Prevalensi Blood Borne Virus pada Pasien Hemodialisis Kronik di Instalasi Hemodialisis RSMH Palembang

Pasien hemodialisis kronik lebih berisiko untuk mendapat infeksi Blood Borne Virus (BBV) seperti hepatitis B, hepatitis C, dan HIV karena penggunaan akses vaskular berulang. Pada pasien hemodialisis terdapat tiga faktor risiko utama mempengaruhi terjadinya penularan infeksi BBV yaitu, riwayat transfusi darah, riwayat transplantasi ginjal, dan durasi hemodialisis. Prevalensi BBV pada pasien hemodialisis berkisar 12-29%. Penelitian ini bertujuan untuk mengetahui prevalensi BBV di lingkungan hemodialisis. Penelitian ini adalah penelitian deskriptif observasional, dengan pendekatan potong lintang. Data diperoleh dari catatan medik pasien hemodialisis di Instalasi Rekam Medik RSUP Dr. Mohammad Hoesin Palembang periode 1 Januari 2013-31 Desember 2013. Dari 290 catatan medik pasien didapat 92 catatan medik yang memenuhi kriteria inklusi dan eksklusi. Didapatkan 6 (6,5%) pasien terinfeksi HCV, 5 (5,4%) pasien terinfeksi HBV, 2 (2,2%) pasien terinfeksi HIV, dan tidak didapatkan pasien dengan koinfeksi. Pasien yang terinfeksi HBV dan HCV lebih banyak perempuan dari laki-laki. Infeksi Lebih banyak didapatkan pada pasien dengan riwayat transfusi darah. Rerata lama hemodialisis pasien yang terinfeksi lebih besar dibanding rerata pasien yang tidak terinfeksi dan rerata lama hemodialisis seluruh pasien. Pasien yang terinfeksi HBV dan HCV memiliki rerata usia lebih kecil dibanding dengan rerata usia pasien yang tidak terinfeksi. Prevalensi HCV pada pasien hemodialisis kronik di Instalasi Hemodialisis RSUP Dr. Mohammad Hoesin Palembang adalah 6,5%, prevalensi HBV adalah 5,4%, dan prevalensi HIV adalah 2,2%. Pasien perempuan lebih banyak terinfeksi HBV dan HCV. Pasien dengan riwayat transfusi darah lebih banyak terinfeksi. Rerata lama hemodialisis pasien terinfeksi lebih lama dibanding pasien yang tidak terinfeksi

Characteristics and clinical outcomes of patients with pre-delta, delta and omicron SARS-CoV-2 infection in Indonesia (2020–2023): a multicentre prospective cohort studyResearch in context

Summary: Background: Limited data exist from southeast Asia on the impact of SARS-CoV-2 variants and inactivated vaccines on disease severity and death among patients hospitalised with COVID-19. Methods: A multicentre hospital-based prospective cohort was enrolled from September 2020 through January 2023, spanning pre-delta, delta, and omicron periods. The participant hospitals were conveniently sampled based on existing collaborations, site willingness and available study resources, and included six urban and two rural general hospitals from East Nusa Tenggara, Jakarta, and North Sumatra provinces. Factors associated with severe disease and day-28 mortality were examined using logistic and Cox regression. Findings: Among 822 participants, the age-adjusted percentage of severe disease was 26.8% (95% CI 22.7–30.9) for pre-delta, 50.1% (44.0–56.2) for delta, and 15.2% (9.7–20.7) for omicron. The odds of severe disease were 64% (18–84%) lower for omicron than delta (p < 0.001). One or more vaccine doses reduced the odds of severe disease by 89% (65–97%) for delta and 98% (91–100%) for omicron. Age-adjusted mortality was 11.9% (8.8–15.0) for pre-delta, 24.4% (18.8–29.9) for delta and 9.6% (5.2–14.0) for omicron. The day-28 cumulative incidence of death was lower for omicron (9.2% [5.6–13.9%]) than delta (28.6% [22.0–35.5%]) (p < 0.001). Severe disease on admission was the predominant prognostic factor for death (aHR34.0 [16.6–69.9] vs mild-or-moderate; p < 0.001). After controlling for disease severity on admission as an intermediate, the risk of death was 48% (32–60%) lower for omicron than delta (p < 0.001); and 51% (38–61%; p < 0.001) lower for vaccinated participants than unvaccinated participants overall, and 56% (37–69%; p < 0.001) for omicron, 46% (−5 to 73%; p = 0.070) for pre-delta (not estimable for delta). Interpretation: Infections by omicron variant resulted in less severe and fatal outcomes than delta in hospitalised patients in Indonesia. However, older, and unvaccinated individuals remained at greater risk of adverse outcomes. Funding: University of Oxford and Wellcome Trust