Dian Sidik Arsyad

Existence of the rdl mutant alleles among the anopheles malaria vector in Indonesia

BackgroundThe gamma-aminobutyric acid (GABA) receptor-chloride channel complex is known to be the target site of dieldrin, a cyclodiene insecticide. GABA-receptors, with a naturally occurring amino acid substitution, A302S/G in the putative ion-channel lining region, confer resistance to cyclodiene insecticides that includes aldrin, chlordane, dieldrin, heptachlor, endrin and endosulphan.MethodsA total of 154 mosquito samples from 10 provinces of malaria-endemic areas across Indonesia (Aceh, North Sumatra, Bangka Belitung, Lampung, Central Java, East Nusa Tenggara, West Nusa Tenggara, West Sulawesi, Molucca and North Molucca) were obtained and identified by species, using morphological characteristic. The DNA was individually extracted using chelex-ion exchanger and the DNA obtained was used for analyses using sequencing method.ResultsMolecular analysis indicated 11% of the total 154 Anopheles samples examined, carried Rdl mutant alleles. All of the alleles were found in homozygous form. Rdl 302S allele was observed in Anopheles vagus (from Central Java, Lampung, and West Nusa Tenggara), Anopheles aconitus (from Central Java), Anopheles barbirostris (from Central Java and Lampung), Anopheles sundaicus (from North Sumatra and Lampung), Anopheles nigerrimus (from North Sumatra), whereas the 302 G allele was only found in Anopheles farauti from Molucca.ConclusionThe existence of the Rdl mutant allele indicates that, either insecticide pressure on the Anopheles population in these areas might still be ongoing (though not directly associated with the malaria control programme) or that the mutant form of the Rdl allele is relatively stable in the absence of insecticide. Nonetheless, the finding suggests that integrated pest management is warranted in malaria-endemic areas where insecticides are widely used for other purposes.

Distance to Anopheles sundaicus larval habitats dominant among risk factors for parasitemia in meso-endemic Southwest Sumba, Indonesia.

Abstract Background: The decline in intensity of malaria transmission in many areas now emphasizes greater importance of understanding the epidemiology of low to moderate transmission settings. Marked heterogeneity in infection risk within these populations creates opportunities to understand transmission and guide resource allocation to greater impact. Methods: In this study, we examined spatial patterns of malaria transmission in a hypo- to meso-endemic area of eastern Indonesia using malaria prevalence data collected from a cross-sectional socio-demographic and parasitological survey conducted from August to November 2010. An entomological survey performed in parallel, identified, mapped, and monitored local anopheline larval habitats. Results: A single spatial cluster of higher malaria prevalence was detected during the study period (relative risk  =  2·13; log likelihood ratio  =  20·7; P < 0·001). In hierarchical multivariate regression models, risk of parasitemia was inversely correlated with distance to five Anopheles sundaicus known larval habitats [odds ratio (OR)  =  0·21; 95% confidence interval (CI)  =  0·14–0·32; P < 0·001], which were located in a geographically restricted band adjacent to the coastline. Increasing distance from these sites predicted increased hemoglobin level across age strata after adjusting for confounders (OR  =  1·6; 95% CI  =  1·30–1·98; P < 0·001). Conclusion: Significant clustering of malaria parasitemia in close proximity to very specific and relatively few An. sundaicus larval habitats has direct implications for local control strategy, policy, and practice. These findings suggest that larval source management could achieve profound if not complete impact in this region.

Descriptive Epidemiology of Neonatal Mortality in Gowa District 2015

The aim of this study is to describe epidemiology of neonatal mortality in Gowa district 2015. The study type was an observational descriptive study. The population for this study was all neonatal deaths had recorded in Gowa district health office in 2015. Meanwhile, the sample sizes were 77 neonatal death cases. The point coordinates were determined by using geographic positioning system (GPS) and exported into geographic information system (GIS). The result showed neonatal death cases occurred by maternal characteristics with received antenatal care visit (ANC) ≥ 4visits (71.2%), 2 times of tetanus toxoid (TT) vaccination (81.9%) and birth attendance by midwife (85.7%). Based on infant characteristics occurred based on parity 1 (51.9%), gestational age < 37 weeks (64.9%), birth weight < 2500 gram (54.2%). The main cause of neonatal mortality was asphyxia neonatorum (45.5%). The neonatal mortality was occurred at health centres (46.8%) and hospital (57. 1%).The average distance from respondent house to the hospital respectively 19. 41 km and 19.94 km. Most of neonatal mortality occurred in September with total of 12.52/1000 live births. The number of midwives should be increasing to reduce neonatal mortality.

Relationship Of Exposure Of Air Pollution In House With Occurrence Of Acute Respiratory Infections In Children Under Five At Puskesmas Malimongan Baru in 2016

Acute Respiratory Infections (ARI) is a major killer of children <5 years old in developing countries and has been estimated to be responsible for> 2 million deaths per year. World Health Organization (WHO) in 2013 stated that the incidence of Acute Respiratory Infections (ARI) in children under five in the world over 40 per 1,000 live births. This study aims to determine the relationship exposure indoor air pollution with ARI of toddlers in Puskesmas Malimongan Baru 2016. Design of study was observational analytic with cross sectional study, conducted in February-March 2016 Puskesmas Malimongan Baru. The population in this study were all toddlers recorded in the medical record as many as 2,500 health centers. Sampling using simple random sampling with a sample of 156 people. The results showed that there is a relationship between exposure to secondhand smoke, relationship is weak (p = 0.026, &phis; = 0178), exposure to household fuel, relationship is weak (p = 0048, &phis;=0149) exposure to mosquito coils, relationship is weak (p= 0.000, &phis;= 0.290) with ARI. Conclusions of research there is a relationship between exposure to air pollution in homes with ARI in infants in Puskesmas Malimongan Baru 2016.