The THE RELATIONSHIP BETWEEN SCHOOL ENVIRONMENT CONDITION AND DENGUE HEMORRHAGE FEVER INCIDENCE AT PUBLIC ELEMENTARY SCHOOL

Background: Dengue cases in Indonesia remain a significant public health concern, with incidence rates increasing over the years. The school environment, including lighting, humidity, temperature, and ventilation, plays a crucial role in the spread of Dengue Hemorrhagic Fever (DHF). This study aims to analyze the relationship between school environmental conditions and DHF incidence. Materials and Methods: This was an analytical observational study with a cross-sectional design. The sample consisted of 157 individuals selected using simple random sampling. Data collection was conducted from August to October 2023 using a validated questionnaire assessing school environmental conditions and DHF incidence. Statistical analysis was performed using chi-square and logistic regression tests with a significance level of p < 0.05. Results: School environmental factors significantly associated with DHF incidence included lighting (p = 0.008, PR = 1.82), humidity (p = 0.008, PR = 1.75), temperature (p = 0.045, PR = 1.498), and screen ventilation (p = 0.000, PR = 2.26). Logistic regression analysis identified humidity (OR = 7.16; 95% CI, 2.09–38.37) and ventilation (OR = 18.12; 95% CI, 3.36–56.70) as the most influential factors. Conclusion: The incidence of DHF is closely related to school environmental conditions. Preventive measures focusing on environmental cleanliness and improved ventilation could significantly reduce the risk of dengue transmission among school children

DOES COVID-19 PANDEMIC AFFECT THE ELIMINATION OF TUBERCULOSIS? LESSONS LEARNED FROM INDONESIA

Background: Tuberculosis is one of the tropical diseases which still exist in the tropical country specifically Indonesia. This study aims to investigate the recent epidemiology of tuberculosis before and during the pandemic of COVID-19. Materials and Methods: Data were collected from East Java Health Profile 2019 and 2020 which was provided by East Java Health Officer. Data were extracted and analyzed by statistical software SPSS and QGIS Application for the geographical map interpretation. Results: This study shows that the total cases of tuberculosis in 2019 was 606,985 cases, while in 2020 was decreased to 384,752 cases. The incidence rate of tuberculosis in 2019 was 224.98 per 100,000 populations, while in 2020 was 134.58 per 100,000 populations. The province with the highest amount of tuberculosis in 2019 was West Java with 143,935 cases, and also in 2020 with 90,905 cases. The province with the lowest number of tuberculosis was North Kalimantan with 2,113 cases, while in 2020 were 985 cases.  The highest incidence rate of tuberculosis in 2019 was found in Jakarta which was 443,47 per 100,000 population, while in 2020 was found in Papua which was 279.92 per 100,000 population. The lowest incidence rate in 2019 was found in Bali Province which was 102.72 per 100,000 population, while in 2020 was 67.43 per 100,000 population. Conclusion: There was a decrease in TB cases before the COVID-19 pandemic (2019) compared to during the COVID-19 pandemic (2020).

BLOOD URINE POSITIVITY RATE DIPSTICK METHOD ON THE INCIDENCE OF ANEMIA IN URINARY TRACT INFECTION PATIENTS

Background: The prevalence of anemia in children suffering from urinary tract infections with positive hematuria is very high. UTI is confirmed by a complete urine examination including macroscopic, chemical and microscopic examinations. Chemical examination can be carried out using the dipstick method, while urine microscopy involves looking at the image of the urine sediment. One of the parameters on the dipstick is blood. Examination with a reagent strip (dipstick) function to detect erythrocytes, free hemoglobin and myoglobin. So, the presence of erythrocytes, myoglobin or hemoglobin in the urine will give a positive result on the urine blood dipstick parameters, which means hematuria occurs. Materials and Methods: This is a cross-sectional analytical observational method, namely by comparing the results of blood urine examination using the dipstick method, with the results of the erythrocyte index and hemoglobin levels on the incidence of anemia in UTI patients. Result: The results of the blood urine dipstick examination obtained the highest positive value of 3. The average values for Hb, MCV, MCH, MCHC were respectively 10.9 g/dL, 83.3 fL, 28.5 pg, and 34.24%. Conclusion: The results of the Pearson correlation test obtained a degree of relationship of -0.363 which indicates a weak correlation. Blood urine is negatively related to the incidence of anemia (Hb levels), so that the higher the positive blood urine value, the lower the Hb value

FAMILY SUPPORT, MOTIVATION, AND PATIENT ADHERENCE TO TUBERCULOSIS TREATMENT: INSIGHTS FROM INDONESIA

Background: Tuberculosis (TB) remains a significant public health issue globally, with patient adherence to treatment being critical for successful outcomes. This study aimed to investigate the roles of family support and motivation in influencing adherence to TB treatment in Indonesia.  Materials and Methods: A cross-sectional study was conducted among patients at four health centers in Padang Municipality, Indonesia, between January and November 2024. A total of 125 respondents diagnosed with drug-sensitive TB and in the second stage of treatment participated. Data were collected through structured interviews using validated questionnaires, assessing family support, motivation, and treatment adherence. Structural Equation Modeling (SEM) was used to analyze the relationships between variables.  Results: The findings revealed significant relationships between family support and motivation (β = 0.931, t-value = 47.016,  P<0.001), family support and adherence to TB treatment (β = 0.229,  t-value = 2.743,  P=0.006), and motivation and adherence to TB treatment (β = 0.775,  t-value = 9.334,  P<0.001). Conclusion: Family support and motivation play crucial roles in enhancing patient adherence to TB treatment. Strategies to strengthen family involvement and patient motivation should be integrated into TB control programs to improve treatment outcomes. Further research is recommended to explore additional factors influencing adherence in different contexts

DETERMINANTS AND MAPPING LEPTOSPIROSIS INCIDENCE IN KEBUMEN, INDONESIA: CASE-CONTROL STUDY

Background: Leptospirosis is a health concern with a high mortality rate. As of 2022, 9.8% of Indonesians are vulnerable to leptospirosis, and Kebumen Regency has been recognized as an endemic area since 2012. This study aims to identify the determinants and map the incidence of leptospirosis in Kebumen, Indonesia, in 2023. Material and Methods: This study used a 1:1 sample of 53 cases and 53 controls in a case-control study design. Each group was sampled using a purposive sampling technique. Cases were defined as individuals seeking care at a health center or hospital and identified as leptospirosis patients in 2023, while controls were individuals living nearest to the cases. Data analysis for this study involved the use of a logistic regression model. Results: Individuals with a history of wounds have 40.20 times higher odds of experiencing leptospirosis. Men have 2.58 times higher odds of experiencing leptospirosis, while poor use of personal protective equipment (PPE) increases the odds by 2.27. Leptospirosis risk is elevated in areas where rats and standing water are prevalent, as these factors are typically found nearby. Furthermore, pets at risk are commonly found in high-risk areas. Conclusion: History of wounds, sex, and use of PPE are factors that can predict the incidence of leptospirosis. Environmental determinant mapping is observed in high-density, geographically proximate locations

SPATIAL MODELING OF RISK FACTORS FOR UNDER-FIVE PNEUMONIA IN ROKAN HILIR DISTRICT, INDONESIA

Background: Under-five pneumonia poses a critical health issue that significantly affects children in Indonesia. Identifying risk factors based on spatial models is essential for developing comprehensive and sustainable disease-prevention strategies.Objectives: This study aimed to identify risk factors and develop a spatial model of the distribution of under-five pneumonia cases in Indonesia based on regional vulnerability.Materials and Methods: This study used a mixed-method approach that integrated mathematical models and GIS to identify risk factors using the GPR model and developed a GIS-based spatial model with IDW and natural break methods.Results: The GPR model found that an increase in under-five pneumonia cases was associated with population density (β = 0.004, Z-score = 6.118), rainfall (β = 0.002, Z-score = 6.031), malnutrition (β = 1.786, Z-score = 3.696), and health facilities (β = 0.073, Z-score = 13.527). In contrast, exclusive breastfeeding (β = -0.004, Z-score = -2.874), healthy homes (β = -0.021, Z-score = -9.532), and under-five health service coverage (β = -0.003, Z-score = -2.225) decreased under-five pneumonia cases. The spatial distribution model of vulnerable regions by risk factors resulted in the classification of high-risk (5 subdistricts), medium-risk (11 subdistricts), and low-risk (3 subdistricts) areas.Conclusion: This study confirmed significant risk factors and the spatial distribution of vulnerability levels for under-five pneumonia. The results highlight the need for comprehensive and integrated program interventions targeting vulnerable areas to achieve the global goal of reducing the incidence of pneumonia to less than 12 cases per 1,000 children under five in 2030

THE REPLICATION EFFICIENCY OF DENGUE VIRUS SEROTYPE 1 ISOLATED FROM PATIENTS WITH DENGUE FEVER IN HUMAN HEPATOCYTE CELL LINES

ABSTRACT Background. The Efficiency of viral replication in cells depends on the capability of supporting virus replication by the cells. We characterized the effectiveness of Dengue Virus Serotype 1 (DENV-1) replication in various cell lines and various multiplicity of infection (MOI) starting from 2 FFU/cell up to 0,3125 FFU/cell. Material and Methods. We used HepG2 and Huh-7 human hepatocyte cell lines and in addition, we also used nonhuman kidney cells (Vero cells). DENV-1 strain IDS 11/2010 was isolated from DF patients and previously propagated in Huh7 and Vero cells as DENV-1-adapted Huh-7 and DENV-1-adapted Vero cells, respectively. Huh7 cells, Hep G2 cells, and Vero cells were infected with DENV-1 at various MOI and incubated for 48 hours at 370C with 5% CO2. DENV-infected cells were determined by indirect immuno-peroxidase staining using 3,3'-Diaminobenzidine (DAB). DENV-1 infected cells as foci were counted under inverted light microscopy and were used to determine the virus titer. Result. The virus was adapted to Huh-7 and Vero cells, with results showing that Vero cells exhibited the highest replication efficiency, evidenced by significant viral titers. Among human hepatocyte cell lines, DENV-1 demonstrated greater replication in Huh-7 cells than in HepG2 cells. Notably, no foci formation was observed in HepG2 cells after 48 hours of infection. Conclusion. These findings underscore the suitability of Vero and Huh-7 cells as optimal environments for DENV-1 replication, offering valuable insights for enhancing laboratory diagnostics and advancing antiviral strategies and vaccine development against DENV-1.   Keywords: Huh-7, HepG2, Vero, DENV-1, Efficiency, Replicatio

EVALUATION OF GRA6 AS GENETIC MARKER FOR DETERMINING TOXOPLASMA GONDII GENOTYPE IN THE CEREBROSPINAL FLUID OF HIV/AIDS PATIENTS WITH TOXOPLASMIC ENCEPHALITIS

Background: Toxoplasmic encephalitis is a severe manifestation of Toxoplasma gondii infection, with potentially fatal outcomes, particularly among immunocompromised patients. Clinical manifestation of this infection is associated with a specific genotype of T. gondii, requiring the use of genetic marker for genotype determination. Aims: This study critically evaluated the application of GRA6 gene as genetic marker for genotyping T. gondii in cerebrospinal fluid (CSF) samples from HIV/AIDS patients diagnosed with Toxoplasmic encephalitis. Methods: The study analyzed 69 CSF samples from HIV/AIDS patients with Toxoplasmic encephalitis. These samples tested positive for Toxoplasma IgG serology and SAG2 PCR, while GRA6 genotyping was conducted using PCR-sequencing methods. Results: The results showed that GRA6 had potential for genotyping in positive control settings from culture cells. However, there was limited effectiveness in CSF samples from Toxoplasmic encephalitis patients. Conclusion: GRA6 had been proven effective as a genetic marker for the identification of T. gondii genotype among HIV/AIDS patients with Toxoplasmic encephalitis. However, the evaluation of GRA6 showed more effectiveness in cultured cells compared to direct clinical samples, such as cerebrospinal fluid obtained from HIV/AIDS patients with Toxoplasmic encephalitis.

MODIFIABLE AND NON-MODIFIABLE RISK FACTORS FOR TUBERCULOSIS AMONG ADULTS IN INDONESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Controlling tuberculosis (TB) determinant factors in Indonesia is one way TB control in the community. A review is needed to explore risk factors for TB in Indonesia as the key strategies for accelerating the TB preventive program. Aim: The purpose of this review was to determine modifiable and non-modifiable risk factors for TB among adults in Indonesia. Methods: A meta-analysis was undertaken to review current studies related to modifiable and non-modifiable risk factors for TB among adults in Indonesia. A search of PubMed, ProQuest, and Google Scholar for related articles published (January 2000 until December 2023). The Pooled Odds Ratio (POR) from the acquired data was calculated with a 95% CI. The fixed and random effects analysis was performed. The results were presented as forest plots, and Egger's test was used to examine study bias. Review Manager (RevMan) 5.4 and Stata 14.2 were used to process and analyze all of the data.   Results: This study results revealed the POR of non-modifiable risk factors (family history of TB) for TB among adults in Indonesia was 6.08 (95% CI 2.99-12.34). Based on modifiable risk factors, it is known household contact has the highest POR (6.01, 2.57-14.04), followed by malnutrition (5.86, 2.50-13.69), inappropriate ventilation (5.57, 1.74–17.86), diabetes mellitus (4.92, 3.04-7.96), smoking behavior (3.24, 2.22-4.72), and low-income level (2.34, 1.42-3.87). Conclusion: Based on significant factors that are related to TB incidence, the results of this review may be valuable to the government in identifying the optimal strategy for TB prevention among adults

TOXICITY PROFILING REVEALED BENEFICIAL EFFECTS OF THE ETHANOL STEM BARK EXTRACT OF ADANSONIA DIGITATA (MALVACEAE) AT LOW DOSE

Background: The increasing patronage of Adansonia digitata for medicinal and cosmetics values makes it a potential source of indiscriminate uses. This study aims at establishing the toxicity potential of the ethanol stem bark extract with a view to providing scientific evidence for the safe use of the plant. Materials and Methods: The stem bark of Adansonia digitata was identified, collected, dry, milled to powder, extracted in absolute ethanol, filtered and concentrated in vacuo with rotary evaporator at 45oC. The oral median lethal dose (LD50) was determined using Lorke’s method. Male and female rats (100–140g) were used in this study. Toxicity effects on haematological and plasma biochemical indices, as well as histopathological effect in the selected organs was done using single (1000, 3000 and 5000 mg/kg) and repeated dose (250, 500 and 1000mg/kg) toxicity profiling, and in silico toxicity profiling of its selected phytoconstituents.   Results: The oral LD50 was greater than 5000 mg/kg, suggesting non-toxic potential. Our results show varying degree of significant alterations in heamatological, biochemical and histopathological indices following single and repeated doses. These alterations were dose and sex dependent, more pronounced at doses ≥ 1000 mg/kg and correlated well with in silico toxicity profiling. Though some of the phytoconsituents were predicted to show some elements of toxic potentials, our in silico toxicity profiling revealed that none has potential for mutagenicity, genotoxicity, nor inhibit major P450 cytochrome enzymes.   Conclusion: The study concluded that the extract may be more beneficial at lower repeated doses than high doses with toxic potential. &nbsp