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Abstrak :
Dilaporkan kasus seorang perempuan Bali, berumur 33 tahun, agama Hindu dengan nodul multipel sistiserkosis di bawah kulit dan otak. Ditemukan gejala kejang sejak remaja yang kemudian tidak diobati. Sejak tiga tahun sebelum dirawat di rumah sakit, penderita menemukan nodul multipel di dalam kulit, mulai pada dahi dan sejak setahun yang lalu juga di bagian lain dari kepala dan tubuh, seperti pada bahu, dada dan punggung. Ternyata sampel serum yang diperiksa dengan cara immunoblot positif terhadap antigen Taenia solium. Hasil tes kopro-antigen yang juga positif memberi petunjuk adanya cacing dewasa T. solium di usus. Penderita diterapi dengan prazikuantel terhadap infeksi dengan cacing dewasa dan kemudian dengan albendazol terhadap stadium larva, yang berupa kista. Tidak berhasil ditemukan cacing dewasa di dalam tinja 24 jam. Setelah tiga minggu jumlah kista yang teraba di dalam kulit sangat berkurang, demikian juga di dalam otak. Setelah setahun tes imunoblot masih positif. (Med J Indones 2002; 11: 169-73)

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A case of multiple subcutaneous and cerebral cysticercosis in a 33-year-old Balinese female, is reported. The patient suffered from seizures since adolescence, which was not treated. Since three years before admission she started developing multiple nodules in the skin, starting from her forehead and since a year ago also in other parts of the head and body such as shoulders, chest and back. Serum sample tested against cysticercus antigen by immunoblot assay against antigen of Taenia solium was positive. The copro-antigen test was also positive, indicating the presence of the adult worm in the intestines. The patient was treated with praziquantel for the adult T. solium infection and thereafter with albendazole for the larval stages, which resulted in obvious reduction of the cerebral cysts and most of the subcutaneous nodules disappeared. However the adult worm was not recovered in the 24 hours stool specimen and after one year the immunoblot test was still positive. (Med J Indones 2002; 11: 169-73)

Abstrak :
Metode mutakhir, dosis dan hasil pengobatan medik taeniasis/ sistiserkosis, penyakit zoo-parasitik yang disebabkan Taenia solium dan Taenia saginata dibahas. Pada kasus sistiserkosis T. solium, khususnya neurosistiserkosis waktu optimal dan dosis untuk sistiserkosis dengan albendazol adalah selama 8 hari, 15 mg/kg/hari dibagi untuk dua kali sehari ditambah prednison 50 mg/hari pada pagi hari. Obat ini efektif terhadap parasit di hampir semua lokasi sebanyak yaitu 80-90% terhadap kista yang makroskopik tampak dengan cara imaging. Untuk taeniasis dosis tunggal prazikuantel, 10-15 mg/kg memberi hasil angka penyembuhan lebih dari 90%. Efek samping ringan seperti nausea, sakit kepala dan perut dapat ditemulan. Evaluasi terapi dengan obat dilakukan berdasarkan evaluasi klinik, radiologi dan serologi. Di Papua (=Irian Jaya) sembilan kasus dengan diagnosis kemungkinan neurosistiserkosis, sero-positif, telah diterapi dengan albendazol, 1200 mg dosis tunggal selama 15 hari. Ditambah dengan prednison, tiga kali sehari 1 tablet, 5 mg selama 7 hari. Setelah setahun 6 kasus masih tetap sero-positif. Pada waktu yang sama prazikuantel, 1200 mg, dosis tunggal diberikan kepada sepuluh pasien selama 15 hari dengan prednison, 3 kali sehari 1 tablet, 5mg selama 7 hari. Setelah setahun 5 kasus masih tetap sero-positif. Kedua-duanya, albendazol dan prazikuantel, adalah obat yang efektif terhadap taeniasis dan sistiserkosis dengan efek samping ringan. Terapi simptomatik diberikan bilamana dianggap perlu. (Med J Indones 2005; 14:253-7)

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Recent methods, doses and results of medical treatment on taeniasis/cysticercosis, a zoo-notic parasitic disease caused by Taenia solium and Taenia saginata are discussed. In cases of cysticercosis T. solium, especially neurocysticercosis the optimal length and dose of albendazole is a course of 8 days with doses of 15 mg/kg/day divided in two times added by 50 mg/day of prednisone in the morning. The drug is effective in almost any location of the parasites for 80-90% of macroscopic cysts seen by imaging studies. For taeniasis a single dose of praziquantel, 10-15 mg/kg achieves cure rates of more than 90%. Side effects such as nausea, headache and abdominal pain are mild. Evaluation of drug treatment is done by clinical, radiological and serological evaluation. In Papua (=Irian Jaya) nine cases with suspected neurocysticercosis, serologically positive, were treated with 1200 mg single dose albendazole for 15 days. Prednisone tablets, three times daily one tablet, 5 mg during 7 days were added. After one year 6 cases were still serologic positive. At the same time praziquantel, 1200 mg, single dose was given to ten cases during 15 days and prednisone tablets, 3 times daily one tablet, 5 mg during 7 days. After one year 5 sero-positive cases were still found. Albendazole and praziquantel are both effective drugs for taeniasis and cysticercosis, with minor side effects. In addition symptomatic treatment should be given if necessary. (Med J Indones 2005; 14:253-7)

Abstrak :
Sistiserkosis adalah penyakit yang disebabkan oleh stadium larva Taenia solium (cacing pita babi), sedangkan taeniasis solium disebabkan cacing dewasa yang hidup di dalam rongga usus halus manusia. Penyakit ini sampai sekarang terutama ditemukan di tiga propinsi yaitu Bali, Sumatera Utara dan Papua. Prevalensi tertinggi ditemukan di Propinsi Papua pada tahun 1997 yaitu 42.7%. Studi kasus kontrol ini bertujuan untuk mendapatkan faktor-faktor yang berhubungan dengan kejadian sistiserkosis di Kecamatan Wamena, Kabupaten Jayawijaya. Kelompok kasus ini merupakan seluruh penderita sisterserkosis berusia lebih dari 8 tahun yangditemukan melalui kuesioner pada surveri Tarniasis, Sistiserkosis dan Neurosistiserkosis yang dilaksanakan oleh tim bulan Januari sampai dengan Februari 2002, sedangkan kelompok kontrol diambil secara acak dari orang yang tidak menderita sistiserkosis pada survei tersebut. Diagnosis sistiserkosis ditentukan dengan pemeriksaan ELISA terhadap serum antibodi parasit tersebut baik pada kasus maupun kontrol. Dari seluruh variabel yang ditelliti didapatkan beberapa faktor yang secara statistik berhubungan bermakna dengan kejadian sistiserkosis setelah dikontrol secara bersamaan yaitu cuci tangan (OR 4.9 95% CI:2.55-9.61), jenis pekerjaan (OR 2.11 95% CI:1,14-4\3.91), frekuensi mandi (OR 2.59% CI: 1.31-5.12), jenis sumber air bersih (OR 2.41 95 CI:1.31-4.44) dan tempat buang air besar (OR 6.25 95% CI:3.14-12.44). Perlu dilakukan pendidikankesehatan kepada masyarakat tentang hal hal sebagai berikur: kebiasaan mencuci tangan, pentingnya mandi dengan menggunakan air bersi serta membuang air besar pada tempat yang terlindung. Pemerintah daerah perlu mengadakan saranan air bersih da n sarana umum untuk tempat buang air besar.

Factors Associated With Occurrence of Cysticercosis Among Wamena People’s, at Jayawijaya District, Papua Province, In 2002. Cysticercosis is a disease caused by the larva of Taenia solium, the pig tapeworm, whereas taeniasis solium is caused by the adult worm, which lives in the small human intestines. The prevalence of taeniasis/cysticercosis in Indonesia varies from 1.0% to 42.7% and until now is found predominantly in three provinces i.e. Bali, North Sumatera and Papua. The highest prevalence was found in Papua during the year 1997 (42,7%). This case-control study was designed for finding factors in connection with the existing cysticercosis in Sub-district Wamena, District Jawawijaya. The number of cases consisted of all patients suffering from cysticercosis aged more than 8 years, found by questionaires during a survey for Taeniasis, Cysticercosis and Neurocysticercosis, conducted by the team from January till February 2002 and the control group consisted of individuals without cysticercosis during the survey. The diagnosis of cysticercosis was determined with ELISA by antibody detection of the parasites in the serum of both groups. Among the total number of variables several factors were found significantly associated with the existence of cysticercosis after calculation as a whole i.e. washing hands (OR 4.9 95%CI:2.55-9.61), profession (OR 2.11 95%CI:1.14-3.91), frequency of bathing (OR 2.59 95%CI:1.31-5.13), source of clean water (OR 2.41 95%CI:1.31- 4.44) and sanitation (OR 6.25 95%CI:3.14-12.44). Community health education is recommended on topics such as the habit of washing hands, bathing with clean water and using standard toilets. It is suggested that the local government provides clean water facilities and general sanitation facilities.

Abstrak :
Daerah Jayawijaya, termasuk Kecamatan Wamena dan Assologaima, adalah daerah yang hiperendemis penyakit taeniasis/sistiserkosis. Dikatakan bahwa taeniasis/sistiserkosis adalah penyakit yang disebut penyakit rumah tangga yaitu suatu penyakit dengan karakteristik sebagai berikut: sering dijumpai lebih dari 1 anggota keluarga di suatu rumah tangga yang terinfeksi penyakit tersebut. Tujuan studi ini adalah mendapat gambaran taeniasis/sistiserkosis pada keluarga yang tinggal di satu komplek perumahan (silimo) dan mengetahui distribusi penderita sistiserkosis yang tinggal bersama penderita taeniasis (adult worm carriers). Telah dilakukan studi terbatas terhadap adanya antibodi terhadap antigen Taenia solium dan tes ELISA-coproantigen. Tes imunoblot menggunakan glikoprotein yang dimurnikan (GP) yang bertindak sebagai antigen Taenia solium. Antibodi anti-sistiserkosis yang terdeteksi sebesar 51.7% dari 89 sampel serum manusia. Angka seroprevalensi ini pada keluarga di Kecamatan Wamena (68.4%, 26/38) lebih tinggi dibandingkan di Kecamatan Assologaima (35.3%, 18/51), pada laki-laki (61.2%, 30/49) lebih banyak yang terinfeksi dari perempuan (40.0, 16/40). Disamping itu ELISA-coproantigen yang terdeteksi positif sebesar 2.4% (3/42) hanya ditemukan pada keluarga di Assologaima, sedangkan pada 5 keluarga di Kecamatan Wamena maupun Assologaima ditemukan anggota keluarga seropositif tanpa adanya individu coproantigen positif di rumah komplek masing-masing. Di daerah hiperendemis taeniasis/sistiserkosis seorang dapat terinfeksi oleh keluarganya yang tinggal bersama di silimo maupun mendapat infeksi ini dari keluarga lain. Semua penderita taeniasis mengkontaminasi lingkungan.

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Taeniasis/cysticercosis among family members in villages of Jayawijaya District, Papua. The area of Jayawijaya, including the Subdistricts of Wamena and Assologaima, is a hyperendemic area of taeniasis/cysticercosis. The disease is considered as a household disease because often if one family member is infected with the disease we can also expect other family members with the same disease. The aim of this study is to obtain data on the condition of taeniasis/cysticercosis in families living in a complex of houses (silimo) and to know the distribution of cysticercosis patients living together with taeniasis patients (adult worm carriers). A limited study was conducted using a test on the detection of antibodies against antigen Taenia solium and the ELISA-coproantigen test. The immunoblot test used purified glycoproteins (GP) as a Taenia solium antigen. Antibodies anti-cysticercosis were detected in 51.7% of 89 human sera samples. The seroprevalence of families in Wamena (68.4%, 26/38) was higher in comparison with that in Assologaima (35.3%, 18/51), men (61.2%, 30/49) were more infected than women (40.0, 16/40). In addition positive ELISA-coproantigen was found in 2.4% (3/42) of the families in Assologaima, whereas in 5 families in Wamena as well as in Assologaima family members were found seropositive without an individu with coproantigen positive in their families living in their respectively silimo?s. In hyperendemic areas of taeniasis/cysticercosis one can be infected by his family living in the same complex of houses as well as by other families. All adult worm carriers are contaminating the whole environment.

Abstrak :
Taeinia saginata dan Taeinia solium ditemukan di seluruh dunia, khususnya di negara-negara berkembang. Kedua jenis cacing pita ini hidup dalam rongga usus halus. Hospes perantaranya adalah ternak dan babi. Gejala-gejala berat ditemukan bilamana T. solium menginfeksi sistim saraf pusat. Kasus-kasus dengan kejang epilepsi dan perilaku abnormal sering ditemukan di daerah endemis. Di Mexico diantara 68.754 sampel serum manusia 0,06-2,97% ditemukan positif untuk cysticercosis. Rupa-rupanya ada hubungan antara angka sero-prevalensi yang tinggi dengan tingkat keadaan sosio-ekonomi yang rendah. Di berbagai negara di Amerika Latin ditemukan prevalensi antara 0,1- 8,7%, sedangkan prevalensi berkisar antara 0,05-10,4% di Asia dan Afrika. Di Indonesia taeniasis/sistiserkosis terutama ditemukan di tiga provinsi yaitu Sumatera Utara, Bali dan Irian Jaya (Papua). Sejumlah kasus juga ditemukan di Lampung, Sulawesi Utara, Sulawesi Tenggara, Nusa Tenggara Timur dan Kalimantan Barat. Di Indonesia prevalensi taeniasis/sistiserkosis berkisar antara 1,0-42,7%. Prevalensi tertinggi ditemukan di Irian Jaya. Tidak banyak laporan mengenai sistiserkosis pada ternak di dunia, termasuk Indonesia. Pengumpulan data epidemiologi seperti tentang prevalensi dan distribusi diperlukan supaya program penanggulangan berhasil. Disamping itu perlu dilakukan penyuluhan kesehatan di masyarakat pada tiap program penaggulangan

Prevalence and distribution of Taeniasis and Cysticercosis. Taenia saginata and Taenia solium are found through the whole world, especially in developing countries. These tapeworms live in the small intestines of humans. Cattle and pigs are the intermediate animal hosts. Serious signs and symptoms are found if T. solium is infecting the central nervous system. Cases with epileptic seizures and abnormal behavior are often found in endemic areas. In Mexico among 68.754 human serum samples 0,06-2,97% were found positive for cysticercosis. Apparently there was an association between high sero prevalence rates and low socio-economic conditions. In several countries in Latin America, prevalences were between 0,1-8,7%, whereas prevalences between 0,05-10,4% were detected in Asia and Africa. In Indonesia taeniasis/cysticercosis are mostly found in three provinces i.e. North Sumatra, Bali and Irian Jaya. Cases were also discovered in North Sulawesi, Southeast Sulawesi, East Nusa Tenggara and West Kalimantan. The prevalences of taeniasis/cysticercosis in Indonesia were between 1,0-42,7%. The highest prevalence rate was in Irian Jaya (Papua). Not many reports are available for cysticercosis in cattle and in pigs in the world, including Indonesia. The collection of epidemiological data such as on prevalence rates and distribution are needed for a successful control program. In addition community health education should be implemented in control programs.