MENINGKATKAN PENGETAHUAN MASYARAKAT TENTANG KERACUNAN KEHAMILAN

Prenatal Mortality Rates and Maternal Mortality Rates in Indonesia still high because of many factors and pre-eclamsia/eclamsi is one of that. However the uncomplete knowledge of the community about pre-eclamsia have lead to the indication malpractice done by doctors or midwifes. Pre-eclamsia actually is a common complication of pregnancy. It is mild in many cases but in some cases it becomes severe, and can cause serious complications. The condition goes when the baby is born . Medication may be advised to help prevent complication

The prevalence of anti HBs among healthy reproductive-age female in Indonesia : National Health Survey 2007

Introduction:Hepatitis B virus  during  pregnancy  has  a  high vertical  transmission  rate,  causing  fetal  and  neonatal hepatitis  and  maternal  mortality.  Neonatal hepatitis  can lead  to chronic  virus  carriage,  which in turn  may  lead  to  liver  cirrhosis  and  hepatocellular carcinoma in young adults. Acute Hepatitis B carries a particular risk, not only for the mother, but also for the newborn. Therefore identifying female in reproductive-age for anti HBs is a useful indicator for the immunity of the disease. Objectives: The aim of this study is was to determine the prevalence of anti HBs in healthy reproductive-age female during the national health survey in 2007. Methods:The data used was secondary data obtain from National Health Survey in healthy respondent in Indonesia in 2007. In this study, we analysed biomedical data that can be linked to the demographic data from public health questionaire. The samples were reproductive-age female aged 15 to 49 years. The Enzyme Linked Immunosorbent Assay (ELISA) kit (Murrex-Abbot Laboratories) was used for serodetection of anti HBs according to manufacturer instruction.  The number of respondents of reproductive-age female who were sampled in this analysis were 1302 respondents Results:The samples collections were obtained from urban area in 272 districts/municipalities in 33 provinces. The survey collected 7520 sera from all respondents. The 1302 of 7520 sera tested for anti HBs were reproductive-age female. Most of respondents were at 25 to 34 age group (481/1302,39.4%). Among 1302 sera, we found that 330 (25.4%) had positive anti HBs. A 117 of 1302 (8.9%) samples were pregnant women. A 32 of 117 (27.4%) pregnant women had positive anti HBs. A 81 of 1302 (6.2%) samples were delivered women. A 18 of 81 (22.2%) delivered-women had positive anti HBs.  Conclusions:The high seroprevalence of anti HBs among healthy reproductive-age females are a public health concern. Further comprehensive studies are required to provide epidemiological information for public health awareness in the community

Virulensi dan Transmisi Virus Influenza A pada Manusia, Hewan Mamalia dan Unggas

In the 20th century, influenza virus A infections caused the pandemic severe respiratory illness in humans, some of the cases were fatal. Therefore, it is important for us to know the transmission mechanism and factors that can affect the virulence of influenza viruses. Virulence of influenza virus in birds, mammals and humans is determined by its ability to inflict damage to host cells caused by the eight genes in the virus. Eight of these genes have different tasks and functions that need to be analyzed. Besides knowing the virulence of influenza virus, should also know the transmission mechanism of these viruses. Influenza type A virus in poultry (called avian influenza) can transmit directly from birds to humans that can cause fatal infections. Understanding of the factors that play a role in the transmission between species of birds, mammals and humans can help the development of surveillance strategies to determine rapidly the potential strain of influenza A virus that can cause a pandemic. Keywords: Influenza A, virulence, virus transmission, avian Abstrak Di abad ke-20, beberapa pendemi/wabah gangguan saluran pernafasan yang berat pada manusia dan dapat juga menyebabkan kematian, disebabkan oleh virus influenza A. Oleh karena itu penting bagi kita mengetahui bagaimana virus Influenza ini bertransmisi dan faktor–faktor yang mempengaruhi virulensi dari virus Influenza. Virulensi virus influenza pada unggas, hewan mamalia dan manusia ditentukan oleh kemampuannya untuk menimbulkan kerusakan pada sel host yang disebabkan oleh delapan gen yang ada padanya. Delapan gen ini mempunyai tugas dan fungsi yang berbeda-beda yang perlu dipelajari. Selain mengetahui virulensi virus Influenza, perlu juga diketahui cara transmisi dari virus ini. Virus influenza tipe A pada unggas (disebut juga avian influenza) dapat bertransmisi secara langsung dari unggas ke manusia yang dapat menyebabkan infeksi fatal. Pemahaman terhadap faktor-faktor yang berperan dalam transmisi antara spesies unggas, hewan mamalia dan manusia dapat membantu pengembangan strategi surveilans guna mengetahui dengan cepat potensi strain virus influenza A yang dapat menimbulkan pandemi. Kata kunci: Influenza A, virulensi, transmisi, ungga

The Stages of HIV Infection and the Risk of Opportunistic Tuberculosis Infection

Background: Opportunistic infection (OI) by tuberculosis is the most common cause of death for peopleinfected with HIV worldwide, mainly in persons with untreated HIV infection. The aim of the study wasto determine the risk factors associated with TB as an OI of HIV-infected patients.Methods: The study conducted in Voluntary Counseling Testing (VCT) clinics in several hospitals ofseven provinces (North Sumatera, West Sumatera, Riau Islands, South Sulawesi, North Sulawesi, Maluku,and Papua). This was a cross sectional study and the respondents selected by purposive sampling. Therewere 490 HIV patients included in this study. Data were collected using a specific questionnaire. Statisticalanalyses were done using STATA 9.0 version.Results: Among 490 HIV patients, there were 238 (48.6%) patients with TB as IO. The precentage ofTB as OI in the younger HIV-infected group was higher than the older group. Among the HIV-infectedpersons, males had a 24 % higher risk of becoming infected with TB than females [adjusted relative risk(RRa)=1.24; P=0.023]. Stage 4 HIV-infected persons had 52% risk of TB as OI compared to stages 1-3(RRa=1.55; P=0.000).Conclusion: Patients with stage 4 HIV infection and male were more at risk for developing opportunistictuberculosis infection. (Health Science Journal of Indonesia 2015;6:121-5

The Primer Design of Domain-specific C-terminus of the Avian H5N1 NS Gene From Indonesia

Background: The avian influenza (AI) H5N1 viruses have caused nearly 600 fatal cases in the world since 2003. The H5N1 AI virus is still circulating in wild birds and domestic. One of the known of AI virus pathogenicity is the ability of the nonstructural protein (NS1 and NS2) to induce cytokine storm. Mutations of the NS1 and NS2 proteins may aggravate infections.Methods: Genetic sequences of NS gene that encodes the C - terminus domain of AI H5N1 virus were obtained by sequencing method using specific primer to amplify the NS gene. The primers design were done by using several bioinformatics software available then retested to determine the primer success in amplifying the target sequence. RT- PCR testing performed on four H5N1 AI virus isolates, followed by sequencing to determine the nucleotide sequences generated from the primer were prepared in this study. Results: Primers, which can be designed to amplify four chicken H5N1 isolates tested were two isolates from Bali (A/Ck/Bali-KH/2009 and A/Ck/Bali-T/2009), and two isolates from East Java (A/Ck/East Java-S/2009 and A/Ck/East Java-D/2009). Conclusion: The designated primer can be used in PCR amplification and sequencing of genes that express NS section C terminus of the protein NS1 and NS2 end portion. The primer design of H5N1 NS gene. (Health Science Indones 2014;2:83-8

Comparison of Rotavirus Detection From Rectal Swab and Feces in Patients with Diarrhea Symptoms

Background: Rotavirus is the most common etiologic agent causes severe diarrhea in infants and children worldwide. Globally, every year 600,000 deaths in children less than 5 years associated with rotavirus infection. Commonly used to detect rotavirus stool samples, but getting stool samples were more difficult than rectal swab. The purpose of this study was to compare the results of the use of specimen of rectal swabs and feces to detect Rotavirus by RT-PCR method.Methods: To evaluate rotavirus that cause diarrhea we used rectal swabs and stool samples taken from infants and identified by RT-PCR method. Data were analyzed with sensitivity and specificity analysis tests.Results:A number 189 specimen pairs were included of which 24 were negative in both specimen types and 112 were positive in both specimen types. Forty four 42 pairs was positive in the stool specimen only and 11 pairs was positive in the rectal swab specimen only. Sensitivity of rectal swab specimen was 72.7% and specificity was 68.6%. Rectal swab positive predictive value of 91.1%, while a negative predictive value of 36.3%.Conclusion:The result of the sensitivity and specificity of rectal swab specimen was adequate compared with the feces specimen. (Health Science Indones 2012;2:xx-xx

Establishment of Realtime RT-PCR Assay to Detect Polio Virus in the Acute Flaccid Paralysis Laboratory Surveillance

Background: The last indigenous polio was detected in 1995 but the threat of wild type polio viruses and themutation of Oral Polio Vaccine into Vaccine-Derived Poliovirus still continue. Since 1991, WHO has developedAcute Flaccid Paralysis (AFP) laboratory based surveillance. In 2014, the polioviruses identification by real-timeReverse Transcriptase Polymerase Chain Reaction (rRT-PCR), has been introduced to National Polio Laboratory(NPL) Center for Biomedical and Basic Technology of Health. The objective of the rRT-PCR application is to havefaster and better diagnostic methods to monitor the circulation and mutation of polio viruses.Methods: Isolate tested by rRT-PCR using a combination of primers and probe mentioned by WHO manual.The viral RNA is converted to cDNA using reverse transcriptase and amplified in a PCR reaction using Taqpolymerase. The PCR products are detected and identified by hybridization with specific probes. The combinationof primers and probes will result in the serotype identification and intratypic differentiation of poliovirus isolates.Results: In 2014 NPL Jakarta received 604 AFP cases through the surveillance system, five cases foundpositive for polio viruses by culture. All of the specimens were positive for polio vaccine viruses. Twocases were polio virus type P2 (40%), one cases polio virus type P1 (20%), 1 case polio virus type P3(20%) and one case mix polio viruses type P1+P2 (20%).Conclusion: The real-time PCR assay was able to help the identification of polio viruses rapidly in Jakartalab. The test can be utilized for monitoring the population routinely immunized with OPV. (Health ScienceJournal of Indonesia 2016;7:27-31

Karakteristik Kasus Fatal Akibat Gigitan Hewan Penular Rabies di Indonesia 2016 – 2017

Abstract Rabies is a zoonotic disease that is transmitted to humans by bites or scratches or licks (on damaged skin or mucous membranes) from infected animals, most often dogs. Rabies is endemic in several regions in Indonesia. If untreated, bites of rabies will cause fatal. The aim of this analysis is to explore the characteristics of fatal human cases caused by the bites of rabies transmitting animal in Indonesia in 2016–2017. The collection of human case data with bites of rabies transmitting animals (GHPR) from all provinces of Indonesia in 2016 and 2017 by the zoonotic Subdirectorate, Directorate Pencegahan dan Pengendalian Penyakit Tular Vektor dan Zoonosis (P2PTVZ), Directorat General of Disease Prevention and Control. We analyzed tha characteristics of the provincial which was reported GHPR cases, incubation period, bite location, clinical symptoms, history of vaccination and the demography of fatal GHPR cases. The clinical case definition for GHPR based on the World Health Organization. The results show that GHPR cases were reported from 25 out of 34 provinces. The most frequently reported incubation period is 1-2 month (40.7%). The location of most bites on the legs (37.3%). Most clinical symptoms reported were hydrophobia (76.6%), followed by hypersalivation (64.5%), convulsion (35.5%), photophobia and hyperhidrosis respectively (31.2%). Fever is not the main symptom, only 19.9%. Most fatal GHPR cases do not receive appropriate vaccination post-exposure (VAR). Male as fatal GHPR cases are more often than women with ratio 1.8 to 1 and adult cases more than children. Inconclusions immediate treatment with complete post-exposure vaccination has not been well implemented in reported fatal GHPR cases.  Abstrak Rabies merupakan salah satu penyakit zoonosis yang ditularkan ke manusia melalui gigitan atau goresan atau jilatan (pada kulit yang rusak atau selaput lendir) dari hewan yang terinfeksi, paling sering anjing. Rabies endemis di beberapa daerah di Indonesia. Jika tidak ditangani, gigitan hewan rabies dapat menyebabkan kematian. Tujuan dari penulisan ini untuk memberi informasi karakteristik kasus manusia yang fatal akibat gigitan hewan penular rabies (GHPR) di Indonesia selama kurun waktu 2016- 2017. Pengumpulan data kasus manusia dengan gigitan hewan penular rabies dari seluruh provinsi Indonesia pada tahun 2016 dan 2017 dilakukan oleh Subdirektorat Zoonosis, Direktorat Pencegahan dan Pengendalian Penyakit Tular Vektor dan Zoonosis (P2PTVZ), Direktorat Jenderal Pencegahan dan Pengendalian Penyakit (P2P). Analisis karakteristik kasus GHPR fatal meliputi aspek provinsi yang melaporkan kasus GHPR, masa inkubasi, lokasi gigitan, gejala klinis, riwayat pemberian vaksinasi dari kasus fatal dan demografi. Definisi kasus GHPR secara klinis berdasarkan Organisasi Kesehatan Dunia. Hasil menunjukkan bahwa kasus GHPR dilaporkan di 25 dari 34 provinsi. Masa inkubasi yang paling sering dilaporkan yaitu 1-2 bulan (40,7%). Lokasi gigitan terbanyak pada kaki (37,3%). Gejala klinis terbanyak yang dilaporkan hidrofobia (76,6%), diikuti dengan hipersalivasi (64,5%), kejang (35,5%), fotofobia dan hiperhidrosis masing-masing (31,2%). Demam bukan gejala utama, hanya 19,9%. Sebagian besar kasus GHPR fatal tidak mendapatkan vaksinasi pascapajanan (VAR) yang sesuai. Kasus GHPR fatal pada laki-laki lebih banyak daripada perempuan dengan perbandingan 1,8 : 1 dan jumlah orang dewasa lebih banyak dibandingkan dengan anak-anak. Disimpulkan bahwa pengobatan segera dengan pemberian vaksinasi pascapajanan secara lengkap belum dilaksanakan dengan baik pada kasus-kasus GHPR fatal yang dilaporkan

Assessment of biorisk management implementation in NIHRD laboratory as national referral laboratory of emerging infectious diseases in Indonesia

Latar belakang: Laboratorium Badan Penelitian dan Pengembangan Kesehatan (Balitbangkes) ditunjuk sebagai laboratorium rujukan nasional dalam mendeteksi penyakit infeksi Emerging (EID) dan bertugas dalam mendeteksi pathogen infeksius serta berperan penting dalam sistem penanggulangan wabah. Laboratorium Balitbangkes harus menerapkan sistem manajemen biorisiko untuk mencegah terjadinya penyebaran penyakit yang bersumber dari laboratorium. Penerapan manajemen biorisk laboratorium yang terdiri dari biosafety dan biosecurity bertujuan untuk melindungi pekerja, lingkungan dan produk atau agen biologi. Penelitian ini bertujuan untuk menemukan kesenjangan terkait penerapan manajemen biorisk di Laboratorium Balitbangkes dengan standar. Metode: Studi dilakukan oleh Asesor professional pada tahun 2015 dengan mewawancara penanggung jawabLaboratorium BSL-3 (PJ BSL-3) dan Biosafety Officer (BSO) serta pemeriksaan dokumen. Pemilihan respondenberdasarkan jabatannya di laboratorium. Responden dipilih karena sebagai pelaksana teknis dan memilikiinformasi pelaksanaan biosafety dan biosecurity yang mendalam di laboratorium Balitbangkes. Pertanyaandiadopsi berdasarkan CWA 15793: 2011, berisi 160 pertanyaan dari 16 elemen. Analisis skor diinterpretasikanantara 0-2. Skor 0 memenuhi kesesuaian dengan standar dan skor 2 berarti tidak memenuhi standar. Hasil: Studi ini menunjukan 3 dari 16 elemen, memiliki kesesuaian penuh dengan standar yaitu teknik mikrobiologi yang baik, alat pelindung diri serta peralatan dan pemeliharaan alat laboratorium. Elemen yang memiliki kesenjangan paling tinggi adalah keamanan dengan skor 1.16. Tidak ada elemen yang dinilai tidak memenuhi kesesuaian standar atau skor2. Kesimpulan: Secara keseluruhan, Laboratorium Balitbangkes memiliki sistem manajemen biorisiko yang kuatdan sudah mapan disetiap elemen. Namun, tindakan perbaikan harus segera dilakukan di beberapa elemen untuk memenuhi standard CWA 15793:2011. (Health Science Journal of Indonesia 2018;9(2):70-5) Kata kunci: EID Laboratory, biorisk management, laboratory assessment, CWA15793 Abstract Background: NIHRD laboratory was appointed as a national referral laboratory to perform laboratory detectionfor emerging infectious disease (EID). Because of its important role, NIHRD laboratory must implement bioriskmanagement system. A reliable high containment laboratory is crucial to perform laboratory diagnosis forEIDs and to avoid further spread of EIDs. The protection of laboratory workers, environment, and biologicalagents is achieved by addressing laboratory biorisk management consist of laboratory biosafety and biosecurity measures. This study aims to find gaps related the implementation of biorisk management with standard. Methods: This study was carried out by Professional Assessor in 2015 by conducting document checking andinterviewing BSL-3 Technical Managers and BSO who were considered to have in-depth information regardingbiosafety and biosecurity activities in NIHRD laboratory. Questionnaire developed based on CWA 15793:2011,which contain 160 questions provided from 16 elements of the standard. Analysis of the scores was interpretedbetween ranges of 0-2. Score 0 means full conformity and score 2 means doesn’t meet the required standard. Results: The study showed that only 3 out of 16 elements have full conformity with the standard. Theywere good microbiological technique, clothing and personal protective equipment, laboratory equipmentand maintenance. The highest gap was in security elements with the score: 1.16. No elements has a noncompliance with the standard or score 2. Conclusion: Overall the NIHRD laboratory has a strong biorisk management system already establishedwhich is working well in many areas. However, important action is needed in several elements in order tocomply with the standard. (Health Science Journal of Indonesia 2018;9(2):70-5) Keywords: EID Laboratory, biorisk management, laboratory assessment, CWA15793