Abstract

Pada saat kehamilan, terjadi peningkatan kebutuhan zat besi (Fe) yang diperlukan untuk meningkatkan jumlah sel darah merah ibu dan membentuk sel darah merah janin dan plasenta. Apabila kebutuhan zat besi ini tidak terpenuhi, akan terjadi anemia defisiensi besi. Ibu hamil yang tinggal di daerah endemis malaria rentan terinfeksi malaria, yang berdampak terhadap anemia pada kehamilan. Penelitian ini merupakan penelitian deskriptif dengan desain potong lintang yang bertujuan untuk mengetahui gambaran profil zat besi pada ibu hamil yang berada di daerah endemis malaria vivax kota Bengkulu. Pemeriksaan mikroskopis malaria dan pengambilan sampel darah dilakukan untuk pemeriksaan profil zat besi terhadap 55 orang ibu hamil trimester II dan III yang mempunyai riwayat malaria di 5 wilayah kerja puskesmas. Data yang diperoleh kemudian dilakukan analisis univariat. Pada ibu hamil yang tidak terinfeksi malaria tetapi mempunyai riwayat malaria, 90,5% mengalami anemia, 41,5% mengalami penurunan kadar Total Iron Binding Capacity (TIBC), dan 17% mengalami penurunan kadar Fe serum. Ibu hamil yang terinfeksi malaria vivax selain terjadi penurunan kadar hemoglobin juga disertai dengan penurunan kadar Fe serum dan kadar TIBC. Pada ibu hamil yang menderita malaria falsiparum, terjadi penurunan kadar hemoglobin (Hb) dan kadar TIBC tetapi tidak disertai dengan penurunan kadar Fe serum. Ibu hamil yang terinfeksi malaria maupun yang mempunyai riwayat terinfeksi malaria mengalami anemia pada kehamilan. During pregnancy, the need of iron increase significantly. Iron is needed for increasing the amount of mother’s red blood cell and form the red blood cell of fetus and placenta. If this iron needs is not fulfilled, it could cause iron deficiency anemia. Pregnant women who live in endemic malaria will be vulnerable to be infected malaria, and will cause anemia in pregnancy. This research was aimed to know iron profile in pregnant women that live in endemic malaria area. Malaria microscopic examination and blood sampling for examination of iron profile in 55 pregnant women trimester II and III who have a history of malaria in 5 working area health centers. The data obtained was then performed univariate analysis. The results showed pregnant women who have malaria history, 90.5% are suffering anemia, decreasing of Total Iron Binding Capacity (TIBC) level (41.5%) and 17% Fe serum level (17%). Pregnant women who are infected vivax malaria not only experiencing decrease of hemoglobin level but also experiencing decrease of Fe serum level and TIBC level, while pregnant woman who suffers from falciparum malaria haemoglobin (Hb) level and TIBC are decreasing but not in serum Fe levels. Pregnant women with history of malaria infection will suffer from anemia during pregnancy.

References

1. Larocque R, Casapia M, Gotuzzo E, Gyorkos T. Relationship between intensity of soil-transmitted helminth infections and anemia during pregnancy. American Journal of Tropical Medicine and Hygiene. 2005; 73: 783–9. 2. Nugroho A, Harijanto PN, Datau EA. Imunologi pada malaria. Dalam: Harijanto PN, eds. Malaria: epidemiologi, manifestasi klinis & penanganan. Edisi ke-1. Jakarta : EGC; 2009. p. 129-47. 3. Sylvia AP. Patofisiologi: konsep klinis proses-proses penyakit. Edisi ke- 6. Jakarta: EGC; 2005. 4. Yawan FS. Analisis faktor risiko kejadian malaria di wilayah kerja Puskesmas Bosnik Kecamatan Biak Timur Kabupaten Biak – Numfor Papua [Tesis]. Semarang: Universitas Dipenogoro; 2006. 5. Kyabayinze KJ, Tibenderana JK, Nassali M, Tumwine LK, Riches C, montague M, et al. Placental Plasmodium falciparum malaria infection: Operational accuracy of HRP2 rapid diagnostic tests in a malaria endemic setting. Malaria Journal. 2010; 10 (1): 306. 6. Lamikanra AA, Brown D, Potocnik A, Casals-Pascual C, Langhorne J, Roberts DJ. Malarial anemia: of mice and men. Blood. 2007; 110: 18-28. 7. Dinas Kesehatan Propinsi Bengkulu.Profil kesehatan Provinsi Bengkulu, Bengkulu: Dinas Kesehatan Propinsi Bengkulu; 2012. 8. Baird JK, Hoffman SL. Primaquine therapy for malaria. Clinical Infectious Diseases. 2004; 39: 1336–45. 9. Wiknjosastro. Ilmu Kebidanan. Edisi ke-3. Jakarta: EGC; 2007. 10. Saifuddin AB. Demam dalam kehamilan dan dalam persalinan. Jakarta: Buku Panduan Praktis Pelayanan Kesehatan Maternal dan Neonatal; 2002. 11. Manuaba IG. Ilmu kebidanan dan penyakit kandungan dan keluarga berencana untuk pendidikan bidan. Jakarta: EGC; 1998. 12. De Beaudrap P, Turyakira E, White LJ, Nabasumba C, Tumwebaze B, Muehlenbachs A, et al. Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malaria Journal. 2013; 12: 139-50. 13. Ouma P, van Eijk AM, Hamel MJ, Parise M, Ayisi JG, Otieno K, et al. Malaria and anemia among pregnant women at first antenatal clinic visit in Kisumu, western Kenya. Tropical Medicine & International Health. 2007 Dec; 12(12): 1515-23. 14. Sylvia AP. Patofisiologi : konsep klinis proses-proses penyakit. Edisi ke- 6. Jakarta: EGC; 2005. 15. Brutus J, Santalla D, Schneider J, Avila C, Deloron P. Plasmodium vivax Malaria during Pregnancy, Bolivia. Emerging Infectious Diseases. 2013; 19 (10):1605-11. 16. Schantz-Dunn J, Nour NM. Malaria and pregnancy: a global health perspective. Reviews in Obstetrics & Gynecology. 2009; 2(3): 186-92. 17. Rogerson SJ, Brown HC, Pollina E, Abram ET, Tadesse E, Lema VM, et al. Placental tumor necrosis factor alpha but not gamma interferon is associated with placental malaria and low birth weight in Malawian women. Infection and Immunity. 2003; 71: 267–70. 18. Suwanarusk R, Cooke BM, Dondorp AM, Silamut K, Sattabongkot J, White NJ, et al. The deformability of red blood cells parasitized by Plasmodium falciparum and P. vivax. The Journal of Infectious Diseases. 2004; 189: 190-4. 19. Baird JK, Schwartz E, Hoffman SL. Prevention and treatment of vivax malaria. Current Infectious Disease Reports. 2007;9;39-46. 20. Ayoya MA, Spiekermann-Brouwer GM, Traoré AK, Stoltzfus RJ, Garza C. Determinants of anemia among pregnant women in Mali. Food and Nutrition Bulletin. 2006 Mar; 27(1): 3-11. 21. Rosenthal PJ, Meshnick SR. Hemoglobin catabolism and iron utilization by malaria parasites. Molecular and Biochemical Parasitology. 1996; 83: 131-9. 22. Prentice AM. Iron metabolism, malaria, and other infections: what is all the fuss about? The Journal of Nutrition. 2008; 138: 2537-41. 23. Ezebialu IU, Eke AC, Ezeagwuna DA, Nwachukwu CE, Ifediata F, Ezebialu CU. Prevalence, pattern, and determinant of placental malaria in a population of southeastern Nigerian parturient. International Journal of Infectious Diseases. 2012; 16: e860-65.

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