Plasmodium Edit

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PLASMODIUM

Dr. Hanina

Bagian Parasitologi

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Learning Objectives

• Taksonomi, Epidemiologi

• Hospes, vektor 

• Morfologi

• Siklus Hidup

• PDIK

• Pengobatan dan penega!an

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TaksonomiTaksonomi

• Kingdom " Protista

• P!#llum " $piomple%a

• Kelas " Sporo&oa• 'rdo " Haemosporidia

• (amili " Plasmodiidae

• )enus " Plasmodium

• Spesies " P. falciparum, P. vivax, P.

malariae, P. ovale, P. knowlesi  

Kingdom " Protista

 Kelas " Sporo&oa

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EpidemiologiEpidemiologi

• P. falciparum " $frika dan Melanesia*

• P. vivax  " $merika Sentral, $merika Selatan,

 $frika +tara, Timur Tenga!, dan subkontinen

India*• P. ovale " $frika Barat* -TT, Papua.

• P. malariae " seluru! dunia, terutama di daera!

tropis /ampung, -TT, Papua.

• P. knowlesi : $sia tenggara Bangka, Kalimantan.

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Morfologi

• Trofo&oit0bentuk inin ring form.

• S!i&on

• gametosit " mikro tepi0padat., makrotenga!0difuse.

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Morfologi

Pembesaran eritrosit : P. vivax, P. ovale

Parasitemia tinggi 

•P. falciparum: double chromatin dot, Acoley sign, delicated ring 

• P. vivax : sitoplasma amuboid 

• P. malariae : 1band form1 , rossete

• P. ovale : fimbriae 

• P. knowlesi 

trofo&oit muda

trofo&oit tua

trofo&oit tua

ski&on matang

ski&on muda

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Siklus Hidup

E%o2er#t!ro#ti 3#le

E#t!ro#ti 3#le

Sporogoni 3#le

4 menit

Hipno!oit

"P. viva# $ovale%

Mero!oit

& mingg'

(& jam

)* jam

Mero!oit

Sc+i!ogon,

♀

♂

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PDI-PDI- 

• P. vivax  " malaria tertiana

• P. malaria " malaria kuartana

• P 4 ovale " malaria ovale• P 4 falciparum " malaria tropika

/ )

M / 4

0 / 1

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Pat+ogenicit,

Process  5. T!e cold stage !ill., 67 min to 5 !r4

  8. T!e +ot stage fever., 5 to 9 !rs4

  6. S2eating stage 5 to 8 !rs4 Mec+anism 

2222liberation of mero&oites and malarial

pigment* :B3 debris into t!e blood stream4

Splenomegal, and anemia

!emo&oin

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  3elapse

:elapse onl# ours in P.vivax  

Malignant malaria

erebral malaria*

blak;ater fever*

aute respirator# distress s#ndrome*

severe gastrointestinal s#mptoms*

s!ok and renal failure

dan ovale sebenarn#a

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Laborator, diagnosis

Mirosopi e%amination of p!erip!eral

blood

• T!in film

• T!ik film

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1reatment 

• +lor5'ine and 5'inine

anti/er,t+roc,tic stage drugs4

?uestion" =!i! stage of plasmodium ant!ese drugs kill>.

• Prima5'ine and p,rimet+amine anti/e#oer,t+roc,tic stage drugs4

• A1 "Artemisin ombined 1+erap,%

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Prevention

• +emoprop+,la#is

+loro5'ine 6 p,rimet+amine

 3!emot!erap#" 5 ;eek before entr# into

t!e endemi area * for 9 ;eeks after

returning from t!e endemi area4

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• Mos5'ito control

  (1) Reconstruction of environment:

eradicate the breeding places of

moquitoes.

  (2) Spry insecticides: DD! and so

on.

  (") #se mosquito nets$ screen$ ormosquito repellents to protect the

person from mosquito bites.

Prevention 

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 P.knowlesi P.knowlesi 

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Patogenesis

• P.knowlesi  bereplikasi per 89 @am  

?uotidian fever , parasitemia berat

• 7ejala 8+as " n#eri kepala, demam,

menggigil dan keringat dingin

• )e@ala tidak k!as " n#eri perut, sesak

napas dan batuk berda!ak, takipnea dan

takikardi4

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DiagnosisDiagnosis 

• Pemeriksaan mikroskopis " pengeatan

)iemsa P. knowlesi  " tro9o!oit a2al

double chromatin dot  dan infeksi multipel,

tro9o!oit lanj't band form ),

• Polymerase Chain eaction P3:.

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Penatala8sanaanPenatala8sanaan

• =H' " belum memberikan rekomendasi

• kombinasi klorokuin dan primakuin

memberikan respons klinis #ang baik

• ge@ala berat dan !itung parasit tinggi"

tatalaksana malaria berat

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TE:IM$K$SIH