Infeksi Cacing Yang Penting di

Indonesia

Blok Tropmed 2015/2016

Tusy Triwahyuni,S.Si.M.BioMed
 Dunia helminthologi
Bulat memanjang
Nemathelminthes
Terdapat rongga badan
(cacing Terdapat species jantan
gilig;benang) dan betina

Bentuk Pipih
Platyhelminthes Tidak mempunyai rongga
(cacing pipih) badan
Biasanya hermafrodite
 Klasifikasi Besar

Nematoda
Nemathelminthes

Trematoda (Daun)
Platyhelminthes
Cestoda (Pita)
Klasifikasi helminthologi
Infeksi cacing yang penting di
Indonesia
Nematoda
Infeksi STH (USUS)
Filariasis(Jaringan)

Trematoda
Schistosomiasis

Cestoda
Taeniasis
Infeksi cacing usus /STH

Cacing usus/Ascaris lumbricoides

Cacing cambuk/Trichuris Trichiura

Cacing Tambang
(Necator americanus, Ancylostoma
duodenale)
 Habitat

Dewasa di usus halus/telur ada

di tanah/rute fecal -oral

Dewasa di cecum/ telur di

tanah/rute fecal-oral

Dewasa di usus halus/larva

menembus kulit/ oral-
percutaneous
 Life cycle of A. lumbricoides
Human ingested embryonated
egg. In the stomach, larvae
hatch from the eggs. and are
carried via the hepatic portal
vein, then systemic circulation
to the lungs, mature in the
lungs (10 -14 days), penetrate
the alveolar walls, ascend the
bronchial tree to the throat,
and are swallowed.
Once swallowed, they reach the
intestines and develop into
adults worms. Adult female
worms lay eggs that are then
passed in feces; this cycle will Eggs are passed in the stool.
take between 2 3 months Unfertilized eggs may be ingested but
not infective.
 After 10-14 days in soil, eggs
Life cycle become infective. Trichuriasis
is transmitted by the fecal-oral
route, as with A lumbricoides,
but in contrast to this parasite
and to hookworm no tissue
migratory phase occurs.
Larvae hatch in the small
intestine, where they grow
and molt, finally taking up
residence in the large
intestine.
The time from ingestion of
eggs to development of
mature worms is
approximately 3 months. Adult
females lay eggs for up to 5
years.
 Hookworm
Hookworm eggs require warm, moist,
shaded soil to hatch into larvae.
These barely visible larvae
penetrate the skin (often through
bare feet), are carried to the lungs,
go through the respiratory tract to
the mouth, are swallowed, and
eventually reach the small
intestine. This journey takes about
a week. In the small intestine, the
larvae develop into half-inch-long
worms, attach themselves to the
intestinal wall, and suck blood. The
adult worms produce thousands of
eggs. These eggs are passed in
the feces (stool). If the eggs
contaminate soil and conditions
are right, they will hatch, molt, and
develop into infective larvae again
after 5 to 10 days.
Gejala Klinis yang khas

Malnutrisi/3L/lose apetite

Diare disertai pus

Hypoprotein/anemia
 Diagnosis dan Pengobatan
Pemeriksaan telur dalam tinja

Treatment:
Albendazole 400 mg (single dose)
Mebendazole -100 mg (twice a day for
consecutive days)
 Tusy Triwahyuni S.Si,M.Biomed
Departemen Parasitologi Unmal
 Definisi
Filariasis adalah penyakit menular ( Penyakit Kaki Gajah ) yang
disebabkan oleh cacing Filaria yang ditularkan oleh berbagai
jenis nyamuk(culex,anopheles,mansonia).
Penyakit ini bersifat menahun ( kronis ) dan bila tidak
mendapatkan pengobatan
dapat menimbulkan cacat menetap
berupa pembesaran kaki, lengan
dan alat kelamin baik perempuan
maupun laki-laki.
 Etiologi
Filariasis disebabkan oleh cacing filarial yang menyerupai benang yang
hidup didalam tubuh manusia.
Cacing ini dapat bertahan hidup selama 4-6 tahun dalam kelenjar
getah bening ( bagian tubuh yang melindungi kita dari penyakit)
Cacing ini berkembang biak di dalam tubuh daan menghasilkan
jutaan anak cacing yang beredar dalam darah.
Filariasis disebabkan oleh
tiga jenis cacing filarial yaitu :
Wuchereria Bancrofli, Brugia
Malayi dan Brugia Tintori.
Penderita Filariasis
 Gejala klinis Filariais Akut
a. Demam berulang-ulang selama 3 - 5 hari
b. pembengkakan kelenjar getah bening (tanpa ada luka)
didaerah lipatan paha, ketiap (lymphadenitis) yang tampak
kemerahan, panas dan sakit ;
c. radang saluran kelenjar getah
bening yang terasa panas dan
sakit yang menjalar dari pangkal
kaki atau pangkal lengan kearah
ujung (retrograde lymphangitis) ;
 pengobatan filariasis
DEC (Diethil Carbamazine Citrate)
adalah satu satunya obat yang
ampuh, sifatnya membunuh
mikrofilaria dan makrofilaria (cacing
dewasa)
Schistosomiasis

Tusy Triwahyuni. S.Si.M.BioMed

 Introduction
Schistosomiasis important disease problem
in several asian countries.
Schistosoma, from the class of trematodes
constitute a genus commonly known as blood-
flukes, are the parasites causing a disease
called bilharzias
schistosomiasis which, according to the WHO
(2010) is amongst the most devastating
parasitic disease, second only to malaria, with
207 million infected and around 700 million at
risk
Life cycle
 The Species
Onchomelania Schistosoma Schistosoma
Hupensis lindoensis
japonicum mansoni Biomphalaria spp.

Schistosoma Schistosoma
Bulinus spp. haematobium intercalatum Bulinus forskalii

Schistosoma
mekongi

Neotricula aperta
 Habitat

S.Japonicum di vena S. Mansoni di vena

mesentarika superior mesenterica inferior
usus halus colon

S.Haematobium di vena
kandung kemih
 Clinical symptom of Schistosomiasis
Schistosoma haematobium
Causes urinary schistosomiasis Schistosoma mansoni
Causes intestinal schistosomiasis
1. PREPATENT PERIOD 10-12 wks
2. EGG DEPOSITION AND EXTRUSION:
1. painless haematuria 1. PREPATENT PERIOD 5-7 wks
2. Inflammation of bladder and 2. EGG DEPOSITION AND
burning micturition EXTRUSION:
3. TISSUE PROLIFERATION AND 1. dysentery (blood and mucus in
REPAIR: stools),
Fibrosis , papillomata in the bladder 2. hepatomegaly splenomegaly
and lower ureter leading to 3. TISSUE PROLIFERATION AND
obstructive uropathy. REPAIR:Fibrosis ,
Periportal fibrosis Papillomata in intestine,
Lung and CNS involvement Pperiportal
fibrosis,hematemesis
Lung and CNS involvement.
 Patogenesis
Serkaria menembus kulit gatal-gatal.
Stadium Akut; telur ada di hati
pseudoabses pseudotuberkel dan jaringan
ikat.
Stadium menahun penyembuhan
jaringan pembentukan fibrosis hepar
(pembesaran) terjadi pengecilan sirosis
periportal/ hipertensi periportal
splenomegali, asites dan ikterus
 Hepatosplenomegaly in
cronic case

Swimmwer itch ,

Schistosomisasis
penetrated serkaria fork
tailed
 Diagnosis of Schistosomiasis
Schistosoma haematobium Schistosoma mansoni
Parasitological: Parasitological
Examination of urine Examination of stools
Immunological Immunological
Serological tests Serological tests
Indirect: Indirect:
Radiological Radiological
Cystoscopy endoscopy
Drug of choice for schistosomiasis is
Praziquantel
TAENIASIS
 Pendahuluan
Taenia Sp, agen penyebab taeniasis
dan sistiserkosis

Tiga Spesies penting, T.solium,

T.saginata, T Asiatica

Distribusi Spesies menjadi penting

untuk epidemiologi &kontrol penyakit
 Indonesia :
- endemic with 3 species of human Taenia tapeworm
- North Sumatra, Bali and Papua
- Timor, Flores, North Sulawesi, West Kalimantan and South
Sumatra
- 23% of pork liver samples in Bali were found to contain T.
Asiatica metacestodes

2003-2006 : 371 local people in Samosir Island :

- 6 of 240 (2.5%) infected with T. asiatica
- 2 of 58 (3.4%) and 4 of 182 (2.2%) cases in 2003 and 2005
Siklus Hidup
 DIAGNOSIS
Menemukan proglotid dalam tinja
Menemukan telur dalam tinja (Jarang)
Deteksi antibodi denganUji Elisa
Deteksi DNA dengan PCR
 Pengobatan dan pencegahan
Prazikuantel dan albendazole
Hindari makan daging yang kurang matang
( Sate, steak, Shabu Shabu sirloin,dll)
THANKS FOR ATTENTION