dr Mayang Anggraini Naga SESI 5 READING 1 INFECTIOUS DISEASE (PENYAKIT INFEKSI) Dikutip oleh: dr Mayang Anggraini Naga

DESKRIPSI Bacaan ini mengulas tentang penyakit infeksi menular, berbagai jenis mikroorganisme dan parasit penyebabnya, yang masih merupakan grup penyakit morbiditas dan mortalitas penting di banyak negara termasuk Indonesia. Upaya pencegahan dengan imunisasi sejak bayi, balita dan setelah dewasa belum mampu mengatasi semua jenis yang kita kenal. Pengetahuan tentang berbagai penyakit infeksi menular diperlukan para pengkode diagnosis agar informasi klinis dan epidemiologis dapat dipertanggungjawabkan kebenaran dan ketepatannya.

TUJUAN INSTRUKSIONAL UMUM Paham tentang berbagai jenis penyakit infeksi sebagai penyakit morbiditas dan mortalitas masyarakat; pentingnya keakurasian dan ketepatan nomor kode bagi pelaporan tentang kehadiran penyakit infeksi menular serta cara pendokumen- tasiannya, guna menunjang keberhasilan program manajemen morbiditas dan mortalitas penyakit infeksi rutin, epedemis ataupun timbulnya suatu KLB

TUJUAN INSTRUKSIONAL KHUSUS Menjelaskan: - Definisi communicable diseases - Insiden penyakit menular - Berbagai sebutan jenis penyebab penyakit infeksi menular - Berbagai istilah gejala umum penyakit infeksi - Menjelaskan metode pencegahan dan pengobatan penyakit infeksi Latihan mencari nomor kode istilah penyakit yang ada pada materi Reading 1

POKOK & SUBPOKOK BAHASAN Infectious Diseases: - Definition - Incidence - Causes & Avoidance - Symptoms & Diagnosis - Treatment & Outlook Menceriterakan kembali dan mengenal istilah medis penyakit infeksi menular Mencari nomor kode ICD-nya dan mendiskusikan hasil jawaban soal latihan.

READING 1 (Sumber: AMA Encyclopedia of Medicine) INFECTIOUS DISEASE Any illness, that is caused by a specific microorganisme. COMMUNICABLE DISEASEA Any disease caused by a microorganism or parasite that can be transmitted from one person or animal to another .

INCIDENCE Infectious diseases are a large and important group of conditions and, until recently, were the major cause of illness and death throughout the world. (In many developing countries, they remain a major cause of death). Over the last century or so, the situation has changed in the more developed countries as a result of four important advances.

4 (four) important advances. First: better methods are employed for controlling the spread od disease organisms – including: - better sanitation, - water purification, - housing , - pest control, - personal hygiene, and - quarantining procedures. (See Public Health) Second: many effective antimicrobial drugs have been developed,

4 (four) important advances (Cont.) Third, vaccines and other preparations has been developed to provide immunity to certain infectious disease (See Immunization = the process of inducing immunity as a preventive measure against certain infectious diseases)) Fourth: better general health and nutrition have been bolstered immunity and improved survival. (Bolstered = mendukung, menyokong) (Immunity = A state of protection against a disease or diseases through the activities of the immune system)

In developed countries such measures have brought INCIDENCE (Cont.-1) In developed countries such measures have brought about a dramatic decline in the incidence of some serious diseases (such as: - poliomyelitis, - small pox, - diphtheria, and - tuberculosis”. In poorer countries, however, infectious diseases remains a huge problem, for reasons that include lack of resources, ignorance, low standards of public and personal hygiene, the presence of insect transmitters of disease, and perhaps most importantly, malnutrition. Diseases such as measles have a mortality of 20% or more in malnourished children.

CAUSES Disease-causing organisms fall into a number of well-defined groups. Among the most important are the: - viruses, - bacteria, and - fungsi, along with three smaller groups. - the rikecttsiae, - chlamydiae, and - mycoplasmas. All are relatively simple organisms that can readily multiply in a host’s tissues when defenses are low.

Other groups include the: - protozoa, - worms, and - flukes. Causes (Cont.) Other groups include the: - protozoa, - worms, and - flukes. These more complex parasites may spend only part of their life cycle, in human tissues; the rest of their lives is spent in another animals or in soil. Colonization of the body by worms and flukes (along with external parasites, such as scabies and lice), is generally referred to as an infestation rather than an infection. (see table, for examples of transmission mechanisms)

AVOIDANCE Serious infectious diseases can largely be avoided by measures such as: - immunization, - good hygiene with respect to: - food and - drink and - washing the hands after using the toilet, - avoiding contact with animal feces and secretions, and - prudence in choice of sexual partners (or precautions, such as the use of condoms).

SYMPTOMS AND DIAGNOSIS Fever is a feature in many infectious diseases; symptoms generally are related to the system or organ attacked – for example: - cough, - diarrhea or - skin-rash. Apart from diseases in which the symptoms and signs are usually easily recognizable (such as chickenpox), diagnosis relies on identifying the causative micro- organism; testing may be by direct microscope examination of a specimen of infected tissue (tuberculosis) or body fluid, by culture techniques, or by detecting antibodies (typhoid fever, hepatitis) (see immunoassay).

SYMPTOMS AND DIAGNOSIS (Cont.-1) A particular problem with infectious diseases is that there is always a time gap (the incubation period) between entry of the microorganisms into the body and the first appearance of symptoms. The incubation period may last from a few hours to several years, during this time, the infected person is likely to pass the microorganism to other people (carrier). Moreover symptoms may never develop in some infected people, but they nonetheless continue to carry the diseases organisms and unwittingly transmit them to others.

SYMPTOMS AND DIAGNOSIS (Cont.-2) As a result, an epidemic can be well established before it is recognized and control measures introduced. This can be particularly devastating when the disease is a new one and has the long incubation period and high mortality (AIDS) (AIDS = Acquired immune deficiency syndrome, due to infection with HIV (human immunodeficiency virus). AIDS appears to be new to the human population (1982), as yet there is no curative treatment and no vaccine for AIDS, but the symptoms and complications variably respond to antibiotics, antiviral agents, radiation therapy and antifungal drugs).

TREATMENT The mainstay of treatment is the use of antibiotic and other antimicrobial drugs. Drug treatment must be carefully selected through culture and identification of organisms because certain microorganisms are susceptible only to certain antibiotics. For many virus, no effective antiviral drug is available and treatment relies on supportive measures, such as reducing temperature, maintaining food and fluid intake and so on.

OUTLOOK Although great strides have been made in the fight against infectious diseases, many problems remain, even in developed countries. The spread of certain diseases (such as sexually transmitted infections) is difficult to control except by modifying human behavior. For many infections, no effective vaccines has been developed. The majority of viral illnesses cannot be effectively combated with drugs, and some bacteria have developed resistance to the drugs available. When a new infectious disease appears, it may be years before an effective vaccine or drug-treatment can be devised. In the meantime, large numbers of people may die (AIDS again provides the most recent example).

TUGAS READING 1 Ceriterakan kembali paper di atas dalam bahasa Indonesia 2. Apa arti kata yang dicetak tebal tanpa garis bawah? Cari nomor kode istilah yang tercetak dengan huruf kapital dan diberi garis bawah, di ICD-10 Istilah: (hal. Vol. 3) [ ] No: (1) poliomyelitis ( ) [ ] No: small pox ( ) [ ] No: (3) diphtheria ( ) [ ] No: tuberculosis ( ) [ ] No: (5) malnutrition. ( ) [ ] No:

Istilah: (hal. Vol. 3) [ ] No: (6) measles ( ) [ ] No: Tugas (Lanjutan) Istilah: (hal. Vol. 3) [ ] No: (6) measles ( ) [ ] No: (7) scabies ( ) [ ] No: (8) infestation ( ) [ ] No: (9) infection ( ) [ ] No: immunization ( ) [ ] No: (11) fever ( ) [ ] No: (12) diarrhea ( ) [ ] No: (13) skin-rash ( ) [ ] No: (14) chickenpox) ( ) [ ] No: (15) chickenpox) ( ) [ ] No: (16) (AIDS) ( ) [ ] No:

Jawaban soal tugas READING 1 Catatan: Huruf dengan kapital dan cetakan tebal adalah alfabet petunjuk pencarian di volume 3. Istilah: (hal. Vol. 3) [hal. Vol. 1] No: (1) Poliomyelitis (446 ) [142 ] No: A80.9 Jelaskan mengapa harus kita pilih nomor kode A80.9 ini? (2) Small pox (500 ) [150 ] No: B03 Ada keterangan apa di baris bawah halaman 150? (3) Diphtheria (160 ) [124 ] No: A36.9 Apa dasar penentuan kode subdivisi kategori Diphtheria?

Jawaban soal tugas READING 1 (Lanjutan-1) (4) Tuberculosis (542 ) [115 ] No: A16.9 Apa yang membedakan TB dengan kode A15.- dari A16.-? (5) Malnutrition. (345 ) [292 ] No: E46 Mengapa harus E46 dan bukan E40, E41, E43 atau E44? (6) Measles (350 ) [150 ] No: B05.9 Campak yang bagaimana yang diberi nomor kode di atas? (7) Scabies (486 ) [176 ] No: B86 Apa sebutan lain bagi scabies?

Jawaban soal tugas READING 1 (Lanjutan-2) (8) Infestation (299 ) [177 ] No: B88.9 Infestasi parasit dengan nomor kode ini untuk jenis penyakit infestasi yang apa? (9) Infection (290 ) [180 ] No: B99 Kelompok penyakit infeksi apa saja yang dapat diberi \ nomor ini? (10 Immunization (285 ) [1137 ] No: Z26.9 Mengapa istilah ini tidak menggunakan alphabet A atau B? Apa saja yang tidak dapat diberi nomor kode Z26.-?

Jawaban soal tugas READING 1 (Lanjutan-3) (11) Fever (222 ) [871 ] No: R50.9 Untuk demam yang tipe apa kode ini bisa digunakan? (12) Diarrhea (158 ) [112 ] No: A09 Untuk diarrhae jenis apa kode ini boleh dipilih? (13) Skin-Rash (500)(471) [862 ] No: - No: R Mengapa tidak dapat ditemukan melalui penelusuran lead-term Skin ? Gejala penyakit apakah R21 ini? (14) Chickenpox) (96 ) [149 ] No: B01.9 Apa dasar pembagian subdivisi kategori Varicella ini?

Jawaban soal tugas READING 1 (Lanjutan-4) (15) (AIDS) (37 ) [155 ] No: B24 HIV yang mana yang dikode dengan B24 ini? (16) Typhoid fever No: (17) Hepatitis No: Catatan: Setelah Anda menemukan kode di Volume 3, semua jawaban pertanyaan di atas dapat ditelusuri ketepatannya melalui pengetahuan Anda tentang cara mengontrol kepastian pemilihan kode yang akurat dan tepat dengan menggunakan ICD-10 volume 1