RESPON ANTIBODI TERHADAP MEROZOITE SURFACE PROTEIN-1 (MSP-1) DAN APICAL MEMBRANE ANTIGEN-1 (AMA-1) PLASMODIUM VIVAX PADA PENDUDUK DAERAH ENDEMIS RENDAH DAN ENDEMIS SEDANG DI INDONESIA

SIGIT SETYAWAN, Prof. dr. Supargiyono, DTM&H., SU., PhD., SpParK;Dr. dr. Mahardika A Wijayanti, DTM&H., M.Kes

2015 | Tesis | S2 Ilmu Kedokteran Tropis

Latar Belakang. Malaria di Indonesia tersebar di hampir seluruh provinsi dengan endemitas dan transmisi yang bervariasi. Penelitian perlu dilakukan untuk mengetahui respon antibodi terhadap Merozoite Surface Protein-1 (MSP-1) dan Apical Membrane Antigen-1 (AMA-1) Plasmodium vivax pada penduduk daerah endemis rendah dan endemis sedang di Indonesia. Metode. Pengukuran dilakukan terhadap sampel darah penduduk daerah endemis rendah (Purworejo) dan endemis sedang (Lampung). Pengukuran antibodi dilakukan dengan metode indirect ELISA dengan protein rekombinan MSP19 dan AMA-1 P. vivax sebagai agen penangkap. Sampel dinyatakan positif jika antibodi dengan titer diatas (rerata+3SD) nilai titer kelompok sampel individu negatif. Persentase seropositif, perbedaan rerata antibodi dan hubungan titer dengan usia individu dianalisis secara statistik. Hasil. Seroprevalensi antibodi IgG anti P.v.MSP-1 dan P.v.AMA-1 pada berbagai kelompok usia penduduk di Purworejo lebih rendah dibanding dengan penduduk di Lampung, baik saat transmisi tinggi maupun saat transmisi rendah. Rerata titer antibodi IgG anti P.v. MSP-1 dan Pv. AMA-1 pada berbagai kelompok usia penduduk di daerah endemis rendah Purworejo dan daerah endemis sedang Lampung pada saat transmisi tinggi relatif sama dibanding pada saat transmisi rendah. Terdapat hubungan yang bermakna antara usia individu dengan titer IgG anti P.v.MSP-1 dan anti P.v.AMA-1 penduduk Purworejo dan Lampung saat transmisi tinggi dan saat transmisi rendah. Kesimpulan. Respon antibodi anti P.v.MSP-1 dan anti P.v.AMA1 dapat berubah sesuai waktu transmisi. Pemeriksaan antibodi bisa menjadi indikator yang sensitif untuk menilai perubahan tersebut. Kata kunci. Seroprevalensi, titer antibodi, transmisi malaria, P.v.MSP-1, P.v.AMA-1

Background. Malaria is distributed in almost all provices in Indonesia in differant levels of endemicity and transmission. In this study, antibody responses againts Plasmodium vivax MSP-1 and AMA-1 is measured in population living ini hypo-endemic area of Purworejo and meso-endemic area of Lampung during low and high transmission to asss the transmission intensity in this region. Methods. Serum antibody are measured from blood samples collected from people in hypo-endemic area (Purworejo) and medium endemic area (Lampung) during high transmission season and during low transmission season. Antibody titers is measured by indirect ELISA assays using recombinant P.v.MSP19 and P.v.AMA-1. The seroprevalence of anti P.v.MSP-1 dan P.v.AMA-1antibodies, the mean antibody titers and correlation of antibody titer and age in both site and season were analyzed. Result. During high and low transmission season, seroprevalence of antibody P.v.MSP-1 and P.v.AMA-1 antibodies in most group of age in Purworejo is lower than in Lampung. Both in Purworejo and Lampung mean antibody titers and correlation of antibody titer with age of anti P.v.MSP-1 and P.v.AMA-1 antibodies during low is lower than high transmission season. Both in Purworejo and Lampung mean antibody titers have correlation with age of individual. Conclusion. Seasonal changes may be detectable by changes in antibody responses. Examination of antibody levels rather than seroprevalence is likely to be a more sensitive indicator of changes in transmission. These data suggest that sero-epidemiological analysis may have a role in assessing short-term changes in exposure. Key words. Antibody titer, seroprevalence, transmission, P.v.MSP-1, P.v.AMA-1

Kata Kunci : Antibody titer, seroprevalence, transmission, P.v.MSP-1, P.v.AMA-1