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PubMed1989

Epidemiological model and cost-effectiveness analysis of tuberculosis treatment programmes in Indonesia.

An epidemiological model of tuberculosis, based on the natural history of tuberculosis and the control programmes in Indonesia, was constructed. This model was used for estimating future tuberculosis-prevented cases and costs for three treatment strategies--the 100% standard course, the 100% short course, and the existing strategy (a combination of 65% standard course and 35% short course)--in accordance with the master plan of the Indonesian Government's tuberculosis control programme. A cost-effectiveness analysis of the three strategies confirmed that the short-course strategy was the most cost-effective. Sensitivity analysis, which applied a broad range of parameters, continued to confirm the short-course strategy as the most cost-effective. If the short-course strategy had been applied in 1980 instead of the existing strategy (using the most likely parameters), the short-course strategy would prevent 1.8 million sputum-positive cases and would save 61.0 million dollars by the year 2000.

Antitubercular Agents↗
PubMed1995

Lombok Hepatitis B Model Immunization Project: toward universal infant hepatitis B immunization in Indonesia.

The Lombok Hepatitis B (HB) Model Immunization Project was the first mass infant HB immunization project in Indonesia. Key aspects were the procurement of low-cost HB vaccine, integration into routine infant immunization services, and delivery of the first dose in the home within 1 week of birth. The project achieved > 90% coverage with 3 doses of vaccine. The prevalence of HB surface antigen was 1.4% in infants who received 3 doses (with the first dose within 7 days of birth) and 3.0% in those who received the first dose > 7 days after birth, compared with a baseline prevalence of 6.2% (P < .001 in each case). Most vaccine failures occurred in children born to HBe antigen-positive mothers. Antibody prevalence and titers did not correlate with protection. HB vaccine can be successfully integrated into the Expanded Programme on Immunization (EPI), strengthening the EPI and significantly reducing chronic HB infection.

BCG Vaccine↗
PubMed1995

Mosquito (Diptera: Culicidae) and predator abundance in irrigated and rain-fed rice fields in north Sulawesi, Indonesia.

Immature mosquito species composition and abundance were studied in irrigated and rain-fed rice fields of North Sulawesi, Indonesia. Irrigated rice fields were characterized by the prevalence of aquatic macrophytes and cyprinodont larvivorous fish, Aplocheilus panchax (Hamilton), but abundance per dip of most aquatic insect predators was lower than that in rain-fed rice fields. Anopheles peditaeniatus (Leicester), Culex vishnui Theobald, and Culex tritaeniorhynchus Giles, were dominant in both irrigated and rain-fed fields, but the abundance of the Culex species was lower in irrigated fields. The effect of irrigation system introduction on regional mosquito abundance cannot be evaluated by the enlarged surface water area alone. Changes in habitat quality, expressed as the abundance per dip (index of density per unit water area), also need to be considered.

Aedes↗
PubMed1996

Occurrence of Aedes (Stegomyia) spp. mosquitoes (Diptera: Culicidae) in Halmahela villages, Indonesia.

Aedes (Stegomyia) spp. mosquitoes breeding in containers in and around human houses were surveyed in Halmahela villages, the North Moluccas, Indonesia. Adults reared from larvae found in containers and those reared from eggs collected by ovitraps revealed the dominance of Aedes scutellaris (Walker) in residential areas. Breeding of Aedes aegypti (L.) and Aedes albopictus (Skuse) was confirmed in a few coastal villages with high human densities.

Aedes↗
PubMed1996

Inter- and intraspecific variation in resistance to desiccation by adult Aedes (Stegomyia) spp. (Diptera: Culicidae) from Indonesia.

Desiccation survival times of adult mosquitoes were studied for yellow fever mosquito, Aedes aegypti (L.) (6 strains), Asian tiger mosquito, Ae. albopictus (Skuse) (5 strains), and Ae. paullusi Stone & Farmer (1 strain) colonized from South Sulawesi, Indonesia. At both 90 and 70% RH, Ae. aegypti males and females outlived the other species. The forest species Ae. paullusi was least resistant to desiccation. Strains of Ae. aegypti and Ae. albopictus from urban areas were more resistant to desiccation than conspecific strains from rural villages. When water was accessible, Ae. albopictus females outlived Ae. aegypti females, indicating that death from deprivation of water was not a result of energy depletion. Ae. aegypti was largest in body size, followed by Ae. albopictus and Ae. paullusi. Among strains within species, the relationship between body size and survival time was significant only for Ae. aegypti females at 70% RH. Adult desiccation resistance may be a factor that influences distribution and abundance of Aedes (Stegomyia) species.

Aedes↗
PubMed1999

Differences in energy metabolism and adult desiccation resistance among three Aedes (Stegomyia) species (Diptera: Culicidae) from South Sulawesi, Indonesia.

To determine the mechanisms of adult desiccation resistance of Aedes (Stegomyia) species, we estimated the carbohydrate and lipid contents of newly emerged adult mosquitoes from South Sulawesi, Indonesia. Inter- and intraspecific differences in glycogen and free fatty acid accumulation were found in Aedes aegypti (L.), Ae. albopictus (Skuse), and Ae. paullusi (Stone & Farmer). High glycogen content was determined for both sexes in all Ae. aegypti strains and in the Ujung Pandang strain of Ae. albopictus. There were no differences among species in either trehalose or sorbitol content. A trend similar to glycogen was seen for lipid content, especially the free fatty acids of neutral lipids. These energy reserves of adult mosquitoes correlated with adult desiccation survival time at 90% RH calculated by Mogi et al. (1996). In both sexes, survival time was longer in strains with high glycogen and free fatty acid content, and low trehalose content. Ae aegypti, Ae. albopictus, and Ae. paullusi are species with high, intermediate, and low levels of glycogen and free fatty acids, respectively. However, longevity of these species under desiccation conditions is associated strongly with glycogen-trehalose conversion, and free fatty acid accumulation.

Aedes↗
PubMed1999

Culex (Acallyntrum) miyagii (Diptera: Culicidae): new species from Seram Island, Indonesia, with keys to the species of the subgenus.

Culex (Acallyntrum) miyagii is described as a new species from Seram Island, Indonesia. The adult male, female, pupa, and larva are described in detail, and illustrations of the male genitalia, pupa, and larva are provided. Cx. miyagii is a forest species breeding in inflorescences of Costus sp. (Costaceae). Keys are provided for identifying the females and 4th-instar larvae of the species of Acallyntrum.

Animals↗
PubMed1999

Black flies (Diptera: Simuliidae) of the Special Province of Aceh, Indonesia.

The black fly fauna of the Special Province of Aceh, Indonesia, was surveyed in 24 streams in 5 regencies, from 7 to 13 June 1998. Ten species were identified, Simulium (Nevermannia) aureohirtum Brunetti, S. (Gomphostilbia) duolongum Takaoka & Davies, S. (G.) sheilae Takaoka & Davies, S. (G.) sundaicum Edwards, S. (S.) nobile de Meijere, S. (S.) fenestratum Edwards, S. (S.) argyrocinctum de Meijere, S. (S.) nebulicola Edwards, S. (S.) iridescens de Meijere, and S. (S.) minangkabaum Takaoka & Sigit. These species are essentially oriental in distribution, because they belong to the 3 subgenera that are dominant groups in oriental or Palaearctic regions, or both.

Animals↗
PubMed2000

Poor micronutrient status of active pulmonary tuberculosis patients in Indonesia.

Malnutrition is observed frequently in patients with pulmonary tuberculosis (TB), but their nutritional status, especially of micronutrients, is still poorly documented. The objective of this study was to investigate the nutritional status of patients with active TB compared with that of healthy controls in Jakarta, Indonesia. In a case-control study, 41 out-patients aged 15-55 y with untreated active pulmonary TB were compared with 41 healthy controls selected from neighbors of the patients and matched for age and sex. Cases had clinical and radiographic abnormalities consistent with pulmonary TB and at least two sputum specimens showing acid-fast bacilli. Anthropometric and micronutrient status data were collected. Compared with the controls, TB patients had significantly lower body mass index, skinfold thicknesses (triceps, biceps, subscapular, suprailiac), mid-upper arm circumference, proportion of fat, and concentrations of serum albumin, blood hemoglobin, plasma retinol and plasma zinc, whereas plasma zinc protoporphyrin concentration, as a measure of free erythrocyte protoporphyrin concentration, was greater. When patients and controls were subdivided on the basis of nutritional status, concentrations of serum albumin, blood hemoglobin, and zinc and retinol in plasma were lower in malnourished TB patients than in well-nourished healthy controls, well-nourished TB patients and malnourished healthy controls. In conclusion, the nutritional status of patients with active pulmonary TB was poor compared with healthy subjects, i.e., significantly more patients were anemic and more had low plasma concentrations of retinol and zinc. Low concentrations of hemoglobin, and of retinol and zinc in plasma were more pronounced in malnourished TB patients.

Adolescent↗
PubMed2001

Variability in nutrient intakes among pregnant women in Indonesia: implications for the design of epidemiological studies using the 24-h recall method.

Few studies have assessed the reliability of dietary intake methods during pregnancy. Between 1996 and 1998, a longitudinal study of dietary intake during pregnancy was carried out among 451 women in Central Java, Indonesia. Six 24-h recalls were performed each trimester. We report here on intraindividual and interindividual variability in energy and nutrient intakes, as well as the reliability of the 24-h diet recall method. Implications of the use of different numbers of replicate days for estimating dietary intake and the relationships between dietary intake and health outcomes are also discussed. Intravariance-to-intervariance ratios were <1 for energy and carbohydrates and >1 for all other nutrients throughout pregnancy. Reliability analyses found good agreement (reliability coefficient >0.7) with three replicates for the macronutrients, but at least six replicates were needed for an agreement of > or =0.6 for the micronutrients. To estimate true individual average intake with a precision of +/-20%, six replicate recalls were sufficient for energy, carbohydrates, vitamin A, iron and vitamin C. In conclusion, mean intake of several nutrients can be reliably measured with the 24-h recall method, using a limited number of days. The nutrient of interest, the primary objectives and method of analyses should all be taken into account when planning sample size and number of replicates.

Adult↗
PubMed2005

Food-for-work programs in Indonesia had a limited effect on anemia.

Indonesia's economic crisis of late 1990s lowered consumption of micronutrient-rich foods, which increased the prevalence of micronutrient deficiencies, including anemia. As a postcrisis response, 5 nongovernmental organizations (NGOs) implemented Food for Work (FFW) programs to protect food consumption levels and nutritional status by providing rice, sometimes combined with oil and/or pinto beans. An independent evaluation assessed the effect of the FFW programs on nutrition outcomes, particularly anemia. A quasi-experimental design was used in which 1500 beneficiary and 1500 control households were randomly selected and followed in each of 3 urban and 2 rural sites. Baseline data were collected before program implementation and subsequently at approximately 6-mo intervals for 2.5 y. The poor were found to be appropriately targeted, and program participation ranged from 4 to 18 mo. The proportion of households with debts ranged from 32 to 70%; although it was higher among beneficiaries than controls, it increased among controls, but not beneficiaries. However, only among urban poor mothers in Surabaya were the odds of anemia at endline lower when participating in the FFW program (0.60, 95%CI [0.40-0.89]). Other risk factors for anemia in mothers and children included nutritional status (anemia at baseline, low BMI, receipt of vitamin A capsule, child age) and socioeconomic status (maternal education, having official residency in the area, income level). Thus, postcrisis FFW programs had limited effect on anemia, the main identified nutritional problem. Closer attention is required to the potential for affecting nutritional outcomes through FFW, including food aid quality and quantity and complementary nonfood interventions. Micronutrient deficiencies should be addressed directly via supplements and fortified foods.

Adult↗
PubMed1990

Breast feeding protects infants in Indonesia against illness and weight loss due to illness.

The authors tested the hypothesis that breast feeding modifies the effect of morbidity on growth by examining, at different levels of breast feeding: 1) number of days ill; and 2) the relation between morbidity and weight change. A total of 200 observations made at 3-weekly intervals between 1983 and 1984 on 33 breast-fed infants from a rural village on the island of Madura, Indonesia were used. Levels of breast feeding were defined as quartiles (Q1-Q4) of proportion of household visit time spent breast feeding. Regression analysis and analysis of variance were used and within child effects examined. Number of days ill from respiratory tract illness decreased significantly (p = 0.01) as quartile of breast feeding increased. Weight change was not affected by respiratory tract illness in Q2-Q4 but was significantly and negatively affected by such illness in the lowest quartile, Q1 (beta = -22.5 +/- 4.8 g/day ill). The slopes of Q2-Q4 were not significantly different from each other but were significantly different (p = 0.0094) from the Q1 slope. The authors examined whether measurement, reverse causality, or confounding bias changed the interpretation of findings; they did not. The authors conclude that breast feeding protects infants against the nutritional consequences of illness by decreasing the number of days with respiratory tract illness and protecting against weight loss due to this form of illness. However, this protective effect of breast feeding is attained only when levels of breast feeding are adequate, because at the lowest level of breast feeding, illness had a negative impact on weight performance.

Breast Feeding↗
PubMed2001

Mother's working status and nutritional status of children under the age of 5 in urban low-income community, Surabaya, Indonesia.

A cross-sectional anthropometrics survey was carried out in a low-income community of Surabaya, Indonesia, to examine the association between mother's employment and the child's nutritional status for identifying a group at risk of having malnourished children. Subjects were 274 children under the age of 5. The children of non-working mothers had significantly higher height-for-age z-score (HAZ) (p < 0.05) than those of working mothers. When mother's work was divided into 'formal' and 'informal', HAZ and weight-for-age z-score (WAZ) of children of the informal worker's group were significantly lower than those of the non-working mother and the formal worker's group (p < 0.05). Mother's education and income of the formal worker's group were significantly higher than those of the informal worker's group (p < 0.01). Our study identified a group at risk of malnutrition, i.e., children of mothers working in informal sectors. The programs to provide childcare for working mothers should target this particular group of poor households.

Adult↗
PubMed2002

Assessment of vitamin A status of preschool children in Indonesia using plasma retinol-binding protein.

Although plasma retinol-binding protein (RBP) has been proposed as an indicator of vitamin A status of populations in less technologically developed settings, potential factors which could influence this indicator include inflammation and protein energy status. Plasma RBP, retinol, alpha1-acid glycoprotein (AGP), C-reactive protein (CRP), and albumin were measured in a study of 236 preschool children in Bandung, Indonesia. Spearman correlation coefficient between plasma RBP and retinol concentrations was 0.55 (p < 0.0001). By linear regression, 0.70 pmol/l retinol was equivalent to 0.69 micromol/l RBP. With these cut-off points for defining vitamin A deficiency and plasma retinol as the standard for comparison, RBP had a sensitivity and specificity of 75.0 per cent and 63.2 per cent, respectively. The correlation between RBP and retinol was not affected by plasma AGP, CRP, or albumin concentration. Measurement of plasma RBP by radial immunodiffusion is simple and inexpensive, and this test can be used as a simple surrogate measure for vitamin A concentrations in large field studies.

Biomarkers↗
PubMed2004

Socioeconomic and familial characteristics influence caretakers' adherence to the periodic vitamin A capsule supplementation program in Central Java, Indonesia.

The adherence of program participants to periodic vitamin A capsule (VAC) supplementation among children aged 1-5 years (n = 677) in Central Java, Indonesia was assessed. Fourteen villages from five sub-districts and one ward from one sub-district in Central Java were included in the study to represent rural and suburban areas. All questions about demographic factors, socioeconomic conditions, current dietary practice and healthcare-seeking attitudes for common childhood illnesses, previous breastfeeding experience, their knowledge about vitamin A and adherence to the VAC program after capsule distribution (two periods in 2000) were asked. Caretakers with limited knowledge about the health benefits of vitamin A, households with more than one preschool child, and households with older children (> 36 months) were associated with a decreased likelihood of regular participation in the program with odds ratios of 0.38, 0.55, and 0.26, respectively (p < 0.01). The percentage of caretakers who utilized community health centers, village health posts or midwives' practices in rural areas, was significantly higher (86.6 per cent, p < 0.001) than in suburban areas (62.8 per cent). Living in a rural location was associated with an increased adherence to participate in the program regularly with an odds ratio of 2.02 (p < 0.01). In conclusion, nutritional education and periodic social marketing should be re-emphasized and other potential delivery channels, such as private healthcare practices, could also contribute to an increase adherence of supplementation program.

Caregivers↗
PubMed1996

Behavioral interventions for reduction of sexually transmitted disease/HIV transmission among female commercial sex workers and clients in Bali, Indonesia.

OBJECTIVE: To describe and evaluate a behavioral intervention targeted to low-price female commercial sex workers (CSW) in large brothel complexes, their pimps, and their male clients. DESIGN AND METHODS: Fieldwork was conducted during 1994 in Bali, Indonesia. Intervention activities included an education program for CSW, pimp training, condom sales and distribution, and client media. Theoretical perspectives guiding the intervention were the Health Belief Model and social cognitive theory. Baseline and evaluation surveys were conducted to evaluate the intervention. RESULTS: Both AIDS and sexually transmitted disease (STD) knowledge increased significantly over the intervention period. Condom use for vaginal sex with paid partners the day before the interview increased substantially in the two intervention areas: 18-75% and 29-62%. Condom use also increased in the control area, although the difference between baseline and evaluation measures was smaller. Multivariate analyses indicated that programmatic factors such as attendance at education sessions and reading the project brochure were related to condom use. CONCLUSIONS: Increasing community knowledge and awareness among low-price CSW, pimps, and clients regarding AIDS and STD using trained outreach workers is feasible and effective. In summary, this study has documented the effectiveness of a behavioral intervention for CSW and their clients.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Methanoculleus palmolei sp. nov., an irregularly coccoid methanogen from an anaerobic digester treating wastewater of a palm oil plant in north-Sumatra, Indonesia.

Strain INSLUZT (= DSM 4273T) was isolated from a biogas-producing bioreactor treating wastewater of a palm oil mill on North-Sumatra (Indonesia). Cells of strain INSLUZT were highly irregularly coccoid, 1.25-2.0 microns in diameter, had a cell envelope consisting of the cytoplasmic membrane and an S-layer of hexagonally arranged glycoprotein subunits with an M(r) of 120,000, and were flagellated (motility was not observed). Cells were mesophilic and grew most rapidly at 40 degrees C on H2/CO2' formate, 2-propanol/CO2 2-butanol/CO2 and cyclopentanol/CO2 to give methane. Tungstate promoted growth on H2/CO2 with acetate as the solely required organic medium supplement. The G + C content of DNA was 59 mol% (Tm method) and 59.5 mol% (HPLC method). 16S rDNA analysis revealed a phylogenetic relationship to Methanoculleus species; the name Methanoculleus palmolei sp. nov. is therefore proposed for strain INSLUZT (= DSM 4273T).

Anaerobiosis↗
PubMed2006

Isolation of Salmonella enterica subspecies enterica serovar Paratyphi B dT+, or Salmonella Java, from Indonesia and alteration of the d-tartrate fermentation phenotype by disrupting the ORF STM 3356.

Salmonella enterica subspecies enterica serovar Paratyphi B [O1,4,(5),12 : Hb : 1,2] can cause either an enteric fever (paratyphoid fever) or self-limiting gastroenteritis in humans. The d-tartrate non-fermenting variant S. enterica subsp. enterica serovar Paratyphi B dT- (S. Paratyphi B) is the causative agent of paratyphoid fever, and the d-tartrate fermenting variant S. enterica subsp. enterica serovar Paratyphi B dT+ (S. Paratyphi B dT+; formerly called Salmonella Java) causes gastroenteritis. S. Java is currently recognized as an emerging problem worldwide. Twelve dT+ S. Java isolates were collected in Indonesia between 2000 and 2002. One-third of them contained Salmonella genomic island 1 (SGI1), which gives the multidrug-resistant phenotype to the bacteria. In this study, a PCR-based method to detect a single nucleotide difference responsible for the inability to ferment d-tartrate, reported elsewhere, was validated. The d-tartrate fermenting phenotype of S. Java was converted to the non-fermenting phenotype by the disruption of the ORF STM 3356, and the d-tartrate non-fermenting phenotype of the ORF STM 3356-disrupted strain and the dT- reference strain was changed to the dT+ phenotype by complementing ORF STM 3356 in trans. The results show that the dT+ phenotype requires a functional product encoded by STM 3356, and support the use of the PCR-based discrimination method for S. Paratyphi B and S. Java as the standard differentiation method.

Anti-Bacterial Agents↗