Pengembangan Jaringan Virologi dan Epidemiologi Influenza di Indonesia

Tulisan ini diturunkan untuk menyokong program pengendalian penyakit flu burung, sekaligus untuk menjelaskan riwayat terbentuknya program surveilans penyakit yang menyerupai influenza (Influenza Like Illness=ILI). Tulisan ini disadur dari laporan akhir "pengembangan jaringan surveilans virologim influenza di Indonesia Juni 2007" yang merupakan pertanggungjawaban pelaksanaan proyek surveilans ILI

Studi Evaluasi Pelatihan Penatalaksanaan Pms dengan Pendekatan Sindrom di Beberapa Kabupaten di Jawa Timur

Sexually Transmitted Diseases (STD continue to become major public health problems. Most of STD patients present with urethral or vaginal discharge, even though the causes may be of different micro-organisms. The Syndromic Approach (SA) is an algorithm for STD management currently recommended by the WHO. Diagnosis are made based on clinical signs and symptoms using a certain flowchard-without laboratory confirmation, and all possible causes will be treated. IEC are also given and the patients' partners are notified. The East Java Provincial health office has trained Puskesmas' and hospitals' doctors and paramedics on this new STD management approach.The objecttive of this study is to evaluate the implementation of SA in some Puskesmas and private clinics which personnels have been trained before. Using direct observation, document research, interviews and focus group discussions, data and information on the benefit of SA, the obstacles in implementing SA, and recommendations to improve the health providers' performance in STD management are collected. Results are hopefully used as inpc;ts in improving the STD control program, provincially as well as nationally

Prevalensi Infeksi Menular Seksual, Faktor Risiko Dan Perilaku Di Kalangan Anak Jalanan Yang Dibina Lembaga Swadaya Masyarakat Di Jakarta, Tahun 2000

A rough estimate of 4 to 20 thousand children work and/or live in the streets of Jakarta. These children are at the ages where sexual awareness and activities are rising. Living in an environment where regulations and socio-spiritual norms are more lax gives them more freedom to be sexually active. Previous study showed that many of them were forced to start sexual lives at early age by older peers, some were forced to enter prostitution. All of these put the street children at high risk to get sexually transmitted infections (STI), including HIV. So far, there had not been any STI survey study conducted among this community in Indonesia. The objectives of this study were to measure the prevalence of gonorrhoea, chlamydia, syphilis, and HIV infection among male street children in Jakarta, and to investigate their risky behaviours. In the year 2000, male street children aged 10 to 20 years in Jakarta who were reached-out by NGOs were interviewed using a short questionnaire. Specimens of venous blood, urethral, anal and throat swabs were taken for laboratory tests. As the results, among the 274 children who participated, more than half (58.4%) were children "on" the street (had somewhat regular contact with their family), and the rest were children "of" the street (little or no contact with the family). Knowledge of STI was low, while 22.3%) admitted to be sexually active (one out of 3 children "of" the street). Condom use was very low: 85.2% among the sexually active never used condoms and only 5% used it continuously. The prevalence of gonorrhoea was 7.7%, chlamydia 7.4%, syphilis 0%, and HIV 0%. Self-treatment was practiced by 31.4% of the participants

Validasi Pemeriksaan Infeksi Menular Seksual Secara Pendekatan Sindrom Pada Kelompok Wanita Berperilaku Risiko Tinggi

Accurate and adequate treatment of STIs is a critical component of STI-control activities to reduce transmission and sequelaes. On the other hand, chronic shortage in skilled staff and laboratory equipment in many countries necessitate the use of clinical skills more in order to diagnose and differentiate STIs. For these places, the WHO has recommended and produced a protocol of it syndromic approach management of STIs in place of treatment by -etiology. Since 1997 the Indonesia Ministry of Health has been conducting national training on this method. However, the syndromic approach for vaginal discharge is known to be problematic since differentiation among cervicitis, vaginitis, and even normal condition is difficult. The main objective of this study is to determine the sensitivity, specificity and positive predictive value of the syndromic approach management of women with signs and/or symptoms of abnormal vaginal discharge. The sample population were women with high risk sexual behaviors in East Java and North Sulawesi provinces. The laboratory tests using DNA hybridization probe technique (the PACE 2 test, Gen-Probe, San Diego, Calif.) for Neisseria gonorrhoeae and Chlamydia trachomatis were used as gold standard. In addition, we also compared the clinical approach widely used by clinicians (mainly at hospitals) with laboratory results. A total of 439 participants was recruited purposively (230 from E. Java and 209 from N.Sulawesi). In E.Java, the sensitivity, specificity, and predictive value of the syndromic management for vaginal discharge are 31%, 83%, and 59%, respectively, and in N.Sulawesi 49%, 56%, and 40%,respectively. The clinical approach did not show better results. In E.Java the sensitivity, specificity, and positive predictive value are 13%, 89%, and 50%, res­pectively, while in N.Sulawesi they are 42%, 61%, and 39%, respectively. As a conclusion, the current form of syndromic management has little use for STI screening among high risk women. Further studies by adding more criteria to the syndromes are needed to improve this method

Karakteristik Epidemiologi Kasus-kasus Flu Burung di Indonesia Juli 2005-oktober 2006

Influenza A (H5N1) human cases started to he reported since 1997. In Indonesia, the first human cases were reported in July 2005, as a cluster consisted of a father and two daughters; two of them were fatal confirmed cases. As of 31 October 2006, 72 cases have heen identified (25 were classified into 10 cluster) with a case fatality rate (CFR) of 76.4%. The patients were from 9 (27%) of the 33 provinces in Indonesia. The ratio between male and female patients was 4 to 3. with an extremely high CFR of the women (87%). Most patients were of young adult ages, 39% of them were less than 15 years old. Indirect and direct contact with sick or dead poultry was reported from 81% of these confirmed cases

Epidemiological Study of Influenza in Jakarta and Surrounding Areas

EPIDEMIOLOGICAL STUDY OF INFLUENZA IN JAKARTA AND SURROUNDING AREA

Seasonal Oscillation of Human Infection with Influenza A/H5N1 in Egypt and Indonesia

As of June 22, 2011, influenza A/H5N1 has caused a reported 329 deaths and 562 cases in humans, typically attributed to contact with infected poultry. Influenza H5N1 has been described as seasonal. Although several studies have evaluated environmental risk factors for H5N1 in poultry, none have considered seasonality of H5N1 in humans. In addition, temperature and humidity are suspected to drive influenza in temperate regions, but drivers in the tropics are unknown, for H5N1 as well as other influenza viruses. An analysis was conducted to determine whether human H5N1 cases occur seasonally in association with changes in temperature, precipitation and humidity. Data analyzed were H5N1 human cases in Indonesia (n = 135) and Egypt (n = 50), from January 1, 2005 (Indonesia) or 2006 (Egypt) through May 1, 2008 obtained from WHO case reports, and average daily weather conditions obtained from NOAA's National Climatic Data Center. Fourier time series analysis was used to determine seasonality of cases and associations between weather conditions and human H5N1 incidence. Human H5N1 cases in Indonesia occurred with a period of 1.67 years/cycle (p<0.05) and in Egypt, a period of 1.18 years/cycle (p≅0.10). Human H5N1 incidence in Egypt, but not Indonesia, was strongly associated with meteorological variables (κ2≥0.94) and peaked in Egypt when precipitation was low, and temperature, absolute humidity and relative humidity were moderate compared to the average daily conditions in Egypt. Weather conditions coinciding with peak human H5N1 incidence in Egypt suggest that human infection may be occurring primarily via droplet transmission from close contact with infected poultry

The Role of Host Genetics in Susceptibility to Influenza: A Systematic Review

Background: The World Health Organization has identified studies of the role of host genetics on susceptibility to severe influenza as a priority. A systematic review was conducted to summarize the current state of evidence on the role of host genetics in susceptibility to influenza (PROSPERO registration number: CRD42011001380). Methods and Findings: PubMed, Web of Science, the Cochrane Library, and OpenSIGLE were searched using a pre-defined strategy for all entries up to the date of the search. Two reviewers independently screened the title and abstract of 1,371 unique articles, and 72 full text publications were selected for inclusion. Mouse models clearly demonstrate that host genetics plays a critical role in susceptibility to a range of human and avian influenza viruses. The Mx genes encoding interferon inducible proteins are the best studied but their relevance to susceptibility in humans is unknown. Although the MxA gene should be considered a candidate gene for further study in humans, over 100 other candidate genes have been proposed. There are however no data associating any of these candidate genes to susceptibility in humans, with the only published study in humans being under-powered. One genealogy study presents moderate evidence of a heritable component to the risk of influenza-associated death, and while the marked familial aggregation of H5N1 cases is suggestive of host genetic factors, this remains unproven. Conclusion: The fundamental question ‘‘Is susceptibility to severe influenza in humans heritable?’ ’ remains unanswered. No

Dose-specific efficacy of Haemophilus influenzae type b conjugate vaccines: a systematic review and meta-analysis of controlled clinical trials.

Global coverage of infant Haemophilus influenzae type b (Hib) vaccination has increased considerably during the past decade, partly due to GAVI Alliance donations of the vaccine to low-income countries. In settings where large numbers of children receive only one or two vaccine doses rather than the recommended three doses, dose-specific efficacy estimates are needed to predict impact. The objective of this meta-analysis is to determine Hib vaccine efficacy against different clinical outcomes after receiving one, two or three doses of vaccine. Studies were eligible for inclusion if a prospective, controlled design had been used to evaluate commercially available Hib conjugate vaccines. Eight studies were included. Pooled vaccine efficacies against invasive Hib disease after one, two or three doses of vaccine were 59%, 92% and 93%, respectively. The meta-analysis provides robust estimates for use in decision-analytical models designed to predict the impact of Hib vaccine