Diphtheria remains a public health concern in Indonesia despite long-standing inclusion of diphtheria-containing vaccines in the national immunization program. This study assessed temporal trends in diphtheria immunity among Indonesian children aged 1-14 years, identified vulnerable age groups, and examined factors associated with seroprotection. We analyzed diphtheria IgG antibody data measured by ELISA from the Indonesian Community Health Surveys (Riskesdas) conducted in 2007, 2013, and 2018. The analysis included 6,622 children (2007), 7,110 (2013), and 7,203 (2018). Bivariate and multivariate logistic regression analyses were performed to identify determinants of seroprotection. Across all surveys, diphtheria IgG levels were lowest at ages 1-6 years, increased at ages 7-10 years, and declined again from age 11 years onward. Overall seroprotection ranged from 71.1% to 83.6%, with a two- to threefold increase in long-term protection observed in 2018 compared with 2007 and 2013. In multivariate analyses, complete DTP immunization consistently remained the strongest independent predictor of seroprotection among children aged 1-4 years (p < 0.05). Among children aged 1-14 years, maternal education (Riskesdas 2007) and household economic status (Riskesdas 2018) were also associated with seroprotection. Following the introduction of the DTP4 booster, higher diphtheria IgG concentrations (GMC 0.48 IU/mL to 0.77 IU/mL) were observed among children aged 1-2 years old in 2018 compared with earlier surveys (GMC 0.18 IU/mL to 0.33 IU/mL). Diphtheria immunity among Indonesian children remains suboptimal, with the highest vulnerability at ages 5-6 years and evidence of waning immunity after ten years of age. Ensuring complete routine DTP immunization is critical, and booster strategies may be considered to sustain long-term population immunity.

Purpose:Kaempferia parviflora extracellular vesicles (KPEVs) have been reported as promising nanovesicles for drug delivery. This study aimed to load clarithromycin (CLA) into KPEVs (KPEVS-CLA) and determine the physical properties, drug-releasing efficiency, gastric cell uptake, anti-H. pylori activities, and anti-inflammatory responses in comparison with free CLA and KPEVs. Methods:The size and surface charge of KPEVs-CLA were evaluated using dynamic light scattering and visualized using a transmission electron microscope. The encapsulation efficiency (EE%), loading capacity (LC%), and drug release of KPEVs-CLA were examined using HPLC. Anti-H. pylori growth and anti-adhesion were evaluated. IL-8 gene expression, NF-κB signaling proteins, and anti-inflammatory profiles were examined using qRT-PCR, Western blotting, and Bio-Plex immunoassay, respectively. Anti-chemotaxis was then examined using a Transwell assay. Results:KPEVs-CLA were intact and showed a negative surface charge similar to that of KPEVs. However, slightly enlarged KPEVs were observed. CLA was successfully loaded into KPEVs with EE of 93.45% ± 2.43%, LC of 9.3% ± 3.02%. CLA release in the PBS and gastric mimic buffer with Fickian diffusion (n ≤ 0.43) according to Korsmeyer-Peppas kinetic model (R2=0.98). KPEVs-CLA was localized in the gastric cells' cytoplasm and perinuclear region. Anti-H. pylori growth and anti-H. pylori adhesion of KPEVs-CLA were compared with those of free CLA with no cytotoxicity to adenocarcinoma gastric cells. KPEVs-CLA significantly reduced IL-8, G-CSF, MIP-1α, and MIP-1β levels. Moreover, KPEVs-CLA showed a superior effect over CLA in reducing G-CSF, MIP-1α, and NF-κB phosphorylation and monocyte chemotactic activities. Conclusion:KPEVs serve as potential carriers of CLA. They exhibited a higher efficiency in inhibiting gastric cell inflammation mediated by H. pylori infection than free CLA. The establishment of KPEVs-CLA as a nanodrug delivery model for H. pylori treatment could be applied to other plant extracellular vesicles or loaded with other cancer drugs for gastric cancer treatment.

Bordetella pertussis infection is a highly contagious respiratory disease that can cause complications such as pneumonia and death. A total of 62,646 cases of pertussis worldwide were reported by WHO in 2022. This study aimed to obtain the pertussis seroprevalence and sociodemographic data in children aged 1-14 years and its association factors in the community based on Riskesdas 2013 and 2018. Bivariate and multivariate analysis was carried out on data from 12,753 children aged 1-14 years collected from Riskesdas 2013 and 2018 in Indonesia. Pertussis serology data was obtained based on the results of the ELISA examination which was categorized as seropositive if anti-pertussis toxin IgG >= 100 IU/mL or anti-pertussis IgG > 11 NTU. Pertussis seropositive indicated recent pertussis infection if no pertussis vaccine was received within the last twelve months. Pertussis seroprevalence was found at 9.8% and 33.4% in Riskesdas 2013 and 2018 respectively. While 10.1% of children aged 5-14 years were found pertussis seropositive by excluding the possible effect of vaccination in the last twelve months in Riskesdas 2013. The most important associated factor in seropositive pertussis at ages 1-4 years and 5-14 years was a history of pneumonia in the last month (OR = 2.709, 95%CI: 2.592-2.831 in Riskesdas 2013 and OR = 2.421, 95%CI: 2.299-2.550 in Riskesdas 2018). In the adjusted analysis for respondents' characteristics, low maternal education was the predictive factor that most influenced pertussis seropositivity, especially in the 2013 Riskesdas (APOR = 2.983, 95%CI: 2.670-3.333). In conclusion, the results of this study showed that the seroprevalence of pertussis was high, especially in children aged 5-14 years, so that pertussis vaccine booster administration could be considered. Because the most influencing factor towards pertussis seropositive was low maternal education, the groups of children with low-educated mothers should be targets for strengthening complete vaccination coverage and disease control.

Vaccination is one of the methods of preventing SARS-Cov-2 infection. Although the efficacy of several vaccines has been observed, it is unknown how long the antibodies remain in the body. The purpose of this study was to examine the antibody titers in adults, 18 months after receiving two doses of the Astra Zeneca vaccine. This is a cross-sectional study with adult subjects who received two doses of the Astra Zeneca vaccine in the Bogor area, conducted in 2023. To evaluate antibody titers (IgG) in serum specimens, the Chemiluminescent Microparticle Immunoassay (CMIA) method was utilized. The antibody titer ≥ 50.0 AU/mL was considered positive. The characteristics 122 subjects were mostly: female (63,1%), 36-45 years old, senior high school graduate (45.9%), unemployed (62,3%), had hypertension history (44.7%), and had no COVID-19 infection during the last six months. The results demonstrate that all the subjects had a positive SARS Cov-2 antibody titer, with a range titer of 87 - 80260 AU/mL and a geometric mean titer of 3246.4 AU/mL. In conclusion, this study found that the two doses of the Astra Zeneca vaccine made a significant contribution to the acquisition of anti-SARS-CoV-2S antibodies in adults.

Purpose:A better understanding of the factors that influence engagement is needed to provide a reference for conducting genetic testing in female relatives of patients with hemophilia (PWH). We therefore determined the perceptions and understanding of genetic testing among female relatives of PWH in China. Methods:We carried out a qualitative study using in-depth, semi-structured interviews with 11 female relatives of PWH in Shanxi Province, China. The resulting data were analyzed using thematic analyses. Results:This study extracted four topics: uncertainty about carrier genetic status; limited understanding of genetic testing; coexistence of positive and negative coping; and multi-aspect demands. Conclusion:Healthcare professionals should provide personalized and multidimensional health education and comprehensive decision-making support to female relatives of PWH, to enhance their motivation and willingness to undergo genetic testing. It is also important to actively improve relevant policies, strengthen the genetic testing service system, and promote the popularization of genetic testing in female relatives of PWH.

Background Hepatitis B is a viral infection that has a high prevalence in Indonesia. The Ministry of Health of Indonesia has conducted a national vaccination program for hepatitis B. In order to evaluate the success of the hepatitis B vaccination in Indonesia, a community study based on basic health research (Riskesdas) was performed nationwide since 2007 for five year period in 2007, 2013, and 2018. Methods Further statistical analysis was performed specifically for the children under 59 months old (toddlers) immunized in both urban and rural areas in 2007, 2013, and 2018 based on certain characteristics by examining antibodies against HBsAg (anti-HBs), IgG antibodies against the core antigen (HBcAb), surface antigen (HBsAg) of hepatitis B virus (HBV). The data obtained from the data management laboratory of Ministry of Health, Indonesia, was analyzed with Bivariate analysis with continuity correction chi-square or Pearson chi-square using Stata software version 16. Results This study showed an increase in hepatitis B coverage of complete immunization (30% in 2007, 60.3% in 2013, and 57% in 2018), which was also influenced by mothers’ level of education (Pearson chi-square , p ¡ 0.05) and access to health service points within 30 minutes (OR = 1.3–2.8, p ¡ 0.05). The trend of the percentage of immune status (anti-HBs) was increased (41.8% in 2007; 56.1% in 2013; and 79.1% in 2018). The higher anti-HBs was found in complete hepatitis B immunization status (OR = 1.5–2, p ¡ 0.05) and in good nutritional status (p ¡ 0.05). However, the anti-HBs was found decreased with increasing age (p ¡ 0.05). The trend of positive HBcAb (exposure to HBV infection) showed a decrease gradually of almost ten times from 2007 (8.6%-13.5%) compared to 2013 (2.6%-11.1%) and 2018 (1.1%-2%). Urban areas were at higher risk of hepatitis B exposure (OR = 1.4–2.2) than rural areas (OR = 0.37–0.80). The HBsAg data were only available in 2013 and 2018. Riskesdas data analysis showed the prevalence of hepatitis B (HBsAg) was lower in complete immunization status than that in incomplete one (p ¡ 0.05), but with an increase from 3.9% (2013) to 9.3% (2018), possibly due to inappropriate implementation of birth dose immunization or a vaccine-escape mutant from the HBV variants. Conclusions The effectiveness of hepatitis B vaccine obtained from the three Riskesdas periods in Indonesia showed an improvement, with an increase in immune status, reduced exposure to HBV and a lower prevalence of hepatitis B in children with complete vaccination. However, there is still an increase in hepatitis B infection, especially in urban areas. Therefore, a long-term evaluation of immunization coverage especially ensuring that the initial dose of immunization was given within the first 24 h of birth, HBsAg and HBcAb, nutritional status, genomic surveillance of HBV, and other aspects of program quality evaluation are needed to ensure that elimination efforts have been implemented properly.

Diabetes mellitus is one of metabolic diseases characterized by the elevated blood glucose levels. There are growing studies regarding the effect of diabetes to the development of other diseases such as hypertension, stroke, and even blindness. In the study performed by Dzięgielewska-Gęsiak et al, the comparison of two different treatments in diabetic type-2 patients regarding the effect to the microbiota composition was shown and discussed. Their study compared the microbiota profile in patients treated by metformin only and metformin supplemented with insulin. This study is an interesting and informative study, which gives a novel idea and hint of the different pattern of microbiota composition as the effect of different treatments given to patients. However, certain suggestions are given to the authors as consideration for their future studies. The alteration of homeostatic gut microbiota composition has been continuously reported to play important role in the health field, especially in metabolic diseases, such as diabetes mellitus. 1 The study performed by Dzięgielewska-Gęsiak, et al, compared the profile of gut microbiota of the patients with diabetes mellitus type-2 given by two different treatments, metformin or metformin and insulin. 2 Their results showed that there were no significant differences in the gut microbiota profile detected and analyzed from the patients treated with metformin compared to those treated with metformin and insulin. A question addressed here was why and how? Were the patients included in this study

Pertussis cases have been reported most frequently in developed countries, but they are predicted to be the most prevalent in developing countries. Indonesia, a developing country, routinely conducts case-based surveillance for pertussis. We reviewed the data on pertussis cases and close contacts based on clinical sample documents examined in the National Reference Laboratory for pertussis, Indonesia (2016–2020). Our objective was to analyze the laboratory and epidemiological aspects of pertussis cases and close contacts, particularly to evaluate the implementation of a 5-year case-based surveillance of pertussis in Indonesia. Data were collected from sample documents and annual laboratory reports between January 2016 and December 2020. We analyzed the proportion of pertussis cases and close contacts by geographic region, year, age, and sex. We used the χ 2 test to correlate the laboratory and epidemiological data. In total, 274 clinical cases of pertussis and 491 close contacts were recorded in 15 provinces. The peak number of cases occurred in 2019, with a positivity rate (percentage of laboratory-confirmed cases) of 41.23% (47/114). Clinical cases were dominated by infants aged <1 year (55.5%), and 52.9% of them were aged <6 months. Similarly, 72.3% (68/94) of the laboratory-confirmed cases were infants. Both clinical cases and positivity rates tended to be higher in females (155 cases, 38.1%) than in males (119 cases, 29.4%). No confirmed cases were found in children aged ≥10 years, although positive results still occurred in close contact. Age-group and laboratory-confirmed cases were correlated ( p = 0.00). Clinical and confirmed cases of pertussis occurred mostly in the early age group and may be lower in those aged ≥10 years, especially in confirmed cases. New policies are needed for pertussis prevention at an early age, as well as the application of serology tests to increase laboratory-confirmed cases in children aged ≥10 years.

The occurrence of diarrhea in children under five years old (toddlers) is still a serious health problem because it can cause mortality and malnutrition in children. Diarrhea is one of the biggest causes of death in toddlers in the world. Data from the World Health Organization (WHO) reports that more than 10 million children under five years old die every year and around 20 percent of them die because of diarrhea. One etiology of diarrhea infection in children under five years old who often escapes attention is diarrhea caused by parasites. As a developing and tropical country, the incidence of diarrhea due to parasitic infections in Indonesia is quite high. Examination of diarrhea samples in children under five years old to identify the type of parasites that play a role in the incidence of diarrhea. Stool samples were collected from patients seeking treatment at several primary health care and hospitals in Jakarta, Banjarmasin and Makassar during 2015-2016. The stool specimens were collected in containers containing formaldehyde for microscopic examination. Blastocystis hominis was found to be the most prevalent parasite with an infection rate of 12.46% followed by Entamoeba coli 1.73%, Ascaris lumbrichoides 0.35%, Oxiuris vermicularis 0.35%, Endolomax nana 0.35%, and Hookworm (Ancylostoma sp and Necator americanus) 0.35%. Parasitic diarrhea increases susceptibility to other infections, should not be neglected, particularly in patients with chronic diarrhea. Accurate diagnosis decreases morbidity and mortality in patients with parasite infection.

The treatments of diphtheria were done by giving Anti-diphtheria serum (ADS) and antibiotics. Penicillin and eritromisin are drugs of choice were recommended for cases and contacts of diphtheria. The presence of antimicrobial resistance against C.diphtheriae will increase the problem of eradication, prevention and treatment of diphtheria.Meanwhile the selection of sensitivity test methods must be considerated with the laboratory conditions . The aims of study to determine the pattern of resistance and effectiveness several antibiotics againts to C. diphtheriae and compare two antibiotic sensitivity test methods, between disc immunodiffusion and minimum inhibitory concentration (MIC). Determination of two sensitivity test methods were conducted by using diffusion disk agar with medium Muhler hilton agar by addition of 2 - 5% sheep blood. A total of 57 diphtheria isolates showed by MIC E-test methods were sensitive to ciprofloxacin, rifampicin, gentamicin and linezolid. Then all ciprofloxacin and linezolid showed sensitive against to C,diphtheriae by agar disc diffusion method. A quite high resistance was found 84.2% tetracycline for agar disc diffusion method and 77.2% for MIC E-test method. Furthermore, the drugs programs of C. diphtheriae infection showed 10.5% penicillin and 5.3% erythromycin resistant by agar diffusion disc method. Then 7% penicillin and 3,5% Erythromycin showed resistance by the MIC E-test methods. Both of those methods have agreement between 82.0% - 100% depending on the antibiotic agents.Key Words : Corynebacterium diphtheriae, Antimicrobial , Resistence, sensitivity test AbstrakPengobatan penyakit difteri dilakukan dengan pemberian anti difteri serum (ADS) dan antibiotik. Penisilin dan eritromisin merupakan antibiotik yang direkomendasikan menjadi obat pilihan untuk kasus dan kontak difteri. Adanya resistensi antibiotik terhadap C. diphtheriae akan menambah masalah dalam pemberantasan, pencegahan dan pengobatan difteri, sementara pemilihan metode uji kepekaan harus disesuaikan dengan kondisi di lapangan. Penelitian ini bertujuan untuk mengetahui pola resistensi dan efektifitas beberapa antibiotik terhadap C.diphtheriae serta membandingkan dua metode uji kepekaan antibiotik yakni disk difusi agar dan minimum inhibitory concentration (MIC) dengan strip E-test. Penentuan kedua metode uji kepekaan menggunakan medium Muhler hilton agar dengan penambahan darah domba 2-5% . Sebanyak 57 isolat difteri menunjukkan dengan metode baku standar MIC E-test sensitif terhadap ciproflokasin, rifampisin, gentamisin dan linezolid. Sementara hanya ciproflokasin dan linezolid yang menunjukkan semuanya sensitif dengan metode disk difusi agar. Resistensi antibiotik yang cukup tinggi resistennya adalah tetrasiklin 84,2% untuk metode disk difusi agar dan 77,2% untuk metode MIC E-test. Selanjutnya obat program yang digunakan terhadap infeksi C.diphtheriae menunjukkan 10,5% penisilin dan 5,3% eritromisin resisten dengan metode disk difusi agar dan dengan metode MIC E-test hasil resistensi menunjukkan penisilin 7% dan Eritromisin 3,5%. Kedua metode ini mempunyai tingkat kesesuian antara 82,0% - 100 % tergantung dari jenis antibiotiknya.Kata Kunci : Corynebacterium diphtheriae, Antimikroba , Resistensi, uji kepekaan

Japanese Enchepalitis is one of viral infection that became health problem in Asia, including Indonesia.The information of JE cases are rare since the symptoms are very wide and JE is not familiar amongclinicians. This study aims to describe the JE cases from enchepalitis outbreak. A total of 19 samplesconsisting of serum and CSF specimens collected during 2014 was obtained from reports JE outbreaksof five provinces (Banten, Central Java, West Kalimantan, North Sulawesi and North Sumatera). Themain symptoms were fever (100%), loss of consciousness (58%), confuse (53%), paralyzed (32%) andseizure (21%). The laboratory test results found two cases with positive IgM JE, two cases equivocaland 15 negative. From this preliminary results we concluded that 2 out of 19 suspected cases werepositive JE that came from Landak District in West Kalimantan and Manado District in North Sulawesi.Keywords: Japanese Enchepalitis, IgM, ELISA AbstrakJapanese Enchepalitis (JE) adalah salah satu penyakit ensefalitis yang disebabkan oleh virus dan merupakan masalah kesehatan di Asia, termasuk di Indonesia. Data JE di Indonesia masih sangat minim, karena diagnosis klinis yang cukup luas dan belum terpaparnya para klinisi tentang kasus JE. Penelitian ini bertujuan memaparkan secara dekriptif hasil Kejadian Luar Biasa (KLB) JE di Indonesia. Sampel penelitian ini adalah kasus KLB JE sepanjang tahun 2014. Spesimen diperiksa dengan menggunakan metode ELISA Capture IgM JE, sementara gejala klinis dianalisis secara deksriptif. Hasil penelitian terdapat 19 kasus KLB JE selama tahun 2014 yang berasal dari 5 Provinsi yaitu Provinsi Banten, Provinsi Jawa Tengah, Provinsi Kalimantan Barat, Provinsi Sulawesi Utara, dan Provinsi Sumatera Utara. Gejala klinis utama penderita kasus JE adalah panas (100%), diikuti dengan penurunan kesadaran (58%), perubahan status mental (53%) dan lumpuh (32%) serta kejang-kejang(21%). Hasil pemeriksaan laboratorium terhadap antibodi IgM JE menunjukkan terdapat 2 kasus positifJE, 2 Equivokal dan 15 Negatif. Kesimpulan penelitian ini selama tahun 2014 dilaporkan 19 kasus KLBJE, dengan 2 kasus positif JE yang berasal dari Provinsi Kalimantan Barat (Kabupaten Landak) danSulawesi Utara (Kota Manado).Kata Kunci: Japanese Enchepalitis, IgM, ELISA

Abstract Backgroud: Brucellsos is a neglected zoonoses diseases. Brucellosis is occupational hazard with a high prevalence in developing countries. Transmission to human can occur through contact with infected animals, inhalation or eat raw materials from animals. Brucellosis also caused abortus on human. Objective: To determined the seroprevalence of human brucellosis and abortus case associated with human brucellosis among dairy farm worker in Cilawu-Garut Methods: The calculation sample size was using proportion test;, 57 respondents man and woman based on inclusion criterias. Respondents received the questionnaire to screen the abortion case history during the last 5 years. We tested their serum samples using Rose Bengal Test (RBT). Result: We found that 7.02% abortion record. There were 57 sera collected and 7.02% showed RBT positive result. Respondent who have abortion record have their negative RBT results. Conclusions: There were Brucella antibody among the respondents in Cilawu. The seroprevalence were negative result to abortus cases, so its need further test to detect the abortion to be caused by Brucella sp

Japanese Enchepalitis is one of viral infection that became health problem in Asia, including Indonesia. The information of JE cases are rare since the symptoms are very wide and JE is not familiar among clinicians. This study aims to describe the JE cases from enchepalitis outbreak. A total of 19 samples consisting of serum and CSF specimens collected during 2014 was obtained from reports JE outbreaks of five provinces (Banten, Central Java, West Kalimantan, North Sulawesi and North Sumatera). The main symptoms were fever (100%), loss of consciousness (58%), confuse (53%), paralyzed (32%) and seizure (21%). The laboratory test results found two cases with positive IgM JE, two cases equivocal and 15 negative. From this preliminary results we concluded that 2 out of 19 suspected cases were positive JE that came from Landak District in West Kalimantan and Manado District in North Sulawesi.

Latar Belakang: Demam berdarah dengue disebabkan oleh infeksi virus dengue (DENV) yang terdiri atas serotipe 1 sampai dengan serotipe 4. Masing-masing serotipe dibedakan lagi menjadi beberapa genotipe. Studi ini dilakukan untuk mendeteksi genotipe DENV yang bersirkulasi di lokasi surveilans sentinel dengue. Metode: Untuk menentukan genotipe dilakukan analisis genetik menggunakan perangkat bioinformatik. Urutan nukleotida yang lengkap dari gen selubung DENV diperoleh melalui amplifikasi genetik menggunakan primer overlapping untuk masing-masing serotipe. Pohon filogenetik dibuat menggunakan perangkat lunak MEGA 6.0, metode Neighbor Joining dengan 1000 replikasi dan parameter Kimura-2. Sekuen nukleotida dari GenBank yang telah diketahui genotype DENV digunakan sebagai referen. Hasil: Jumlah sampel dengan gen selubung DENV yang dapat diamplifikasi adalah 64 dari 204 kasus yang terkonfirmasi. Empat belas sekuen dari DENV-1, 22 sekuen DENV-2, dan 28 sekuens DENV-3. Dari studi ini belum didapatkan sekuen untuk DENV-4. DENV-1 dan DENV-2 masing-masing masuk dalam kelompok genotipe I dan Cosmopolitan, sementara DENV-3 masuk dalam kelompok genotipe I. Kesimpulan: Genotipe DENV di lokasi surveilans sentinel dengue sama dengan genotype yang sebelumnya dilaporkan bersirkulasi di Indonesia. (Health Science Journal of Indonesia 2016;7(2):69-74) Kata kunci: surveilans sentinel dengue, virus dengue, genotype Abstract Background: Dengue hemorrhagic fever was caused by dengue virus (DENV). This virus has four serotypes, DENV-1 to DENV-4, in which each serotype consists of various genotypes. This study present the distribution of DENV genotype circulate in dengue sentinel surveillance sites. Methods: We performed molecular analyses using bioinformatics tools to identify genotype of DENV. Sequencing targeting envelope gene was carried out on DENV-positive samples. Full-length sequence of envelope gene was obtained using overlapping primers for DENV 1, 2, 3 and 4. Phylogenetic tree was generated by Neighbor Joining using MEGA 6.0 with 1000 bootstrap replications and Kimura 2-parameter model. Known genotype of DENV sequences from Indonesia and other countries obtained from GenBank were included in the analyses as references. Results: A total of 64 complete coding sequences of envelope gene from DENV-1, DENV-2 and DENV-3 were successfully sequenced from 204 confirmed DENV cases. There are fourteen sequences of DENV-1, 22 sequences of DENV-2 and 28 sequences of DENV-3. Unfortunately, there was no complete coding sequence of envelope gene obtained for DENV-4. DENV-1 and DENV-2 were grouped into genotype I and cosmopolitan genotype, respectively. The DENV-3 was grouped into genotype I. These viruses were belongs to various genotypes that have been circulating previously in Indonesia. Conclusion: This finding suggests that the distribution of DENV genotype in sentinel sites remained stable. (Health Science Journal of Indonesia 2016;7(2):69-74) Key words: dengue sentinel surveillance, dengue virus, genotype

Kasus Japanese Encephalitis pada manusia di Indonesia telah ditemukan di beberapa provinsi. Penelitian ini bertujuan untuk mengetahui besarnya angka infeksi JE pada babi sebagai reservoir utama. Penelitian dilakukan di 12 provinsi yang meliputi 15 kabupaten/kota pada tahun 2012. Jumlah seluruh babi yang diperiksa adalah 726 ekor yang terdiri dari 59-62 ekor di tiap provinsi. Darah vena diambil dari tiap ekor babi dan diperiksa dengan Enzyme Link Immuno-Sorbent Assay (ELISA). Jenis kelamin, umur dan lingkungan peternakan babi juga dicatat. Hasil menunjukkan bahwa prevalensi JE pada seluruh babi adalah 14,2% (103 ekor) yang berkisar antara 1,7% (1/60) di Provinsi Kalimantan Tengah dan 32,3% (20/62) di Provinsi Sulawesi Tengah. Kisaran angka infeksi menurut kabupaten/kota adalah antara 0% (0/19) di Palangkaraya (Kalimantan Tengah) dan 33,3% (2/6) di Batanghari(Lampung). Jenis kelamin dan umur babi tidak berhubungan secara signifikan dengan besarnya angka infeksi JE pada babi. Angka infeksi pada babi berbeda bermakna menurut lingkungan, dimana angka infeksi tertinggi adalah di sekitar danau/setu dan terendah di sekitar pantai. Disimpulkan bahwa babi di 12 provinsi tersebut potensial sebagai sumber infeksi JE ke manusia. Sebab itu perlu dilakukan advokasi tentang ancaman penularan JE tersebut ke pemerintah daerah dan masyarakat di sekitar peternakan babi di daerah penelitian, kecuali di Palangkaraya.

Japanese Encephalitis (JE) cases in humans in Indonesia have been found in several provinces. This study aims to determine the infection rates of JE in pigs as the main reservoir. The study was conducted in 12 provinces covering 15 districts/cities in 2012. The total number of pigs examined was 726, which ranged from 59-62 in each province. Venous blood was taken from each pig and examined by Enzyme Link Immuno-Sorbent Assay (ELISA). Sex, age and pig farm environment were also recorded. The results showed that the JE infection rates in overall pig samples was 14.2% (103/726) which ranged from 1.7% (1/60) in Central Kalimantan Province to 32.3% (20/62) in Central Sulawesi Province. The range of JE infection rates by district/city was between 0% (0/19) in Palangkaraya (Central Kalimantan) and 33.3% (2/6) in Batanghari (Lampung). Sex and age of the pig were not significantly associated with infection rates in pigs. Infection rates in pigs was significantly different according to environment, where the highest infection rates was in around the lake and the lowest infection rates was in around the coast. In conclusion, the pigs in 12 provinces were potential as a source of JE infection to humans. So, the advocation of the JE transmission threat is needed to local administration and people around the pig farms in the study area, except in Palangkaraya.

To the Editor: Chikungunya virus (CHIKV) is a single-stranded, positive-sense RNA virus of ≈11.8 kb molecules (1) belonging to the family Togaviridae and genus Alphavirus. Genotypes of CHIKV include Asian, East/Central/South African (ECSA), and West African. CHIKV is endemic to Africa, southern Asia, and Southeast Asia and frequently causes debilitating but nonfatal illness.

Chikungunya is a re-emerging disease that caused byalphavirus family Togaviridae. Chikungunya also can often caused outbreak in Asia, including Indonesia. Disease characterized by fever accompanied by pain in the joints of the dominant. Chikungunya virus is transmitted by mosquitoes, especially Aedes aegypti, A. Albopictus and Mansoniasp. This study was conducted to identify significant clinical symptoms of chikungunya virus infection. Sampling was carried from Chikungunya outbreak area. Suspected Chikungunya are interviewed and taken blood. Specimens were examined using reverse transcription - polymerase chain reactions (RT-PCR). Interviews were conducted on111suspectedchikungunya from 6 provinces.Clinical symptoms analisys was performed from 28 confirm chikungunya cases based on laboratory result. Chikungunyashowedmore onthe malesex, and the productive age group (64.3%). The most joint pain symptom reported is wristand knee joints (92.9%), followed by the ankle joint (75%) and finger joints (64.3%). Othernon-specific clinical symptomssuch asheadaches(78.6%), decreased appetite(71.4%), nausea/vomiting(60.7%), feverwith chills(55%), and abdominal pain andvisual impairment(25 and17.9% ). Laboratory results showed 28 positive specimen for Chikungunya.Chikungunya is more common in males and productive age groups, with the joint pain symptoms especially knee and wrist joints followed by non -specific symptoms such as headache, decreased appetite and also nausea/vomiting. Key words : Chikungunya, Outbreak, Clinical symptoms, Indonesia. Abstrak Chikungunya disebabkan alphavirus famili Togaviridae, merupakan penyakit re-emerging yang sering menyebabkan kejadian luar biasa (KLB) di kawasan Asia termasuk Indonesia, ditandai dengan demam disertai nyeri pada sendi yang dominan. Virus chikungunya ditularkan oleh nyamuk terutama Aedes aegypti, A. albopictus dan Mansonia sp. Penelitian ini dilakukan bertujuan melihat gejala klinis pada infeksi virus chikungunya. Pengambilan sampel dilakukan di daerah yang melaporkan Kejadian Luar Biasa chikungunya. Suspek Chikungunya diwawancara dan diambil darahnya. Spesimen tersebut diperiksa menggunakan reverse transcription-polymerase chain reactions (RT-PCR).Wawancara dilakukan pada 111 suspek chikungunya yang tersebar pada 6 Propinsi. Analisis gejala klinis dilakukan pada 28 orang kasus terkonfirmasi dengan hasil laboratorium positif. Hasil menunjukkan penyakit chikungunya lebih banyak pada laki-laki, dan kelompok usia produktif (64.3 %). Keluhan nyeri sendi yang paling banyak dialami adalah keluhan pada sendi pergelangan tangan dan sendi lutut (92.9%), diikuti dengan sendi pergelangan kaki (75%) dan sendi jari tangan (64.3%).Gejala klinis non spesifik lain juga dikeluhkan seperti sakit kepala (78.6%), nafsu makan menurun (71.4%), mual/muntah (60.7%), demam disertai menggigil (55%), sakit perut dan dan gangguan penglihatan (25 dan 17.9%).Penyakit chikungunyalebih banyak menyerang laki-laki dan kelompok usia produktif, dengan keluhan yang utama adalahnyeri sendi, terutama sendi lutut dan pergelangan tangan dikuti dengan gejala non spesifik seperti sakit kepala, nafsu makan menurun dan mual/muntah. Kata Kunci : Chikungunya, Wabah, Gejala klinis, Indonesia

Objectives: The study aimed to assess outcome, including level of disability, following Japanese encephalitis (JE) in children in Indonesia.Methods: A cohort of children diagnosed with laboratory-confirmed JE from January 2005 to August 2006 was followed-up, with disability measured at least 4 months after discharge from hospital. An assessment tool that can be used to rapidly determine practical level of disability and the likelihood that a child will be able to live independently after illness, the Liverpool Outcome Score, was used.Results: Of 72 children with JE, determination of outcome was possible for 65 (90%). Sixteen died in hospital or before follow-up assessment (25%). Sixteen children (25%) had severe sequelae, indicating their function was impaired enough to likely make them dependent. Five (7%) had moderate sequelae and 12 (18%) had minor sequelae. The remaining 16 children (25%) were considered to have recovered fully.Conclusions: Half of the children with JE either died or were left with serious disabilities likely to impair their ability to lead independent lives, demonstrating the severe impact of JE. Immunization can effectively prevent JE, and an immunization program could avert some of the economic and social burden of JE disease in Indonesia. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Japanese encephalitis (JE) results in significant mortality and disability in children in Asia. In Indonesia, despite recognition of JE virus transmission, reports of human disease have been few and from limited geographic areas. Hospital-based surveillance for acute encephalitis syndrome (AES) and JE in children 15 years of age and under was undertaken in 15 hospitals in six provinces from 2005 to 2006. High- and low-risk provinces in geographically dispersed areas were included. Health center-based surveillance also was undertaken in one province. Eighty-two JE cases were confirmed among 1,496 AES cases detected. JE cases were confirmed in all provinces, but the proportion varied between 18% and 2% among provinces of different risk levels. Children younger than 10 years of age represented 95% of JE cases, and 47% of all cases either died or were disabled. The study shows JE is an endemic human disease across Indonesia. Immunization strategies are being considered.