3. Laporan tahunan Direktorat Daerah P3M /Din Kes Tk. I Prop Jawa
Tengah, tahun 1977/1978 s/d I979/1980.
4. Laporan Penyelidikan Filaria dan Malaria di Kabupaten Dati II
Cilacap - oleh : dr. F A Sudjadi (Bagian Parasitologi UGM, Yogya-
karta) dan dr. Djakaria (Bagian Parasitologi UI, Jakarta) Desember
1978 - Maret 1979.
S.Kazsner HT. Human Pathology, 8 ed. Philadelphia Montreal :
JB Lippincott Co, pp 216 - 218.
6.Flu PC. Voordrachten over aethiologie, Epidemiologie en spicieole
prophylaxis van de infectie en parasitaire ziekten van den mensch
Harlem - De Erven F. Bohn N.V.
Pengobatan Brugia timori dengan
Pemberian DEC Takaran Rendah oleh
Penduduk kepada Penduduk.
F. Partono , Purnomo , A Soewarto
, Sri Oemiyati
Bagian Parasitologi Fakultas Kedokteran UI., NAMRU-2
Jakarta,
Dokter di Ruteng, Flores
Ringkasan
Pemberantasan
Brugia timori
telah dilakukan sejak tahun
1977 di tiga desa di Kecamatan Reok, Kabupaten Manggarai,
di Flores Barat, Propinsi NTT. Sebelum pemberantasan dimu-
lai, diadakan survey pendahuluan dengan melakukan sensus
penduduk dan mencatat dari setiap penduduk yang hadir,
nama, umur, jenis kelamin dan hubungan keluarganya. Semua
penduduk diperiksa secara klinis dan semua gejala dan tanda-
tanda filariasis dicatat. Darah malam untuk filariasis diambil
dari ujung jari sebanyak 20 pl antara jam 8.00 dan 12.00
malam dan pada waktu yang sama diambil pula darah vena
sebanyak I ml sebelum pengobatan dan 3 ml setelah pemberi-
an obat. Darah vena disaring dengan Nuclepore yang mem-
punyai lubang saring 5 u. Semua contoh darah dipulas dengan
Giemsa dengan cara yang telah diuraikan oleh Partono dan
Idris (1977) dan jenis dan jumlah mikrofilaria dihitung.
Diethylcarbamazine (DEC) diberikan dengan takaran rendah
sebanyak 50 mg untuk anak sama atau lebih dari 10 tahun dan
25 mg untuk anak di bawah umur 10 tahun, diberikan 1 x
seminggu selama 1½
tahun. Pemberian obat dilakukan oleh
guru sekolah atau pemuka desa di masing-masing desa dan
jumlah pemberian obat dan reaksi samping obat dicatat secara
terperinci. Setiap tahun semua penduduk diperiksa ulang
secara klinis maupun parasitologis dengan cara yang sama.
Hasil pemberantasan filariasis atas dasar "oleh penduduk
kepada penduduk" ini sangat memuaskan. Setelah tiga tahun
hanya tinggal tiga orang pengandung mikrofilaria di tiga desa
tersebut dan jumlah mikrofilarianya tinggal beberapa mikro-
filaria dalam 3 ml darah malam.
Gejala-gejala klinik filariasis akut maupun menahun berkurang
secara menyakinkan. Efek samping DEC dengan takaran
rendah ini dapat dikatakan tidak ada.
lmmunity in Filariasis
D.A. Higgins
Australian-Indonesian Immunology Project, Pusat Penelitian
Bio Medis, Badan Peneltian dan Pengembangan Kesehatan
Departemen Kesehatan RI.
INTRODUCTION
In Indonesia three parasites of the order Filarioidea are
known to affect man :
Wuchereria bancrofti, Brugia malayi
and
Brugia timori.
They are lymph-dwelling and hence develop an uniquely
intimate relationship with the immune system of the host.
Clinical expressions of filariasis are manifold and include
recurrent febrile episodes associated with lymphangitis and
lymphadenitis,
lymphoedema,
elephantiasis,
hydrocoele,
asymptomatic infections demonstrable by microfilaraemia,
and tropical eosinophilia. In addition a significant proportion
of any exposed community will never develop signs of disease
or parasitism.
Filarial Parasite Antigens
There are three important life cycle stages: the adult worm,
the microfilariae produced by female adult worms, and the
third stage infective larvae (L3) which develop within the
mosquito vector. These worms do not possess secretory glands
such as those shown to be a source of potent antigens in the
intestine-dwelling nematodes (1). Thus the major degree of
host exposure is to the antigens associated with the cuticle or
sheath of these parasites. It is towards these antigens that
attention has been focused and, although crude antibody-
antigen analysis has shown considerable cross reaction between
life cycle stages, between the various species of filarial para-
sites, and between filarial and other nematodes, it now seems
probable that parasites and their life cycle stages possess
highly specific antigens (2). The importance of these stage-
specific antigens in the stimulation of protective immunity or
in the immunopathogenesis of filariasis remains to be proven,
but protection and pathogenesis might be closely linked to
stage-specific reactions.
In addition to antigens associated with the body wall of the
parasite, the possibility of soluble antigens cannot be ruled
out. These could be actively secreted, or metabolic and ex-
cretory products, and could explain the observations of
circulating immune complexes in filariasis (3). In some diseases
secretory products protect the parasite by "diverting" the
host s immune response away from the parasite itself. This
concept is certainly worthy of examination as a mechanism of
survival of the filarial parasites.
Animal Models
Research into the immunobiology of human filariasis is
limited by practical and ethical considerations. Considerable
effort has therefore been expended in the development and
examination of animal models of filariasis. The usefulness of
many of these animal models in immunological research is
sometimes questionable. In many cases no clinical signs of
infection develop, microfilaraemia being used as the sole index
of successful infection. Obviously it is difficult to transpose
results obtained in an unnatural host/parasite relationship to
4 1
Cermin Dunia Kedokteran, Nomor Khusus 1980