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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