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Wulan WN, Yunihastuti E, Arlinda D, Merati TP, Wisaksana R, Lokida D, Grossman Z, Huik K, Lau CY, Susanto NH, Kosasih H, Aman AT, Ang S, Evalina R, Ayu Yuli Gayatri AA, Hayuningsih C, Indrati AR, Kumalawati J, Mutiawati VK, Realino Nara MB, Nurulita A, Rahmawati R, Rusli A, Rusli M, Sari DY, Sembiring J, Udji Sofro MA, Susanti WE, Tandraeliene J, Tanzil FL, Neal A, Karyana M, Sudarmono P, Maldarelli F. Development of a multiassay algorithm (MAA) to identify recent HIV infection in newly diagnosed individuals in Indonesia. iScience 2023; 26:107986. [PMID: 37854696 PMCID: PMC10579430 DOI: 10.1016/j.isci.2023.107986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/12/2023] [Accepted: 09/16/2023] [Indexed: 10/20/2023] Open
Abstract
Ongoing HIV transmission is a public health priority in Indonesia. We developed a new multiassay algorithm (MAA) to identify recent HIV infection. The MAA is a sequential decision tree based on multiple biomarkers, starting with CD4+ T cells >200/μL, followed by plasma viral load (pVL) > 1,000 copies/ml, avidity index (AI) < 0 · 7, and pol ambiguity <0 · 47%. Plasma from 140 HIV-infected adults from 19 hospitals across Indonesia (January 2018 - June 2020) was studied, consisting of a training set (N = 60) of longstanding infection (>12-month) and a test set (N = 80) of newly diagnosed (≤1-month) antiretroviral (ARV) drug naive individuals. Ten of eighty (12 · 5%) newly diagnosed individuals were classified as recent infections. Drug resistance mutations (DRMs) against reverse transcriptase inhibitors were identified in two individuals: one infected with HIV subtype C (K219Q, V179T) and the other with CRF01_AE (V179D). Ongoing HIV transmission, including infections with DRMs, is substantial in Indonesia.
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Affiliation(s)
- Wahyu Nawang Wulan
- Doctoral Program in Biomedical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta 10430, Indonesia
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
| | - Evy Yunihastuti
- Department of Internal Medicine, Faculty of Medicine Universitas Indonesia – HIV Integrated Clinic, Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Dona Arlinda
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
- Health Policy Agency, Ministry of Health Republic of Indonesia, Jakarta 10560, Indonesia
| | | | | | - Dewi Lokida
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
- Tangerang District Hospital, Tangerang 15111, Indonesia
| | - Zehava Grossman
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
- School of Public Health, Tel Aviv University, Tel Aviv 69978, Israel
| | - Kristi Huik
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
- Department of Microbiology, University of Tartu, 50090 Tartu, Estonia
| | - Chuen-Yen Lau
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
| | - Nugroho Harry Susanto
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
| | - Herman Kosasih
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
| | | | - Sunarto Ang
- A. Wahab Sjahranie Hospital, Samarinda 75123, Indonesia
| | | | | | | | | | | | | | | | - Asvin Nurulita
- dr. Wahidin Sudirohusodo Hospital, Makassar 90245, Indonesia
| | | | - Adria Rusli
- Prof. Dr. Sulianti Saroso Infectious Hospital, Jakarta 14340, Indonesia
| | - Musofa Rusli
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo Hospital, Surabaya 60286, Indonesia
| | | | | | | | | | | | | | - Aaron Neal
- Collaborative Clinical Research Branch, National Institute of Allergy and Infectious Diseases, Bethesda, MD 20892, USA
| | - Muhammad Karyana
- The Indonesia Research Partnership on Infectious Disease (INA-RESPOND), Jakarta 10560, Indonesia
- Health Policy Agency, Ministry of Health Republic of Indonesia, Jakarta 10560, Indonesia
| | - Pratiwi Sudarmono
- Department of Microbiology, Faculty of Medicine, Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
| | - Frank Maldarelli
- HIV Dynamics and Replication Program, National Cancer Institute, Frederick, MD 21702, USA
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Solin RSC, Kumalawati J, Yusra Y, Indrasari ND. Microbial Profile, Peritoneal Fluid White Blood Cell Count, and Outcome of Peritoneal Dialysis-Related Peritonitis at Indonesian Tertiary Hospital. J Glob Infect Dis 2023; 15:108-112. [PMID: 37800088 PMCID: PMC10549902 DOI: 10.4103/jgid.jgid_16_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/14/2023] [Accepted: 04/26/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction Peritonitis caused by peritoneal dialysis (PD) remains a common complication of continuous ambulatory PD (CAPD). The purpose of this study is to determine the microbial profile in CAPD-related peritonitis, the optimal cutoff of white blood cell (WBC) count, and the percentage of polymorphonuclear (PMN) in CAPD fluid in the prediction of CAPD-related peritonitis, together with the outcome of CAPD-related peritonitis at an Indonesian tertiary hospital. This is a retrospective cohort study of CAPD-related peritonitis patients at Indonesian tertiary hospitals from November 2020 to October 2022. Methods Patients with suspected CAPD-related peritonitis who were tested for CAPD fluid culture and WBC count in CAPD fluid were eligible for this study. Patient's diagnosis and outcome obtained from medical records. Differences in clinical outcomes by category of microorganisms were analyzed with Fisher exact test. The Mann-Whitney test and receiver operating characteristic curve were used to determine optimal WBC and PMN cutoff. Results This study included 58 patients and 102 episodes of CAPD-related peritonitis. CAPD-related peritonitis was caused by 29.4% Gram-negative bacteria, 21.5% Gram-positive bacteria, 7.8% fungi, and 6.9% polymicrobial bacteria. CAPD fluid WBC count >79 cells/μL and PMN percentage >50% had a sensitivity of 76.4% and a specificity of 92.9% in predicting CAPD-related peritonitis. There was a significant difference in outcome between Gram-negative and Gram-positive bacterial peritonitis. Conclusions It is critical to understand the microbial profile in CAPD-related peritonitis. Lower WBC count cutoff points in CAPD fluids may improve sensitivity in predicting CAPD-related peritonitis.
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Affiliation(s)
- Ro Shinta Christina Solin
- Department of Clinical Pathology, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - July Kumalawati
- Department of Clinical Pathology, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Yusra Yusra
- Department of Clinical Pathology, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
| | - Nuri Dyah Indrasari
- Department of Clinical Pathology, Faculty of Medicine, Cipto Mangunkusumo Hospital, Universitas Indonesia, Jakarta, Indonesia
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Herikurniawan H, Rumende CM, Setiati S, Kumalawati J, Deslanthy BT. Diagnostic Model of COVID-19 Infection Based on the Combination of Clinical Symptoms, Chest Radiography and Laboratory Test. Acta Med Indones 2022; 54:419-427. [PMID: 36156483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND COVID-19 is an infection caused by SARS-COV 2.For screening the patient, Rapid antigen for COVID-19 is used with a high diagnostic value. However, there are still some cases of false-negative even with clinical symptoms suggesting COVID-19. Undetected COVID-19 patients certainly will increase transmission. A simple and practical diagnostic model, using determining factors, is required to guide physicians through a quicker decision making process, especially when deciding the need for the isolation rooms for patients with COVID-like symptoms. METHODS This study is a cross-sectional study. The study was conducted at CiptoMangunkusumo Hospital, Jakarta.History of contact with COVID-19, clinical symptoms, laboratory examination, and chest radiograph data were taken from medical records. Bivariate and multivariate analyses were conducted to assess the effect sizes of patient factors on the diagnostic results.ROCcurve and Hosmer-Lemeshow calibration was used to make the scoring. RESULTS There were 187 patients with the majority of subjects in the age group < 60 years old. The selected variables in this scoring systemwere contact history,fever/history of fever, dyspnea with respiratory rate >20 breaths/minute, leucocyte ≤ 10.000 cells/mLand typical chest radiography. The area under the curve for this model was 0,777 (CI95% (0,706-0,847), P<0,001). The probability was 82% with a cut-off point ≥ 4. CONCLUSION Determinant models based on the combination of contact history, presence or history of fever, dyspnea, leucocyte count ≤ 10.000 cells/mL and typical chest radiography provides good accuracy to aid physicians in managing isolation room needs for patients with suspected COVID-19.
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Affiliation(s)
- Herikurniawan Herikurniawan
- Division of Respirology and Critical Illness, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
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Rinawati W, Kumalawati J. Oligoclonal bands: a laboratory diagnosis of subacute sclerosing panencephalitis (SSPE). J Infect Dev Ctries 2022; 16:1096-1100. [PMID: 35797306 DOI: 10.3855/jidc.15200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 01/26/2022] [Indexed: 10/31/2022] Open
Abstract
The oligoclonal band indicates presence of antibodies specific to the disease, possibly due to the activation of certain clones of B lymphocytes. This intrathecal immunoglobin synthesis can be persistent for months to years, for example, in respons to paramyxoviruses, herpes virus, coxsackievirus, and Treponema pallidum; or can be synthesized for life, for example in multiple sclerosis and subacute sclerosing panencephalitis (SSPE). We report a case of SSPE in a 15-year-old male patient. The patient had myoclonic jerks that occurred in the thoracal femoral region. Necessary laboratory tests identified reactive anti-measles IgG, which indicates a previous measles infection or exposure to vaccination. This report describes the usefulness of the oligoclonal bands in the diagnosis of the neurodegenerative disease SSPE that is progressive and fatal to the central nervous system due to persistent measles virus infection in the gray and white matter.
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Affiliation(s)
- Weny Rinawati
- Laboratory of Clinical Pathology and Blood Bank, Mahar Mardjono National Brain Center Hospital, East Jakarta, Indonesia.
| | - July Kumalawati
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Rinawati W, Kumalawati J, Bardosono S, Immanuel S, Sukartini N, Indrasari ND. Invasive candidiasis among high prevalence neurological patients. J Infect Dev Ctries 2022; 16:871-880. [PMID: 35656960 DOI: 10.3855/jidc.15231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 01/17/2022] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Invasive candidiasis is a severe form of infection. The incidence of invasive fungal infections has increased, due to the increasing number of patients with impaired immunity who are being treated through prolonged stay in hospital facilities. Neurological patient treatment methods such as antimicrobials, corticosteroid, central venous catheter (CVC), total parenteral nutrition, and mechanical ventilation use are associated with common risk factors for invasive candidiasis. Our study demonstrated invasive candidiasis prevalence among neurological patients. METHODOLOGY A cross-sectional study was done with consecutive sampling of neurological patients who were hospitalized from January 2017 to February 2020 at the Mahar Mardjono National Brain Center Hospital East Jakarta Indonesia. Patients with sepsis, septic shock, or fever (> 38.5 °C), and who had not received antifungals before culture were enrolled in the study. Clinical specimens were obtained from blood, liquor cerebrospinal or other sterile sites, CVC, respiratory tract specimens, and urine or other non-sterile sites. Socio-demographic data, potential risk factors based on previous studies, clinical, and other tests data were obtained from medical records. Classification of invasive candidiasis was according to the Paphitou classification criteria. RESULTS One hundred and two subjects met the study criteria. The prevalence of invasive candidiasis in neurological patients was 13.7%. All of the isolates were C. parapsilosis. CONCLUSIONS The prevalence of invasive candidiasis was high in the samples studied. The infection was associated with septic shock, tracheostomy, and duration of use of central venous catheter, ventilator, and steroids.
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Affiliation(s)
- Weny Rinawati
- Laboratory of Clinical Pathology and Blood Bank, Mahar Mardjono National Brain Center Hospital, East Jakarta, Indonesia.
| | - July Kumalawati
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Saptawati Bardosono
- Department of Clinical Nutrition, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Suzanna Immanuel
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Ninik Sukartini
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nuri Dyah Indrasari
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Rinawati W, Kumalawati J. Sphingomonas paucimobilis infection in subcutaneous abdominal preservation of bone flap after craniotomy. J Infect Dev Ctries 2022; 16:388-391. [PMID: 35298437 DOI: 10.3855/jidc.15369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/26/2021] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Sphingomonas paucimobilis, previously known as Pseudomonas paucimobilis, is a Gram-negative rod. It is emerging as an opportunistic pathogen that can infect individuals in community or hospital settings. It is believed that the natural habitat of this organism is soil and water, including water sources in the hospital environment. CASE REPORT We describe the case of a 46-year-old patient in whom S. paucimobilis was identified in the implanted bone flap after craniotomy. The postoperative bone flap was implanted in the right hypochondria and replaced after 8 weeks. There was a hypochondriac abscess in the area under the bone. Specimens from the thickened fascia and bone flap were cultured. The Gram stain showed Gram-negative rods and these rods were identified as S. paucimobilis. The patient was treated with a combination of Gentamicin 240 mg and Levofloxacin 750 mg once daily because the bacteria were resistant to carbapenem, trimethoprim-sulfamethoxazole, and anti-pseudomonal penicillin. CONCLUSIONS Although S. paucimobilis characteristically presents low virulence, for better patient management and outcome, the diagnosis should be immediately followed by appropriate antibiotic therapy guided by susceptibility test results of each case.
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Affiliation(s)
- Weny Rinawati
- Laboratory of Clinical Pathology and Blood Bank, Mahar Mardjono National Brain Center Hospital, East Jakarta, Indonesia.
| | - July Kumalawati
- Department of Clinical Pathology, Faculty of Medicine University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Fadrian F, Chen K, Kumalawati J, Rumende CM, Shatri H, Nelwan EJ. The Validation of Drug Resistance in Pneumonia (DRIP) Score in Predicting Infections due to Drug-Resistant Pathogens in Community-acquired Pneumonia at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Acta Med Indones 2021; 53:416-422. [PMID: 35027488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The emergence of drug-resistant pathogens (DRP) in recent years possibly contributes to the common problems associated with community-acquired pneumonia. However, to predict the risk of the ailment, the DRIP score is mainly applied, although no validation study has been reported in Indonesia. Therefore, the score prediction accuracy in the population, patient characteristics and germ patterns appears indefinite, particularly for Cipto Mangunkusumo Hospital, Jakarta. The purpose of this study is to determine the DRIP performance as an instrument in predicting infections due to drug-resistant pathogens (DRP) in community-acquired pneumonia at Cipto Mangunkusumo Hospital. METHODS This research employed a cross-sectional design, where the subjects were community-acquired pneumonia patients treated between January 2019 and June 2020. In addition, adequate medical records of the participants were obtained. The condition is defined as DRP when the sputum culture results show resistance to non-pseudomonal β-lactam antibiotics, macrolides, and respiratory fluoroquinolones. Furthermore, the score performance was analyzed by determining the calibration and discrimination values, using the Hosmer-Lemeshow test and AUROC, respectively. RESULTS A total of 254 subjects were known to have satisfied the selection criteria. These participants were categorized into DRP and non-DRP groups, with 103 (40.6%) and 151 (59.4%) patients, correspondingly. The DRIP calibration analysis using the Hosmer-Lemeshow test obtained p-value = 0.001 (p <0.05), while an AUC value of 0.759 (CI 95%, 0.702-0.810) was derived from the ROC curve. However, at a score of ≥ 4, the DRIP showed sensitivity, specificity, positive and negative predictive values of 70.9, 92.7, 86.9, and 82.3%, respectively. CONCLUSION The DRIP score demonstrated a significant performance in predicting infections due to DRP in community-acquired pneumonia.
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Affiliation(s)
- Fadrian Fadrian
- 1. Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Division of Tropical Medicine and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, Andalas University - M. Djamil Hospital, Padang, Indonesia.
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Loho T, Venna V, Setiabudy RD, Sukartini N, Immanuel S, Kumalawati J, Victor AA, Waspadji S. Correlation Between Vitreous Advanced Glycation End Products, and D-dimer with Blood HbA1c Levels in Proliferative Diabetic Retinopathy. Acta Med Indones 2018; 50:132-137. [PMID: 29950532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND proliferative diabetic retinopathy (DR) is an advanced form of DR that eventually could lead to blindness. Levels of vitreous advanced glycation end products (AGEs) and D-dimer may reflect the pathological changes in the retina, but only few studies have assessed their correlation with blood hemoglobin A1C (HbA1c) levels. This study aimed to find the association between blood HbA1c levels with vitreous AGEs and D-dimer levels in patients with proliferative DR. METHODS an analytical cross-sectional study was performed in subjects with proliferative DR who underwent vitrectomy. Subjects were divided into 2 subgroups, i.e. uncontrolled (HbA1c >7%) and controlled (HbA1c <7%) groups. Vitreous AGEs and D-dimer levels were assessed; the levels were compared between uncontrolled and controlled hyperglycemic patients. Statistic correlation tests were also performed for evaluating blood HbA1c, vitreous AGEs, and D-dimer levels. RESULTS a total of 47 patients were enrolled in this study and 32 (68.1%) of them were women. Median vitreous AGEs level was 11.0 (3.0 - 48.0) µg/mL; whereas median vitreous D-dimers level was 5,446.0 (44.0 - 37,394.0 ) ng/mL. The median vitreous AGEs levels was significantly higher in patients with uncontrolled vs. controlled hyperglycemia (14.0 vs. 4.0 mg/mL; p<0.001). There was a significant positive correlation with moderate strength between blood HbA1c level and vitreous AGEs level (r=0.524; r2=0.130; p=0.0001). Blood HbA1c level could be used to predict vitreous AGEs level by using the following calculation: vitreous AGEs = -1.442+ (1.740xblood HbA1c). Vitreous D-dimer levels were not significantly different between uncontrolled and controlled hyperglycemia (median 4607.5 vs. 5701.6 ng/mL; p = 0.458). There was a positive significant correlation between blood HbA1c and vitreous D-dimer levels (r = 0.342; p = 0.019); however the correlation was weak. Vitreous AGEs level had a positive significant correlation with vitreous D-dimer levels (r = 0.292; p = 0.046) and the correlation strength was also weak. CONCLUSION median vitreous AGEs levels were significantly higher in proliferative DR patients with uncontrolled than those with controlled hyperglycemia. Blood HbA1c level can be used to assess vitreous AGEs level in patients with proliferative DR by using the following calculation: vitreous AGEs = -1.442+(1.740 x HbA1c). However, the blood HbA1c level can not be used to predict vitreous D-dimer level in patients with proliferative DR.
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Affiliation(s)
- Tonny Loho
- Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta.
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Said WF, Sukoto E, Khoeri MM, Kumalawati J, Safari D. Serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae isolates from adult patients in Jakarta, Indonesia. J Infect Public Health 2017; 10:833-835. [PMID: 28215915 DOI: 10.1016/j.jiph.2017.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/31/2016] [Accepted: 01/28/2017] [Indexed: 11/18/2022] Open
Abstract
Currently, the data on pneumococcal invasive disease in the Indonesian population are limited. In this study, we investigated the serotype distribution and antimicrobial susceptibility of Streptococcus pneumoniae. These samples were isolated from the sputum of adult patients with non-specific clinical symptoms aged 18-87 years in Jakarta, Indonesia, from August to October 2014. Of the 349 sputum specimens, thirteen isolates were identified as S. pneumoniae strains (4%), with two strains each for serotype 19F, 3, and 15A, and one strain each for serotype/serogroup 13, 23A, 6, 34, 17F, 16F, and untypeable. Resistance to tetracycline was most common with only 5 of 13 strains being susceptible. In conclusion, these data provide an initial in the surveillance of invasive pneumococcus in the Indonesia population.
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Affiliation(s)
- Wahyu F Said
- Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Edy Sukoto
- Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | | | - July Kumalawati
- Department of Clinical Pathology, Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Dodi Safari
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia.
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Chiu YHC, Ong J, Walker S, Kumalawati J, Gartinah T, McPhee DA, Dax EM. Photographed rapid HIV test results pilot novel quality assessment and training schemes. PLoS One 2011; 6:e18294. [PMID: 21483842 PMCID: PMC3069085 DOI: 10.1371/journal.pone.0018294] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 02/23/2011] [Indexed: 11/24/2022] Open
Abstract
HIV rapid diagnostic tests (RDTs) are now used widely in non-laboratory settings by non-laboratory-trained operators. Quality assurance programmes are essential in ensuring the quality of HIV RDT outcomes. However, there is no cost-effective means of supplying the many operators of RDTs with suitable quality assurance schemes. Therefore, it was examined whether photograph-based RDT results could be used and correctly interpreted in the non-laboratory setting. Further it was investigated if a single training session improved the interpretation skills of RDT operators. The photographs were interpreted, a 10-minute tutorial given and then a second interpretation session was held. It was established that the results could be read with accuracy. The participants (n = 75) with a range of skills interpreted results (>80% concordance with reference results) from a panel of 10 samples (three negative and seven positive) using four RDTs. Differences in accuracy of interpretation before and after the tutorial were marked in some cases. Training was more effective for improving the accurate interpretation of more complex results, e.g. results with faint test lines or for multiple test lines, and especially for improving interpretation skills of inexperienced participants. It was demonstrated that interpretation of RDTs was improved using photographed results allied to a 10-minute training session. It is anticipated that this method could be used for training but also for quality assessment of RDT operators without access to conventional quality assurance or training schemes requiring wet samples.
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Affiliation(s)
- Yu-Ho C. Chiu
- NRL, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Joanna Ong
- NRL, St Vincent's Institute, Melbourne, Victoria, Australia
| | - Sandy Walker
- NRL, St Vincent's Institute, Melbourne, Victoria, Australia
| | - July Kumalawati
- Clinical Pathology Department, Medical Faculty, University of Indonesia, Dr Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tintin Gartinah
- West Java Provincial Health Laboratory, West Java Health Office, Bandung, Indonesia
| | - Dale A. McPhee
- NRL, St Vincent's Institute, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth M. Dax
- NRL, St Vincent's Institute, Melbourne, Victoria, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Victoria, Australia
- * E-mail:
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Pisani E, Girault P, Gultom M, Sukartini N, Kumalawati J, Jazan S, Donegan E. HIV, syphilis infection, and sexual practices among transgenders, male sex workers, and other men who have sex with men in Jakarta, Indonesia. Sex Transm Infect 2004; 80:536-40. [PMID: 15572631 PMCID: PMC1744942 DOI: 10.1136/sti.2003.007500] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To establish the prevalence of HIV, syphilis, and sexual risk behaviour among three groups of men who have sex with men in Jakarta, Indonesia, and to investigate sexual links between these men and broader heterosexual populations. METHODS Anonymous, cross sectional surveys among community recruited transgender and male sex workers and self recognised men who have sex with men (MSM) were undertaken in mid-2002 in Jakarta, Indonesia. Places where transgender and male sex workers sell sex and where men go to meet non-commercial male sex partners were mapped. Probability samples were selected for the sex worker populations, while a mixed probability and convenience sample was drawn for self recognised MSM. Blood was drawn for HIV and syphilis serology and community interviewers administered a standardised questionnaire. RESULTS HIV prevalence was 22% among transgender sex workers, 3.6% among male sex workers, and 2.5% among self recognised MSM, and syphilis prevalence was 19.3%, 2.0% and 1.1% respectively. 59.3% of transgender sex workers and 64.8% of male sex workers reported recent unprotected anal intercourse with clients, and 53.1% of other MSM reported unprotected anal sex with male partners. Some 54.4% of male sex workers and 18.3% of other MSM reported female partners in the preceding year. CONCLUSION HIV has reached substantial levels among transgender sex workers, and is not negligible in other MSM groups. Risk behaviour is high in all subpopulations, and bisexual behaviour is common, meaning the threat of a wider epidemic is substantial. Prevention programmes targeting male-male sex are needed to reduce this threat.
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Affiliation(s)
- E Pisani
- Family Health International, Asia Regional Office, Jakarta 10560, Indonesia.
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