Pratiwi Sudarmono - Academia.edu (original) (raw)
Papers by Pratiwi Sudarmono
Journal of health, population, and nutrition, 2004
Visits to household during a census in an impoverished area of north Jakarta were used for explor... more Visits to household during a census in an impoverished area of north Jakarta were used for exploring the four-week prevalence of diarrhoea, factors associated with episodes of diarrhoea, and the patterns of healthcare use. For 160,261 urban slum-dwellers, information was collected on the socioeconomic status of the household and on diarrhoea episodes of individual household residents in the preceding four weeks. In households with a reported case of diarrhoea, the household head was asked which form of healthcare was used first. In total, 8,074 individuals (5%)--13% of children aged less than five years and 4% of adults--had a diarrhoea episode in the preceding four weeks. The two strongest factors associated with a history of diarrhoea were a diarrhoea episode in another household member in the four weeks preceding the interview (adjusted odds ratio [OR] 11.1; 95% confidence interval [CI] 10.4-11.8) and age less than five years (adjusted OR 3.4; 95% CI 3.2-3.5). Of the 8,074 diarrh...
Journal of thee Medical Sciences (Berkala Ilmu Kedokteran), 2016
Virus and bacteria are microbes which are the most common cause human infection. Most of the bact... more Virus and bacteria are microbes which are the most common cause human infection. Most of the bacterial infection can be eradicated by antibiotics and infection symptoms disappear. However, eradication is more complicated in viral infection, because viruses will persistently stay in the host, some even undergoes not only lytic cycle but also integration into host genome. Nowadays, there are at least 6 virus types consistently related to human cancer, such as EBV, HPV, HTLV, HBV, HCV, HKSV, and the new one Merkel Virus (MCV). Although not every infected people will get cancer, around 20% of the whole cancers in human are caused by viral oncogene. Class one oncogenic bacteria is Helicobacter pylori. Infection with this bacterium causes persistent gastro-duodenal inflammation, which in turn alters gastric cell growth and transformation. Expression of Cag gene and Vac gene and some expression of OMP protein are usually linked to gastric cancer. The complex molecular mechanisms of carcinogenesis for every infective virus include several processes triggered by cell transformation. In addition, other host and environmental factors play significant roles in cancer development. Some scientist put a hallmark analysis as a model to quickly summarize the ongoing pathobiological process will and which gene or protein caused the process. The hallmark analysis is comprised of several process which may happen simultaneously, because some of the hallmark is caused by the same protein. The hallmark consists of various virus strategies in oncogenesis such as promoting angiogenesis, avoiding immune destruction, triggering genome instability and mutation, deregulating cellular energetics, resisting cell death, sustaining proliferative signals, evading growth suppressors, enabling cellular immortality, promoting inflammation, and triggering metastasis. For example, HPV infection will cause low-grade dysplasia which might continue to become invasive cervical cancer. After host cell transformation, in the long control region genes, E6 and E7 protein will promote several strategies in oncogenesis including resisting cell death and evading growth suppressors. HBV infection will end without any serious liver damage, but after cell transformation, almost all hallmark strategies of viral oncogenesis are happening step by step in line with the severity of hepatocellular damage. As the onset of cancer development after infection can last for years, there is an opportunity to design either vaccine or genetic therapy to minimize further risk of human cancers.
An indirect enzyme-linked immwtosorbent assay (ELISA) was used to detecl immunoglobulin M antibod... more An indirect enzyme-linked immwtosorbent assay (ELISA) was used to detecl immunoglobulin M antibodies against outer membrane protein (OMPs) from Salmonella typhi as the antigen. Acute phase, first week, sera from adult patients with culture confirmed typhoid feve4 sera from culture negative suspected typhoid fever and sera from healthy blood donors were tested. Sera from the three groups gave a nTean absorbance reading at 492 nm, of 1.21 + 0.59, 0.15 + 0.13 and 0.11 + 0.08, respectively. The sensitivity, specificity, positive and negative predictive values were 8l.5Vo, 100Vo, l00Vo and 90.2Vo, respectively. The cut offvalue obtainetl was 0.35 and in which the ELISA test of typhoid fever patients (Group I ) showed the mean absorbance reading approximately 3.5 times higher
Acta medica Indonesiana, 2021
BACKGROUND real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (C... more BACKGROUND real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (Ct) values were expected to have an association with clinical manifestation. However, the diagnostic modalities such as quantitative molecular detection and virus isolation were not yet available for the routine test. This study has been conducted to analyze the relationship between the Ct values of qualitative rRT-PCR and the clinical manifestation and to describe the factors determining the result. METHODS from March to April 2020, specimens were sent to our laboratory from different healthcare centers in Jakarta. The patient's characteristic and clinical manifestation were extracted from the specimen's epidemiology forms. The specimens extracted and tested using rRT-PCR, and the Ct value were collected. The data were analyzed using the appropriate statistic test. RESULTS from 339 positive results, the mild to moderate case was 176 (52%) and the severe cases was 163 (48%). Femal...
International Journal of Pharmacy and Pharmaceutical Sciences, 2014
Objective: The aim of this study was to examine extracts from Indonesian plants to identify a com... more Objective: The aim of this study was to examine extracts from Indonesian plants to identify a compound(s) responsible for antiviral activity against hepatitis C virus (HCV). Methods: Huh7it-1 cells, a clone of human hepatocellular carcinoma-derived Huh7 cells, were infected with the HCV genotype 2a strain JFH1 in the presence of crude methanol extracts from the plants. The extracts were further fractionated and purified by anti-HCV bioactivity-guided analysis using a combination of various column chromatography techniques. The isolated compounds were examined for anti-HCV activity and cytotoxicity, and their structures determined by nuclear magnetic resonance spectroscopy and liquid chromatography–mass spectrometry. Results: Screening of Indonesian plants revealed that a crude methanol extract from Kalanchoe pinnata exhibited anti-HCV activity with a 50%inhibitory concentration (IC50) of 17.2 μg/ml. An ethyl acetate fraction was found to possess strong anti-HCV activity, from which ...
The American Journal of Tropical Medicine and Hygiene
ABSTRACT. HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know th... more ABSTRACT. HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know their status. In a prospective cohort of 1,453 hospitalized patients with unexplained fever, 46 (3.2%) had HIV, including 15 (1.1%) patients without a prior HIV diagnosis. Among 31 subjects previously known to have HIV, 21 (68%) had been receiving combination antiretroviral therapy (cART) at the time of enrollment. Of 39 HIV cases with HIV RNA levels ≥ 100 copies/mL, sequencing for genotype analysis and resistance testing was successful in 30 (77%) subjects. The most common HIV subtypes were AE (90%) and B (10%). Five (16.7%) subjects had resistance mutations to nucleoside and non-nucleoside reverse transcriptase inhibitors, and all of them were on cART. No evidence of transmitted drug resistance was found in newly diagnosed individuals. Hospital-based screening may be an efficient method to expand HIV testing and identify a significant number of new cases. Access to care, close monitoring...
Journal of Medical Microbiology
Introduction. Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem globally... more Introduction. Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem globally, including in Indonesia. Whole-genome sequencing (WGS) analysis has rarely been used for the study of TB and MDR-TB in Indonesia. Aim. We evaluated the use of WGS for drug-susceptibility testing (DST) and to investigate the population structure of drug-resistant Mycobacterium tuberculosis in Java, Indonesia. Methodology. Thirty suspected MDR-TB isolates were subjected to MGIT 960 system (MGIT)-based DST and to WGS. Phylogenetic analysis was done using the WGS data. Results obtained using MGIT-based DST and WGS-based DST were compared. Results. Agreement between WGS and MGIT was 93.33 % for rifampicin, 83.33 % for isoniazid and 76.67 % for streptomycin but only 63.33 % for ethambutol. Moderate WGS–MGIT agreement was found for second-line drugs including amikacin, kanamycin and fluoroquinolone (73.33–76.67 %). MDR-TB was more common in isolates of the East Asian Lineage (63.3%). No eviden...
PLOS Neglected Tropical Diseases
Background Chikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and ... more Background Chikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and subtropical regions. Lack of diagnostic testing capacity in these areas combined with co-circulation of clinically similar pathogens such as dengue virus (DENV), hinders CHIKV diagnosis. To better address CHIKV in Indonesia, an improved understanding of epidemiology, clinical presentation, and diagnostic approaches is needed. Methodology/Principal findings Acutely hospitalized febrile patients �1-year-old were enrolled in a multi-site observational cohort study conducted in Indonesia from 2013 to 2016. Demographic and clinical data were collected at enrollment; blood specimens were collected at enrollment, once during days 14 to 28, and three months after enrollment. Plasma samples negative for DENV by serology and/or molecular assays were screened for evidence of acute CHIKV infection (ACI) by serology and molecular assays. To address the co-infection of DENV and CHIKV, DENV cases were selected randomly to be screened for evidence of ACI. ACI was confirmed in 40/1,089 (3.7%) screened subjects, all of whom were DENV negative. All 40 cases initially received other diagnoses, most commonly dengue fever, typhoid fever, and leptospirosis. ACI was found at five of the seven study cities, though evidence of prior CHIKV exposure was observed in 25.2% to 45.9% of subjects across sites. All subjects were assessed during hospitalization as mildly or moderately ill, consistent with the Asian genotype of PLOS NEGLECTED TROPICAL DISEASES
Influenza and Other Respiratory Viruses
Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. Ho... more Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology.
Journal of Marine Science: Research & Development, 2017
The emergence of new infectious diseases, the resurgence of several infections that appeared to h... more The emergence of new infectious diseases, the resurgence of several infections that appeared to have been controlled, and the increase in bacterial resistance have created the necessity for studies directed towards the development of new antimicrobials; considering the failure to acquire new molecules with antimicrobial properties from marine sponges. The objective of this study was to evaluate screening of antimicrobial activity of seven sponges extract from Pasir Putih, East Java against some Gram-positive bacteria (Staphylococcus aureus and Bacillus subtilis) and Gram negative (Escherichia coli and Klebsiella pneumoniae) as well as drug-resistant bacteria (S. aureus and Pseudomonas aeruginosae) using the agar diffusion method and phytochemical screening of the extract. The findings show that the extract, Xestospongia testudinaria has a stronger antibacterial activity against bacterial pathogens S. aureus, E.coli, K. pneumoniae, Salmonella typhi and bacteria resistant P. aeruginosa MDR and S. aureus MRSA compared to other sponge extract. In conclusion, the showed X. testudinaria ethanol extract was more active than other sponge extracts.
BMC Infectious Diseases
Background The burden of leptospirosis in Indonesia is poorly understood. Data from an observatio... more Background The burden of leptospirosis in Indonesia is poorly understood. Data from an observational study conducted from 2013 to 2016 in seven cities across Indonesia was used to estimate the incidence of leptospirosis and document its clinical manifestations in patients requiring hospitalization. Methods Specimens from patients hospitalized with acute fever were collected at enrollment, 14–28 days, and 3 months. Demographic and clinical information were collected during study visits and/or retrieved from medical records and double-entered into clinical report forms. After initially screening for dengue virus and other pathogens, specimens were tested at a central Reference Laboratory for anti-Leptospira IgM using commercial ELISA kits and for Leptospira DNA using an in-house quantitative real-time PCR assay. Results Of 1464 patients enrolled, 45 (3.1%) confirmed cases (by PCR and/or sero-coversion or four-fold increase of IgM) and 6 (0.4%) probable cases (by high titer IgM) of lep...
Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to... more Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia.Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for rickettsia IgM and IgG by IFA and rickettsia genomes using primers for Rickettsia (R.) sp, R. typhi, and Orientia tsutsugamushi. Testing was performed retrospectively on stored specimens; results did not inform patient management.Results: Subject tested positive for R. typhi, R. rickettsia, and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of subjects, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea...
PLOS Neglected Tropical Diseases
Background The epidemiology of acute febrile illness, a common cause of hospitalization in Indone... more Background The epidemiology of acute febrile illness, a common cause of hospitalization in Indonesia, has not been systematically studied. Methodology/Principal findings This prospective observational study enrolled febrile patients (temperature �38˚C) aged �1 year from July 2013 until June 2016 at eight government referral teaching hospitals in seven provincial capitals in Indonesia. Patients were managed according to the hospital standardof-care (SOC), and blood samples were drawn for molecular and serological assays. Clinical data, laboratory results, and specimens for additional tests were collected at enrollment, days 14-28, and at three months. Regular follow-up visits were then scheduled for every three months either until symptoms resolved or until one year. In total, this study included 1,486 adult and pediatric patients presenting with multi-organ (768, 51.7%), gastrointestinal (497, 33.0%), respiratory (114, 7.7%), constitutional (62, 4.2%), skin and soft-tissue (24, 1.6%), central nervous system (17, 1.1%), or genitourinary (4, 0.3%) manifestations. Microbiological diagnoses were found in 1,003/1,486 (67.5%) participants, of which 351/1,003 (35.0%) were not diagnosed during hospitalization using SOC diagnostic tests. Missed diagnoses included all cases caused by Rickettsia spp., chikungunya, influenza, and Seoul virus. The most common etiologic agents identified were dengue virus (467, 46.6%),
International Journal of Applied Pharmaceutics
Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp... more Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp. Gamma-hexachlorocyclohexane is an effective treatment but its use has been discontinued because of its neurotoxicity. Although the replacement pediculicide is permethrin, this is not affordable for everyone, and thus the recommended treatment is wet combing. The aim of this study is to evaluate the effectiveness of permethrin compared with wet combing for eliminating pediculosis. Methods: This study was a randomized controlled trial (RCT) conducted in a boarding school in Bogor District; the data were collected in July–August, 2018. Subjects were regarded as infested if lice were found during examination. Infested subjects were divided into two groups. In the permethrin group, the hair was wetted with permethrin lotion and left for 10 min. Afterwards, a fine-toothed comb was used to remove lice, and then the subjects were instructed to wash their hair with shampoo. On day 14, each subj...
Emerging Infectious Diseases
Antimicrobial resistance and infection control, 2018
Carbapenem-nonsusceptible complex have emerged worldwide, but the epidemiology in Indonesian hosp... more Carbapenem-nonsusceptible complex have emerged worldwide, but the epidemiology in Indonesian hospitals has not been studied. A prospective observational study was performed on the intensive care units (ICUs) of the national referral hospital in Jakarta-Indonesia, in 2013 and 2014. All consecutive adult patients admitted and hospitalized for >48 h in ICUs were included. Basic and clinical data at admission were recorded. Carbapenem-nonsusceptible complex from clinical cultures and standardized screening were included. Environmental niches and healthcare workers (HCWs) were also screened. PCR was used to detect carbapenemase genes, and Raman spectroscopy as well as multilocus sequence typing (MLST) for typing. Of 412 included patients, 69 (16.7%) carried carbapenem-nonsusceptible complex on admission, and 89 (25.9%) became positive during ICU stay. The acquisition rate was 43 per 1000 patient-days at risk. Six isolates were cultured from environment and one from a HCW. Acquisition ...
eJournal Kedokteran Indonesia, 2015
Buletin Penelitian Kesehatan, 2010
<p class="Style11">Abstract. Mapping TB genotype of Mycobacterium tuberculosis (M... more <p class="Style11">Abstract. Mapping TB genotype of Mycobacterium tuberculosis (Mtb) is an important study to identify their distribution or characteristic and also may lead to improve control of the disease. This study conducted a preliminary mapping of the tubercle bacilli which had been circulating in Indonesia. Cultures of DNA isolated from TB patients at urban areas in 16 provinces in Indonesia, are chosen based on TB Case Detection Rate (CDR) 2006 from Indonesia Directorate General of Communicable Disease Control and Environment Health (Ministry of Health), were analyzed by spoligotyping for strain differentiation. In this first part, the analyzed result only came from urban areas in 10 provinces, i.e. Palembang, Bandar Lampung, Serang, Jakarta, Bandung, Surabaya, Banjarmasin, Makassar, Pontianak and Ambon.</p> <p class="Style11">Sample were 269 DNA from 294 isolates collected from sputum of suspect TB patients with sputum-smear positive (SS+) and age above 15 years old. All samples were obtained from peripheral health laboratory in each province. The procedure collection is accordance to Indonesia DOTs guidelines (AFB smears) and samples were transported from those 10 areas to Bacteriology Laboratory at CBPRD. Sputum was taken for culture in liquid media MGIT Bactec 960 and solid media Lowenstein Jensen. The DNAs from positive liquid media MGIT Bactec 960 were isolated and analyzed by spoligotyping to identify the spoligo pattern. The spoligotyping results converted into octal format within Words & Excel spreadsheets and compared to International Spoligotype-database (SpolDB4).</p> <p class="Style11">The previous study (Parwati et.al.) found some differences geographical distribution between Beijing genotype strain of tubercle bacilli in West Indonesia compare to East Indonesia, and the same pattern was also found in this study. Furthermore, the results in this study showed the differences in spoligo pattern of Mtb complex at 10 urban areas in West, Middle and East Indonesia. The percentage of Beijing [...]
Journal of health, population, and nutrition, 2004
Visits to household during a census in an impoverished area of north Jakarta were used for explor... more Visits to household during a census in an impoverished area of north Jakarta were used for exploring the four-week prevalence of diarrhoea, factors associated with episodes of diarrhoea, and the patterns of healthcare use. For 160,261 urban slum-dwellers, information was collected on the socioeconomic status of the household and on diarrhoea episodes of individual household residents in the preceding four weeks. In households with a reported case of diarrhoea, the household head was asked which form of healthcare was used first. In total, 8,074 individuals (5%)--13% of children aged less than five years and 4% of adults--had a diarrhoea episode in the preceding four weeks. The two strongest factors associated with a history of diarrhoea were a diarrhoea episode in another household member in the four weeks preceding the interview (adjusted odds ratio [OR] 11.1; 95% confidence interval [CI] 10.4-11.8) and age less than five years (adjusted OR 3.4; 95% CI 3.2-3.5). Of the 8,074 diarrh...
Journal of thee Medical Sciences (Berkala Ilmu Kedokteran), 2016
Virus and bacteria are microbes which are the most common cause human infection. Most of the bact... more Virus and bacteria are microbes which are the most common cause human infection. Most of the bacterial infection can be eradicated by antibiotics and infection symptoms disappear. However, eradication is more complicated in viral infection, because viruses will persistently stay in the host, some even undergoes not only lytic cycle but also integration into host genome. Nowadays, there are at least 6 virus types consistently related to human cancer, such as EBV, HPV, HTLV, HBV, HCV, HKSV, and the new one Merkel Virus (MCV). Although not every infected people will get cancer, around 20% of the whole cancers in human are caused by viral oncogene. Class one oncogenic bacteria is Helicobacter pylori. Infection with this bacterium causes persistent gastro-duodenal inflammation, which in turn alters gastric cell growth and transformation. Expression of Cag gene and Vac gene and some expression of OMP protein are usually linked to gastric cancer. The complex molecular mechanisms of carcinogenesis for every infective virus include several processes triggered by cell transformation. In addition, other host and environmental factors play significant roles in cancer development. Some scientist put a hallmark analysis as a model to quickly summarize the ongoing pathobiological process will and which gene or protein caused the process. The hallmark analysis is comprised of several process which may happen simultaneously, because some of the hallmark is caused by the same protein. The hallmark consists of various virus strategies in oncogenesis such as promoting angiogenesis, avoiding immune destruction, triggering genome instability and mutation, deregulating cellular energetics, resisting cell death, sustaining proliferative signals, evading growth suppressors, enabling cellular immortality, promoting inflammation, and triggering metastasis. For example, HPV infection will cause low-grade dysplasia which might continue to become invasive cervical cancer. After host cell transformation, in the long control region genes, E6 and E7 protein will promote several strategies in oncogenesis including resisting cell death and evading growth suppressors. HBV infection will end without any serious liver damage, but after cell transformation, almost all hallmark strategies of viral oncogenesis are happening step by step in line with the severity of hepatocellular damage. As the onset of cancer development after infection can last for years, there is an opportunity to design either vaccine or genetic therapy to minimize further risk of human cancers.
An indirect enzyme-linked immwtosorbent assay (ELISA) was used to detecl immunoglobulin M antibod... more An indirect enzyme-linked immwtosorbent assay (ELISA) was used to detecl immunoglobulin M antibodies against outer membrane protein (OMPs) from Salmonella typhi as the antigen. Acute phase, first week, sera from adult patients with culture confirmed typhoid feve4 sera from culture negative suspected typhoid fever and sera from healthy blood donors were tested. Sera from the three groups gave a nTean absorbance reading at 492 nm, of 1.21 + 0.59, 0.15 + 0.13 and 0.11 + 0.08, respectively. The sensitivity, specificity, positive and negative predictive values were 8l.5Vo, 100Vo, l00Vo and 90.2Vo, respectively. The cut offvalue obtainetl was 0.35 and in which the ELISA test of typhoid fever patients (Group I ) showed the mean absorbance reading approximately 3.5 times higher
Acta medica Indonesiana, 2021
BACKGROUND real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (C... more BACKGROUND real-time RT-PCR was recommended by WHO for COVID-19 diagnosis. The cycle threshold (Ct) values were expected to have an association with clinical manifestation. However, the diagnostic modalities such as quantitative molecular detection and virus isolation were not yet available for the routine test. This study has been conducted to analyze the relationship between the Ct values of qualitative rRT-PCR and the clinical manifestation and to describe the factors determining the result. METHODS from March to April 2020, specimens were sent to our laboratory from different healthcare centers in Jakarta. The patient's characteristic and clinical manifestation were extracted from the specimen's epidemiology forms. The specimens extracted and tested using rRT-PCR, and the Ct value were collected. The data were analyzed using the appropriate statistic test. RESULTS from 339 positive results, the mild to moderate case was 176 (52%) and the severe cases was 163 (48%). Femal...
International Journal of Pharmacy and Pharmaceutical Sciences, 2014
Objective: The aim of this study was to examine extracts from Indonesian plants to identify a com... more Objective: The aim of this study was to examine extracts from Indonesian plants to identify a compound(s) responsible for antiviral activity against hepatitis C virus (HCV). Methods: Huh7it-1 cells, a clone of human hepatocellular carcinoma-derived Huh7 cells, were infected with the HCV genotype 2a strain JFH1 in the presence of crude methanol extracts from the plants. The extracts were further fractionated and purified by anti-HCV bioactivity-guided analysis using a combination of various column chromatography techniques. The isolated compounds were examined for anti-HCV activity and cytotoxicity, and their structures determined by nuclear magnetic resonance spectroscopy and liquid chromatography–mass spectrometry. Results: Screening of Indonesian plants revealed that a crude methanol extract from Kalanchoe pinnata exhibited anti-HCV activity with a 50%inhibitory concentration (IC50) of 17.2 μg/ml. An ethyl acetate fraction was found to possess strong anti-HCV activity, from which ...
The American Journal of Tropical Medicine and Hygiene
ABSTRACT. HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know th... more ABSTRACT. HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know their status. In a prospective cohort of 1,453 hospitalized patients with unexplained fever, 46 (3.2%) had HIV, including 15 (1.1%) patients without a prior HIV diagnosis. Among 31 subjects previously known to have HIV, 21 (68%) had been receiving combination antiretroviral therapy (cART) at the time of enrollment. Of 39 HIV cases with HIV RNA levels ≥ 100 copies/mL, sequencing for genotype analysis and resistance testing was successful in 30 (77%) subjects. The most common HIV subtypes were AE (90%) and B (10%). Five (16.7%) subjects had resistance mutations to nucleoside and non-nucleoside reverse transcriptase inhibitors, and all of them were on cART. No evidence of transmitted drug resistance was found in newly diagnosed individuals. Hospital-based screening may be an efficient method to expand HIV testing and identify a significant number of new cases. Access to care, close monitoring...
Journal of Medical Microbiology
Introduction. Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem globally... more Introduction. Multidrug-resistant tuberculosis (MDR-TB) is a major public health problem globally, including in Indonesia. Whole-genome sequencing (WGS) analysis has rarely been used for the study of TB and MDR-TB in Indonesia. Aim. We evaluated the use of WGS for drug-susceptibility testing (DST) and to investigate the population structure of drug-resistant Mycobacterium tuberculosis in Java, Indonesia. Methodology. Thirty suspected MDR-TB isolates were subjected to MGIT 960 system (MGIT)-based DST and to WGS. Phylogenetic analysis was done using the WGS data. Results obtained using MGIT-based DST and WGS-based DST were compared. Results. Agreement between WGS and MGIT was 93.33 % for rifampicin, 83.33 % for isoniazid and 76.67 % for streptomycin but only 63.33 % for ethambutol. Moderate WGS–MGIT agreement was found for second-line drugs including amikacin, kanamycin and fluoroquinolone (73.33–76.67 %). MDR-TB was more common in isolates of the East Asian Lineage (63.3%). No eviden...
PLOS Neglected Tropical Diseases
Background Chikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and ... more Background Chikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and subtropical regions. Lack of diagnostic testing capacity in these areas combined with co-circulation of clinically similar pathogens such as dengue virus (DENV), hinders CHIKV diagnosis. To better address CHIKV in Indonesia, an improved understanding of epidemiology, clinical presentation, and diagnostic approaches is needed. Methodology/Principal findings Acutely hospitalized febrile patients �1-year-old were enrolled in a multi-site observational cohort study conducted in Indonesia from 2013 to 2016. Demographic and clinical data were collected at enrollment; blood specimens were collected at enrollment, once during days 14 to 28, and three months after enrollment. Plasma samples negative for DENV by serology and/or molecular assays were screened for evidence of acute CHIKV infection (ACI) by serology and molecular assays. To address the co-infection of DENV and CHIKV, DENV cases were selected randomly to be screened for evidence of ACI. ACI was confirmed in 40/1,089 (3.7%) screened subjects, all of whom were DENV negative. All 40 cases initially received other diagnoses, most commonly dengue fever, typhoid fever, and leptospirosis. ACI was found at five of the seven study cities, though evidence of prior CHIKV exposure was observed in 25.2% to 45.9% of subjects across sites. All subjects were assessed during hospitalization as mildly or moderately ill, consistent with the Asian genotype of PLOS NEGLECTED TROPICAL DISEASES
Influenza and Other Respiratory Viruses
Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. Ho... more Severe acute respiratory infection (SARI) accounts for a large burden of illness in Indonesia. However, epidemiology of SARI in tertiary hospitals in Indonesia is unknown. This study sought to assess the burden, clinical characteristics, and etiologies of SARI and concordance of clinical diagnosis with confirmed etiology.
Journal of Marine Science: Research & Development, 2017
The emergence of new infectious diseases, the resurgence of several infections that appeared to h... more The emergence of new infectious diseases, the resurgence of several infections that appeared to have been controlled, and the increase in bacterial resistance have created the necessity for studies directed towards the development of new antimicrobials; considering the failure to acquire new molecules with antimicrobial properties from marine sponges. The objective of this study was to evaluate screening of antimicrobial activity of seven sponges extract from Pasir Putih, East Java against some Gram-positive bacteria (Staphylococcus aureus and Bacillus subtilis) and Gram negative (Escherichia coli and Klebsiella pneumoniae) as well as drug-resistant bacteria (S. aureus and Pseudomonas aeruginosae) using the agar diffusion method and phytochemical screening of the extract. The findings show that the extract, Xestospongia testudinaria has a stronger antibacterial activity against bacterial pathogens S. aureus, E.coli, K. pneumoniae, Salmonella typhi and bacteria resistant P. aeruginosa MDR and S. aureus MRSA compared to other sponge extract. In conclusion, the showed X. testudinaria ethanol extract was more active than other sponge extracts.
BMC Infectious Diseases
Background The burden of leptospirosis in Indonesia is poorly understood. Data from an observatio... more Background The burden of leptospirosis in Indonesia is poorly understood. Data from an observational study conducted from 2013 to 2016 in seven cities across Indonesia was used to estimate the incidence of leptospirosis and document its clinical manifestations in patients requiring hospitalization. Methods Specimens from patients hospitalized with acute fever were collected at enrollment, 14–28 days, and 3 months. Demographic and clinical information were collected during study visits and/or retrieved from medical records and double-entered into clinical report forms. After initially screening for dengue virus and other pathogens, specimens were tested at a central Reference Laboratory for anti-Leptospira IgM using commercial ELISA kits and for Leptospira DNA using an in-house quantitative real-time PCR assay. Results Of 1464 patients enrolled, 45 (3.1%) confirmed cases (by PCR and/or sero-coversion or four-fold increase of IgM) and 6 (0.4%) probable cases (by high titer IgM) of lep...
Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to... more Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia.Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for rickettsia IgM and IgG by IFA and rickettsia genomes using primers for Rickettsia (R.) sp, R. typhi, and Orientia tsutsugamushi. Testing was performed retrospectively on stored specimens; results did not inform patient management.Results: Subject tested positive for R. typhi, R. rickettsia, and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of subjects, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea...
PLOS Neglected Tropical Diseases
Background The epidemiology of acute febrile illness, a common cause of hospitalization in Indone... more Background The epidemiology of acute febrile illness, a common cause of hospitalization in Indonesia, has not been systematically studied. Methodology/Principal findings This prospective observational study enrolled febrile patients (temperature �38˚C) aged �1 year from July 2013 until June 2016 at eight government referral teaching hospitals in seven provincial capitals in Indonesia. Patients were managed according to the hospital standardof-care (SOC), and blood samples were drawn for molecular and serological assays. Clinical data, laboratory results, and specimens for additional tests were collected at enrollment, days 14-28, and at three months. Regular follow-up visits were then scheduled for every three months either until symptoms resolved or until one year. In total, this study included 1,486 adult and pediatric patients presenting with multi-organ (768, 51.7%), gastrointestinal (497, 33.0%), respiratory (114, 7.7%), constitutional (62, 4.2%), skin and soft-tissue (24, 1.6%), central nervous system (17, 1.1%), or genitourinary (4, 0.3%) manifestations. Microbiological diagnoses were found in 1,003/1,486 (67.5%) participants, of which 351/1,003 (35.0%) were not diagnosed during hospitalization using SOC diagnostic tests. Missed diagnoses included all cases caused by Rickettsia spp., chikungunya, influenza, and Seoul virus. The most common etiologic agents identified were dengue virus (467, 46.6%),
International Journal of Applied Pharmaceutics
Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp... more Objective: Pediculus humanus capitis is an ectoparasite that sucks blood from the patient’s scalp. Gamma-hexachlorocyclohexane is an effective treatment but its use has been discontinued because of its neurotoxicity. Although the replacement pediculicide is permethrin, this is not affordable for everyone, and thus the recommended treatment is wet combing. The aim of this study is to evaluate the effectiveness of permethrin compared with wet combing for eliminating pediculosis. Methods: This study was a randomized controlled trial (RCT) conducted in a boarding school in Bogor District; the data were collected in July–August, 2018. Subjects were regarded as infested if lice were found during examination. Infested subjects were divided into two groups. In the permethrin group, the hair was wetted with permethrin lotion and left for 10 min. Afterwards, a fine-toothed comb was used to remove lice, and then the subjects were instructed to wash their hair with shampoo. On day 14, each subj...
Emerging Infectious Diseases
Antimicrobial resistance and infection control, 2018
Carbapenem-nonsusceptible complex have emerged worldwide, but the epidemiology in Indonesian hosp... more Carbapenem-nonsusceptible complex have emerged worldwide, but the epidemiology in Indonesian hospitals has not been studied. A prospective observational study was performed on the intensive care units (ICUs) of the national referral hospital in Jakarta-Indonesia, in 2013 and 2014. All consecutive adult patients admitted and hospitalized for >48 h in ICUs were included. Basic and clinical data at admission were recorded. Carbapenem-nonsusceptible complex from clinical cultures and standardized screening were included. Environmental niches and healthcare workers (HCWs) were also screened. PCR was used to detect carbapenemase genes, and Raman spectroscopy as well as multilocus sequence typing (MLST) for typing. Of 412 included patients, 69 (16.7%) carried carbapenem-nonsusceptible complex on admission, and 89 (25.9%) became positive during ICU stay. The acquisition rate was 43 per 1000 patient-days at risk. Six isolates were cultured from environment and one from a HCW. Acquisition ...
eJournal Kedokteran Indonesia, 2015
Buletin Penelitian Kesehatan, 2010
<p class="Style11">Abstract. Mapping TB genotype of Mycobacterium tuberculosis (M... more <p class="Style11">Abstract. Mapping TB genotype of Mycobacterium tuberculosis (Mtb) is an important study to identify their distribution or characteristic and also may lead to improve control of the disease. This study conducted a preliminary mapping of the tubercle bacilli which had been circulating in Indonesia. Cultures of DNA isolated from TB patients at urban areas in 16 provinces in Indonesia, are chosen based on TB Case Detection Rate (CDR) 2006 from Indonesia Directorate General of Communicable Disease Control and Environment Health (Ministry of Health), were analyzed by spoligotyping for strain differentiation. In this first part, the analyzed result only came from urban areas in 10 provinces, i.e. Palembang, Bandar Lampung, Serang, Jakarta, Bandung, Surabaya, Banjarmasin, Makassar, Pontianak and Ambon.</p> <p class="Style11">Sample were 269 DNA from 294 isolates collected from sputum of suspect TB patients with sputum-smear positive (SS+) and age above 15 years old. All samples were obtained from peripheral health laboratory in each province. The procedure collection is accordance to Indonesia DOTs guidelines (AFB smears) and samples were transported from those 10 areas to Bacteriology Laboratory at CBPRD. Sputum was taken for culture in liquid media MGIT Bactec 960 and solid media Lowenstein Jensen. The DNAs from positive liquid media MGIT Bactec 960 were isolated and analyzed by spoligotyping to identify the spoligo pattern. The spoligotyping results converted into octal format within Words & Excel spreadsheets and compared to International Spoligotype-database (SpolDB4).</p> <p class="Style11">The previous study (Parwati et.al.) found some differences geographical distribution between Beijing genotype strain of tubercle bacilli in West Indonesia compare to East Indonesia, and the same pattern was also found in this study. Furthermore, the results in this study showed the differences in spoligo pattern of Mtb complex at 10 urban areas in West, Middle and East Indonesia. The percentage of Beijing [...]