Karakteristik Klinis dan Epidemiologis Avian Influenza A (H5N1) Anak Di Indonesia, Tahun 2005-2007
Sari
Latar belakang. Indonesia merupakan negara tertinggi di dunia yang melaporkan kasus avian influenza
A(H5N1) dengan proporsi kematian yang tinggi (83%). Sampai saat ini belum banyak penelitian kasus
avian influenza A(H5N1) anak di Indonesia.
Tujuan. Mengetahui pola epidemiologis, klinis, laboratoris, dan radiologis dalam hubungannya dengan
kesembuhan atau kematian kasus avian influenza A (H5N1) anak.
Metode. Studi retrospektif dari 37 kasus konfirmasi avian influenza anak di Indonesia berdasarkan data
Badan Litbangkes dan Dirjen P2PL, Depkes RI serta WHO Indonesia dan disajikan secara deskriptif.
Hasil. Riwayat kontak secara langsung dan tidak langsung dengan unggas (37,84%) sebanding dengan
kontak pada kasus konfirmasi avian influenza (35,14%), 12 kasus diantaranya merupakan anggota kluster
keluarga. Kasus terbanyak pada kelompok umur 5-<12 tahun (50,62%). Domisili kasus anak terutama di
tiga propinsi Indonesia yaitu DKI Jakarta, Jawa Barat dan Banten. Proporsi kematian avian influenza anak
Indonesia lebih rendah (67,57%) dibanding proporsi kematian nasional (82,8%) tetapi masih sedikit lebih
tinggi dari proporsi kematian global (59,45%). Gejala klinis utama yaitu demam (100%), batuk (86,49%),
sesak (81,08%), serta penurunan kesadaran (62,16%). Pneumonia terjadi pada 59,46% kasus dengan proporsi
kematian 68,18%. Kelompok yang mendapat oseltamivir (37%) mempunyai peluang hidup lebih besar
dari pada kelompok yang tidak mendapat oseltamivir (20%), demikian pula lama awitan sakit dan dosis
awal oseltamivir pada kelompok nonfatal lebih pendek (median 5,5 hari dengan rentang waktu 2-10 hari)
dibanding kelompok yang fatal (median 8,5 hari, rentang 3-22 hari) menunjukkan makin cepat mendapat
terapi oseltamivir memberi peluang hidup lebih baik.
Kesimpulan. Spektrum klinis avian influenza yang luas menempatkan penyakit ini sebagai diagnosis banding
yang perlu dipertimbangkan termasuk kematian yang tidak jelas penyakitnya pada kluster keluarga atau
sakit berat lainnya. Terapi oseltamivir memberi peluang hidup lebih baik disamping penemuan kasus dini
serta perawatan secepatnya.
Kata Kunci
Teks Lengkap:
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DOI: http://dx.doi.org/10.14238/sp12.5.2011.347-58
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