Afikasi Artesdiaquine dan Kina + Doxyxycline teregasap densitas parasit dan suhu pada penderita malaria Falciparum tanpa komplikasi di Kabupaten Waropen Propinsi Papua

MANANGSANG, Frans, dr. Haripurnomo Kushadiwijaya, MPH.,DrPH

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Epidemiologi Lapanga

Latar belakang: kendala penyakit Malaria adalah tingginya kasus pengidap parasitemia tanpa adanya gejala (asymptomatik parasitemia). Kelompok ini akan lolos dari pelacakan kasus secara aktif (ACD; Active Case Detection) dan terutama pada pelacakan kasus secara pasif (PCD; Passive Case Detection), kelompok individu ini akan menjadi pembawa penyakit tersamar (silent carrier) dan tidak terobati. Di Papua, Malaria masih diatas Standard Nasional Annual Malaria Incidence (AMI) < 50‰ penduduk, hal ini dapat dilihat Annual Malaria Incidence (AMI) dari 134‰ penduduk pada tahun 2003 menjadi 97‰ penduduk tahun 2004, sedangkan untuk Kabupaten Waropen AMI sebesar 438,4‰ penduduk. Tujuan Penelitian: Mengetahui efikasi Artesdiaquine dan kombinasi Kina + Doxycycline terhadap penurunan densitas parasit dan suhu tubuh penderita malaria (P. falciparum) tanpa komplikasi Bahan dan Cara Penelitian: Jenis penelitian eksperimental lapangan (field trial), dengan rancangan penelitian Double blind randomized post test with control group design. Besar sampel minimal dengan asumsi P1 = 98%, P2 = 75%, α = 5% dan β = 80%, d = 15% dengan jumlah sample sebesar 41 orang untuk tiap kelompok intervensi. Variabel pengaruh (independent variable) adalah regimen obat anti Malaria. Variabel terpengaruh (dependent variable) adalah kepadatan parasit dan suhu tubuh. Variabel terkendali yaitu lama demam sebelumnya, jenis dan stadium parasit. Variabel tak terkendali yaitu status gizi (IMT). Analisis data menggunakan uji homogenitas (Levene’s Test for Equality of Variances), uji perbedaan 2 proporsi (Chi Square- χ2) dan uji Anava. Hasil Penelitian: Densitas parasit (μl) pada masa observasi dilakukan mulai dari H 0 sampai dengan H 28, untuk masing-masing regimen menunjukkan adanya rerata penurunan. Dari hasil analisis normalitas data (Levene’s Test for Equality of Variances) terhadap dua jenis regimen Artesdiaquine dan Kina + Doxycycline diketahui bahwa adanya kemaknaan penurunan densitas parasit (p = 0,000) setelah mengkonsumsi obat tersebut. Kesimpulan: Regimen obat Artesdiaquine dan Kina + Doxycycline memiliki efikasi sama terhadap pengobatan penderita Malaria falciparum tanpa komplikasi di Kabupaten Waropen Propinsi Papua.

Background: The problem of malaria disease is high incidence of asymptomatic parasitemia. This group will slip off from either active or passive case detection. They can be silent carriers who do not get medication. In Papua malaria disease is still above the national standard of annual malaria incidence (AMI), i.e. < 5 per 1000 as indicated in AMI 134 per 1000 in 2003 which became 97 per 1000 in 2004, whereas in District of Waropen AMI was 438.4 per 1000. Objective: Co-signature efficacy of Artesdiaquine and Quinine + Doxycycline against parasite density and temperature of falciparum malaria patients without complication at district of Waropen, province of Papua Materials and Method: This was a field trial of double blind randomized post test with control group design. The quantity of minimum sample with the assumption of P1=98%, P2=75%, α=5% and β=80%, d=15% was as many as 41 people for each group for intervention. The independent variable was reagent of anti malaria. The dependent variable were parasite density and temperature. The controlled variables were period of previous fever, types and stage of parasitemia. The non controlled variable was nutrition status (body mass index). Data analysis used homogenity (Levene's test for equality of variances), chi square and anova. Result: The parasite density (μl) during observation period whid was conducted from day 0 to day 28 for each reagent showed that there was average decrease. The result of Levene's test for equality of variances on Artesdiaquine and Quinine + Doxycline indicated that there was significant decrease of parasite density (P=0.000) after the patient consumed those drugs. Conclusion: The drug reagents of Artesdiaquine and Quinine + Doxycycline had equal efficacy for the medication of falciparum malaria patients without complication at District of Waropen, Province of Papua.

Kata Kunci : Malaria Falciparum,Densitas Parasit dan Suhu,Kina dan Doxycycline, falciparum malaria, efficacy, Artesdiaquine, Quinine, Doxycycline, parasite density, temperature