Pak Andry.. Toksoplasmosis, Penyakit yang Perlu Diwaspadai! Oleh Adi Priyana dr Sp PK Fakultas Kedokteran Universitas Trisakti, Jakarta.
Toksoplasmosis adalah suatu penyakit akibat infeksi parasit Toxoplasma gondii yang sering menimbulkan penyakit pada manusia dan hewan ternak. Parasit ini cenderung untuk masuk ke dalam sel organ (intra sel) tubuh manusia dan terdapat dalam tiga bentuk, yaitu bentuk trofozoit yang beredar dalam darah, bentuk ookista yang dikeluarkan dalam tinja kucing dan bentuk kista yang menetap dalam jaringan tubuh seperti paru, jantung, otot, dan otak. Bentuk kista berupa sebuah kantung yang di dalamnya berisi beribu-ribu trofozoit T gondii. Kucing adalah tempat hidup utama (hospes definitive) parasit ini karena dapat berkembang biak secara seksual maupun aseksual. Adapun dalam tubuh manusia, unggas dan hewan ternak lain sebagai hospes perantara, parasit ini berkembang biak secara aseksual, yaitu kemampuan untuk berkembang biak dengan cara membelah diri. Di tanah yang tercemar, ookista dapat dibawa oleh lalat, kecoak, semut atau cacing tanah ke berbagai tempat di kebun. Ookista dapat menempel di sayuran, buah-buahan atau termakan oleh hewan ternak seperti ayam, kambing, anjing, sapi, dan menembus epitel usus, berkembang biak dengan membelah diri serta menetap dalam bentuk kista pada organ hewan tersebut. Bentuk parasit T gondii seperti batang melengkung dengan ukuran lebih kecil dari sel darah merah (3-6 mm) bergerak dengan gerakan aktinomisin di bawah membran plasma, dapat menembus sel secara aktif masuk ke berbagai jaringan seperti otot, otak, mata, dan usus. Kucing yang menderita toksoplasmosis akan mengeluarkan beribu-ribu ookista yang tetap infektif selama berbulan-bulan di tanah yang tidak terkena sinar matahari. Ookista yang tertelan akan membentuk trofozoit dan ikut aliran darah serta memasuki sel berinti organ tubuh atau membentuk kista. Manusia dapat terinfeksi bila tertelan ookista atau makan daging ternak seperti ayam, kambing atau sapi yang mengandung kista dan tidak dimasak matang. Pada umumnya, infeksi Toxoplasma tidak menunjukkan gejala klinis sehingga diagnosis terhadap penyakit ini sering terabaikan dalam praktik dokter sehari-hari. Umumnya, penderita hanya merasa demam ringan, lemas, mual, dan pembesaran kelenjar getah bening. Infeksi parasit ini pada manusia sehat tidak menyebabkan sakit berat karena sistem kekebalan tubuh dapat menghancurkan parasit ini. Pada keadaan di mana terjadi penurunan kekebalan seperti pada penyakit AIDS, pemakaian kortikosteroid jangka lama, dan penderita keganasan dengan kemoterapi, maka parasit yang semula diam dalam bentuk kista dapat pecah dan tiba-tiba mengganas serta mematikan. Infeksi Toxoplasma pada wanita hamil dapat menyebabkan keguguran (abortus), lahir mati, atau cacat bawaan seperti kebutaan (retinokoroiditis), hidrosefalus, gangguan neurologis, dan tuli. Keadaan seperti ini tidak saja merupakan beban berat bagi keluarga, tetapi karena frekuensi penyakit ini di Indonesia cukup tinggi, berarti juga merupakan beban nasional yang memerlukan perhatian besar. Walaupun secara klinis diagnosis penyakit ini sulit ditegakkan, tetapi dapat mudah diketahui apakah seseorang bebas dari penyakit, sedangkan sakit atau telah kebal, melalui pemeriksaan darah terhadap antibodi Toxoplasma dengan teknik Enzyme Linked Immunosorbent Assay (ELISA). Pemeriksaan darah seperti ini dapat dilakukan di banyak laboratorium kesehatan di negara kita, sayangnya biayanya cukup mahal. Sebenarnya infeksi parasit ini dapat dihindarkan dengan cara hidup bersih seperti mencuci tangan sebelum makan atau kerja di kebun, memasak atau memanggang daging sampai matang, dan mencuci sayur atau buah sebelum dimakan Penting pemeriksaan darah terhadap kemungkinan infeksi penyakit ini pada masa pranikah atau sebelum kehamilan karena penyakit ini dapat diobati sehingga dampak negatif seperti keguguran, lahir mati atau cacat setelah lahir dapat dihindari.* http://www.cfpc.ca/English/cfpc/programs/patient%20education/getting%20ready%20pregnancy/default.asp?s=1 Getting Ready for Pregnancy - Things to think about before you're pregnant Ask Your Family Doctor Developed by the College of Family Physicians of Canada Why is being ready for pregnancy so important? Conception occurs about two weeks before your period is due. That means you may not even know you're pregnant until you're more than three weeks along. Yet your baby is most sensitive to harm two to eight weeks after conception. This is when your baby's facial features and organs, such as the heart and kidneys, begin to form. Anything you eat, drink, smoke or are exposed to can affect your baby. That's why it's best to start acting as if you're pregnant before you are. When should I talk with my doctor about pregnancy? Any time - even before you're thinking about getting pregnant. You can talk about your diet, habits, lifestyle and any concerns you have. Plan on visiting your doctor within a year before you want to get pregnant. At that time, you may be given a physical check-up. You and the father-to-be will probably be asked about your medical history. You'll both also have the chance to ask your doctor questions. You may want to be screened for rubella and HIV or need other blood tests too. What should I eat? What you eat will also feed your baby. Junk food like potato chips, soda and cookies won't have the right nutrients for your baby. You might also need to make some changes if you follow a vegetarian or weight-loss diet. Talk to your doctor before taking extra vitamins and minerals. Some of them may be harmful, like high doses of vitamin A. Folic Acid Alert Women who get enough folic acid (a B vitamin) during pregnancy are much less likely to have a baby with serious problems of the brain or spinal cord. Folic acid should be taken for 3 months before getting pregnant because these problems develop very early in pregnancy-only three to four weeks after conception. Women need to take about 0.4 mg of folic acid a day. That amount is usually in a multivitamin. You may also want to eat more foods rich in folic acid, such as: Green leafy vegetables (like spinach) Foods in the cabbage family (such as broccoli, cauliflower and brussel sprouts), Some fruits (including oranges, cantaloupe and bananas), Milk Grains and organ meats (such as chicken livers). However, it may be difficult to obtain this amount of folic acid in your diet. Therefore, it is recommended you take a multivitamin. What about weight? If you're overweight, your risk during pregnancy is higher for things such as high blood pressure and diabetes. You can use the time before getting pregnant to lose weight if you need to. Is exercise okay? Yes. The more fit you are, the easier your pregnancy and delivery may be. But if you exercise too much, it can make getting pregnant harder. And overdoing it once you're pregnant can be dangerous. If you haven't been exercising, start before you get pregnant. While you are pregnant, you can probably keep up a light exercise program. Walking every day is one of the best exercises. Talk to your doctor about a good exercise plan for you. Do I need to change my habits? Using tobacco, alcohol or drugs can cause serious harm to your baby and sometimes even cause miscarriage. If you use tobacco, alcohol or drugs, get help from your doctor to quit. Try not to be embarrassed or scared to talk to your doctor. He or she will want to help you find a way to stop. Smoking. Smoking can cause miscarriage, bleeding, premature birth and low birth weight. It's also linked to sudden infant death syndrome (SIDS), in which infants suddenly die of no obvious cause. Children of smokers may do less well on IQ tests, and their physical growth may be slower. Alcohol. Drinking by a pregnant woman can cause fetal alcohol syndrome (FAS). FAS can lead to many problems, including mental slowness, poor growth, defects of the face and a head that is too small. Drink no alcohol or as little as possible before and during pregnancy. Illegal drugs. Using marijuana, cocaine and other illegal drugs raises the chances of miscarriage, premature birth and birth defects. With some drugs, the child will be born addicted to the drug that the mother used and will go through withdrawal. Cats and Toxoplasmosis You may have heard that pregnant women shouldn't clean a cat's litter box. That's because a parasite that causes a disease called toxoplasmosis can be spread through the feces of cats. Toxoplasmosis isn't usually harmful to children and adults, but it can cause birth defects, including blindness and brain damage. You can also get toxoplamosis by eating raw or undercooked red meat or touching dirt, such as when gardening, that has been contaminated by cat feces. Am I around things at work or home that could be harmful? Maybe. Some dangers include radiation, heavy metals like lead, copper and mercury, carbon disulfide, acids, and anesthetic gases. The radiation from computer screens doesn't seem to be harmful. Talk with your doctor about your workplace and home to find out if there are any dangers. If anything could harm your baby at work, you may be able to use special clothing or equipment to protect your baby, or you may be able to get a short-term transfer before and during pregnancy. The Hazards of Heat Soaking in a hot tub might sound relaxing, but it could hurt your baby if you're in the first trimester of pregnancy. Some research has shown that high heat-from a fever, hot bath or hot tub-during the first three months may cause birth defects. What about medicines I take? Both prescription and over-the counter medicines can affect your baby. Ask your doctor before taking anything. If you need to take medicine often because of health problems, such as asthma, epilepsy, thyroid problems or migraine headaches, talk with your doctor about your treatment. Many of these drugs can be taken safely in pregnancy but it is always best to ask. What test may I need before I get pregnant? You may need some tests to find out if you have problems that could harm you or your baby during pregnancy. Many things can be handled before pregnancy to help prevent problems for your baby and for you. Rubella. If you don't know whether you've ever had rubella (German measles) or been vaccinated against it, a blood test can give the answer. Catching the German measles while you're pregnant can be very bad for your baby. You can get a vaccination before you try to get pregnant to prevent this. Sexually transmitted diseases (STDs). STDs such as gonorrhea, syphilis and chlamydia can make it hard for you to get pregnant and can also harm your baby. These and other infections can be treated before pregnancy. HIV (human immunodeficiency virus). HIV, which is the virus that causes AIDS (acquired immunodeficiency syndrome), can be passed onto your baby. Other problems. Your doctor may also want to do some other tests depending on if you're at risk for other problems, such as anemia or hepatitis. What if I have health problems? Diabetes, high blood pressure or problems with your circulation may need extra care during pregnancy. It's often easier to treat problems or get them under control before you're pregnant. PKU Alert Were you born with phenylketonuria (PKU)? If so, you had to follow a special diet low in phenylalanine (an amino acid in many high-protein foods) when you were a child. Consult your doctor or dietician in order to start the same diet again before getting pregnant. If you don't, your baby may suffer from mental slowness, low birth weight and other problems. Will my baby be at risk for genetic problems? Your baby may be at risk for certain problems that run in your family. These are genetic diseases. Cystic fibrosis, sickle cell anemia and thalassemia (a type of anemia) are examples. These problems aren't caused by anything you do. Your baby is also at higher risk of genetic problems if you're over age 35. Talk with your doctor about assessing your risk factors and doing screening tests if needed. Revised 2002 The College of Family Physicians of Canada This information provides a general overview on this topic and may not apply to everyone. To find out if this information applies to you and to get more information on this subject, talk to your family doctor. This health education material has been favorably reviewed by the Patient Education Review Committee of the College of Family Physicians of Canada: Dr Cathy MacLean, Halifax, NS (Scientific Editor) Dr C. Richard Fischer, Pickering, ON Dr Patrice Laplante, Fleurimont, QC Dr Richard Moffatt, Red Deer, AB Dr David Nunn, Kentville, NS Dr Cornelius Woelk, Winkler, MB The College of Family Physicians of Canada, one of the nation's largest medical groups, is committed to promoting and maintaining high standards for family physicians - the doctors who provide ongoing, comprehensive care for people of all ages. This patient education information was developed by The College of Family Physicians of Canada in cooperation with the American Academy of Family Physicians. much love, reyna ----- Original Message ----- From: "Manufacturing L/F" <[EMAIL PROTECTED]> To: <balita-anda@balita-anda.com> Sent: Friday, March 11, 2005 7:37 PM Subject: [balita-anda] Toxoplasma Dear All , Mbak-Mbak , Ibu-ibu atapun teman-teman mailing List , Saya Butuh Informasi mengenai Toxoplasma [Sory aku lupa tulisannya gimana] , sekitar 5 bulan yang lalu atau sekitar 6 bulan setelah kami menikah, dari hasil tes darah yang dilakukan kepada istri sata ternyata hasilnya diperoleh menghidap virus toxo plasma .Saran dari Dokter [RS Awal Bross Batam] istri saya harus menjalani terapi dan progressnya dimonitoring selama 2 bulan. Alhamdullilah , pada bulan Desember , Pada Test Darah ke-2 hasilnya negatif. Karena banyak hal-hal yang berhubungan dengan Virus Toxoplasma yang tidak saya ketahui , maka saya butuh bantuan dari teman-teman Mengenai informasi penyakit ini . Mudah-mudahan berguna juga bagi yang lain . Terima kasih atas informasinya , Salam Hangat Selalu, PapaMamaBahagia Andry Kurniawan
