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The oral health status and health behaviour of 12 and 15 year-old adolescents in Jakarta, Indonesia.

Indonesia is a developing country with few dental services and a population at risk to deteriorating oral health. Five hundred and ninety-one 12 and 15 year-old children drawn from a low fluoride (F- less than 0.1 ppm) urban area of Jakarta, Indonesia were examined for dental caries, fluorosis, and periodontal diseases. In addition, a questionnaire was administered investigating socio-demographic background, use of dental services, and preventive oral care. Although the severity of dental caries experience was moderate, untreated caries on the occlusal surface formed the highest proportion of the dental caries experience. CPITN examination revealed a large proportion of the subjects had calculus as their highest score, combined with a substantial number of sites which exhibited bleeding on probing. Questionnaire data revealed a high home use of fluoridated toothpaste by the subjects but a predominant use of dental services for pain relief. Findings from this study suggest a need for primary preventive programmes focusing on occlusal sealants and plaque control.

Adolescent↗

Progress and challenges toward poliomyelitis eradication in Indonesia.

Poliomyelitis is one of few diseases that can be eradicated. The virus cannot survive outside the body and effective vaccine is available to protect children and stop transmission. Today, there are 3 million children each year saved by the oral polio vaccine (OPV) and globally the reported cases have declined from 50,000 to 7,000 in 1999. At present, 20 countries may remain at risk of continued transmission, mostly in Africa and Asia. In the region of SEARO, wild poliovirus is still transmitted in India, Nepal and Bangladesh. Efforts to eradicate polio had been made in Indonesia, through a four-pronged strategy; routine immunization, National Surveillance Days (NIDs), surveillance of Acute Onset of Flaccid Paralysis (AFP) cases, and supplementary immunizations. No polio cases have been detected in Indonesia since 1995, but some problem will remain until the whole SEARO region is certified polio-free. Filling the immunization gap and revitalizing the AFP surveillance program are among the highest priority activities.

Health Plan Implementation↗

Persistent occurrence of a single Streptococcus equi subsp. zooepidemicus clone in the pig and monkey population in Indonesia.

In the present study 41 mucoid growing Streptococcus equi subsp. zooepidemicus strains (37 strains isolated from healthy two from diseased pigs, two strains isolated from healthy monkeys) appeared to be phenotypically and genotypically identical to mucoid growing S. equi subsp. zooepidemicus strains isolated from a previously described outbreak among the pig and monkey population on the island of Bali, Indonesia. These findings indicate that the mucoid growing S. equi subsp. zooepidemicus clone was still present in the pig and monkey population in Indonesia.

Animals↗

Surveillance of psychosomatic disorders in internal medicine in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

AIM: to examine certain characteristics of patients who suffer from psychosomatic disorders. METHODS: We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. RESULTS: the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and depression, and 3.8% unclear. The psychosocial stressor groups were family problems (38%), physical conditions (16%), work-related problems (13.4%), marriage problems (8.4%) and others (1%-4%). CONCLUSION: The most common physical symptoms of psychosomatic disorders were functional. Common functional psychosomatic disorders were multiple psychosomatic syndrome, dyspepsia and functional heart disease. Structural disorders found were chronic diseases. There was no difference in prevalence between males and females. The most frequent functional disorders were more commonly found among those under 40 years of age, while those with structural disorders were more common among patients 40 years of age or more. The psychological diagnoses were anxiety and depression. The most frequent psychological stressors were family problems, medical conditions, work-related problems and marriage problems.

Adult↗

A serological study of Chikungunya virus transmission in Yogyakarta, Indonesia: evidence for the first outbreak since 1982.

A study of epidemic transmission of Chikungunya virus (CHIK) was initiated in April 1999 in Yogyakarta, Indonesia. Three hundred seventeen volunteers from three kelurahans (sub-districts) were recruited. Anti-CHIK IgG antibodies were detected in 68% to 74% of cases and 28% to 32% of controls. In the kelurahan with no reported CHIK illness, 29% of cases and 28% of controls had anti-CHIK IgG antibodies. None of these cases demonstrated anti-CHIK IgM antibodies. In the two kelurahans with disease activity, anti-CHIK IgM antibodies were detected in 3% to 36% of cases, with the highest percentage from the kelurahan with recently reported cases. Ten percent of controls from Gowok had anti-CHIK IgM detected in their serum. Twelve acutely ill volunteers were later included from the kelurahan Pilahan for virus identification. Samples from two volunteers were culture- and RT-PCR-positive for CHIK. This is the first documentation of epidemic transmission of CHIK in Indonesia since 1982.

Adult↗

Molecular epidemiology of Plasmodium falciparum resistance to antimalarial drugs in Indonesia.

The extent of gene polymorphisms associated with resistance to chloroquine and sulfadoxine-pyrimethamine was examined in field isolates of Plasmodium falciparum from Indonesia. Eight malaria-endemic areas, representing a broad region of the western and eastern Indonesian Archipelago were surveyed. Blood from 20-50 patients was collected at each site, DNA was isolated, and the sequences of four different genes (dihydrofolate reductase [dhfr], dihydropteroate synthase [dhps], P. falciparum multidrug resistance 1 [pfmdr1], and P. falciparum chloroquine resistance transporter [pfcrt]) were analyzed using polymerase chain reaction and restriction fragment length polymorphisms to detect polymorphisms previously shown to be associated with resistance. This analysis identified polymorphisms in dhfr at 108-Asn/Thr, 16-Val, and 59-Arg. Polymorphisms in dhps were found less frequently, either 437-Gly alone or paired with 540-Glu. The pfcrt 76-Thr polymorphism was fixed in all parasite populations and pfmdr1 86-Tyr polymorphisms in all populations except in the most eastern regions. The pfmdr1 1042-Asp polymorphism occurred less frequently. These findings indicate that polymorphisms in genes associated with drug resistance in P. falciparum are found across a broad region of Indonesia.

ATP-Binding Cassette Transporters↗

[Contribution of the French Armed Forces Health Services to relief in Indonesia following the tsunami on December 26, 2004].

As of early January 2005, the French Armed Forces Health Services were on the ground in Indonesia to contribute to relief operations following the tsunami in Indonesia on December 26, 2004. Findings of preliminary investigation performed upon deployment of the first French elements demonstrated that a major priority was to speed up vaccination against measles in children between the ages of 6 months and 15 years. A vaccination campaign was planned in cooperation with Indonesian authorities and UNICEF. Implementation involved training of personnel and setting up vaccination clinics in refugee camps, schools, and neighborhoods in the city of Meulaboh. The vaccination campaign was hampered by a number of problems in particular involving logistics and required constant supervision. A survey to evaluate the results of the campaign in terms of vaccination coverage showed that the objective of vaccinating 70% of children in refugee camps was achieved. The survey provided other child health indicators that will be helpful to local authorities taking over after the departure of the French Armed Forces Health Services.

Adolescent↗

Microalbuminuria prevalence study in hypertensive patients with type 2 diabetes in Indonesia.

AIM: To assess the prevalence of macroalbuminuria and microalbuminuria in hypertensive patients with type 2 diabetes in 10 Asian countries. METHODS: This cross-sectional clinic-based epidemiological study is a subanalysis of data collected from patients attending three medical centres in Indonesia from May 2002 to October 2002. A total of 207 patients were enrolled, of which 177 patients constituted the per protocol population (patients with bacteriuria and haematuria were excluded). RESULTS: Overall, the prevalence of diabetic kidney disease was high, with macroalbuminuria comprising 44.7% (41.2-48.1;95% confidence interval) and microalbuminuria comprising 33.0% (29.7-36.3; 95% confidence interval). While the majority (91.53%) of patients were receiving treatment for hypertension, only 6.21% of the patients had systolic/diastolic blood pressures below the 130/85 mmHg target. CONCLUSION: The prevalence of microalbuminuria and macroalbuminuria was high in hypertensive patients with type 2 diabetes in Indonesia, which is indicative of an impending pandemic of diabetic cardiovascular and renal diseases in the region.

Albuminuria↗

Genetic variations and relationship among dengue virus type 3 strains isolated from patients with mild or severe form of dengue disease in Indonesia and Thailand.

Sequence analysis was conducted on structural and non-structural genes of 7 strains of dengue virus type-3 (DENV-3 virus) isolated in Indonesia and Thailand in the year 1973, 1994, and 1998 from patients with different clinical manifestations. In general, sequence similarity among isolates was greater than 93%, indicating that the mutation rate of DENV-3 circulating in this region was not more than 7% in the last 3 decades and suggesting that sequences that may responsible for viral architectures and/or biological function were strictly conserved. Mutations unique to viral strains associated with specific clinical manifestations were not found. Alignment of PrM/M and E nucleic acid sequences followed by parsimony analysis of sequences obtained in this study and published elsewhere allowed generation of phylogenetic trees, demonstrating that DENV-3 strains isolated in Indonesia in 1998 belonged to a separate cluster (subtype 2) from those isolated between 1973-1985 (subtype 1).

Amino Acid Sequence↗

Gene mutation analysis of sinonasal lymphomas in Indonesia.

Sinonasal lymphomas comprise NK/T-cell (NKTCL) type and B-cell type with unique geographical development. In this study, mutations of p53, K-ras, c-kit, beta-catenin, and bak gene were analyzed using polymerase chain reaction (PCR)-single strand conformation polymorphism (SSCP) followed by direct sequencing in 41 sinonasal lymphomas (27 NKTCL and 14 B-cell type) from Indonesia. In situ hybridization study with EBER-1 probe revealed that 85% of NKTCL cases were EBV positive, but none of B-cell type was EBV positive. Frequency of mutations in p53, K-ras, c-kit, beta-catenin, and bak gene was 62.9%, 0%, 11.1%, 18.5%, and 25.9%, respectively, in NKTCL, and 71.4%, 0%, 23.1%, 21.4%, and 57.1%, respectively, in B-cell cases, showing that mutation frequency in all genes was higher in B-cell than in NKTCL cases. These findings suggest that gene mutations might be the driving-force for B-cell lymphoma, whereas combined EBV infection and gene mutations contribute to NKTCL development in Indonesia.

Adolescent↗

Diabetes mellitus is strongly associated with tuberculosis in Indonesia.

SETTING: Diabetes mellitus is a known risk factor for tuberculosis (TB), but no studies have been reported from South-East Asia, which has a high burden of TB and a rapidly growing prevalence of diabetes. OBJECTIVE: To examine if and to what extent diabetes is associated with an increased risk of TB in an urban setting in Indonesia. DESIGN: Case-control study comparing the prevalence of diabetes mellitus (fasting blood glucose level >126 mg/dl) among newly diagnosed pulmonary TB patients and matched neighbourhood controls. RESULTS: Patients and control subjects had a similar age (median 30 years) and sex distribution (52% male), but malnutrition was more common among TB patients (median body mass index 17.7 vs. 21.5 kg/m2). HIV infection was uncommon (1.5% of patients). Diabetes mellitus was present in 60 of 454 TB patients (13.2%) and 18 of 556 (3.2%) control subjects (OR 4.7; 95%CI 2.7-8.1). Adjustment for possible confounding factors did not reduce the risk estimates. Following anti-tuberculosis treatment, hyperglycaemia reverted in a minority (3.7%) of TB patients. CONCLUSION: Diabetes mellitus is strongly associated with TB in young and non-obese subjects in an urban setting in Indonesia. This may have implications for TB control and patient care in this region.

Adult↗

Opportunistic infection of HIV-infected/AIDS patients in Indonesia: problems and challenge.

Infectious diseases are one of the biggest health-problem in the world, while HIV/AIDS itself ranks second in mortality. The latest situation shows a remarkable increase of HIV/AIDS cases in Indonesia. About 90.000 to 130.000 people in Indonesia are predicted of being infected with HIV nowadays. HIV may progress to AIDS as patient's immune status decreases. As well to the condition, opportunistic infections will occur and eventually it may lead to death. An efficient and effective approach in early detection and proper management of opportunistic infections, followed with sufficient anti retroviral administration, may reduce mortality. Other approaches in managing HIV/AIDS and opportunistic infections are needed to support a complete and holistic management for patients with HIV. Full participation from family, medical experts, government and public is strictly a must to overcome this problem.

AIDS-Related Opportunistic Infections↗

Study on the prevalence of toxoplasmosis in Indonesia: a review.

Congenital toxoplasmosis has been confirmed in Indonesia. Many newborn children in Indonesia have congenital anomalies attributable to Toxoplasma gondii. The parasite is widespread, with seroprevalence rates of 2-63% in humans, 35-73% in cats, 75% in dogs, 11-36% in pigs, 11-61% in goats, and less than 10% in cows. The prevalence of Toxoplasma antibodies in pregnant women in the Dr Cipto Mangunkusumo Hospital in Jakarta is 14.3%, and in 50 abortions it is 67.8%. In patients with a history of one or more abortions or stillbirths, the prevalence is 21.5% and 22.8%, respectively. No significant difference has been found in women with or without histories of habitual abortions or stillbirths. In adults and children with chorioretinitis, the prevalence of antibody is 60%; in patients with other eye lesions, it is 17%. The prevalence in hydrocephalic children is 10.6%; in children with mental retardation, 44.6%; in children with eye lesions, 44.6%; and in children with signs of systemic diseases, 9.5%. The diagnosis of an acute Toxoplasma infection using the ELISA should be based on a significant increase in IgG levels in paired sera or on detection of IgM.

Female↗

Risk taking behavior of adolescents in Indonesia (country report).

Adolescent problems in Indonesia are becoming more and more relevant due to the increasing reports recently. Although data gathered are very limited a certain consideration should be well planned to get all resources in terms of motivation in paying more attention to the future of Indonesia youth problems such as narcotics/drug abuse, sexual activities including sexual transmitted diseases etc. A good communication with the other Asian countries in controlling those risk taking behaviors in adolescent will be very promising to gain the improvement of people's life quality by the year 2,000.

Accidents, Traffic↗

[A behavioral dental science research concerning prevention of dental fear. A report on the surveys of dental fear in four countries Japan, Indonesia, Brazil and Argentina].

We conducted a behavioral scientific research from the point of view of dental fear prevention. This time, the writers carried out the surveys with the goal of understanding and making clear the realities concerning dental anxiety in the four countries: Japan, Indonesia, Brazil and Argentina. The subjects were 728 dental students from the four countries, and the surveys consisted of 25 multiple choice questions which were divided into three major areas. The first area consisted of preliminary questions such as chief complaints and treatment experiences, the second area dealt with the reactions and physical responses on receiving dental treatment and the third area was on the different levels of anxiety shown during treatment expressed through feelings and reactions. We concluded as follows: 1. In Japan, 77% of the subjects reported having at least a little fear and this percentage was higher than those of other countries (45-65%). But in all countries, 4-7% of subjects reported having extreme dental fear. 2. In Japan and Brazil, women reported the higher fear than men. In Indonesia and Argentina, these results were the opposite. 3. According to canonical correlation analysis, a significant correlation between the level of physical reactions and the degree of dental anxiety was found in all countries. 4. In the high fear group, dental anxiety increased by psychological stress before treatment and the expressions of physical reactions were stronger than in the low fear group.

Argentina↗

Birthweight distribution in a healthy urban population in Surabaya-Indonesia.

The birthweight distribution was assessed in an apparently healthy urban population in Surabaya, Indonesia. A total of 924 pregnant women of a middle income group were enrolled at 20-24 weeks of gestation of which 543 women delivered in the university hospital. In the latter group mean birthweight of liveborn singletons was 3047 g for males and 2900 g for females. The percentages of low birthweight by sex were 7.9% and 13.8% respectively. These values were lower than those reported for more affluent women in Indonesia and comparable with those of rural Madurese women studied in the same time period.

Adolescent↗

Prevalence of anti-delta antibodies in pregnant women in Bandung, Indonesia.

Knowledge of the epidemiology of hepatitis D virus (HDV)-infection is very scarce in many parts of the world. The endemicity of delta-infection is believed to be maintained and spread through the network of hepatitis B surface antigen (HBsAg) carriers in the community. In the Far East and the Pacific area, the prevalence of chronic HBsAg carriers is mostly high. Markers of HDV infection are very frequent in some regions (e.g. parts of China, Fiji Isles, Samoa), in other regions they are almost absent (e.g. Taiwan, Thailand, parts of China). In the Bandung region (West Java, Indonesia) we found 26 (2.8%) HBsAg carriers among 926 pregnant women. Most of them are chronic carriers (anti hepatitis B core (HBc) IgM negative). Although HBsAg is frequent in this Indonesian population, we could not find any anti-HD positive. This data warrants the conclusion that HDV infection has not yet been introduced in that densely populated area of Indonesia.

Carrier State↗

Mortality from neonatal tetanus in Indonesia: results of two surveys.

Two, 30-cluster, retrospective surveys of deaths from neonatal tetanus in Indonesia were conducted during 1982. The first survey, in the city of Jakarta, identified 16 deaths from neonatal tetanus among 2310 live births, giving a mortality rate of 6.9 per 1000 live births. The second survey covered 19 of Indonesia's 27 provinces. Fifty-three neonatal tetanus deaths occurred among 4971 live births, giving a mortality rate of 10.7 per 1000 live births. Overall, 68.8% of mothers interviewed in the second survey received antenatal care on at least two occasions when tetanus toxoid was, in principle, available.

Humans↗