FAKTOR RISIKO INFEKSI PARASIT USUS PADA PENDERITA HIV DI RSUP Dr. SARDJITO, YOGYAKARTA

UMI LATIFAH, Prof.dr. Supargiyono, DTM&H,SU,Ph.D.,Sp.Park(K).; dr. Yanri Wijayanti Subronto, Ph.D.,Sp.PD

2018 | Tesis | MAGISTER ILMU BIOMEDIK

Latar Belakang. Parasit usus merupakan salah satu penyebab gangguan intestinal diantaranya diare. Parasit usus terdiri dari protozoa usus dan cacing usus. Risiko untuk terinfeksi parasit usus meningkat pada penderita HIV, dengan melemahnya kekebalan tubuh akan memudahkan parasit usus untuk menginfeksi penderita. Penderita HIV dengan sel T CD4+ 200 sel/mcgl darah adalah yang paling rentan untuk terinfeksi parasit usus, bahkan penderita yang sudah mengalami diare kronis karena parasit usus dapat meninggal. Tujuan Penelitian. Penelitian ini bertujuan untuk mengetahui prevalensi dan intensitas cacing usus pada penderita HIV, Mengetahui prevalensi protozoa usus pada penderita HIV, dan mengetahui hubungan antara tingkat imunitas tubuh terhadap infeksi parasit usus pada penderita HIV di RSUP Dr. Sardjito Yogyakarta. Metode Penelitian. Data 75 sampel tinja penderita HIV di RSUP Dr. Sardjito Yogyakarta dari Bulan Juli 2017 - Januari 2018 dikoleksi berdasarkan hasil wawancara, rekam medis, dan diperiksa secara mikroskopis dengan metode pengecatan ziehl neelsen, konsentrasi ritchie, Kato-Katz, dan harada mori. Data dianalisis dengan menggunakan tes chi-square dengan p-value lebih dari 0,05 sehingga data tidak signifikan secara statistik. Hasil Penelitian. Parasit usus yang ditemukan dalam penelitian diantaranya Cryptosporidium parvum., Isospora belli, Entamoeba histolytica, Entamoeba coli, Balantidium coli, Iodomoeba butschlii, Ascaris lumbricoides, Trichuris trichiura, Hookworm, dan Hymenolepis nana. Tidak terdapat hubungan yang bermakna antara infeksi parasit usus dengan status imunitas penderita HIV (jumlah sel T CD4+) (p>0,05). Parasit usus yang banyak ditemukan pada sampel yang diperiksa adalah Cryptosporidium parvum. Kesimpulan. Prevalensi protozoa usus pada penderita HIV di RSUP Dr. Sardjito Yogyakarta bulan Juli 2017 hingga Januari 2018 sebesar 52(69,3%) dan prevalensi cacing usus pada penderita HIV sebesar 6(8%) dari 75 sampel tinja yang diperiksa. semakin rendah jumlah sel T CD4+ dan stadium klinis dengan gejala maka semakin banyak macam parasit usus yang ditemukan.

Background. Intestine parasites were one of the causes behind the occurrence of intestinal disorder such as diarrhoea. The intestine parasites consisted of intestinal protozoa and intestinal worms. The risk of being infected by the intestine parasites increased among the HIV patients due to the weakening immunity, as a result, the intestinal parasites would easily infect the patients. The HIV patients with T CD4+ 200 cell / blood was the most vulnerable amount for being infected by the intestine parasites; even the HIV patients who already suffered from chronic diarrhoea caused by intestine parasite might be dead. Objective. The research was conducted in order to identify the prevalence and the intensity of intestine parasites, to identify the prevalence of intestinal protozoa, and to identify the relationship between the body immunity level and the parasitic intestinal infection among the HIV patients in Dr.Sardjito Central Hospital Yogyakarta. Method.The data were gathered from 75 samples of faeces from the HIV patients in Dr.Sardjito Central Hispital from July 2017 until January 2018. The data were gathered based on the interview results, the medical record, and the microscopic examination using Ziehl Nelsen painting, Ritchie concentration, Kato-Katz, and Harada Mori method. The data were analysed using chi-square test with p-value that had been higher than 0.05; as a result, the data were statistically insignificant. Results. The intestine parasites that had been found in the research were namely Cryptosporidium parvum., Isospora belii, Entamoeba histolytica, Entamoeba coli, Balantidum coli, lodomoeba butschlii, Ascaris lumbricoides, Trichuris trichiura, Hookworm, and Hymenolepis nana. There had not been significant relationship between the parasitic intestine infection and the immunity status of HIV patients (the amount of T cell CD4 ) (p > 0.05). The intestine parasites that had been mostly found in the samples under examination were C. parvum. Conclusions. From 75 samples that had been gathered from July 2017 until January 2018, the prevalence of intestinal protozoa among the HIV patients in Dr.Sardjito Central Hospital was 52 (69.3%), while the prevalence of intestinal worm among the HIV patients in Dr.Sardjito Central was 6 (8%). The lower the amount of T cell CD4+ was, the more types of intestine parasites that would be found.

Kata Kunci : Penderita HIV, infeksi protozoa usus, infeksi cacing usus, faktor risiko, HIV patients, protozoa-caused intestine infection, worm-caused intestine infection, risk factors.