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PubMed1999

The first report on human cases serologically diagnosed as Japanese encephalitis in Indonesia.

Although Japanese encephalitis (JE) virus was isolated from mosquitos in 1974, human JE cases have never been reported in Indonesia in spite of the prevalence of anti-JE antibodies among human and pig populations as well as abundant JE vector mosquitos. In this report, we describe serological diagnosis of JE cases in Bali. Indonesia. using IgM-capture ELISA both on serum and cerebrospinal fluid (CSF) of the patients. In the first series of our investigation (Series 1), we examined serum specimens from 12 patients with clinical diagnosis of viral encephalitis, meningitis or dengue hemorrhagic fever (DHF), and found 2 possible JE cases. In the next series (Series 2), we examined both serum and CSF from encephalitis patients and gave laboratory diagnosis of JE. One of them was suspected to have concomitant or recent infection with dengue virus, probably type 3. These results strongly indicated that JE has been prevalent in Bali, Indonesia.

Child, Preschool↗

PubMedDate not supplied

Characterization of nine Pasteurella multocida isolates from avian cholera outbreaks in Indonesia.

Avian cholera outbreaks have been identified in Indonesia in recent years. Despite vaccination programs, outbreaks continue to occur. To date, there has been a lack of information on the characteristics of Pasteurella multocida isolates involved in these outbreaks. Hence, the objective of this study was to characterize Indonesian P. multocida isolates in poultry. During 1998-99, 20 field outbreaks were reported in Indonesia. Nine isolates of P. multocida were recovered from these field outbreaks. The isolates were compared with four vaccine strains that were used in Indonesia and designated PM-V1, PM-V2, PM-V3, and PM-V4. The isolates were characterized by biotype, capsular type, somatic serotype, restriction endonuclease analysis, plasmid presence, and antimicrobial susceptibility patterns. Of the nine Indonesian isolates, three were of capsular type A (A:1,3,13; A:1,3; and A:8). One isolate was of type B:2,3 and one isolate was of capsular type F. For three isolates, the capsular serogroup could not be identified. Plasmids the size of 2.3 kbp were present in three of the field isolates and two of the vaccine strains. One plasmid less than 2 kbp was isolated from the vaccine strain PM-V4. Eight distinct DNA profiles were obtained from digestion with the restriction endonuclease EcoRI, and seven distinct DNA profiles were obtained from digestion with the restriction endonuclease HindIII. All of the isolates were resistant to lincomycin and sulfadiazine and were susceptible to ampicillin and trimethoprim. Of the nine isolates, seven (78%) were susceptible to doxycycline and gentamicin and six (67%) were susceptible to enrofloxacin.

Ampicillin↗

PubMed2001

Food and nutrition security and the economic crisis in Indonesia.

Indonesia has been afflicted by an economic crisis since July 1997. The economic crisis was preceded by a long drought associated with El Nino. The result has been a decline in food production, especially rice. In the eastern part of the country, especially in Irian Jaya, there was food insecurity during the early stages of the economic crisis. When the crisis escalated to become an economic, social and political crisis in 1998, food insecurity spread to other provinces, especially to urban areas in Java. The crisis led to increasingly high inflation. unemployment, poverty, food insecurity and malnutrition. The official figures indicate that poverty in Indonesia increased from 22.5 million (11.3%) in 1996 to 36.5 million (17.9%) in 1998. Food production decreased by 20-30% in some parts of the country. Compared with prices in January 1998, food prices had escalated 1.5- to threefold by August/November 1998 when acute food shortages occurred, especially in urban Java. Coupled with a drop in purchasing power, the higher food prices worsened health, nutritional status and education of children of urban poor and unemployed families. Despite social and political uncertainties, the Indonesian Government has taken prompt action to prevent a worsening of the situation by massive imports of rice, instituting food price subsidies for the poor and launching social safety net programmes to cope with food shortages and malnutrition. The present paper attempts to highlight the impact of the economic crisis on food insecurity and malnutrition in Indonesia.

Adolescent↗

PubMed2002

External quality assessment scheme and laboratory accreditation in Indonesia.

The National Program on External Quality Assessment Scheme (NEQAS) in Indonesia was first started in 1979, organized by the Indonesian Ministry of Health collaborating with professional bodies. The first trial was for clinical chemistry test with 2 cycles per year, followed by the hematology NEQAS in 1986 in collaboration with WHO-Royal Post Graduate Medical School London. After that, the schemes for serology, microbiology and parasitology were also organized. Around 500-600 laboratories throughout Indonesia participated each year in these quality control schemes, 2-4 cycles per year. Samples would be sent to participants and results will be given back to each laboratory. Poor performers should participate in the workshop or training course conducted by the Central Health Laboratory to improve their results. Participation in this NEQAS is mandatory for obtaining the laboratory license, and the Ministry of Health uses these schemes as one of the means for monitoring and coordinating the performance of laboratories throughout Indonesia. There are also some other EQAS (External Quality Assessment Scheme) programs conducted by professional bodies, such as for hemostasis, clinical chemistry and serology. During the course of conducting these schemes, it could be observed that manual methods were gradually changed to the automatic methods, especially for the clinical chemistry and hematology laboratories, which counts also for improvements of their results. Since the last 6 years, the Ministry of Health also began to conduct the Accreditation System evaluation for hospitals, including the laboratory departments. There are 7 standards that were evaluated, such as the aspect of the organization, administration and management, staffing, facilities and equipment, standard operating procedures, research and developments and quality control. This accreditation program is still in progress for all public and private hospital laboratories.

Chemistry, Clinical↗

PubMed2001

Cysticercosis in Indonesia: epidemiological aspects.

Cysticercosis caused by the larval stage, cysticercus or cysticerci, of the pork tapeworm Taenia solium was recognized at first in Bali and in Paniai District, Irian Jaya (Papua), Indonesia in the 1970s. In the 1990s a rapid increase in the number of the cases of epileptic seizures and burns in Jayawijaya district, eastern Papua, was observed. There were a total of 1,120 new cases of burns (7.0%) and 293 new cases of epileptic seizures (1.8%) from 15,939 local people during 1991-1995. Both histopathological examination and mitochondrial DNA analysis of resected cysts from patients and pigs revealed cysticerci of T. solium. Antibody responses highly specific to cysticercosis were revealed in approximately 67% and 65% of persons respectively with epileptic seizures and with subcutaneous nodules. Therefore, most cases of epileptic seizures and burns were considered to be associated with cysticercosis in Papua. Additional serologically data from Bali showed that 13.5% of epileptic seizures (10/74) and 12.6% of asymptomatic individuals (94/746) were supposed having been exposed to T. solium. Histopathological evaluation of 80,000 tissue samples in East Java revealed that nine were cysticercosis. All cases were non-moslems and from two ethnic groups, Chinese and Balinese. Epidemiological data on cysticercosis are not available from other provinces of Indonesia, although cases of cysticercosis are occasionally reported. Therefore, other intensive epidemiological studies are strongly recommended, especially covering the eastern part of Indonesia.

Adult↗

PubMed1989

Fertility transition in Indonesia, trends in proximate determinants of fertility, based on the 1987 NICPS/DHS.

The authors "estimate proximate determinants of fertility in Indonesia from the 1987 National Indonesia Contraceptive Prevalence Survey (1987 NICPS). For Java and Bali, the results will be compared to the 1976 Indonesia Fertility Survey's estimates of proximate determinants [to]....provide a better understanding of the causes of fertility decline in Java-Bali during 1976-1987." A theoretical model is used to estimate biological and behavioral proximate determinants of fertility, including marriage and divorce, infertility, postpartum amenorrhea, contraceptive use, induced abortion, fecundability and coital frequency, and fetal death. (SUMMARY IN IND)

Abortion, Induced↗

PubMed1994

Latest figures on infection rates in Indonesia released.

At least 258 people in Indonesia have been found infected with HIV, the official Antara news agency said. It quoted Health Minister Sujudi as saying 40% of the virus carriers were foreigners. Indonesia, the world's fourth most populous country, has established HIV centers in all of the country's 27 provinces in efforts to check the disease's spread. A report earlier in 1994 by U.S. Representative Jim McDermott's Congressional Task Force on HIV and AIDS estimated that up to three million of Indonesia's 185 million people might be infected with HIV in six years. It put the total cost for treatment and lost earnings at more than 16 billion dollars by the end of the century. Sujudi said the best way to prevent the spread of HIV is through education in schools and a strengthening of religious and moral values.

Asia↗

PubMed2003

Serologic evidence of infection with ehrlichiae and spotted fever group rickettsiae among residents of Gag Island, Indonesia.

The causative agents of scrub and murine typhus are considered endemic to Indonesia. However, the presence of spotted fever group rickettsiae and ehrlichiae have not been previously described in this country. During an investigation of arthropod-borne diseases on Gag Island, located northwest of the island of New Guinea in eastern Indonesia, the prevalence of antibody to the etiologic agents of monocytic ehrlichiosis, spotted fever rickettsiosis, and scrub and murine typhus were determined. Analysis of 55 blood samples from residents of Gag Island showed seroreactivity to antigen preparations of Ehrlichia chaffeensis (7 of 48, 14.6%), two spotted fever group rickettsiae: Rickettsia rickettsii (5 of 48, 10.4%) and R. conorii (10 of 49, 20.4%), Orientia tsutsugamushi (5 of 53, 9.4%), and R. typhi (1 of 48, 2.1% [by an indirect immunofluorescence assay] and 1 of 50, 2.0% [by an enzyme-linked immunosorbent assay]). These results show serologic evidence of infection with ehrlichiae and spotted fever group rickettsiae for the first time in Indonesia in a location where the prevalence of antibody to O. tsutsugamushi and R. typhi was lower.

Antibodies, Bacterial↗

PubMed2004

Patient Record Information System (PaRIS) for primary health care centers in Indonesia.

This study explores the Patient Record Information System (PaRIS) for primary health care centers in a developing country such as Indonesia. The specific geography of the thousand islands country Indonesia is the reason for transportation difficulties as well as communication problems. This causes a serious adverse effect on the public healthcare service especially in the rural area within the country. Hence, a sustainable system is required that makes use of appropriate Information and Communication Technology (ICT). We developed a clinical information system with modest communication technology combined with a unique database distribution system. The Internet and its free software are the main tools for this system. It is a good opportunity for a developing country such as Indonesia to apply open free software in regard to the healthcare sector. This cost effective and sustainable system can enhance the work of physicians in order to provide better and applicable public health care service.

Ambulatory Care Information Systems↗

PubMedDate not supplied

Prevalence of hypertension without anti-hypertensive medications and its association with social demographic characteristics among 40 years and above adult population in Indonesia.

AIM: To find out the prevalence of hypertension without anti-hypertensive medication and its social demographic risk factors among adult population in Indonesia. METHODS: Random samples of 3080 subjects aged 40-94 years were obtained from various districts in every big island in Indonesia. Blood pressure measurements, as well as assessment on history of hypertension, use of anti-hypertensive medications, and social demographic characteristics were performed. Blood pressure measurements were obtained by trained doctors with the subjects in supine position. Stepwise multiple logistic regression was used to determine variables which were most associated with treatment without anti-hypertensive medication in hypertensive subjects. RESULTS: The prevalence of hypertension without anti-hypertensive medication among 40 years and above adult population in Indonesia was 37.32% (677 our of 1814 hypertensive subjects). From bivariate analysis, we found that male sex, older age, informal education and unemployment were associated with the use of anti-hypertensive medication. Multivariate analysis shows that male sex (OR=1.33), education level of elementary school (OR=1.50), and government employment (OR=1.24) are significantly as risk factors for not taking anti-hypertensive medication. Age more than 60 years old (OR=0.49) and unemployment (OR=0.70) are protective factors for not taking anti-hypertensive medication. CONCLUSION: The prevalence of hypertension without anti-hypertensive medication in this study is higher than the prevalence found in some other studies, and due to several social demographic risk factors, such as low level education, male sex, and being government employees. On the other hand, older people and those who have no formal occupation are protective factors.

Adult↗

PubMed2006

A community-based TB drug susceptibility study in Mimika District, Papua Province, Indonesia.

SETTING: A district level tuberculosis (TB) control programme in Papua Province, Indonesia. OBJECTIVE: To determine the nature and extent of drug-resistant TB in newly diagnosed sputum smear-positive patients. METHODS: Sputum was collected from previously untreated smear-positive pulmonary TB patients diagnosed in the district over a 10-month period. Sputum specimens were processed and inoculated into a BACTEC MGIT960 tube. Isolates were identified by Ziehl-Neelsen staining, hybridisation with nucleic acid probes and biochemical investigations. Susceptibility testing was performed using the radiometric proportion method. Pyrazinamide testing was performed using the Wayne indirect method. RESULTS: One hundred and seven patients had sputum sent to a reference laboratory; 101 (94.4%) were culture-positive for Mycobacterium tuberculosis, with 87 (86.1%) fully sensitive to first-line anti-tuberculosis drugs. Two per cent were multidrug-resistant (MDR-TB) and 12 (11.9%) had other drug resistance. Each of the MDR-TB isolates was susceptible to amikacin, capreomycin, ciprofloxacin and para-aminosalicylic acid (PAS), but were resistant to rifabutin. One isolate was also resistant to ethionamide. CONCLUSIONS: MDR-TB is present in Indonesia but is not a major problem for TB control in this district. Generalisability to other districts in Indonesia, particularly large urban areas, needs to be confirmed by future studies.

Adolescent↗

PubMed1991

The current status of food-borne parasitic zoonoses in Indonesia.

Only a few food-borne parasitic zoonoses have been reported in Indonesia. The most frequently observed food-borne parasitic diseases are: toxoplasmosis, taeniasis and cysticercosis. Little data are available on other parasitic zoonoses in Indonesia. Taeniasis has been reported in nine provinces. Toxoplasmosis in humans, with prevalence rates ranging from 1 to 60%, has been reported in 12 provinces; in animals, toxoplasmosis is known to occur throughout the country, with serologically positive cases in as many as 75% of animals examined. However, it is expected that other parasitic zoonoses, such as anisakiasis, fasciolopsiasis and echinostomiasis, will emerge as the popularity of exotic foods being served in Korean and Japanese restaurants spreads throughout Indonesian cities. This paper reviews the current status of parasitic zoonoses in Indonesia.

Animals↗

PubMed1988

Dengue haemorrhagic fever and Japanese B encephalitis in Indonesia.

Dengue haemorrhagic fever (DHF) was first recognized in Indonesia in the cities of Jakarta and Surabaya in 1968, 15 years after its recognition in the Philippines. During the 1968 outbreak, a total of 58 clinical cases with 24 deaths were reported. The number of reported cases since then has increased sharply, with the highest number of cases recorded in the years 1973 (10,189 cases), 1983 (13,668 cases), and 1985 (13,588 cases). Outbreaks of the disease have spread to involve most of the major urban areas, as well as some of the rural areas. In 1985, the disease had spread to 26 of 27 Provinces and 160 of 300 regencies of municipalities. At present, the disease is endemic in many large cities and small towns. Interestingly, DHF has not been reported in some cities, even though dengue virus transmission rates in those cities are high. The epidemic pattern of DHF for the country as a whole has become irregular. Since 1982, the intensity and spread of DHF has created an increasing public health problem in Indonesia, particularly in Java where 60% of the total population of the country resides. Java contributed about 71% of all cases occurring in the country in 1982, 84% in 1983, and 91% in 1984. The peak monthly incidence of DHF was frequently reported during October through April, months which coincide with the rainy season. The morbidity rate for Indonesia, estimated from reported cases over five years (1981-1985), ranged between 3.39 to 8.65 per 100,000 population. The overall case fatality rate has steadily declined from 41.3% in 1968 to 3% in 1984.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1987

Dengue haemorrhagic fever in Indonesia.

Dengue haemorrhagic fever (DHF) was first recognized in Indonesia in the cities of Jakarta and Surabaya in 1968, 15 years after its recognition in the Philippines. During the 1968 outbreak, a total of 58 clinical cases with 24 deaths were reported. The number of reported cases since then has increased sharply, with the highest number of cases recorded in the years 1973 (10, 189 cases), 1983 (13,668 cases), and 1985 (13,588 cases). Outbreaks of the disease have spread to involve most of the major urban areas, as well as some of the rural areas. In 1985, the disease had spread to 26 of 27 Provinces and 160 of 300 regencies or municipalities. At present, the disease is endemic in many large cities and small towns. Interestingly, DHF has not been reported in some cities, even though dengue virus transmission rates in those cities are high. The epidemic pattern of DHF for the country as a whole has become irregular. Since 1982, the intensity and spread of DHF has created an increasing public health problem in Indonesia, particularly in Java where 60% of the total population of the country resides. Java contributed about 71% of all cases occurring in the country in 1982, 84% in 1983, and 91% in 1984. The peak monthly incidence of DHF was frequently reported during October through April, months which coincide with the rainy season. The morbidity rate for Indonesia, estimated from reported cases over five years (1981-1985), ranged between 3.39 to 8.65 per 100,000 population.

Child↗

PubMed1985

Epidemiological aspects of some malignant neoplasms in Indonesia.

Compared with 20 years ago, the problem of cancer is now on the increase in Indonesia. Cancer as the cause of death in various hospitals in Indonesia ranked No. 7 after infectious diseases, accidents and cardiac diseases. Cancer of the cervix uteri and breast were the most frequent cancer found in females throughout Indonesia, except in Padang (West Sumatra). The highest frequency of cervical cancer was found in Bali (34.0%). For both sexes together, skin cancer has been found to be the 3rd ranking after cancer of the cervix uteri and breast. Nasopharyngeal cancer, and cancer of the liver have been found high ranking among males, and from the reported data from 1981 and before, there has been almost no changes observed in the ranking of cancers among females.

Breast Neoplasms↗

PubMed1983

Mosquitoes of Bali Island, Indonesia: common species in the village environment.

Routine sampling of mosquito populations in rural villages was carried out during 13 months at 4 locations in southern Bali Island, Indonesia. Sampling was by light trapping and early night resting collections around animal stables. Specimens collected were preserved for assay of arthropod-borne viruses; 104,608 specimens representing 20 species were prepared in 2681 pools for viral assay. Anopheles barbirostris and An. subpictus have been shown to be important vectors of Brugia malayi and B. timori and of malaria and Wuchereria bancrofti in other parts of Indonesia but have not been incriminated in transmission of disease agents in Bali. Anopheles vagus may be involved in filarial transmission in other regions but is not regarded as important in Bali. Culex fuscocephala, Cx. gelidus and Cx. tritaeniorhynchus have been incriminated in the transmission of Japanese encephalitis virus in Indonesia and Cx. vishnui has been similarly implicated in other countries. The populations of these mosquitoes are compared and plotted against rainfall. The potential of the more common species as vector of some human pathogens is discussed.

Aedes↗

PubMed1994

Changing prevalence of xerophthalmia in Indonesia, 1977-1992.

OBJECTIVE: The primary objective of this analysis was to determine if the prevalence of xerophthalmia in Indonesia has changed over the period 1977-78 to 1992. DESIGN: The design was two cross-sectional prevalence surveys conducted in the same rural sample locations 14 years apart. SETTING: The studies were conducted in 15 provinces of Indonesia using a stratified random selection of villages. SUBJECTS: All persons in selected villages < 6 years of age were eligible for participation. Children were recruited during a door-to-door census of villages and invited to present for an eye examination at a central point in the village. A total of 19,032 subjects were included in the 1977-78 and 18,508 children in the 1992 survey. RESULTS: Overall, the prevalence of active xerophthalmia among preschool children declined by 75% (1.33% in 1977-78 to 0.34% in 1992). Active corneal disease declined by 95% (1/1000 in 1977-78 to 0.05/1000 in 1992). While the overall declines were dramatic and highly significant (P < 0.0001), selected provinces continued to show rates higher than the WHO criteria for a problem of public health significance. CONCLUSIONS: The prevalence of xerophthalmia has declined significantly over the past 14 years in Indonesia. The specific reasons for this decline cannot be ascribed to any particular intervention due to the multitude of health and social changes that have occurred during this period.

Child, Preschool↗

PubMed1997

A practical method of active case finding and epidemiological assessment: its origin and application in the leprosy control project in Indonesia.

Random sample surveys in the past have revealed high estimated against low registered prevalences for leprosy in several parts of Indonesia. A pilot project showed that the problem of cases that had not yet been detected could not be solved without the active participation of the local authorities, who proved able to overcome the stigma and to convince potential patients to go for examination and treatment. The pilot project was based on the principle of what are called exploration surveys, which were introduced by Sitanala in Indonesia in 1931. The Indonesian government decided to reintroduce these surveys in 1977 under the name of chase or trace surveys. They are carried out within the framework of the leprosy workers' routine duties and no additional expenses are incurred. Since then, thousands of patients of all types and with long case histories have been detected and brought under treatment. Without this "push" it is fair to assume that many would never have sought treatment voluntarily. In view of the experience in Indonesia, one wonders whether leprosy can be eliminated without emphasizing the importance of active case finding, especially in areas in which the disease is still highly endemic. Chase surveys also provide rough information about the local leprosy situation. Although of great value, they are not, in high-endemic regions, an alternative to random sample surveys which reveal, besides a wealth of additional information, the possible unknown sources of infection.

Communicable Disease Control↗