PROGRAM NASIONAL UNTUK ELIMINASI FILARIASIS LIMFATIK: STUDI KASUS DI KABUPATEN PEKALONGAN, JAWA TENGAH

Anggi Septia Irawan, Hasan Boesri, Sidiq Setyo Nugroho

Abstract


Program eliminasi filariasis limfatik sedang berlangsung di semua provinsi di Indonesia. Jawa Tengah termasuk dalam sepuluh besar kasus kronis Lymphatic Filariasis (LF) dari 33 provinsi di Indonesia. Dimulai pada tahun 2015, Kementerian Kesehatan Republik Indonesia meluncurkan program eliminasi filariasis dengan menerapkan Mass Drug Administration (MDA) atau Pembagian Obat Pencegahan Massal “POPM”. Minimal cakupan pembagian adalah 65% dari populasi di kabupaten/kota dengan mendistribusikan diethylcarbamazine citrate (DEC) dan dikombinasikan dengan albendazole. Dengan adanya program ini, diharapkan filariasis dapat tereliminasi dan infeksi cacing dapat dikendalikan. Penelitian ini bertujuan untuk mengetahui kendala dan masalah yang dihadapi dalam pelaksanaan eliminasi filariasis, pengendalian infeksi kecacingan, dan pengendalian vektor. Metode yang diterapkan adalah peninjauan artikel ilmiah, inventarisasi kebijakan, diskusi dengan para ahli dan praktisi, serta konfirmasi data di lapangan. Hasil penelitian ini menggambarkan cakupan POPM di Kabupaten Pekalongan di atas cakupan minimal 65% dan prosentase terjadi reaksi lanjutan (efek samping) setelah mengkonsumsi obat kurang dari 1% dari seluruh target sasaran. Berdasarkan studi yang dilakukan, pelaksanaan POPM tidak sebatas hanya distribusi obat, namun yang lebih penting adalah implementasi POPM dalam pengawasan konsumsi obat. Di Pekalongan vektor potensial adalah Cx. quinquefasciatus dengan lokasi perkembangbiakan di parit, saluran irigasi, sawah. Pekalongan menerapkan program pengendalian vektor terintegrasi dengan malaria dan demam berdarah. Berdasarkan situasi lapangan, implementasi pengendalian terpadu tidak hanya bagaimana pengendalian vektor malaria dan demam berdarah dengue dapat memfasilitasi eliminasi filariasis, karena manajemen vektor terpadu tidak efektif jika kasus malaria dan demam berdarah dengan filaria limfatik tidak di lokasi yang sama. Pasca POPM hasil kajian ini merekomendasikan untuk menggunakan xenomonitoring melalui pemeriksaan molekuler sebagai asesmen kapasitas nyamuk sebagai vektor Filariasis Lymphatic.


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