Deteksi Molekuler Serotipe Virus Dengue dan Faktor Risiko Yang Mempengaruhi Kejadian Infeksi Dengue dI Samarinda

Maria Eka Suryani, Prof. Dr. drh. Wayan Tunas Artama; Dr. dr. Ida Safitri L, Sp. A(K)

2024 | Tesis | S2 Ilmu Kedokteran Tropis

Latar belakang: Infeksi dengue disebabkan oleh virus dengue (DENV) yang ditularkan oleh Aedes sp. Terdapat empat serotipe virus dengue, yaitu DENV-1, -2, -3 & -4. Setiap serotipe dapat menimbulkan manifestasi klinis yaitu Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF) dan Dengue Syock Syndrome (DSS). Surveilans molekuler virus dengue dapat mendeskripsikan karakteristik infeksi berdasarkan data klinis, serologis, dan genetik virus. Pemantauan dan analisis kasus secara berkesinambungan sangat penting di wilayah yang kasus dengue masih tinggi seperti Kota Samarinda. Identifikasi serotipe virus dengue diperlukan untuk melihat potensi patogenitas virus di suatu wilayah dan waktu tertentu.

Tujuan: Tujuan penelitian ini untuk mengetahui distribusi dan frekuensi serotipe virus dengue, serta mengetahui hubungan usia, jenis kelamin, wilayah geografis dengan serotipe DENV. Penelitian ini juga ingin mengetahui hubungan prediktor klinis seperti hari demam, suhu demam, jumlah leukosit, jumlah trombosit dan kadar hematokrit dengan hasil deteksi molekuler serta perbedaannya berdasarkan jenis serotipe DENV yang menginfeksi.

Metode: Jenis penelitian ini observasional analitik dengan desain cross sectional, pengumpulan sampel di Puskesmas wilayah kota Samarinda pada bulan Oktober 2023 – Februari 2024. Sampel berjumlah 155 pasien probable dengue. Deteksi serotipe menggunakan qRT-PCR.

Hasil: Deteksi qRT-PCR menemukan adanya empat serotipe yaitu DENV-1 (9,1%), DENV-2 (31,8%), DENV-3 (36,4%), DENV-4 (19,3%), DENV-1&-4 (1,1%) dan DENV-2&-4 (2,3%). Distribusi infeksi DENV paling banyak pada daerah urban. Ada hubungan antara hari demam, suhu demam dan jumlah leukosit dengan hasil deteksi serotipe DENV. Tidak ada perbedaan spesifik karakteristik infeksi serotipe DENV berdasarkan usia, jenis kelamin, wilayah geografis, jumlah leukosit, trombosit dan kadar hematokrit.

Kesimpulan: Adanya heterogenitas serotipe DENV yang bersirkulasi pada kejadian infeksi dengue di kota Samarinda. Studi ini menunjukkan hari demam, suhu demam dan leukosit dapat dijadikan sebagai indikator awal adanya DENV pada fase akut. 

 

Background: Dengue infection is caused by the dengue virus (DENV), which is transmitted by Aedes species mosquitoes. There are four serotypes of the dengue virus: DENV-1, DENV-2, DENV-3, and DENV-4. Each serotype can cause clinical manifestations, including Dengue Fever (DF), Dengue Hemorrhagic Fever (DHF), and Dengue Shock Syndrome (DSS). Molecular surveillance of the dengue virus can describe the characteristics of the infection based on clinical, serological, and genetic data. Continuous monitoring and analysis of cases are crucial in regions with a high incidence of dengue, such as Samarinda City. Identifying the serotypes of the dengue virus is necessary to assess the pathogenic potential of the virus in specific regions and time periods.

Objectives: The aim of this study is to determine the distribution and frequency of dengue virus serotypes and to examine the relationships between age, gender, and geographic region with DENV serotypes. This research also seeks to identify the associations between clinical predictors, such as the number of days with fever, fever temperature, leukocyte count, platelet count, and hematocrit levels, with molecular detection results and to analyze differences based on the infecting DENV serotype.

Methods: This type of research is an analytical observational study with a cross-sectional design. Sample collection was conducted at community health centers in Samarinda city from October 2023 to February 2024. The sample consisted of 155 probable dengue patients. Serotype detection was performed using qRT-PCR.

Result: Real time-PCR detection identified four serotypes: DENV-1 (9.1%), DENV-2 (31.8%), DENV-3 (36.4%), DENV-4 (19.3%), DENV-1&-4 (1.1%), and DENV-2&-4 (2.3%). The highest distribution of DENV infection was found in urban areas. There is a relationship between the number of days with fever, fever temperature, and leukocyte count with DENV serotype detection results. There were no specific differences in the characteristics of DENV serotype infection based on age, gender, geographical area, leukocyte count, platelet count, and hematocrit levels.

Conclusion: The heterogeneity of circulating DENV serotypes in dengue infection cases was observed in the city of Samarinda. This study demonstrates that the day of fever onset, fever temperature, and leukocyte count can serve as early indicators of DENV presence in the acute phase.

Kata Kunci : Deteksi molekuler, serotipe DENV, faktor infeksi dengue