Sang Pemburu Nyamuk

KOMPAS/AHMAD ARIF
Wajahnya yang dipenuhi peluh tak bisa menyembunyikan letih. Namun, sorot matanya menyala penuh semangat. "Wah, lumayan jauh ternyata jalannya. Mesti lewat jalan setapak, tetapi dapat banyak jentik. Ada 'Aedes (aegypti)', 'Culex', dan 'Anopheles'," kata Syafruddin, begitu keluar dari hutan, dengan napas ngos-ngosan.

Dengan penuh gairah, Syafruddin menunjukkan botol plastik berisi beragam jentik nyamuk. Lalu, ia menerangkan perilaku jentik nyamukAnopheles,penular malaria, penyakit infeksi yang menjadi fokus risetnya selama puluhan tahun. "Jentik Anopheles,kalau berenang, tubuhnya sejajar permukaan air. Nah, seperti yang itu," ujarnya menunjuk sejumlah jentik nyamuk.

Saat rekan-rekan penelitinya dari Lembaga Biologi Molekuler Eijkman sibuk mengambil sampel darah Orang Rimba di Bukit Duabelas, Jambi, Syafruddin punya kesibukan sendiri, yakni berburu nyamuk dan jentik. Berbekal ciduk dari aluminium, ia mengumpulkan sampel air di lingkungan tempat tinggal Orang Rimba. Hampir seharian, ia keliling dari satu kubangan ke kubangan lain. Begitu menemukan jentik yang dicari, ia menyimpannya di botol plastik dan membawanya ke laboratorium Eijkman untuk diteliti.

Padahal, mantan Kepala Unit Malaria Eijkman (1994-2004) yang dipanggil Pak Din itu belum pulih total setelah kena stroke ringan pertengahan 2015 dan diabetes. Selama sepekan survei di pedalaman Jambi pada Desember 2015, Din harus disuntik insulin tiga kali sehari. Puji Budi Setia Asih, rekan peneliti yang menggantikan Din sebagai Kepala Unit Malaria Eijkman sejak 2015, yang biasanya memberi suntikan insulin. "Saya peneliti. Tak tahan kalau hanya duduk," kata Din.

Lelaki itu dikenal gila kerja. Bahkan, saat dirawat di rumah sakit, ia memaksa masuk kerja. Sejumlah rekannya pun mengubah ruang kerja Din di Eijkman seperti suasana rumah, dilengkapi kasur lipat. "Din itu peneliti sejati. Ia seperti vampir, selalu tergoda mengambil sampel darah orang untuk diteliti. Kalau tak ambil darah, ya, sibuk dengan ciduknya mencari jentik," ujar Deputi Direktur Eijkman Herawati Sudoyo.

Dedikasi kepada pekerjaan dan semangatnya meneliti, menurut Din, adalah obat terbaik atas penyakit yang dideritanya. Lebih dari separuh hidupnya dihabiskan untuk meneliti malaria yang menewaskan 600.000 orang di dunia per tahun itu.

"Bandingkan dengan ebola yang menyebabkan kematian 4.000 orang di Afrika tahun (2015) lalu. Angka kematian karena malaria jauh lebih tinggi," katanya. Di Indonesia, kematian karena malaria yang dilaporkan 30 orang per tahun, dari 400.000 pasien.

Angka itu jauh lebih rendah dari kenyataan karena banyak kasus tak terlaporkan. "Di Indonesia, banyak orang meninggal tanpa diagnosis. Biasanya disebut mereka meninggal karena demam tak diketahui penyebabnya," kata Din.

Malaria termasuk penyakit purba. Hampir sepanjang peradaban, manusia berjuang menghadapinya. Penyakit akibat spesies Plasmodium, anggota sporozoa (hewan renik berspora), itu jadi momok mematikan, terutama di daerah tropis. Ada empat jenis spesies Plasmodium penyebab malaria, yaituPlasmodium vivax, Plasmodium ovale, Plasmodium malariae, dan Plasmodium falciparum. Di Indonesia, yang umum ditemui ialah plasmodium vivax danPlasmodium falciparum.

Selain ancaman kematian, malaria mengganggu produktivitas pasien. Mereka yang terinfeksi malaria akan mengalami demam hebat. Bahkan, Plasmodium falciparum bisa memicu kelainan fungsi otak, yang disebut malaria serebral. Penderita mengalami nyeri kepala, linglung, dan penurunan kesadaran. Panas tubuh naik bertahap kemudian mendadak turun. Serangan selama 20-36 jam membaik, lalu muncul gejala lagi selang waktu 36-72 jam.

Padahal, malaria bisa diobati. Penderitanya bisa sembuh total dengan pemberian obat secara tepat, terutama sejak artemisinin ditemukan pemenang Nobel Kedokteran 2015 dari Tiongkok, Youyou Tu. "Kematian karena malaria patut disesali," kata Din.

Namun, artemisinin tak menjamin efektif di kemudian hari karena parasit malaria terus bermutasi sehingga resisten pada obat sebelumnya. Resistensi artemisinin dilaporkan di sekitar lembah Mekong di Vietnam. Untuk menyelidiki resistensi obat itu pula, Din meneliti di daerah endemis malaria, termasuk lingkungan Orang Rimba. "Di Indonesia, tak ada laporan resistensinya," ujarnya.

Dokter nyamuk

Din awalnya belajar kedokteran dengan spesialisasi ilmu gizi. Ia menyelesaikan kuliah di Fakultas Kedokteran Universitas Hasanuddin (Unhas), Makassar, pada 1985. Setahun kemudian, ia diangkat jadi dosen tetap bagian ilmu gizi di kampusnya. Pada 1987, ia melanjutkan sekolah di Toyama Medical and Pharmaceutical University, Jepang. Sejak itu, minatnya beralih ke malaria.

Kampusnya yang ada di pesisir barat Jepang itu dikenal dengan banyak riset penyakit tropis. "Riset tentang penyakit tropis menarik dan amat penting, tetapi ahlinya di Indonesia amat kurang. Akhirnya, saya memutuskan meninggalkan ilmu gizi, beralih ke penyakit tropis," ujarnya.

Ia memilih menekuni malaria yang mewabah di kampung orangtuanya, Pulau Selayar, Sulawesi Selatan. "Akhir 1980-an, malaria jadi masalah amat serius di Indonesia, terutama Papua dengan infeksi 20 persen populasi, tertinggi di dunia selain Afrika," tuturnya.

Din fokus meneliti kehidupan parasit malaria karena problem utama di Indonesia lebih banyak ke aspek parasitnya. "Yang dibutuhkan ialah biologi sel parasitnya. Di Indonesia belum ada doktornya saat itu," katanya.

Ia mendapat hasil bagus dan ada tanda-tanda bisa ditumbuhkan di luar tubuh nyamuk, yakni di media tertentu diberi zat menyerupai tubuh nyamuk Anopheles. Dengan memahami siklus hidup nyamuk itu, ia berharap menemukan cara tepat mengatasi penyebaran penyakit ini.

Akhir tahun 1992, Din menyelesaikan program doktoralnya di Jepang. Dia kembali mengajar di Unhas. Namun, alat-alat pendukung riset di kampusnya tak memadai. Dana riset pun minim. "Pekerjaan saya tiap hari saat itu hanya membersihkan ruangan laboratorium," ucap Din.

Pada awal 1993, ia membaca berita di harian Kompas terkait pendirian Lembaga Eijkman. Din menghubungi Sangkot Marzuki, dokter yang juga ahli genetika, pemimpin Eijkman kala itu. Sejak Maret 1993, Din bekerja di Eijkman, tetapi statusnya sebagai dosen di Fakultas Kedokteran Unhas tak bisa dilepaskan hingga kini. Ia mesti bolak-balik Jakarta-Makassar dengan biaya sendiri.

"Saat pertama bergabung dengan Eijkman, saya diminta membangun sistem kultur parasit malaria di luar tubuh nyamuk sehingga bisa jadi bahan penelitian," ujarnya.

Berikutnya, Din banyak ditugaskan ke lapangan untuk mengumpulkan parasit malaria, sebelum diteliti secara molekuler di Eijkman. "Tahun 1994, saya ditugasi melihat soal malaria di kampung halaman, Pulau Selayar. Itu survei pertama dan berikutnya saya kecanduan ke lapangan."

Selama 22 tahun, Din blusukan ke pelosok Indonesia demi berburu parasit malaria. Puluhan tulisannya dipublikasikan di jurnal internasional. Beberapa rekomendasinya jadi rujukan pemerintah dan Organisasi Kesehatan Dunia (WHO). Namun, ia menganggap tugasnya jauh dari usai. "Meski sebaran malaria di Indonesia turun, kita belum bisa menghilangkannya," katanya.

Bahkan, survei terakhir kepada Orang Rimba di Bukit Duabelas menunjukkan hasil yang membuatnya prihatin. "Tingkat malaria Orang Rimba 24,6 persen, itu tertinggi. Ini seperti angka malaria di Papua sekitar 20 tahun lalu saat saya baru meneliti. Banyak hal masih harus kita kerjakan".



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