Malaria: Perbedaan antara revisi
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{{Infobox disease
| Name = Malaria
| Image = Malaria.jpg
| Caption = Sebuah ''Plasmodium'' dari air ludah nyamuk betina bergerak melalui sel nyamuk
| field = [[Infectious disease (medical specialty)|Infectious disease]]
| ICD10 = {{ICD10|B|50||b|50}}-{{ICD10|B|54||b|54}}
| ICD9 = {{ICD9|084}}
| DiseasesDB = 7728
| MedlinePlus = 000621
| OMIM = 248310
| eMedicineSubj = med
| eMedicineTopic = 1385
| eMedicine_mult = {{eMedicine2|emerg|305}} {{eMedicine2|ped|1357}}
| MeshName = Malaria
| MeshNumber = C03.752.250.552
|Orphanet=673
}}
<!-- Definisi dan gejala -->
'''Malaria''' adalah penyakit yang ditularkan oleh nyamuk dari manusia dan hewan lain yang disebabkan oleh [[protozoa]] parasit (sekelompok [[mikroorganisme]] bersel tunggal) dalam [[Genus|tipe]] ''[[Plasmodium]]''.<ref name="WHO2014" /> Malaria menyebabkan gejala yang biasanya termasuk [[demam]], kelelahan, [[muntah]], dan [[sakit kepala]].<!-- <ref name="Caraballo 2014"/> --> Dalam kasus yang parah dapat menyebabkan [[penyakit kuning|kulit kuning]], [[kejang]], [[Koma (medis)|koma]], atau [[kematian]].<ref name="Caraballo 2014"/> Gejala biasanya muncul sepuluh sampai lima belas hari setelah digigit.<!-- <ref name=WHO2014/> --> Jika tidak diobati, penyakit mungkin kambuh beberapa bulan kemudian.<ref name=WHO2014/> Pada mereka yang baru selamat dari infeksi, infeksi ulang biasanya menyebabkan gejala ringan.<!-- <ref name="Caraballo 2014"/> --> [[Imunitas (medis)|resistensi]] parsial ini menghilang selama beberapa bulan hingga beberapa tahun jika orang tersebut tidak terpapar terus-menerus dengan malaria.<ref name="Caraballo 2014">{{cite journal |author=Caraballo H |title=Emergency department management of mosquito-borne illness: Malaria, dengue, and west nile virus |journal=Emergency Medicine Practice |year=2014 |volume=16 |issue=5 |url=http://www.ebmedicine.net/topics.php?paction=showTopic&topic_id=405}}</ref>
<!--Penyebab dan diagnosis-->
Penyakit ini paling sering ditularkan oleh nyamuk ''[[Anopheles]]'' betina yang terinfeksi.<!-- <ref name=WHO2014/> --> Gigitan nyamuk memasukkan [[parasit]] dari air liur nyamuk ke dalam [[Sistem sirkulasi|darah]] seseorang.<ref name=WHO2014/> Parasit bergerak ke hati di mana mereka dewasa dan bereproduksi.<!-- <ref name="Caraballo 2014"/> --> Lima spesies ''Plasmodium'' dapat menginfeksi dan disebarkan oleh manusia.<ref name="Caraballo 2014"/> Sebagian besar kematian disebabkan oleh ''[[Plasmodium falciparum|P. falciparum]]'' karena ''[[Plasmodium vivax|P. vivax]]'', ''[[Plasmodium ovale|P. ovale]]'', and ''[[Plasmodium malariae|P. malariae]]'' umumnya menyebabkan bentuk yang lebih ringan dari malaria.<ref name=WHO2014/><ref name="Caraballo 2014"/> Spesies ''[[Plasmodium knowlesi|P. knowlesi]]'' jarang menyebabkan penyakit pada manusia.<ref name=WHO2014/> Malaria biasanya didiagnosis dengan pemeriksaan mikroskopis darah menggunakan [[film darah]], atau dengan [[Tes deteksi antigen malaria|uji diagnostik cepat]] berdasarkan-[[antigen]].<ref name="Caraballo 2014"/> Metode yang menggunakan [[reaksi berantai polimerase]] untuk mendeteksi [[DNA]] parasit telah dikembangkan, tetapi tidak banyak digunakan di daerah di mana malaria [[Endemik (epidemiologi)|umum]] karena biaya dan kompleksitasnya.<ref name="Nadjm 2012">{{Cite journal |author=Nadjm B, Behrens RH |title=Malaria: An update for physicians |journal=Infectious Disease Clinics of North America |year=2012 |volume=26 |issue=2 |pages=243–59 |pmid=22632637 |doi=10.1016/j.idc.2012.03.010}}</ref>
<!--Pencegahan dan penanganan-->
Risiko penyakit dapat dikurangi dengan mencegah gigitan nyamuk dengan menggunakan [[kelambu]] dan [[penolak serangga]], atau dengan tindakan kontrol-nyamuk seperti penyemprotan [[insektisida]] dan menguras genangan air.<ref name="Caraballo 2014"/> Beberapa obat tersedia untuk [[Profilaksis malaria|mencegah malaria]] pada wisatawan ke daerah di mana penyakit umum.<!-- <ref name=WHO2014/> --> Dosis sesekali obat [[sulfadoksin/pirimetamin]] direkomendasikan pada [[bayi]] dan setelah [[trimester pertama]] kehamilan di daerah dengan tingkat malaria tinggi.<!-- <ref name=WHO2014/> --> Meskipun adanya kebutuhan, tidak ada [[vaksin]] yang efektif, meskipun upaya untuk mengembangkannya sedang berlangsung.<ref name=WHO2014/> Pengobatan yang direkomendasikan untuk malaria adalah kombinasi [[obat antimalaria]] yang mencakup [[artemisinin]].<ref name=WHO2014/><ref name="Caraballo 2014"/> Obat kedua mungkin baik [[meflokuin]], [[lumefantrin]], atau [[sulfadoksin/pirimetamin]].<ref name=WHO2010>{{cite book|last1=Organization|first1=World Health|title=Guidelines for the treatment of malaria|date=2010|publisher=World Health Organization|location=Geneva|isbn=9789241547925|page=ix|edition=2nd}}</ref> [[Kuinin]] bersama dengan [[doksisiklin]] dapat digunakan jika artemisinin tidak tersedia.<ref name=WHO2010/> Direkomendasikan bahwa di daerah di mana penyakit ini umum, malaria dikonfirmasi jika mungkin sebelum pengobatan dimulai karena kekhawatiran peningkatan [[resistensi obat]].<!-- <ref name=WHO2014/> --> Resistensi parasit telah berkembang untuk beberapa obat antimalaria; misalnya, ''P. falciparum'' resisten-[[klorokuin]] telah menyebar ke sebagian besar wilayah malaria, dan ketahanan terhadap artemisinin telah menjadi masalah di beberapa bagian Asia Tenggara.<ref name=WHO2014>{{cite web|title=Malaria Fact sheet N°94|url=http://www.who.int/mediacentre/factsheets/fs094/en/|website=WHO|accessdate=28 August 2014|date=March 2014}}</ref>
<!--Epidemiologi, masyarakat, dan budaya-->
Penyakit ini tersebar luas di daerah [[Tropika|tropis]] dan [[subtropis]] yang ada di pita lebar sekitar [[khatulistiwa]].<ref name="Caraballo 2014"/> Ini termasuk banyak dari [[Afrika Sub-Sahara]], [[Asia]], dan [[Amerika Latin]].<!-- <ref name=WHO2014/> --> Pada 2015, ada 214 juta kasus malaria di seluruh dunia.<ref name=WHO15>{{cite web|title=Malaria Fact sheet N°94|url=http://www.who.int/mediacentre/factsheets/fs094/en/|publisher=WHO|accessdate=2 February 2016}}</ref> Hal ini mengakibatkan sekitar 438.000 kematian, 90% di antaranya terjadi di Afrika.<ref name=WHO15/> Tingkat penyakit menurun dari tahun 2000 hingga 2015 sebesar 37%,<ref name=WHO15/> namun meningkat dari 2014 di mana ada 198 juta kasus.<ref name=WHO2014Book>{{cite book|last1=WHO|title=World Malaria Report 2014|date=2014|publisher=World Health Organization|location=Geneva, Switzerland|isbn=978-92-4156483-0|pages=32–42|url=http://www.who.int/entity/malaria/publications/world_malaria_report_2014/en/index.html}}</ref> Malaria umumnya terkait dengan kemiskinan dan memiliki efek negatif yang besar pada [[pembangunan ekonomi]].<ref name="IftSoL"/><ref name="Worrall 2005"/> Di Afrika, malaria diperkirakan mengakibatkan kerugian sebesar US$12 miliar setahun karena meningkatnya biaya kesehatan, kehilangan kemampuan untuk bekerja, dan efek negatif pada pariwisata.<ref name="Greenwood 2005"/>
==Tanda-tanda dan gejala==
[[File:Symptoms of Malaria.png|thumb|250px|Gejala utama dari malaria<ref name="PPID 2010"/>]]
Tanda-tanda dan gejala malaria biasanya mulai 8-25 hari setelah terinfeksi;<ref name="PPID 2010"/> namun, gejala dapat terjadi kemudian pada orang-orang yang telah mengambil obat antimalaria sebagai pencegahan.<ref name="Nadjm 2012"/> Manifestasi awal dari penyakit—umum untuk semua spesies malaria—mirip dengan gejala [[flu]],<ref name="Bartoloni 2012"/> dan dapat menyerupai kondisi lain seperti [[sepsis]], [[gastroenteritis]], dan [[penyakit virus]].<ref name="Nadjm 2012"/> Presentasi mungkin termasuk [[sakit kepala]], [[demam]], [[menggigil]], [[artralgia|nyeri sendi]], [[muntah]], [[anemia hemolitik]], [[penyakit kuning]], [[hemoglobinuria|hemoglobin dalam urin]], [[Retinopati|kerusakan retina]], dan [[kejang|kejang-kejang]].<ref name="Beare 2006"/>
Gejala klasik malaria adalah [[paroksismal]]—kejadian bersiklus kedinginan tiba-tiba diikuti dengan menggigil dan kemudian demam dan berkeringat, terjadi setiap dua hari ([[Demam#Jenis-jenis|demam tertiana]]) di infeksi ''P. vivax'' dan ''P. ovale'', dan setiap tiga hari ([[Demam#Jenis-jenis|demam kuartana]]) untuk ''P. malariae''. Infeksi ''P. falciparum'' dapat menyebabkan demam berulang setiap 36-48 jam, atau demam kurang menonjol dan hampir terus menerus.<ref name="Ferri 2009"/>
Malaria berat biasanya disebabkan oleh ''P. falciparum'' (sering disebut sebagai malaria falciparum). Gejala malaria falciparum timbul 9-30 hari setelah terinfeksi.<ref name="Bartoloni 2012"/> Individu dengan malaria serebral sering menunjukkan gejala [[Gangguan neurologis|neurologis]], termasuk [[postur abnormal]], [[nistagmus]], [[kelumpuhan tatapan konjugat]] (kegagalan mata untuk bergerak bersama-sama dalam arah yang sama), [[opistotonus]], [[kejang]], atau [[Koma (medis)|koma]].<ref name="Bartoloni 2012"/>
==
Malaria memiliki beberapa [[Komplikasi (kedokteran)|komplikasi]] yang serius. Di antaranya adalah pengembangan [[gangguan pernapasan]], yang terjadi di hingga 25% dari orang dewasa dan 40% dari anak-anak dengan malaria ''P. falciparum'' parah. Kemungkinan penyebab termasuk kompensasi pernapasan [[asidosis metabolik]], [[edema paru]] nonkardiogenik, [[pneumonia]] bersamaan, dan [[anemia]] berat. Meskipun jarang terjadi pada anak-anak dengan malaria berat, [[sindrom gangguan pernapasan akut]] terjadi pada 5-25% dari orang dewasa dan sampai 29% dari wanita hamil.<ref name="Taylor 2012"/> [[Koinfeksi]] [[HIV]] dengan malaria meningkatkan angka kematian.<ref name="Korenromp 2005"/> Gagal ginjal adalah fitur dari [[demam blackwater]], di mana hemoglobin dari sel darah merah yang [[Lisis|pecah]] bocor ke dalam urin.<ref name="Bartoloni 2012"/>
Infeksi ''P. falciparum'' dapat mengakibatkan malaria serebral, bentuk malaria berat yang melibatkan [[ensefalopati]]. Hal ini terkait dengan memutihnya retina, yang mungkin merupakan tanda klinis yang berguna dalam membedakan malaria dari penyebab lain dari demam.<ref name="Beare 2011"/> Splenomegali, sakit kepala parah, [[hepatomegali]] (pembesaran hati), [[hipoglikemia]], dan hemoglobinuria dengan [[gagal ginjal]] dapat terjadi.<ref name="Bartoloni 2012"/> Komplikasi dapat mencakup perdarahan spontan dan koagulopati. Dapat menyebabkan syok.<ref>Davidson's Principles and Practice of Medicine/21st/351</ref>
[[Malaria terkait-kehamilan|Malaria pada ibu hamil]] merupakan penyebab penting dari [[lahir mati]], [[kematian bayi]], [[aborsi]] dan [[berat badan lahir rendah]],<ref name="Hartman 2010"/> terutama pada infeksi ''P. falciparum'', tetapi juga dengan ''P. vivax''.<ref name="Rijken 2012"/>
==
{{
[[Parasit]] malaria termasuk dalam genus ''[[Plasmodium]]'' (filum [[Apicomplexa]]). Pada manusia, malaria disebabkan oleh ''[[Plasmodium falciparum|P. falciparum]]'', ''[[Plasmodium malariae|P. malariae]]'', ''[[Plasmodium ovale|P. ovale]]'', ''[[Plasmodium vivax|P. vivax]]'' dan ''[[Plasmodium knowlesi|P. knowlesi]]''.<ref name="Mueller 2007"/><ref name="Collins 2012"/> Di antara mereka yang terinfeksi, ''P. falciparum'' merupakan spesies yang paling umum diidentifikasi (~75%) diikuti oleh ''P. vivax'' (~20%).<ref name="Nadjm 2012"/> Meskipun ''P. falciparum'' secara tradisional menyumbang mayoritas kematian,<ref name="Sarkar 2009"/> bukti terbaru menunjukkan bahwa malaria ''P. vivax'' terkait dengan kondisi yang berpotensi mengancam jiwa sekitar sesering dengan diagnosis infeksi ''P. falciparum''.<ref name="Baird 2013"/> ''P. vivax'' secara proporsional lebih umum di luar Afrika.<ref name="Arnott 2012"/> Telah didokumentasikan infeksi manusia oleh beberapa spesies ''Plasmodium'' dari [[Simiiformes|kera yang lebih tinggi]]; namun, kecuali untuk ''P. knowlesi''—spesies [[zoonosis|zoonotik]] yang menyebabkan malaria pada [[makaka]]<ref name="Collins 2012"/>—hal ini kebanyakan tidak begitu penting bagi kesehatan masyarakat.<ref name="Collins 2009"/>
[[Efek pemanasan global pada kesehatan manusia#Malaria|Pemanasan global]] kemungkinan akan mempengaruhi penyebaran malaria, namun tingkat keparahan dan distribusi geografis dari efek itu tidak pasti.<ref name="Parham 2011"/><ref name=who-chap6>{{cite web|title=Climate Change And Infectious Diseases|url=http://www.who.int/globalchange/climate/en/chapter6.pdf|work=CLIMATE CHANGE AND HUMAN HEALTH—RISK AND RESPONSES|publisher=World Health Organization |format=PDF}}</ref>
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}}
;Literatur yang dikutip
* {{Cite report |author=WHO |title=Guidelines for the Treatment of Malaria |edition=2nd |year=2010 |publisher=World Health Organization |isbn=978-9-2415-4792-5 |url=http://whqlibdoc.who.int/publications/2010/9789241547925_eng.pdf |format=PDF |ref=harv}}
* {{Cite book |author=Schlagenhauf-Lawlor P |title=Travelers' Malaria |year=2008 |publisher=PMPH-USA |isbn=978-1-55009-336-0 |url=https://books.google.com/books?id=54Dza0UHyngC |ref=harv}}
==Bacaan lebih lanjut==
* {{Cite book |author=Bynum WF, Overy C |title=The Beast in the Mosquito: The Correspondence of Ronald Ross and Patrick Manson |url=https://books.google.com/books?id=5BXbsSJLaToC |year=1998 |publisher=Rodopi |isbn=978-90-420-0721-5 |series=Wellcome Institute Series in The History of Medicine}}
* {{cite book|title=Guidelines for the treatment of malaria|date=2015|publisher=World Health Organization|isbn=9789241549127|edition=3rd |url=http://www.who.int/malaria/publications/atoz/9789241549127/en/}}
==Pranala luar==
{{Sister project links |wikt=malaria |commons=Malaria |n=Malaria |q=no |s=Malaria |b=Malaria |voy=Malaria |v=Malaria}}
* {{dmoz|Health/Conditions_and_Diseases/Infectious_Diseases/Parasitic/Malaria}}
* [http://www.emro.who.int/entity/malaria-control-and-elimination/ WHO site on malaria]
* [http://www.unhco.org/malaria/ UNHCO site on malaria]
* [http://www.rollbackmalaria.org/gmap/ Global Malaria Action Plan] (2008)
* [http://doctorswithoutborders.org/news/issue.cfm?id=2395 Doctors Without Borders/Médecins Sans Frontières – ''Malaria''] information pages
* [https://web.archive.org/web/20130520072620/http://www.wehi.edu.au/other_domains/MalDB/who.html WHO/TDR Malaria Database] via the [[Wayback Machine]]
* [http://www.antimalariaomd.org/en/index.php Anti-malaria and sustainable development]
* [http://www.wwarn.org Worldwide Antimalarial Resistance Network (WWARN)]
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[[Kategori:Malaria| ]]
[[Category:Apicomplexa]]
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