Tata Laksana Komprehensif Terkini Penanganan Re-Emergensi Hand, Foot, and Mouth Disease (HFMD) di Indonesia: Tinjauan Lingkup
Tinjauan Pustaka
DOI:
https://doi.org/10.55175/cdk.v51i10.1122Kata Kunci:
Penyakit eksantema, penyakit tangan, kaki, dan mulut, ruam makulopapularAbstrak
Hand, foot, and mouth disease (HFMD) merupakan penyakit eksantema dengan manifestasi utama berupa erupsi ruam makulopapular pada tangan, kaki, dan mulut disertai demam dengan berbagai komplikasi berbahaya yang dapat timbul pada anak usia di bawah lima tahun. Indonesia memiliki siklus wabah HFMD berulang menjadikannya sebagai penyakit re-emergensi yang perlu diwaspadai. Penulis melakukan pencarian sistematis penelitian pada 3 database, yaitu Pubmed, Wiley Online Library, dan Science Direct, dengan kata kunci “Hand, Foot, and Mouth Disease”, “enterovirus”, and “therapy” yang dipublikasikan hingga Oktober 2023. Sebanyak 791 penelitian masuk dalam analisis dan kualitasnya dinilai menggunakan Newcastle-Ottawa Scale. Tata laksana komprehensif HFMD yang tersedia hingga kini mencakup upaya pencegahan, terapi, dan manajemen komplikasi. Penelitian terkini belum berhasil mengungkap pengobatan antivirus definitif, sehingga penatalaksanaan bersifat simtomatik, diikuti isolasi serta perawatan mulut dan kulit yang baik. Pada kasus berat, intervensi kasus kritis meliputi terapi antivirus, imunoglobulin intravena, serta dukungan sistem pernapasan dan sirkulasi darah. Vaksin enterovirus A71 (EV-A71) yang dinonaktifkan terbukti menjadi pilihan paling efektif dan hemat biaya untuk perlindungan jangka panjang terhadap HFMD terkait EV-A71. Namun, evolusi epidemiologi enterovirus menyebabkan intervensi yang hanya didasarkan satu agen tidak memadai, diperlukan pengembangan tata laksana definitif dan vaksin multivalen yang efektif.
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