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[Indonesia: the largest archipelago in the world].
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Efficacy of permethrin-impregnated bed nets on malaria control in a hyperendemic area in Irian Jaya, Indonesia: influence of seasonal rainfall fluctuations.
A malaria intervention study was carried out using permethrin impregnated bed nets in the south-central part of Irian Jaya with perennial transmission, from April 1993 to April 1995. Malariometric surveys were carried out periodically for parasite prevalence by species and for spleen rates. Prior to intervention, the percentage of Plasmodium falciparum infected inhabitants was significantly higher in Hiripau, where permethrin-impregnated bed nets were used during the study, than in the placebo-treated control village, Kaugapu. After two years of intervention the situation was reversed and figures higher in the control village (RR 0.19, 95% CI 0.10-0.36, p < 0.0001). Similarly, P. vivax infection rates, 12.4% in Hiripau vs 5.7% in Kaugapu in April 1993. were reversed in April 1995 (3.6% in Hiripau and 11.3% in Kaugapu, p < 0.001). In the treated village, pre-control hyperendemicity was reduced to a low mesoendemic level (spleen rate 12.5%) during two years of intervention, whereas the level was mesoendemic (spleen rate 35.2%) in the control village. Impregnated bed nets were found an effective intervention both in moderate (April 1993 through April 1994, 1,626 mm rainfall) and high (April 1994 through April 1995/1995, 3,321 mm) transmission seasons.
Dietary macro/micro-nutrients as a breast cancer risk: findings from nutritional case-control study in Jakarta, Indonesia.
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Maritime health and medical examinations for seagoing personnel in Indonesia.
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Seroprevalence of hepatitis A virus and varicella zoster antibodies in a Javanese community (Yogyakarta, Indonesia).
Hepatitis A virus (HAV) cause an acute inflammation of the liver. Varicella-zoster virus (VZV) cause chickenpox (varicella) and herpes zoster. Effective vaccines against hepatitis A and varicella are available for children, adolescents and adults. In order to implement an appropriate vaccination policy, a baseline to assess the potential benefits and sections of the population who would benefit most are required. We investigated seroprevalence of hepatitis A virus and varicella zoster antibodies in a Javanese community. A total of 1,103 subjects were studied. The 600 subjects aged 4 to 9 years were sampled between 23 October and 2 November, 1995. The other subjects were sampled between 12 October and 1 November, 1996. The overall prevalence of anti-HAV in cohort was 28.7%. Anti-HAV seroprevalence rates were below 30% until the age of 15 and below 40% until the age of 25. The anti-varicella seroprevalence showed only in two thirds of seropositive population at the age of 15. The results of the study have implications for vaccination strategies for both hepatitis A and varicella zoster.
Factors associated with TT (tetanus toxoid) immunization among pregnant women, in Saparua, Maluku, Indonesia.
A cross sectional study was conducted at Saparua Health Center to determine factors associated with the administration of tetanus toxoid. In all, 64 pregnant women were recruited. The majority of the women were housewives, aged 17 to 30 years old, and having more than one child. They were educated to high school, knew some information on tetanus toxoid, and knew at least one of the tetanus symptoms. Almost all did not know the cause of tetanus. The logistic regression of knowledge on tetanus and TT immunization: mothers who heard of TT were 1.54 more likely to have been immunized than those who did not, while mothers who knew the use of tetanus toxoid were 2.15 times more likely to have been immunized than those who did not, and those who knew at least one of the tetanus symptoms were 1.86 times more likely to have been immunized than those who did not, respectively controlling other variables constant. Furthermore, women who had antenatal care were 30 times more likely to have been immunized than those who did not. Enhancing mothers knowledge on tetanus is important to increase the coverage of tetanus toxoid. Moreover, antenatal care would cause contact with sources of tetanus toxoid and hence increase the chance of having the immunization. At the same time, this decreases tetanus neonatorum. Considering the majority of pregnant women received information on tetanus from healthworkers, the use a variety of media would be advantageous.
A universal precautions education intervention for health workers in Sardjito and PKU Hospital Indonesia.
A non-randomized control trial was conducted to develop and evaluate a culturally appropriate academic detailing intervention on the universal precautions knowledge, attitude and behavior of health care workers in hospitals. Fivety-five health care workers (44 nurses and 11 doctors) participated in the study. They were visited individually to discuss principles of universal precautions as well as the effect of automatic pilot on their work practices. Self-reported measures of knowledge and attitudes were collected from each participant before and after the intervention. A nurse observer collected measures of participants' compliance with the universal precautions guidelines according to a pre-determined protocol before and after the intervention. There was a significantly different level of knowledge, attitudes and compliance on universal precautions between the control and intervention hospital with p=0.0007, p=0.038 and p=0.03 respectively following the intervention. It is concluded that an academic detailing approach of education used in this study has significantly improved knowledge, attitudes and compliance scores.
Proceedings: Streptococcus surveys in Indonesia and India.
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Proceedings: Epidemiology of rheumatic fever and rheumatic heart disease in Indonesia.
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Health care for seafarers in Indonesia.
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Prevalence of soil-transmitted helminth infections in the rural population of Bali, Indonesia.
The objectives of this cross-sectional study were to identify the prevalence of soil-transmitted helminth infection in the rural population of Bali and its relation to age, gender, and geoclimatic conditions. The subjects of study were derived from four villages of different geoclimatic conditions, namely wet lowland, dry lowland, wet highland and dry highland, by a multistage, stratified random sampling technique, based on age and gender of the target populations. The technique of Kato-Katz thick smear was used to determine presence of worm eggs in stools, and modified Harada Mori fecal culture technique was used to identify the species of hookworm larvae in stools. The data were analysed descriptively as well as statistically using chi2 test. Of 2,394 completely examined and analysed samples, the results showed as follows: The prevalences of Ascaris lumbricoides, Trichuris trichiura, hookworms and Strongyloides stercoralis were 73.7%, 62.6%, 24.5%, 1.6%, respectively. Of 2,082 infected samples, 33.1% were single infections and 66.9% were mixed infections. Among the mixed infections, dualfection was most frequent (47.8%), followed by single infection (33.1%), triplefection (18.3%), and quadrifection (0.8%). A combination of A. lumbricoides and T. trichiura was predominant in dualfection, while in triplefection a combination of A. lumbricoides, T. trichiura, and hookworms was most frequently identified. The prevalence in males was not statistically different, except for hookworms where it was higher in males than in females. The differences of prevalence of infection according to age groups for A. lumbricoides, T. trichiura and hookworms proved to be highly significant, but not with Strongyloides stercoralis. The prevalence of hookworm infection increased steadily with age to reach its maximum (37.7%) in adulthood (> 18 years), while A. lumbricoides and T. trichiura reached the highest prevalence level in elementary school age (77.3% and 70.7% respectively). The highest prevalence of S. stercoralis infection was found also in elementary school age, but it was not statistically significant. In wet highland the prevalence of infection of A. lumbricoides was 87.6%, T. trichiura 82.4%, hookworms 44.5%, and S. stercoralis 3.3%; these were significantly higher compared to the prevalence of infection in other areas (wet lowland, dry highland, dry lowland).
Introduction of a rapid dipstick assay for the detection of Leptospira-specific immunoglobulin m antibodies in the laboratory diagnosis of leptospirosis in a hospital in Makassar, Indonesia.
An easy, rapid and robust dipstick assay for detection of leptospira-specific immunoglobulin M (IgM) antibodies was evaluated on 403 patients admitted for hospitalization because of fever. The clinical symptoms and signs of 35 patients were consistent with leptospirosis. The final diagnosis for the remaining patients was as follows: 136 with typhoid fever, 82 with hepatitis, 74 with malaria, 48 with infections of the respiratory tract, and 20 with fever of unknown origin. The clinical diagnosis of leptospirosis was confirmed for 24 (68.6%) patients by the combined results of the microscopic agglutination test (MAT), the reference test for leptospirosis, and of IgM ELISA, a standard laboratory test for the serodiagnosis of leptospirosis. In addition, serum specimens from 8 (2.2%) patients with a final clinical diagnosis other than leptospirosis were found to be positive in MAT and/or IgM ELISA. Compared with the results of MAT and IgM ELISA a sensitivity of 91.6% and specificity of 93.6% was calculated for the dipstick assay. Most of the serum samples from the laboratory confirmed patients gave a moderate to strong staining intensity of the antigen band of the dipstick and were easy to read. The results demonstrate that the dipstick assay is convenient to use and allows the rapid and accurate confirmation of patients with clinical suspicion of leptospirosis in areas where the disease is endemic.
The risk of dengue hemorrhagic fever (DHF) outbreak based on vector density in Kurau, Riau province, Indonesia.
It is known that in Padang, Rantau, Rangsang, Merbau and Bengkalis islands, Riau Province, the deposit of oil was found in a huge quantity. The drilling concession belongs to Kondur Petroleum Company. To operate an exploitation, hundreds of workers not only Indonesian but also the workers from foreign countries come and go to that area. It was recorded that the workers from foreign countries come from Singapore, Malaysia, Thailand, The Philippines, Taiwan, Japan, Korea. United States of America and from France, Britain, Australia and Germany. These workers have a close interaction with about 50,00 local population distributed with a high concentration in some places. The high risk of DHF was determined since the significant density of Aedes aregypti larvae, the main vector of DHF, were found in Lukit, Mengkikip and Melibur, three locations of survey. Of 104 (53.3%) of 195 houses in these three survey locations were found positive for the larvae. Even though there were no positive of larvae in 65 houses in Lukit, in Melibur and Mengkikip, the House Index (HI) was 61.7% and 95.7%. Outside the houses 521 containers were examined in three locations of survey and 329 (63.1%) were positive for Ae. aegypti larvae. The highest number of containers positive for Ae. aegypti larvae were 213 (94.7%) out of 225 and found in Mengkikip. In Melibur, 114 (68.3%) out of 167 of containers were positive and in Lukit only 2 (1.56%) out of 129 containers were positive of Ae. aegypti larvae. These larvae density constitute a high risk of DHF outbreak, and unfortunately is supported by the rainfall situation recorded in Kurau and BZ Climatology Stations. It was recorded that all along the year, at least one day in a month there was the rain which the rainfall volume was 30 ml.
Helminth parasites of Rattus rattus diardi in Bogor, West Java, Indonesia.
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A survey of Toxoplasma gondii antibodies in pigs in Indonesia.
In August 1994, blood samples were collected from 110 pigs at a slaughter house in Bandar Lampung (Sumatra) and from 98 pigs in a slaughter house in Ujung Pandang (Sulawesi), 208 pigs in total. Anti-Toxoplasma gondii antibody titer in these samples was surveyed using the latex agglutination test. The positivity rate was 3.6% (4/110) in Bandar Lampung, and 9.2% (9/98) in Ujung Pandang. The antibody titer was 1:128 in two and 1:512 in two in Bandar Lampung, and 1:64 in six, 1:128 in two, and 1:256 in one in Ujung Pandang, showing that the titer was higher in Bandar Lampung.
A history of the Mennonite medical work in the Muria Mountain area of Java, Indonesia, 1894-1971.
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Studies on filariasis in the Pacific. 4. The application of the membrane filter concentration technique to a survey of Wuchereria bancrofti filariasis in Kepu district, Jakarta, Indonesia.
A blood survey for filariasis was carried out in the Kepu District of Jakarta. Examination of stained 20 c.mm finger-prick blood thick films and membrane filter concentration (MFC) of 1 ml venous blood. The youngest age group examined, 5-9 years old revealed a mf rate of 17% of which 71% were of a low density character detected by MFC only. The mf rate appears to remain relatively constant from the 10-14 year old group onward, approximately 35%, but at all age groups at least half the infections were of low density. The highest mf rate and density was observed present in the 15-20 year old group.