KAJIAN INFEKSI PROTOZOA USUS PADA PASIEN DIARE DI BAGIAN RAWAT INAP RSUD PANEMBAHAN SENOPATI BANTUL YOGYAKARTA

NURLAILI FARIDA M., dr. Elsa Herdiana M., M.Kes., Ph.D.; Dr. Budi Mulyaningsih, MS., Apt.

2015 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Latar Belakang: Penyebab diare dapat berupa infeksi E. histolytica, G. lamblia, B. coli, dan protozoa usus oportunistik yaitu Cryptosporidium. Keberadaan infeksi protozoa usus di RSUD Panembahan Senopati Bantul Yogyakarta belum diketahui datanya secara khusus. Penelitian ini bertujuan mengetahui persentase kasus protozoa usus pada pasien diare di bagian rawat inap RSUD Panembahan Senopati Bantul Yogyakarta Periode September 2014-Februari 2015 serta faktor-faktor yang berkaitan dengan kejadian infeksi tersebut. Metode: Metode dalam penelitian ini adalah analitik observasional dengan desain cross sectional. Sampel adalah pasien rawat inap diare yang memenuhi kriteria inklusi dan eksklusi berjumlah 82 orang. Data yang diambil antara lain karakteristik subjek penelitian, kondisi sarana air, sarana jamban, dan sarana pengelolaan sampah di rumah tempat tinggal pasien diare. Pemeriksaan protozoa usus menggunakan metode sedimentasi Ritchie. Pemeriksaan protozoa oportunistik menggunakan pewarnaan Ziehl Neelsen. Analisis statistik yang digunakan adalah Chi-Square. Hasil: Kejadian infeksi protozoa usus sebanyak 37 orang (45%) dari total 82 penderita diare. Protozoa usus yang ditemukan adalah E. histolytica 4 orang (4,9%), E. coli 1 orang (1,2%), Cryptosporidium 25 orang (30,5%), Blastocystis 2 orang (2,4%), dan infeksi campuran (E. histolytica & Cryptosporidium) 5 orang (6,1%). Hasil analisis bivariat faktor-faktor yang menunjukkan hubungan yang signifikan (p<0,05) adalah sanitasi sarana air bersih (p<0,000), sarana jamban (p<0,000), dan sarana pengelolaan sampah (p<0,004). Kesimpulan: Persentase kasus infeksi protozoa usus pada pasien diare di bagian rawat inap RSUD Panembahan Senopati Bantul Yogyakarta Periode September 2014-Februari 2015 adalah 45%. Distribusi jumlah kejadian infeksi protozoa usus berdasarkan karakteristik subjek penelitian yaitu paling banyak berumur lansia yaitu >45 tahun, berjenis kelamin laki-laki, latar belakang pendidikan adalah SD, pekerjaan sebagai petani, tidak mempunyai riwayat penyakit dan kontak penderita, serta berstatus gizi normal. Karakteristik feses subjek penelitian dengan infeksi protozoa usus paling banyak berwarna coklat dengan konsistensi cair, tidak mengandung lendir dan darah. Tanda dan gejala klinis yang paling banyak ditemukan pada subjek penelitian dengan infeksi protozoa usus adalah letih atau lesu sebanyak 57 orang (69,5%), dan pusing sebanyak 55 orang (67,1%). Sanitasi air, sarana jamban, dan sarana pengelolaan sampah berhubungan dengan kejadian infeksi protozoa usus tersebut.

Background: The cause of diarrhea can be infection of E. histolytica, G. lamblia, B. coli, and opportunistic intestinal protozoa namely Cryptosporidium. The presence of intestinal protozoan infection in RSUD Panembahan Senopati Bantul Yogyakarta is not known specifically. This study aims to determine the percentage of cases of intestinal protozoa in patients with diarrhea in the inpatient patient in the hospital of Panembahan Senopati Bantul Yogyakarta in period of September 2014-February 2015 and factors which have relationship with the infection occur. Methods: The method used in this study was observational analytic research with crossectional design. Samples are diarrhea inpatient who meet the inclusion and exclusion criteria which amount 82 people. Data taken among others characteristic of research subject, search condition of water facilities, toilet facilities, and facilities of garbage management. Intestinal protozoa examination using sedimentation method of Ritchie, whereas opportunistic intestinal protozoa examination using staining method of Ziehl Neelsen. Statistical analysis is used the method of Chi-Square. Result: The number of intestinal protozoan infection in patient with diare is 37 people (45.1%) of total 82 research subjects. Intestinal protozoa E. histolytica is found as many as 4 people (4.9%), E. coli 1 people (1.2%), Cryptosporidium 25 people (30.5%), Blastocystis 2 people (2.4%), and mix infection (E. histolytica & Cryptosporidium) 5 people (6.1%). Result of bivariate analysis factors that indicate a significant relationship (p<0.05) are water sanitation facilities (p<0.000), toilet facilities (p<0.000), and garbage management (p<0.004). Conclusion: The percentage of intestinal protozoan infection in patients with diarrhea in the inpatient patient in the hospital of Panembahan Senopati Bantul Yogyakarta in period of September 2014-February 2015 was 45%. The distribution of the amount of the incidence of infection by intestinal protozoa characteristics of research subjects that most elderly age is> 45 years, male gender, educational background is Elementary School, work as farmers, have no history of the disease and the patient contact, as well as the normal nutritional status. Stool characteristics of the study subjects with intestinal protozoan infection most brown liquid with the consistency, not containing mucus and blood. Clinical signs and symptoms most commonly found in research subjects with intestinal protozoan infections are tired or sluggish as many as 57 people (69.5%), and dizziness as many as 55 people (67.1%). Sanitary water facilities, toilet facilities, and garbage management facilities associated with the incidence of intestinal protozoan infection.

Kata Kunci : infeksi protozoa usus, pasien diare, sarana air, sarana jamban, sarana pengelolaan sampah; intestinal protozoan infection, diarrhea patient, water sanitation facilities, toilet facilities, and garbage management