ECTOPARASITE IN PALEMBANG’S CHILDREN

Ahmad Ghiffari

Department of Parasitology, Faculty of Medicine, Sriwijaya University, Palembang, Indonesia

DAAD Summer School Program 2012 IGHEP 24 June-3 July Göttingen Germany

CASE REPORT

• First case report in Palembang

• Twelve years old girl• Arrival from

Dermatovenereology Dept

• Prolonged Nasolabial dermatitis

• Asymptomatic nodule• Kortikosteroid

VIDEO PRESENTATION

• Click Window Media Player

Jörg Heukelbach, Hermann Feldmeier, the Lancet 2004.

TAXONOMY

Phylum Arthropoda Class Arachnida Order Trombidiformes Family Demodicidae Genus Demodex Species Demodex folliculorum (Simon, 1842)

MORPHOLOGY

Length : 0,3-0,4 mm, abdomen striae & worm movement

4 pair of legs and 1 pair of short one in the extremity of1/3 anterior part

7

LIFE CYCLE

HISTORY

Permanent Ectoparasite live in pilosebaseus unit

Feed on sebum using the lipolitik Demodex lipase hidrolisetrigliserida (irritating fatty acid)

Localize in: Face: forehead, cheek, nose, eye lids & eye brows Meibom gland Scalp: epidermis/sebaseus gland/hair follicle Outer part of ear Nipple

Also incidently found ini several skin disease including Seborrhoic Dermatitis and tumor skin disease

9

DIAGNOSTIC TEST

o SKIN (and hair) Two lessions was clean up with

saline and dried with kassa Standard surface area 1 cm2 is

drawn in the deck glass usingwaterproof pen

One drop of cyanoacrylate((Loctite®) in the object glass isgently sticked for minute in theprepared lession & release

2-3 drops of imersi oil in thedeck glass & sealed

Gender Grup of infestation

Gender Frekuensi

n %

MaleFemale

1757

22,677,4

Jumlah 74 100

Gender Grup of infestation

Gender Frekuensi

n %

MaleFemale

515

2575

Total 20 100.0

Gender Grup of infestation

A. Ozer et al, 2012. Journal of the Formosan Medical Association 111, 30-33

Age grup of infestationAge grup (years old) Frequent

n %

Children (12-16 y.o) Adult (17-59 y.o)Age (> 60 y.o)

2720

2.797.3

0

Total 74 100

Age grup of infestation

A. Ozer et al, 2012. Journal of the Formosan Medical Association 111, 30-33

Total related to Complaint

Total DF scalpFrekuensi

n %

0 50 81.11 11 14.92 6 1.43 7 2.7

Jumlah 74 100

Dermatological Complaint related to Demodicidosis

Hsu, et all, 2008. American Academy of Dermatology

With Anti-acaridal

Hsu, et all, 2008. American Academy of Dermatology

Jorg Heukelbach, Ulrich R. Hengge, 2004.

Sarcoptes scabiae

Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

• Mites Infestasi S. scabiei var hominis

• Infestate: School children

• Risk factor : low economy, poor nutrition status, homeless, lack of hygiene, medical services

HISTORY

LIFE CYCLELIFE CYCLE

Arlian, 1989. Ann. Rev. Entomol. vol. 34:139-161

7/14/20127/14/2012 2222

Gender Distribution

51 orang (25%)

153 orang (75%)

Male

Female

Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

Gender Distribution

J Infect Dev Ctries 2009; 3(10):789-783.

7/14/20127/14/2012 2424

Age DistributionAge Distribution

Kelompok usia

persentase

Grafik 5.2. Distribusi kelompok usia subjek penelitian

anak pubertas remaja

Age DistributionAge Distribution

J Infect Dev Ctries 2009; 3(10):789-783.

7/14/20127/14/2012 2626

Predilection SitePredilection SiteLokasi pemeriksaan Frekuensi mikroskopik Frekuensi dermoskopik

n % n %

interdigitalis manus 9 47,0 8 47,0

palmar manus 1 5,7 1 5,9

wrist joint 4 21,0 4 23,5

Antecubiti 2 10,5 2 11,8

Umbilikus 1 5,3 0 0

Genital 2 10,5 2 11,8

Olivier Chosidow, 2000. THE LANCET • Vol 355.

Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

Predilection SitePredilection Site

7/14/20127/14/2012 2828

Socioeconomic VariablesSocioeconomic Variables Tabel 5.3 Distribusi frekuensi mandi dalam sehari subjek penelitian

Frekuensi mandi dalam sehari

Frekuensin %

1 kali 3 1,52 kali 195 95,63 kali 6 2,9Total 204 100

Pemakaian pakaian dan handuk bersama

Frekuensi

n %ya 79 38,7

tidak 125 61,3

Total 204 100

Tabel 5.4 Distribusi pemakaian pakaian/handuk bersama subjek penelitian

S.A. Karim et al. Public Health (2007) 121, 923–934

Fig. 1. Electronmicrograph of an adult head louse Pediculus capitisA.M.R. Downs, K.A. Stafford and G.C. Coles, Parasitology Today, vol. 15, no. 1, 1999

Pediculus capitis

H. Morsy et al. Travel Medicine and Infectious Disease (2007) 5, 243–246

Terri Lynn Meinking, Curr Probl Dermatol, May/June 1999.

Moh Hoesin Hospital

dr. Afaf Agil Almunawar, SpKKdr. Inda Astri Aryani, SpKK

Sriwijaya University

Prof. Charil Anwar, PhDdrh. Muhaimin Ramdja, MSc

Acknowledgements