Tesis

Kadar Antibodi Campak Pada Anak Usia 1-4 tahun Pasca Imunisasi Campak = Measles Antibody Level in Children 1-4 Years Old After Measles Immunization

Latar belakang. Cakupan imunisasi campak di Indonesia mencapai 80% namun
prevalens campak di Indonesia masih tinggi, terutama pada anak usia 1-4 tahun. WHO
merekomendasikan pemberian imunisasi campak ke-2 pada tahun kedua kehidupan. Di
Indonesia diberikan pada usia 15-18 bulan dalam kombinasi vaksin MMR. Sayangnya
cakupan imunisasi MMR masih rendah sehingga Depkes merekomendasikan pemberian
imunisasi campak ke-2 pada usia 2 tahun untuk meningkatkan imunitas seorang anak
terhadap penyakit campak.
Tujuan. Penelitian ini untuk mengetahui: (1) proporsi anak usia 1-4 tahun yang telah
mendapatkan imunisasi campak 1 kali yang memiliki antibodi campak mencapai kadar
protektif dan rerata kadar antibodinya, (2) proporsi anak usia 1-4 tahun yang telah
mendapatkan imunisasi campak ≥ 2 kali yang memiliki antibodi campak mencapai
kadar protektif dan rerata kadar antibodinya, (3) hubungan antara usia saat diperiksa
kadar antibodi campak, usia saat imunisasi, status gizi, kondisi kesehatan saat imunisasi
campak terhadap antibodi campak, (4) hubungan antara pemberian imunisasi campak
dosis ke-dua terhadap antibodi campak.
Metode. Penelitian potong lintang di 6 posyandu di 5 wilayah DKI Jakarta pada bulan
Juni hingga Agustus 2014. Anak yang memenuhi kriteria inklusi diperiksa kadar IgG
campak. Dari hasil pemeriksaan IgG campak, kemudian ditentukan apakah mencapai
kadar protektif atau tidak dan rerata kadar antibodinya. Dicari apakah terdapat
hubungan antara imunisasi campak dosis ke-dua dengan kadar antibodi campak.
Hasil. Dari 145 subjek penelitian, 125 subjek (86,2%) memiliki kadar antibodi campak
yang mencapai kadar protektif (≥ 120 mIU/ml) dan 20 subjek (13,8%) memiliki kadar
antibodi campak yang tidak mencapai kadar protektif (< 120 mIU/ml). Median kadar
antibodi campak pada kelompok protektif adalah 844 mIU/ml, dengan nilai minimum
129 mIU/ml dan nilai maksimum 5000 mIU/ml. Kelompok usia 3-4 tahun memiliki
kadar antibodi campak yang mencapai kadar protektif terbanyak (91,8%) dibanding
kelompok usia 2-3 tahun (88,2%) dan 1-2 tahun (72,7%). Tidak didapatkan hubungan
antara usia saat mendapatkan imunisasi campak dan status gizi terhadap kadar antibodi
campak.
Simpulan. (1) Proporsi anak usia 1-4 tahun yang mendapatkan imunisasi campak 1 kali
dan memiliki antibodi campak mencapai kadar protektif sebesar 77% (54/70) dengan
median kadar antibodinya adalah 733,5 mIU/ml, (2) Proporsi anak usia 1-4 tahun yang
mendapatkan imunisasi campak ≥ 2 kali dan memiliki antibodi campak mencapai kadar
protektif sebesar 94,6% (71/75) dengan median kadar antibodinya adalah 885 mIU/ml.
(3) Pemberian imunisasi campak ≥ 2 kali meningkatkan timbulnya antibodi campak
yang mencapai kadar protektif sebesar 1,227 kali dibanding pemberian imunisasi
campak 1 kali.


Background. Indonesia measles immunization coverage reach 80% but measles
prevalence remains high especially in children 1-4 years old. WHO recommended
second dose of measles containing vaccine at second year of age. In Indonesia, it has
been done through MMR vaccine at 15-18 month. Unfortunately MMR immunization
coverage still low and Ministry of Health recommended second dose of measles
containing vaccine for all 2 years old children who have never been immunized with
MMR vaccine at 15-18 month to increase the immunity against measles.
Objectives. This study aimed to know: (1) proportion of children 1-4 years old who has
been immunized one time measles vaccine and reach protective antibody level and
mean of antibody, (2) proportion of children 1-4 years old who has been immunized
twice or more measles vaccine and reach protective antibody level and mean of
antibody, (3) association between age, age of immunization, nutritional status, and
health status when being immunized with measles antibody level, (4) association
between second dose of measles vaccine with measles antibody level.
Methods. Cross-sectional study performed in 6 posyandu in 5 region of Jakarta since
June until August 2014. Children who met the inclusion criteria were checked for
measles IgG, identified for reaching protective level and mean of antibody. Association
between second dose of measles vaccine with measles antibody level was also
measured.
Results. From 145 participants, 125 (86,2%) had protective measles antibody level (≥
120 mIU/ml) and 20 (13,8%) had not reached protective level (< 120 mIU/ml). The
median measles antibody level in protective group was 844 mIU/ml, with minimum
point was 129 mIU/ml and maximum point was 5000 mIU/ml. Children in 3-4 years old
group had highest percentage of protective measles antibody level (91,8%) compare to
children in 2-3 years old group (88,2%) and 1-2 years old group (72,7%). There were no
association between age of immunization and nutritional status with measles antibody
level.
Conclusion. (1) Proportion of children 1-4 years old who has been immunized one time
measles immunization and reach protective measles antibody level was 77% (54/70)
with the median of measles antibody level was 733,5 mIU/ml, (2) Proportion of children
1-4 years old who has been immunized twice or more measles immunization and reach
protective measles antibody level was 94,6% (71/75) with the median of measles
antibody level was 885 mIU/ml, (3) Twice or more measles immunization will increase
protective level of measles antibody 1,227 times compare to one time measles
immunization.