Masalah kesehatan akibat

infeksi parasit
dalam kedokteran komunitas

Silvia Fitrina Nasution

 - Port de entry
KESEIMBANGAN ALAM - Infected organ and
tissues
Host - Clinical symptom
- Imunity
- Heredity
- Behavioral and life style
for health (PHBS)

Agent Environment
-Spesies of parasite -Habitat of human
- Stadium /stage of life - Habitat of vector
- Load of infection - Sanitation
- Life cycle in human - Media of transmission
- Phatogenetic - Temperature, Ph, Salinity
Vektor / Hospes perantara
-Species of vector
- stadium
- Age of vector
- Life cycle
- Way of transmission to human
- Load of parasite
Pangandaran, August 2005
angandaran, August 2005
Kubangan ditepi pantai
Salinitas 3‰
 INTERMEDIATE HOST

Oncomelania sp
Alor, July 2006
Alor, July 2006
LYMPHATIC FILARIASIS
 Masalah Kesehatan dan
Lingkungan Hidup
• Status kesehatan dipengaruhi oleh faktor :

Pelayanan Kesehatan

Perilaku Status Kesehatan Lingkungan

Biologik

H.L. Bloem (1974)

• Perilaku hidup seseorang mempengaruhi
keseimbangan faktor lain yg berperan
dalam status kesehatan

Host Agent
Environment

Multiple caution of disease

Host

Environment
Agent
 Pelayanan Kesehatan

Untuk mencegah berjalannya penyakit ke tahap yg

lebih lanjut, diperlukan pelayanan kesehatan yg
menyeluruh, melalui pendekatan :
1. Holistik (jasmani, mental, sosial)
2. Faktor lingkungan (home, environment, social care)
3. Pencegahan penyakit (Five level of prevention)
4. Pelayanan rujukan
 Five Level of Prevention

Health promotion & education Special Protection

Early Diagnosis & prompt treatment

Disability limitation

Rehabilitation
 MANAGEMENT
• Preventive
– Health Education
– Health campaign
• Curative
– Self based
– Home based
– Environment/social based
• Mass Drug Administration (MDA)
• Eradiacation (vector, agent, intermediate host)
• Rehabilitative
Masalah kesehatan lingkungan

• Point of view
A. Diagnosis
B. Intervention
C. Evaluation
 Diagnosis/EARLY DETECTION

• Peran petugas KesLing

• Langkah diagnosis masalah Kesehatan
komunitas termasuk Rapid diagnosis penyakit
• Menentukan jenis & sumber masalah
kesehatan komunitas
• Menentukan prioritas masalah kesehatan
 Intervention

• Menentukan prioritas pemecahan masalah

kesehatan komunitas
• Menentukan cara intervensi masalah
kesehatan komunitas
• Menyusun rencana intervensi masalah
kesehatan komunitas
• Menentukan faktor-faktor yg berperan &
perlu diperhatikan pd rencana intervensi
Evaluation of Intervention

• Program evaluation
• Problem solving cycle
CASE ?
Rapid Assessment Parasit yg masih menjadi
masalah kesehatan di Indonesia

Vs
WHY IDENTIFY PARASITES ?

 for subsequent treatment

 understanding epidemiology

 implementation of control measures

 fundamental research
A DIAGNOSIS PROBLEM ?
Traditionally diagnosis of infection
based on finding parasite
some parasites morphologically
indistinguishable
parasites hidden in various host
tissue
Traditional diagnosis of Malaria
 THE SOLUTION ?

Current laboratory techniques

not entirely satisfactory
Need trained staff, equipment,
slow throughput

Rapid molecular tests being
developed
 RAPID DIAGNOSIS
Rapid diagnosis of infection used as a screening
tool should meet some criteria :
High prevalence of the disease case
Cause significant morbidity or mortality
Effective therapy required
Early therapy result a significant effect to
prevent a chronic disease
 ANTIBODY based DIAGNOSIS
Disadvantages
 cannot distinguish past/ present
infections
 cannot distinguish morphologically
similar parasites
 expensive to develop – significant
research prior to commercialization
 Antibody based Diagnosis

 Advantages
 rapid easy field based tests can be
developed
 useful for both individual & mass
population screening
Antigen Detection Test for
Malaria & Filariasis
 CASE
• Dari gambaran foto kejadian diatas, Rapid
assessment apa yang anda dapatkan ttg:
– Perilaku ?
– Biologik atau agent / vector of disease ?
– Masalah lingkungan ?

• Intervensi ?
• Evaluasi ?