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PCR amplification and sequence of the p33 piroplasm surface antigen gene of a Theileria species isolated from cattle in west Java, Indonesia.

Oriental theileriosis, a parasitic disease of cattle caused by protozoa of the Theileria orientalis/sergenti/buffeli group, has been reported in Indonesia but its causal agent had not yet been characterized. This study was carried out to isolate and characterize the parasite through comparison of its p33 piroplasm surface antigen gene sequence, with known p32 sequences of T. sergenti and T. buffeli isolates. A Theileria spp. isolate was collected from an Ongole cow in Jonggol, West-Java, and transferred into a splenectomized calf for antigen production. Piroplasms were extracted from erythrocytes by ammonium chloride-lysis, separated from unlysed leukocytes and parasitic DNA was phenol-extracted. Polymerase chain reaction (PCR) was carried out on genomic DNA with a pair of 20 bp primers showing consensus for the p32-35 nucleotide sequence of 7 known T. orientalis/sergenti/buffeli isolates. An 875 bp fragment was amplified, and further sequenced on both strands by the dye-labeled terminators method. It showed an 88% homology with the p33 nucleotide sequence of the Japanese T. sergenti Ikeda stock and a lesser homology with 6 other sequences of Australian T. buffeli or Japanese T. sergenti stocks. It was shown to share the presence of the Pst 1 and the absence of the HindIII restriction sites of the T. sergenti Ikeda stock and of one Australian T. buffeli stock, respectively. In conclusion, the affiliation to and the relative position of this Indonesian isolate within the T. orientalis/sergenti/buffeli group has been elucidated.

Amino Acid Sequence↗

Results of oral health and hygiene education in an institution for multiple handicapped children in Indonesia.

In a collaboration between the Dutch and Indonesian Dental Associations a system for oral health care for multiple handicapped children was initiated in a large care and rehabilitation institution in Jakarta, Indonesia. Part of the project was to develop a programme for oral health and hygiene education (OHE), with a specific plaque control component. This programme was aimed not only at the handicapped children but also at their parents and the teaching and (para) medical staff of the institution. A study to investigate the feasibility, acceptability and effectiveness of the OHE programme was carried out over a period of 2 1/2 years. The programme was well accepted, effective and of clinical significance. It is probably one of the first of its kind in a developing country.

Adolescent↗

[A fatal case of acute enteritis caused by Salmonella Weltevreden after travel to Indonesia].

A 67-year-old male was admitted to our hospital because of watery diarrhea and pre-shock status at 10:30 am on March 20, 1995. He had travelled to Bali Island in Indonesia from March 13 to March 18, 1995. On admission, his systolic blood pressure was 60 mmHg and body temperature was 35.2 degrees C. His skin was very dry. Laboratory tests showed that s-Cr was 6.3 mg/dl and CPK was 5620 IU/l. A massive fluid transfusion was given immediately and then his blood pressure rose to 158/92 about two hours after admission. However, he developed a high grade fever and systemic cyanosis in the evening of the first hospital day and died at 0:20 am on March 21st. Salmonella Weltevreden was detected in the fecal and blood cultures obtained on admission. We considered that his acute renal failure was attributable to rhabdomyolysis due to dehydration and that the cause of death was probably septic shock. The patient had a previous history of cholecystectomy ten years ago and also suffered from hypertension, but his general condition was not so bad before this episode. Therefore, we were surprised that his illness became so severe. This case emphasizes that Salmonella enteritis may occasionally be a serious and lethal disease.

Acute Disease↗

Age of the earliest known hominids in Java, Indonesia.

40Ar/39Ar laser-incremental heating of hornblende separated from pumice recovered at two hominid sites in Java, Indonesia, has yielded well-defined plateaus with weighted mean ages of 1.81 +/- 0.04 and 1.66 +/- 0.04 million years ago (Ma). The hominid fossils, a juvenile calvaria of Pithecanthropus and a partial face and cranial fragments of Meganthropus, commonly considered part of the Asian Homo erectus hypodigm, are at least 0.6 million years older than fossils referred to as Homo erectus (OH-9) from Olduvai Gorge, Tanzania, and comparable in age with the oldest Koobi Fora Homo cf. erectus (Homo ergaster) in Kenya. These ages lend further credence to the view that Homo erectus may have evolved outside of Africa. If the ancestor of Homo erectus ventured out of Africa before 1.8 Ma, the dispersal would have predated the advent of the Acheulean culture at 1.4 Ma, possibly explaining the absence of these characteristic stone cleavers and hand axes in East Asia.

Africa↗

In vitro antibiotic susceptibility of Neisseria gonorrhoeae in Jakarta, Indonesia.

Antibiotic susceptibilities were determined for 122 Neisseria gonorrheae isolates obtained from 400 sex workers in Jakarta, Indonesia, and susceptibilities to ciprofloxacin, cefuroxime, cefoxitin, cefotaxime, ceftriaxone, chloramphenicol, and spectinomycin were found. All isolates were resistant to tetracycline. A number of the isolates demonstrated decreased susceptibilities to erythromycin (MIC >/= 1.0 microg/ml), thiamphenicol (MIC >/= 1.0 microg/ml), kanamycin (MIC >/= 16.0 microg/ml), penicillin (MIC >/= 2.0 microg/ml), gentamicin (MIC >/= 16.0 microg/ml), and norfloxacin (MIC = 0.5 microg/ml). These data showed that certain antibiotics previously used in the treatment of gonorrhea are no longer effective.

Anti-Bacterial Agents↗

Characterization and distribution of Vibrio alginolyticus and Vibrio parahaemolyticus isolated in Indonesia.

Previous studies have shown that Vibrio alginolyticus and Vibrio parahaemolyticus can be isolated from similar types of marine samples. In this report, the results of an examination of 567 V. alginolyticus and V. parahaemolyticus strains, isolated from seawater in Jakarta Bay and from more than 30 types of seafood from markets in Jakarta, Indonesia, are presented. Most isolates were from mackerel, shrimp, or squid. Numerical taxonomic analyses clustered 337 isolates and three V. alginolyticus reference strains at S greater than or equal to 80%. These strains produced acid from sucrose, but only approximately 80% produced acetoin or grew in the presence of 10% NaCl. The frequency of occurrence of V. alginolyticus in seawater samples ranged from 0% (in February and March 1972) to 100% (in September and December 1972) and was highest in seafood samples from August to December 1972. A second cluster of 230 isolates and seven V. parahaemolyticus reference strains was observed at S greater than or equal to 82%. These strains did not produce acetoin or acid from sucrose, and approximately 20% grew in the presence of 10% NaCl. V. parahaemolyticus was detected in seawater samples each month, with the highest frequency of occurrence (83.3%) in May 1972. Twenty-nine K antigen serotypes were demonstrated in V. parahaemolyticus isolates, and another 40% were untypable. The modal antibiotic resistance pattern for each species included five drugs. Only 12% of the V. parahaemolyticus strains were Kanagawa positive, and 10% elicited fluid accumulation in ligated rabbit ileal loops. All of the 7 V. alginolyticus strains and 94 (70%) of the V. parahaemolyticus strains tested killed mice when inoculated intraperitoneally.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Evidence for anti-Plasmodium falciparum antibodies that cross-react with human T-lymphotropic virus type I proteins in a population in Irian Jaya, Indonesia.

This study was performed to demonstrate the presence of anti-Plasmodium falciparum antibodies in a population living in Irian Jaya, Indonesia that cross-react with human T-lymphotropic virus type I (HTLV-I) proteins. Serum samples from 63 volunteers living in Oksibil, a secluded highland valley in Irian Jaya, were tested for anti-P. falciparum antibodies by an immunofluorescence assay and for anti-HTLV-I antibodies by an enzyme immunoassay (EIA). All samples were positive for anti-P. falciparum antibodies at titers of > or = 1:256. Twenty-four samples were reactive by EIA for HTLV-I, and of these, 23 were tested by western blotting (immunoblotting). Five of the 23 samples were classified as western blot positive and 18 were classified as western blot indeterminate. In competitive blocking assays with malaria proteins, western blot immunoreactivity to all HTLV-I Gag proteins was either reduced or eliminated. Significant reductions in the HTLV-I EIA optical density values of the Oksibil sera occurred when the sera were competitively blocked with the malaria antigens. The optical density values of HTLV-I-positive control sera showed no significant change. Competitive blocking with HTLV-I antigens produced reductions in the optical density values of both the Oksibil sera and the HTLV-I-positive control sera. These data suggest that in this population, anti-P. falciparum antibodies are cross-reactive with HTLV-I proteins in the western blot and EIA tests.

Animals↗

Further consideration of the clonal nature of Salmonella typhi: evaluation of molecular and clinical characteristics of strains from Indonesia and Peru.

We examined envelope protein profiles, chromosomal restriction endonuclease digest patterns, and immune responses to envelope proteins for collections of Salmonella typhi strains isolated in Peru and Indonesia. Only minor differences in envelope protein patterns were apparent among strains. Strains from 7 of 20 Indonesian patients had a distinct chromosomal digest pattern compared with patterns of Peruvian and other Indonesian strains. Strains with this pattern carried the gene for the j flagellar antigen (H1-j); differences in response to envelope proteins of j and d strains were noted on immunoblot analysis. Our data suggest that there are genotypic and phenotypic differences among S. typhi strains. The clinical importance of these differences remains to be fully evaluated; however, in this study it was not possible to show a clear correlation between strain characteristics and disease severity.

Bacterial Proteins↗

Differential prevalence of hepatitis C virus subtypes in healthy blood donors, patients on maintenance hemodialysis, and patients with hepatocellular carcinoma in Surabaya, Indonesia.

Determination of the prevalence of liver disease caused by hepatitis C virus (HCV) of various genotypes helps provide an understanding of the virulences of these genotypes. Differences in the prevalences of these genotypes are known to exist in the various geographical regions of the world. Hence, we performed seroepidemiological and molecular epidemiological analyses of HCV in Surabaya, Indonesia. The prevalences of anti-HCV antibodies were 2.3, 76.3 and 64.7% in healthy blood donors, patients on maintenance hemodialysis, and patients with hepatocellular carcinoma (HCC), respectively. HCV-2a was the most common (52%) among the HCV clones obtained from blood donors; this was followed by HCV-1b (15%), HCV-1a (7%), and HCV-1d (7%), a unique Indonesian subtype. The high prevalence of HCV-2a in blood donors was further supported by serotyping analysis that could discriminate HCV type 2 (HCV-2a and -2b) from HCV type 1 (HCV-1a, -1b, and -1d). HCV-1a, -1b, and -1d were strongly associated with elevated serum alanine aminotransferase (ALT) levels in blood donors, suggesting a possibly more pathogenic feature of those subtypes than HCV-2a. In patients on maintenance hemodialysis, HCV-1a and -1b (each 31%) were among the most common subtypes, and in contrast to the case with blood donors, HCV-1a, -1b, and -1d were found in those with normal ALT as well as those with elevated ALT levels. Impaired immune responses of hemodialyzed patients might be responsible for the apparently decreased hepatocytic injury caused by infection with HCV type 1. In patients with HCC, HCV-1b (57%) was the most common; this was followed by HCV-1d (19%) and HCV-2a (5%). Subtype prevalence was not different between HCC patients with advanced liver cirrhosis and those without advanced cirrhosis.

Blood Donors↗

Distribution of colonization factor antigens among enterotoxigenic Escherichia coli strains isolated from patients with diarrhea in Nepal, Indonesia, Peru, and Thailand.

Samples (1,318) of enterotoxigenic Escherichia coli (ETEC) isolated in 1994-1995 from children with diarrhea from Nepal, Indonesia, Peru, and Thailand were examined for colonization factor antigen (CFA) and coli surface (CS) antigens. Fifty-five percent of 361 heat-labile and heat-stable (LT-ST), 14% of 620 LT-only, and 48% of 337 ST-only ETEC had CFA/CS antigens. LT-ST ETEC strains were predominantly in the CFA II group, and ST only strains were in the CFA IV group. Additional studies are needed to identify ETEC strains that do not have CFA/CS antigens.

Adult↗

Evaluation of a rapid assay for detection of Chlamydia trachomatis infections in outpatient clinics in South Kalimantan, Indonesia.

A multicenter cross-sectional survey was conducted comparing a commercially available chlamydial optical immunoassay (OIA) to the chlamydial ligase chain reaction (LCR). Endocervical samples from 415 outpatients visiting clinics from three hospitals in South Kalimantan, Indonesia, were evaluated. Relative to the LCR, the overall sensitivity and specificity of the OIA were 31.6 and 98.9%, respectively. The sensitivity of the OIA varied among the three hospital laboratories, ranging from 20 to 50%. The OIA performance was slightly lower on samples from patients attending dermatovenereology clinics than on samples from nondermatovenereology clinic patients. The results indicate that the OIA did not perform well compared to LCR.

Ambulatory Care Facilities↗

Prevalence of GB virus C/Hepatitis G virus infection among various populations in Surabaya, Indonesia, and identification of novel groups of sequence variants.

A molecular epidemiological study was performed to investigate the prevalence of GB virus C/hepatitis G virus (GBV-C/HGV) infection among various populations in Surabaya, Indonesia. The prevalence of GBV-C/HGV RNA, determined by reverse transcription-PCR for a portion of the NS3 region of the viral genome, was 2.7% (4 of 150) among randomly collected blood donor sera, which were all negative for both hepatitis B virus surface antigen and antibodies against hepatitis C virus (HCV). On the other hand, the prevalence among anti-HCV-positive blood donors was 17.8% (13 of 73), with the ratio being significantly higher than that observed with the anti-HCV-negative blood donors (P < 0.001). A high prevalence of GBV-C/HGV infection was also observed among patients with chronic liver disease, such as chronic hepatitis (5.7%), liver cirrhosis (11. 5%), and hepatocellular carcinoma (7.0%), and patients on maintenance hemodialysis (29.0%). No correlation was observed between GBV-C/HGV viremia and serum alanine aminotransferase levels in the populations tested, suggesting the possibility that GBV-C/HGV does not cause apparent liver injury. Phylogenetic analysis of sequences of a portion of the 5' untranslated region and the E1 region of the viral genome identified, in addition to a previously reported then novel group of GBV-C/HGV variants (group 4), another novel group of variants (group 5). This result suggests that GBV-C/HGV can be classified into at least five genetic groups. GBV-C/HGV isolates of group 4 and group 5 were each shown to comprise approximately 40% of the total Indonesian isolates.

5' Untranslated Regions↗

Epidemiology of rheumatic diseases in rural and urban populations in Indonesia: a World Health Organisation International League Against Rheumatism COPCORD study, stage I, phase 2.

To determine the incidence of musculoskeletal pain, disabilities, and help seeking behaviour, a questionnaire was administered to a rural population of 2184 men and 2499 women and an urban population of 481 men and 590 women aged over 15 years by house to house interviews with completion rates of 95.2% (rural) and 97.1% (urban). The incidences of pain in the joints, back, or neck were 23.6% (rural) and 31.3% (urban). The incidence of disability due to an inability to walk, lift, carry, and dress was 2.8% (rural) and 0.9% (urban). The percentage of the population with pain who had to stop work owing to disability was 75% (rural) and 78% (urban). Official health care facilities were used by 62% (rural) and 71% (urban) of the population. Traditional health care was used by 87% (rural) and 89% (urban). The high percentage of subjects unable to work was due to a predominance of manual labour occupations (rural, 90%, urban, 80%). The age and sex specific incidence of rheumatic diseases in these populations were similar to other developing and developed countries. The primary rheumatology service was inadequate due to the low priority given by the health service to non-communicable diseases and inadequate rheumatology teaching of the primary health care doctors during undergraduate training. Musculoskeletal pain is a major public health problem in Indonesia and is still not fully appreciated.

Adolescent↗

Infant mortality and family welfare: policy implications for Indonesia.

STUDY OBJECTIVE: To examine the effect of family welfare index (FWI) and maternal education on the probability of infant death. DESIGN: A population based multistage stratified clustered survey. SETTING: Women of reproductive age in Indonesia between 1983-1997. DATA SOURCES: The 1997 Indonesian Demographic and Health Survey. MAIN RESULTS: Infant mortality was associated with FWI and maternal education. Relative to families of high FWI, the risk of infant death was almost twice among families of low FWI (aOR=1.7, 95%CI=0.9 to 3.3), and three times for families of medium FWI (aOR=3.3,95%CI=1.7 to 6.5). Also, the risk of infant death was threefold higher (aOR=3.4, 95% CI=1.6 to 7.1) among mothers who had fewer than seven years of formal education compared with mothers with more than seven years of education. Fertility related indicators such as young maternal age, absence from contraception, birth intervals, and prenatal care, seem to exert significant effect on the increased probability of infant death. CONCLUSIONS: The increased probability of infant mortality attributable to family income inequality and low maternal education seems to work through pathways of material deprivation and chronic psychological stress that affect a person's health damaging behaviours. The policies that are likely to significantly reduce the family's socioeconomic inequality in infant mortality are implicated.

Adolescent↗

Sexually transmitted diseases in Indonesia.

Epidemiological factors and changing ecological conditions have greatly facilitated the spread of sexually transmitted diseases and led to their rising incidence in Indonesia. Gonorrhoea is at present very prevalent, and drug resistance among circulating strains of gonococci is a contributing factor. Despite medical advances in both diagnosis and treatment of sexually transmitted diseases, these are becoming commoner; unlike other communicable diseases they have so far defied efforts to control them.

Female↗

Treponemal serology on Bali Island, Indonesia.

As part of a multidisciplinary study of the population of Bali, Indonesia, treponemal serology was carried out on 2452 serum samples from subjects of both sexes. Sera reactive to the Treponema pallidum immobilisation test (TPI) were found in 81 (3.3%) subjects with a male prevalence of 4% and a female prevalence of 2%. All the reactive sera were from villagers. Of 1118 students sampled in various towns, none had reactive TPI tests. The prevalence of reactive sera varied greatly from one village to another; up to 50% of the sera examined were reactive. Geographical and socioeconomic analyses of the data show a strict correlation between poor socioeconomic status and high reactivity rates to the TPI test. Fifty-seven per cent of all the reactive sera originated from subjects living in two districts where yaws had recently been reported. Only three of the 1406 subjects, aged 15-29 years, had reactive sera. The reactivity rate steadily increased in the age groups 30-44, 45-59, and 60 years and over. Biological false-positive reactions occurred in 3.8% of the sera tested.

Adolescent↗