Pengobatan Malaria di Perkotaan dan Pedesaan di Indonesia (Analisis Lanjut Riskesdas 2013)

Malaria control in Indonesia still against many challenges, especially in terms of malaria treatment. One of the causes of low coverage of Artemisin Based Combination Therapy (ACT) is that several locations are no longer malaria endemic, being negligent with malaria cases coming from endemic areas, so that patients are not immediately diagnosed as malaria patients. The purpose of this further analysis was to describe malaria treatment based on Plasmodium species associated with access, time, and administration of ACT treatment between urban and rural areas. The method used is descriptive analysis of secondary data from Basic Health Research in 2013 as many as 1,027,763 people by taking the unit of analysis of individuals who have been diagnosed with malaria by health personnel and individuals whose blood test results are positive for malaria. The results of the analysis provide information that in urban and rural areas, the treatment of P. falciparum and P. vivax is classified as good, namely the majority received ACT treatment, the time to receive ACT treatment was within the first 24 hours, and ACT treatment was given within 3 days of being drunk. However, it was found that in rural areas, P. vivax treatment was still not good because the majority did not receive ACT treatment. The implementation of malaria control in areas that are easily accessible and well-targeted are groups that can afford the costs involved in accessing targeted interventions by public subsidized programs. This encourages all regions to have good health services that provide better access to malaria control interventions.

Deteksi Gen Kdr pada Nyamuk Anopheles di Kabupaten Maluku Tenggara Barat

Malaria is still a health problem in Indonesia, particularly in Eastern part of Indonesia. The use of LLIN insecticide bed nets is one of the efforts to reduce the malaria morbidity rate by protecting human from malaria vector bites. The Anopheles flavirostris, Anopheles barbirostris, and Anopheles subpictus mosquitoes are three of the species reported as malaria vectors in West-Southeast Maluku Regency. The aim of this research was to detect the kdr gene in An. flavirostris, An. barbirostris, and An.subpictus mosquitoes collected from Alusi Kelaan village, West-Southeast Maluku Regency. The research was conducted at the Papua Biomedical Research and Development Center, in June 2016. A total of six An. flavirostris, 42 An. barbirostris, and 24 An. subpictus were pooled separately for genomic DNA extraction. The sample used was the An. flavirostris, An. barbirostris, and An. subpictus that survived after the impregnated paper test. The kdr gene detection was carried out using quantitative PCR (qPCR) focused on points V1010 and L1014. The results showed that there were no kdr mutant strains in the An. flavirostris, An. barbirostris, and An. subpictus. These results indicated that the sensitivity of pyrethroid insecticides contained in LLIN mosquito nets to An. flavirostris, An. barbirostris, and An. subpictus mosquitoes was not decreased in West Southeast Maluku Regency.

Optimasi Analisis Melting Curve untuk Skrining Cepat dan Sensitif Mutasi V1016G pada Aedes aegypti Resisten Sintetik Piretroid dengan Reaksi Rantai Polimerase Spesifik Alel

Detection of V1016G mutation is important for identifying the mechanism of synthetic pyrethroid resistance in Aedes aegypti population. The previous method has described an allele specific polymerase chain reaction (AS-PCR) using conventional PCR to detect the mutation. Although the method has great differentiating power and reproducibility, faster and more sensitive genotyping method is essential to accurately detect the mutation. This study evaluate the used of SYBR® Green real-time PCR and melting curve analysis (MCA) to identify the V1016G mutation. The collection of homozygous 1016G, heterozygous, and wild type (1016 V) mosquitoes DNA genome was extracted using genomic DNA mini kit. The SsoAdvanced™ Universal SYBR® Green Supermix was used to identify alleles by real-time PCR followed melting curve analysis of the amplicons. Melting curve analysis produced reproducible results for the loci tested. The melting temperature was reached at 78.5 oC for homozygous 1016G mosquito and at 86 oC for wild type mosquito. Meanwhile, the heterozigous mosquito revealed two peaks of melting temperature at both 78.5 oC and 86 oC. These easily interpretable and distinguishable melting curve results were consistent with AS-PCR results obtained for the same alleles. The described MCA application for screening V1016G mutation is fast and widely accessible also could be implemented under field conditions

Kajian Entomologi dalam Mendukung Pengendalian Malaria melalui Program Flying Health Care (FHC) di Kabupaten Yahukimo, Provinsi Papua

Flying Health Care is one of the programs of the Ministry of Health to accelerate the elimination of malaria in an integrated manner, especially in the Yahukimo Regency. The purpose of this activity is to describe the role of entomological aspects in malaria control efforts. The data includes cases of malaria, mosquitoes and Anopheles larvae, breeding place, and vector control efforts. Data was collected by observation, survey, and secondary data analysis. The results of the study show that malaria cases rank first out of 10 diseases in health facilities. Malaria cases were more common occurred at the age of 10-19 years, male and near to health facilities. Breeding places in the form of swamps and puddles in the environment around patients with water depths ranging from 5-30 cm. There is no entomological data at the district level or at Puskesmas Aplim. Ongoing vector control efforts are in the form of distributing insecticide-treated mosquito nets. Insecticide mosquito nets have not been fully distributed to the community, this is constrained by the existing infrastructure in health care facilities. Vector control efforts should be supported by the results of entomological surveys and it is important to do socialization on how to use and maintain mosquito nets at the time of mosquito net distribution.

Uji Diagnostik Filariasis Menggunakan Rapid Diagnostic Test (RDT) Brugia malayi terhadap Pemeriksaan Mikroskopis di Desa Buntoi Kabupaten Gunung Mas, Provinsi Kalimantan Tengah

Gunung Mas Regency, Central Kalimantan Province is one of the endemic filariasis areas with Microfilaria rate of 3.4%. One of the efforts made to control this problem is Mass Drug Administration once a year for 5 years. Currently, the Rapid Diagnostic Test (RDT) method is being developed, a quick and easy diagnostic technique to detect the presence of parasites in the patient's body. This study aims to determine the results of the filariasis diagnostic test using the Brugia malayi RDT on the microscopic examination in Buntoi Village, Gunung Mas Regency, Central Kalimantan Province. This research is a descriptive study with a cross-sectional approach with the research subjects all residents of Buntoi Village with inclusion and exclusion criteria totaling 161 samples. Collecting data was carried out by examination and interviews with questionnaires. Data analysis by calculating the microfilaria rate, sensitivity and specificity and calculating the frequency distribution of research variables. Data is presented in percentage form and displayed in tabular form. The results of the diagnostic study of B. malayi RDT and the microscopic examination were the same, i.e all were negative and no microfilariae were found. The diagnostic test for filariasis RDT Brugia malayi on microscopic examination (SDJ) obtained 0% sensitivity, 100% specificity, 0% Positive Predictive Value and 100% Negative Predictive Value. The level of public knowledge about filariasis includes 61% good category, knowledge of MDA 40% good category and knowledge about prevention of filariasis in good category 53%.

Deteksi Endoparasit Cacing pada Hepar Tikus Laboratorium (Rattus norvegicus) dari Sentra Peternak di Kabupaten Banyumas dan Kabupaten Purbalingga

The presence of laboratory rats that are maintained and bred for laboratory purposes or laboratory observations is very necessary. The presence of endoparasite in laboratory rats will have an impact on the result of the research or laboratory observations. This study aims to detect helminth endoparasites in the liver of laboratory rats (Rattus norvegicus) from animal breeders in Banyumas and Purbalingga Districts. This research was an observational study with a cross-sectional design. A total of 52 laboratory rats were used in the study. Rats are killed with chloroform, liver surgery then identify the presence of worm larvae. Out of the 52 rats obtained, 7 (29.17%) from 24 laboratory rats in Banyumas District and 5 (17.86%) from 28 laboratory rats in Purbalingga District were infected with Taenia taeniaeformis. It is necessary to control helminth infections in laboratory rats, such as laboratory animal quarantine, health monitoring, and antihelmintic treatment. It is important to handle carefully during travel to assure the results of research or laboratory observations using the animals.

Gambaran Epidemiologi Peningkatan Kasus Chikungunya di Desa Kajongan Kecamatan Bojongsari Kabupaten Purbalingga

Purbalingga is one of the chikungunya endemic districts which have cases increased until April in 2021 as many as 512 cases from the previous 116 cases in 2020. One of the areas of the increasing case occurred in Kajongan Village, Bojongsari Subdistrict. This study aims were to describe chikungunya cases, identify sources of transmission, and risk factors for increased chikungunya cases. A case-control design was performed in Kajongan Village in March 2021. The sample consisted of 36 cases and 36 controls. Cases are patients with suspected chikungunya, controls are people who are not chikungunya suspects who live close to the suspected case. Data was collected by blood specimen collection, larvae survey, interviews and examination using Reverse Transcriptase-Polymerase Chain Reaction. The results showed that the peak of case transmission occurred in the fourth week of February 2021. The main symptoms are fever and joint pain. Of the 21 blood samples examined, 19 (90.5%) tested positive for Chikungunya virus. Of the 9 pools Aedes sp. analyzed, 1 pool tested also positive Chikungunya virus. Chi-square analysis showed that the presence of larvae in container (p-value=0.03; OR=3.5; 95% CI=0.953-24.746) and mosquito nest eradication has not carried out routinely (p-value=0.04; OR=4.8; 95% CI=0.953-24.746) have been identified as a potential risk factor. The increasing of chikungunya cases in Kajongan Village was a local transmission supported by Chikungunya virus was detected in mosquitoes.

Prevalensi Wuchereria bancrofti Paska Pemberian Obat Pencegahan Massal Filariasis Limfatik di Wilayah Endemis Rendah Kota Pekalongan

Pekalongan district has completed mass drug administration (MDA) of lymphatic filariasis (LF) for two rounds but still remains positive for microfilariae (Mf rate) > 1%. This study aimed was to assess the prevalence of Wuchereria bancrofti and its association with sociodemographic among the adult community to the incidence of lymphatic filariasis. This study is an analytic study with a cross-sectional design. The prevalence of W. bancrofti was detected by the presence of circulating filarial antigen (CFA) using a filarial test strip (FTS). The study population consisted of an adult group living in ten villages in the Pekalongan district's low-endemic region, with 1804 samples collected from 72 clusters. Statistical analysis was performed to test the difference between variables. There were 13 (0.72%) positive W. bancrofti antigen samples out of 1804 total samples. Males were found to be infected at a higher rate than females (61.5%). The age of subjects infected with W. bancrofti was dominated in the range of 13-50 years as many as 9 people (69.2%). The proportion of positive CFA in Medono village with the highest proportion was 6 people (2.7%). There was no statistically significant difference between gender and age with LF cases, but it is significantly different by sub-district (p-value = 0.041). LF transmission occurred in border areas between high and low endemic LF areas. MDA implementation must be constantly supervised in required to address the elimination target.

Dampak Trichinella sp. dalam Daging Babi Terhadap Kesehatan Masyarakat

Trichinellosis/Trichinosis is one of the most common zoonotic parasites in the world caused by infection with Trichinella nematodes. The infection occurs after the larvae have been eaten in the muscles of the infected animal. Due to its spread and spread, several outbreaks of trichinosis have occurred around the world, which has caused serious public health problems. The main risk factor for trichinosis is the consumption of raw or undercooked meat from pigs and hunted meat. In the first stage of infection, adults nematode in the intestine can cause transient gastroenteritis, but the most serious symptoms are associated with the larval formation and muscle migration. a study conducted in India to investigate at the clinical and biochemical profile of Trichinella infection stated that clinical symptoms first appeared at 2-3 weeks after consuming pork and the symptoms would gradually disappear at 4-5 weeks, but there were also some who experienced myalgia. Supervision and implementing proper biosecurity in livestock areas by monitoring and surveillance of the risk of Trichinella infection in pig products and their derivatives as well as preventing transmission to humans.

Eliminasi Endosimbion Wolbachia sp. pada Nyamuk Aedes albopictus dengan Antibiotik Tetrasiklin

Dengue Hemorrhagic Fever (DHF) is a disease caused by the dengue virus which is transmitted through the bite of the Aedes mosquito. Aedes aegypti, which is known as the primary vector of dengue virus, is naturally not infected by Wolbachia sp. endosymbiont, while Ae. albopictus which is a secondary vector naturally infected with Wolbachia sp. The Wolbachia sp. known to inhibit the transmission of Dengue virus, to study the mechanism, it is necessary to eliminate Wolbachia sp. from Ae. albopictus, then infects the Ae. albopictus with the Dengue virus. The aim of the study was to determine the ability of tetracycline antibiotics to eliminate Wolbachia sp. from the Ae. albopictus mosquito. Ae. albopictus eggs was obtained in the Ciamis area by survey method using ovitrap which was installed outside the house. The Ae. albopictus eggs are then incubated in the laboratory and reared until they become adult mosquitoes. Mosquitoes were treated with sugar feeding which had been given tetracycline 0.25mg/ml every two days alternated with blood feed. Detection of the presence of Wolbachia sp. on mosquitoes carried out in first to third generations by the polymerase chain reaction (PCR) method using Wsp-specific primers. The results showed that the first to third generation mosquitoes were still infected with Wolbachia sp. This shows that the dose of tetracycline antibiotics used has not been able to eliminate Wolbachia sp. from the Ae. albopictus mosquito.