E. Elsa Herdiana Murhandarwati
Bagian Parasitologi, Fakultas Kedokteran, Universitas Gajah Mada, Jogjakarta, Indonesia

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Faktor-Faktor yang Mempengaruhi Ketepatan Diagnosis Malaria di Puskesmas Kabupaten Belu Nusa Tenggara Timur Mau, Fridolina; Murhandarwati, E. Elsa Herdiana
Media Penelitian dan Pengembangan Kesehatan Vol 25, No 2 Jun (2015)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (345.992 KB)

Abstract

Pengobatan malaria di Kabupaten Belu Propinsi Nusa Tenggara Timur berdasarkan pada diagnosisklinis dan mikroskopis. Angka kesalahan diagnosis mikroskopis malaria dilaporkan masih tinggi, di atasnilai toleransi kesalahan diagnosis menurut Kementerian Kesehatan >5%. Tujuan penelitian ini untukmengetahui faktor-faktor penyebab kesalahan diagnosis malaria di Puskesmas. Rancangan penelitianini adalah explorasi dan observasional secara potong lintang terhadap 16 mikroskopis sampel dalammendiagnosis mikroskopis malaria. Penelitian dilakukan di 10 puskesmas Kabupaten Belu dari bulanApril hingga Juni 2012. Hasil pengamatan menunjukkan faktor yang mempengaruhi kesalahan diagnosisadalah kelengkapan mempersiapkan alat dan bahan sebelum pengambilan darah (p < 0,029), tidakmelakukan sediaan darah tipis (p < 0,07), menggunakan Kaca Sediaan (KS) bekas/slide bekas (p <0,08) hasil pewarnaan Sediaan Darah (SD) tidak baik (p < 0,02), kurang pengalaman kerja (p < 0,029)dan kurang pelatihan (p <0,08). Penilaian terhadap mikroskopis dilakukan oleh expert microscopistyang tersertifiasi dan ditemukan responden memiliki nilai Kappa jelek (0,00-0,20) sebanyak 35,2%.
Evaluation of artemisinin-based combination therapy (ACT) to uncomplicated falciparum malaria patients in Purworejo District, Central Java, Indonesia Bia, Michael Bhadi; Murhandarwati, E. Elsa Herdiana; F Lobo, Neil; A Hawley, William; Supargiyono, .
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 1 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1401.807 KB) | DOI: 10.19106/JMedSci004801201605

Abstract

Artemisinin-based Combination Therapy (ACT) to treat uncomplicated Plasmodiumfalciparum malaria has been applied in Purworejo District, Central Java, Indonesia, since2004. However evaluation of the two ACT regimens used ie: Artesunate Amodiaquine(AAQ) and Dihydroartemisinin-Piperaquine (DHP) co-administered with Primaquine (PQ)has not been performed. This study aims to evaluate the efficacy and side effects ofAAQ+PQ and DHP+PQ treatment in uncomplicated falciparum malaria in Purworejo. Inthis descriptive and observational study, 46 Pf infected patients who fullfill the inclusionand exclusion criterias were recruited from December 2010 to August 2011. StandardACT treatment were given to the patients followed by WHO drug efficacy evaluation for28 days. The clinical symptoms and adverse events was also evaluated over the course ofthe treatment. From all recruited subjects, 37 patients received DHP+PQ and 9 patientsreceived AAQ+PQ. On the DHP+PQ treated patient, all subjects were free of asexualand sexual parasites by Day-3 while on AAQ+PQ treated patient, this parasite clearancewas achieved faster as early as on D-2 at the latest. On the otherhand, the disappearanceof fever was also last longer in DHP+PQ treated patient which in one patient last onD-14, while in AAQ+PQ treated patient, the symptom of fever dissappeared by D-2at the latest. No Early or Late Treatment Failures were found on either DHP+PQ orAAQ+PQ treatment as well as clinical and parasitological failures. However, the presenceof adverse events cause by both drugs should not be ignored to ensure drug compliance.