KELOMPOK II

Ermilawati Bahri
Fadilah D.W.
Ferdinand K. Letty
Jovan M.P. Sawias
Kenet Sineri
Lea Tabuni
Manuel H.Y. Rumi
Rahmawati
Surio Arrang Bua
Yanti Y. Awaki
Welmina N. Punyanan
Gambaran Penderita Malaria
di Abepura
Periode Februari – Juli 2019
 Latar Belakang
Di Indonesia malaria menjadi salah satu penyakit
menular utama khususnya di beberapa wilayah yang
dinyatakan masih endemis

Menurut Riset Kesehatan Dasar 2013, insiden malaria

berdasarkan diagnosis sebesar 0,35% atau 3,5 per
1.000 penduduk

Pada survei ini tiga provinsi dengan insiden tertinggi

sama dengan hasil laporan rutin yaitu Papua (6,1%),
Papua Barat (4,5%) dan Nusa Tenggara Timur (2,6%)
 Definisi

Malaria adalah suatu penyakit akut

maupun kronik, yang disebabkan oleh
protozoa genus Plasmodium dengan
manifestasi klinis berupa demam,
anemia, dan pembesaran limpa
Epidemiologi
Distribusi
Frekuensi Malaria;
1) Orang
2) Tempat
3) Waktu

Determinan Malaria;
1) Faktor Host
2) Faktor Agent
3) Faktor Environment
Siklus Hidup Plasmodium
Siklus Hidup Nyamuk
 Etiologi

Penyebab infeksi malaria ialah plasmodium, yang

selain menginfeksi manusia juga menginfeksi
binatang seperti golongan burung, reptil dan
mamalia

Termasuk Genus Plasmodium dari Family

plasmodidae, Ordo Eucoccidioridia, Kelas
Sporozoasida, dan Phylum apicomplexan
 Klasifikasi
Malaria Malaria tanpa Malaria berat
asimtomatik komplikasi

Penderita malaria dengan Ditemukan nya parasit bentuk
ditemukannya parasit malaria
pada pemeriksaan darah dan
penderita tidak ada
gejala/keluhan
aseksual dari seorang
penderita disertai dengan
gejala-gejala klinis malaria
Malaria selebral, Asidosis,
Anemia berat normostik, Gagal
ginjal akut, Edema paru,
Ketidaakmampuan untuk
makan,
Hipoglikemia, Syok, Perdaahan
spontan, Kejang berulang,
Hiperglikemia, Makroskopik
hemoglobnuri, Diagnosis
postmortem
 Manifestasi Klinik

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2013 2015 2017
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 Manifestasi Klinik

Manifestasi umum malaria

Manifestasi malaria tanpa komplikasi
Gejala yang klasik yaitu terjadinya “Trias Malaria”
Dikenal 5 jenis plasmodium yang menginfeksi
secara berurutan: periode dingin (15-60 menit),
manusia yaitu P. vivax yang paling sering
diikuti dengan periode panas, kemudian periode
menyebabkan malaria tertian/vivaks, P.
berkeringat.
falciparum memberikan banyak komplikasi
dan mempunyai perjalanan klinis yang cukup
serius, mudah resisten dengan pengobatan
dan menyebabkan malaria tropika/falsiparum
 Diagnosis Malaria

WHO merekomendasikan diagnosis

berdasarkan gejala klinis:
1) Bila risiko infeksi malaria rendah; demam
selama 3 hari dan tidak ditemukan
penyebab infeksi lainnya
2) Bila penderita risiko malaria tinggi; demam
satu hari disertai adanya anemia, pada
anak sering ditandai dengan pucat ditelapak
tangan
Diagnosis pasti dengan menemukan
adanya parasite malaria ditegakkan
dengan pemeriksaan mikroskopik
sebagai standar baku dan bila tidak
dimungkinkan dibantu dengan tes
diagnose cepat (Rapid Diagnosis
Test =RDT)
 Pemeriksaan malaria

Tetesan Tes
darah tebal Tes Tes Diagnosis
dan apusan Antigen Serologi Molekuler
darah
tipis
 Diagnosis banding

Pada malaria dengan icterus,

diagnosis banding adalah demam
tifoid dengan hepatitis, kolesistitis,
abses hati dan leptospirosis

Pada malaria serebral harus

dibedakan dengan infeksi pada otak
lainnya seperti meningitis,
ensefalitis, tifoid ensefalopati,
tripanososmiasis
 Komplikasi
1) Malaria serebral
2) Anemia berat
3) Gagal ginjal akut
4) Edema paru atau ARDS (Acute Respiratory
Distress Syndrome)
5) Hipoglikemia
6) Gagal sirkulasi atau syok
7) Perdarahan spontan dari hidung, gusi, alat
pencernaan dan atau disertai kelainan laboratorik
adanya gangguan koagulasi intravascular
8) Kejang berulang >2 kali per 24 jam pada
hipertermia
9) Asidemia (pH darah <7,25) atau asidosis (biknat
plasma <15 mmol/L)
10)Makroskopik hemoglobinuria karena infeksi
malaria akut
 Pencegahan
Manajemen Pencegahan

1) Tingkah laku dan intervensi non-

obat:
2) Pemilihan obat kemoprofilaksis
3) Obat kemoprofilaksis: Prognosis

Prognosis bergantung pada derajat

beratnya malaria

Konseling dan edukasi

1) Menghindari gigitan nyamuk dengan

kelambu atau repellen
2) Menghindari aktivitas diluar rumah
pada malam hari
3) Mengobati pasien hingga sembuh
misalnya dengan pengawasan minum
obat
 Penatalaksanaan

 
Hari Jenis Jumlah tabel perhari menurut berat badan
.>80
obat <5 kg 5-6 >6-10 kg 11-17 kg 18-30 kg 31-40 kg 41-59 kg 60-80 kg  
kg
kg
>15
0-1 bulan 2-5 bulan 6-11 tahun 1-4 tahun 5-9 tahun 10-14 >15 >15  
tahun
tahun tahun tahun
5
1-3 DHP 1/3 ½ ½ 1 11/2 2 3 4
1
1 Primakuin - - ¼ ¼ 1/2 3/4 1 1

Pengobatan Malaria Falsifarum Dan Malaria

Knwlesi Menurut Berat Badan Dengan DHP
Dan Primakuin
 Penatalaksanaan

 
Hari Jenis Jumlah tabel perhari menurut berat badan
.>80
obat <5 kg 5-6 >6-10 kg 11-17 kg 18-30 kg 31-40 kg 41-59 kg 60-80 kg  
kg
kg
>15
0-1 bulan 2-5 bulan 6-11 tahun 1-4 tahun 5-9 tahun 10-14 >15 >15  
tahun
tahun tahun tahun
5
1-3 DHP 1/3 ½ ½ 1 11/2 2 3 4
1
1-14 Primakuin - - ¼ ¼ 1/2 3/4 1 1

Pengobatan Malaria vivaks Menurut Berat Badan

Dengan DHP Dan Primakuin
 Penatalaksanaan

 
Hari Jenis Jumlah tabel perhari menurut berat badan
.>80
obat <5 kg 5-6 >6-10 kg 11-17 kg 18-30 kg 31-40 kg 41-59 kg 60-80 kg  
kg
kg
>15
0-1 bulan 2-5 bulan 6-11 tahun 1-4 tahun 5-9 tahun 10-14 >15 >15  
tahun
tahun tahun tahun
5
1-3 DHP 1/3 ½ ½ 1 11/2 2 3 4
1
1-14 Primakuin - - ¼ ¼ 1/2 3/4 1 1

Pengobatan Infeksi Campur P.Falciparum, P. Vivax

Dan Ovale DHP Dan Primakuin
 Metode Penelitian
Jenis Peneltian Teknik Pengumpulan Data
05
penelitian deskriptif 01 Total sampling
retrospektif
Lokasi Penelitian Analisis Data
06 analisis
  univariat mengunakan
wilayah kerja Puskesmas 02 rumus distribusi frekuensi.
Abepura Kelurahan Hedam,
P= x 100%
Distrik Heram
Waktu penelitian Etika Penelitian
07
Penelitian dilaksanakan 03 Anonimity
sejak tanggal 19 sampai
Confidentiality
21 Maret 2019
Populasi dan Sampel Variabel Penelitian
08
Populasi sebanyak 896 04
Usia, jenis kelamin,
penderita, sampel dalam kelurahan, jenis
penelitian ini adalah total plasmodium
populasi
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