. Meflokuin (kuinolinmetanol +
fenantrenmetanol)
 Penggunaan Obat
1. Profilaksis
2. Kuratif
3. Pencegahan Transmisi
 Sifat Malaria
Tergantung pada :
1. Parasit resisten
2. Manusia Kebal dan Tidak
kebal
3. Vektor 2000 sp Anopheles
(60 = penular)
4. Lingkungan Iklim
 Parasit
• Manusia gametosit

• Nyamuk Stadium infektif (Sporozoit)

• Sifat Parasit
# Berbeda ditiap daerah
# Sensitivitas Obat
# Resisten Klorokuin
 Manusia

• Rentan (suseptibel)
Faktor rasial
• Kebal

• Manusia Pendatang Endemi

Rentan
dari penduduk asli
 Vektor

• Nyamuk Anopheles ( 2000 Sp ) 60 Sp

Indonesia : 80 Sp 16 Sp ditempat berbeda
• Di jawa & Bali
• Di sumatra An. Sundaicus
• Sulawesi
• Kalimantan
• Irian jaya
• NTT
 Lingkungan
Dingin Pegunungan tinggi Bebas
• Iklim Musim panas berjangkit
Panas
# Suhu
# Kelembaban Genangan air
# Curah hujan
Pemberantasan
1. Memutuskan mata rantai siklus hidup
• Memusnahkan parasit dalam tubuh manusia
• Membasmi vektor. Insektisida.

2. Istilah dalam Pemberantasan Malaria

• Pemberantasan (Control)
• Pembasmian (Eradication)