[ABSTRAK Tingkat bebas parasit dini merupakan gambaran fungsi dari aktivitas artemisinin. Beberapa faktor yang dianggap berperan terhadap bebas parasit hari pertama setelah pengobatan salah satunya adalah kepadatan parasit sebelum pengobatan. Penelitian ini bertujuan untuk mengetahui hubungan antara kepadatan parasit sebelum pengobatan dengan bebas parasit pada hari pertama setelah pengobatan dihidroartemisinin-piperakuin pada anak dengan malaria tanpa komplikasi di enam propinsi di Indonesia. Desain penelitian ini adalah kohort retrospektif yang dianalisis dengan cox regression dan menggunakan data sekunder efikasi dan keamanan obat dihidroartemisinin-piperakuin (DP) di enam propinsi di Indonesia. Kejadian tidak bebas parasit pada penelitian ini sebesar 31,74%. Terdapat hubungan yang bermakna secara statistik antara kepadatan parasit sebelum pengobatan dengan kejadian bebas parasit setelah hari pertama setelah pengobatan, dimana kepadatan parasit >20000/μl mempunyai risiko tidak bebas parasit sebesar 2,327 kali (CI 95% 1,418-3,820, p-value = 0,001) dibandingkan kepadatan parasit <4000/μl dan kepadatan parasit 4000-20000/μl berisiko tidak bebas parasit sebesar 1,669 kali (CI 95% 1,099-2,533, p-value = 0,016) dibandingkan kepadatan parasit <4000/μl setelah dikendalikan faktor jenis parasit dan wilayah. Kepadatan parasit (μl) dapat dijadikan pemeriksaan standar penderita malaria dan penilaian pengobatan. ABSTRACT Early parasite clearance is the function of artemisinin?s activity. One of the factors that are related to parasite clearance on the first day after treatment is parasite density pre treatment. The aim of this study was to determine the relationship between parasite density pre treatment and parasite clearance on first day after treatment in children with uncomplicated malaria at six provinces in Indonesia. The design of this study was retrospective cohort and analyzed with cox regression and used the secondary data of efficacy and safety of dihydroartemisinin-piperaquine (DP) at six provinces in Indonesia. The proportion of uncleared parasite in this study was 31,74%. There was statically relationship between parasite density pre treatment and parasite clearance on the first day after treatment, where parasite density >20000/μl had uncleared parasite? risk 2,327 times (CI 95% 1,418-3,820, p-value = 0,001) more than parasite density <4000/μl and parasite density 4000-20000/μl had uncleared parasite? risk 1,669 times (CI 95% 1,099-2,533, p-value = 0,016) more than parasite density <4000/μl after controlled by Plasmodium species and region. Parasite density (μl) can be used as standard tests for patients with malaria and treatment evalution., Early parasite clearance is the function of artemisinin’s activity. One of the factors that are related to parasite clearance on the first day after treatment is parasite density pre treatment. The aim of this study was to determine the relationship between parasite density pre treatment and parasite clearance on first day after treatment in children with uncomplicated malaria at six provinces in Indonesia. The design of this study was retrospective cohort and analyzed with cox regression and used the secondary data of efficacy and safety of dihydroartemisinin-piperaquine (DP) at six provinces in Indonesia. The proportion of uncleared parasite in this study was 31,74%. There was statically relationship between parasite density pre treatment and parasite clearance on the first day after treatment, where parasite density >20000/μl had uncleared parasite’ risk 2,327 times (CI 95% 1,418-3,820, p-value = 0,001) more than parasite density <4000/μl and parasite density 4000-20000/μl had uncleared parasite’ risk 1,669 times (CI 95% 1,099-2,533, p-value = 0,016) more than parasite density <4000/μl after controlled by Plasmodium species and region. Parasite density (μl) can be used as standard tests for patients with malaria and treatment evalution.] |