Prevalence and risk factors of intestinal protozoan infection among child students with disabilities in Bantul District, Yogyakarta Special Region, Indonesia

Children with disabilities are excluded from many aspects of life. Unfortunately, they have an increased risk of infection from many kinds of pathogens including intestinal protozoan. This study aimed to determine the prevalence of intestinal protozoan infections and to evaluate the associated factors among children with disabilities in Bantul District, Yogyakarta Special Region, Indonesia. A cross-sectional study was conducted at school with special needs between June-December, 2019. A total of 150 participants were recruited through simple random sampling. Stool samples were examined microscopically by formalin-ether concentration and Ziehl-Neelsen staining technique. Age was analyzed using the Mann-Whitney tests, while the other variables used chi-square tests. Multivariable logistic regression was conducted to identify factors associated with intestinal protozoan infections. The adjusted prevalence ratio with a 95% confidence interval at a 5% level of significance was used to measure the strength of association. Overall, there were 15 children infected by intestinal protozoan among 130 subjects with mean age of participants of 9.83 ± 3.1 years. The intestinal protozoan species were Entamoeba histolytica 7 (5.38%), Giardia lamblia 4 (3.08%), Blastocystis hominis 7 (5.38%) and Iodamoeba butschlii 1 (0.77%). Prevalence of intestinal protozoan infection among children with disabilities in Bantul District, Yogyakarta, Special Region was 11.54%. There were no significant correlations between the risk factors and intestinal protozoan infection among children with disabilities (p>0.05)

Validity of p-LDH/HRP2-Based Rapid Diagnostic Test for the Diagnosis of Malaria on Pregnant Women in Maluku

ABSTRACTIntroduction: Pregnant women are one of the groups at risk for infection by the malaria parasites in endemic areas. The dangerous impacts of malaria in pregnancy are anemia and severe malaria that can cause death for mother, fetus and newborn. Clinical symptoms that are likely to be not typical until asymptomatic in pregnancy are one of the obstacles on diagnosing malaria in pregnancy in endemic areas. p-LDH/HRP2-RDT (Pf/Pan) is one of the WHO recommended RDT product on round 1-4 and has been used in Maluku. This tool is able to detect antigens of the Plasmodium metabolism results in peripheral blood so that it is regarded to be more sensitive than microscopic examination. The use of p-LDH and HRP2-RDT (Pf/Pan) for the detection of P. falciparum HRP-2 antigen and P. vivax, P.malariae, P.ovale p-LDH antigen have not been previously evaluated in the Province of Maluku.Objectives: To evaluate the validity of p-LDH/HRP2-RDT (Pf/Pan) compared with microscopic examination and nested Polymerase Chain Reaction (PCR) as the gold standard for the diagnosis of malaria in pregnancy in Maluku.Methods: This was a cross-sectional study using a diagnostic test of malaria in pregnant women. The study was conducted in Ambon City health center, Savana Jaya Buru Island health center and Haulussy Ambon Local Hospital. Sample data, the data of pregnancy, RDT results and microscopic results on the field were recorded in the questionnaire. Nested PCR examination was conducted at the Laboratory of Parasitology, Faculty of Medicine, Universitas Gadjah Mada as well as second reading for microscopic examinationResults: The results showed that p-LDH/HRP2-RDT  (Pf/Pan) had the same sensitivity with micoscopic of 11%, a specificity of 100% higher than microscopic 96% compared with nested PCR as the gold standard, p-LDH/HRP2-RDT (Pf/Pan) had PPV and NPV of 100% and 98% compared with nested PCR as the gold standard. p-LDH/HRP2-RDT (Pf/Pan) sensitivity was 80% compared to the microscopic examination.Conclusion: diagnostic malaria in pregnancy in Maluku with p-LDH/HRP2-RDT (Pf/Pan) was less sensitive than nested PCR and microscopic.Keywords: Malaria, pregnant woman, diagnostic test, validity, p-LDH/HRP2 Rapid Diagnostic Test (RDT) (Pf/Pan

Keragaman Genetik Dari Msp 1, Msp 2, Dan Glurp Pada Plasmodium Falciparum Di Kabupaten Sumba Tengah, Nusa Tenggara Timur

Malaria is still a public health problem in Central Sumba regency, East Nusa Tenggara. Over the past decade, anti malaria drugs resistance has rapidly become a major public health problem in the East Nusa Tenggara, including Central Sumba regency. The problem of malaria control are not only influenced by the anti malaria drugs resistance on P. faciparum and specific genes but also by many variations of allele of Plasmodium malaria. A study is needed especially on molecular epidemiology of P. falciparum using locus gene Merozoites Surface Protein 1 (MSP 1) , Merozoites Surface Protein (MSP2) and Glutamate Rich Protein (GLURP), which aims to identify the genetic diversity marker of Plasmodium falciparum in Central Sumba Regency. The method applied was a nested Polymerase Chain Reaction (PCR) to each locus gen separately. The results of the 50 fresh blood of patients infected with P. falciparum, each gene locus of MSP 1, MSP 2 and GLURP can be identified as muchas 38%, 12% and 10%. The third gene locus was found only in 38 % (19/50) positive samples. It can be identified 7 alleles at each locus genes, three classes'MSP1 allele (15.8 %), four classes of MSP alleles (21.1%) and three classes of GLURP alleles (15.8 %). A multigenotype infection of P. falciparum and MSP 2 deleted was diverse marker of P. falciparum gene locus with varied class of alleles. It can be concluded that multigenotype infections have occurred in research location

Evaluation of the Performance of Malaria Microscopist in Primary Health Center and Cross Checker in Belu, East Nusa Tenggara.

ABSTRACTIntroduction: It was reported that error rate of malaria microscopic examination of microscopist at Primary Health Center and District Health of fice of Belu, Nusa Tenggara Timur (NTT) was high (45-100%). These high level of error rate might becaused by several factors such as lack of qualified personnel, lack of technical skills in the microscopic slide preparation (blood smear) or incompetency in parasite identification on bloods mear preparation.Objectives: To evaluate the performance of malaria microscopists at Primary Health Centers and cross checker in Belu District and determining the factors that contribute to those condition.Methods: The study was an observational and exploratory research with cross sectional approach. The competency of the malaria microscopist at the primary health center and district health office in examining malaria blood smears were evaluated using standard bloods mears and the one from Passive Case Detection (PCD) activities. Performance in preparing bloods mear were evaluatied by observation and filling the checklist. The study was conducted in December 2012 – March 2013 in Belu District, NTT.Results: The competency of the microscopists to identify malaria in fection was low.The error rate in examining PCD bloods mears ranged from 20 - 100%. The error rate of the microscopic reading at district level reached 52%, with a kappa value between 0.41 to 0.60. There was different levels of the error rate using standard and PCD bloods mears. Error rate in diagnosing malaria on PCD blood smears was higher than those on gold standard blood smears. Accuracy to identify P.falciparum was high (100%) than those to identify P.vivax (0 - 75%). False-positive diagnosis is as high as 90% when examining PCD blood smears. Missed diagnosis of malaria parasite also occure in around 60% of personnel when examining blood smears with low density of less than 1000 parasites/ìl of blood)Conclusion: The accuracy of malaria diagnosis by microscopist in the Health Center in District of Belu is low. The factor that might contribute is the ability of the microscopist to produce a good quality of malaria blood smears. Working experience of the health center microscopist is statistically significant to correlate with accuracy of malaria diagnosis.Keywords: Errorrate, the performance evaluation of microscopists, microscopic examination, blood smear Bel

Intestinal Helminth Infections among Children with Disabilities in Bantul Regency, Special Region of Yogyakarta

Due to physical, intellectual, mental, and/or sensory limitations, person with disabilities tend to experience obstacles and limitations in their ability to care for themselves, knowledge of health, and access to health services. As a result, people with disabilities are more at risk of experiencing health problems, one of which is intestinal helminth infection. The aim of this study was to assess the prevalence of intestinal helminth infections and associated risk factors among children with disabilities at school age in Bantul Regency, Special Region of Yogyakarta. A school-based cross-sectional study design was conducted from October until December 2019. A total of 130 stool samples were collected and examined by the flotation, Kato-Katz, Harada-Mori, and Baermann methods to detect the presence of helminth eggs and/or larvae. An interview with parents/guardians of the subject based on a questionnaire was conducted to obtain information regarding the associated risk factor. The overall prevalence of intestinal helminth infections among subjects was 1.5% (CI=95%). Of these, 0,07% (1/130) was positive for hookworm infection, and the remaining 0,07% (1/130) was positive for Trichuris trichiura. Analysis for all risk factors showed no statistically significant association between all risk factors and the intestinal helminths infections in the study subjects (p>0.05)

Comparing the Sensitivity and Specificity of Zinc Sulphate Flotation Method to Formol Ether Sedimentation Method in Identifying Intestinal Protozoa’s Cysts

ABSTRACTIntroduction: The two main methods to detect the presence of intestinal protozoa’s cysts are zinc-sulphate flotation (Faust’s) and formol-ether sedimentation (Ritchie’s) methods. Some researchers have recommended using both flotation and sedimentation in detecting the intestinal parasites. However, this approach is unpractical for most laboratories. To date there are no studies that conclude which method, either Faust’s method or Ritchie’s method, is more effective in term of sensitivity and specificity of detecting the intestinal protozoa cyst. This study was done to conclude which method has higher sensitivity and specificityObjectives: To compare the sensitivity and specificity of Faust’s to Ritchie’s methods in identifying intestinal protozoa.Methods: Thirty anonymous fecal samples were obtained from Parasitology Laboratory Faculty of Medicine Gadjah Mada University. Each sample was tested using both Faust’s and Ritchie’s methods and then microscopically examined to find the intestinal protozoa’s cysts. Numbers of samples with cyst-positive were recorded to determine which method has higher ability to detect the intestinal protozoa’s cysts. Data was analyzed by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).Results: From all the five identified cysts (Entamoeba histolytica, Giardia lamblia, Entamoeba coli, Iodamoeba butschlii, Blastocystis hominis), Ritchie’s method was able to detect more cyst than Faust’s method. The sensitivity and specificity of Ritchie’s method compared to Faust’s were 100% and 93.33% respectively. The positive predictive value (PPV) and negative predictive value (NPV) of Ritchie’s compared to Faust’s method were 93.75% and 100% respectively. Ritchie’s method is proven to have higher sensitivity and specificity than Faust’s method. This method has high sensitivity probably because of the cysts are concentrated and so more cysts could be collected.Conclusion: This study concludes that the Ritchie’s method has higher sensitivity and specificity compared to Faust’s method in detecting five common intestinal protozoa’s cysts.Keywords: formol-ether sedimentation method, zinc-sulphate flotation method, intestinal protozoa, sensitivity, specificity

Infection, cure and egg reduction rates of soil-transmitted helminth infections after anthelminthic drugs treatment among school children in Kokap, Yogyakarta, Indonesia

The prevalence of helminthiasis on primary school children in Indonesia is high, around 40-60%. This study aims to assess the impact of treatment and predictors of soil-transmittedhelminth (STH) infections at 3 months after treatment. Population of this study wasstudents of a primary school in Kokap (Sekolah Dasar Negeri/SDN Gunung Agung), KulonProgo, Yogyakarta, determined based on the inclusion and exclusion criteria (n = 65).Stool samples examined using Kato Katz method. Students infected with STH were givenappropriate treatment and stool samples were collected again to determine cure rate (CR)and egg reduction rate (ERR) at 2 week post-treatment and at 3 months post-treatmentto determine incidence of re-infection, new infection or failed treatment. Informationon personal hygiene and sanitation were collected by interview with students of SDNGunung Agung. Treatment with pyrantel pamoat was effective against hookworm andAscaris lumbricoides with CR of 100% and ERR of 100% while treatment with albendazolwas ineffective against Trichuris trichiura (CR = 12.8%, ERR = 62.4%) though theWilcoxon test for T. trichiura showed a significant reduction egg count (epg) before and2 week after treatment (p0.05). The existence ofdouble infection before treatment showed p value 0.05. Presence of re-infection, new infection and untreated casesconfirms that an integrated approach is necessary to control STH infection in Kokap,Kulon Progo, Yogyakarta

Malaria Risk Factors and Mapping in Amfoang Barat Daya-Kupang Nusa Tenggara Timur

Introduction: Amfoang District is one of malaria-endemic areas in East Nusa Tenggara Province. The areas are adjacent to the shore at the lowland and adjacent to the forest at the highland respectively. Residential areas are surrounded by forest, shrubs, field, streams and pools of water. Most population work as farmers, have low education levels and do not use mosquito bed netObjectives: This study aims to investigate the factors that influence the incidence of malaria risk and determine the pattern of clustering of cases in the Amfoang Barat Daya, District of Kupang, Nusa Tenggara Timur.Methods: Mass blood surveys were conducted to investigate malaria cases in three villages in October 2011, January 2012 and April 2012. The 3,515 blood samples were collected for thick blood film. Riskfactors were identified through questionares and OR were calculated. Significance was assumed at p <0.05. Coordinates were taken from residence of patients by GPS and analyzed with Purely Spatial Bernaullymodel to investigate any cluster of malaria cases. River with potentials breeding place was buffered 1km by ArcGis to determine whether malaria cases were in the mosquito fly distance areas.Results: Dry land farmer, education, malaria symptomatic, habitual of sleep outdoors, farming and fishing (06.00pm-06.00 am), outdoors gathering (06.00pm-06.00 am), wooden wall, mosquito wire, ventilation, plafond, animal shelter distance, breeding place and climate were insignificant for prevalence of malaria. Bed nets and breeding place were significant for prevalence of malaria. Potential of malaria vectors (An. barbirostris and An. sundaicus) were found in lowlands but was not found in highlands. Bed nets is protective factor from incidence of malaria. One primer most likely cluster and 3 secondary clusters were insignificant.Conclusion : Lowland has risk from malaria. The use of bed nets during 06.00pm – 06.00am is as protective factor for malaria OR 0.1.Keyword:Amfoang Barat Daya, risk factormalaria, thick blood smear, Anopheles sp., bed nets,mappin

Comparison of Immunochromatography Method and Immunocytochemistry Method in Rapid Detection of NS-1 Antigen in Dengue Infection

ABSTRACT Introduction: Rapid test kit based on immunochromatography test (ICT) in detecting dengue NS-1 antigen for early dengue infection is available in the market. Its availability allows earlier management for dengue infected patient but it remains costly to most people. Recently, Dengue Team of Universitas Gadjah Mada has developed monoclonal antibodies to detect the presence of dengue NS-1 antigen in leucocytes of infected patients based on Streptavid in Biotin Peroxidase Complex (SBPC) immunocytochemistry method.Objectives: The objective of this study is to determine the validity of the immunochromatography (SD Dengue NS1 Ag) method by determining kappa agreement index between two observers, and to compare the diagnostic performances of ICT and immunocytochemistry methods in detecting dengue NS1 antigen in the blood samples.Methods: A cross sectional study design is used. This study uses 35 blood plasma remains from a previous study conducted on RT-PCR method. Three drops of blood plasma were added into the well of SD Dengue Duo NS1 and results were read after 15-20 minutes. The diagnostic performances of ICT which defined by sensitivity, specificity, positive predictive value and negative predictive value were calculated and compared to secondary data of immunocytochemistry result from the same blood samples, with reference of RT-PCR as a gold standard. A McNemar’s test was conducted and p value less than 0.05 was considered as significant different.Result: Detection of dengue infection by using SD Dengue NS1 Ag has strong agreements between two observers with kappa value of 1, and the sensitivity of 50%, specificity of 91%, positive predictive value of 92% and negative predictive value of 45% with reference of RT-PCR as a gold standard. Meanwhile sensitivity and specificity value of the immunocytochemistry test were 88% and 100% respectively, and the positive and negative predictive values were 100.0% and 70.0% respectively with reference of RT-PCR as a gold standard. The immunocytochemistry assay showed overall accuracy of 91,0%.Conclusion: Immunochromatography (SD Dengue NS1 Ag) method to detect NS-1 antigen has less sensitivity and specificity compared to SBPC immunocytochemistry method.Keyword: Immunocytochemistry, Immunochromatography, Streptavidin Biotin Peroxidase Complex (SBPC), NS-1 Ag, dengu

The Relationship Between The Prevalence of Head Lice Infestation with Hygiene and Knowledge Among The Rural School Children In Yogyakarta

Introduction: Pediculosis capitis causes considerable social distress. Rural children are in great risk because they live in conditions where poor knowledge and hygiene are related to this matter. However, the prevalence of pediculosis capitis among school age children in rural area in Yogyakarta have not known yet.Objectives: The objective of this study is to find the prevalence of head lice infestation among the rural school children and associating it with hygiene and knowledge.Methods: This was a cross sectional study done in February 2011 in 2 primary public schools in the rural areas of Yogyakarta with 158 subjects age ranging from 8 to 16 years old. Questionnaires inclusive of hygiene and knowledge aspect were given prior to the gross visual head lice examination by trained personnel.Results: The prevalence of head lice infestation among the rural school children is 19.6%. There is no significant relationship between this with knowledge and hygiene.Conclusion: The prevalence of head lice infestation in rural school areas in Yogyakarta is 19.6%. There is no significant relationship between the prevalence of head lice infestation with hygiene and knowledge among the rural school children in Yogyakarta.Keywords: Pediculosis capitis, head lice infestation, hygiene, knowledg