Reinout van Crevel
Radboud University Netherlands

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Implementation of 25-well culture plates for M. tuberculosis drug susceptibility testing in Indonesia Rosana, Yeva; Sudiro, Tjahjani M.; Alisjahbana, Bachti; Parwati, Ida; van Crevel, Reinout; van Soolingen, Dick
Medical Journal of Indonesia Vol 14, No 3 (2005): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (322.775 KB) | DOI: 10.13181/mji.v14i3.186

Abstract

At present, there is no standardized method for Mycobacterium tuberculosis drug susceptibility testing (DST) among laboratories in Indonesia. Since January 2001 to January 2004 we have tried to establish the method of 25-well culture plates with middlebrook’s media (Drug Susceptibility Culture Plate (DSCP) method) used by the Dutch Supranational Reference Laboratory at the Institute of Public Health and the Environment (RIVM), Bilthoven, Netherlands. Our experience showed that this method potentially gives better result as it can be very well standardized, faster and provides detailed MIC (Minimal Inhibitory Concentration) values. Data from 364 isolates that have been tested by DSCP method showed that resistance to INH, rifampicin, ethambutol, and streptomycin were 21.4%, 19.8%, 15.7%, and 16.5% respectively. Multidrug resistance were found in 13.2% isolates. (Med J Indones 2005; 14: 142-6)Keywords: M. tuberculosis, DST, DSCP method
Peluang Kematian Penderita Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome berdasarkan Gabungan Derajat Anemia, Indeks Massa Tubuh, dan Jumlah Cluster Differentiation 4 Sumantri, Rachmat; Supandiman, Iman; Indjradinata, Ponpon; van der Ven, Andre; van Crevel, Reinout
Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prevalensi anemia pada infeksi human immunodeficiency virus (HIV) cukup tinggi, berkisar antara 1,3% sampai 95% bergantung pada stadium penyakitnya. Anemia, cluster differentiation 4 (CD4), dan viral load (VL) merupakan faktor risiko independen untuk kematian. Indeks massa tubuh (IMT) merupakan faktor risiko yang penting untuk anemia dan progresivitas penyakit. Dilakukan penelitian kohor untuk mengevaluasi respons pengobatan selama follow-up 6 bulan dengan endpoint kematian, serta menghitung peluang kematian penderita acquired immunodeficiency syndrome (HIV-AIDS) berdasarkan gabungan derajat anemia, IMT, dan jumlah CD4. Subjek penelitian adalah penderita HIV-AIDS di klinik Teratai Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung, periode Januari−Juni 2008, studi kohor dilakukan pada periode Juli−Desember 2008. Tercatat 534 penderita HIVAIDS yang masuk dalam data di klinik Teratai RSHS, sampai akhir penelitian terdapat 458 penderita yang masih aktif berobat, 38 penderita drop-out, 8 penderita pindah ke tempat lain, dan 28 penderita meninggal. Prevalensi anemia kelompok yang sama pada penelitian sebelumnya yaitu 41,6%. Dalam follow-up selama 6 bulan terdapat 26 kematian pada kelompok anemia dan hanya 2 kematian pada kelompok nonanemia. Gabungan antara derajat anemia sedang-berat, dengan CD4 ≤50/mm3, dan IMT <18,5 menunjukkan peluang kematian terbesar, dalam penelitian ini sebesar 80%. Simpulan, faktor risiko yang penting untuk kematian pada penderita HIV-AIDS yaitu jumlah CD4, derajat anemia, dan IMT. [MKB. 2012;44(1):50–6].Kata kunci: Anemia, CD4, indeks massa tubuhOpportunity of Death in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome Patients by Combining Degree of Anemia, Body Mass Index, and Cluster Differentiation 4 CountThe prevalence of anemia in human immunodeficiency syndrome (HIV) infection was quite high, ranging from 1.3 to 95% depending on the stadium of HIV infection. Anemia, cluster differentiation 4 (CD4), and viral load were known as the independent risk factors for death. Body mass index (BMI) is an important risk factor for anemia and progression of the HIV infection. A cohort study had been conducted to evaluate the response of therapy, and deaths as the end point, and to calculate the opportunity of death  by combining the degree of anemia, BMI, and CD4 in HIV-AIDS patients. The subjects were patients in Teratai Clinic Dr. Hasan Sadikin General Hospital-Bandung from  January to June 2008. During 6 months of follow-up from  July−December 2008, there were 534 patients in the database of Teratai Clinic, with only 458 continuing the therapy, thirty eight  patients were dropped-out, eight patients moved to other hospital and 28 patients died. The prevalence of anemia from previous study of those 534 patients was 41.6%. After 6 months of follow-up, there were 26 deaths among anemic patients and 2 deaths in non-anemic patients. The combination of moderate-severe anemia, CD4 ≤50/mm3 and BMI <18.5 showing the highest opportunity of death in this study was 80%. In conclusion, the important risk factors of deaths in HIV-AIDS patients were CD4, grade of anemia, and BMI. [MKB. 2012;44(1):50–6].Key words: Anemia, body mass index, CD4DOI: http://dx.doi.org/10.15395/mkb.v44n1.212