Program Pengendalian Demam Tifoid di Indonesia: Tantangan dan Peluang

Typhoid fever (hereinafter referred to as typhoid) is a communicable disease with a heavy publichealth burden estimated at 22 million cases per year globally resulting in 216,000 to 600,000 deathsannually. In Indonesia, typhoid should receive serious attention from various parties as it is endemic.The purpose of this study is to review the typhoid control program in Indonesia as well as the challenges and opportunities in the implementation of the program. The method used is review of literature and documents related to the study obtained from National Institute of Health Research and Development library, as well as Directorate General of Disease Control and Environmental Health, and the google search results with the keywords “demam tifoid”, “typhoid fever”, “program pengendalian demam tifoid”, and “typhoid fever control program”. Overall, we collected 31 articles and documents relevant to the study topic. The study found that the typhoid control program has not been implemented optimally in Indonesia with many outstanding challenges such as lack of financing the control program as well as the increasing cases of carriers or relapse and resistance. To strengthen the typhoid control program and reduce the typhoid morbidity, there is a need to intensify advocacy, improve cooperation across programs and sectors particularly on access to clean water, the role of travel agents in typhoid vaccination for travelers, study of the effectiveness of typhoid vaccination in control program for adding the vaccine to a national immunization program, prevention of carriers or relapse and resistance, as well as financing the control program in provinces and districts/cities

A Case Report of Neurocysticercosis at Sanglah Hospital, Denpasar, Bali

We reported one neurocysticercosis (NCC) case who visited neurological outpatient clinic of Sanglah hospital, Denpasar, Bali. The patient is a 46-year-old man from Sumba, East Nusa Tenggara Province, and eastern part of Indonesia. The main symptoms of patient was headache and history of epileptic seizures, and spastic monoparesis on left lower limb. Diagnosis and follow up patient was performed clinically including CT scan and serologically. Detection of specific antibodies to Taenia solium in serum was performed by ELISA and immunoblot using native and recombinant antigens

Sympatric Occurrence of Taenia solium, T. saginata, and T. asiatica, Thailand

We confirmed sympatric occurrence of Taenia solium, T. saginata, and T. asiatica in western Thailand. DNA analysis of morphologically identified T. saginata, in a dual infection with T. solium, indicated it was T. asiatica. To our knowledge, this report is the first of T. asiatica and a dual Taenia infection from Thailand

Serological Studies of Neurologic Helminthic Infections in Rural Areas of Southwest Cameroon: Toxocariasis, Cysticercosis and Paragonimiasis

A total of 188 people (168 and 20 with and without symptoms confirmed by clinicians, respectively, 84.6% under 20 years old) were selected on a voluntary basis in Cameroon. Soil transmitted helminthic infections were prevalent among persons surveyed as is common in developing countries, since eggs of Ascaris lumbricoides, Trichuris trichiura and hookworms were found from 56 (33.3%), 72 (42.8%) and 19 (11.3%) persons, respectively. Serological analyses revealed that 61 (36.3%), 25 (14.9%) and 2 (1.2%) persons were positive to the diagnostic antigens specific for toxocariasis, paragonimiasis and cysticercosis, respectively. Among 14 people with epilepsy, 5 persons were seropositive to the antigen of Toxocara and one of them was simultaneously positive to the antigens of Paragonimus. Serological confirmation of cysticercosis in two children is very important, and we suggest that further serologic surveys of cysticercosis be carried out in both children and adults in this area for the promotion of a better quality of life including control and early treatment

Human Taeniasis and cysticercosis in Asia

Elsevier, Ito, Akira ; Nakao, Minoru ; Wandra, Toni, Lancet, 362(9399), 2003, 1918-1920. authorCONTEXT: Human Taeniasis caused by the pork, Taenia solium, or beef, T saginata, tapeworm arises after eating pork or beef contaminated with metacestodes, the larval stage of these parasites. Taeniasis with T solium can lead to neurocysticercosis and threaten others by accidental ingestion of eggs released from asymptomatic Taeniasis patients. The 2003 World Health Assembly declared that T solium is of worldwide public-health importance, and that it is an eradicable parasitic disease worldwide. Adult taeniid tapeworms expelled from people in almost all Asian countries appeared to be T saginata (the so-called Asian Taenia), even though they ate pork. The organism is now named T asiatica, and has been found in Taiwan, Korea, China, Vietnam, and Indonesia. But it has been difficult to differentiate T saginata from beef and Asian Taenia from pork. STARTING POINT: Marshall Lightowlers and colleagues (Int J Parasitol 2003; 33: 1207-17) recently demonstrated that recombinant oncosphere vaccines against several taeniid cestodes, including T ovis, T saginata, T solium, and Echinococcus granulosus, are highly effective. Protection was almost 100%, in the laboratory and in the field. These researchers found several common features, including a predicted secretory signal sequence, and one or two copies of a fibronectin type III domain, each encoded by separate exons within the associated gene. WHERE NEXT? Molecular and immunological techniques, including vaccine research and development of animal models for differentiation of taeniid species in humans, have greatly advanced over the past decade. The clinical importance of infections by these taeniids, including T asiatica, in humans, and the potential for cysticercosis attributable to T asiatica in humans, needs further study

Taenia solium cysticercosis in Bali, Indonesia: serology and mtDNA analysis

authorAn active Taenia solium cysticercosis case in Bali, Indonesia, was followed-up by serology and computed tomography. Serology using semi-purified glycoprotein and recombinant antigens showed a drastic drop in titers after calcification of the cysts. Three paraffin-embedded cysts, prepared for histopathological examination, from three other patients were used for mtDNA analysis. The sequences of cox1 gene from T. solium cysticerci from Bali differed from those in Papua and other Asian countries

High prevalence of Taenia saginata taeniasis and status of Taenia solium cysticercosis in Bali, Indonesia, 2002-2004

Elsevier, T. Wandra ; P. Sutisna ; N.S. Dharmawan ; S.S. Margono ; R. Sudewi ; T. Suroso ; P.S. Craig ; A. Ito, Transactions of the Royal Society of Tropical Medicine and Hygiene, 100(4), 2006, 346-353 authorAn epidemiological survey of taeniasis/cysticercosis was carried out in one semi-urban and two urban villages in three districts of Bali, Indonesia in 2002 and 2004. In total, 398 local people from 247 families were diagnosed by anamnesis and clinical examinations, and 60 residents were suspected to be taeniasis carriers. Among 60 suspected carriers, 56 persons expelled a total of 61 taeniid adult worms after praziquantel treatment. From 398 residents, 252 stool samples were available for analysis of taeniid eggs, coproantigens or copro-DNA for identification of taeniid species, and 311 serum samples were available for detection of antibodies against Taenia solium cysticercosis. Taeniasis prevalences were highly variable among three villages (1.1-27.5%), and only one case of cysticercosis due to T. solium infection was detected. All expelled tapeworms were confirmed to be Taenia saginata by mtDNA analysis. There was no Taenia asiatica human case in Bali. Case control analysis of 106 families chosen at random from 179 families in 2004 and another 106 families from non-endemic areas revealed that risk factors of T. saginata taeniasis for families were: level of education (P<0.01); consumption of beef lawar (P<0.01); and the source of lawar (P<0.01)