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Risk Factor of HIV Infection Among Young Agein Voluntary Counseling Testing (VCT) Clinics of Yogyakarta Ismael Saleh; Sumardi Sumardi; Lutfan Lazuardi
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: HIV/AIDS is a health problem in the world. The Highest HIV/AIDS cases in Indonesia were reported in young age groups, including in Province of Yogyakarta (DIY). Knowing the determinant and risk factors of HIVis necessary to determine effective prevention programs, especially in young agewhich one of the vulnerable populations, either because of individual and family characteristics, media influence, peer pressure, substance use and risky behavior.Objectives: To know the relationship between risk factors for HIV infection amongyoung age in VCT clinic of Yogyakarta.Methods: This study used a cross-sectional design and the population was young clients at VCT clinics of Yogyakarta. Samples were obtained from VCT clinics of Griya LenteraPKBI Yogyakarta and Edelweis Clinics of Dr Sardjito Hospital. Variable risk factors were obtained byquestionnaire and interviews than HIV test results was obtained from VCT clinics.Results: Of the 62 respondents, 74.2% were female, age average were 24,4 years old, 41.9% level education were junior high school, 82.3% had migration, 62.9% received less monitoring from families, 61.3% ever use the TV / HP for pornography, 56.5% getting high sexual pressure from peers, 62.9% had been smoking and alcohol consumption, 98.4% had ever sexual intercourse, 95.2% had sexual intercourse in the last 6 months, 93.5% risky sexual intercourse, 32.3% HIV positive and 55% through heterosexual.Conclusion: HIV infection among young people in VCT Clinic of Yogyakarta, by bivariate analysis correlated with gender, residency status, education level, relationship with parents, TV / mobile and internet used to watch pornography. However, according to multivariate analysis, HIV infection correlated with education level at senior high school and college, residing with their parents/ family and in the last 6 months are still using alcohol and illicit drugs. It is recommended to enhance more comprehensive prevention for young people in accordance with the factors associated with HIV risk behaviour.Keywords: HIV infection, young age, individual characteristics, family, peers, media usage, substance use, risky behavior.

Evaluation of the Performance of Malaria Microscopist in Primary Health Center and Cross Checker in Belu, East Nusa Tenggara. Fridolina Mau; Supargiyono Supargiyono; Elsa Herdiana Murhandarwati
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: It was reported that error rate of malaria microscopic examination of microscopist at Primary Health Center and District Health of fice of Belu, Nusa Tenggara Timur (NTT) was high (45-100%). These high level of error rate might becaused by several factors such as lack of qualified personnel, lack of technical skills in the microscopic slide preparation (blood smear) or incompetency in parasite identification on bloods mear preparation.Objectives: To evaluate the performance of malaria microscopists at Primary Health Centers and cross checker in Belu District and determining the factors that contribute to those condition.Methods: The study was an observational and exploratory research with cross sectional approach. The competency of the malaria microscopist at the primary health center and district health office in examining malaria blood smears were evaluated using standard bloods mears and the one from Passive Case Detection (PCD) activities. Performance in preparing bloods mear were evaluatied by observation and filling the checklist. The study was conducted in December 2012 – March 2013 in Belu District, NTT.Results: The competency of the microscopists to identify malaria in fection was low.The error rate in examining PCD bloods mears ranged from 20 - 100%. The error rate of the microscopic reading at district level reached 52%, with a kappa value between 0.41 to 0.60. There was different levels of the error rate using standard and PCD bloods mears. Error rate in diagnosing malaria on PCD blood smears was higher than those on gold standard blood smears. Accuracy to identify P.falciparum was high (100%) than those to identify P.vivax (0 - 75%). False-positive diagnosis is as high as 90% when examining PCD blood smears. Missed diagnosis of malaria parasite also occure in around 60% of personnel when examining blood smears with low density of less than 1000 parasites/ìl of blood)Conclusion: The accuracy of malaria diagnosis by microscopist in the Health Center in District of Belu is low. The factor that might contribute is the ability of the microscopist to produce a good quality of malaria blood smears. Working experience of the health center microscopist is statistically significant to correlate with accuracy of malaria diagnosis.Keywords: Errorrate, the performance evaluation of microscopists, microscopic examination, blood smear Belu

The Kinetics of White Blood Cells in Acute Dengue Infection Mohd Nasrul Bin Mohd Ghazali; Umi Solekhah Intansari; Ida Safitri Laksanawati
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Dengue is a mosquito borne viral febrile illness with a high incidence rate of approximately 50 million cases of infection world wide every year. Dengue virus can infect many cells, e.g. monocytes, dendritic cells, Kuppfer cells, B cells including bone marrow and lung. Leukocytes plays an important roles in eliminating dengue virus especially monocytes. However, dengue virus sometimes attack the monocytes and uses them for replication causing monocyte to unde go apoptosis in order to prevent spreading by certain mechanisms.Objectives: To explore the difference in white blood cells count in acute dengue patients from day 2 to day 6.Methods: This research is conducted in a cross sectional observational study method by recording the WBC count, Lymphocytes count, Neutrophils Count, Relative Monocytes Count, and Absolute Monocytes Count from NS-1 positive dengue infection patient using the hematology analyzer. The data was taken from day 2 to day 6 of the fever. One-way ANOVA test was used and a p value <0.05 was considered as significant.Results: In this study, there is a significant difference of leukocyte count, relative and absolute lymphocytes count, relative and absolute neutrophils count, and relative and absolute monocytes count from day 2 to day 6 of dengue infection (p value less than 0.05).Conclusion: Dengue patient have leucopenia on day 2 until day 6 of dengue fever. Lymphocytosis occurs on day 6 of dengue fever. Neutrophils decrease in early infection. Monocytes count is normal in dengue fever, but decrease in DHFKeywords: dengue in fection, leukocyte, lymphocytes, neutrophils, monocytes

The Effect of Pandanus conoideus Lamk Extract to the Serum Level of TNF-α, IL-10 and Parasitemia of Plasmodium berghei Infected in Mice Zeth Robeth Felle; Mahardika Agus Wijayanti; Supargiyono Supargiyono
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACT Introduction: Study on the effects of red fruit (Pandanusconoideus Lamk) has been conducted with various result.Objectives: In this study, the effect of red fruit extract on the level of cytokines TNF-α, IL-10 and the parasitemia of Plasmodium berghei infected Swiss mice were evaluated.Methods: Quasi-experimental design with pre and post test only control group was applied. Sixty male Swiss mice of 8 weeks old and weighs 20-30 g, was simply randomized into four treatment groups. Group I (K1) was stimulated with the extract for 2 weeks before and 2 weeks after infection with P.berghei. K2 was stimulated with the extract for 2 weeks before infection, K3 was stimulated with the extract for 2 weeks after infection and K4, negative control, was given 0.6% tween 40. The dose of the extract was 7.8 mg/30g mice BW, intra gastric once a day. Serum level of TNF-α and IL-10 was measured by ELISA Sandwich methods and the number of parasitemia were examined microscopically. The difference level of TNF-α, IL-10 and parasitemia of each treatment group were analyzed by t-test, one way anova, honestly significant different (HSD) and multivariate analysis (manova).Results: There were significan cedifferences of parasitemia in K3 group compared to others. Parasitemia on day-3 was 18.464% and reduced to 1.054% on day-9. Parasitemia of K2 group was 13.204% on day-3 and 32.455% on day-9. Parasitemia of negative control group was 27.304% on day-3 and 78.506% on day-9. The TNF-α level of K3 group decreased along with the infection, it was 26.985 pg/Ml on day-0 and 22.244 pg/mL on day-6. The IL-10 level increased at all groups and the highest level was on K3 group.Conclusion: Effect of red fruit extract on P.berghei infected mice was reduced both parasitemia and TNF-α level but increased of IL-10 level.Keywords : Pandanus conoideus Lamk, Malaria, Parasitemia, TNF-α, IL-1

Comparison of Immunochromatography Method and Immunocytochemistry Method in Rapid Detection of NS-1 Antigen in Dengue Infection How Tien Jack; Sitti Rahmah Umniyati; Elsa Herdiana Murhandarwati
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACT Introduction: Rapid test kit based on immunochromatography test (ICT) in detecting dengue NS-1 antigen for early dengue infection is available in the market. Its availability allows earlier management for dengue infected patient but it remains costly to most people. Recently, Dengue Team of Universitas Gadjah Mada has developed monoclonal antibodies to detect the presence of dengue NS-1 antigen in leucocytes of infected patients based on Streptavid in Biotin Peroxidase Complex (SBPC) immunocytochemistry method.Objectives: The objective of this study is to determine the validity of the immunochromatography (SD Dengue NS1 Ag) method by determining kappa agreement index between two observers, and to compare the diagnostic performances of ICT and immunocytochemistry methods in detecting dengue NS1 antigen in the blood samples.Methods: A cross sectional study design is used. This study uses 35 blood plasma remains from a previous study conducted on RT-PCR method. Three drops of blood plasma were added into the well of SD Dengue Duo NS1 and results were read after 15-20 minutes. The diagnostic performances of ICT which defined by sensitivity, specificity, positive predictive value and negative predictive value were calculated and compared to secondary data of immunocytochemistry result from the same blood samples, with reference of RT-PCR as a gold standard. A McNemar’s test was conducted and p value less than 0.05 was considered as significant different.Result: Detection of dengue infection by using SD Dengue NS1 Ag has strong agreements between two observers with kappa value of 1, and the sensitivity of 50%, specificity of 91%, positive predictive value of 92% and negative predictive value of 45% with reference of RT-PCR as a gold standard. Meanwhile sensitivity and specificity value of the immunocytochemistry test were 88% and 100% respectively, and the positive and negative predictive values were 100.0% and 70.0% respectively with reference of RT-PCR as a gold standard. The immunocytochemistry assay showed overall accuracy of 91,0%.Conclusion: Immunochromatography (SD Dengue NS1 Ag) method to detect NS-1 antigen has less sensitivity and specificity compared to SBPC immunocytochemistry method.Keyword: Immunocytochemistry, Immunochromatography, Streptavidin Biotin Peroxidase Complex (SBPC), NS-1 Ag, dengue

Filariasis Bancrofti Epidemiology Post Mass Drug Administration in Waris District Keerom Regency Province of Papua Korinus Suweni; Soeyoko Soeyoko; Sri Sumarni
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Filariasis remains to be world’s health problems including Indonesia. Based on survey conducted in 2009, the occurrence cases in Indonesia reached 11.914 chronic cases. Further, there were 59 chronic cases in Keerom Regency in 2005. The number of chronic filariasis cases in Waris District reached 25 cases, with 12 people were having positive microfilaria bancrofti.Objectives: The aim of study to find out epidemiology of filariasis bancrofti after collective treatment in Waris District, Keerom Regency, Papua.Methods: This study used descriptive research with cross sectional design. Data are collected by finger blood survey, survey of acute morbidity rate, survey of chronic morbidity rate, microfilaria periodicity survey, and L3 examination on mosquitoes.Result : Survey finger blood taken from 517 samples show 32 positive microfilariae, and filariasis prevalence of 6.19%. There are 13 patients (2.15%) having acute symptoms of filariasis, and 24 patients (4.64%) have symptoms of chronic filariasis. From the examination and dissection of 358 mosquitoes, there are nolarvae stage 3 (L3). From 7 people having microfilaremia, there is periodic nocturnal of 71.43% and subperiodic nocturnal of 28.57%.Conclusion: The prevalence of filariasis was 6.19%. There were 13 people having acute morbidity (2.51%), and there were 24 chronic morbidity (4.64%). There was no L3 found from dissected 358 mosquitoes. Periodicity of microfilariae in Waris District is periodic nocturnal which reach 71.43% and nocturnal subperiodik is28.57%.Keywords: Epidemiology, Filariasis, Finger Blood Survey

The Relationship of Behavior and Environment to the Incidence of Malaria in the Work Area of Oesao Public Health Center (PHC) of East Kupang Sub-District of Kupang District in 2013 Titik Yuliati; Yayi S Prabandari; Tri Baskoro T Satoto
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACT Introduction: Oesao PHC is one of three PHCs in Kupang District experiencing increased malaria cases. According to API figure, its rate in 2008 was 7.01% and in 2009 it decreased to 4.04%; however, the rate showed an increase again in 2010 up to 7. 67%o (Kupang District Health Office, 2010).The work area of Oesao PHC has a heterogeneous society with high malaria cases in each year; it is because the residents have habits to sleep without using nets, people perform activities at night without the use of mosquito repellent, there is an availability of mosquito breeding place and resting place and there is a lack of compliance in taking medication.Objectives: To analyze the relationship between behavior and the environment and the incidence of malaria.Methods: This was an observational analytic study with a case-control study design2. The samples in this study were part of the populations residing within the work area of Oesao PHC of East Kupang Sub-District of Kupang District. The sample size was 116 people3 selected using a random and matching method. Data were analyzed by chi-square test for calculating the value of OR (odds ratio) to determine the magnitude of the risk2 .Results: There was a significant association between the use of nets (OR = 0.061 with p = 0.000, p < 0.05), the use of mosquito repellent or anti-mosquito drugs (OR = 3.417 and p = 0.003, p < 0.05), the use of wire gauze on ventilation (OR = 7.187 with p = 0.000, p < 0.05), the condition of home walls (OR = 2.318 with p = 0.041, p < 0.05), the availability of ceiling OR = 2.657 with p = 0.000, p<0.05), the presence of cattle sheds (OR = 4.742 with p = 0.001, p <0,05), the presence of puddle around the home (OR = 2.007 and p = 0.047, p < 0.05), and the presence of shrubs around the home (OR = 2.706 with p = 0.000, p < 0.05) and the incidence of malaria in Oesao PHC.Conclusion: The incidence of malaria in the work area of Oesao PHC was related to behavior and physical environment inside and outside the house.Keywords: behavior, environment, malaria

Training of Sputum Microscopy Improves the Smear Quality and Slide Positivity Rate for Pulmonary Tuberculosis Diagnosis Dede Kurniawan; Ning Rintiswati; Dibyo Pramono
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACT Introduction: Microscopic examination of sputum is a key component of the diagnosis of pulmonary tuberculosis. The accuracy of this method is influenced by quality of laboratory and human resources. Indonesia is one of endemic country for pulmonary tuberculosis. Efforts to improve the quality of microscopic examination are needed, including training of human resources.Objectives: To determine impact of microscopic examination training to smear quality and slide positivity rate.Methods: This work is an analytic quasi experimental research. The research was involved 18 laboratory technician. Subjects were divided in to experimental and control group, which was consisting 9 technicians in each group. The differences of smear quality and slide positivity rate were analyzed by using independent t-test and Mann-Whitney test with 95% of Confident Interval.Results: Training increased the knowledge of laboratory technician (40.7 points) and the smear quality. Specimen quality was increased 90 points, staining 84.4, cleanness 85.6, thickness 91.1, smear size 88.9, evenness 87.8 and increase the average of smear readings score test 22 points. The mean of smear quality and slide positivity rate of the experimental group were higher than control group. Statistical test of smear quality between eksperimental group with contol group were: specimen quality p=0.03, staining quality p=0.03, cleanness p=0.02, thickness p<0.001, size p<0.001, good evenness p<0.001, and slide positivity rate p=0.02Conclusion: The mean of smear quality and slide positivity rate of the experimental group were higher than control group. There were significant differences of smear quality and slide positivity rate between experimental group with control group at 3 months after training.Keywords: training, sputum microscopy, smear quality, slide positivity rate, tuberculosis

Integrated and Comprehensive Action to Reduce and Control Dengue Hemorrhagic Fever: A Survey in Pekalongan City, Central Java Nur Siyam
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Dengue Hemorrhagic Fever (DHF) is an infectious disease that caused outbreaks in many areas in the Indonesia which led to high morbidity and mortality. Pekalongan City has the highest case fatality rate (CFR) of DHF among 35 cities and regencies in Central Java Province, which was 7.41% in 2008 and increased to 18.00% in 2009. The success of DHF control is largely determined by the cooperation of the public and decision-makers in various aspects and actions to be carried out. Therefore, it needs an integrated and comprehensive action to reduce and control DHF. In addition, to obtain the frequency distribution of DHF accurately and appropriately, an effective surveillance of hospital-early warning (KD-RS) and weekly outbreak (W2) reports are needed which requires timeliness and completeness as its report for early warning system of outbreak, so the morbidity and mortality due to DHF can be reduced.Objectives: This study is a survey with a descriptive approach to describe the level of implementation and regulation and activities conducted for dengue fever’s eradication program.Methods: Data was collected through observation, check list documentation and interviews. The subjects of this research were officers (head and staff) in the Division of Disease Prevention and Control-Environmental Health (P2P-PL) at Department of Health, Pekalongan City. Sampling technique is a total sampling. Data was analyzed and presented qualitatively.Results: The results showed that the key persons in population are an important individuals who responsible for community engagement in the village, institutions (schools and places of business, industries, offices), health centers, hospitals, families and individuals. Key interventions include organizing and managing resources. DHF prevention activities including preparation and implementation which cover many programs such as socialization, mobilization, selective larvacides, fogging prevention and focus, partnership with the non-goverment organisation (NGO), DHF suspect handling and monitoring and evaluation of activities through surveillance program.Conclusion: In conclusion, both reducing and controlling DHF in Pekalongan City was an integrated and comprehensive actions, involving key persons in populations and interventions.Keywords: integrated action, key persons, survey, DHF prevention

The Red Fruit (Pandanus Conoideus Lam) Ethanol Extract Decreased the Nitric Oxide (NO) Levels of Plasmodium Berghei Infected Swiss Mice Malaria Model but not the Interferon Gamma (IFN-γ) Mujur Mujur; Demianus Tafor; Widya Wasityastuti; Achmad Djunaidi; Eti Sholikhah Nurwening
Tropical Medicine Journal Vol 3, No 1 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/tmj.60593

ABSTRACTIntroduction: The immunity against malaria infection was very complex, involving humoral immunity and cellular immunity. One of the methods to improve body immune response was using antioxidant. Red fruit (Pandanus conoideus Lam) containing carotenoid and tocopherol that have antioxidants effects increase phagocytosis activity of macrophage and proliferation activity of lymphocyte as immune response againts parasite infection.Objectives: This study was intended to know the effect of red fruit (P. conoideus Lam) ethanol extract on IFN-γ and nitric oxide (NO) levels in Plasmodium berghei infected Swiss mice malaria model.Methods: This quasi experimental study used post test only control group design. Sixty eight-week aged male Swiss mice were devided into 6 groups. Group I was not given red fruit ethanol extracts neither infected by P.berghei, group II was given 260mg/kg/day of red fruit ethanol extracts, and it was not infected by P.berghei, groups III, IV and V were given red fruit ethanol extracts at 130, 260 and 520mg/kg/day respectively and infected by P.berghei. Group VI was not given the extract, however it was infected by P.berghei as control group. The red fruit ethanol extracts or the carrier was given for 28 days and the mice were infected by P.berghei in the beginning of week 3. On the day 3 and 9 after infection, 2 mL blood was taken from 3 mice of each group for serum isolation.Results: There was not any significant difference (p>0.05) mean of IFN-γ levels in all groups neither on day 3 nor day 9 after infection. The nitric oxide levels mean of mice group which have received red fruit extracts at 130 and 260mg/kg/day on the day 9 and in mice group which have received red fruit extracts 260mg/kg/day on day 3 were lower than they were in control group without any extract (group VI). However, the nitric oxide levels mean of mice group which have received 520mg/kg/day did not show any significant difference (p>0.05) compared with control group.Conclusion: The red fruit (P. conoideus Lam) ethanol extract did not show any significant effect on the IFN-γ levels, however at doses of 130 and 260mg/kg/day it decreased the nitric oxide level of P. berghei infected Swiss mice malaria model significantly. Keywords: Pandanus conoideus Lam, Interferon gamma (INF-γ), Nitric oxide (NO), Plasmodium berghei, and Malaria ModelKeywordsPandanus conoideus Lam, Interferon gamma (INF-γ), Nitric oxide (NO), Plasmodium berghei, and Malaria Model

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