Genotype and Transmission Human Immunodeficiency Virus-1 in Seven Provinces in Indonesia

Background:Previous studies in Indonesia with a limited sample of HIV-1 subtypes revealed that HIV-1 subtype distribution and mode of transmission differed between the regions. This analysis aimed to describe subtypes and mode of transmission of HIV-1 in wider area in Indonesia.Methods:This analysis used a part of HIV/AIDS cross sectional study in seven provinces in Indonesia in 2011 among HIV/AIDS purposive selected cases visited Volunteer Care and Treatment (VCT) clinics in seven provinces (North Sumatera, West Sumatera, Riau islands, South Sulawesi, North Sulawesi, Maluku, and Papua). For each province was selected 1 or 2 hospitals purposive.Results: AE subtype of HIV-1 was existed in all participating. Subtype B was found in almost all provinces except in Riau islands. The other type (A, C, and AG) found in 2 provinces only, and the rarest type (D) found in one province only.The high proportion of transmission was through heterosexual in all provinces except in South Sulawesi. The percentage of the common transmission by intra venous drug user (IDU) IDU occurred in South Sulawesi, whereas via perinatal transmission occurred in Papua.Conclusion: HIV-1 subtype distribution and mode of transmission differed between the provinces. The AE subtype HIV-1 was existed in all provinces, whereas among provinces the highest proportion transmission via perinatal occurred in Papua. (Health Science Indones 2012;2:xx-xx

Hubungan Antara Kepatuhan Ante Natal Care Dengan Pemilihan Penolong Persalinan

Background: Although ANC coverage tends to be high, the pregnant women will not always giving birth by health provider. Jati Sampurna subdistrict, where most of the pregnant women prefer deliver their baby in Bekasi city and about 14.30% giving birth by traditional birth attendant. Objective: Analyze the maternal cohort data to prove correlation between compliance of ANC with selection of birth attendant in those area, which consisted of obedience of ANC, age, parity, birth spacing, pregnancy history, with selection of birth attendant. Methode: The retrospective cohort design study was used. After deciding several criteria: inclusion and exclusion criteria, and by simple random sampling, we achieved 372 subjects which consisted of 186 subjects in exposed group, and 186 subjects in unexposed group. Data analyzed by univariate, bivariate and multivariate. Result: The study showed that two out of five variables were statistically significant correlation, those are compliance of ANC [RR=2,41(95% CI 1,45-4,01)] and pregnancy history [RR=0,22 (95% CI 0,10-0,47)] or on the other result that [RR=4,55 (95% CI 2,13 -10,00)]. Conclusion: Promotion to pregnant women about the importance obedience of ANC and the selection of safe childbirth helper were in need of improvement. The measurement of history of pregnancy should be carried out consistently in ANC package as well

Pengaruh Usia dan Waktu Pengambilan Sampel pada Surveilans Campak Berbasis Kasus (Cbms) di Pulau Sumatra dan DKI Jakarta Tahun 2009

Case-based measles surveillance (CBMS) in Indonesia began in Jogjakarta in 2008. In 2009 this surveillance expanded in seven province in Sumatera Island (South Sumatera, West Sumatera, Jambi, Bengkulu, Riau, Lampung, Bangka Belitung), DKI Jakarta, NTB and Gorontalo. Laboratory confirmation become important because many diseases had almost similar clinical appearance. The aim of this study is to determine age of the patients and time collecting samples which influence the positivity results. This research was a cross-sectional study using demographic data from CBMS cases in 2009 and serological confirmation results in National Measles Laboratory Jakarta. Out of 871 samples received, 31.3% were measles positive. 68.4% positive cases were from DKI Jakarta. Samples collected in 3 days after rash increased measles positive result 1.5 fold compared to those collected in 3-35 days (ORa= 1.48; 95% CI= 1.11-1.98, p value=0.000). Group with age under five years old increased measles positive result 5.75 fold compared to adult and old age group (ORa= 1.48; 95% CI = 3.61-9.21, p value= 0.006), meanwhile group with age 5-15 years increased measles positive result almost two fold (ORa= 1.97; 95% CI = 1.22-5.21, p value= 0.008). Age under five years and children until 15 years old and time collecting samples 3-35 days after rash were factors that increased measles positive results in CBMS 2009 in Indonesia

Identifikasi Single Nucleotide Polymorphism (SNP) Gen Pvmdr1 Pada Penderita Malaria Vivaks Di Minahasa Tenggara (Sulawesi Utara)

Parasite resistance to antimalarial drugs is an obstacle to malaria elimination. In Plasmodium vivax, up to now, a marker to distinguish between resistant and susceptible is no available yet. Identify Single Nucleotide Polymorphisms (SNP) in P. vivax for multidrug resistance (pvmdr1)is potential approach due to pvmdr1 gene is orthologous to the pfmdr1 of P.falciparum, have been related to multidrug resistance. The purpose of this study was to identify SNPs/mutations on pvmdr1 gene of malaria vivax patients who came to the Primary Healthe Centers, Touluaan and Tombatu Minahasa Tenggara (North Sulawesi).Blood samples and slide of blood smears were collected from patients who infected with P.vivax or mixed infection of P.vivax and P.falciparum. After the species were cross checked by certified microscopist then confirmed by PCR, SNP identification were performed by sequencing technique. Only 83 of 99 recruited subjects were included inclution criteria. Sequensing result showed that 59 of 83 subjects were analysed to identify the SNP. We found 5 nonsynonymous SNPs, namely at the point G698S, M908L, Y976F, L1076F, and K1261E

Status Kekebalan Dan Faktor Risiko Toxoplasmosis Pada Wanita Usia Subur Hasil Riskesdas 2007

Toxoplasmosis disebabkan oleh parasit Toxoplasma gondii. Diperkirakan sekitar 30 - 50% populasi dunia telah terinfeksi oleh toxoplasma, sebagian besar tanpa gejala. Penderita dengan kekebalan tubuh yang kuat apabila terinfeksi T. gondii pada umumnya tidak mengalami keadaan patologik yang nyata walaupun pada beberapa kasus dapat juga mengalami pembesaran kelenjar limfe, rasa lelah yang berlebihan, miokarditis akut, miositis hingga radang otak. Analisis ini bertujuan untuk mengukur hubungan kekebalan tubuh (titer antibodi) pada wanita usia subur terhadap kejadian toxoplasmosis dan faktor risiko tingkat kekebalan tubuh. . Analisis ini menggunakan data potong lintang Riskesdas 2007. Subjek adalah wanita usia subur (WUS) yang berusia 15-45 tahun. Kekebalan terhadap toxoplasmosis dilihat dengan mengukur kadar immunoglobulin G (IgG) melalui tehnik ELISA (toxolisa). Subjek dikatakan tidak memiliki kekebalan terhadap toxoplasmosis jika toxolisanya <32 IU Sampel yang terpilih di analisis lebih lanjut untuk mengetahui faktor demografi, risiko, dan perilaku yang berhubungan dengan status kekebalan toksoplasmosis. Jumlah sampel yang terpilih dan mempunyai data yang lengkap sejumlah 6068 subjek dari 10521 women in repeoductive age. Hasil menunjukkan bahwa 63,7% memiliki kekebalan, dan 36,3% tidak memiliki kekebalan terhadap toxoplasmosis. WUS yang berusia 15-17 tahun mempunyai risiko yang lebih tinggi untuk tidak memiliki kekebalan toxoplasmosis yaitu sebesar 26% (ORs=1,26, 95% CI 1,03-1,55, p=0,027), begitu juga dengan WUS yang berstatus Ibu Rumah Tangga (IRT) dan pelajaryaitu 16% (ORs=1,16, 95% CI 1,04-1,30, p=0,007), dan WUS yang berstatus kawin yaitu 30% (ORs=1,30, 95% CI 1,13-1,49, p=0,000). WUS yang berusia 15-17 tahun, berstatus kawin, dan IRT serta pelajar, merupakan kelompok yang berisiko tidak memiliki kekebalan terhadap toxoplasmosis, sehingga perlu kewaspadaan untuk meningkatkan upaya pencegahan dan perlindungan terhadap toxoplasmosis

Hubungan antara Pengetahuan dan Sikap Pengelola Vaksin dengan Skor Pengelolaan Vaksin di Daerah Kasus Difteri di Jawa Timur

Provinsi Jawa Timur merupakan daerah endemis penyakit difteri dari tahun 2000 sampai- 2012. Setiap tahunnya selalu terjadi kenaikan kasus (KLB), meskipun angka cakupan imunisasi tinggi. Kasus banyak terjadi pada anak-anak baik yang sudah diimunisasi maupun yang belum diimunisasi dengan angka kematian cukup tinggi.Tujuan penelitian ini adalah menilai pengetahuan dan sikap petugas pengelola vaksin dalam mengelola vaksin di tempat pelayanan kesehatan di daerah Jawa Timur. Metode penelitian menggunakan desain potong lintang, yang dilakukan di 6 Kabupaten/kota di Jawa Timur, dengan lama penelitian 11 bulan dari Januari sampai November 2011. Variabel dependen adalah kualitas vaksin dan variabel independen adalah cara kerja pengelola vaksin dan skor pengelolaan vaksin. Hasil penelitian menemukan bahwa pelatihan petugas dalam mengelola vaksin berpengaruh terhadap ketepatan dalam pengelolaan vaksin di tempat pelayanan kesehatan. Kata kunci : pengelolaan, vaksin , difteri. Abstract East Java Province is an area endemic diphtheria from 2000 to-2012., Every year is always an increase in cases (KLB), despite a high rate of immunization coverage. Common cases in both children who have been immunized or not immunized with mortality rate is quite high. The purpose of this study was to assess the knowledge and attitude of management personnel in managing vaccine vaccines in the health service in the area of East Java. The method used is a design study using cross-sectional design, which was done in the study in six districts / cities in East Java, with a long 11-month study period is the month of January to November 2011. The dependent variable is the quality of the vaccine used and the independent variable is how the Human Resources (HR) managers vaccines and vaccine observed score management. The results found that the training of administer vaccines officer was affecting the accuracy in vaccine management in the health service. Keywords: management, vaccines, diphtheria