MINI PROJECT

GAMBARAN KASUS DEMAM BERDARAH DENGUE (DBD)

DI WILAYAH KERJA PUSKESMAS GOMBONG I

Disusun oleh:
dr. Ria Tustina Hendrayani

Pembimbing:
dr. Anastasia Ardiningsih

PROGRAM DOKTER INTERNSHIP INDONESIA

DINAS KESEHATAN KABUPATEN KEBUMEN
PUSKESMAS GOMBONG I
2019
EPIDEMIOLOGI
Kasus Demam Berdarah di Indonesia
Angka Kematian
TINJAUAN PUSTAKA
DENGUE VIRUS
• Family : Flaviviridae
• Genus : Flavivirus
• Serotypes : DV1, DV2, DV3, DV4
• Vector:
Aedes aegypti (Female)
Aedes albopictus (Female)
Clinical course of Dengue
CLINICAL FEATURES

incubation period ranges from 3-14 days, commonly 4-7 days

CLINICAL FEATURES
• Some infected people may not have obsious symptoms

• Some may only have symptoms like fever

e.g young children may have milder symptoms than adult
or have non-spesific febrile illness with rash

• Symptoms of first infection

usually mild
once recovered, lifelong immunity to that serotype od
dengue virus will develop

• Subsequent infections with other serotypes of dengue virus are

more likely to result in severe dengue
SEVERE DENGUE

• A complication of dengue fever

• Severe and potentially fatal
• Initially, there are non-spesific symptoms of dengue
fever
high fever, wich lasts for 2-7 days and can be as
high as 40-41 C
• Later, there may be bleeding tendency:
such as skin bruises, nose or gum bleeding, and
possibly internal bleeding
• In severe cases
circulatory failure, shock and death
After Recovery
• Immunity is attained against that serotype from its
subsequent infection

• No effective protection is conferred against

subsequent infection by the other 3 serotypes
 Dengue Viruses

• Each serotype provides specific lifetime

immunity, and short-term cross-
immunity
• All serotypes can cause severe and fatal
disease
• Genetic variation within serotypes
• Some genetic variants within each
serotype appear to be more virulent or
have greater epidemic potential
 Transmission of Dengue Virus
by Aedes aegypti

Mosquito feeds / Mosquito refeeds /

acquires virus transmits virus

Extrinsic Intrinsic
incubation incubation
period period
Viremia Viremia
0 5 8 12 16 20 24 28
Days
Illness Illness
Human #1 Human #2
 Replication and Transmission
of Dengue Virus (Part 1)

1. Virus transmitted 1
to human in mosquito
saliva

2
2. Virus replicates
in target organs
4

3. Virus infects white 3

blood cells and
lymphatic tissues

4. Virus released and

circulates in blood
 Replication and Transmission
of Dengue Virus (Part 2)

5. Second mosquito 6
ingests virus with blood

6. Virus replicates
in mosquito midgut
and other organs, 7
infects salivary
glands

5
7. Virus replicates
in salivary glands
 BAB V
HASIL DAN PEMBAHASAN
Tabel 1. Distribusi Kasus DBD Infeksi Primer dan Sekunder Per Desa

Desa
Kasus Wero Patemon Kedungpuji Panjangsari Banjarsari Total

1st Inf 4 1 1 2 1 9
2nd Inf 4 1 6 2 2 15

Jumlah 8 2 7 4 3 24
Grafik 1. Jumlah kasus DBD Per Desa (Januari-Mei 2019)
Puskesmas Gombong 1

Banjarsari
13%

Wero
33%

Panjangsari
17%

Patemon
8%
Kedungpuji
29%
 Grafik 2. Distribusi Jenis Infeksi DBD Per Desa
(Januari-Mei 2019) di Puskesmas Gombong I

1st Infection
4
2nd Infection

0
Wero Patemon Kedungpuji Panjangsari Banjarsari
Grafik 3. Distribusi Jenis Infeksi DBD (Januari-Mei 2019)
di Puskesmas Gombong I

Infeksi Primer
37%

Infeksi Sekunder
63%
Tabel 2. Distribusi Kasus DBD dan DD Per Desa

Desa
Kasus Wero Patemon Kedungpuji Panjangsari Banjarsari Total

DD 5 0 2 2 2 11
DBD 3 2 5 2 1 13
DSS 0 0 0 0 0 0
 Grafik 4. Distribusi Kasus DBD dan DD Per Desa

4
DD
DBD
3
DSS

0
Wero Patemon Kedungpuji Panjangsari Banjarsari
Grafik 5. Distribusi Kasus DBD dan DD

DD
46%

DBD
54%
Tabel 3. Distribusi Karakteristik Penderita

Variabel Kategori n %
Jenis Kelamin Laki-laki 15 62,5%
Perempuan 9 37,5%
Usia 0-10th 2 8,5%
11-20 7 29%
21-30 1 4%
31-40 7 29%
41-50 2 8,5%
51-60 4 17%
61-70 1 4%
Bulan (mulai sakit) Januari 2 8%
Febuari 4 17%
Maret 5 21%
April 8 33%
Mei 5 21%
Mulai dirawat di RS Sakit hari ke-3 6 25%
Sakit hari ke-4 10 42%
Sakit hari ke-5 7 29%
Sakit hari ke-6 1 4%
Lama perawatan di RS 2 hari 3 12,5%
3 hari 5 21%
4 hari 11 46%
5 hari 3 12,5%
6 hari 2 8%
Tabel 4. Hasil Kegiatan Penyelidikan Epidemiologi DBD

Desa RT/RW Penderita DBD Tersangka DBD Persentase jentik Keterangan Perlu
Lainnya Fogging

Kedungpuji 01/01 0 0 3/14 (21%) -+ Tidak

04/01 0 3 4/18 (22%) ++ Iya
04/02 0 0 4/18 (22%) +- Tidak
03/03 0 0 4/13 (31%) -+ Tidak
03/03 0 1 3/12 (25%) -+ Tidak
Wero 06/01 0 0 1/12 (8%) -+ Tidak
07/01 2 0 6/17 (35%) ++ Tidak
03/03 0 0 4/12 (33%) -+ Tidak
04/03 0 0 8/12 (67%) ++ Tidak
02/04 0 0 3/15 (20%) -+ Tidak
Banjarsari 01/01 0 1 4/19 (21%) -+ Tidak
01/03 0 0 5/12 (42%) -+ Tidak
Panjangsari 01/02 0 0 4/12 (33%) -+ Tidak
02/02 0 0 4/18 (22%) -+ Tidak
01/03 0 1 4/10 (40%) -+ Tidak
01/04 0 1 6/13 (46%) -+ Tidak
Patemon 02/01 0 0 9/17 (53%) -+ Tidak
03/04 0 0 3/15 (20%) -+ Tidak