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"Deteksi Infeksi Submikroskopis Necator americanus, Ancylostoma duodenale, dan Ascaris lumbricoides dari Sampel Feses di Nangapanda, Ende, Menggunakan Real-Time Polymerase Chain Reaction. Infeksi dari Soil-Transmitted Helminthes (STH) (N. americanus, A. duodenale (Hookworm), dan A. lumbricoides) dapat menyebabkan anemia, kekurangan zat besi, bahkan malnutrisi. Pemeriksaan infeksi STH dapat dilakukan menggunakan mikroskop, tetapi metode tersebut masih kurang sensitif. Penelitian bertujuan mendeteksi dan mengetahui persentase infeksi submikroskopis STH dari sampel feses anak (usia 5-18 tahun) di Nangapanda, Ende menggunakan metode real-time polymerase chain reaction (PCR). Sampel feses dikoleksi sebanyak dua kali, yaitu sebelum dan sesudah pemberian albendazole 400 mg. Total sampel yang diperoleh adalah 242 tetapi hanya 45 sampel yang negatif secara mikroskopis yang diuji dengan real-time PCR. DNA sampel diisolasi dan diamplifikasi menggunakan primer dari daerah internal transcribed spacer (ITS-1 dan ITS-2) rDNA. Deteksi dengan real-time PCR menghasilkan kurva amplifikasi pada fluorophore VIC, FAM, dan Texas Red. Sebanyak tiga sampel (6,7%) pada pre treatment termasuk low load of DNA (N. americanus and A. lumbricoides) (Ct > 35), empat sampel (9,1%) termasuk low load of DNA untuk N. americanus saja (Ct > 35), dan lima sampel (11,4%) termasuk moderate load of DNA untuk A. lumbricoides saja (30 < Ct < 35) pada post treatment. Hasil penelitian menunjukkan bahwa real-time PCR dapat mendeteksi infeksi submikroskopis dari Hookworm dan A. lumbricoides.

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Soil-transmitted helminth (STH) infections (Necator americanus (hookworm), Ancylostoma duodenale (hookworm), and Ascaris lumbricoides) can lead to anemia, malnutrition, and iron deficiency. Traditionally, STH infections have been diagnosed using microscopy to detect eggs in human fecal samples. However, there are several limitations of this method. The aim of this research was to detect the percentage of submicroscopic STH infections from human fecal samples (children, 5?18 years old) in Nangapanda, Ende, using the real-time polymerase chain reaction (PCR) method. The fecal samples were collected in two time periods, which were before and after treatment, using 400 mg of Albendazole. There were 242 samples in total, but only 45 negative samples from microscopic detection were tested with real-time PCR. The DNA samples were isolated and amplified wih primers of internal transcribed spacer (ITS-1 and ITS-2) region of rDNA. The detection of samples with real-time PCR generated an amplification curve in VIC, FAM, and Texas Red fluorophore. Three samples (6.7%) in pre-treatment were low load of DNA (N. americanus and A. lumbricoides) (Ct > 35). Four samples (9.1%) were low load of DNA (N. americanus) (Ct > 35) in post-treatment. Five samples (11.4%) were moderate load of DNA (A. lumbricoides) (30 < Ct < 35) in post-treatment. real-time PCR could detect submicroscopic infections from specific species of hookworm and A. lumbricoides."

"Deteksi Infeksi Submikroskopis Necator americanus, Ancylostoma duodenale, dan Ascaris lumbricoides dari Sampel Feses di Nangapanda, Ende, Menggunakan Real-Time Polymerase Chain Reaction. Infeksi dari Soil-Transmitted Helminthes (STH) (N. americanus, A. duodenale (Hookworm), dan A. lumbricoides) dapat menyebabkan anemia, kekurangan zat besi, bahkan malnutrisi. Pemeriksaan infeksi STH dapat dilakukan menggunakan mikroskop, tetapi metode tersebut masih kurang sensitif. Penelitian bertujuan mendeteksi dan mengetahui persentase infeksi submikroskopis STH dari sampel feses anak (usia 5-18 tahun) di Nangapanda, Ende menggunakan metode real-time polymerase chain reaction (PCR). Sampel feses dikoleksi sebanyak dua kali, yaitu sebelum dan sesudah pemberian albendazole 400 mg. Total sampel yang diperoleh adalah 242 tetapi hanya 45 sampel yang negatif secara mikroskopis yang diuji dengan real-time PCR. DNA sampel diisolasi dan diamplifikasi menggunakan primer dari daerah internal transcribed spacer (ITS-1 dan ITS-2) rDNA. Deteksi dengan real-time PCR menghasilkan kurva amplifikasi pada fluorophore VIC, FAM, dan Texas Red. Sebanyak tiga sampel (6,7%) pada pre treatment termasuk low load of DNA (N. americanus and A. lumbricoides) (Ct > 35), empat sampel (9,1%) termasuk low load of DNA untuk N. americanus saja (Ct > 35), dan lima sampel (11,4%) termasuk moderate load of DNA untuk A. lumbricoides saja (30 < Ct < 35) pada post treatment. Hasil penelitian menunjukkan bahwa real-time PCR dapat mendeteksi infeksi submikroskopis dari Hookworm dan A. lumbricoides.

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Soil-transmitted helminth (STH) infections (Necator americanus (hookworm), Ancylostoma duodenale (hookworm), and Ascaris lumbricoides) can lead to anemia, malnutrition, and iron deficiency. Traditionally, STH infections have been diagnosed using microscopy to detect eggs in human fecal samples. However, there are several limitations of this method. The aim of this research was to detect the percentage of submicroscopic STH infections from human fecal samples (children, 5?18 years old) in Nangapanda, Ende, using the real-time polymerase chain reaction (PCR) method. The fecal samples were collected in two time periods, which were before and after treatment, using 400 mg of Albendazole. There were 242 samples in total, but only 45 negative samples from microscopic detection were tested with real-time PCR. The DNA samples were isolated and amplified wih primers of internal transcribed spacer (ITS-1 and ITS-2) region of rDNA. The detection of samples with real-time PCR generated an amplification curve in VIC, FAM, and Texas Red fluorophore. Three samples (6.7%) in pre-treatment were low load of DNA (N. americanus and A. lumbricoides) (Ct > 35). Four samples (9.1%) were low load of DNA (N. americanus) (Ct > 35) in post-treatment. Five samples (11.4%) were moderate load of DNA (A. lumbricoides) (30 < Ct < 35) in post-treatment. real-time PCR could detect submicroscopic infections from specific species of hookworm and A. lumbricoides."

"Introduction: Constant exposure to a variety of microorganisms in domestic environment plays an important role in the shaping of individual immune response mechanism, which can affect one's susceptibility to the diseases. The aim of the study to get an understanding how the exposure of microorganisms in the the different area where the people living might give a contribution to the profile and the regulation of the immune respons after stimulated to malaria, vaccine BCG and oxLDL antigents in PBMC and whole blood cultures, and to evaluate the character of T reg as a mediator to suppress the cell proliferation.Methode: It is an in vitro experimental study performed at Laboratorium Terpadu, Faculty of Medicine Univertas Indonesia, Jakarta in 2013 2014. As a model of infectious diseases is used pathogenic antigents such as Plasmodium falciparum infected red blood cells malaria and bacille calmette gu rin BCG vaccine, and as a modell of inflammatory disease is used non a patonegic antigen, low density lipoprotein LDL . Whole blood cultures is done for 80 blood samples to know how the regulation of immune respons from people living a rural populatin. PBMC cultures is also done to explore macrophages after stimulated to malaria, BCG and LDL. PHA stimulated to the PBMC culture with and without T reg cells to evaluate the character of T reg. T regulatory cells perhaps play the important roles to suppress the immune respons to microorganisms was also done.Results: The profile of the immune respons of the people living in the unslum area is significantly more inflamatif than that in the slum area. The ratio of pro anti inflammation cytokines TNF IL 10 of the people living in the unslum area is significantly higher than that in the slum area. This is marked by increasing of oxLDL accumulationis that is the important point of the low protection to oxLDL of the people living in the unslum area p 0.01 . T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum area marked by increasing not only the expression of IL 10 cytokines but also the sum of T regulatory sells p 0.01 significantly.Conclusion: The immune respons of the people living in the unslum area is more inflamatif and responsive to malaria, BCG vaccine and oxLDL. The character of macrophage of the people living in the slum area is marked by the low ratio of pro anti inflammation cytokines TNF IL 10 to malaria, BCG vaccine and oxLDLstimulations. T regulatory cell may suppress the proliferation in the PBMC culture for the people living in the slum."

"Latar Belakang: Saat ini terdapat 1,3 miliar penduduk di dunia berisiko tertular filariasis pada lebih dari 83 negara dan 50% orang terinfeksi tinggal di Asia Tenggara termasuk Indonesia. Indikator keberhasilan pengendalian filariasis yang telah ditetapkan Kementerian Kesehatan berdasarkan pedoman WHO yaitu kabupaten/kota endemis yang berhasil menurunkan angka mikrofilaria menjadi < 1% dengan menerapkan Mass Drug Administration (MDA) minimal cakupan pengobatan >65% populasi. Pemberian Obat Pencegahan Massal (POPM) dengan Diethylcarbamazine citrate dan Albendazole telah dilakukan di Kota Pekalongan sejak tahun 2011-2015 dengan cakupan pengobatan sebesar >65%, namun hasil evaluasi mini TAS tahun 2019 prevalensi antigen masih > 2%. Berdasarkan pedoman WHO, program POPM Kota Pekalongan harus diperpanjang selama 2 tahun dengan obat Ivermectin, Diethylcarbamazine citrate dan Albendazole (IDA), namun cakupan pengobatan IDA putaran pertama <65%. Perlu dilakukan penelitian untuk membuat model evaluasi POPM filariasis agar dapat dilakukan perbaikan dalam program serta meningkatkan cakupan pengobatan. Metode: Penelitian ini menggunakan desain mixed methods sekuensial eksplanatori dengan jumlah sampel sebanyak 646 sampel untuk data kuantitatif (pengambilan darah jari sebanyak 300µl untuk pemeriksaan antigen dan wawancara terstruktur kuesioner) dan 9 informan dari petugas kesehatan dan penduduk untuk data kualitatif (input, proses, out, outcome program, serta perilaku minum obat penduduk). Penelitian dilakukan pada total 10 kelurahan di daerah endemik Kota Pekalongan dengan teknik sampling menggunakan sistem cluster (40 cluster RW) dipilih secara consecutive sampling. Hasil: Didapatkan model evaluasi pada aspek input yang memerlukan perbaikan berupa evaluasi pendanaan, pada evaluasi aspek proses didapatkan evaluasi pendampingan petugas kesehatan pada masyarakat dengan kriteria tertentu dengan perbaikan komunikasi untuk sosialisasi pengobatan, didapatkan juga model evaluasi pada aspek output dan outcome. Kesimpulan: Model evaluasi program POPM yang tepat yaitu model evaluasi komprehensif (input, proses, ouput, outcome), pada bagian proses harus dioptimalkan pada evaluasi pendampingan petugas kesehatan pada praktik minum obat untuk masyarakat dengan kriteria tertentu dan perbaikan komunikasi untuk sosialisasi melalui pendekatan kuantitatif dan kualitatif, untuk dapat meningkatan cakupan pengobatan dan sosialisasi yang merata. Saran : Model evaluasi program Pemberian Obat Pencegahan Massal yang komprehensif (input, proses, output, outcome) perlu dilakukan agar dapat memperbaiki pendampingan petugas kesehatan dalam praktik minum obat dan perbaikan komuniasi sosialisasi pengobatan pada masyarakat dengan kriteria tertentu untuk dapat meningkatkan cakupan pengobatan di daerah endemik tipe perkotaan.

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Background: Currently, there are 1.3 billion people in the world at risk of contracting filariasis in more than 83 countries and 50% of infected people live in Southeast Asia, including Indonesia. The indicators for the success of filariasis control that have been determined by the Ministry of Health based on WHO guidelines are endemic districts/cities that have succeeded in reducing the number of microfilariae to <1% by implementing Mass Drug Administration (MDA) with a minimum treatment coverage of >65% of the population. Mass Preventive Drug Administration (POPM) with Diethylcarbamazine citrate and Albendazole have been carried out in Pekalongan City since 2011-2015 with a treatment coverage of >65%. However, the 2019 TAS mini-evaluation results showed that antigen prevalence was still >2%. Based on WHO guidelines, the Pekalongan City POPM program should be extended for 2 years with Ivermectin, Diethylcarbamazine citrate, and Albendazole (IDA) drugs, but the coverage of the first round of IDA treatment was <65%. Research needs to be conducted to create an evaluation model for POPM filariasis so that improvements can be made to the program and treatment coverage can be increased. Method: This study used a mixed methods sequential explanatory design with a sample size of 646 samples for quantitative data (taking 300µl of finger blood for antigen examination and structured questionnaire interviews) and 9 informants from health workers and residents for qualitative data (input, process, output, program outcome, and residents' medication-taking behavior). The research was conducted in 10 sub-districts in the endemic area of ​​Pekalongan City using a sampling technique using a cluster system (40 RW clusters) selected using consecutive sampling. Results: An evaluation model was obtained for the input aspect that required improvement in the form of funding evaluation, in the process aspect evaluation an assessment of health worker assistance was obtained for the community with certain criteria with improved communication for treatment socialization, an evaluation model was also obtained for the output and outcome aspects. Conclusion: The appropriate evaluation model for the POPM program is comprehensive (input, process, output, outcome). The process section must be optimized in evaluating health worker assistance in taking medication for the community with certain criteria and improving communication for socialization through quantitative and qualitative approaches, to increase the coverage of treatment and socialization evenly. Suggestion: A comprehensive evaluation model for the Mass Preventive Drug Administration program (input, process, output, outcome) needs to be carried out to improve the assistance of health workers in the practice of taking medication and improve communication and socialization of treatment in the community with certain criteria to be able to increase treatment coverage in endemic urban areas."