HASIL GUNA TERAPI ARTEMETER DAN PRIMAKUIN DIBANDINGKAN SULFADOKSIN-PIRIMETAMIN DAN PRIMAKUIN PADA PASIEN ANAK DENGAN MALARIA FALSIPARUM STUDI DI RSUD SUNGAILIAT KABUPATEN BANGKA PROVINSI KEPULAUAN BANGKA BELITUNG

Baiq Watik Widya Rochmawati Juniastuti, Prof. dr. Djauhar Ismail, MPH, Ph.D., Sp.A.K.

2012 | Tesis | S2 Ked.Klinik/MS-PPDS

Latar BelakangMalaria masih merupakan masalah kesehatan utama di Indonesia,termasuk di Kepulauan BangkaBelitung. Di RSUD Sungailiat, malaria menempati urutan pertama kasus pasien rawat inap. Banyak terjadi resistensi obat antimalaria,salah satunya adalah sulfadoksinpirimetamin, oleh karena itu WHOmerekomendasikan Artemisininbased Combination Therapy (ACT). Di RSUD Sungailiatsulfadoksinpirimetamin masih digunakan, meskipun ACT telahdiperkenalkan. Diperlukan terapi yang berhasil guna lebih baik untuk pengobatanmalaria. Tujuan Membandingkanhasil guna terapi malaria falsiparum menggunakanartemeter dan primakuin dibandingkan dengan sulfadoksinpirimetamin danprimakuin. Metode Merupakan penelitian kuasieksperimental,menggunakan64 subyek penelitianyang terdiagnosis malaria falsiparum dan memenuhi kriteriainklusi. Datadiambil dari rekam medis RSUD Sungailiat antara bulan Juli 2008 sampai dengan Juni 2012. Subyek dibagi menjadi dua kelompok pengobatan yaitu artemeter danprimakuin (Kelompok A),sulfadoksinpirimetamin dan primakuin (Kelompok B). Data gejala klinis dan laboratorisdicatat sejakHari ke-0-7. Respon Pengobatan dinilai berdasarkan kriteria WHO2006.Analisis data menggunakan Chi-square test. HasilRespon Klinik dan Parasitologi memadai (ACPR) dalam kelompok terapi Aadalah 87,5% dibandingkan dengan kelompok terapi B 84,4% (p = 0,50). Kegagalanpengobatan dini (ETF) ditemukan 12,5% vs 15,6% (p = 0,50). Tidak ada KegagalanPengobatan Kasep (LTF)pada kedua kelompok. Efek samping yang ditemukan yaitu mual (9,4% vs 3,1%, p=0,31), sakit perut (3,1% vs 6,3%, p=0,50), diare (0% vs9,4%, p=0,12) dan sakit kepala (6,3% vs 9,4%, p=0,50). Kesimpulan Hasil gunaterapi artemeter dan primakuin dibandingkan dengan terapi sulfadoksinpirimetamin dan primakuin pada anak dengan malaria falsiparum tidak berbeda bermakna.

Background Malaria remains a major health issue in Indonesia, including in the Bangka-Belitung Islands. In Sungailiat General Hospital, malaria is the illness of the most inpatients. The occurrence of antimalarial drug resistance, one of those is sulfadoxine-pyrimethamine, therefore WHO recommended Artemisinin-based Combination Therapy (ACTs). In Sungailiat General Hospital sulfadoxinepyrimethanime is still used, although ACTs has been introduced. Effective therapy is required in order to better malaria treatment. Objectives To examine the effectiveness of falciparum malaria therapy using artemether and primaquine compared to sulfadoxine-pyrimethamine and primaquine. Method A quasi-experimental study, using 64 subjects diagnosed with falciparum malaria who met inclusion criteria. Data was taken from the medical records of Sungailiat Hospital between July 2008 and June 2012. Subjects were divided into two treatment groups: artemether and primaquine therapy (Group A), and sulfadoxine-pyrimethamine and primaquine therapy (Group B), those with clinical symptoms and parasitological measurements of D0-7. Results of therapy were assessed based on WHO-2006 criteria of therapeutic response, and analyzed with a chi-square test. Results The Adequate Clinical and Parasitology Response (ACPR) in group A therapy was 87.5% compared with group B therapy 84.4% (p=0.50). Early treatment failure was found 12.5% vs 15.6% (p=0.50. Side effects were found: nausea (9.4% vs 3.1%, p=0.31), abdominal pain (3.1% vs 6.3%,p=0.50), diarrhea (0% vs 9.4%, p=0.12) and headache (6.3% vs 9.4%, p=0.50). Conclusion The effectiveness of artemether and primaquine therapy and sulfadoxine-pyrimethamine and primaquine therapy for children with falciparum malaria showed no significant difference.

Kata Kunci : artemeter, sulfadoksin pirimetamin, malaria falsiparum