Tropical Medicine Journal
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Immune Response against Hepatitis B Virus after Vaccination among Low Birth Weight and Preterm Newborns: A Retrospective Cohort Study in Magelang District Central Java
Get PDFABSTRACTIntroduction: Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in the world. Over 2 billion people are infected with HBV and 378 million are carriers. The mortality rate is approximately 1-2 million and over 4 millions acute clinical cases are documented each year. The prevalence of HBV infection in Indonesia is 3-20%. Vertical and horizontal transmission in newborn and children occurs in 25-45%. Near 25-50% of children are infected before 5 years. The most effective approach to reduce the burden of HBV infection is mass vaccination of newborns and children.Objectives: To determine immune response against HBV after HBV vaccine among low birth weight (LBW) and preterm newborns after HBV vaccination, and factors related to the immune response i.e. gender and weight gain in the first 6 months of life.Methods: During May-July 2012, 106 infants aged 13-15 months were recruited after HBV vaccination. They were completed 4 doses of HBV basic vaccination in 0, 2, 3, and 4 months of life. Sera were examined for anti-HBs antibody titers using ELISA.Results: A total of 98 subjects (92.5%) completed the study. Immune response of LBW subjects were positive in 89.7%, newborns were 95.9%. The Relative Risk (RR) were 2.5 CI (0.50 to 12.2) p=0.2178. Gender was not related to immune response RR 0.6 CI (0.15 to 2.69) p=0.6996. Gestational age associated with immune response RR 8 CI (1.05 to 63.9) p=0.0399. The first 6 months weight was not related to immune response RR 3.6 CI (0.73 to 17.7) p=0.1178. Logistic regression analysis showed LBW was not correlated with the immune response OR 1 CI (0.16 to 7.17) p=0.929. Gestational age correlated with immune response OR 9 CI (1.05 to 79.3) p=0.044 and the first 6 months of weight was not correlated with immune response OR 3.7 CI (0.65 to 21.1) p=0.138.Conclusion: Immune response against HBV after vaccination was similar between LBW and NBW. Immune response was correlated with gestational age.Keywords: Hepatitis B vaccine, immune response, LBW and preterm
Risk Factor of HIV Infection Among Young Agein Voluntary Counseling Testing (VCT) Clinics of Yogyakarta
Get PDFABSTRACTIntroduction: HIV/AIDS is a health problem in the world. The Highest HIV/AIDS cases in Indonesia were reported in young age groups, including in Province of Yogyakarta (DIY). Knowing the determinant and risk factors of HIVis necessary to determine effective prevention programs, especially in young agewhich one of the vulnerable populations, either because of individual and family characteristics, media influence, peer pressure, substance use and risky behavior.Objectives: To know the relationship between risk factors for HIV infection amongyoung age in VCT clinic of Yogyakarta.Methods: This study used a cross-sectional design and the population was young clients at VCT clinics of Yogyakarta. Samples were obtained from VCT clinics of Griya LenteraPKBI Yogyakarta and Edelweis Clinics of Dr Sardjito Hospital. Variable risk factors were obtained byquestionnaire and interviews than HIV test results was obtained from VCT clinics.Results: Of the 62 respondents, 74.2% were female, age average were 24,4 years old, 41.9% level education were junior high school, 82.3% had migration, 62.9% received less monitoring from families, 61.3% ever use the TV / HP for pornography, 56.5% getting high sexual pressure from peers, 62.9% had been smoking and alcohol consumption, 98.4% had ever sexual intercourse, 95.2% had sexual intercourse in the last 6 months, 93.5% risky sexual intercourse, 32.3% HIV positive and 55% through heterosexual.Conclusion: HIV infection among young people in VCT Clinic of Yogyakarta, by bivariate analysis correlated with gender, residency status, education level, relationship with parents, TV / mobile and internet used to watch pornography. However, according to multivariate analysis, HIV infection correlated with education level at senior high school and college, residing with their parents/ family and in the last 6 months are still using alcohol and illicit drugs. It is recommended to enhance more comprehensive prevention for young people in accordance with the factors associated with HIV risk behaviour.Keywords: HIV infection, young age, individual characteristics, family, peers, media usage, substance use, risky behavior
Integrated and Comprehensive Action to Reduce and Control Dengue Hemorrhagic Fever: A Survey in Pekalongan City, Central Java
Get PDFABSTRACTIntroduction: Dengue Hemorrhagic Fever (DHF) is an infectious disease that caused outbreaks in many areas in the Indonesia which led to high morbidity and mortality. Pekalongan City has the highest case fatality rate (CFR) of DHF among 35 cities and regencies in Central Java Province, which was 7.41% in 2008 and increased to 18.00% in 2009. The success of DHF control is largely determined by the cooperation of the public and decision-makers in various aspects and actions to be carried out. Therefore, it needs an integrated and comprehensive action to reduce and control DHF. In addition, to obtain the frequency distribution of DHF accurately and appropriately, an effective surveillance of hospital-early warning (KD-RS) and weekly outbreak (W2) reports are needed which requires timeliness and completeness as its report for early warning system of outbreak, so the morbidity and mortality due to DHF can be reduced.Objectives: This study is a survey with a descriptive approach to describe the level of implementation and regulation and activities conducted for dengue fever’s eradication program.Methods: Data was collected through observation, check list documentation and interviews. The subjects of this research were officers (head and staff) in the Division of Disease Prevention and Control-Environmental Health (P2P-PL) at Department of Health, Pekalongan City. Sampling technique is a total sampling. Data was analyzed and presented qualitatively.Results: The results showed that the key persons in population are an important individuals who responsible for community engagement in the village, institutions (schools and places of business, industries, offices), health centers, hospitals, families and individuals. Key interventions include organizing and managing resources. DHF prevention activities including preparation and implementation which cover many programs such as socialization, mobilization, selective larvacides, fogging prevention and focus, partnership with the non-goverment organisation (NGO), DHF suspect handling and monitoring and evaluation of activities through surveillance program.Conclusion: In conclusion, both reducing and controlling DHF in Pekalongan City was an integrated and comprehensive actions, involving key persons in populations and interventions.Keywords: integrated action, key persons, survey, DHF preventio
Effication Test of Srikaya Seeds Extract (Annona squamosa L.) to Kill Aedes aegypti Larvae in Laboratory
Get PDFABSTRACTIntroduction: Dengue fever is still becoming national health problem. Control of it have been done but the cases still increase significantly. One way to control the disease is vector control of Aedes sp. Generally, people prefer to choose synthetics insecticides than botanical insecticides and environmental management. Used of synthetics insecticides causing mosquito resistence.Objectives: To know the potency of Srikaya seeds as botanical larviciding to Aedes aegypti larvae as main vector of dengue fever.Methods: Experimental study with cross sectional design have done with three times repeat of efication test. Extraction process of Srikaya seeds according to Kardinan (2000). Concentration of Srikaya seeds extracts are 25%, 50% and 75% with control. Population of the study is Ae.aegypti larvae (L3) from Entomology Laboratory of Balai P2B2 Banjarnegara. Data was observed are mortality and growth of larvae into pupa and imago stages. Probit analyzed was done and describes by graphic and table.Results: Srikaya seeds extracts effect to Ae. aegypti larvae and causing larvae death for each concentration test (concentration 25%, 50%, and 75%). Growth of Ae.aegypti larvae also decreases that shown by pupa failure to reach imago stages after 6th day. This result shows that Srikaya seeds extracts have potency as larvicide might be due to annonain and squamosin content as acetogenine that can cause mortality of some insects Ordo.Conclusion: Srikaya seeds extracts have potency as larvicide on Aedes aegypti larvae. Srikaya seeds extract have a potency as botanical insecticides, not only to pest control on farm and poultry but also in vector diseases control.Keywords: Srikaya seeds extracts, larvicide, Aedes aegypti, mortalit
Comparing the Sensitivity and Specificity of Zinc Sulphate Flotation Method to Formol Ether Sedimentation Method in Identifying Intestinal Protozoa’s Cysts
Get PDFABSTRACTIntroduction: The two main methods to detect the presence of intestinal protozoa’s cysts are zinc-sulphate flotation (Faust’s) and formol-ether sedimentation (Ritchie’s) methods. Some researchers have recommended using both flotation and sedimentation in detecting the intestinal parasites. However, this approach is unpractical for most laboratories. To date there are no studies that conclude which method, either Faust’s method or Ritchie’s method, is more effective in term of sensitivity and specificity of detecting the intestinal protozoa cyst. This study was done to conclude which method has higher sensitivity and specificityObjectives: To compare the sensitivity and specificity of Faust’s to Ritchie’s methods in identifying intestinal protozoa.Methods: Thirty anonymous fecal samples were obtained from Parasitology Laboratory Faculty of Medicine Gadjah Mada University. Each sample was tested using both Faust’s and Ritchie’s methods and then microscopically examined to find the intestinal protozoa’s cysts. Numbers of samples with cyst-positive were recorded to determine which method has higher ability to detect the intestinal protozoa’s cysts. Data was analyzed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).Results: From all the five identified cysts (Entamoeba histolytica, Giardia lamblia, Entamoeba coli, Iodamoeba butschlii, Blastocystis hominis), Ritchie’s method was able to detect more cyst than Faust’s method. The sensitivity and specificity of Ritchie’s method compared to Faust’s were 100% and 93.33% respectively. The positive predictive value (PPV) and negative predictive value (NPV) of Ritchie’s compared to Faust’s method were 93.75% and 100% respectively. Ritchie’s method is proven to have higher sensitivity and specificity than Faust’s method. This method has high sensitivity probably because of the cysts are concentrated and so more cysts could be collected.Conclusion: This study concludes that the Ritchie’s method has higher sensitivity and specificity compared to Faust’s method in detecting five common intestinal protozoa’s cysts.Keywords: formol-ether sedimentation method, zinc-sulphate flotation method, intestinal protozoa, sensitivity, specificity
Filariasis Bancrofti Epidemiology Post Mass Drug Administration in Waris District Keerom Regency Province of Papua
Get PDFABSTRACTIntroduction: Filariasis remains to be world’s health problems including Indonesia. Based on survey conducted in 2009, the occurrence cases in Indonesia reached 11.914 chronic cases. Further, there were 59 chronic cases in Keerom Regency in 2005. The number of chronic filariasis cases in Waris District reached 25 cases, with 12 people were having positive microfilaria bancrofti.Objectives: The aim of study to find out epidemiology of filariasis bancrofti after collective treatment in Waris District, Keerom Regency, Papua.Methods: This study used descriptive research with cross sectional design. Data are collected by finger blood survey, survey of acute morbidity rate, survey of chronic morbidity rate, microfilaria periodicity survey, and L3 examination on mosquitoes.Result : Survey finger blood taken from 517 samples show 32 positive microfilariae, and filariasis prevalence of 6.19%. There are 13 patients (2.15%) having acute symptoms of filariasis, and 24 patients (4.64%) have symptoms of chronic filariasis. From the examination and dissection of 358 mosquitoes, there are nolarvae stage 3 (L3). From 7 people having microfilaremia, there is periodic nocturnal of 71.43% and subperiodic nocturnal of 28.57%.Conclusion: The prevalence of filariasis was 6.19%. There were 13 people having acute morbidity (2.51%), and there were 24 chronic morbidity (4.64%). There was no L3 found from dissected 358 mosquitoes. Periodicity of microfilariae in Waris District is periodic nocturnal which reach 71.43% and nocturnal subperiodik is28.57%.Keywords: Epidemiology, Filariasis, Finger Blood Surve
Comparison of Immunochromatography Method and Immunocytochemistry Method in Rapid Detection of NS-1 Antigen in Dengue Infection
Get PDFABSTRACT Introduction: Rapid test kit based on immunochromatography test (ICT) in detecting dengue NS-1 antigen for early dengue infection is available in the market. Its availability allows earlier management for dengue infected patient but it remains costly to most people. Recently, Dengue Team of Universitas Gadjah Mada has developed monoclonal antibodies to detect the presence of dengue NS-1 antigen in leucocytes of infected patients based on Streptavid in Biotin Peroxidase Complex (SBPC) immunocytochemistry method.Objectives: The objective of this study is to determine the validity of the immunochromatography (SD Dengue NS1 Ag) method by determining kappa agreement index between two observers, and to compare the diagnostic performances of ICT and immunocytochemistry methods in detecting dengue NS1 antigen in the blood samples.Methods: A cross sectional study design is used. This study uses 35 blood plasma remains from a previous study conducted on RT-PCR method. Three drops of blood plasma were added into the well of SD Dengue Duo NS1 and results were read after 15-20 minutes. The diagnostic performances of ICT which defined by sensitivity, specificity, positive predictive value and negative predictive value were calculated and compared to secondary data of immunocytochemistry result from the same blood samples, with reference of RT-PCR as a gold standard. A McNemar’s test was conducted and p value less than 0.05 was considered as significant different.Result: Detection of dengue infection by using SD Dengue NS1 Ag has strong agreements between two observers with kappa value of 1, and the sensitivity of 50%, specificity of 91%, positive predictive value of 92% and negative predictive value of 45% with reference of RT-PCR as a gold standard. Meanwhile sensitivity and specificity value of the immunocytochemistry test were 88% and 100% respectively, and the positive and negative predictive values were 100.0% and 70.0% respectively with reference of RT-PCR as a gold standard. The immunocytochemistry assay showed overall accuracy of 91,0%.Conclusion: Immunochromatography (SD Dengue NS1 Ag) method to detect NS-1 antigen has less sensitivity and specificity compared to SBPC immunocytochemistry method.Keyword: Immunocytochemistry, Immunochromatography, Streptavidin Biotin Peroxidase Complex (SBPC), NS-1 Ag, dengu
The Relationship of Behavior and Environment to the Incidence of Malaria in the Work Area of Oesao Public Health Center (PHC) of East Kupang Sub-District of Kupang District in 2013
Get PDFABSTRACT Introduction: Oesao PHC is one of three PHCs in Kupang District experiencing increased malaria cases. According to API figure, its rate in 2008 was 7.01% and in 2009 it decreased to 4.04%; however, the rate showed an increase again in 2010 up to 7. 67%o (Kupang District Health Office, 2010).The work area of Oesao PHC has a heterogeneous society with high malaria cases in each year; it is because the residents have habits to sleep without using nets, people perform activities at night without the use of mosquito repellent, there is an availability of mosquito breeding place and resting place and there is a lack of compliance in taking medication.Objectives: To analyze the relationship between behavior and the environment and the incidence of malaria.Methods: This was an observational analytic study with a case-control study design2. The samples in this study were part of the populations residing within the work area of Oesao PHC of East Kupang Sub-District of Kupang District. The sample size was 116 people3 selected using a random and matching method. Data were analyzed by chi-square test for calculating the value of OR (odds ratio) to determine the magnitude of the risk2 .Results: There was a significant association between the use of nets (OR = 0.061 with p = 0.000, p < 0.05), the use of mosquito repellent or anti-mosquito drugs (OR = 3.417 and p = 0.003, p < 0.05), the use of wire gauze on ventilation (OR = 7.187 with p = 0.000, p < 0.05), the condition of home walls (OR = 2.318 with p = 0.041, p < 0.05), the availability of ceiling OR = 2.657 with p = 0.000, p<0.05), the presence of cattle sheds (OR = 4.742 with p = 0.001, p <0,05), the presence of puddle around the home (OR = 2.007 and p = 0.047, p < 0.05), and the presence of shrubs around the home (OR = 2.706 with p = 0.000, p < 0.05) and the incidence of malaria in Oesao PHC.Conclusion: The incidence of malaria in the work area of Oesao PHC was related to behavior and physical environment inside and outside the house.Keywords: behavior, environment, malari
Knowledge, Attitude and Practice on Dengue Fever Transmission Among Urban and Periurban Residents of Dhaka City, Bangladesh
Get PDFABSTRACTIntroduction: Dengue is one of the most important emerging viral diseases of major public health concern in Bangladesh.Objectives: The purpose of this study is to assess the level of knowledge, attitude and practice on dengue fever transmission and prevention among the residents of Dhaka city, Bangladesh.Methods: A cross-sectional study was done among three hundred and forty three randomly selected residents of urban and periurban regions of Dhaka city in November in 2012 using a pretested and self administered questionnaire. Data was analyzed by a Chi square test and p value less than 0.05 is considered as significant.Results: The study found that among the respondents 63.3% were female, 48% were married and 37.7% were of age group of 21-30 (mean=31.34, SD=11.758). Majority of the respondents had secondary/higher secondary (50.9%) and students represented 34.1% of the total respondents. It was found most of them had no history of having affected from dengue fever (97.7%) and 53.2% did not travel to the subtropical or tropical region. Television (61.2%) and radio (50.4) were most common source of information of dengue fever. Majority of the respondents had low level of knowledge on dengue (89.1%). It was found that 81% knew that mosquitoes generally lay their eggs on dirty water, 79.6% knew mosquitoes spread dengue from one person to another and 70.6% were aware that dengue can fever is flu like illness that affects infants, young, children and adults. The study revealed 50.1% had neutral attitude towards dengue fever, and there was significant association between age and practice (p=0.031); knowledge and practice (p<0.000) and also attitude and practice (p<0.000). Conclusion: There is a different level of knowledge regarding dengue fever among respondents in the study area. Public awareness is necessary to address the knowledge gap revealed by this study. Hence it is necessary to organize the public education program to prevent the people from the outbreak of dengue by increasing level of Knowledge so that they can attain positive attitude and adopt desired behavioral changes.Keywords: Knowledge, Attitude, Practice, Dengue Fever, Dengue Hemorrhagic Fever, Dengue Shock Syndrome
Evaluation of the Performance of Malaria Microscopist in Primary Health Center and Cross Checker in Belu, East Nusa Tenggara.
Get PDFABSTRACTIntroduction: It was reported that error rate of malaria microscopic examination of microscopist at Primary Health Center and District Health of fice of Belu, Nusa Tenggara Timur (NTT) was high (45-100%). These high level of error rate might becaused by several factors such as lack of qualified personnel, lack of technical skills in the microscopic slide preparation (blood smear) or incompetency in parasite identification on bloods mear preparation.Objectives: To evaluate the performance of malaria microscopists at Primary Health Centers and cross checker in Belu District and determining the factors that contribute to those condition.Methods: The study was an observational and exploratory research with cross sectional approach. The competency of the malaria microscopist at the primary health center and district health office in examining malaria blood smears were evaluated using standard bloods mears and the one from Passive Case Detection (PCD) activities. Performance in preparing bloods mear were evaluatied by observation and filling the checklist. The study was conducted in December 2012 – March 2013 in Belu District, NTT.Results: The competency of the microscopists to identify malaria in fection was low.The error rate in examining PCD bloods mears ranged from 20 - 100%. The error rate of the microscopic reading at district level reached 52%, with a kappa value between 0.41 to 0.60. There was different levels of the error rate using standard and PCD bloods mears. Error rate in diagnosing malaria on PCD blood smears was higher than those on gold standard blood smears. Accuracy to identify P.falciparum was high (100%) than those to identify P.vivax (0 - 75%). False-positive diagnosis is as high as 90% when examining PCD blood smears. Missed diagnosis of malaria parasite also occure in around 60% of personnel when examining blood smears with low density of less than 1000 parasites/ìl of blood)Conclusion: The accuracy of malaria diagnosis by microscopist in the Health Center in District of Belu is low. The factor that might contribute is the ability of the microscopist to produce a good quality of malaria blood smears. Working experience of the health center microscopist is statistically significant to correlate with accuracy of malaria diagnosis.Keywords: Errorrate, the performance evaluation of microscopists, microscopic examination, blood smear Bel