Indonesian Journal of Tropical and Infectious Disease

Correlation Between MTB/RIF Gene Xpert Cycle Threshold Values and Clinical Radiological Severity of Pulmonary Tuberculosis

Rachmi Merrina — 2024-08-30

The determination of bacterial load was essential for assessing disease severity, transmission rate, and prognosis. Gene Xpert is a diagnostic test that provides Cycle Threshold (Ct) value as a potential measure of Mycobacterium Tuberculosis (Mtb) load. Despite its potential, there are limited reports exploring the relationship between Ct value and clinicoradiological severity. This study aimed to correlate Ct value and clinicoradiological severity of pulmonary tuberculosis (TB). The study was a retrospective design using medical record data of confirmed TB patients from January to December 2022. These patients were identified based on Gene Xpert test and classified as high, moderate, or low detection Mtb when Ct value was <16, 16-22, and 22-28, respectively. In assessing the severity of clinical using the Bandim score, thoracic TB lesions was categorized by Chest XRay into minimal, moderate, and advanced. The total of 90 TB patients and the majority were males (78.9%) aged 46-65 years (59.0%), with comorbidities (95.0%). The most of the participants had mild clinical severity (44.4%), with Ct value of 16-22 (52.2%), and moderate lesions (35.6%). The most common lesions were fibroinfiltrates on the chest X-ray (61.1%). The Ct value of <16 had a significant correlation with clinical severity of TB (p<0.05) but no significant association with advanced lesions (p>0.05). Based on the results, Ct value had a strong correlation with clinical severity in pulmonary TB. In addition, it could be used as a predictor for managing pulmonary TB patients and an important indicator for control programs.

Efficacy of Shampoo Made from Bangle Rhizome Extract (Zingiber montanum) Against Head Lice (Pediculus humanus capitis)

Rina Priastini Susilowati — 2024-08-30

Head lice is a major public health problem worldwide. Its treatment is challenging due to product failures resulting from rapidly emerging resistance to existing treatments, incorrect treatment application, and misdiagnosis. Various head lice treatments with different mechanisms of action have been developed and explored over the years, with limited reports on systematic assessments of their efficacy and safety. The head lice shampoo currently in circulation is 1% permethrin-based. Side effects of using permethrin-based shampoos include skin irritation and high resistance. The research conducted aims to present strong evidence that the use of shampoo made from bangle rhizome extract against head lice mortality is safer to use. The study used 240 head lice taken from elementary school students aged 8-12 years in a school in Bekasi. The study group was divided into 6 groups: negative control group (using baby shampoo), positive control group (using permethrin-based anti-lice shampoo), shampoo treatment group made from bangle rhizome extract with dose of 0.5%, 1%, 2% and 4%. In addition to calculating the number of head lice deaths per group, the time of death was also calculated to determine LC₅₀ (Lethal Concentration 50), LC₉₀(Lethal Concentration 90), LT₅₀ (Lethal Time 50), and LT₉₀ (Lethal Time 90). The results showed a highly significant difference between the number of head lice deaths in the control group and the shampoo treatment group made from bangle rhizome extract (p<0.01). Likewise, there was a highly significant difference for the time of death of head lice in the control group and the shampoo treatment group made from bangle rhizome extract. Statistical analysis showed LC₅₀ of 0.96%, LC₉₀ of 2.84%, LT₅₀ of 57.72 minutes, and LT₉₀ of 28.79 minutes. It can be concluded that the effective dose of shampoo made from bangle rhizome extract is 4%, which can kill 100% of head lice within 27 minutes.

Effect of Immunization of The Pili Protein 65.5 kDa Klebsiella pneumoniae on IFN-Î³ Levels of Spleen BALB/c Mice

Ajeng Samrotu Sa'adah — 2024-08-30

Klebsiella pneumoniae is a Gram-negative bacterium that poses a threat to the global community. Currently, no vaccine for K. pneumoniae is licensed by the Food and Drug Administration (FDA). The delay in the manufacture of the K. pneumoniae vaccine was because many vaccine candidates failed at the clinical trial stage due to adverse cross-reactions. Pili can be used as a choice as a vaccine candidate. Pili K. pneumoniae is an immunogenic substance that triggers an immune response, one of which is the cytokine IFN-Î³. Splenic splenocytes are the main source of IFN-Î³-producing cells. The aim of this study is to determine the effect of immunization pili protein 65.5 kDa K. pneumoniae on IFN-Î³ levels from spleen BALB/c mice. There were 3 groups, K1 as control given PBS, K2 given pili protein 65.5 kDa + adjuvant, and K3 given adjuvant. IFN-Î³ was then measured by the ELISA method and analyzed by the ANOVA test. The results of measuring IFN-Î³ levels using One-way ANOVA showed that the total for all groups was 243.50 ± 43.7 with p < 0.05, the Post Hoc LSD test was continued. The Post Hoc test showed significant differences between K1 control and K2 groups, and between K1 and K3 groups, but not between K2 and K3 groups. It can be concluded that immunization with 65.5 kDa of pili protein does not affect the increase in IFN-Î³ levels in the spleen of BALB/c mice.

Predictive Positive Value Xpert MTB/RIF in Detecting Mycobacterium tuberculosis on Adult Pulmonary Tuberculosis Patients in Dr. Soetomo Referral Hospital Surabaya Indonesia

Mayoori Akirasena — 2024-08-30

Pulmonary tuberculosis is an infectious disease caused by Mycobacterium tuberculosis (Mtb) and transmitted via droplets. Southeast Asia is the largest contributor of TB, and Indonesia itself has the second-highest number in the world with an incidence of approximately 824000 cases. The most common symptoms of active TB are cough, fever, weight loss, and night sweats. The diagnosis can be established upon the confirmation that one of the specimens contains M. tuberculosis. Xpert MTB/RIF provides results in less than 2 hours, whereas culture takes approximately 2-6 weeks. This research aims to evaluate the characteristics and determine the Predictive Positive Value (PPV) percentage of GeneXpert MTB/RIF, utilizing parameters derived from the gold standard examination results, namely culture. This research method is descriptive- analytic based on secondary data extracted from medical records of patients receiving care at the multi-drug resistant TB (MDR-TB) Outpatient Management at Dr. Soetomo Referral Hospital Surabaya from the period January 2019 – April 2022. The results showed that the PPV level of GeneXpert MTB/RIF in detecting the presence of M. tuberculosis is 90%. The diagnosis of pulmonary TB is also supported by the chest X-ray infiltrate's appearance and clinical symptoms of cough, weight loss, fever, and night sweats. Smoking and diabetes are the most common comorbid and risk factors in TB. The conclusion of this study is that the PPV for diagnosing adult pulmonary TB using the Xpert MTB/RIF is relatively high. This suggests the potential use of this method as a diagnosing tool for accurately diagnosing pulmonary tuberculosis.

In Silico Analysis of Inhibitor Potential of Punicalagin Compound in Pomegranate (Punica granatum) Against NS5 DENV-3 Protein

Radinal Kautsar — 2024-03-06

Indonesia is one of the Dengue Virus (DENV) endemic areas which are dominated by DENV-2 and DENV-3. Until now, no specific drug therapy has been found to cure Dengue Virus Infection (DVI). Punicalagin is one of the active compounds that have the potential to be used as an antiviral. Unfortunately, not many studies have used punicalagin as a DENV antivirus. This study aims to determine the inhibitory potential of punicalagin compounds against NS5 DENV-3 protein through molecular docking. Molecular docking was performed using AutoDock Tools, ChemDraw, and Discovery Studio Visualizer. The target protein used is NS5 DENV-3 protein with PDB ID code: 4V0Q. The ribavirin compound was used as a positive control. The results obtained show that the punicalagin compound has the ability to attach to target receptors in the C-Terminal domain complex. This docking produces a bond free energy (Î”G) of -6.39 kcal/mol. This result is better than the Î”G of the control compound. Punicalagin's Inhibition Constant (Ki) value also showed better results than ribavirin. So it can be seen that the compound punicalagin effectively inhibits DENV replication and has the potential as a DENV drug candidate.

Early Detection of Infectious Diseases among the Refugees of UNHCR in South Tangerang, Banten; the Problems and Strategies to Prevent the Disease's Transmission

Silvia Fitrina Nasution — 2024-08-30

The previous study at Puskesmas Pisangan, Ciputat had reported that among 23.8 % patient of the UNHCR was infected by malaria Plasmodium vivax, and one patient with bacterial urinary infection. However, the result can not represent the actual case of the disease, because of the lack number of participant to visit the Puskesmas since the Covid-19 pandemic which had been contributing to decrease number of the patients. The study purposed to improve data and information about parasitic infection, and to design strategy in early detection and prevention to the disease. Design of the study was approached in cross-sectional with a total sampling method of the UNHCR out patients visiting the Puskesmas Pisangan and Cirendeu.We collected specimen of feces, urine, and blood, and performed blood diff-count, rapid diagnostic, microscopic, dipstick, and bacterial culture. The study revealed some parasitic and bacterial infections as defined: five cases (17.24%) of malaria, which is suspected as imported cases; Enterobacteriacea family as non-specific bacteria of negative gram in urine; also Entamoeba coli in stool. This finding was confirmed 17.24% of leucocytosis in blood diffcount and 24.14 % in urinalysis. By nationality, Sudanese was detected the most prevalent 10.34% of parasitic infections, followed by Somalia (6.9%), Yaman (3.45%), and Afghanistan (3.45%) respectively. While mosquitoes and poor living conditions were also contributed as the major potential risk of transmission to the diseases. In conclusion, early detection, health screening, vaccination, access to primary, and upgraded levels of healthcare are important for diseases control and management to prevent transmission.

Examining convalescent plasma transfusion in severe COVID-19 patients, recent research highlights the significance of S-RBD antibodies and IL-10 levels

Aditea Etnawati Putri — 2023-12-07

Convalescent plasma (CP) may be an option for people with severe COVID-19. However, its efficiency remains unknown. A study was done to determine whether the levels of Anti-SARS-CoV-2 Spike Receptor-Binding Domain (S-RBD) antibodies and IL-10 in COVID-19 patients who had CP transfusion were related to their survival status. The observational cohort study included 40 patients with severe COVID-19 who were followed for 28 days after receiving a CP transfusion. Antibody and IL-10 levels were assessed on Day 1 before to CP transfusion and on Days 1, 2, and 7 following CP transfusion. Twenty six (65%) of the 40 patients survived. Anti-SARS-CoV-2 S-RBD antibody levels were observed to be significantly higher on Days 1, 2, and 7 following CP transfusion (p-value 0.05). Furthermore, IL-10 levels dropped significantly on Days 2 and 7 (p-value 0.05). However, neither the CT value nor the patients' survival status were linked to greater antibody levels or changes in IL-10 levels. According to the findings, CP transfusion can greatly enhance anti-SARS-CoV-2 S-RBD antibody levels while drastically decreasing IL-10 levels. These findings may have therapeutic implications for the use of CP as a COVID-19 therapy option. More research is needed to determine its efficacy in enhancing the survival rate of COVID-19 patients with severe symptoms.

Comparative Analysis of Essential Oil Profiles From Emprit Ginger Rhizome (Zingiber officinale var. amarum) Grown in Different Locations and Antibacterial Activity Againts Staphylococcus aureus

Anita Agustina Styawan — 2024-08-30

Indonesia, as a tropical country, boasts significant biodiversity, particularly regarding its flora and fauna. The country's medicinal plants are one inherited natural resource passed down through generations. The "emprit ginger” (Zingiber officinale var. amarum), a native Indonesian medicinal plant, is often employed in treating various diseases. Scientifically, the primary constituent of emprit ginger is the phenolic ketone homolog compound, gingerol, known for its antioxidant activity. In addition to its antioxidant potential, emprit ginger exhibits potential as an antibacterial agent. However, herbal substances used for therapeutic purposes often yield inconsistent effects due to the fluctuating chemical composition in the plants, typically a result of varying growing locations. These location differences can cause discrepancies in the content of active metabolites. Therefore, data on the chemical profile of medicinal plants is paramount for the standardization process.

This study was conducted by obtaining essential oils from the rhizomes of emprit ginger, extracted via steam distillation obtained from various cultivation lands in Ponorogo, Magetan, Pacitan, Wonogiri, Karanganyar, Boyolali, Semarang, Magelang, Purworejo, Temanggung, Wonosobo, Banyumas, Bantul, and Kulonprogo. One of the efforts in standardizing natural materials involves the analysis of their metabolite profiles. The emprit ginger essential oil profile was obtained through Gas Chromatography-Mass Spectrometry (GCMS) testing. The emprit ginger essential oil profile was analyzed using a multivariate calibration of Principal Component Analysis utilizing SIMCA 17 software. Antibacterial activities were assessed using the microdilution method on Staphylococcus aureus bacteria. The analysis of antibacterial activity was determined using the Probit analysis method to ascertain the Minimum Inhibitory Concentration (MIC) 50 value.

This study also involved the extraction of essential oils from emprit ginger rhizomes. The individual profiles of these essential oils were determined via Gas Chromatography Mass Spectrometry. The essential oil profiles of emprit ginger were subjected to a multivariate calibration using Principal Component Analysis facilitated by the SIMCA 17 software. Antibacterial activity tests were conducted using the microdilution method on Staphylococcus aureus bacteria. The antibacterial activity was ascertained using probit analysis to derive the Minimum Inhibitory Concentration 50 (MIC 50) values. The highest MIC 50 of emprit ginger rhizome on Staphylococcus aureus bacteria was found in samples from Wonogiri, with a concentration of 0.3408%. Compounds displaying significant discriminative influence on Staphylococcus aureus bacteria included Z-Citral, Geranyl acetate, Zingiberenol, Beta-Myrcene, (1S0-2,6,6-Trimethylbicyclo [3.1.1] hept-2-ene, and Bicyclo [2.2.1]heptan-2-ol, 1,7,7-trimethyl, exo-(CAS)

Neutrophil-to-lymphocyte and Platelet-to-lymphocyte Ratio as Predictors of CD4 Count among People Living with HIV

Zahra Roidah Amalia Hasna — 2024-03-06

Human Immunodeficiency Virus (HIV) infection remains a global health concern characterized by the reduction of CD4 lymphocyte cells and weakened immune systems. Knowing the CD4 count and the factors affecting it is crucial for assessing the immune status of HIV patients. Hematological markers, including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), have been recognized as prognostic tools that were associated with CD4 Count. The goal of this study was to determine the impact of NLR and PLR on CD4 count among people living with HIV (PLHIV). This study used analytic observational method with a cross-sectional on HIV-positive individuals who were treated at Moewardi Hospital, Surakarta, Indonesia. The Chi-Square and Pearson correlation tests were performed to identify the correlation between variables and the linear regression test was done to investigate the association between NLR and PLR with CD4 count. A total of 80 PLHIV were identified for this study, with the median CD4 count of 103 cells/mm3. NLR and PLR were found to be 3.06 and 181.03, respectively. This study found that opportunistic infection, duration on ARV treatment, body mass index, total lymphocyte count, and hemoglobin were significantly associated with CD4 count. The Pearson correlation test revealed a strong correlation between NLR and PLR to CD4 count. Linear regression analyses showed that NLR and PLR could predict the CD4 count. These findings indicate that NLR and PLR could serve as alternative prognostic parameters for monitoring treatment outcomes in PLHIV, particularly in health facilities where access to CD4 count testing is limited.

Exploring the Therapeutic Potential of Glycyrrhizic Acid in Liver Implication in Dengue Infection: A Case Report

Indah Sagitaisna Putri — 2024-03-06

Dengue is one of the most common infectious diseases affecting humans. The virus is transmitted between humans by the Aedes mosquito. It occurs hyperendemically in tropical and subtropical climates worldwide. Dengue infection can affect numerous organs, with the liver being the most frequently affected organ. The clinical spectrum of liver disorders ranges from mild elevation of transaminase enzymes to severe conditions such as acute liver failure. Several mechanisms have been proposed to describe hepatic dysfunction observed in dengue fever and dengue hemorrhagic fever, such as immunological injury, hypoxic injury, and direct viral damage due to reduced hepatic perfusion during shock. Glycyrrhizic acid, extracted in the form of glycyrrhizin from the root of the licorice plant Glycyrrhiza glabra, is referred to as Stronger Neo-Minophagen-C (SNMC®). It has shown effectiveness in reducing serum aminotransferase and bilirubin levels, attenuating hepatocyte apoptosis, and producing endogenous interferon. The following is a case report of a 23-year-old woman with dengue fever and elevated liver enzyme level. The patient's vital signs were stable. A physical examination revealed no abnormalities. A complete blood count test showed thrombocytopenia without an elevation of the hematocrit. AST level was 901"‰U/L after admission. Causes of other hepatitis infections, such as hepatitis A, B, and C, were excluded. The dengue IgM and IgG antibody levels were reactive. After several days of hospitalization, the patient experienced clinical improvement after supportive therapy and the administration of glicyrrhizic acid or SNMC®.