Latar belakang Infeksi malaria dalam kehamilan berefek serius terhadap ibu hamil maupun janin. Di Purworejo, Jawa Tengah dimana transmisi malaria terjadi sepanjang tahun dan tergantung musim, program pencegahan malaria belum difokuskan pada wanita hamil. Penelitian mengenai infeksi malaria dalam kehamilan masih sangat jarang dilakukan di Indonesia.Tujuan : Mengetahui karakteristik kasus malaria pads wanita usia reproduksi dan hubungan yang valid antara kehamilan dengan infeksi malaria pada wanita usia reproduksi di Indonesia. Metode: disain penelitian Studi Kasus Kontrol tidak berpadanan. Responden adalah wanita usia 15-49 tahun yang datang ke tempat pelayanan kesehatan di 9 kecamatan endemis di Kabupaten Purworejo, Jawa Tengah. Penelitian dilakukan bulan Juni-Juli 2003 dengan metode wawancara dan pengambilan sediaan apus darah tebal dan tipis.Hasil : Terdapat 1065 subjek terdiri dari 64 kasus (4531% adalah wanita hamil) dan 1001 kontrol (33,17% hamil). Jenis parasit malaria menginfeksi adalah Pfalciparum (46.88%) dan sisanya P.vivax. kasus malaria asimptomatik terdapat pada 24 kasus (37.40%) dan dari 29 kasus wanita hamil sebanyak 44.83% asimptomatik. Wanita yang tinggal di daerah LCI dan tidak beraktivitas keluar rumah di malam hari bila hamil memiliki OR 6.42 (CI 95 % 1.34-30.79) dibandingkan wanita tidak hamil. Wanita hamil yang tinggal di daerah LCI namun beraktivitas keluar rumah di malam hari akan meningkat risikonya secara bermakna menjadi 27 kali (OR 27.39; CI 95 % 4.79-156.44) dibandingkan wanita tidak hamil yang tinggal di daerah dan memiliki aktivitas yang sama. Wanita yang tinggal di daerah dengan tingkat transmisi sedang (MCI) dan keluar rumah di malam hari, bila hamil memiliki OR 5.35 (CI 95 % 1.85-1232) dibandingkan wanita tidak hamil.Kesimpulan : Kehamilan meningkatkan resiko untuk terkena malaria pada wanita usia reproduksi dan efeknya bcrbeda menurut aktivitas dan tingkat transmisi malaria daerah tempat tinggal. Program malaria perlu dimasukkan dalam pelayanan ANC pada program KIA.
Pregnancy as a Risk Factor of Malaria Infection among Women at Reproductive Age in Purwerejo Distric, Central Java, 2003Background : Malaria in pregnancy has serious effect for pregnant women and the fetus. In Purworejo where malaria is perennial and highly seasonal, malaria's program not yet focusing on pregnant women. Recently study about malaria and pregnancy still rare in Indonesia. Objective : To examine the characteristic of malaria cases among women at reproductive age and to prove the valid relationship between pregnancy and malaria infection among them.Methods : Unmatched case control study. Subjects were collected from women (15-49 years old) who visited primaries health cares in 9 endemic subdistricts in Purworejo district, Central Java. Research was held on June - July 2003, by interviewing respondent using questionnaire and taking thick and thin blood smears.Results: There were 64 cases (45.31% were pregnant) and 1001 controls (33.17% were pregnant). 46.88% cases were infected by P. falciparum and the rest were by P.vivax. There were 37.40% asymptomatic cases from all cases and 44.83% asymptomatic cases from 29 eases who were pregnant. Compare with nonpregnant women who lives in LCI areas and has no outdoor activity at night, pregnant woman who lives in the same areas and same activity, have risk 6 times fold to have malaria infection (OR 6.42; CI 95 % 1.34-30.79). But if pregnant woman, who lives in LCI areas, has outdoor activity at night then the risk become 27 times fold (OR 27.39%; CI 95 % 4.79-156.44) compare to nonpregnant women who lives in the same area and same activity. Woman who lives in MCI areas and has outdoor activity at night, if she become pregnant then she will have OR 5.35 (CI 95 % 1.85-12.72) than nonpregnant woman.Conclusion: Pregnancy has a significant effect with malaria infection and the effect depend on the outdoor activity at night and level of malaria transmission of the living area. |
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