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All Journal International Journal of Electrical and Computer Engineering Tropical Medicine Journal Media Penelitian dan Pengembangan Kesehatan ASPIRATOR Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Disease Prevention and Public Health Journal Jurnal Kesehatan Masyarakat Indonesian Journal of Tropical and Infectious Disease Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) Jurnal Kesehatan Vokasional Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of Community Empowerment for Health Indonesian Journal of Electrical Engineering and Computer Science JUMANTIK (Jurnal Ilmiah Penelitian Kesehatan) Berita Kedokteran Masyarakat ASPIRATOR - Journal of Vector-Borne Diseases Studies

E. Elsa Herdiana Murhandarwati

Departemen Parasitologi, Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia

Author-ID : 325448

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Earth & Planetary Sciences Education Electrical & Electronics Engineering Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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Validity of p-LDH/HRP2-Based Rapid Diagnostic Test for the Diagnosis of Malaria on Pregnant Women in Maluku Vebiyanti Vebiyanti; Elsa Herdiana Murhandarwati; Bambang Udji Jokorianto
Tropical Medicine Journal Vol 3, No 2 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Pregnant women are one of the groups at risk for infection by the malaria parasites in endemic areas. The dangerous impacts of malaria in pregnancy are anemia and severe malaria that can cause death for mother, fetus and newborn. Clinical symptoms that are likely to be not typical until asymptomatic in pregnancy are one of the obstacles on diagnosing malaria in pregnancy in endemic areas. p-LDH/HRP2-RDT (Pf/Pan) is one of the WHO recommended RDT product on round 1-4 and has been used in Maluku. This tool is able to detect antigens of the Plasmodium metabolism results in peripheral blood so that it is regarded to be more sensitive than microscopic examination. The use of p-LDH and HRP2-RDT (Pf/Pan) for the detection of P. falciparum HRP-2 antigen and P. vivax, P.malariae, P.ovale p-LDH antigen have not been previously evaluated in the Province of Maluku.Objectives: To evaluate the validity of p-LDH/HRP2-RDT (Pf/Pan) compared with microscopic examination and nested Polymerase Chain Reaction (PCR) as the gold standard for the diagnosis of malaria in pregnancy in Maluku.Methods: This was a cross-sectional study using a diagnostic test of malaria in pregnant women. The study was conducted in Ambon City health center, Savana Jaya Buru Island health center and Haulussy Ambon Local Hospital. Sample data, the data of pregnancy, RDT results and microscopic results on the field were recorded in the questionnaire. Nested PCR examination was conducted at the Laboratory of Parasitology, Faculty of Medicine, Universitas Gadjah Mada as well as second reading for microscopic examinationResults: The results showed that p-LDH/HRP2-RDT (Pf/Pan) had the same sensitivity with micoscopic of 11%, a specificity of 100% higher than microscopic 96% compared with nested PCR as the gold standard, p-LDH/HRP2-RDT (Pf/Pan) had PPV and NPV of 100% and 98% compared with nested PCR as the gold standard. p-LDH/HRP2-RDT (Pf/Pan) sensitivity was 80% compared to the microscopic examination.Conclusion: diagnostic malaria in pregnancy in Maluku with p-LDH/HRP2-RDT (Pf/Pan) was less sensitive than nested PCR and microscopic.Keywords: Malaria, pregnant woman, diagnostic test, validity, p-LDH/HRP2 Rapid Diagnostic Test (RDT) (Pf/Pan)

Comparing the Sensitivity and Specificity of Zinc Sulphate Flotation Method to Formol Ether Sedimentation Method in Identifying Intestinal Protozoa’s Cysts Dini Alyani; Elsa Herdiana Murhandarwati; Sri Sumarni; Ernaningsih Ernaningsih
Tropical Medicine Journal Vol 3, No 2 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: 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.

Evaluation of artemisinin-based combination therapy (ACT) to uncomplicated falciparum malaria patients in Purworejo District, Central Java, Indonesia Michael Bhadi Bia; E. Elsa Herdiana Murhandarwati; Neil F Lobo; William A Hawley; . Supargiyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 1 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Artemisinin-based Combination Therapy (ACT) to treat uncomplicated Plasmodiumfalciparum malaria has been applied in Purworejo District, Central Java, Indonesia, since2004. However evaluation of the two ACT regimens used ie: Artesunate Amodiaquine(AAQ) and Dihydroartemisinin-Piperaquine (DHP) co-administered with Primaquine (PQ)has not been performed. This study aims to evaluate the efficacy and side effects ofAAQ+PQ and DHP+PQ treatment in uncomplicated falciparum malaria in Purworejo. Inthis descriptive and observational study, 46 Pf infected patients who fullfill the inclusionand exclusion criterias were recruited from December 2010 to August 2011. StandardACT treatment were given to the patients followed by WHO drug efficacy evaluation for28 days. The clinical symptoms and adverse events was also evaluated over the course ofthe treatment. From all recruited subjects, 37 patients received DHP+PQ and 9 patientsreceived AAQ+PQ. On the DHP+PQ treated patient, all subjects were free of asexualand sexual parasites by Day-3 while on AAQ+PQ treated patient, this parasite clearancewas achieved faster as early as on D-2 at the latest. On the otherhand, the disappearanceof fever was also last longer in DHP+PQ treated patient which in one patient last onD-14, while in AAQ+PQ treated patient, the symptom of fever dissappeared by D-2at the latest. No Early or Late Treatment Failures were found on either DHP+PQ orAAQ+PQ treatment as well as clinical and parasitological failures. However, the presenceof adverse events cause by both drugs should not be ignored to ensure drug compliance.

Infection, cure and egg reduction rates of soil-transmitted helminth infections after anthelminthic drugs treatment among school children in Kokap, Yogyakarta, Indonesia Fitria Siwi Nur Rochmah; Elsa Herdiana Murhandarwati; Sri Sumarni
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 48, No 4 (2016)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The prevalence of helminthiasis on primary school children in Indonesia is high, around 40-60%. This study aims to assess the impact of treatment and predictors of soil-transmittedhelminth (STH) infections at 3 months after treatment. Population of this study wasstudents of a primary school in Kokap (Sekolah Dasar Negeri/SDN Gunung Agung), KulonProgo, Yogyakarta, determined based on the inclusion and exclusion criteria (n = 65).Stool samples examined using Kato Katz method. Students infected with STH were givenappropriate treatment and stool samples were collected again to determine cure rate (CR)and egg reduction rate (ERR) at 2 week post-treatment and at 3 months post-treatmentto determine incidence of re-infection, new infection or failed treatment. Informationon personal hygiene and sanitation were collected by interview with students of SDNGunung Agung. Treatment with pyrantel pamoat was effective against hookworm andAscaris lumbricoides with CR of 100% and ERR of 100% while treatment with albendazolwas ineffective against Trichuris trichiura (CR = 12.8%, ERR = 62.4%) though theWilcoxon test for T. trichiura showed a significant reduction egg count (epg) before and2 week after treatment (p<0.05). The overall infection rate at 3 months after treatmentwas 35.4% with cases of re-infection, new infection and untreated cases. This result wasnot significantly different with infection rate before treatment (p>0.05). The existence ofdouble infection before treatment showed p value <0.05 (OR = 2) with the prevalence ofSTH infections 3 months after treatment. Bivariate analysis between personal hygiene andenvironmental sanitation with the prevalence of STH infections 3 months after treatmentwas obtained p value >0.05. Presence of re-infection, new infection and untreated casesconfirms that an integrated approach is necessary to control STH infection in Kokap,Kulon Progo, Yogyakarta.

Prevalence and risk factors of intestinal protozoan infection among child students with disabilities in Bantul District, Yogyakarta Special Region, Indonesia Fahriana Azmi; Elsa Herdiana Murhandarwati; Mahardika Agus Wijayanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Children with disabilities are excluded from many aspects of life. Unfortunately, they have an increased risk of infection from many kinds of pathogens including intestinal protozoan. This study aimed to determine the prevalence of intestinal protozoan infections and to evaluate the associated factors among children with disabilities in Bantul District, Yogyakarta Special Region, Indonesia. A cross-sectional study was conducted at school with special needs between June-December, 2019. A total of 150 participants were recruited through simple random sampling. Stool samples were examined microscopically by formalin-ether concentration and Ziehl-Neelsen staining technique. Age was analyzed using the Mann-Whitney tests, while the other variables used chi-square tests. Multivariable logistic regression was conducted to identify factors associated with intestinal protozoan infections. The adjusted prevalence ratio with a 95% confidence interval at a 5% level of significance was used to measure the strength of association. Overall, there were 15 children infected by intestinal protozoan among 130 subjects with mean age of participants of 9.83 ± 3.1 years. The intestinal protozoan species were Entamoeba histolytica 7 (5.38%), Giardia lamblia 4 (3.08%), Blastocystis hominis 7 (5.38%) and Iodamoeba butschlii 1 (0.77%). Prevalence of intestinal protozoan infection among children with disabilities in Bantul District, Yogyakarta, Special Region was 11.54%. There were no significant correlations between the risk factors and intestinal protozoan infection among children with disabilities (p>0.05).

Uji Silang Digital sebagai Alternatif Uji Banding Manual Pemeriksaan Mikroskopis Malaria di Kulon Progo Elsa Herdiana Murhandarwati; Anis Fuad; Guntur Budi Herwanto; Rizqiani Amalia Kusumasari; Mahardika Agus Wijayanti; supargiyono supargiyono
Jurnal Pengabdian kepada Masyarakat (Indonesian Journal of Community Engagement) Vol 4, No 1 (2018): September
Publisher : Direktorat Pengabdian kepada Masyarakat Universitas Gadjah Mada

Malaria is an infectious disease in tropical countries including Indonesia which causes serious clinical manifestations and even death. Indonesia Ministry of Health targets that malaria is eliminated from this country by 2030. In Java, malaria is targeted to be eliminated by 2015. However, elimination has not been achieved because some areas, including Kulon Progo, Daerah Istimewa Yogyakarta often experiences outbreaks (Kejadian Luar Biasa) in recent years. As microscopic diagnosis is a gold standard diagnosis for malaria, thus accurate microscopic examination is important. Disappearance of malaria cases in malaria pre-elimination areas causes laboratory workers/microscopists are less exposed to experience in identifying malaria. As part of quality assurance, continuous quality control is expected to maintain the accuracy of malaria diagnosis in endemic areas. However, the cross-check sistem as a part of this quality control strategy still has constraints, such as: transportation costs, limited human resources and irregularity. Ibm team of Faculty of Medicine UGM has successfully developed a digital microscopic cross-check sistem. This method is able to bridge the distance and time constraint also transportation costs of slide submissions to be cross-checked to the referral laboratory. Our study partners were microscopists of Kulon Progo Primary Health Centers (Puskesmas) facilitated with digital devices installed in a microscope. Partners were trained to: 1. take microscopic images of suspected malaria parasites and 2. familiarize with digital cross-check sistem. The successful implementation of digital malaria cross-check is expected to improve the accuracy of malaria diagnosis and assist the Government in malaria elimination program especially in Kulon Progo. This system has been registered for Intellectual Property Right no. 091306 obtained from Department of Justice and Human Right of Republic of Indonesia.

Analisis Indikator Entomologi dan Sebaran Jentik Aedes aegypti pada Daerah Stratifi kasi Endemisitas Demam Berdarah Dengue di Kota Jayapura Risda Hartati; Tri Baskoro T. Satoto; Elsa Herdiana Murhandarwati; Mutiara Widawati
ASPIRATOR - Journal of Vector-borne Disease Studies Vol 13 No 2 (2021): Jurnal Aspirator Volume 13 Nomor 2 2021
Publisher : Loka Litbang Kesehatan Pangandaran

The incidence rate (IR) of Dengue Hemorrhagic Fever in Papua Province in 2017 was8.04 per 100,000 population, with a case fatality rate (CFR) of 1.12%. In 2016, the Health Offi ce ofJayapura City declared six urban villages as high endemic areas, four urban villages as high sporadicareas, and ten villages as DHF-free areas from a total of 39 urban villages in Jayapura. This studyaims to analyze larval by House index [HI], Container index [CI], Breateu index (BI), and Maya index[MI] as well as the distribution of vector Ae. aegypti in endemic, sporadic and DHF-free areas inJayapura City. The design of this study was a cross-sectional study. This research was conducted fromJanuary to March 2019. Subjects (375 houses) were surveyed according to WHO guidelines basedon its endemicity stratifi cation. Observations of mosquitos’ larvae were done using visual and singlelarvae methods. The result of this research showed that endemic areas had their HI, CI and BI as muchas 43.3%, 16.5%, and 90.0%, respectively, with density fi gure is six. Sporadic areas had their HI,CI and BI as much as 35.4%, 10.9%, and 57.5%, respectively, with density fi gure is fi ve. DHF-freeareas had their HI, CI, and BI as much as 14.8%, 5.7%, and 35.2%, respectively, with density fi gureis fi ve. The Maya index for endemic and sporadic areas was categorized as moderate, while DHF-freeareas were low.

Classification of plasmodium falciparum based on textural and morphological features Doni Setyawan; Retantyo Wardoyo; Moh Edi Wibowo; E. Elsa Herdiana Murhandarwati
International Journal of Electrical and Computer Engineering (IJECE) Vol 12, No 5: October 2022
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijece.v12i5.pp5036-5048

Malaria is a disease caused by plasmodium parasites transmitted through the bites of female anopheles-mosquito that infect the human red blood cell (RBC). The standard malaria diagnosis is based on manual examination of a thick and thin blood smear, which heavily depends on the microscopist experience. This study proposed a system that can identify the life stages of plasmodium falciparum in human RBC. The image preprocessing process was done by illumination correction using gray world assumption, contrast enhancement using shadow correction, extraction of saturation component, and noise filtering. The segmentation process was applied using Otsuthresholding and morphological operation. The test results showed that the use of artificial neural network (ANN) using a combination of texture and morphological features gives better results when compared to the use of only texture or morphology features. The results showed that the proposed feature achieved an accuracy of 82.67%, a sensitivity of 82.18%, and a specificity of 94.17%, thus improving decision-making for malaria diagnosis.

Pelatihan mikroskopis dan entomologi pada tenaga laboratorium dan entomologis lokal di Kecamatan Kokap untuk mendukung eliminasi malaria di Kabupaten Kulon Progo, DIY Elsa Herdiana Murhandarwati; Rizqiani Amalia Kusumasari; Purwono Purwono; Kuswati Kuswati; Sulistyawati Sulistyawati; Sitti Rahmah Umniyati; Mahardika Agus Wijayanti; Tri Baskoro Tunggul Satoto
Journal of Community Empowerment for Health Vol 2, No 1 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Malaria is a serious public health problem in Indonesia. This disease is one of several indicators that have been targeted by the Millennium Development Goals (MDGs) 2015 to become Sustainable Development Goals (SDGs). In malaria-endemic areas such as in Kokap, Kulon Progo, Yogyakarta, reported malaria cases declined in 2000 with no case, but increased in 2011 following by some outbreaks in 2012. Future outbreaks could be avoided when health personnel including Primary Health Care (PHC) microscopists and entomologist surveyors were equipped with adequate trainings related to malaria. This training also be used for refreshment for existing personnel to support elimination at the Kokap I, Kokap II, and several nearby PHCs. In October 2013, the Department of Parasitology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada carried out microscopic training and basic entomology related to malaria in the working area of PHC in Kokap. Training methods were giving material and direct activities in the field. The training provided basic entomology training, malaria microscopic training and malaria vector mapping using a Global Positioning System (GPS). The training facilitated PHC personnel to do correct identification of Plasmodium species, identification of old and new vector breeding sites, and found out how to map vector distribution and malaria cases in their area. The results showed that there was an increase in knowledge from PHC personnel who participated in the pre-test and post-test. From field activity, three adult mosquitoes species were found i.e. Anopheles vagus, An. annularis and An. maculatus. Nulliparous and parous mosquitoes from adult mosquito based on the examination of their tracheole skeins of ovarium were found from the collected mosquitoes although oocyst in midgut and sporozoite in salivary gland were not found during adult mosquito surgical. Similar trainings were expected to be applied in other similar areas in the future.

Feature analysis for stage identification of Plasmodium vivax based on digital microscopic image Hanung Adi Nugroho; I Md. Dendi Maysanjaya; Noor Akhmad Setiawan; E. Elsa Herdiana Murhandarwati; Widhia K.Z Oktoeberza
Indonesian Journal of Electrical Engineering and Computer Science Vol 13, No 2: February 2019
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijeecs.v13.i2.pp721-728

Plasmodium parasite is identified to confirm malaria disease. Paramedics need to observe the presence of this parasite prepared on thick and thin blood films under microscope. However, false identification still occurs which is caused by human factor during the examination. Thus, malaria identification based on digital image processing has been widely developed to overcome the error possibility. This paper proposes a scheme to identify and classify the stages of Plasmodium vivax parasite on digital microscopic image of thin blood films based on feature analysis. Shape and texture features are extracted from segmented parasite objects. Feature selection based on wrapper method is then conducted to obtain relevant features which may contribute in improving the classification result. The classification process is conducted based on Naïve Bayes classifier. The performance of proposed method is evaluated using 73 digital microscopic images of P.vivax parasite on thin blood films comprising of 29 trophozoites, 10 schizonts and 34 gametocytes stages. By using six selected features including perimeter, dispersion, mean of intensity, ASM, contrast GLCM and entropy GLCM, the proposed scheme achieves the best classification rate with the accuracy, sensitivity and specificity of 97.29%, 97.30% and 97.30%, respectively. This indicates that the proposed scheme has a potential to be implemented in the development of a computerised aided malaria diagnosis system for assisting the paramedics.

Co-Authors . Supargiyono Agustina Mbiliyora Anastasia Joyce Lim Yit Zhen Anis Fuad Azmi, Fahriana Bambang Udji Jokorianto Bia, Michael Bhadi Devi Octaviana Dini Alyani Doni Setyawan Dwi Sarwani Sri Rejeki Dwita Anastasia Deo Ernaningsih Ernaningsih Fitria Siwi Nur Rochmah Fridolina Mau Fridolina Mau Hanung Adi Nugroho Hari Kusnanto Hartati, Risda Hemelamariae Munusamy Herwanto, Guntur Budi How Tien Jack I Md. Dendi Maysanjaya Kusnanto, Hari Kusumasari, Rizqiani Amalia Kuswati Kuswati Lala Foresta Valentine Gunasari Lalangpuling, Indra E. Made Satria Wibawa Mahardika Agus Wijayanti Mahardika Agus Wijayanti Mahardika Agus Wijayanti Moh Edi Wibowo Mutiara Widawati Mutiara Widawati Neil F Lobo Noor Akhmad Setiawan Onesiforus, Benaya Yamin Purwono Purwono Ratna Lestari Budiani Buana Retantyo Wardoyo Retna Siwi Padmawati Risda Hartati Shreya Khanal Sitti Rahmah Umniyati Sitti Rahmah Umniyati Sitti Rahmah Umniyati Sri Nurlaela Sri Sumarni Sri Sumarni Sulistyawati Sulistyawati Supargiyono Supargiyono supargiyono supargiyono Tri Baskoro T. Satoto Tri Baskoro T. Satoto Tri Baskoro Tunggul Satoto Utomo, Prattama Santoso Vebiyanti Vebiyanti Wafiyyah Rizki Wiariyanti Widhia K.Z Oktoeberza Widyandana Widyandana Wijayanti, Mahardika A. William A Hawley

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