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KETERKAITAN ANTIGEN NS1 INFEKSI VIRUS DENGUE DENGAN SEROTIPE VIRUS DENGUE Roudhotul Ismaillya Noor; Aryati Aryati; Puspa Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 2 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i2.1005

Abstract

Dengue virus infection (DVI) currently is detected by using dengue virus NS1 antigen (NS1 Ag). The sensitivity of NS1 Ag is 27.8%–93.4%,but recent study of Kumarasamy the sensitivity of NS1 Ag is better than the virus isolation and polymerase chain reaction (PCR). This studyis focussed on the evaluation of the validity of Panbio Dengue Early Rapid for the diagnosis of DVI and the NS1 Ag sensitivity associated withdengue virus serotypes. The sera was obtained from 65 DVI patients which diagnosed by the clinicians. The resulted diagnosis was foundby serology tests (positive IgM/IgG antidengue/NS1 Ag ELISA) and 1997 WHO criteria as the gold standard, and which also found 35 nonDVI patients (typhoid fever, HAV, malaria, UTI, tuberculosis and bronchopneumonia). The samples were examined by Panbio Dengue EarlyRapid. PCR was performed on each positive serological test result to determine the dengue virus serotypes. The sensitivity and specificity ofPanbio Dengue Early Rapid was 49.2% and 100%. The PCR results of 65 sera showed positive PCR in 49.2% (positive NS1 Ag was 62.5%).Meanwhile, and negative PCR in 50.8% (positive NS1 Ag was 36.4%). The predominance of serotypes (positive NS1 Ag) were DEN-3 (37.5%),DEN-4 (28.1%), DEN-1 (21.9%) and DEN-2 (12.5%). The Panbio Dengue Early Rapid can be used as early detection of DVI, although itshould be used in conjunction with other dengue serological tests as well. Unfortunately there is still not enough evidence about the NS1 Agsensitivity associated with the dengue virus serotypes.
IDENTIFICATION OF DENGUE VIRUS SEROTYPES AT THE DR. SOETOMO HOSPITAL SURABAYA IN 2016 AND ITS CORRELATION WITH NS1 ANTIGEN DETECTION Jeine Stela Akualing; Aryati Aryati; Puspa Wardhani; Usman Hadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 2 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i2.1138

Abstract

Serotipe virus dengue yang beredar terus mengalami perubahan dan berbeda di setiap daerah. Pergeseran serotipe maupun genotipedi dalamnya, mempengaruhi terjadinya wabah dengue di berbagai negara. Perbedaan serotipe diduga bernasab dengan deteksi antigen(Ag) non-structural 1 (NS1), namun belum banyak penelitian yang mendukung hal tersebut. Penelitian potong lintang dikerjakan sejakFebruari-Agustus 2016 dan didapatkan 60 subjek infeksi virus dengue (IVD) dan 25 non-IVD. Ribonucleic acid (RNA) virus denguediperiksa di semua subjek menggunakan Simplexa Dengue Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)termasuk identifikasi serotipe virus dengue dan pemeriksaan NS1 menggunakan uji cepat NS1 Panbio. Perbedaan perbandingan variabelkategorikal dianalisis dengan uji Fisher Exact. Kenasaban antara serotipe dengan deteksi Ag NS1 dianalisis dengan Chi-Kuadrat. RNAvirus dengue terdeteksi di 43 dari 60 subjek IVD (71,7%). Serotipe terbanyak adalah DENV-3 (62,8%). Pergeseran dominasi serotipetelah terjadi di Surabaya, sebelumnya dari DENV-2 ke DENV-1 dan sekarang DENV-3, kemungkinan akibat mobilitas pejamu, transporvirus dan faktor geografis. Kepekaan uji cepat NS1 75% dan kekhasan 100%. Persentase deteksi NS1 antar serotipe berbeda bermakna(p=0,002). Deteksi NS1 lebih rendah pada DENV-1 dibandingkan DENV-2 (p=0,007) ataupun DENV-3 (p=0,003). Serotipe virusdengue bernasab dengan deteksi NS1 (p=0,005). Ciri serotipe maupun genotipe virus dengue kemungkinan mempengaruhi sekresiNS1. Telah terjadi pergeseran serotipe virus dengue di pasien IVD di Surabaya sehingga diperlukan surveillance berkesinambunganuntuk memperkirakan terjadinya wabah. Serotipe bernasab dengan deteksi NS1. Salah satu penyebab hasil negatif palsu NS1 adalahperbedaan serotipe.
IgA ANTI-DENGUE PROFILE IN SAMPLES WITH POSITIVE DENGUE PCR OR NS1 M Thohirin Ramadhani; Aryati Aryati; M Vitanata Arfijanto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1483

Abstract

Dengue Virus Infection (DVI) causes several clinical manifestations and requires varied diagnostic instruments. IgA anti-dengue as one of the diagnostic markers of DVI is suspected to have a shorter lifespan and greater sensitivity in detecting secondary infections compared to IgM anti-dengue. This study was conducted using 34 sera with positive RT-PCR or NS1 dengue virus. Samples were examined by a reverse flowimmunochromatographic method using AIM Dengue IgA Assure Rapid Test and will be analyzed its profile toward the day of fever, serotype, severity, platelet count, and type of infection. The overall sensitivity of IgA anti-dengue was 61.76% (n=34); in which IgA anti-dengue detected 14.29% primary and 66.67% secondary cases. IgA anti-dengue detected DEN1, DEN2, DEN3, and Mixed DEN1 – DEN3 virus serotype respectively 55.56%, 22.22%, 16.67%, and 5.56% (n=20). The day of fever was dominated by day-4 and day-5 respectively 28.57% (n=21). IgA anti-dengue was detected in DD, DHF grade I, II, and III 42,86%, 28.57%, 19.05%, and 9.52% (n=21) respectively. IgA anti-dengue detected in all levels of platelet count, it detected 60% in < 50,000 cell/mm3, 30% in 50,000 - 100.000 cell/mm3 and 10% in > 100,000 cell/mm3 platelet count sample (n=20). In conclusion, IgA anti-dengue showed a good performance, applicable as a diagnostic marker of DVI.
PERBANDINGAN NILAI DIAGNOSTIK IGE SPESIFIK TUNGAU DEBU RUMAH, METODE ELISA DAN IMUNOBLOT PADA RINITIS ALERGI Janti Tri Habsari; Aryati Aryati; Dwi Reno Pawarti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1113

Abstract

The detection of allergen types is very helpful in allergic rhinitis (AR) management. Some methods had been performed to examinethe specific IgE due to HDM such as ELISA and immunoblot methods. The aim of this research is to know the difference of specificIgE diagnostic value due to HDM between ELISA and immunoblot in allergic rhinitis method which is expected to be used as in vitroalternative method which is safe, fast, effective, with a high sensitivity and specificity by provement. The samples were allergic rhinitisand non-allergic rhinitis patients at ENT of Head and Neck Out patients Clinic of Dr. Soetomo Hospital Surabaya. The sera was examinedfor specific IgE due to HDM by ELISA and immunoblot methods and then analyzed for its diagnostic value using the 2 x 2 table with a95% confidence interval. The comparation between both methods were analyzed with Wilcoxon test. The diagnostic value of the specificHDM IgE with immunoblot method showed sensitivity of 90% and 80% specificity, positive predictive value 90% and the negative 80%and diagnostic efficiency 86.67%. The positive likelihood ratio 4.5 and the negative one 0.125. The diagnostic value of the specific IgEHDM/D.p with ELISA showed a sensitivity of 75% and specificity 75%, the positive predictive value 85.71% and the negative one 0%and diagnostic efficiency 75%. The positive likelihood ratio was 3 and the negative one 0.33. The diagnostic value of the specific IgEHDM with immunoblot showed a sensitivity of 90% and specificity 80%, the positive predictive value 90% and the negative one 80%and the diagnostic efficiency 86.67%. The positive likelihood ratio was 4.5 and the negative one 0.125. The difference of diagnostic valuein both methods revealed that the p value was 0.013. It can be concluded in this study that there was a significant difference of specificIgE due to HDM between ELISA and immunoblot methods in allergic rhinitis.
ANTI DENGUE IGG/IGM RATIO FOR SECONDARY ADULT DENGUE INFECTION IN SURABAYA Aryati Aryati; Puspa Wardhani; Ade Rochaeni; Jeine Stela Akualing; Usman Hadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1161

Abstract

Infeksi Virus Dengue (IVD) dibedakan menjadi infeksi primer dan sekunder berdasarkan respons antibodi yang dihasilkan. Infeksisekunder perlu dibedakan dari infeksi primer karena umumnya menimbulkan manifestasi klinis yang berat. Uji hemaglutinasi inhibisisebagai baku emas untuk menentukan infeksi primer atau sekunder dirasa tidak praktis karena membutuhkan sepasang sera denganselang waktu waktu yang cukup lama. Penelitian ini bertujuan mengetahui cut-off rasio IgG/IgM anti dengue untuk infeksi denguesekunder dewasa di Surabaya. Subjek adalah pasien IVD dengan hasil NS1 dan/atau PCR dengue positif. Rasio IgG/IgM anti-denguediperoleh dari pembagian nilai indeks IgG dan IgM metode ELISA. Nilai cut-off rasio ditentukan berdasarkan kurva ROC. Berdasarkanpola reaktivitas IgM dan IgG ELISA, 19 (31,1%) pasien dikelompokkan sebagai infeksi primer dan 42 (68,9%) infeksi sekunder. HasilPCR didominasi DEN-3. Nilai cut-off optimal rasio IgG/IgM ≥0,927 sebagai peramal infeksi sekunder memiliki kepekaan 66,7% dankekhasan 63,2%. Dianalisis pula nilai cut-off optimal IgM dan IgG anti dengue, yaitu IgM ≥1,515 dan IgG ≥2,034 sebagai peramalinfeksi sekunder memiliki kepekaan dan kekhasans masing-masing 85,7% dan 84,2%; 100% dan 100%. Disimpulkan bahwa rasioIgG/IgM ≥0,927 tidak dapat digunakan sebagai tolok ukur tunggal peramal infeksi sekunder sedangkan cut-off IgG ≥2,034 dapatdipertimbangkan sebagai peramal infeksi sekunder.
PROKALSITONIN SEBAGAI PENANDA PEMBEDA INFEKSI BAKTERI DAN NON BAKTERI Bastiana Bastiana; Aryati Aryati; Dominicus Husada; M.Y. Probohoesodo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1019

Abstract

Early diagnosis of an infection and prompt administration of an antibiotic can dramatically reduce morbidity and mortality.Procalcitonin (PCT), a precursor of calcitonin, has been proposed as a marker of bacterial infection. The aim of this study is to assess theefficiency of procalcitonin in children for the diagnosis of bacterial vs. non bacterial infection. This was a prospective, cross-sectional study.The subjects were enrolled consecutively, consisting of feverish children (temperature ³38.5° C) admitted to the Pediatric EmergencyDepartment with ages up to 12 years old. The subjects were divided into two groups according to their final diagnosis, bacterial and nonbacterial infection. Serum PCT concentration was measured by enzyme linked fluorescent assay (ELFA) method. Sensitivity, specificity,positive predictive and negative predictive values, and receiver operating curve (ROC) of PCT were calculated. Out of 54 patients,24 (44.4%) had a final diagnosis of bacterial infection. PCT showed a wide concentration range in the bacterial infection group (median:1.09 ng/mL, lower (L)=0.05 ng/mL, upper (U)=128.7 ng/mL) compared with non bacterial infection group (0.21 ng/mL; L=0.05ng/mL; U=12.15 ng/mL). There was a significant difference in PCT between the 2 groups (p=0.020). ROC analysis demonstrated anarea under curve (AUC) of 0.686 (95% CI, 0.534 to 0.838). Using a cut-off point of 0.5 ng/mL, the sensitivity, and specificity, positivepredictive and negative predictive values of PCT were 66.7%, 76.7%, 69.6%, 74.2%, respectively. In this study, PCT may be useful fordifferentiation of bacterial vs. non bacterial infection in children.
DIAGNOSIS MOLEKUL DAN APLIKASI DALAM PENGOBATAN HEPATITIS B & C Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 16, No 2 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v16i2.974

Abstract

In the whole world, up to now hepatitis B and C virus are still the main causes of chronic hepatitis, cirrhosis until hepatocellularcarcinoma. Most diagnosis is based on a serological examination such as the determination of antigen and antibody, for exampleHbsAg, HbeAg and anti HCV. Recently, for hepatitis C examination, HCV core antigen is used for the detection of HCV infection duringthe window period, chronic C hepatitis and for treatment monitoring. At present, serological assays are not sufficient to confirm thediagnosis of hepatitis B and C due to mutations of false negative HbsAg or HbeAg results. Occult hepatitis B can occur with a negativeresult of HbsAg, which cause difficulties in confirming the diagnosis and treatment as well. The success of treatment can be influencedof both hepatitis B and hepatitis C that have genotypes. By using molecular examination, such as determination of HBV-DNA and HCVRNA,it is expected that the problem of serological determination can be overcome. Molecular examination is not only useful for just thediagnosis confirmation, such as for active phase and replicative determination. This sequence is also very useful as a data base prior tothe treatment of hepatitis B and hepatitis C as well as for their following success result.
DIAGNOSTIC OF C-REACTIVE PROTEIN IN FEBRILE CHILDREN Johanis Johanis; Aryati Aryati; Dominicus Husada; Djoko Marsudi; M. Y. Probohoesodo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 2 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i2.1010

Abstract

The measurement of C-reactive protein (CRP), an acute-phase protein synthesized by hepatocytes, is valuable to distinguish bacterialinfection from non-bacterial infections in children. The aim of this study is to know the diagnostic properties of quantitative CRPassociated with clinically bacterial and non-bacterial infection in febrile children. Febrile children which was studied were presentingin the Paediatric Emergency Department, their ages were up to 12 years, with axillary’s temperature ≥38.5° C, and the clinicallyundetectable source of fever were enrolled in this consecutive study from September, 2009, up to August, 2010. Informed consent wasobtained for the use of CRP evaluation. The CRP concentration was measured with immunoturbidimetry method (Pure auto S CRP latex(SS-type), Sekisui Medical Co., Ltd) and an auto photometer TMS 1024i. The main outcome result was the presence of the laboratoryexamination results, blood culture, or radio graphically. The receiver operator characteristic (ROC) curve was modelled for quantitativeCRP to identify the optimal test value. Eighty-six patients were enrolled in this study. Forty-one (47.6%) had bacterial infection and 45(52.3%) had non-bacterial infection. The CRP concentration was significantly different between the two groups (p=0.003). The ROCanalysis demonstrated an area under curve (AUC) 0.689, standard error (SE) 0.059, and 95% confidence interval (CI): 0.573-0.805.The optimal cut-off point for CRP in this data set at 5 mg/L, achieved sensitivity of 0.61, specificity of 0.71, and likelihood ratio 2.11(Kappa 0.003, McNemar 0.711) for the detection of bacterial infection in this population. The Quantitative CRP concentration is avaluable laboratory test for the evaluation of febrile children who are at risk of bacterial infection.
IMMATURE PLATELET FRACTION DI DEMAM DENGUE DAN DEMAM BERDARAH DENGUE (Immature Platelet Fraction in Dengue Fever and Dengue Hemorrhagic Fever) Izzuki Muhashonah; Juli Soemarsono; Puspa Wardhani; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1257

Abstract

Thrombocytopenia is a hematological abnormality found in the majority of Dengue Virus Infection cases with manifestations suchas Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF). Bone marrow response to the decrease in platelets is by increasingthrombopoiesis which can be identified by Immature Platelet Fraction (IPF) examination as an indirect indicator of bone marrow responseto thrombocytopenia. The examination of IPF in venous blood was performed on 29 subjects who met the 1997 WHO criteria, carriedout from January until August 2012. The EDTA blood samples were examined twice, on the day of their admittance and two days later,based on a flowcytometry principle using Sysmex XE-2100. The IPF was derived from the immature platelet ratio against the total numberof platelets (IPF %). The test results were statistically analyzed by using SPSS 20. It was found, that IPF in DHF compared between thefirst and the third day of their admittance was statistically significantly different with p = 0.033 compared to DF with p = 0.444. ThePearson’s correlation showed an inverse correlation between IPF and platelets with r = -0.675 and p = 0.01. The statistical analysisrevealed a significant difference in IPF between moderate- and mild-thrombocytopenia on the first and third day of their admittance withp = 0.014 and 0.001, respectively. Based on this study it can be concluded that IPF can be used to indicate the bone marrow response inboth DF and DHF related to thrombocytopenia.
DIAGNOSIS JANGKITAN (INFEKSI) VIRUS DENGUE DENGAN UJI CEPAT (RAPID TEST) IgA ANTI-DENGUE Sri Kartika Sari; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1020

Abstract

Dengue IgM, IgG Capture ELISAs and NS1 Ag ELISA become the most widely used serological methods for dengue diagnosis untilnow. Previous studies reported a possible use of IgA antibodies for dengue virus as a new serologic marker to make dengue infectionactive. In the present study, the performance of IgA anti-dengue rapid test as a new marker of dengue infection was assessed. In thisstudy, the sera were obtained from 30 dengue virus infection patients and 30 non dengue virus infection patients. Thirty dengue pairedsera were collected twice, at the time of hospital admission (acute) and at discharge (convalescent). All sera samples were characterizedusing dengue reference ELISAs (NS1 Ag, Dengue IgM and IgG capture ELISAs). The results of IgA anti-dengue rapid test were comparedwith the corresponding dengue reference tests. The sensitivity and specificity of IgA anti-dengue rapid test respectively were 78.3% (95%CI: 65.5–87.5%), and 73.3% (95% CI: 55,6–85,8%). Meanwhile, from acute sera, sensitivity of IgA anti-dengue rapid test was 83.3%(95% CI: 64.5–93.7), higher than IgM (73.3%, 95% CI: 53.8–87.0), IgG (66.7%, 95% CI: 47.1–82.1) and NS1 Ag ELISAs (60%,95% CI: 40.7–76.8). Positive IgA anti-dengue rapid test results in acute sera was higher in the secondary (91%) than primary infection(57%). IgA anti-dengue rapid test can be considered as a new marker for dengue infection, because it gives a high sensitivity, especiallyin the acute phase and in the secondary infections as well.