Indonesian Journal of Tropical and Infectious Disease

Role of Clinical Features and GeneXpert MTB/RIF Assay in Diagnosing Tuberculosis Among Toddler Patients in Surabaya

2024-12-11T10:41:16+07:00

Tuberculosis (TB) is a leading cause of global morbidity and mortality, mainly in the age of 0-5 years old (toddlers). Several risk factors make toddlers more prone to TB infection. Although it commonly depends on clinical evidence, diagnosis of toddler TB can be done using microbiological confirmation like GeneXpert MTB/RIF Assay. However, this is still challenging to perform due to the low bacterial loads and difficulties in obtaining specimens. While prior studies focused more on the clinical aspects, this study will determine both the clinical and microbiological profiles of toddler TB patients at Dr. Soetomo General Academic Hospital Surabaya. This study was conducted using a retrospective approach. Samples were obtained using a total sampling technique from electronic medical records from January 2018 to September 2023. Variables collected include age, gender, type of TB, BCG vaccination status, history of household contact, nutritional status, symptoms, and GeneXpert MTB/RIF examination specimens and results. Among 125 toddler TB patients, the majority being female (57%), between the ages of 1–2 (45%), had BCG vaccination (86%), and without a history of household contact (63%). Most of the samples were malnourished (56%) and had cough as the symptom (62%). In GeneXpert MTB/RIF examination, gastric aspirate was the most collected specimen (52%) and the most common result found was negative (70%). In addition, two toddler patients were found to have DR-TB. In conclusion, while GeneXpert MTB/RIF assay predominantly resulted in negative, clinical features become the essential evidence to establish a diagnosis of tuberculosis among toddler patients.

Fungemia in Tertiary Hospitals; An Overview Fungal Profile, Antifungal Resistance, and Antifungal Therapy

2024-12-13T08:02:04+07:00

Fungemia is a bloodstream infection caused by fungal pathogen and commonly occurs in hospitalized patients with certain risk factors. Indonesia itself is a tropical country with middle income that makes the incidence rate of fungemia tend to be higher, namely10/1 0,000 people. A recent study about candidemia conducted in Dr. Soetomo General Academic Hospital stated that the most common species that caused candidemia is Candida albicans (33.96%) and the blood sample mostly collected from patients from high care unit and patient with diabetes. We conducted this study to provide a new overview of data on the profile of the causes of fungal infections, patterns of fungal resistance to antifungals, and antifungal therapy in patients with fungemia in hospitalized patients at Dr. Soetomo General Academic Hospital, Surabaya, for the period of January December 2023. This research is a descriptive study using the patient’s medical records. Variables observed in this study include; gender, age, care unit, risk factor, species distribution, resistance pattern, type of antifungal therapy, and duration of antifungal therapy. Mostly the blood cultures are collected from female patients aged 0-9 years old. This study also found that most blood cultures are collected from patients in intensive care unit with use of CVC. Most of the patients did not receive antifungal therapy The most frequent found species is Candida parapsilosis with highest resistance rate found in Amphotericin-B. The most common antifungal that is used is Fluconazole which is mostly given within the range of 8-14 days .

Clinical Patterns and Demographic Characteristics of Dermatophytosis in Surabaya

2024-12-13T08:10:03+07:00

Dermatophytosis, the most common fungal infection in humans, significantly impacts quality of life due to its clinical and cosmetic effects. Its high prevalence underscores the need to evaluate patient profiles to improve management strategies. This study aim is to identify the most prevalent type of dermatophytosis, patient demographics, clinical characteristics, laboratory investigations, and therapy in dermatophytosis into the clinical and epidemiological characteristics of dermatophytosis in a tropical, high-burden region. This descriptive retrospective study used total sampling of medical records of dermatophytosis patients from January 2017 to December 2022. Tinea corporis and tinea cruris was the most common, while tinea manuum is the least common dermatophytosis. Female adults were the most affected group. Common clinical features for each type included alopecia for tinea capitis, erythematous macules for other types, and nail dystrophy for tinea unguium. Trichophyton mentagrophytes was the commonest pathogen in 2017. Most of the therapies followed Clinical Practice Guidelines with extensive use of griseofulvin and ketoconazole cream. Further research should explore therapeutic outcomes, preventive measures, and factors influencing recurrence and adherence to treatment.

In Vitro Analysis of SARS-CoV-2 Variants that Caused Severe COVID-19 in the Elderly

2025-01-24T13:10:09+07:00

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the global problem of respiratory disease from 2019 to 2024. One of the earliest variations in the SARS-CoV-2 S protein was the S D614G mutation. SARS-CoV-2 has several important variants, namely, Alpha, Beta, Gamma, Delta, and Omicron. Omicron is the variant that has caused severe health problems, some
resulting in death, in the elderly. Omicron has further differentiated to some wellknown variants, such as, BA.1, BA.2, BA.2.75, BA.5, BQ.1.1, and XBB.1. According to Japanese Government data, the number of citizens aged 65 years old and above reached 28.9% in 2021. From our previous experiment, antibodies of the elderly that have received four doses of mRNA vaccine still could not optimally neutralize Omicron BQ.1.1 and XBB.1. We aimed to analyze the plaque size of SARS-CoV-2 variants that caused severe COVID-19 in the elderly. SARS-CoV-2 variants were seeded in Vero E6-TMPRSS2 cell culture to create plaques. The resulting plaques were analyzed with ImageJ application to select solitary plaques and to determine plaque sizes. The size of BA.1 plaque was indifferent to BA.2 plaque. The plaque area comparison result was as follows, BA.1/BA.2<BA.5<BA.2.75<BQ.1.1<XBB.1. The plaque sizes of Omicron BQ.1.1 and XBB.1 were bigger that those of Omicron BA.1 and BA.2. The plaque sizes of all Omicron variants were smaller than those of the previous
variants, S D614G and Delta. The result of this in vitro experiment inferred that there is increase in fusogenicity of BQ.1.1 and XBB.1, when compared with BA.1 and BA.2.

Profile of Nontuberculous Mycobacteria and Mycobacterium tuberculosis Detected in the Sputum of Pulmonary Tuberculosis Re-treatment Patients at Dr. Soetomo General Hospital

2024-12-11T14:40:08+07:00

Tuberculosis (TB) remains one of the leading infectious diseases worldwide. Despite global efforts to control TB, it remains a major public health issue, affecting 10.6 million people annually in 2021, with significant morbidity and mortality, particularly in resource-limited settings. Effective treatment of TB requires strict adherence to long-term medication, but challenges such as treatment failure, relapse, and loss to follow-up complicate outcomes. This is especially concerning for patients with comorbidities such as diabetes, HIV, or hypertension, which not only increase the risk of TB but also hinder its treatment and elevate the likelihood of nontuberculous mycobacteria (NTM) infections. This study aimed to analyze 326 pulmonary TB retreatment cases at Dr. Soetomo General Academic Hospital from October 2023 to April 2024. The retrospective design identified that 323 cases involved MTB and 3 involved NTM. The findings show that loss to follow-up was the most common reason for retreatment, particularly among males and older adults. Comorbidities were found to exacerbate treatment challenges, with some retreatment cases lasting up to 24 months. The study concludes that loss to follow-up remains a major risk factor for TB retreatment, particularly in MTB cases, and highlights the importance of managing comorbidities to improve treatment outcomes.

Correlation Between Complete Blood Count Parameters with Procalcitonin in Immunogenomic Phases of COVID-19 Patients

2025-01-17T10:06:42+07:00

Coronavirus Disease 2019 (COVID-19), a global pandemic caused by SARSCoV-2, presents varying degrees of severity influenced by different immunogenomic phase. The immunogenomic phase that occurs in patients with COVID-19 is divided into three phases, namely the initial phase, propagating phase, and complicating phase. Severity disease progression can be monitored from the results of complete blood count (CBC) parameters and several inflammatory parameters such as procalcitonin. The purpose of this study was to investigate, during the immunogenomic phase of COVID-19 patients, the correlation between PCT levels and full blood count parameters. Patients treated at Dr. Soetomo General Hospital for COVID-19 were the subjects of this crosssectional study. Data analysis used in this study is Kolmogorov-Smirnov Test for normality, followed by Wilcoxon signed-rank test and bivariate Pearson correlation test to determine the correlation between complete blood count (CBC) parameters and PCT. Our findings reveal that most patients are male, predominantly aged between 50 and 60 years. Distinct variation of CBC parameters and PCT levels were observed in each phase. A significant relationship between these hematological markers, the immunogenomic phase and the progression of the disease. The PCT level of COVID-19 patients was associated with parameters of red blood cells, including hemoglobin, hematocrit, and the width-standard deviation of red blood cell distribution, leukocytes and their differential count, including lymphocytes and neutrophils, and platelets.. This analysis further understanding regarding the hematological dynamics in COVID-19 patients, providing important information about the pathophysiology of the disease and potential biomarkers for monitoring its progression.

Red Laser-Activated Silver Nanoparticles from Green Synthesis Extract of Butterfly Pea for Antimicrobial Photodynamic Therapy Against Staphylococcus aureus

2024-10-11T20:39:28+07:00

This study investigated the potential of photodynamic therapy (PDT) using green-synthesized silver nanoparticles (AgNPs) derived from butterfly pea extract (Clitoria ternatea L.) to combat Staphylococcus aureus (S. aureus). The use of a red diode laser as a method for enhancing the antimicrobial activity of AgNPs presents a novel approach to treating bacterial infections. The red diode laser is crucial, as it activates the AgNPs, enhancing their antimicrobial properties. This combination of light, natural extract, and nanoparticles underscores the innovative approach of using PDT in treating bacterial infections. By integrating these elements, the study aims to provide insights into effective, biocompatible treatments for antibiotic-resistant bacteria. The primary objective of this study is to synthesize and characterize AgNPs using butterfly pea extract and evaluate their effectiveness against S. aureus when combined with red laser irradiation. Silver nanoparticles were synthesized using an environmentally friendly method that processes butterfly pea extract as the reducing agent for the synthesis of the nanoparticles. Using UV-Vis spectrophotometry to track the creation of silver nanoparticles (AgNPs), it was determined that the butterfly pea extract was an effective source of nanoparticles. The particle size distribution and peak absorbance wavelength were determined by characterization utilizing a Particle Size Analyzer (PSA). Tryptic soy agar (TSA) plates were used to investigate the antibacterial activity of AgNPs against Staphylococcus aureus (S. aureus). The effectiveness of photoinactivation against S. aureus was evaluated by exposing AgNPs at a concentration of 1 mM to a red diode laser for 90 seconds. The results showed that the produced AgNPs had potential antibacterial capabilities when combined with red light therapy. The results demonstrated that the synthesized silver nanoparticles can effectively kill or inhibit the growth of Staphylococcus aureus (S. aureus) when exposed to a red diode laser for 90 seconds. The findings suggest that photodynamic therapy using green-synthesized AgNPs and red laser irradiation could be a promising approach to controlling bacterial infections like S. aureus. Further research is recommended to explore the underlying mechanisms of photoinactivation and to optimize treatment parameters for in vivo applications on experimental animals.

Association between Hair Hygiene and Pediculus capitis Infestation among Elementary School Students in Sukorambi District, Jember Regency

2024-11-05T13:40:35+07:00

Pediculus humanus capitis (P.h. capitis) is an ectoparasite which inhabits hair and scalp of human, causing a neglected disease called Pediculus humanus capitis infestation or pediculosis capitis. This disease, easily transmitted between people directly or indirect, often affects girls around 3–12 years old in tropical countries with high humidity. This can be avoided with applying personal hygiene focused on hair area (hair hygiene). Hair hygiene in this study was divided into several parameters, such as frequency of hair washing, shampoo usage, hair drying, towel sharing habit, comb and hair accessories sharing habit, head cover sharing habit, and close contact with an infested person. The aim of this study is not only to know the prevalence of P. h. capitis infestation, but also to determine the correlation between hair hygiene and P. h. capitis infestation among elementary school students in Sukorambi District, Jember Regency. This study was held around January to February 2024 using cross-sectional approach with total 83 respondents. Respondents were given several questions about parameters of hair hygiene and their hair was examined using lice comb to find P. h. capitis. Prevalence of Pediculosis capitis infestation among elementary school students in Sukorambi District reached 71.1%. Statistical analysis showed that towel sharing habit and comb and other hair accessories sharing habit had a significant relationship with P. h. capitis infestation (p-value <0.05). Multivariate analysis using logistic regression showed that comb and other hair accessories sharing habit were the most significant hair hygiene parameters.

Diagnosis Approach of Endobronchial Tuberculosis: Literature Review

2024-07-15T06:28:12+07:00

Pulmonary tuberculosis (PTB) remains a global health problem and the leading cause of death from infectious diseases. Indonesia as an endemic country and the second highest contributor of PTB cases in the world provides support and attention to PTB case finding and treatment success. Endobronchial tuberculosis (EBTB) is problematic PTB because the lesions are often not detected by sputum examination and chest X-ray. Clinically, there is no significant difference in symptoms between TB and EBTB. In general, EBTB gives a more severe clinical appearance due to airway stenosis. Bronchoscopy and thoracic computed tomography scan (CT scan), along with microbiological investigations, are the most useful diagnostic tools for confirming and evaluating tracheobronchial stenosis. In addition, bronchoscopy can also be used as a longterm treatment in cases of EBTB due to airway stenosis. The goals of treatment are the eradication of Mycobacterium tuberculosis (Mtb) bacilli with antituberculosis drugs (ATD) and the prevention of airway stenosis. Intervention of bronchoscopic techniques and surgery are required for those patients who develop severe tracheobronchial stenosis that causes significant symptoms, including dyspnea, repeated post-obstructive pneumonia or bronchiectasis. The most common complications of EBTB are airway stenosis, atelectasis, hemoptysis and shortness of breath accompanied by wheezing despite the administration of ATD. Bronchoscopic intervention can support the acceleration of EBTB treatment, prevent repeated hospitalizations and improve the quality of life of patients. Acceleration of diagnosis and administration of ATDs in a complete and routine way is expected to reduce morbidity and even mortality rates in EBTB cases.

Factors Analysis That Affecting The Treatment Success In Tb Patients In Situbondo Regency

2025-01-17T09:37:10+07:00

Tuberculosis (TB) remains one of the top 10 lethal infectious diseases). In addition, the low case detection rate indicates that the community still has a large number of sources of transmission. Directly Observed Treatment Short-course (DOTS) strategy aims to reduce the new TB cases number by 80% and deaths by up to 90% in 2030. Drug-resistant TB cases especially multidrug resistant TB, exacerbate tuberculosis control because they receive TB treatment irregularly and do not comply to recommended treatment schedules, nonetheless, consistent treatment is critical to successful TB treatment. TB data in Situbondo district show that case detection was 911 out of 1539 cases or 59.14% and treatment success rate was 275 out of 911 cases or 30.2%. This study aims to examine the influence of knowledge, medication supervisors, family support, drug side effects, attitudes, length of treatment, and house physical environment on the treatment success through medication compliance factors. This research is explanatory with 196 respondents while the analysis uses SMART PLS 4.1.0.3. There is a direct influence of medication supervisors, family support, drug side effects, house physical environment and medication compliance and an indirect influence of medication supervisors, family support, drug side effects, and attitudes to TB treatment success. It is hoped that Public Health Centre officers can be more active to educate, detect TB suspect, and also supervise patient so compliance and treatment can be achieved. The patient's family can be more active in providing support during the treatment period for TB sufferers.