DETEKSI RESPON ANTIBODI DAN FAKTOR RISIKO KEJADIAN INFEKSI VIRUS AI (INFLUENZA A/H5N1) PADA PEDAGANG UNGGAS DI PASAR TRADISIONAL KABUPATEN SUKOHARJO PROPINSI JAWA TENGAH

Betty Indah Purnama, Prof. drh. Setyawan Budiharta, MPH, Ph.D.,

2012 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Kabupaten Sukoharjo merupakan daerah endemis AI (H5N1) tetapi laporan yang menyatakan pedagang terinfeksi virus H5N1 dari unggas tidak ada. Perlu dilakukan pemeriksaan serologi dengan tujuan mengetahui prevalensi pedagang unggas terinfeksi virus AI (Influenza A/H5N1) di pasar tradisional Kabupaten Sukoharjo dan menganalisa hubungan kontak langsung dan tidak langsung dengan kejadian infeksi AI (Influenza A/H5N1). Metode Penelitian : Penelitian observasional dengan desain cross sectional. Subyek penelitian (75 pedagang unggas) di 8 pasar tradisional (kecamatan) diseleksi menggunakan simple random sampling secara proporsional. Variabel terikat (kejadian infeksi virus AI (Influenza A/H5N1) dan variabel bebas (kontak langsung dengan unggas dan kontak tidak langsung) yang didiagnosis positif H5N1 dengan uji hemaggIutination inhibition (HI). Analisis data menggunakan analisis deskriftif. Hasil : Karakteristik subyek penelitian yang terbanyak perempuan (74,7%), umur 41-60 tahun (64,0%), pendidikan SD (40,0%), pekerjaan utama berdagang unggas (69,3%), lama berdagang 6-10 tahun (33,3%), pedagang dan unggas berasal dari daerah endemis di Kabupaten Sukoharjo dan kabupaten tetangga. Faktor risiko terbanyak dari kontak langsung (membersihkan karkas unggas 84,0%), paling sedikit kontak dengan bangkai unggas (28,0%), kontak tidak langsung terbanyak memakai wadah pengangkut unggas/karkas, membersihkan tempat berdagang (94,7%) dan paling sedikit mencuci tangan setelah berdagang (86,7%). Titer antibodi anti H5N1 yang negatif (<40) pada 75 subyek penelitian. Kesimpulan : Semua pedagang unggas di pasar tradisional Kabupaten Sukoharjo memiliki titer antibodi anti H5N1 negatif (prevalensi 0%). Kemungkinan penyebab negatifnya infeksi virus H5N1 pada pedagang unggas adalah virus H5N1 tidak mudah menular dari unggas ke manusia meskipun sering kontak langsung dengan unggas yang diduga terinfeksi virus H5N1, perbedaan penggunaan antigen dalam pengujian HI dengan virus yang menginfeksi para pedagang unggas di Kabupaten Sukoharjo dan perubahan antigenik virus pada unggas telah terjadi sehingga tidak bersifat infektif terhadap manusia. Faktor risiko yang dtemukan dalam penelitian ini adalah kontak langsung (membersihkan karkas 84,0%, menyembelih unggas 80,0%, mencabut bulu 77,3%, memelihara unggas 33,3%, kontak dengan bangkai unggas 28,0%) dan kontak tidak langsung (menggunakan wadah pengangkut unggas/karkas dan membersihkan tempat berdagang 94,7%, mencuci tangan 86,7%). Asosiasi antara kontak langsung dan tidak langsung dengan kejadian infeksi virus AI (Influenza A/H5N1) pada pedagang unggas tidak dapat dianalisis.

Background: The Sukoharjo District is an endemic area of Avian Influenza (H5N1). However, there are no reports stating traders of poultry infected with avian H5N1 virus. Therefore, serology investigation should be done to know the prevalence of AI virus infected (Influenza A/H5N1) on poultry traders in Sukoharjo traditional markets and to analyze the asociation of direct and indirect contact with the incidence of AI (Influenza A/H5N1) infection. Methods: The observational study was conducted with cross sectional design on 75 poultry traders from 8 traditional markets (sub-district) as the subjects. They were selected using simple random sampling proportionally. The dependent variable is the incidence of AI virus infection (Influenza A/H5N1) and the independent variables are direct contact with poultry and indirect contacts who were diagnosed H5N1 positive with the Hemagglutination Inhibition (HI) test. The descriptive used for statistical analysis. Results: Most of the subjects are women (74.7%), aged 41-60 years old (64.0%) and had elementary education (40.0%), the main job of poultry trade (69.3%), 6- 10 years of trading (33.3 %). The traders and poultry come from endemic areas in Sukoharjo District and neighboring districts. The highest risk factor of the AI virus infection incidence found on poultry traders by direct contact was washing carcasses (84.0%) and the lowest was contact with dead birds (28.0%), the highest by indirect contact were using the container carrier birds/carcasses and cleaning place of trading (94.7%). The lowest was washing hands after trading (86.7%). The anti-H5N1 antibody titer was negative (<40) in 75 subjects. Conclusion: The anti-H5N1 antibody titer were negative on poultry traders in the Sukoharjo traditional markets (prevalence 0%). That can be caused by the H5N1 virus is not easily transmitted from birds to humans whereas by frequent direct contact with suspected poultry, the differences of antigen that used for HI test with infective virus in Sukoharjo and virus antigenic changes in poultry. Percentage of direct contact risk factors found in this study were, in orderly fashion, washing carcass (84.0%), butchering poultry (80.0%), plucking feathears from poutry (77.3%), caring poutry (33.3%), contacting dead bird (28.0%), while for indirect one were using the container carrier birds/carcasses and cleaning place of trading 94.7%, washing hands after trading (86.7%). The Asociation between each of risk factors (direct and indirect contact) and infection of Avian Influenza virus (Influenza A/H5N1) in poultry traders could not be analyzed.

Kata Kunci : Influenza A/H5N1, uji hemagglutination inhibition (HI), titer antibodi, pedagang unggas, pasar tradisional.