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Journal : Narra J

Decline of notified dengue infections in Indonesia in 2017: Discussion of the possible determinants Dhewantara, Pandji Wibawa; Jamil, Kurnia F.; Fajar, Jonny Karunia; Saktianggi, Panji Probo; Nusa, Roy; Garjito , Triwibowo Ambar; Anwar, Samsul; Firzan, Firzan; Megawati , Dewi; Sasmono, R. Tedjo; Mudatsir, Mudatsir
Narra J Vol. 1 No. 1 (2021): April 2021
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narraj.v1i1.23

Abstract

This study was conducted to quantify the trend in dengue notifications in the country in 2017 and to explore the possible determinants. Annual nation-wide dengue notification data were obtained from the National Disease Surveillance of Ministry of Health of Indonesia. Annual incidence rate (IR) and case fatality rate (CFR) in 2017 and the previous years were quantified and compared. Correlations between annual larva free index (LFI), implementation coverage of integrated vector management (IVM), El Niño Southern Oscillation (Niño3.4), Dipole Mode Index (DMI), Zika virus seropositivity and the percent change in IR and CFR of dengue were examined. The change of dengue IR and CFRs were mapped. In 2017, dengue IR was declined by 71% (22.55 per 100,000 population) compared to 2016 (77.96 per 100,000 population) while the CFR was slightly reduced from 0.79% to 0.75%. Reduction in IR and CFR occurred in 94.1% and 70.1% out of 34 provinces, respectively. The trend of dengue IR seems to be influenced by Niño3.4 but there is no clear evidence that Niño3.4 is the main reason for dengue reduction in 2017. It is difficult to elucidate that the reduction of dengue in 2017 was associated with previous Zika outbreaks. In conclusion, there was a significant reduction on dengue notifications in Indonesia in 2017. Further investigation is needed to look at the role of climate on the decline of dengue IR at finer temporal scale. In addition, study on the role of cross-protective immunity generated by Zika infection on dengue incidence is also warranted.
Attitude towards Zika among frontline physicians in a dengue-endemic country: A preliminary cross-sectional study in Indonesia Yufika, Amanda; Anwar, Samsul; Maulana, Reza; Wahyuniati, Nur; Ramadana, Rizki R.; Ikram, Ikram; Mudatsir, Mudatsir; Utomo, Prattama S.; Te, Haypheng; Enitan, Seyi Samson; Sirinam, Salin; Müller, Ruth; Setiawan, Abdul Malik
Narra J Vol. 1 No. 1 (2021): April 2021
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narraj.v1i1.32

Abstract

In dengue-endemic countries such as Indonesia, Zika may be misdiagnosed as dengue, leading to underestimates of Zika disease and less foreknowledge of pregnancy-related complications such as microcephaly. Objective: To assess the attitudes of frontline physicians in a dengue-endemic country toward testing for Zika infection among patients with dengue-like illnesses. Methods: A cross-sectional online survey was conducted among general practitioners (GPs) in Indonesia. The survey assessed their attitude and also collected sociodemographic data, characteristics of their medical education, professional background, and workplace, and exposure to Zika cases. A two-step logistic regression analysis was used to assess possible variables associated with these attitudes. Results: A total of 370 GPs were included in the final analysis of which 70.8% had good attitude. Unadjusted analyses suggested that GPs who were 30 years old or older and those who had medical experience five years or longer had lower odds of having a positive attitude compared to those who aged younger than 30 years and those who had medical experience less than five years, OR: 0.58; 95%CI: 0.37, 0.91 and OR: 0.55; 95%CI: 0.35, 0.86, respectively. No explanatory variable was associated with attitude in the fully adjusted model. Conclusion: Our findings point to younger GPs with a shorter medical experience being more likely to consider testing for Zika infection among their patients presenting with dengue-like illnesses. Strategic initiatives may be needed to enhance older or longer-experienced physicians' capacity in diagnosing Zika infection.
Acceptance and willingness to purchase a hypothetical COVID-19 vaccine in a region under Shariah law: A cross-sectional study in Aceh, Indonesia Rayhan, Muhammad A.; Mudatsir, Mudatsir; Nurjannah, Nurjannah; Ichsan, Ichsan; Amir-Behghadami, Mehrdad; Khader, Yousef S.; Koyanagi, Ai; Sah, Ranjit; Viveiros-Rosa, Sandro G.; Mamun, Mohammed A.; Lemu, Yohannes K.; Bouchra, Assarag; Linguissi, Laure SG.; Ikram, Aamer; Sallam, Dina E.; Parperis, Konstantinos; Wollina, Uwe; Rademaker, Marius; Vento, Sandro; Usman, Said
Narra J Vol. 2 No. 2 (2022): August 2022
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v2i2.85

Abstract

Vaccines are urgently needed to control the coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to determine the acceptance of and willingness to purchase a hypothetical COVID-19 vaccine in the general population of Aceh, a holistic Shariah law implementation province in Indonesia. An online cross-sectional study was conducted using a quota sampling technique between 1 to 24 September 2021. To determine hypothetical vaccine acceptance, respondents were asked if they were willing to accept vaccines with combinations of either 50% or 95% effectiveness and either 5% or 20% risk of adverse effects. Willingness to purchase was assessed by asking whether the participants would pay for such vaccines at certain price points. Logistic regression analysis was used to assess the associated determinants. Out of 377 respondents included in the final analysis, 86.5% were willing to accept a COVID-19 vaccine with 95% effectiveness and 5% adverse effects. The acceptance rate dropped to 45.1% if the risk of adverse effects was 20%. Vaccines with 50% effectiveness and 5% adverse effects were acceptable to 42.2% but the acceptance went down to 17.2% if the risk of adverse effects increased to 20%. Multivariate analysis found that men were twice as likely to accept a vaccine with 95% effectiveness and 5% adverse effects compared to females (aOR: 2.01; 95% CI 1.05–3.86). We found that 156/377 (41.3%) of respondents were willing to purchase a COVID-19 vaccine and of these participants 71.1% were willing to pay between Indonesian Rupiah (IDR) 50,000–150,000 (US$ 3.33–10.00). In conclusion, the acceptance rate of a hypothetical COVID-19 vaccine varied based on effectiveness and the risk of adverse effects.
Antibacterial and anti-inflammatory activities of Nothopanax scutellarium, Moringa oleifera and Piper betle extracts on staphylococcal mastitis animal model Sriyanti, Cut; Siregar, Tongku N.; Mudatsir, Mudatsir; Gani, Azhari; Hasan, Denny I.; Sutriana, Amalia
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.176

Abstract

Inappropriate and prolonged administration of antibiotics in mastitis could cause antibiotic resistance and herbal treatment might could be one alternative treatment. Nothopanax scutellarium, Moringa oleifera, and Piper betle are medicinal plants that contain various active compounds, including antibacterial and anti-inflammatory agents, but their potentials in treating mastitis are not well understood. The aim of this study was to assess the effectiveness of those plants against mastitis in rabbit model induced by Staphylococcus aureus. A total of 25 lactating rabbits (Oryctolagus cuniculus) weighing 3.0±0.4 kg were grouped into five groups: healthy control; mastitis control, and three treatment groups (Nothopanax scutellarium, Moringa oleifera, and Piper betle). Except the healthy control group, all animals were inoculated with 0.15 mL of Staphylococcus aureus containing 1.5x107colony forming unit (CFU)/mL on eight days after giving birth. The extract was administered orally after four hours Staphylococcus aureus inoculation at a dose of 50 mg/kg body weight, twice a day for five consecutive days. The number of bacteria in the milk and the level of serum interleukin 6 (IL-6) were measured and histopathological examination of mammary gland tissues were analyzed. The log number of total plate count of Staphylococcus aureus indicated that all extract groups had significant lower of bacterial logs compared to mastitis control (all comparisons had p<0.05) with the lowest was found in Piper betle group, followed by Nothopanax scutellarium and Moringa oleifera. The enzyme-linked immunosorbent assay (ELISA) results showed that all ethanolic extract groups had significantly lower levels of IL-6 compared to the mastitis control (all comparisons had p<0.05). The histopathologyassessment suggested that extract groups had lower infiltration of inflammatory cells such as lymphocytes and macrophages in alveoli compared to the mastitis control group. In conclusion, all three extracts contained antibacterial and anti-inflammatory activities and Piper betle had the most effective in reducing bacterial growth and IL-6 level compared to others.
Hemostatic and liver function parameters as COVID-19 severity markers Iqbal, Qanita; Mudatsir, Mudatsir; Harapan, Harapan; Nurjannah, Nurjannah; Maulana, Teuku
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.178

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease newly discovered in December 2019 which affects coagulation cascade and liver functions. The aim of this study was to investigate the potential of hemostatic and liver function parameters as severity markers in COVID-19 patients. This study was an observational analytic with cohort retrospective design using total sampling method. Data were retrieved from medical record of COVID-19 patients admitted to provincial hospital in Banda Aceh, Indonesia from March 2020 to March 2022. There were 1208 data eligible for the study after applying certain criteria. Mann–Whitney, logistic regression, and receiving operating characteristic (ROC) analyses were used to analysis the data. Thrombocyte count (p<0.001), prothrombin time (p<0.001), activated partial thromboplastin time (p<0.001), D-dimer (p<0.001), fibrinogen (p<0.001), aspartate aminotransferase (p<0.001), and alanine transaminase (p<0.001) significantly increased in severe compared to mild COVID-19 patients. After being adjusted, age (odds ratio (OR); 1.026 (95% confidence interval (CI): 1.016–1.037) was the most significant factor in predicting COVID-19 severity. Fibrinogen (cut-off 526.5 mg/L) was the best parameter associated with COVID-19 severity with 70% sensitivity and 66.4% specificity. Meanwhile, D-dimer (cut-off 805 ng/mL) had a sensitivity of 72.3% and specificity of 66.4%. Combining the parameters resulted in improved sensitivity to 82.0% with a slight decline of specificity to 65.5%. In conclusion, fibrinogen and D-dimer level on admission could be used as biomarkers in predicting COVID-19 prognosis. Routine monitoring and evaluation of laboratory testing especially D-dimer and fibrinogen could be implemented in order to reduce morbidity and mortality rate of COVID-19.
Quantity of antibiotic use and its association with clinical outcomes in COVID-19 patients: A snapshot from a provincial referral hospital in Indonesia Yossadania, Asyriva; Hayati, Zinatul; Harapan, Harapan; Saputra, Irwan; Mudatsir, Mudatsir; Diah, Muhammad; Ramadhana, Ika F.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.272

Abstract

Irrational antibiotic use in Indonesia is considered high, yet there are still lacks reliable information regarding the issue. The quantity of antibiotic use studies, in particular during coronavirus disease 2019 (COVID-19) pandemic, was not well reported. The aim of this study was to evaluate antibiotic use in COVID-19 patients at a province referral hospital in Aceh, Indonesia, Dr Zainoel Abidin Hospital, and to assess the association between antibiotic use and COVID-19 clinical outcomes. The defined daily dose (DDD) method was used and expressed in DDDs per 100 patient-days as in hospital setting. The data were obtained from inpatient confirmed COVID-19 patients between March 2020 and December 2021. A logistic regression was used to determine the association between patients’ characteristics and antibiotic usage with clinical outcomes. A total of 361 treated COVID-19 patients were included using a random sampling technique and analyzed. Out of 361 patients, 89.2% of them were treated with antibiotic(s). All the antibiotics were given empirically except for cefazoline (5.5%) that was used as prophylaxis to obstetric patients who underwent the c-section. Azithromycin was the most prescribed antibiotic and levofloxacin had the highest DDD. Our data suggested that there was no association between antibiotic use and clinical outcomes of COVID-19 patients (p=0.128). Having sepsis and another pulmonary disease however were associated with mortality of COVID-19 patients with adjusted odds ratio (aOR) 14.14; 95%CI 2.94–67.90, p=0.001 and aOR 8.64; 95%CI 3.30–22.63, p<0.001, respectively. In addition, patients older than 60-year-old had a higher chance to an unfavorable outcome compared to those younger than 30-year-old, aOR: 7.61; 95%CI: 1.07–53.94. In conclusion, the use of antibiotics is prevalent among COVID-19 and it is not directly associated with clinical outcomes.
Risk factors of pulmonary tuberculosis in Indonesia: A case-control study in a high disease prevalence region Fahdhienie, Farrah; Mudatsir, Mudatsir; Abidin, Taufik F.; Nurjannah, Nurjannah
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.943

Abstract

Tuberculosis (TB) remains one of the most widespread infectious diseases in the world, with high mortality and morbidity rates, contributing to a significant disease burden, particularly in developing countries. The aim of this study was to determine the risk factors of TB among the population aged 17 years (late adolescent) and above in one of the high TB prevalence countries, Indonesia. A case-control study was conducted in Banda Aceh, Indonesia, involving newly diagnosed pulmonary TB patients who visited one of the eleven community health centers in Banda Aceh. The controls were individuals matched by age and sex who lived near the cases and had no TB infection. A total of 16 risk factors were assessed. Hierarchical multivariable logistic regression models were used to examine the association between the risk factors and the occurrence of TB. A total of 196 cases and 196 controls were included in the study. Multivariable logistic regression analysis identified 11 independent predictors for the occurrence of TB after controlling possible confounders. Patients who lived in houses with insufficient light exposure were 77 times more likely to develop TB compared to those living in houses with sufficient light exposure (adjusted odds ratio (AOR): 77.69; 95%CI: 27.09, 222.79). The study also showed that people who had close contact with TB patients (AOR: 25.39; 95%CI: 2.10, 306.52), had poor knowledge of TB  (AOR: 24.2; 95%CI: 6.89, 85.17), had comorbidities (AOR: 4.49; 95%CI: 1.35, 14.89), insufficient food utilization (AOR: 3.41; 95%CI: 1.51, 7.71), negative preventive behavior (AOR: 3.39; 95%CI: 1.49, 7.72), low education level (AOR: 3.08; 95%CI: 1.26, 7.55), and insufficient housing humidity (AOR: 2.89; 95%CI: 1.18, 7.12) were associated with increased the odds of having TB. Being employed, having income above minimum wage, and having good nutritional intake were protective factors for developing TB. In conclusion, the determinants of TB among people aged 17 years and older are a clear indication of the need for TB prevention programs targeting not only individual risk factors but also environmental risk factors, particularly providing adequate housing conditions. This study provided useful information that might help to develop and adopt effective policies for TB control in Indonesia.
Comparative study of anti-SARS-CoV-2 receptor-binding domain total antibody titer before and after heterologous booster with mRNA-based COVID-19 vaccine Kamil, Qatrunnada; Putri, Widia; Ayulinda, Arianisah P.; Maelani, Imelda; Anwar, Samsul; Ichsan, Ichsan; Pranata, Agung; Mudatsir, Mudatsir; Syukri, Maimun; Rizal, Samsul; Kurniawan, Rudi; Sofyan, Sarwo E.; Harapan, Harapan
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.788

Abstract

The waning immunity following the COVID-19 vaccination become a significant concern and the immunological dynamics of vaccine-induced antibodies after vaccination need to be explored. The aim of this study was to compare anti-SARS-CoV-2 receptor-binding domain (RBD) antibody levels before and after a booster dose with heterologous COVID-19 vaccine and to identify factors influencing the levels after receiving the booster dose. A cross-sectional study was conducted in which individuals who received primary doses of CoronaVac and a booster dose with an mRNA-based vaccine were recruited using a purposive sampling technique. The titers of anti-SARS-CoV-2 RBD antibodies were measured using an enzyme-linked immunosorbent assay (ELISA), and plausible associated factors were collected using a questionnaire-assisted face-to-face interview. The Wilcoxon test was used to compare the titers before and after the booster dose, while the Kruskal-Wallis and Mann-Whitney tests, followed by multivariate linear regression, were used to assess the factors associated with RBD total antibody titers. The results showed that there was a significant increase of anti-SARS-CoV-2 RBD total antibody titers before and after receiving the booster dose (1,558.7 BAU/mL vs 140.6 BAU/mL, p<0.001). The analysis revealed that age (p=0.555), sex (p=0.254), type of vaccine (p=0.914), presence of hypertension (p=0.541), diabetes (p=0.975), chronic obstructive pulmonary disease (COPD, p=0.620), and gout (p=0.364) were not associated with anti-SARS-CoV-2 RBD total antibody titers. However, the titers of anti-SARS-CoV-2 RBD total antibody were significantly different between those with and without hyperlipidemia (p=0.021). This study suggests that a booster dose with a heterologous COVID-19 vaccine could significantly enhance immune responses against COVID-19, and therefore, this strategy may be recommended as part of preventive measures to strengthen immunity against COVID-19.
Acceptance for a booster dose of COVID-19 vaccine in Indonesia: A follow-up study Harapan, Harapan; Maelani, Imelda; Anwar, Samsul; Latief, Kamaluddin; Mellinia, Sania A.; Nanda, Cut M.; Nainu, Firzan; Nirwana, Aura; Aksa, Rahmad; Sarifuddin, Sarifuddin; Astri, Yesi; Fathima, Raisha; Nalapraya, Widhy Y.; Ikram, Ikram; Mutiara, Suci; Syahraini, Aigia; Mudatsir, Mudatsir
Narra J Vol. 5 No. 1 (2025): April 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i1.803

Abstract

The coronavirus disease 2019 (COVID-19) vaccination program in Indonesia has been implemented as a key strategy to mitigate the spread of the virus within communities. The success of this program depends on public acceptance of COVID-19 vaccines, including booster doses. The aim of this study was to assess the acceptance of the COVID-19 booster dose in Indonesia and to identify factors influencing individuals' acceptance. A cross-sectional study was conducted across 34 provinces in Indonesia on June 2023. Logistic regression analysis was used to identify the factors associated with booster dose uptake. The findings revealed that 88.8% (2,049/2,308) of respondents were willing to receive a booster dose if provided free of charge by the Indonesian government. However, acceptance decreased to 61.7% when respondents were informed of a 20% likelihood of side effects, even with a reported 95% vaccine efficacy. Adjusted logistic regression analysis identified ten significant factors associated with booster dose acceptance: sex, age, religion, history of previous COVID-19 infection, type of primary vaccine received, belief in vaccine-related conspiracy theories, trust in traditional medicine conspiracies, confidence in natural immunity, perceived vaccine efficacy, and perceived vaccine effectiveness. These findings suggest that acceptance of COVID-19 booster doses in Indonesia is influenced by intrinsic and extrinsic factors, including limited knowledge of booster dose benefits and concerns about potential side effects. To enhance public acceptance, targeted health campaigns and educational initiatives should be intensified, emphasizing the safety, efficacy, and importance of booster vaccinations in controlling the COVID-19 pandemic.
Co-Authors . Zulfan Abda Abda Abdul Malik Setiawan Abidin, Taufik F. Abram L. Wagner Adlim Adlim Agung Pranata Agus Hendra Al Rahmad Agussabti Agussabti Ainal Mardhiah Aksa, Rahmad Al-kautsar Al-kautsar Alfingsih, Dede Alfonso J. Rodriguez-Morales Ali A. Rabaan AlKautsar, AlKautsar Allaily Allaily Amalia Sutriana Amanda Yufika Amanulloh, Fahmi Rahmat Amir-Behghadami, Mehrdad Anak Agung Dewi Megawati, Anak Agung Dewi Andhy Romdani, Andhy Armayanti, Feby Asrudi, Asrudi Ayulinda, Arianisah P. Bakhtiar Bakhtiar Binti Firdaus, Shausan Bouchra, Assarag Damayanti Damayanti Damayanti Damayanti Dedhi Yustendi Dedy Syahrizal Dewi Puji Rahayu Diah, Muhammad El Ghifari, Muhammad Raka Elfrida Ratnawati Empung, Empung Endah Widyastuti1 Enitan, Seyi Samson Erizal Erizal Evendi Evendi Fajar, Jonny Karunia Farhan, M. Farrah Fahdhienie Fathima, Raisha Ferdi Riansyah Firzan Nainu Firzan, Firzan Gani, Azhari Garjito , Triwibowo Ambar Habeahan, Nova Lina Sari Hafnati Rahmatan Hamny Sofyan Hanipah, Sri Harapan Harapan Harapan Harapan Hasan, Denny I. Herlina Dimiati, Herlina Hibran, Syukron Hilman Syarif Hizir Sofyan Ibnu Khaldun Ichsan Ichsan Ikram Ikram Ikram, Aamer Ima Maria Iqbal, Qanita Irwan Saputra Ismail Ismail Ismail, M. Nasir Iswahyudi Iswahyudi Jayawarsa, A.A. Ketut Kamil, Qatrunnada Khader, Yousef S. Koyanagi, Ai Kuldeep Dhama Kurnia F. Jamil Latief, Kamaluddin Lemu, Yohannes K. Linguissi, Laure SG. M. Aman Yaman M.Aman Yaman Maelani, Imelda Maimun Syukri, Maimun Makmur, Ali Mamun, Mohammed A. Maulana, Teuku Maulina Maulina Mellinia, Sania A. Monica, Santy Muhammad Daud Muhammad Hanafiah Müller, Ruth Mulyadi Mulyadi Mutiara, Suci Mutiya Oktariani Nalapraya, Widhy Y. Nanda, Cut M. Nirwana, Aura Nur Wahyuniati, Nur Nurjannah Nurjannah Nurjannah Nurjannah Oktariani, Mutiyah Pandji Wibawa Dhewantara Parera, Aser Parperis, Konstantinos Puspita, Laurensia Elya Putri, Tryantini Sundi Putri, Widia Rademaker, Marius Rahly, Fawwa Ramadana, Rizki R. Ramadhana, Ika F. Ramli, Ratu Bulkis Ratu Bulkis Ramli Rayhan, Muhammad A. Reza Maulana Rina Purnama Sari Roy Nusa Rudi Kurniawan Sah, Ranjit Said Usman Saktianggi, Panji Probo Sallam, Dina E. Samingan Samingan Samsul Anwar Saputra, Irwan Saputra, Jefri Dwi Sarifuddin Sarifuddin Sasmono, R. Tedjo Selvina, Selvina Shylvana Adella* Siagian, Afwandy Taga Siregar, Tongku N. Sirinam, Salin Sofyan, Sarwo E. Sri Hanifah Sri Jeksi Sriyanti, Cut Susanna Susanna Syahraini, Aigia Synat Keam Te, Haypheng Teuku Heriansyah, Teuku Teuku Zahrial Helmi Tiara Mustika Wardani* Usman, Said Utomo, Prattama S. Vento, Sandro Viveiros-Rosa, Sandro G. Wahyuniar Wahyuniar Wartha , Eva Wartha, Eva Wira Winardi Wollina, Uwe Yesi Astri Yossadania, Asyriva Yufika, Amanda Yuliana Yuliana Yusmanidar Yusmanidar Zahrul Fuadi Zinatul Hayati Zinatul Hayati Zulfan Zulfan Zulfikar Zulfikar