Ilmu Kedokteran Tropis Penyakit tropis Tropical diseases PENDIDIKAN DOKTER FAKULTAS KEDOKTERAN UNIVERSITAS AIRLANGGA SURABAYA 2007
Kuntaman M-03, 2 SKS, 1/1, Sem IV
TUJUAN INSTRUKSIONAL UMUM • Setelah menyelesaikan modul ini mahasiswa S1 FK diharapkan mengetahui, memahami dan bisa menjelaskan terjadinya penyakit tropis; Serta mengetahui dan memahami penanggulangan penyakit tropis
TUJUAN INSTRUKSIONAL KHUSUS •
Konsep dasar muncul & menyebarnya penyakit tropis
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Mengetahui, memahami dan bisa menjelaskan faktor lingkungan
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Mengetahui, memahami dan bisa menjelaskan faktor genetik
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Mengetahui, memahami dan bisa menjelaskan faktor perilaku dan sosio-budaya;
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Mengetahui dan memahami beberapa penyakit tropis yang banyak di Indonesia maupun Negara lain;
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Mengetahui dan memahami prinsip dasar mengendalikan muncul dan menyebarnya penyakit tropis
DESKRIPSI SINGKAT •
Prevalensi penyakit: Tropis ≠ Non-tropis
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Indonesia: Tropis, Luas, multi etnik, genetik, sosio-budaya
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Penyakit Tropis/infeksi: Interaksi inang, agen dan lingkungan; dipengaruhi: genetik, perilaku-sosial budaya dan lingkungan.
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Penyakit tropis: penyakit infeksi & Non-infeksi
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Pengendalian penyakit tropis: Komprehensif, dasar faktor2
introduction • • • • •
Concept of TD Area Framework Examples Concept of Disease control
Bangkok School of Tropical Medicine, Faculty of Tropical Medicine, Mahidol University
“ … …… of Science in Tropical Medicine …..the program focuses on tropical diseases and enriches student understanding of the biological, epidemiological, and social dimension of tropical disease particularly in the South east Asia “
Institute of Tropical Medicine, Nagasaki University “….. The institute of Tropical Medicine , Nagasaki University aim to : overcome tropical disease, particularly infectious disease and various health problem associated with them, in cooperation with related institution, for excelence in the following area : 1. research in the tropical medicine and international health 2. Global contribution through disease control and health tropics by applying the fruit of the research promotion in the tropics by applying the fruit of research 3. Cultivation of the researchers and specialists in the above fields
Dominant determinant factors in tropical disease medical genetic
tropical disease
tropical environment
sosio cultural
Development of tropical disease Inang
Tropical Disease
Environment
Agents
Mengetahui, memahami dan bisa menjelaskan muncul dan menyebarnya penyakit tropis (PT) Menjelaskan muncul dan menyebarnya PT dari aspek genetik, lingkungan dan perilaku–sosio budaya Mengetahui dan memahami interaksi H, A, E sbg penyebab munculnya PT
Menjelaskan faktor genetik terhadap munculnya PT
Menjelaskan faktor perilaku sbg penyebab muncul dan menyebarnya PT
Mampu menjelaskan faktor lingkungan, thd muncul dan menyebarnya PT
Agent
Lingkungan
Parasit Mikroba Agen lain/fisik/kimia
Env.
Genetic Tropical Diseases
Budaya Sosio-antropol/ Perilaku
SocioCulture Host Sifat Genetik Status Imunologi Status Nutrisi
Kharakter Genetik Perubahan genetik Evolusi genetik
Dominant factors to be discussed in Tropical Medicine 1. Primary care: provision of promotive, preventive, curative, and rehabilitative a) Disease control programmes b) Nutritional supplementation c) Clean and safe water supply 2. Epidemiology of Dis.: a) Distribution and determinant of TD b) Focus on six deadly diseases: pneumonia, diarrhoeal illness, malaria, measles and HIV/AIDS. BUT also others high fatality rates cases: Ebola, Hantavirus, Nipah Virus
Dominant factors to be discussed in Tropical Medicine 3. Traditional medicine healers: a) Frequently the first point of contact for Pts in the Tropic b) Play a significant role in access to health care c) Have an important role in the framework in the treatment of common tropical illness. 4. Genetics: a) Pattern of autosomal and sex linked inheritance b) Deversity of human genome c) Selective pressure of human genome (~haemoglobinopathy) d) Genetic constribution to common disease (i.e.: HLA type that confer resistance or susceptibility)
Dominant factors to be discussed in Tropical Medicine 5. Immunological aspect of TD: a) Host factor b) Illustrate the delicate balance involving the host and invading pathogens c) Mechanisms involved in host susceptibility and parasite evasion 6. Economic and financing: a) Focuses on the effects of poverty and inadequate resources b) Most developing countries (mostly in the tropic) have an inability to reduce the burden of diseases, due to economic reasons c) Poverty is underlying factor for poor health in tropic d) Poor people are more vulnerable to disease (TD)
Produces
malnutrition
Diminished food -Absorbtion -Intake -Micronutrient store
reduces
- Cell med immunity - humoral immunity - secretory IgA
Increase food -Requirements -Untilization
- complement - neutrophil function - external barrier
Diarrhoea
Induces
infection
increases
Tropical Disease -
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The word of TROPICAL DISEASES is more convenient than accurate Deseases peculiar to, and confined to, the tropics All diseases occuring in the tropics Medicine in the tropics OR Tropical medicine? Pathogenic microbes: 1973 Ebola Virus Acute haemorrh.fever 1977 Legionella pneu. Legionnaires’ dis 1981 Toxin S.aureus TSSyndrome 1982 E coli O157:H7 Haemorrh. Colitis 1983 HIV AIDS 1989 Hepatitis C Hepatitis 1993 Hanta virus Adult Resp Distress Syndr. 1996 nvCJD (Prion) Creutzfeldt-Jacob Dis 1997 H5N1 Influenzae 1999 Nipah Severe encedphalitis
Tropical Disease -
Vaccine preventable infectious diseases: Measles Hepatitis B Tetanus (neonatal)
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Emerging and resurgent diseases: Ebola Dengue fever Diphtheria CholeraNipah virus AI (Hongkong)
Primary Primary Health Health Care Care Malaria 5% Campak 7% Lain-lain 32% Malnutrisi 54%
Perinatal 18%
Diare 19% Kematian karena malnutrisi, justru tinggi
ISPA 18%
Distribusi penyebab kematian balita disemua negara berkembang, 1995 (WHO)
Epidemiologi Epidemiologi Penyakit Penyakit Kecelakaan 11%
Penyakit tidak menular 35%
Perinatal 6%
Faktor Ibu 2% Nutrisi 1%
Penyakit menular 45%
Estimasi, 1998, penyebab utama kematian dinegara berpendapatan rendah, Asteng dan Afrika (WHO)
Tutorial Modul Integrasi Kasus 1: Separuh Kelompok
Tutorial 1
Kasus 2: Separuh Kelompok
Tutorial 2
Tutorial 3
Kasus 1 Pleno Kasus 2
Jawablah pertanyaan ini? 1. Jelaskan makna penyakit tropis 2. Faktor apa yang mempermudah berkembangnya penyakit tropis 3. Apakah penyakit tropis itu penyakit infeksi? 4. Coba cari sosio-budaya etnis di Indonesia yang bisa mempermudah penyebaran penyakit tropis 5. Terangkan salah satu gangguan genetik yang bisa mencegah terjangkitnya penyakit tropis. Khususnya yang disertai kelainan morfologi sel darah merah.
Tropical Disease Center TDC-UNAIR
Terima kasih Manson’s Tropical Disease
