Infect. Dis. Rep., Volume 12, Issue s1 (July 2020) – 33 articles

Background: East Java has become one of the provinces that have higher prevalence of leprosy, especially in the coastal region. Environment has also influenced for leprosy transmission and early detection could reduce the incidence rate of new leprosy cases. Epidemiological studies of leprosy in children can give an illustration of the important aspects of the environment. Presence of Mycobacterium leprae (M. leprae) DNA in nasal swabs and seropositivity level among them can describe M. leprae exposure in that area. Objective: Analyzing PCR from nasal swab and seropositivity level among elementary school children between northern coast and southern coast of East Java province. Methods: Five hundred and thirty children in Pacitan and Lamongan were involved. Both areas are representation of northern and southern coastal region in East Java Province. After clinical examination, nasal swab and blood samples were obtained. ELISA test was performed to measure the titer of IgM anti Phenolic Glicolipid-1 (PGL-1) antibody then continued by PCR to detect M. leprae DNA. Results: From 301 students in Pacitan, 25 students (8.3%) are sero-positives and 9 students (2.9%) are PCR positives. from 229 students in Lamongan, 110 (48.3%) students are sero-positives and 49 students (21.4%) are PCR positives. Both are analyzed by Chi-Square, and from the PCR and ELISA, it concluded that there are statistically significant differences between the two regions. Conclusion: From study above shows that in the northern coast of East Java, incidence of subclinical leprosy is still high, it means that in this area still has a high risk of new cases of leprosy in the future and early detection tools need to performed as a preventative measure. Full article

Relationship between humans and cats has negative impact associates with zoonotic diseases. It is the reason why studies on the prevalence of gastrointestinal (GI) parasites in cats are important. Some of zoonotic GI parasites in cats are Toxocara spp., Ancylostoma sp., and Toxoplasma gondii. The current study was conducted to investigate the prevalence of GI parasites in owned and stray cats in Lumajang East Java Indonesia. One hundred and twenty fecal samples were collected from owned and stray cats on November 2018 to January 2019. The samples were examined by direct smears, sedimentation and flotation techniques. Identification of parasites was determined based on the morphology of worm eggs and protozoan cysts. The results showed that gastrointestinal parasites were found in 68.33% (82/120) examined samples, respectively, 48.33% (29/60) and 88.33% (53/60) from owned cats and stray cats. We found 7 genera of parasites, 4 genera of worm eggs and 2 genera protozoan oocyst. The egg worm were Toxocara cati (40%), Toxocara leonina (10.33%), Ancylostoma sp. (18.33%), Diphylobothrium sp. (3.33%) and Dipylidium caninum (1.67%). The protozoan oocyst were Isospora felis (27.5%), Isospora rivolta (13.33%) and Eimeria spp. (8.33%). Toxocara cati, Ancylostoma sp. (hookworm), Diphylobothrium sp. and Dipylidium caninum were zoonotic parasites. Rate infection in younger and older cat were no significant difference. One cat can be infected one or more parasite. To conclude, the prevalence of zoonotic GI parasites both in owned and stray cats were high. It is necessary to plan a program to control this zoonotic parasites. Full article

Background: Human herpesvirus 8 (HHV-8) infection is etiologically related to Kaposi’s sarcoma. Antibodies directed against HHV-8 can be detected in 80%–95% of HIV-seropositive patients with KS. HHV-8 serological tests have been done in several countries in Southeast Asia such as Malaysia, and Thailand however no serological data is available in Indonesia. This study was to examine the presence of HHV-8 antibodies in HIV-positive patients in Surabaya, Indonesia. Material and methods: Ninety-one serum samples were collected from HIV-positive patients in Surabaya, Indonesia. Human immunodeficiency virus-positive serum samples were collected from 10 homosexual men, 25 intravenous drug users (IVDUs) and 56 heterosexuals. Serums were then tested for the presence of HHV-8 antibody by using sandwich ELISA (Abbexa Ltd, Cambridge, UK). Results: The total of 91 HIV-infected were testing with antibodies to HHV-8 using enzyme-linked immunosorbent assay. Antibodies of HHV-8 were detected in 7/91 (7.7%) of the samples. According to a gender, six men (85.7%) and a women (14.3%) were positive of HHV-8 antibodies. No correlation regarding the gender and age from this study. The antibodies of HHV-8 was detected among intravenous drug users (IVDUs) men 5/7 (42.8%) and 2/7 (28.6%) from homosexual and heterosexual, respectively. Conclusion: This study found the presence of HHV-8 antibodies in 7.7% of patients in Surabaya, Indonesia. This finding was higher more than Southeast Asian countries. The patients with a positive result could suggest measures to prevent HHV-8 infection. Full article

Enteroaggregative haemorrhagic Escherichia coli (E. Coli, EAHEC) has been identified as the agent responsible for one of the largest outbreaks of gastroenteritis and Haemolytic-uremic syndrome (HUS) that is transmitted through food in Germany in 2011. The hypervirulent pathotype has a unique combination of two pathogens namely enterohemorrhagic E.coli strain (EHEC) which produces shiga/verotoxin and enteroaggregative E.coli toxins (EAEC) which produces toxins similar to ST and hemolysin. The toxin produced by the EAHEC strain is a hybrid pathotype that combines the virulence potential of the EAEC and EHEC strains that will damage the microcirculation, cause vasculitis and other toxic effects. The purpose of this study was to determine the percentage of samples infected with enteroaggregative hemorrhagic E. coli bacteria (EAHEC) in pediatric diarrhea patients at DR. Soetomo Hospital, Surabaya, Indonesia, 2015. This study used PCR (Polymerase Chain Reaction) method to detect enteroaggregative E. coli strains (CVD432 and aaic genes) and enterohemorrhagic E.coli (eae gene).The results showed that 33 out of 40 (82.5%) stool samples examined were detected enteroaggregative E. coli (EAEC), 4 out of 40 (10%) enterohemorrhagic E. coli (EHEC) and 3 out of 40 (7.5%) enteroaggregative haemorrhagic E. coli bacteria (EAHEC) , which caused diarrhea in pediatric diarrhea patients at Dr. Soetomo General Hospital. The unique combination of genomic features of the Surabaya outbreak strain, containing characteristics from pathotypes EAEC and EHEC, suggested that it represents a new pathotype enteroaggregative haemorrhagic E. coli (EAHEC). It is expected that development of specific primer design and sequencing are needed to continue in this research. Full article

Dengue fever and dengue hemorrhagic fever are transmitted to humans by the Aedes aegypti and Aedes albopictus mosquitoes, with an observed 30-fold increase in global incidence the last 50 years. Despite the tremendous efforts invested anti-dengue virus research, no clinically approved vaccine or antiviral chemotherapeutics are available for humans, and disease treatment is limited to supportive care. Over the years there has been a continuous interest in the chemistry of metal complexes with biological activity, including platinum complexes with antitumor activity and silver complexes with antimicrobial action. Aim of the project was to investigate [Cu(2,4,5-triphenyl-1H- imidazole)₂ (H₂O)₂].Cl₂ as antiviral compound that was further tested for inhibitory effect on the replication of dengue virus type 2 (DENV-2) in Vero cell. DENV-2 were infected in Vero cells and replication of virus was measured by Viral ToxGlo with selectivity index value (SI) and determined as the ratio of cytotoxic concentration 50 (CC₅₀) to inhibitory concentration 50 (IC₅₀) for com- pound. The standard curve between concentration of compound (μg/mL) and %viability of cells was analyzed by logarithmic cor- relation regression with regression equation. For infection rates, t-test was used to exam- ine the statistical significances among the concentrations of compound. P < 0.05 was considered to be significant. The maximum inhibitory concentration (IC₅₀) of [Cu(2,4,5- triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ against DENV-2 was 98.62 μg/mL. The cytotoxic concentration (CC₅₀) of compound against Vero cells was 300.36 μg/mL. The SI values for [Cu(2,4,5-triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ 1.86. Based on selectivity index values, [Cu(2,4,5-triphenyl-1H-imidazole)₂ (H₂O)₂].Cl₂ can inhibit the growth of DENV- 2 and has low toxicity values for Vero cells. Full article

Cellular immune has an important role in response HIV infection, which is attack the infected cells to activate signaling molecule. Hyperbaric Oxygen (HBO) worked as complementary treatment for HIV infection. The production of ROS and RNS molecules during hyperbaric exposure can affect gene expression which contributes to cellular adaptative response. This study was conducted to explore the mechanisms of cellular adaptive response to HIV infection during hyperbaric exposure. This study was carried on in vitro using healthy volunteers’ PBMCs (Peripheral Blood Mononuclear Cells) cultures infected with HIV-1. The study was conducted as a post- test only group design. The experimental unit was PBMC from venous blood of healthy volunteers which were cultured in vitro and infected by co-culturing with HIV-1 in MT4 cell line. The experimental unit consist of treatment and control group. Each group examined the expression of transcription factor NFκB, Interferon α, reverse transcriptase inhibitors (p21), and the amount of HIV-1 p24 antigen. There were increasingly significant differences in the expression of the trancription factor of NFκB, p21, and HIV-1 p24 antigen,as well as mRNA transcription of interferon α2 between treatment and controlgroup. By decreasing p24 antigen showed that HBO exposure was able to suppress HIV-1 replication. The exposure to hyperbaric oxygen at the pressure of 2.4 ATAand 98% oxygen wasable to produce ROS and RNS molecules, which play a role in cellular adaptive responses through increasing the expression of nfĸb, p21 and mRNA of interferon α2 plays a role in inhibition mechanism of HIV-1 replication in cells. Full article

The presence of transmitted drug resist- ance (TDR) in human immunodeficiency virus type 1 (HIV-1) infected individuals naive to antiretroviral therapy, may affect the effectiveness of treatment. Jakarta, the capital city of Indonesia, recorded the high- est number of cumulative HIV infection cases in the country. This study aimed to identify on the appearance of TDR, as well as to identify HIV-1 subtypes circulating among treatment-naive individuals in Jakarta. Whole blood samples collected from 43 HIV-1 infected, treatment-naive individuals. Viral subtyping and drug resist- ance testing were performed on HIV-1 pol genes amplified using nested polymerase chain reaction. CRF01_AE was detected most frequently in Jakarta (73.08%). Drug resistance-related major mutation was not detected in protease fragments of pol gene, but two major mutations, K103N (6.67%) and Y181C (6.67%), were detected in reverse transcriptase fragments of pol gene. Our results suggest that TDR was emerged in Jakarta at a certain extent, thus further surveillance study to monitor the TDR prevalence and circulating HIV-1 subtypes in this region is considered to be necessary. Full article

Staphylococcus aureus (S. aureus) is a round-shaped Gram-positive bacteria that caused infection in the human body. S. aureus infection can be inhibited by the use of antibiotics. However, these bacteria displayed resistance to some antibiotics. The purpose of this study is to determine the effects of Tembelekan (Lantana camara L.) and Kopasanda (Chromolaena odorata L.) leaf extracts against S. aureus. The method used in this study is the disc method to determine the inhibition zone. The test results showed there was no significant difference in the sensitivity of Tembelekan leaf extract (L. camara L.) and Kopasanda leaf extract (C. odorata L.) against S. aureus (P0.8>α0.05). However, based on the average value of the inhibition zone, Kopasanda leaf extract was showed higher inhibition zone compared to Tembelekan leaf extract. In conclusion, Tembelekan leaf and Kopasanda leaf at a concentration of 100% were produced inhibition zones of 0.6 cm and 0.8 cm respectively against S. aureus. Full article

Background: Tuberculosis (TB) remains a major cause of morbidity and mortality worldwide. Problem of Latent Tuberculosis Infection (LTBI) is increasing in number especially in countries with high TB incidence rate, such as Indonesia. Although not every LTBI will become active TB, if untreated and not handled appropriately it can still be a source of transmission and may increase the rate of resistance to the first-line TB drugs. Mycobacterium tuberculosis as a cause of tuberculosis disease is an intracellular pathogens that survives within the phagosome of host macrophages. Several host factors are involved in this process, including the Tryptophan Aspartate-containing Coat Protein (TACO). TACO is a protein recruited and retained by viable Mycobacterium tuberculosis on the surface of the phagosome membrane to maintain its survival in phagosome, because the presence of TACO plays an important role in inhibiting the fusion of phagosomes and lysosomes. Objective: the aim of this studyis to assess the difference of gene expression TACO protein in Latent Tuberculosis Infection (LTBI) and healthy people. Method: A preliminary studyof mRNA examination of TACO protein using Immunocytochemistry (ICC) and Real Time-Polimerase Chain Reaction (RT-PCR) method by a PCR Light Cycler 2.0 machine (Roche) in LTBI and healthy groups. Results: 18 samples of peripheral blood monocyte cells (PBMCs) were collected and divided into 2 groups. We found that there was a significantly difference between the 2 groups of samples. Conclusion: Further research is required to consider that the measurement of TACO expression using RT-PCRcan used as one of the other method to determine LTBI. Full article

Anti retroviral drugs for HIV has problems with uncomfortable side effects and that endanger the lives of HIV sufferers. Several herbs have been empirically proven to have an effect on HIV eradication through inhibition of reverse transcriptase. One of such antiviral herbs is Justicia gendarussa (J. gendarussa). The aim of research is to evaluate anti-HIV activity of 70% fractionated-ethanol extract (with releasing alkaloids) and 70% ethanol extract (without releasing alkaloids) of J. gendarussa leaves on in vitro HIV-infected of MOLT-4 cells. The effect of the extracts in inhibiting viral replication and fusion process on acute HIV infection was identi- fied through syncytia formation assay. Effect of the extracts on HIV p24 antigen was evaluated using HIV-1 p24 ELISA kit. It was found that 70% fractionated-ethanol extract and 70% ethanol extract of J. gendarussa leaves significantly inhibited of HIV replication by inhibition of syncytia formation, where the 50% effective concen- tration (EC50) values of the 70% fractionated-ethanol extract and 70% ethanol extract are 70.5 μg/mL and 228.7 μg/mL, respec- tively. Both of the extracts were also significantly inhibited HIV replication by decreasing HIV p24 antigen level where the EC 50 values of the 70% fractionated-ethanol extract and 70% ethanol extract are 88.8 μg/mL and 540.7 μg/mL, respectively. Moreover, it was found that 70% fractionated-ethanol extract of J. gendarussa leaves has anti-HIV activity since its EC50 values less than 100 μg/mL. It was concluded that J. gendarussa could be potentially developed into a phytopharmaceutical product due to its anti-HIV activity. Full article

Stunting is caused by chronic malnutrition and recurrent infectious diseases. Stunting in Pasongsongan Village affects less than 20% of the children under two, leading to problems in growth in early childhood. Ocean fish is the main animal products in this village on the coast, but it turned out that it is not served to the children, even if they should have begun to be introduced to animal products by the age of 9 months. The purpose of this study was to observe the practices of complementary feeding among stunted children under the age of two in Pasongsongan Village. This research was carried out by qualitative method. The informants were twelve mothers of children under the age of two. Data was collected from interviews, observations and documentation. The stunted children only consumed rice porridge until the age of one, which means that the food intake contains mostly carbohydrates. The mothers who have stunted children have argued that the children’s intestines is not strong enough to digest food with coarser texture like eggs, fish, beef and chicken. Sea fish are given when the children can walk because there has long been a belief that fish contain worms. No feeding fishes and other animal products that are good source of protein can affect their growth in a nega- tive way. The feeding practice of stunted children under the age of two in Pasongsongan Village was strongly influenced by culture. The mindsets of mothers of the stunted children regarding feeding practices must be changed. Full article

Antigen and collagen-induced arthritis (ACIA) is animal model of rheumatoid arthritis. The aim of this study was to identify the effect of different doses of hyperbaric oxygen (HBO) exposure in reducing inflammation on ACIA through analysis hypoxia inducible factor-1α (HIF-1α), anticyclic citrullinated peptide antibody (ACPA) and interleukine 17a (IL-17a). 24 male Balb/C mice were divided into 3 groups, 8 mice did not receive HBO exposure as a control group (G1) and 16 mice received HBO exposure as treatment group (G2 and G3). G2 was ACIA which was exposed to HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days. G3 was ACIA which was exposed to HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 5 consecutive days, break 5 days, 5 consecutive days. ACPA and IL-17a were measured by enzyme-linked immunosorbent assay (ELISA) technique. The expression of HIF-1α was measured by immunohistochemistry technique. There was significant decrease of ACPA levels, IL-17a levels and HIF-1α expression (P < 0.05) in G2 and G3 compared to G1. There was not significant decrease of ACPA levels (P > 0.05), there was significant decrease of IL-17a levels and HIF-1α expression (P < 0.05) in G2 compared to G3. G2 was a group with a higher oxygen partial pressure than G3. HBO 2.4 ATA O₂ 100% 90 minutes divided by 3 each 30 minutes intervals 2 times 5 minutes breathing with normal air for 10 consecutive days more effective in reducing inflammation than exposure 5 consecutive days, break 5 days, 5 consecutive days in ACIA. HBO has therapeutic potential for the treatment of RA. Full article

Kendari city had serious issues related to emerging a hundred of fast food sellers in 2017, including in Mokoau Health Centre area. However, there were only two health environmental staffs in that health care centre. Therefore, involving cadres in the fast food control become necessary. This study aimed to analyse the relationship between cadre’s capacity and Assessing to the food seller’s performance in food hygiene and sanitation management in Mokoau Health Centre in Kendari City since March 2019. There were 15 active cadres who controlled 35 fast food sellers. This study used the One-Group Pretest- Posttest Design. Data analysis used Paired T-test, Mann-Whitney test and Chi-Square test. This study found that 93.3% cadres had a senior high school diploma and only 6.7% of them had a Bachelor degree. There were 60.6% active cadres who had been in social health work for more than 5 years. The majority of cadres have got training about less than 15 times (86.7%). Involving cadres in the fast food control affected to seller’s performance change in fast food hygiene and sanitation management (P=0.006). Cadre with bachelor degree (P=0.006), were active in the social health work for less than 5 years (P=0.003), and got training less than 15 times (Pvalue= 0.026) influenced significantly to cadre’s assessing for the seller’s performance in food hygiene and sanitation management. This study suggested that improving cadre’s or community volunteer’s knowledge and skill related to fast food control technique becomes necessarily in fast food control. Full article

Transformation of infectious diseases is a dynamic movement of the spread of disease that is largerly determined by the ability to understand geomedical maps, disease transmission and impacts on national security. Disease transformation is an order of infection that can be life threatening in a clinical perspective an outbreak at the community level. The involvement of the Indonesian National Military (Tentara Nasional Indonesia, TNI) in the transformation of infected diseases is a network that needs to be strengthened, considering that its role is very important to maintain health security as a gate for national security. Strength in dealing with the extraordinary event of infection requires on going collaboration, competence, networking and integration. Full article

Congenital Rubella Syndrome (CRS) consists of hearing impairment, ophthalmology abnormalities, and congenital heart disease in children, resulting from rubella infection during pregnancy. Rubella vaccine has been implemented as national immunization program in Indonesia since 2017, and needed to be evaluated. This study aimed to report the CRS patients’ profile of Audiology Outpatient Clinic in Surabaya. A descriptive study from patient’s medical record was conducted in Dr. Soetomo Hospital Surabaya from January 2016 to December 2017. CRS was categorized using World Health Organization classification. Suspected infants with CRS burden were assessed by Otoacoustic Emission and rubella antibody test. Ninety five infants suspected with CRS classified as laboratory- confirmed CRS (58.95%), clinically confirmed CRS (15.79%), and discarded CRS (25.26%). Clinical manifestations included combination of congenital heart disease and hearing impairment (17.89%), congenital heart disease, ophthalmology abnormalities, and hearing impairment (16.84%), and hearing impairment and ophthalmology abnormalities (13.68%). The data show a high burden of CRS in Surabaya. These implies the urgent need for national rubella immunization program. Full article

Identification of solid state to investigate the possibility of physical interaction between Antimalarial Artemisinin Combination Treatment base Artesunate (AS) and Amodiaquine (AQ) by hot contact method Kofler, cold contact method (crystallization reaction) and binary phase diagram confirmation had been carried out. The results of hot contact method Kofler shown the formation a new crystalline habit as a long and thin needle on the contact zone (mixing zone) between AS and AQ. A different melting point was seen in its single component. Cold contact methods between two of supersaturated solution of component AS and AQ in methanol solvent also indicated the growth of crystal habit as similar as hot contact method Kofler. Confirmation by biner phase diagram shown the specific diagram for cocrystalline phase. Solid state interaction between AS and AQ was analysed by powder X-ray diffraction, FTIR (Fourier Transformed Infra Red) spectrophotometric, microscopic SEM (Scanning Electron Microscopic) and thermal DTA (Differential Thermal Analysis), TG-DSC (Thermal Gravimetry- Differential Scanning Calorimetry). Microscopic analysis by SEM showed significantly the change of habit and morphology of crystal to long and thin needle shaped. The difference of powder X-ray diffraction (PXRD) interferences peaks were observed in addition to PXRD interference peaks of each component and its physical mixtures that proved formation of cocrystalline phase. DSC Thermogram indicated a new endothermic peak corresponding to melting point of a new cocrystalline phase at temperature 160,4 °C. Full article

Early childhood caries (ECC) is still one of the many diseases found in children throughout the world. Cariogenic bacteria are a significant risk factor for ECC associated with early colonization and high levels of cariogenic microbes (Streptococcus mutans, S. mutans). Lymphocyte T (CD4⁺) cells known as helper T cells, are effector cells for mediated host immunity. Naive T cells (CD4⁺) must be activated to initiate effector function. This activation occurs through interaction with professional antigen- presenting cells (pro-APC), especially dendritic cells that lead to intracellular pathways that regulate T cell receptor (TCR) more specifically against antigen in T cells. Lymphocyte cells from samples were collected from severe early childhood caries (S-ECC) and Free caries aged 5 to 6 years. The subjects were instructed to gargle 10 mL of sterile NaCl 1.5% solution for 30 seconds, and expectorate it into a sterile glass then analyzing T lymphocyte cell (CD4⁺) expression using flow cytometry. Lymphocyte T (CD4⁺) cell expression at SECC (6.2525 ± 64482) while in free caries (8.4138 ± 1.10397) with P-value (P = 0. 000). Conclusion of lymphocyte T (CD4⁺) cells expression at S-ECC is lower than that occurring in free caries. Full article

Airports need high security procedures, especially for preventing outbreaks of infectious diseases spread by passenger and carried goods. Outbreaks of disease form real threat to national defense that can endanger national sovereignty, territorial integrity and national security. Biological agents that are dangerous sources of outbreaks infectious diseases can be spread by criminal and terrorists for biological warfare. Based on data, the spread of diseases in Indonesia came from abroad, such as SARS from China, Mers-CoV from the Middle East, Avian Influenza from China, HIV from Africa etc. Indonesia has a population of more than 262 million peoples, 17,500 islands, and climate conditions that allow microorganisms to grow well. In 2017 domestic flights transported 95,401,545 persons and international flights 16,253,259 persons, we need to prevent the spread of diseases in Indonesia entering through the Airports. Efforts to prevent the entry of dangerous biological agents in Indonesia were carried out by Quarantine Officers and Port Health Officers. The development of threat outbreak disease in air transportation is real in the future, so all Indonesia airports must have action plans to prevent the spread of infectious diseases. The Air Force must act as guardian of sovereignty by having medical personnel on the spot for role interoperability with the personnel Port Health Office for prevent the entry of dangerous biological agents. Capacity building need for be enhanced for prevention, detection, identification and response through a training of the personnel, procurement facilities for readiness prevent, detect and respond when facing biological threat. Full article

In the treatment of tuberculosis (TB), the patient is generally directly given Anti Tuberculosis Drugs (Obat Anti Tuberculosis/OAT) without examining Serum Glutamic Pyruvic Transaminase (SGPT) and Serum Glutamic Oxaloacetic Transaminase (SGOT) to see whether or not there is liver damage before treatment. Because of the side effects by OAT, it is important to know how the condition of the liver function of TB patients who consume OAT in Kendari City General Hospital (Rumah Sakit Umum Daerah/RSUD) Kota Kendari by looking at SGOT and SGPT levels in order to provide maximum treatment to TB patients. The method of this research was descriptive analysis with cross sectional approach. The sample is all patients had previously been diagnosed with TB by a doctor based on medical records by in RSUD Kota Kendari after 1-2 months OAT treatment without any sign of liver injury before. Examination of SGOT and SGPT levels was performed on all samples in the Laboratory of RSUD Kota Kendari using clinical chemistry analyzer. The results of this study showed that 20% patients with TB had elevated levels of SGPT and SGOT with average SGOT is 51 U/L and SGPT is 42.5. The Inference of this study that there is an increase in SGOT and SGPT levels in patients who consume OAT 1-2 months in RSUD Kota Kendari. Elevated levels of SGPT and SGOT due to Anti Tuberculosis (OAT) drugs did not occur in all patients and only increased in 3 people, but qualitatively the effect of administering anti-tuberculosis drugs significantly increased levels of SGPT and SGPT. Thus, monitoring of liver physiology remains recommended especially for elderly patients. Full article

Biofilms are able to cause microorganisms to be 80% more resistant to antibiotics. The extracelullar polymeric substance (EPS) in biofilm functions to protect bacteria, making it difficult for antibiotics to penetrate the biofilm layer. This study aims to determine the effective- ness of photodynamic inactivation with blue diode laser to reduce Staphylococcus aureus biofilm at various ages of biofilms. The light source is a 403 nm blue diode laser with an energy power of about 27.65 ± 0.01 mW. The study was designed with two groups: Group C was the untreated control group with variations in age of biofilms (0; 6; 11; 17; 24; 32; 40 and 48) hours; Group T was a laser treatment group with variations in age of biofilm and energy density (4.23; 8.46; 12.70; 16.93 and 21.16) J/cm². Biofilm reduction measurement method using ELISA test was performed to calculate OD₅₉₅ value. The statistical analysis results of variance showed that there was an influence of biofilm age and irradiation energy density of laser on biofilm reduction. Optical density analysis showed the most optimum biofilm reduction happened when biofilm age is perfectly constructed (about 17 hours) and with 91% reduction. The longer biofilm age lived among those biofilms, the greater the reduction. The results of the Scanning Microscope Electron and fluorescent microscope measurement showed destruction site of the EPS biofilm and bacterial cell death. So, the activated photodynamic with 403 nm laser diode is effective to reduce the Staphylococcus aureus biofilm in the maturation phase. Full article

Background: The diagnostic test for malaria is mostly based on Rapid Diagnostic Test (RDT) and detection by microscopy. Polymerase Chain Reaction (PCR) is also a sensitive detection method that can be considered as a diagnostic tool. The outcome of malaria microscopy detection depends on the examiner's ability and experience. Some RDT has been distributed in Indonesia, which needs to be evaluated for their results. Objective: This study aimed to compare the performance of RightSign RDT and ScreenPlus RDT for detection of Plasmodium in human blood. We used specific real-time polymerase chain reaction abTESTMMalaria qPCRII) and gold standard of microscopy detection method to measure diagnostic efficiency. Methods: Blood specimens were evaluated using RightSign RDT, ScreenPlus RDT, Microscopy detection, and RT-PCR as the protocol described. The differences on specificity (Sp), sensitivity (Sn), positive predictive value (PPV), and negative predictive value (NPV) were analyzed using McNemar and Kruskal Wallis analysis. Results: A total of 105 subjects were recruited. Based on microscopy test, RightSign RDT had sensitivity, Specificity, PPV, NPV, 100%, 98%, 98.2%, 100%, respectively. ScreenPlus showed 100% sensitivity, 98% specificity, 98.2% PPV, 100% NPV. The sensitivity of both RDTs became lower (75%) and the specificity higher (100 %) when using real-time PCR. Both RDTs showed a 100% agreement. RT-PCR detected higher mix infection when compared to microscopy and RDTs. Conclusion: RightSign and ScreenPlus RDT have excellent performance when using microscopy detection as a gold standard. Real-time PCR method can be considered as a confirmation tool for malaria diagnosis. Full article

Background: This study discusses the analysis of Tuberculosis (TB) program management at the Perak Timur Primary Health Care (PHC) and the Sawahan PHC in Surabaya. Early detection and adequate treatment can prevent transmission and improve control programs. Objective: This study aims to analyze management of the tuberculosis program at PHCs in Surabaya. Methods: The research method used is qualitative research. Data collection was done by interviewing tuberculosis officers about TB program and carrying out observations at the PHCs. Results: The study showed that case finding in the Perak Timur PHC and the Sawahan PHC was passive-active. The Perak Timur PHC has facilities for rapid molecular testing, while the Sawahan PHC have to go to a center for Health Laboratory if rapid molecular testing is needed. In terms of treatment, patients at the Perak Timur PHC would come according to an agreement with TB officer, while at the Sawahan PHC, patients have to come every Monday. Officer at the Perak Timur PHC tended to accommodate the needs of TB patients compared to officer at the Sawahan PHC. The level of adherence to taking medication in two PHCs is good but there are a number of patients who have not really understood the frequency of taking medication. Conclusion: Generally, both PHCs have good TB program management but the Perak Timur PHC tends to be more flexible towards patients while the Sawahan PHC tends to be stricter towards patients. Full article

Background: Extrapulmonary Tubercolosis (EPTB) is an infectious disease that affects tissue outside the lungs. EPTB patients cannot be source of infection, therefore the findings in the community indicate that there are still active pul- monary TB patients acting as a source of infection. Understanding distributions of EPTB can be used as indicator to individu- ate the unmonitored source of TB transmission in the community. Objectives: The aim of this study is to analyze EPTB using spatial modeling based on patients’ location. Methods: This study is an observational research with spatial analysis approach using SatScanv.9.4.4 and ArcGis v.10.4. Involving 46 samples of EPTB patients in Anatomy Pathology Laboratory of RSUD Abdul Wahab Sjahranie in 2017 and 7 pul- monary TB patients who were contacts of EPTB patients. The distribution of EPTB patients is mostly located in areas with high population density. Results: The results showed that the dis- tribution pattern of EPTB patients was mostly in areas with high population densi- ties. Space-time permutation model shows there are 3 clusters of EPTB with a 2.91, 0.97, 1.13 km radius centered on -0.504177 S/117.092132 E, -0.476895 S /117.141700 E, -0.517031 S/117.092132 E. Conclusion: The distribution of patients with EPTB and pulmonary TB indicates there is an interaction between EPTB and pulmonary TB in the cluster area. Bernoulli model shows that there is 1 cluster of EPTB and pulmonary TB with relative risk 5.29, radius of 3.19 km, and centered on - 0.458159 S / 117.149945 E. Full article

Background: Tooth extraction is a dental procedure for removing a teeth from the alveolar bone socket. The tooth extraction process causes damage to hard tissue and soft tissue, so the body will respond physiologically to heal the wound. The wound healing process is divided into several phases, one of which is the proliferation phase of fibroblasts, which is one of the most important phases in the process of wound healing. Okra fruit contains saponins, tannins, flavonoids and alkaloids that have anti-inflammatory, antibacterial, antioxidant effects, and can stimulate angiogenesis so to accelerate the process of wound healing. Objective: to prove that the administration of okra fruit extract can accelerate the process of wound healing after extraction in the teeth of Wistar rats through increased expression of fibroblast cells. Methods: 18 Wistar rats were divided into 2 groups; control group and treatment group. The treatment group received a 30% okra fruit extract. The number of fibroblasts was calculated statistically using One Way ANOVA and Tukey HSD. Results: The results showed that the expression of control group fibroblast cells on day 3 (19.00 ± 2.0), day 5 (21.67 ± 2.08), day 7 (24.00 ± 2.00), whereas in the treatment group on day 3 (24.00 ± 1.00), day 5 (29.00± 2.00), day 7 (30.00 ± 1.53). Anova test between groups showed a significant difference with P-value 0.006. Conclusion: 30% okra fruit extract can increase fibroblast expression in wound healing process after extraction of Wistar rat teeth. Full article

Septic arthritis caused by bacteria Gram positive Staphylococcus aureus (S. aureus) infection has been widely reported from Europe and the United States. This case presentation reported the first Staphylococcal septic arthritis, preceded by systemic erythroderma skin lesions from aregional hospital in Surabaya, Indonesia. Radiology imaging was used for confirming the defect. Joint fluid aspirate from the affected knee joint lesion was sent for joint fluid analysis and microbiology culture. The analysis showed infiltration of neutrophil inflammatory cells. S. aureus was isolated on culture and demonstrated catalase positive and coagulase positive reactions. Antimicrobial susceptibility testing was performed to determine the appropriate selection of antibiotics. Clindamycin was used for treatment and the complicated occurrence of deep vein thrombosis was treated with anticoagulant. Awareness of this disease and its progression to its complication deep vein thrombosis is required to understand the burden of this disease. Full article

Background: Monkeypox is a zoonosis. The disease has a similar appearance to chickenpox caused by the varicella-zoster virus (VZV). On May 9th 2019, there was one laboratory-confirmed case of monkeypox reported in Singapore. A man was also suspected of having monkeypox on June 1st 2019 in Surabaya, Indonesia, a neighboring country. Objective: To report on a suspected case of monkeypox with differential diagnosis to chickenpox. Case: A 51-year-old male was suspected of having monkeypox after a differential diagnosis of chickenpox. His chief complaint was multiple blisters on his body. From the dermatological status on his facial, trunk and extremity regions, there were multiple pleiomorphic vesicles, some with umbilication, with a centripetal distribution, and crusts. Methods and Results: A PCR using VZV specific primers, followed by genome sequencing showed homologies of more than 99 % to other VZVs and less than 50% to Monkeypox sequences. Conclusion: Molecular laboratory techniques have confirmed the case as chickenpox. Full article

Background: This is an initial study of the biofilm of Streptococcus mutans (S. mutans) and Aggregatibacter actinomycetemcomitans (A.a). S. mutans and A.a are bacteria that cause infection diseases in the oral cavity. These bacteria have the ability to form biofilms. The study of bacterial biofilm proteins was used as an alternative to early prevention for oral infections. It would be used for the purpose of creating a marker for Infection Detection Kit in the oral cavity. Objective: To easily detect caries or Periodontitis with the biofilms of S. mutans and A.a at the early stage. The forming of biofilm proteins from S. mutans and A.a induced with 5% glucose, 5% lactose, 5% soy protein, and 5% iron will be use as a marker for early detection to Dental caries and Periodontitis. Methods: SDS-PAGE electrophoresis technique was used in the study to measure the molecular weight of S. mutans and A.a biofilms induced with 5% glucose, 5% lactose, 5% soy protein, and 5% iron. Results: Biofilm bands of S. mutans and A.a were formed with the various numbers depending on the induction used. These results are early chararterization of biofilm that will beused as a marker for early detection of infectious diseases in oral cavity (Dental Caries and Periodontitis). Conclusions: S. mutans bacteria induced with 5% glucose had one band of biofilm protein, with 5% lactose had four bands of biofilm proteins, and with soy protein had seven bands of biofilm protein, but with 5% iron did not produce any protein bands and neither did A.a. Full article

Background: The effects of α-tocopherol on intracellular Ca2+ intensity in semen cryopreservation by regulate intracellular Ca2+ intensity have not been reported yet. Objective: The research was conducted to evaluate the effect of supplementation α-tocopherol into egg yolk skim milk extender on sperm quality and intracellular Ca2+ intensity. Methods: Semen samples were collected and supplemented with respectively 0mM (P0); 0.5mM (P1); 1mM (P2); 1.5mM (P3) and 2mM (P4) α-tocopherol in extender before cryopreservation processes. Post-thawing sperm was evaluated for motility, viability, and abnormality using Phase Contrast Microscope (200x) with eosin-nigrosine staining, and intracellular Ca2+ intensity of the best result dose was evaluated using Confocal Laser Scan Microscope (400x) with Fluo-3 Staining. Results: The results showed there was a significant difference (P≤0.05) in sperm motility and viability between P0; P1 with P2; P3; P4. The Motility and viability between groups P0; P1 and P3; P4 showed no significant difference (P≥0.05), while P2 with P3; P4 showed significant difference (P≤0.05). There was a significant difference (P≤0.05) in sperm abnormality of P0; P1 with P2; P3; P4. The abnormality between P0; P1 and P2; P3 showed no significant difference (P≥ 0.05), while P2; P3 showed a significant difference with P4 (P≤0.05). The best result in sperm quality was supplementation with 1.5mM α-tocopherol. Ca2+ intracellular intensity: 142.76 ± 21.8 au (P0) and 176.06 ± 61.43 au (P3). Conclusions: It was concluded that 1.5mM α-tocopherol is the best dose to improve sperm quality by regulating intracellular Ca2+ intensity on Simmental bull cattle. Full article

Background: Several traditional medicines have been developed among communities as part of the efforts to improve thrombocytopenia in patients with Dengue virus infection (DVI). Among those efforts is the administration of Monascus jmbA rice (MJR), which is rice fermented with Monascus purpureus. The administration of MJR is believed to increase the platelet count in patients with DVI. Aim: The objective of this study is to elucidate the mechanism of the effects of MJR on increased levels of platelets in DVI serotype 3 through changes in IL-3, IL-6, IL-11 and TNF-α. Methods: It was a true experimental laboratory study using the randomized post-test only control group design. The study compared between groups of wistar rats were being treated only with group IVD wistar rats who experienced treatment followed by administration of MJR as well as groups of wistar rats without any treatment as a control group. Results: The increase in platelet count in the group treated with DVI + MJR was higher than that treated with only DVI and the difference was a significant (P < 0.05). Increased levels of TNF-α in the group treated with DVI + MJR were lower than that treated with only DVI and the difference was significant (P < 0.05). The significant levels of the causal relationship of TNF-α with IL-6, TNF-α with IL-11 and IL-6 with platelets were 0.044 (P < 0.05), 0.029 (P < 0.05) and 0.041 (P < 0.05), respectively. Conclusion: MJR is capable of increasing platelet count through the role of TNF-α and IL-6 in Wistar rats infected with DVI serotype 3. Full article

Indonesia is one of the high burden tuberculosis (TB) countries. The utilization of molecular diagnostic has been setting over the country, however there are still a lot of remote areas that only depend on microscopic smear. Bleach might be used to increase the value of microscopy diagnos- tic. The study aimed to evaluate the added value of 1% bleach to increase the positivity rate of TB compared to conventional stain. This study was conducted on 70 subjects who were suspected as TB from various pri- mary care centers in West Java and Banten, Indonesia. The sputum was 2-3 mL, and divided into two parts, both of them were stained using Ziehl-Neelsen (ZN), however the first was only stained and the second added 1% bleach. Bleach was added in same volume with sputum and incubated for 10 minutes. After 10 minutes, the spu- tum was stained with ZN. The positivity rate for ZN only was 39 (55.7%) compared to 1% bleach was 63 (90%), and significant- ly different (P=0.000) using Mann-Whitney U test. Bleach can be used as an alternative agent to improve the TB smear in setting that only depends on microscopy diagnostic. Full article