Survei Demam Secara Massal Berhasil Mengendalikan Wabah Malaria Di Pulau Bungin Kabupaten Sumbawa Nusa Tenggara Barat : Pelajaran Tentang Pentingnya Deteksi Agresif Di Salah Satu Pulau Terpenting Di Dunia

Philip Habib, Ahmad Taufik S, Adnanto Wiweko, Didit Yudhanto, Mohammad Rizki, Lalu Hamri Fikri, M. Mulyanto
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Abstract

Bungin Island is a very small island where population density is high, with a total population of 3,287 in a 2 kilometer-square area. The Annual Parasite Index (API) on Bungin Island in 2006 was 16,0 per thousand people. Outbreaks of malaria in Bungin Island are correlated with several controllable factors. The goal of this study is to aggressively detect and treat malaria, as well as to identify the factors that contribute to malaria outbreaks. Data was collected from the resident of Bungin Island who came to Sub-Primary Health Center Bungin Island in October 1, 2007. The data collection when outbreak malaria occurs, consisted of anamnesis, physical examination and test for type of malaria. A finger prick blood sample was collected and tested with  rapid diagnostic test (RDT) for type of plasmodium. Treatment base on standard treatment for malaria from Indonesian Health Department was given to the subjects were malaria positive.  The total 201 subjects was tested by RDT, in which 93 positive malaria (46,27%). Most of them were infected by Plasmodium vivax (97.85%) and only 2 subjects were infected by Plasmodium falciparum (2.15%). There were 23 subjects (24.27%) showed malaria positive without clinical symptoms. The subjects positive malaria with clinical symptoms, 8.57% were found to have spleenomegaly and  7.14% were found to have hepatomegaly. Incidence of malaria decrease siginifantly in few week after aggresive detection and appropriate treatment. A few years later, malaria incidence was disappeared. The incidence of malaria in Bungin Island was high when an outbreak occured. Aggressive detection with mass blood survey could find asymptomatic malaria in the population and appropriate treatment would decrease positive malaria until it disappeared.
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邦根岛是一个非常小的岛屿,人口密度很高,在2平方公里的区域内总人口为3287人。2006年本金岛的年度寄生虫指数为每千人1.6个。本金岛的疟疾暴发与若干可控因素相关。这项研究的目标是积极地检测和治疗疟疾,并确定导致疟疾爆发的因素。数据收集自2007年10月1日来到本根岛次级初级保健中心的本根岛居民。疟疾暴发时的数据收集包括记忆、体格检查和疟疾类型测试。采集手指刺血标本,用快速诊断试验(RDT)检测疟原虫类型。对疟疾阳性受试者按印尼卫生部疟疾标准治疗方法进行治疗。共201人接受RDT检测,其中疟疾阳性93人(46.27%)。其中间日疟原虫感染者最多(97.85%),恶性疟原虫感染者仅有2例(2.15%)。无临床症状的疟疾阳性23例(24.27%)。有临床症状的疟疾阳性人群中,脾肿大者占8.57%,肝肿大者占7.14%。经过积极的发现和适当的治疗,疟疾的发病率在几周内显著下降。几年后,疟疾发病率消失了。本金岛疟疾暴发时发病率很高。积极的大规模血检检测可以在人群中发现无症状疟疾,适当的治疗可以减少阳性疟疾直至消失。
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