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Dengue Hemorrhagic Fever

Dengue Hemorrhagic Fever 





DEFINITIONS

Dengue fever or DF and dengue hemorrhagic fever or dengue fever (dengue hemorrhagic fever abbreviated as DHF) is an infectious disease caused by the dengue virus with clinical manifestations of fever, muscle pain and/or joint pain accompanied by leukopenia, rash, lymphadenopathy, thrombocytopenia and hemorrhagic tests. In DHF, plasma permeation occurs which is characterized by hemoconcentration (increased hematocrit) or accumulation of fluid in the body cavity. Dengue shock syndrome is characterized by shock or shock (Nurarif & Kusuma 2015).

Dengue Hemorrhagic Fever (DHF) is a disease that attacks children and adults caused by a virus with manifestations in the form of acute fever, bleeding, muscle and joint pain. Dengue is an acute Arbovirus infection (Artropod Born Virus) that is transmitted by the Aedes Aegypti mosquito or by Aedes Aebopictus (Wijayaningsih 2017).

Dengue Hemorrhagic Fever (DHF) is transmitted through the bite of the Aedes aegypti mosquito. DHF is a vector-based disease that is the leading cause of death in many tropical countries. DHF Disease

are endemic, often attack the community in the form of outbreaks and are accompanied by a fairly high death rate, especially in those under 15 years old (Harmawan 2018).

B. PHYSIOLOGICAL ANATOMY


Blood is a fluid in blood vessels that has the function of transporting oxygen, carbohydrates and metabolites, regulating the balance of acids and bases, regulating body temperature by conduction or transmission, carrying body heat from heat production centers (liver and muscles) to be distributed throughout the body, regulating hormones by carrying and conducting from the glands to the target (Syaifuddin, 2016).

Blood is the fluid inside the blood vessels that is red in color. This red color is not constant, depending on the amount of oxygen and carbon dioxide in it. Blood is in the body because of the work of the heart pump. As long as the blood is in the vessels, the blood will remain diluted. But when it is outside the blood vessels, it will clot. Blood function (Syaifuddin, 2016):

a. As a transport system from the body, which is to deliver chemicals, oxygen, and nutrients throughout the body.

b. Transport the remaining metabolites to the disposal organs.

c. Delivering hormones to the target organ.

d. Transport enzymes, buffers, electrolytes throughout the body.

e. Regulates temperature balance.

In adults and children red blood cells, white blood cells, and blood clotting cells are formed in the bone marrow. The active cellular marrow is called the red marrow and the inactive marrow is called the yellow marrow. The bone marrow is one of the largest organs in the body, almost the same size and weight as the liver. 13 Blood consists of two components, namely the solid component consisting of blood cells (red blood cells or erythrocytes, white blood cells or leukocytes, and blood clotting cells or platelets) and the liquid component, namely blood plasma, There are 3 types of blood cells, namely:

a. Erythrocytes (red blood cells)

Erythrocytes are blood cells that have been far deferred and have a special function for oxygen transport. Because it contains hemoglobin that binds oxygen, erythrocytes carry oxygen from the lungs to the tissues and carbon dioxide is carried from the tissues to the lungs to be excreted through the respiratory tract. Red blood cells: Deficiency of erythrocytes, Hb, and Fe will result in anemia.

b. Leukocytes (white blood cells)

White blood cells: Functions to defend the body from disease attacks by eating or phagocytosis of the disease. That is why leukocytes are also called phagocytes. White blood cells that contain nuclei are between 6,000-9,000/mm³.

c. Platelets (blood clotting cells)

Blood plates in the form of protoplasmic discs are small which in the circulation are colorless, the number can vary between 200,000-300,000 pieces/mm³. Platelets are made in the bone marrow, lungs, and spleen with a size of approximately 2-4 microns. Its function plays an important role in the process of blood clotting and hemostasis or stopping blood flow. When there is damage to the blood vessel wall, platelets will gather there and close the leakage hole by sticking together, grouping, and clotting or hemostasis. Then the blood clot process occurs. The cell structure in the blood is:

a. Cell membrane (cell membrane)

The membrane of the elastic structure is very thin, the thickness is only 7.5-10nm. Almost entirely consists of fine pieces of fat proteins that are the passage of various substances in and out of the cell. This membrane is in charge of regulating the life of the cell and receiving everything for the stimuli that come along.

b. Plasma

It consists of several components, namely: 1) Water forms 90% of plasma volume, 2) Plasma protein, which functions to maintain blood volume and pressure and fight disease germs (immunoglobulins), 3) Salts and plasma minerals and gases consisting of O2 and CO2 function to maintain osmotic pressure and blood pH so that the normal function of body tissues, 4) Food substances as cell food,  5) Other substances such as hormones, vitamins, and enzymes that function to help metabolism, 6) Antibodies and antitoxins protect the body from bacterial infections.

C. ETIOLOGY

Dengue virus, belonging to the genus Flavivirus, the family of flaviridae. There are 4 virus serotypes, namely DEN-1, DEN-2, DEN-3 and DEN-4. All four were found in Indonesia with the most DEN-3 serotypes. Infection of one serotype will cause antibodies to the serotype in question, while antibodies formed against other serotypes are very lacking, so they cannot provide adequate protection against the other serotype. A person living in an endemic dengue area can be infected by 3 or 4 serotypes during his or her lifetime. All four dengue virus serotypes can be found in various regions in Indonesia (Nurarif & Kusuma 2015)

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