Leishmaniasis: Penyebab, Gejala, Pengobatan
DokterSehat.Com – Leishmaniasis adalah penyakit akibat infeksi parasit. Penyakit ini ditularkan melalui gigitan lalat sandfly betina (sejenis lalat penghisap darah) yang terinfeksi. Terdapat 3 jenis penyakit leishmaniasis yang memiliki tingkat keparahan yang berbeda dan menyerang bagian tubuh yang berbeda. Ketahui selengkapnya tentang leishmaniasis mulai dari penyebab, jenis, gejala, pengobatan, hingga pencegahannya berikut.
Apa Itu Leishmaniasis?
Leishmaniasis adalah penyakit infeksi yang disebabkan karena parasit leishmania. Parasit ini hidup di beberapa spesies lalat sandfly yang terinfeksi. Umumnya lalat sandfly yang membawa parasit ini hidup di wilayah tropis dan subtropis.
Seringkali daerah endemis leishmaniasis merupakan daerah terpencil yang memiliki sumber daya terbatas untuk mengatasi penyakit ini. Dilansir dari Healthline, penyakit leishmaniasis merupakan jenis penyakit infeksi parasit kedua yang mematikan setelah malaria.
Penyebab Leishmaniasis
Seperti yang sudah disebutkan sebelumnya bahwa penyebab leishmaniasis adalah parasit leishmania. Parasit ini tinggal dan berkembang biak pada lalat sandfly dan manusia dapat terinfeksi oleh karena gigitan lalat tersebut. Sandfly adalah sejenis lalat penghisap darah yang kemudian menghasilkan telur.
Selain penularan melalui gigitan lalat, manusia yang terinfeksi juga dapat menularkan penyakit ini apabila mendonorkan darahnya ke orang lain.
Faktor risiko
Beberapa faktor risiko dapat meningkatkan kemungkinan penyebaran dan penularan penyakit leishmaniasis. Berikut adalah beberapa faktor risiko tinggi leishmaniasis:
- Parasit leishmania banyak ditemukan di daerah tropis dan subtropis seperti Afrika, America, Middle East, Mediterranian. Orang yang bepergian ke negara-negara tersebut mempunyai risiko tinggi tertular penyakit ini.
- Kondisi sosial ekonomi yang rendah. Kemiskinan dapat meningkatkan risiko leishmaniasis. Kondisi ini termasuk pemukiman dan kondisi sanitasi buruk yang meningkatkan jumlah tempat berkembang biak lalat sandfly dan mempermudah akses lalat tersebut ke manusia.
- Kekurangan protein, zat besi, vitamin A, dan zinc dapat meningkatkan risiko infeksi leishmaniasis
- Kekebalan tubuh yang rendah seperti pada orang HIV.
Jenis Leishmaniasis
Infeksi parasit leishmania dapat menimbulkan 3 jenis penyakit yang berbeda. Berikut adalah 3 jenis leishmaniasis:
- Cutaneous leishmaniasis, jenis leishmaniasis yang menyerang kulit. Jenis ini merupakan yang paling umum ditemui dan merupakan yang paling ringan dari ketiga jenis leishmaniasis.
- Mucocutaneous leishmaniasis, merupakan jenis leishmaniasis yang menyerang kulit dan mukosa.
- Visceral leishmaniasis, dikenal juga dengan nama kala-azar. Jenis leishmaniasis ini menyerang organ dalam tubuh dan merupakan jenis leishmaniasis paling serius dan dapat berakibat fatal.
Gejala Leishmaniasis
Gejala leishmaniasis berbeda-beda berdasarkan jenisnya. Berikut adalah berbagai gejala leishmaniasis:
1. Gejala cutaneous leishmaniasis
Seperti yang sudah disebutkan sebelumnya bahwa cutaneous leishmaniasis merupakan bentuk Leishmaniasis yang paling sering ditemukan dan yang paling ringan. Gejala khas dari cutaneous leishmaniasis yaitu
- Adanya ulkus atau luka bergaung (seperti sariawan tetapi pada kulit), luka ini timbul beberapa minggu setelah tergigit oleh sandfly.
- Timbulnya bintik kecil kemerahan sebagai gejala awal setelah tergigit, semakin lama dapat membesar membentuk benjolan seperti bisul yang dapat pecah sehingga menimbulkan luka bergaung.
- Pembengkakan kelenjar getah bening.
2. Gejala mucocutaneous leishmaniasis
Jenis leishmaniasis ini lebih jarang ditemukan dibandingkan dengan cutaneous leishmaniasis, namun lebih berbahaya. Pada beberapa kasus, mucocutaneous leishmaniasis disebabkan karena penyakit leishmania yang pada kulit, yang kemudian menyebar dan menyerang membran mukosa seperti hidung, mulut dan tenggorokan.
Gejala klinis mucocutaneous leishmaniasis meliputi:
- Hidung tersumbat
- Keluarnya cairan dari hidung
- Mimisan
- Kesulitan bernapas.
3. Gejala visceral leishmaniasis (Kala Azar)
Jenis Leishmaniasis yang paling berbahaya karena menyerang organ-organ dalam seperti hati dan limpa. Gejala visceral leishmaniasis meliputi:
- Demam
- Perasaan lemah dan lesu
- Penurunan berat badan yang drastis
- Pembesaran pada hati, limpa dan kelenjar getah bening.
Diagnosis Leishmaniasis
Dokter akan melakukan wawancara spesifik seperti apakah pasien memiliki riwayat bepergian ke daerah endemis. Setelah itu, dokter juga akan melakukan pemeriksaan fisik secara menyeluruh pada kulit, mulut, hidung dan palpasi (perabaan) organ dalam.
Dokter dapat meminta pemeriksaan biopsi kulit, yaitu mengambil sebagian kecil sampel pada kulit untuk dilihat di bawah mikroskop untuk mengonfirmasi diagnosis. Apabila ditemukan pembesaran hati atau limpa pada pemeriksaan fisik, dokter dapat meminta pemeriksaan biopsi sumsum tulang belakang dan pemeriksaan darah.
Pengobatan Leishmaniasis
Pengobatan leishmaniasis juga bergantung pada jenisnya. Umumnya cutaneous leishmaniasis dapat sembuh dengan sendirinya tanpa pengobatan. Namun biasanya dokter tetap menganjurkan pengobatan untuk mempercepat penyembuhan dan mengurangi komplikasi.
Sedangkan untuk mucocutaneous dan visceral leishmaniasis harus segera diobati karena berpotensi untuk menyebabkan komplikasi yang fatal. Mucocutenous dan visceral leishmaniasis dapat diobati dengan obat-obatan anti parasitik seperti Amphoterisin B dan Paramomycin.
Pencegahan Leishmaniasis
Belum tersedia vaksin untuk mencegah penyakit leishmaniasis. Pencegahan hanya dapat dilakukan dengan cara menghindari gigitan lalat sandfly. Berikut adalah beberapa pencegahan yang bisa Anda lakukan jika ingin berpergian atau tinggal ke daerah endemis leishmaniasis:
- Menggunakan pakaian tertutup seperti celana panjang, baju lengan panjang (baju diselipkan ke dalam celana bila perlu), dan kaus kaki tinggi.
- Menggunakan obat nyamuk pada bagian tubuh yang tidak tertutup baju seperti pada bagian ujung tangan dan kaki.
- Menyemprotkan insektisida pada ruang tidur.
- Tidur di permukaan lantai yang lebih tinggi dari sebuah bangunan, serangga akan lebih sulit untuk terbang lebih tinggi.
- Gunakan pendingin ruangan jika memungkinkan, kipas angin juga dapat membuat sandfly kesulitan terbang.
- Hindari keluar rumah ketika senja dan fajar, karena sandfly lebih aktif pada waktu tersebut.
- Gunakan kelambu yang diselipkan di Kasur dan bisa perlu disemprotkan insektisida. Ukuran sandfly lebih kecil dari nyamuk sehingga membutuhkan kelambu yang lebih rapat.
Sumber:
- Leishmaniasis – https://www.who.int/news-room/fact-sheets/detail/leishmaniasis diakses 13 Juni 2019
- Leishmaniasis – https://www.healthline.com/health/leishmaniasis diakses 13 Juni 2019
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