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Profil Dehabilitasi Pasien Kusta di Rumah Sakit Kusta Alverno Singkawang: Studi Pendahuluan Sri Linuwih Susetyo Wardhani Menaldi; Valensia Vivian The; Inosensia Diajeng Kusumo; Melani Marissa
eJournal Kedokteran Indonesia Vol 9, No. 1 - April 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (410.164 KB) | DOI: 10.23886/ejki.9.24.30

Abstract

Abstrak Kusta dapat menyebabkan disabilitas permanen yang memengaruhi fisik dan psikis pasien. Stigmadiri dan stigma sosial menyebabkan pasien mengalami dehabilitasi yang dapat menurunkan kualitashidup penyandangnya. Penelitian ini merupakan studi pendahuluan yang bertujuan untuk mendapatkanprofil dehabilitasi pasien kusta termasuk orang yang pernah mengalami kusta (OYPMK). Penelitian inimenggunakan metode potong lintang untuk menilai profil dehabilitasi pasien kusta dan OYPMK menggunakanskala dehabilitasi Anandaraj di RS Kusta Alverno Singkawang, bulan Juli 2019. Delapan puluh delapan subjekdiikutkan dalam penelitian ini. Analisis data dilakukan menggunakan uji Mann Whitney untuk menilai hubungantipe kusta dan derajat dehabilitasi, serta uji Kruskal Wallis untuk melihat hubungan antara reaksi kusta danderajat disabilitas terhadap skala dehabilitasi. Analisis dilakukan menggunakan perangkat lunak SPSS formac. Subjek terbanyak adalah laki-laki, usia produktif, bekerja sebagai petani, berpenghasilan kurang dari 1,5juta per bulan, tidak bersekolah, sudah menikah, etnis Tionghoa, tinggal di dalam rumah yang padat, memilikikeluarga serumah yang menderita kusta, terdiagnosis kusta tipe multibasiler, pernah mengalami reaksi dantelah menyelesaikan pengobatan. Dari penelitian ini didapatkan bahwa tipe kusta dan disabilitas derajat noldan dua berhubungan dengan skala dehabilitasi Anandaraj (p<0.05). Stigma terhadap kusta hingga kinimerupakan masalah yang belum dapat diatasi. Stigma dan disabilitas akibat kusta berperan penting terhadapkejadian dehabilitasi yang menyebabkan penurunan kualitas hidup pasien kusta dan OYPMK. Kata kunci: Anandaraj, dehabilitasi, kusta, Singkawang.   Dehabilitation Profile of Leprosy Patients in Alverno Singkawang Hospital: a Preliminary Study Abstract Leprosy causes permanent disability that affects both physical and psychological aspect of the patient.Self-stigma and social stigma cause dehabilitation; therefore, reducing the quality of life of the patients. Thisresearch is a preliminary study to assess the dehabilitation profile of leprosy patients, including people whohave had leprosy (OYPMK). A cross-sectional method was used to assess the dehabilitation scale of leprosypatients in Alverno Leprosy Hospital, Singkawang, using the Anandaraj dehabilitation scale. Eighty-eightsubjects were included in the analysis. Mann-Whitney test was done to analyze the association betweentype of leprosy and dehabilitation scale, and Kruskal Wallis test was done to analyze the association betweenleprosy reaction and grade of disability with dehabilitation scale. Most subjects are male, productive age,farmers, less than 1.5 million wages per month, uneducated, married, Chinese ethnicity, living in a crowdedhouse, had a family with leprosy, diagnosed with multibacillary leprosy, had an episode of leprosy reaction danreleased from treatment. Type of leprosy and WHO disability grade 0 and 2 are related to the dehabilitationscale. Leprosy stigmatization is still a worrisome problem. Together with the disability, stigmatization affectsthe dehabilitation scale of leprosy patients leading to reduced quality of life. Keywords: Anandaraj, dehabilitation, leprosy, Singkawang.
KEGAGALAN TERAPI PADA KUSTA TIPE LEPROMATOSA DAN FAKTOR YANG MEMENGARUHINYA: SEBUAH LAPORAN KA Joanne Natasha; Sri Linuwih Menaldi; Melani Marissa; Rizka Farah Hilma
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.339

Abstract

Children is a group that is nine times more likely to contract leprosy. The finding of new cases of leprosy in children is a strong indicator that indicates the disease transmission is still ongoing. World Health Organization (WHO) in 2019 reported 14,981 out of 202,185 (7.4%) new cases of children. Cases of resistance to multidrug therapy (MDT) can be primary or secondary. It is important to detect drug resistance earlier considering children’s quality of life would be affected by leprosy complication. A 14 years old girl from Lebak Regency, Rangkasbitung, Banten was diagnosed as lepromatous type (LL) leprosy and a second grade disability on the 5th finger of her left hand. Unimproved clinical and increasing the morphological index (IM) on the 9th month of treatment from 0.16% to 1%, leading the patient experience the drug resistance. The polymerase chain reaction (PCR) examination did not show any mutation in the RpoB gene. Inadequate and irregular MDT consumption have the potential to cause secondary resistance and the risk of becoming primary resistance later. It is not easy to determine drug resistance in endemic areas. Morphological index monitoring should be closely watched before treatment is complete thus the modified therapy can be given earlier.
DIAGNOSIS DAN TATA LAKSANA KEKAMBUHAN KUSTA Caroline Oktarina; Melani Marissa; Wresti Indriatmi; Sri Linuwih Menaldi
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.340

Abstract

Leprosy relapse is defined as the reappearance of leprosy’s signs and symptoms following completion of adequate Multidrug Therapy (MDT) regimen. Indonesia is the third biggest contributor for leprosy relapse with 284 cases in 2018. Several factors contribute to the occurrence of relapse, which include presence of persisters, history of inadequate therapy, drug resistance, history of irregular treatment, history of dapsone monotherapy, high initial bacteriological index, high number of skin and nerve lesions, negative lepromin test, history of antireaction therapy, human immunodeficiency virus (HIV) infection, and pregnancy. Diagnosis of relapse can be established based on clinical, bacteriological, and therapeutic criteria, also histopathological and serological criteria, if possible. With those criteria, it should be easier to differentiate relapse from reaction, resistance, reactivation, and reinfection. The principal management for leprosy relapse is re-administration of MDT according to the type of relapse; however, therapy should be modified if there are any evidences of drug resistance. Things which are important to be taken into account during relapse treatment are leprosy type, past medication history, and the possibility of drug resistance. With proper knowledge and diagnostic algorithm, it is expected that the treatment can be administered immediately in order to prevent disability and transmission of infection.