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All Journal Public Health of Indonesia Jurnal Respirologi Indonesia Jurnal Respirasi (JR) World Nutrition Journal Respiratory Science Narra J Cermin Dunia Kedokteran Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Agustin, Heidy
Department Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department Pulmonology And Respiratory Medicine, Persahabatan Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Immunopathogenesis of Pneumocystis Pneumonia (PCP) and Its Clinical Implications Malik, Andi Sri Suryani; Agustin, Heidy; Nurwidya, Fariz; Rozaliyani, Anna
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.172

Abstract

Pneumocystis pneumonia (PCP) is a serious lung infection caused by Pneumocystis jirovecii, primarily affecting immunocompromised individuals. It remains a major health concern, especially in HIV/AIDS patients and those undergoing immunosuppressive therapy. This review discusses how the immune system responds to P. jirovecii and why immunocompromised individuals are more vulnerable. In healthy individuals, CD4+ T cells, B cells, and macrophages help control the infection. However, in immunocompromised individuals, a weakened immune response allows fungal overgrowth, leading to severe lung damage. The review also covers symptoms, diagnosis, and treatment options. TMP-SMX is the preferred treatment, while alternative drugs are available for those who cannot tolerate it. Understanding the immune response to PCP can help improve treatment and patient care.
The Combination Diagnostic Test for Tuberculosis Screening in HIV Patients in Referral Hospitals in Indonesia Murtiani, Farida; Rosamarlina, Rosamarlina; Purnama, Asep; Farhanah, Nur; Utama, Made Susila; Agustin, Heidy; Sarif, Armaji Kamaludi; Widiantari, Aninda Dinar; Hasugian, Armedy Ronny
Public Health of Indonesia Vol. 11 No. 3 (2025): July - September
Publisher : YCAB Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36685/phi.v11i3.1094

Abstract

Background: Screening tests are needed to help screen suspected Tuberculosis (TB) pulmonary with HIV positive. With the limitation of specificity of the screening test and the need for combination with laboratory tools to increase that, a combination with standard examination is still needed, especially for limited healthcare facilities. Objective: This study aimed to determine Pulmonary TB screening tests with Human Immunodeficiency Syndrome (HIV) positive. Method: This observational study with a cross-sectional design was conducted in four government hospitals. Study subjects were inpatients and outpatients who met study inclusion criteria (> 14 years of age, HIV positive based on HIV test results, had clinical symptoms of episodic history of fever, and volunteered to take part in the study). Total subjects were 193 people, with episodic history of fever from <24 hours to 120 hours. Result: This study assessed a subject's clinical manifestation, physical examination and X-ray test. The “Night Sweat”, Infiltrates in the Upper Lobe”, “Enlargement of Lymph Nodes and “Left Rhonchi” and their combination have a sensitivity of>85%. Still, only the complete combination has a specificity of> 70%. The combination of “Night Sweat + Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” and then “Enlargement of Lymph Nodes + Left Rhonchi + Infiltrates in the Upper Lobe” can be an alternative for screening Pulmonary TB-HIV positive with history of fever. Conclusion: Pulmonary TB screening in HIV patients with a history of fever can be used by completely combining clinical manifestation, physical examination, and X-ray. the variables "Night Sweat, Enlarged Lymph Nodes, left rhonchi breath sounds and pulmonary upper lobe infiltrates" in a gradual manner. Keywords: Diagnostic Combination Test; HIV-Tb Coinfection; Tuberculosis Screening; Clinical Manifestations in TB-HIV; Pulmonary TB in HIV Patients
Epidemiological and Clinical Features of COVID-19 Patients at National Emergency Hospital Wisma Atlet Kemayoran, Jakarta, Indonesia Susanto, Agus Dwi; Rozaliyani, Anna; Prasetyo, Budi; Agustin, Heidy; Baskoro, Hario; Arifin, Arief Riadi; Pratama, Satria; Zaini, Jamal; Hasto, Bambang Dwi; Ratmono, Tugas; Savitri, Ary Indriana; Samoedro, Erlang; Husain, Bahtiar; Nawas, Arifin; Burhan, Erlina
Kesmas Vol. 16, No. 5
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The emergency hospital is intended to prevent transmission of COVID-19 in the community by isolating patients without symptoms, with mild or moderate symptoms. This study evaluated the clinical characteristics and outcomes of COVID-19 patients who were admitted to this facility. This retrospective study re-viewed data of patients treated at the National Emergency Hospital Wisma Atlet Kemayoran in Jakarta, Indonesia, from March 23 to April 30, 2020. Patient characteristics (clinical symptoms, laboratory test results, Chest X-Ray, SARS-CoV-2 immunoserology, and RT-PCR results from nasopharyngeal/ oropharyngeal preparations) were compared between severity groups. There were 413 COVID-19 cases analyzed, of which 190 (46%) were asymptomatic, 93 (22.5%) were mild, and 130 (31.5%) were moderate cases. Most asymptomatic cases were male, with young age, and without comorbidity. Mild cases were dominated by female and young patients, while most moderate cases were male and older patients. The number of patients with comorbidities was higher in mild and mod-erate cases. The patient’s overall outcome was good and did not differ based on the severity of symptoms. Despite the many challenges, patients with moderate symptoms can be safely treated in the emergency hospital.
Combined Institutional and Telerehabilitation Programs for A Post-Tuberculosis Lung Disease Patient with Low Cardiorespiratory Endurance: A Case Report Widjanantie, Siti Chandra; Agustin, Heidy; Handayani, Diah; Burhan, Erlina; Susanto, Agus Dwi
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497//jri.v45i4.719

Abstract

Background: Post-tuberculosis lung disease (PTLD) can lead to long-term respiratory issues and impaired lung function, which can impact quality of life. Pulmonary rehabilitation (PR) is a personalized strategy designed to address these problems and improve overall well-being. It is administered by a diverse team of experts. Case: A 28-year-old female patient with a history of tuberculosis (TB) presented with breathing difficulty. The physical examination revealed decreased chest expansion, shoulder asymmetry, a slight forward neck, and a rounded shoulder. The radiologic findings and bronchoscopy showed PTLD, atelectasis in several parts of the right lung, and regional destruction of the right lung. Discussion: The patient underwent pulmonary rehabilitation (PR), which included endurance exercises, strength training, several types of breathing exercises, breath-stacking exercises, thoracic expansion exercises, physical agents for rehabilitation modalities, education on posture correction, and energy conservation in daily activities. The patient was also monitored remotely through telerehabilitation from home. There were significant improvements in pulmonary function tests. Measurement of FVC, FEV1, the six-minute walking test (6MWT), and the PCF after two weeks of follow-up. After eight weeks of training, there were improvements in cardiopulmonary endurance, muscle endurance, and reduced dyspnea. Conclusion: Comprehensive pulmonary rehabilitation programs, including a combination of institutional and telerehabilitation synchronous approaches, can help improve cardiopulmonary endurance, muscle strength-endurance, and the overall patient's functional life who was suffering from chronic respiratory diseases, such as post-TB sequelae.
Nutritional Status and Lung Cavity in Pulmonary Tuberculosis Patient Hanafi, Christi Giovani Anggasta; Nurwidya, Fariz; Lestari, Wiji; Agustin, Heidy; Syam, Shaogi
Jurnal Respirasi Vol. 11 No. 1 (2025): January 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.1.2025.6-14

Abstract

Introduction: As one of the leading causes of death worldwide, pulmonary tuberculosis (PTB) is an infectious disease that continues to pose a serious threat to public health. The presence of cavities in radiological imaging of patients with PTB is associated with malnutrition, age, gender, and other comorbidities, including diabetes mellitus. This study aimed to find the association between nutritional status and lung cavity in PTB patients. Methods: This was an analytical observational study with a cross-sectional design that involved 134 adult patients who were diagnosed with PTB at Persahabatan National Respiratory Referral Hospital, Jakarta. All patients were interviewed using a questionnaire for sociodemographic and anthropometric data, the nutritional status was assessed using the subjective global assessment (SGA), and the lung cavity was determined using a chest X-ray interpreted by radiologists. The Chi-square test was performed using the Statistical Package for the Social Sciences (SPSS) version 25 for Windows. Results: Of 134 PTB patients, 61.9% were males, and 92.5% were from the 18-59 years old age group. Based on the SGA score, 77 (57.5%) were grouped as mild-moderate malnutrition/SGA B and 22 (16.4%) as severe malnutrition/SGA C. Lung cavity was found in 42 (31.3%) patients. The analysis showed that malnutrition was statistically significantly associated with lung cavity with OR=6.933 (95%CI 1.986-24.205; p=0.002) and the adjusted OR were 7.303 (95%CI 2.060-25.890; p=0.002) after controlling for age, sex, smoking, education, and comorbidities. Conclusion: This study found that malnutrition was associated with lung cavities in PTB patients. These findings might indicate how malnutrition impaired the immune function in PTB patients.
Interventional Approach on Lung Abscess Audina, Dea Putri; Agustin, Heidy; Reisa, Tina
Jurnal Respirologi Indonesia Vol 44 No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.440

Abstract

Lung abscess is a necrotic liquefaction process containing necrotic debris or fluid from the lung parenchyma tissue, creating a cavity of more than 2 cm caused by bacterial infection. The most common etiology of lung abscess is oral aspiration. With a high incidence of tuberculosis in Indonesia, Mycobacterium tuberculosis may also cause cold abscesses, although rarely reported. Several things can increase the risk of developing a lung abscess, such as oral aspiration, sepsis, and history of previous lung infection. The treatment for lung abscess was classified into two groups, the pharmacology group which uses antibiotics including clindamycin, ampicillin-sulbactam, moxifloxacin, carbapenem, and piperacillin-tazobactam; and the other group is non-pharmacology therapy including drainage which is indicated for patient with a size cavity of more than 6 cm. There are several options for drainage such as percutaneous or endoscopic drainage. Bronchoscopy may serve as a diagnostic and also intervention tool in lung abscess.
The 4T Approach for Smoking Cessation Compliance for Pulmonary Tuberculosis Patients in Persahabatan Referral Hospital Septauli, Kolanda Maria; Susanto, Agus Dwi; Agustin, Heidy; Ginting, Tribowo Tuahta; Taufik, Feni Fitriani
Jurnal Respirologi Indonesia Vol 44 No 1 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i1.578

Abstract

Background: Smoking increases the risk of tuberculosis infection and affects its treatment success rate and mortality. Most TB patients who smoke quit at the initial diagnosis, but may continue to smoke if the clinical symptoms improve. Studies show that the 4T approach (Tanya, Telaah, Tolong nasehati, and Tindak lanjut) helps smokers quit. The 4T approach was applied in Indonesia as a smoking cessation program for TB patients.Methods: We conducted a randomized controlled trial on 43 male TB patients who smoke. The trial group received a 4T approach consisting of education, counseling, and motivation to quit smoking for three months. The control group received a self-help leaflet. Smoking status, Fagerström nicotine dependence scale, exhaled carbon monoxide level, and peak expiratory flow rate were collected. We observed the subjects at months 1, 2, and 3 after quitting smoking and reported on the Motivation and Minnesota Withdrawal Scale.Results: Smoking cessation levels during months I, II, and III (Continuous Abstinence Rate I, II, and III) were higher in the trial group than in the control group. The trial group had a higher percentage of smoking cessation than the control group: until 4 weeks (66.7% vs. 54.5%), until 8 weeks (57.1% vs. 45.5%), and until 12 weeks (52.4% vs. 45.5%). The control group had higher numbers of smoking relapses (18.2% vs. 14.3%) and still smokers (18.2% vs. 9.5%) after the study. Withdrawal symptoms included an increase in appetite (44.1%), cigarette cravings (6.9%), agitation (2.3%), insomnia (2.3%), and irritability (2.3%). There were no significant differences in the withdrawal scale between groups (P=0.788), but the trial group showed better motivation to stop smoking during CAR II (P=0.043).Conclusion: The 4T approach is effective in maintaining abstinence from smoking among lung tuberculosis patients until months 1, 2, and 3 after quitting. Smoking cessation programs during tuberculosis treatment can help patients quit smoking and reduce relapse.
Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital Dewantoro, Luhur; Wiyono, Wiwien Heru; Yunus, Faisal; Agustin, Heidy; Damayanti, Triya; Antariksa, Budhi; Fachrucha, Fanny; Samoedro, Erlang; Elhidsi, Mia
Jurnal Respirologi Indonesia Vol 44 No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.774

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age. 
Co-Authors Agus Dwi Susanto Ammar Abdurrahman Hasyim Andayani, Diyah Eka Anna Rozaliyani Arief Riadi Arifin Arifin Nawas Arifin Nawas Arifin, Arief Riadi Armedy Ronny Hasugian Ary Indriana Savitri Asep Purnama, Asep Audina, Dea Putri B Setyanto, Darmawan Bahtiar Husain Bambang Dwi Hasto Baskoro, Hario Budhi Antariksa Budi Prasetyo Budi Prasetyo Christi Giovani Anggasta Hanafi Damayanti, Triya Dewantoro, Luhur Diah Handayani Diah Handayani Dwi Rendra Hadi Elhidsi, Mia Erlina Burhan Fachrucha, Fanny Faisal Yunus Fariz, Nurwidya Ginting, Tribowo Tuahta Hanafi, Christi Giovani Anggasta Hario Baskoro Hasto, Bambang Dwi Husain, Bahtiar Isbaniah, Fathiyah Ismulat Rahmawati Mahdani, Wilda Malik, Andi Sri Suryani Murtiani, Farida Nabila Fawzia Nisyra, Mailani Novita Andayani, Novita Nur Farhanah, Nur Rabbani, Hadiati Raden Ena Sarikencana Reisa, Tina rosamarlina, rosamarlina Samoedro, Erlang Sarif, Armaji Kamaludi Satria Pratama Satria Pratama Savitri, Ary Indriana Septauli, Kolanda Maria Syah Putra Yahya, Wiendo Syam, Shaogi Taufik, Feni Fitriani Tugas Ratmono Tugas Ratmono, Tugas Utama, Made Susila Widiantari, Aninda Dinar Widjanantie, Siti Chandra Wiji Lestari Wiji Lestari Wiji Lestari Wiwien Heru Wiyono Zaini, Jamal