Karakteristik Kasus Fatal Akibat Gigitan Hewan Penular Rabies di Indonesia 2016 – 2017
Characteristics of Fatal Human Rabies Cases in Indonesia 2016 - 2017
Abstract
Abstract
Rabies is a zoonotic disease that is transmitted to humans by bites or scratches or licks (on damaged skin or mucous membranes) from infected animals, most often dogs. Rabies is endemic in several regions in Indonesia. If untreated, bites of rabies will cause fatal. The aim of this analysis is to explore the characteristics of fatal human cases caused by the bites of rabies transmitting animal in Indonesia in 2016–2017. The collection of human case data with bites of rabies transmitting animals (GHPR) from all provinces of Indonesia in 2016 and 2017 by the zoonotic Subdirectorate, Directorate Pencegahan dan Pengendalian Penyakit Tular Vektor dan Zoonosis (P2PTVZ), Directorat General of Disease Prevention and Control. We analyzed tha characteristics of the provincial which was reported GHPR cases, incubation period, bite location, clinical symptoms, history of vaccination and the demography of fatal GHPR cases. The clinical case definition for GHPR based on the World Health Organization. The results show that GHPR cases were reported from 25 out of 34 provinces. The most frequently reported incubation period is 1-2 month (40.7%). The location of most bites on the legs (37.3%). Most clinical symptoms reported were hydrophobia (76.6%), followed by hypersalivation (64.5%), convulsion (35.5%), photophobia and hyperhidrosis respectively (31.2%). Fever is not the main symptom, only 19.9%. Most fatal GHPR cases do not receive appropriate vaccination post-exposure (VAR). Male as fatal GHPR cases are more often than women with ratio 1.8 to 1 and adult cases more than children. Inconclusions immediate treatment with complete post-exposure vaccination has not been well implemented in reported fatal GHPR cases.
Abstrak
Rabies merupakan salah satu penyakit zoonosis yang ditularkan ke manusia melalui gigitan atau goresan atau jilatan (pada kulit yang rusak atau selaput lendir) dari hewan yang terinfeksi, paling sering anjing. Rabies endemis di beberapa daerah di Indonesia. Jika tidak ditangani, gigitan hewan rabies dapat menyebabkan kematian. Tujuan dari penulisan ini untuk memberi informasi karakteristik kasus manusia yang fatal akibat gigitan hewan penular rabies (GHPR) di Indonesia selama kurun waktu 2016- 2017. Pengumpulan data kasus manusia dengan gigitan hewan penular rabies dari seluruh provinsi Indonesia pada tahun 2016 dan 2017 dilakukan oleh Subdirektorat Zoonosis, Direktorat Pencegahan dan Pengendalian Penyakit Tular Vektor dan Zoonosis (P2PTVZ), Direktorat Jenderal Pencegahan dan Pengendalian Penyakit (P2P). Analisis karakteristik kasus GHPR fatal meliputi aspek provinsi yang melaporkan kasus GHPR, masa inkubasi, lokasi gigitan, gejala klinis, riwayat pemberian vaksinasi dari kasus fatal dan demografi. Definisi kasus GHPR secara klinis berdasarkan Organisasi Kesehatan Dunia. Hasil menunjukkan bahwa kasus GHPR dilaporkan di 25 dari 34 provinsi. Masa inkubasi yang paling sering dilaporkan yaitu 1-2 bulan (40,7%). Lokasi gigitan terbanyak pada kaki (37,3%). Gejala klinis terbanyak yang dilaporkan hidrofobia (76,6%), diikuti dengan hipersalivasi (64,5%), kejang (35,5%), fotofobia dan hiperhidrosis masing-masing (31,2%). Demam bukan gejala utama, hanya 19,9%. Sebagian besar kasus GHPR fatal tidak mendapatkan vaksinasi pascapajanan (VAR) yang sesuai. Kasus GHPR fatal pada laki-laki lebih banyak daripada perempuan dengan perbandingan 1,8 : 1 dan jumlah orang dewasa lebih banyak dibandingkan dengan anak-anak. Disimpulkan bahwa pengobatan segera dengan pemberian vaksinasi pascapajanan secara lengkap belum dilaksanakan dengan baik pada kasus-kasus GHPR fatal yang dilaporkan.
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