Konfirmasi Pemeriksaan Mikroskopik terhadap Diagnosis Klinis Malaria

Abstract

Penyakit malaria masih menjadi salah satu masalah kesehatan masyarakat yang penting di dunia. Di Indonesia, terutama di luar daerah Jawa dan Bali, sampai kini angka kesakitan malaria masih tergolong tinggi. Di Puskesmas Bunta Kabupaten Banggai, pada tahun 2008 Annual Malaria Incidence (AMI) dilaporkan mencapai 109,9‰. Penelitian ini bertujuan untuk membandingkan serta mengetahui hubungan gejala, tanda klinis, dan hasil pemeriksaan mikroskopik malaria. Desain studi yang digunakan adalah cross sectional. Pengumpulan data wawancara dan mengambil sediaan darah dilakukan pada 150 penderita suspect malaria di puskesmas dan rumah penduduk. Penderita malaria klinis dengan pemeriksaan mikros- kopik malaria positif ditemukan sekitar 52%. Gejala dan tanda klinis malaria yang berhubungan bermakna dengan pemeriksaan mikroskopik meliputi menggigil (nilai p = 0,000); sakit kepala (nilai p = 0,007); nyeri otot/ tulang (nilai p = 0,001); pusing (nilai p = 0,000); demam (nilai p = 0,003); anemia (nilai p = 0,000); dan splenomegali (nilai p = 0,000). Berdasarkan analisis multivariat ditemukan gejala dan tanda klinis yang paling dominan berhubungan dengan pemeriksaan mikroskopik adalah menggigil (nilai p = 0,002; CI 95% = 1,593-7,797) dan anemia (nilai p = 0,000; CI 95% = 2,265 11,191) yang merupakan faktor prediksi terbaik untuk diagnosis dini, skrining, dan surveilans malaria.Kata kunci: Malaria klinis, pemeriksaan mikroskopik, gejala dan tanda klinis malariaAbstractMalaria which morbidity still high is one of health problems in the world in- cluding in Indonesia, mainly in outside Java and Bali island. In Bunta Public Health Center Banggai Regency in 2008, the AMI was 109,9‰ still high. The objective of this research is to compare and to know the relationship between clinical malaria diagnosis and microscophic examination. The methods used in research were observasional study with cross sectional study by interviewing and taking blood stoke of malaria suspected among 150 respondents in Public Health Center and people residents. The data was analyzed by SPSS program according to univariate, bivariat, and mul- tivariate. The result showed that positive mycroscopic cases among clinical malaria cases is 52%. The sign and symptomps of malaria is corelated to positif microscophic examinated cases such as shiver (p value = 0,000); headache (p value = 0,007); muscle/bones pain (p value = 0,001); dizzyness (p value = 0,000); fever >37,5°C (p value = 0,003); anemia (p value = 0,000); and splenomegaly (p value = 0,000). Based on the multivariate test, indicated that the sign and symptoms that related dominantly to micros- cophic examination includes shiver symptom (p value = 0,002; CI 95% = 1,593-7,797) and anemia (p value = 0,000; CI 95% = 2,265-11,191). Malaria clinical signs and symtomps is the alternative diagnosis of malaria in endemic areas that have microscophic examination restictiveness.Key words: Clinical malaria, microscophic examination, clinical sign and symptoms