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Transovarial Transmission Index of Dengue Virus on Aedes aegypti and Aedes albopictus Mosquitoes in Malalayang District in Manado, North Sulawesi, Indonesia Angle Maria Hesti Sorisi; Sitti Rahmah Umniyati; Tri Baskoro Tunggul Satoto
Tropical Medicine Journal Vol 1, No 2 (2011): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introduction: Dengue Hemorrhagic Fever (DHF) is an infectious vector-borne disease caused by Aedes sp mosquitoes still cause serious health problem in Indonesia. Based on Manado Health Office Report, Malalayang was identified as dengue-endemic areas. In 2010, number of DHF cases in Malalayang is 211 cases with Incidence Rate (IR) 328 per 100,000 populations. Dengue viruses (DENV) survive in nature by two mechanisms; by horizontal transmission through infected vertebrates and mosquitoes, and by vertical (transovarial) transmission in the mosquitoes. Transovarial transmission is assumed as an important aspect in the maintanance of DENV during inter epidemic, but this problem has not been studied in Malalayang District, Manado. An effort to prevent and control DHF requires knowledge of an Aedes sp Dengue virus transovarial infection.Objectives: To prove the existence of Dengue virus transmission in Ae. aegypti and Ae. albopictus mosquitoes and its relationship with the incidence of DHF in Malalayang District in Manado, North Sulawesi, Indonesia.Methods: The method of this research was an observational analytic study with cross-sectional design. Study samples were unbloodfed Aedes aegypti and Aedes albopictus mosquitoes on the F1 generation from ovitrap placed in five selected villages based on the number of cases in the District Malalayang. The secondary data of DHF patients from Malalayang district was obtained from Health Office Manado and the Community Health Center in 2010. The presence of dengue antigen in head squashes preparation were detected using monoclonal antibody against dengue (DSSE10) based on immunohistochemical streptavidin biotin peroxidase complex (ISBPC) technique to confirm the presence of transovarial transmission of dengue virus both in Ae. Aegypti and Ae. Albopictus, and to obtain the data of transovarial transmission index. Fisher’s Exact test and Pearson correlation are used to analyze those data.Results: Transovarial transmission of Dengue virus in Aedes sp was found from 5 villages in Malalayang district with Transovarial Transmission Index (TTI) ranges 6.1%-17.1%. Statistic test showed significant differences in positive rate (p-value=0.00<0.05) on Ae. aegypti higher than Ae. albopictus. It is also known that there is no statistically significant correlation (p-value=0.528>0.05) between the Aedes sp. Dengue virus TTI and DHF IR in Malalayang district.Conclusion: This study demonstrates the existence of Dengue virus transovarial transmission in Aedes sp in Malalayang district. Ae. aegypti’s TTI is higher than that of Ae. Albopictus, and no significant correlation between TTI and DHF IR in Malalayang district.Keywords: DHF, transovarial transmission, Ae. aegypti, Ae. albopictus

THE KINETIC OF ACTIVATED MONOCYTES IN ACUTE PHASE DENGUE INFECTION Umi Solekhah Intansari; Arif Bahiyuddin bin Badaruddin; Ida Safitri Laksanawati
Tropical Medicine Journal Vol 1, No 2 (2011): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introductions: Nowadays dengue infection is at present one of the most common mosquito-borne viral diseases of humans worldwide. Initially, Dengue infections were primarily recorded when they occurred as epidemics in tropical and subtropical countries. Monocyte/macrophage infection is central to the pathogenesis of dengue fever and to the origin of dengue hemorrhagic fever. Increased activation of monocytes and greater numbers of DEN-infected cells were associated with more severe Dengue, implicating a role for monocyte activation in dengue immunopathogenesis. Thus, more knowledge about the relation between numbers of activated monocyte with dengue severities is essential for better understanding regarding this subject.Objectives: Studying the relation between numbers of activated monocyte, marked by HLA-DR marker intensity with Dengue Fever severity throughout the disease course, from day 2 until day 6 of acute dengue fever.Methods: This research is cross sectional observational study. The location in done at Dr. Sardjito Hospital in 6 months time.Results: There is a negative correlation between median number of activated monocyte with dengue severity, on day 3 of acute dengue fever.Conclusion: There was a negative correlation between numbers of activated monocyte marked by HLADR intensity with disease severity on day 3 of acute dengue infection.Keywords: Activated Monocyte; Human Leukocyte Antigen (HLA)-DR intensity; Percentage of Activated Monocyte; Dengue Fever Severity.

The Relationship Between The Prevalence of Head Lice Infestation with Hygiene and Knowledge Among The Rural School Children In Yogyakarta Hemelamariae Munusamy; Elisabeth Elsa Herdiana Murhandarwati; Sitti Rahmah Umniyati
Tropical Medicine Journal Vol 1, No 2 (2011): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introduction: Pediculosis capitis causes considerable social distress. Rural children are in great risk because they live in conditions where poor knowledge and hygiene are related to this matter. However, the prevalence of pediculosis capitis among school age children in rural area in Yogyakarta have not known yet.Objectives: The objective of this study is to find the prevalence of head lice infestation among the rural school children and associating it with hygiene and knowledge.Methods: This was a cross sectional study done in February 2011 in 2 primary public schools in the rural areas of Yogyakarta with 158 subjects age ranging from 8 to 16 years old. Questionnaires inclusive of hygiene and knowledge aspect were given prior to the gross visual head lice examination by trained personnel.Results: The prevalence of head lice infestation among the rural school children is 19.6%. There is no significant relationship between this with knowledge and hygiene.Conclusion: The prevalence of head lice infestation in rural school areas in Yogyakarta is 19.6%. There is no significant relationship between the prevalence of head lice infestation with hygiene and knowledge among the rural school children in Yogyakarta.Keywords: Pediculosis capitis, head lice infestation, hygiene, knowledge

DEVELOPMENT OF A PROTOTYPE OF MALARIA CLINICAL DIAGNOSTIC DECISION SUPPORT SYSTEM Sudarta Yabesman Harefa; Lutfan Lazuardi; Anis Fuad
Tropical Medicine Journal Vol 1, No 2 (2011): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introduction : Malaria is a public health problem that still causes mortality, particularly in high risk population. Kabupaten Nias is one of the malaria endemic areas. Malaria diagnosis is mainly determined according to physical examination, despite the fact that laboratory examination is the gold standard of malaria diagnosis. To help health workers in diagnosing malaria accurately, it is necessary to develop a decision support system for malaria diagnosis.Objectives: To develop a prototype of malaria diagnostic decision support system.Methods: It was a descriptive study with action research design to explore each phase in the development of a prototype of malaria diagnostic decision support system. Participants of the study consisted of 5 general practitioners in RSU Gunungsitoli and 2 nurses in Puskesmas Gunungsitoli.Results: The study created an application model of computer-based malaria diagnostic decision support system designed using PHP programming language and MySQL database. This system worked by entering malaria clinical symptoms into the expert system, and data of symptoms were processed by the expert system to determine diagnosis and medical advice that was useful to assist health staff in making decision.Conclusion: Malaria diagnostic decision support system that had been developed attracted the interest of health workers and help them in diagnosing malaria clinically.Keywords: diagnostic decision support system, prototype, malaria, computer application, Gunungsitoli

In vivo Antiplasmodial of the Most Active Fraction and Its Compound of Kapur Leaves (Harmsiopanax aculeatus Harms) Extract Against Plasmodium berghei Rachel Turalely; Ratna Asmah Susidarti; Mahardika Agus Wijayanti
Tropical Medicine Journal Vol 1, No 2 (2011): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

Introduction : The rising of Plasmodium resistance towards chloroquine and other antimalarial drugs have encouraged to discover and develop new drugs mainly derived from natural products. Harmsiopanax aculeatus (kapur plant) has traditionally used by people of in Maluku Province to treat malaria.Objectives: The aims of this study were to identify antiplasmodial activity and its chemical constituents of the most active fraction of kapur leaves.Methods: The dried powder of Kapur leaves (1.3 kg) were extracted successively by maceration with n-hexane, ethyl acetate and methanol. After removal the solvents the hexane 15.6 g (1.2%), ethyl acetate 53.3 g (4.1%) and methanol 61.1 g (4.7%) extracts were obtained. Those extracts were assayed for their in vivo antiplasmodial activities by using 4-days suppressive test in Swiss mice infected with Plasmodium berghei, HPIA and identified the compound by GC-MS.Results: The ED50 of hexane, ethyl acetate and methanol extracts were 467.58, 2074.02 and 16.16 mg/kgBW, respectively. Fractionation of the methanol extract gave 18 combined fractions (FG1 – FG18). FG8 was the most active fraction with the IC50 HPIA of 18.22 μg/ml. Phytochemical test of this fraction using spray reagent showed the existence of essential oils, triterpenoids, and phenolic compounds. Separation of FG8using pressed chromatography gave 19 combined fractions (FG8.1-FG8.19). The fraction containing intense blue fluorescent spot (FG8.5) was further separated by PLC fourthly eluted with chloroform. Seven major components with the percentage of compotition more than 3.11% were identified as eugenol (tr = 12.692; 18.22%), isoprophyl myristate (tr = 16.333; 3.99%); bis(2-methylpropyl) phtalat (tr = 16.939; 7.15%); methyl palmitic (tr = 17.442; 3.11%); palmitic acid (tr = 17.883; 25.72%); butyl 2-methylpropyl phtalat (tr = 17.957; 9.37%) and bis(2-ethylhexyl) phtalat (tr = 23.258; 23%).Conclusion: Methanol extract of H. aculeatus was the most potential in vivo antiplasmodial activity. Combined fraction 8 which contain 7 compounds was the most active fraction.Keywords: Harmsiopanax aculeatus Harms, in vivo antiplasmodial, HPIA, PLC, GC-MS

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

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