e-Journal Badan Penelitian dan Pengembangan Kesehatan / National Institute of Health Research and Development
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EFIKASI Bacillus thuringiensis israelensis YANG DITUMBUHKAN PADA MEDIA AIR CUCIAN BERAS MEKONGGA TERHADAP LARVA Aedes aegypti STRAIN KENDARI
No full textBacillus thuringiensis var.israelensis (Bti) is bacterium which is potential as bioinsecticidies. However, it is difficult for multiply bacterium on a large scale due to difficulty in obtaining standard media to develop Bti. This study aimed to find out whether Bti can grow in Mekongga rice dishwater media and effective to eliminate Ae.aegypti larvae strain Kendari, to find out the larvicide power, to find out the value of LT50, and to find out the residual effect. Method of this study was laboratory experimental with post test only one group control design. Twenty five Ae.aegypti instar III larvae was used in this research. The result showed Bti can grow in Mekongga rice dishwater media and effective in eliminating the Ae.aegypti larvae strain Kendari after 24 hours exposure, with LC50 and LC90 are 3,321 ppm and 4,945 pp respectively, while in 48 hours exposure with LC50 and LC90 are 3,119 ppm and 4,945 ppm respectively. The values of LT50 Bti on Mekongga rice dishwater media is 45,49 hours and the residual effect is 4 days. Anova analysis show significant differences on various ceoncentrations of Bti in Mkongga rice dishwater media againts the mortality of Ae.aegypti larvae strain Kendari.The study proves that the Mekongga rice dishwater is a potential media which can be alternative media to grow Bti which is pathogen against Ae.aegypti starin kendari. Bacillus thuringiensis var.israelensis (Bti) adalah bakteri yang potensial sebagai bioinsektisida. Kendala dalam memperbanyak bakteri ini adalah sulit mendapatkan media standar untuk mengembangbiakan Bti. Penelitian ini bertujuan untuk mengetahui efikasi Bti yang ditumbuhkan pada media air cucian beras pada berbagai variasi konsentrasi terhadap larva Ae.aegypti strain Kendari. Penelitian ini menggunakan metode laboratorium eksperimental dengan rancangan post test only group control design. Sampel dalam penelitian ini adalah larva Ae.aegypti instar III. Hasil penelitian menunjukkan bahwa Bti yang ditumbuhkan pada media air cucian beras Mekongga efektif mematikan larva Ae.aegypti setelah 24 jam paparan, dengan LC50 dan LC90 masing-masing adalah 3,321 ppm dan 4,945 ppm, dan pada paparan 48 jam dengan LC50 dan LC90 masing-masing adalah 3,119 ppm dan 4,721 ppm. Nilai LT50 yaitu 45,49 jam. Efek residu Bti media air cucian beras Mekongga yang dapat mematikan larva sampai 50% adalah 4 hari. Analisis Anova menunjukkan adanya perbedaan yang bermakna pada berbagai konsentrasi Bti media air cucian beras Mekongga terhadap kematian larva Ae.aegypti strain Kendari. Hal ini menunjukkan bahwa air cucian beras Mekongga merupakan media potensial yang dapat menjadi media alternatif untuk menumbuhkan Bti yang bersifat patogen terhadap larva Ae.aegypti strain Kendari
Toksisitas dan Aktivitas Antimalaria Melalui Penghambatan Polimerisasi Hem Secara In Vitro Ekstrak Daun Sambiloto (Andrographis paniculata)
No full textSambiloto (Andrographis paniculata) has been used to treat malaria. In vitro research using parasite or through heme polymerization inhibition using andrografolide and in vivo using infected animal test have been done widely, however, heme polymerization inhibition from extracts with different polarity levels has not been studied yet. The aims of this study were to investigate the heme polymerization inhibition activity and toxicity of sambiloto leaf extracts. Sambiloto leaf extracted with gradually maceration using n-hexane, ethyl acetate, and 70% ethanol respectively. Heme polymerization inhibition activity was used as in vitro antimalarial test. Brine shrimp lethality test (BSLT) was used to determine toxicity of the extracts. Phytochemically screening was done for all extracts qualitatively. The results of this study were n-hexane, ethyl acetate, and 70% ethanol extracts had heme polymerization inhibition activities with IC50 values at 2,196.57; 1,235.54; and 1,157.24 μg/mL respectively. N-hexane, ethyl acetate, and 70% ethanol have LC50 values at 1,155.79; 1,133.89; and 5,229.15 μg/mL respectively. 70% ethanol extract contains alkaloid, flavonoid, steroid/triterpenoid, saponin, and tannin. N-hexane and ethyl acetate extracts has only contains alkaloid and flavonoid. 70% ethanol, ethyl acetate, and n-hexane extracts of sambiloto leaf have ability to inhibit heme polymerization and also non toxic to Artemia salina larvae. Abstrak Sambiloto (Andrographis paniculata) telah lama digunakan untuk mengobati malaria. Penelitian in vitro dengan parasit maupun melalui penghambatan polimerisasi hem dengan senyawa andrografolida dan in vivo dengan hewan uji terinfeksi telah dilakukan, namun demikian belum ada penelitian tentang penghambatan polimerisasi hem ekstrak dengan tingkat kepolaran yang berbeda. Penelitian ini bertujuan untuk mengetahui aktivitas penghambatan polimerisasi hem dan toksisitas ekstrak daun sambiloto. Daun sambiloto diekstraksi secara maserasi bertingkat berturut-turut menggunakan pelarut n-heksan, etil asetat, dan etanol 70%. Uji antimalaria secara in vitro menggunakan metode penghambatan polimerisasi hem. Uji toksisitas menggunakan metode uji kematian larva Artemia salina (BSLT). Skrining fitokimia dilakukan secara kualitatif untuk seluruh ekstrak. Hasil penelitian menunjukkan bahwa ekstrak n-heksan, etil asetat, dan etanol 70% memiliki aktivitas penghambatan polimerisasi hem dengan nilai IC50 masing-masing sebesar 2.196,57; 1.235,54; dan 1.157,24 μg/mL. Ekstrak n-heksan, etil asetat, dan etanol 70% masing-masing memiliki nilai LC50 sebesar 1.155,79; 1.133,89; dan 5.229,15 μg/mL. Ekstrak etanol 70% mengandung alkaloid, flavonoid, steroid/triterpenoid, saponin, dan tannin. Ekstrak n-heksan dan etil asetat hanya mengandung alkaloid dan steroid/triterpenoid. Ekstrak etanol 70%, etil asetat, dan n-heksan daun sambiloto memiliki kemampuan dalam menghambat polimerisasi hem dan tidak toksik terhadap larva Artemia salina
Efektivitas Leaflet dan Konseling terhadap Kepatuhan Minum Tablet Besi dan Kadar Hemoglobin Ibu Hamil dengan Anemia di Puskesmas di Kabupaten Bogor
No full textAccording to National Basic Health Research (Riskesdas) 2013, the prevalence of anemia in pregnant women in urban area is 36.4%. The treatment of anemia in pregnant women is conducted by administering 90 iron tablets during pregnancy. The majority of anemia in pregnant women is mostly caused by lacking of iron (Fe) due to lack of adherence in taking iron tablets. The objective of this research was to assess the effectiveness of leaflet compared to counseling to improve adherence and increasing hemoglobin status of pregnant women with anemia in primary health care in Bogor District. The research design was quasi-experimental by giving counseling as an intervention conducted by pharmacists to 79 pregnant women with anemia in Cibungbulan primary health care and delivering leaflet to 79 pregnant women with anemia in Ciluengsi primary health care Bogor District in 2013. The evaluation was conducted by using MMAS-8 (Morisky Medication Adherence Scale) questionnaires and Hb rate with STAT-Site MHgb equipment a month after the intervention. Data analysis was carried out with Chi-Square test, Wilcoxon test, Mann-Whitney test and multivariate logistic regression analysis. This research suggests that either counseling by pharmacist or leaflet increases adherence to take iron tablets (P < 0.05). The effectiveness of leaflets and counseling to increase adherence to pregnant women with anemia were not statistically different. Pregnant women with anemia who adhere to take iron tablet have their Hb rate improved 3.24 times compared to those who do not adhere to take iron tablet. Pregnant women with anemia who eat food source of heme every day have their Hb rate improved 2.31 times compared to those who do not eat food source of heme every day. Abstrak Menurut Riset Kesehatan Dasar (Riskesdas) 2013, prevalensi anemia pada ibu hamil di perkotaan sebesar 36,4%. Penanggulangan anemia pada ibu hamil dilakukan dengan pemberian minimal 90 tablet besi selama kehamilannya. Sebagian besar anemia pada ibu hamil di Indonesia disebabkan karena kekurangan zat besi (Fe) akibat ketidakpatuhannya meminum tablet besi. Tujuan penelitian ini adalah menilai efektivitas leaflet dibandingkan konseling terhadap peningkatan kepatuhan minum tablet besi dan kadar hemoglobin (Hb) ibu hamil dengan anemia di dua puskesmas di Kabupaten Bogor. Rancangan penelitian yang digunakan adalah kuasi eksperimen, dengan intervensi berupa konseling oleh apoteker pada 79 ibu hamil dengan anemia di Puskesmas Cibungbulan dan pemberian leaflet pada 79 ibu hamil dengan anemia di Puskesmas Cileungsi Kabupaten Bogor pada tahun 2013. Sebulan setelah intervensi, dilakukan evaluasi untuk menilai peningkatan kepatuhan minum tablet besi dan kadar Hb menggunakan kuesioner MMAS-8 dan pengukuran kadar Hb. Analisis data dilakukan dengan uji Chi-square, uji Wilcoxon, uji Mann Whitney dan uji regresi logistik multivariat. Kesimpulan bahwa konseling oleh apoteker atau pemberian leaflet pada ibu hamil dengan anemia meningkatkan kepatuhan minum tablet besi (P < 0,05) secara bermakna. Efektivitas leaflet dan konseling terhadap peningkatan kepatuhan minum tablet besi pada ibu hamil dengan anemia secara statistik tidak berbeda. Peningkatan kepatuhan minum obat dan makan makanan yang mengandung protein setiap hari dapat meningkatkan kadar Hb secara bermakna (P < 0,05). Ibu hamil dengan anemia yang patuh minum tablet besi, kadar Hb-nya meningkat 3,24 kali dibandingkan yang tidak. Ibu hamil dengan anemia yang makan makanan yang mengandung protein setiap hari, kadar Hb-nya meningkat 2,31 kali dibandingkan ibu yang tidak makan makanan yang mengandung protein
KEWASPADAAN DINI KASUS LEPTOSPIROSIS DI PROVINSI SULAWESI TENGAH
No full textLeptospirosis is a zoonotic disease caused by Leptospira spp infecting human body through contact with urine of infected animals. Although leptospirosis has been reported in Indonesia, however there is no data of the disease in some regencies of Central Sulawesi Province, particularly in Toli-Toli, Tojo Una-una and Parigi Moutong . The clinical diagnosis of leptospirosis is difficult to be determined. As a result, the disease report is lower than the real condition in the field. This research was designed using an observational descriptive cross-sectional study. Samples were collected by purposive sampling based on geographic stratification and ecosystems as well as line transect method. The present Leptospira spp in rats were confirmed by Polymerase Chain Reaction (PCR) and Microscopic Agglutination Test (MAT). The results demonstrated that Leptospira spp was successfully detected in rats distributed in various ecosystems (far and near settlements) in the three regencies. The infected rats were Bunomys sp., Rattus sp., Maxomys whiteheadi, Rattus tanezumi, Maxomys cf. hellwaldii, Bunomys penitus, Rattus facetus, Maxomys cf. musschenbroekii, Mus musculus, Rattus hoffmanni, and Rattus exulans. The results also indicated that the risk of leptospirosis attacking in human transmitted by rats in those three regencies was relatively high.
Interaksi Kelelawar dan Manusia: Potensi Zoonotik di Indonesia
No full textIn the last two decades, various types of infections caused by microorganisms occurred in some countries and most of them are emerging /re-emerging infectious diseases (EID/REID). Majority of EID/REID cases are a zoonosis, a disease that is naturally transmitted from animals to human. Bats are wild animals attracting global public health attention because they are related to the transmission of infectious viral diseases, such as Ebola, Marburg, Nipah, Severe Acute Respiratory Syndrome (SARS) Co-V and the Middle East Respiratory Syndromes (Mers Co-V). This review discusses the bats as a potential source of viral zoonotic both global and Indonesia, including the research activities that have been done. In the last two decades, various types of infections caused by microorganisms occur in some countries and are generally emerging/re-emerging infectious diseases (EID / REID). Most cases of EID / REID are zoonotic, a disease that is transmitted naturally from animal to human. Bats are wild animals that attract much attention in terms of global public health as they relate to the transmission of infectious diseases caused by viruses, such as Ebola, Marburg, Nipah, Severe Acute Respiratory Syndrome (SARS) Co-V and the Middle East Respiratory Syndromes Mers Co-V.
Keterjangkauan Biaya untuk Mendapatkan Pengobatan pada Anak dengan HIV AIDS dan Infeksi Oportunistik
No full textHIV AIDS treatment is a lifelong treatment, so the continuity of treatment is very influential on the treatment outcome. Affordability is one aspect that can improve access and continuity to HIV AIDS and opportunistic infections (OI) treatment in Children Living with HIV AIDS (CLWHA). This study was conducted to determine the affordability of HIV and OI treatment costs on CLWHA in the study area. The study was conducted cross sectional in 5 provinces, 10 districts / cities and 238 CLWHA companions as a responden. This study showed that source of medical cost still varies between health insurance (BPJS), free local government and out of pocket cost, with median cost of treatment for once visit was starting from Rp. 52,773 to Rp. 222,042 with maximum cost was Rp. 1,203,000. The average percentage of treatment costs compared to household expenditures for 1 month were ranged from 3.8 to 8.9% with a maximum value of 56.7%. The most medical costs covered by CLWHA was a laboratory tested, while the non-medical costs that were still problems was transportation cost to health facilities. Based on this study, the government needs to facilitate the HIV AIDS treatment in the BPJS treatment package starting from enrollment, doctor’s examination, ARV and OI medication, routine laboratory tested and OI treatment. Case manager or counselor should begin to be brought closer to the health facility closest to the patient’s home, so CLWHA’s companion does not feel worried about the stigma during treatment.AbstrakPengobatan HIV AIDS merupakan pengobatan seumur hidup, sehingga keberlangsungan pengobatansangat berpengaruh terhadap hasil pengobatan. Keterjangkauan biaya adalah salah satu aspek yang dapat meningkatkan akses dan keberlangsungan pengobatan. Penelitian ini dilakukan untuk mengetahui keterjangkauan biaya pengobatan HIV dan IO pada ADHA di daerah penelitian. Penelitian dilakukan secara potong lintang di 5 provinsi, 10 kabupaten/kota dengan responden sebanyak 238 pendamping ADHA. Hasil penelitian menunjukkan bahwa sumber biaya pengobatan masih bervariasi antara BPJS, gratis pemda, dan biaya sendiri, dengan nilai rata-rata biaya berobat sekali kunjungan mulai dari Rp. 52.773 hingga Rp. 222.042 dengan besar biaya maksimal Rp. 1.203.000. Persentase rata-rata biaya berobat dibanding pengeluaran rumah tangga selama 1 bulan berkisar 3,8–8,9% dengan nilai maksimal sebesar 56,7%. Biaya medis yang ditanggung ADHA paling besar adalah untuk pemeriksaan laboratorium, sementara biaya non medis yang masih bermasalah adalah biaya transportasi ke fasilitas kesehatan. Berdasarkan hasil penelitian ini, maka pemerintah perlu memfasilitasi kebutuhan pengobatan HIV AIDS dalam bentuk satu paket pengobatan pada BPJS, mulai dari pendaftaran, pemeriksaan dokter,obat ARV dan IO, pemeriksaan laboratorium rutin serta pengobatan IO. Manajer kasus atau konselor sebaiknya mulai didekatkan ke fasilitas pelayanan kesehatan yang terdekat dengan rumah pasien, sehingga pendamping ADHA tidak merasa khawatir dengan stigma selama menjalani pengobatan
Pengaruh Diabetes Melitus terhadap Gambaran Klinis dan Keberhasilan Pengobatan Tuberkulosis di Tujuh RSU Kelas A dan B di Jawa dan Bali
No full text Diabetes mellitus (DM) may complicate tuberculosis (TB) treatment and control. The National Institute of Health Research and Development in collaboration with seven referral public hospitals in Java and Bali established a disease registry system for tuberculosis (TB) and diabetes mellitus (DM). Medical records containing data of ≥15 years old patients, diagnosed with TB (ICD-10 code A15-A19) in 2014, with or without DM (ICD-10 code E10-E14) were recorded into case report form (CRF). From January 1st 2014 to January 12th 2016, the registry recorded 1975 TB cases, 15% of cases were TB-DM. 73.6% TB-DM were ≥45 years old and 70,8% TB-non DM were <45 years old. Previously treated TB cases were higher than naïve in TB-DM (OR 2.588; 95%CI 2.0-3.4). In TB-DM, predominant symptoms were cough >2 weeks (76.4%), weight loss (72.6%), loss of appetite (65.9%), and night sweats (65.2%). In TB-non DM, predominant symptoms were weight loss (59.4%), loss of appetite (57.8%), cough >2 weeks (57.6%), and fever (56.9%). Higher chest X-rays abnormality in TB-DM (OR 7.249; 95%CI 3.2-16.5) and higher positive AFB smears (OR 2.568; 95%CI 1.8-3.8). TB treatment failure (death, defaulted, failure, or transferred out) were three times higher in TB-DM (aOR 3.042; 95%CI 1.7-5.4). TB-DM Registry showed negative effects of DM on clinical condition and the treatment success of TB. Abstrak Diabetes melitus (DM) menyulitkan pengobatan dan kontrol tuberkulosis (TB). Badan Penelitian dan Pengembangan Kesehatan bersama tujuh rumah sakit (RS) umum kelas A dan B di Pulau Jawa dan Bali mengembangkan Sistem Registri Penyakit TB-DM. Data pasien berusia ≥15 tahun, didiagnosis TB (kode A15-A19 ICD-10) mulai tahun 2014, dengan atau tanpa DM (kode E10-E14 ICD-10) diabstraksi ke dalam case report form (CRF). Mulai 1 Januari 2014 – 2 Januari 2016, terdapat 1975 kasus TB, 15% adalah TB dengan DM. 73,6% pasien TB-DM berusia ≥45 tahun dan 70,8% TB-non DM berusia <45 tahun. Pada kasus TB-DM, kasus TB sebelumnya pernah diobati lebih tinggi dibanding TB naïve (OR 2,588; KI95% 2,0-3,4). Pada TB-DM, gejala terbanyak adalah batuk lebih dari dua minggu, penurunan berat badan, penurunan nafsu makan, dan berkeringat di malam hari, berturut-turut sebanyak 76,4%; 72,6%; 65,9%; dan 65,2%. Pada TB-non DM, gejala dominan adalah penurunan berat badan, penurunan nafsu makan, batuk lebih dari dua minggu, dan demam, berturut-turut sebanyak 59,4%; 57,8%; 57,6%; dan 56,9%. Foto toraks abnormal lebih banyak pada TB-DM (OR 7,249; KI95% 3,2-16,5), demikian juga dengan BTA positif (OR 2,568; KI95% 1,8-3,8). Kegagalan pengobatan TB (meninggal, putus berobat, gagal pengobatan, atau pindah) tiga kali lebih besar pada TD-DM dibanding TB-non DM (aOR 3.042; KI95%1.7-5.4). Registri TB-DM menunjukkan efek negatif DM terhadap gambaran klinis dan keberhasilan pengobatan TB.
