Eddy Fadlyana

Carriage of Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in Indonesian children: A cross-sectional study.

Streptococcus pneumoniae is an important cause of infection and commonly colonizes the nasopharynx of young children, along with other potentially pathogenic bacteria. The objectives of this study were to estimate the carriage prevalence of S. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus in young children in Indonesia, and to examine interactions between these bacterial species. 302 healthy children aged 12–24 months were enrolled in community health centers in the Bandung, Central Lombok, and Padang regions. Nasopharyngeal swabs were collected and stored according to World Health Organization recommendations, and bacterial species detected by qPCR. Pneumococcal serotyping was conducted by microarray and latex agglutination/Quellung. Overall carriage prevalence was 49.5% for S. pneumoniae, 27.5% for H. influenzae, 42.7% for M. catarrhalis, and 7.3% for S. aureus. Prevalence of M. catarrhalis and S. pneumoniae, as well as pneumococcal serotype distribution, varied by region. Positive associations were observed for S. pneumoniae and M. catarrhalis (OR 3.07 [95%CI 1.91–4.94]), and H. influenzae and M. catarrhalis (OR 2.34 [95%CI 1.40–3.91]), and a negative association was found between M. catarrhalis and S. aureus (OR 0.06 [95%CI 0.01–0.43]). Densities of S. pneumoniae, H. influenzae, and M. catarrhalis were positively correlated when two of these species were present. Prior to pneumococcal vaccine introduction, pneumococcal carriage prevalence and serotype distribution varies among children living in different regions of Indonesia. Positive associations in both carriage and density identified among S. pneumoniae, H. influenzae, and M. catarrhalis suggest a synergistic relationship among these species with potential clinical implications.

Wabah Difteri di Kecamatan Cikalong Wetan, Kabupaten Cianjur, Jawa Barat, Indonesia

Latar belakang. Sejak tahun 1986 tidak ditemukan lagi kasus difteri yang dirawat di Rumah Sakit Hasan Sadikin Bandung Jawa Barat. Namun, wabah difteri selalu terjadi di beberapa kabupaten di Jawa Barat seperti yang dilaporkan sejak tahun 1993 sampai tahun 2010. Kementerian Kesehatan juga melaporkan peningkatan kasus difteri di beberapa provinsi di Indonesia tahun 2010. Suatu penelitian saat wabah di Kecamatan Cikalong Wetan Kabupaten Cianjur tahun 2001 sebagai gambaran kejadian wabah di salah satu kabupaten di Jawa Barat. Tujuan. Menggambarkan kejadian wabah difteri, mengetahui tingkat kekebalan dengan mengukur kadar antibodi difteri dan untuk menemukan kemungkinan adanya kuman C. difteriaeberedar di masyarakat di daerah wabah. Metode. Data kejadian penyakit dan kematian diperoleh dari Puskesmas Cikalong Wetan RS Cianjur dan Dinas Kesehatan Kabupaten Cianjur. Data kadar antibodi diperoleh dengan mengukur kadar anti bodi terhadap difteri pada 698 subyek, yang dibagi menurut kelompok usia. Titer antibodi diukur dengan menggunakan teknik ELISA ganda. Hasil. Selama wabah terdapat 25 kasus yang dilaporkan dari Puskesmas Cikalong Wetan dengan angka kematian/crude fatality rate(CFR) 28%. Diduga kuat bahwa kasus pertama berasal dari kecamatan yang berdekatan dengan Kecamatan Cikalong Wetan. Beberapa bulan sebelumnya dijumpai kasus rawat inap 21 pasien, 55% di antaranya balita, dengan angka kematian 35% terutama disebabkan oleh miokarditis. Walaupun cakupan imunisasi difteri pertusis tetanus (DPT) tinggi pada anak kurang dari 1 tahun di Kecamatan Cikalong Wetan, hanya 19,3% anak usia 1 tahun memiliki tingkat kekebalan protektif yang memadai. Titer antibodi terus berkurang sesuai dengan meningkatnya usia anak, bahkan tidak ada subjek yang memiliki kadar protektif yang memadai pada kelompok usia 5 – 6 tahun. Enam dari 324 biakan apus tenggorokan pada masyarakat tumbuh strain toxigenic C. difteriae gravis. Kesimpulan. Wabah yang terjadi di Kecamatan Cikalong Wetan Kabupaten Cianjur disebabkan oleh karena rendahnya kadar antibodi terhadap toxigenic C.difteriaepada masyarakat.

Risk factors for obesity in 6 to 12-year-old children

Background The causes of obesity in children are multifactorial, including genetics, physiology, metabolism, psychology, socioeconomic status, lifestyle, and culture. Objective To assess for relationships between obesity in 6 to 12-year-old children and maternal nutritional status, maternal education, eating breakfast, eating fast food, physical activity, TV watching, and playing video games. Methods This case-control study included students of Sejahtera Public School aged 6 to 12 years. Questionnaires were distributed to their parents for data on maternal education, eating breakfast, eating fast food, physical activity, TV watching and playing video games. Maternal nutritional status was assessed by one of the researchers. Univariate analysis with Chi–square test was used to assess every risk factor. Those with a P value of <0.25 were subjected to multivariate analysis, performed using multiple logistic regression analysis. Results From June to July 2013, 60 obese children and 60 wellnourished children, as a control group, were enrolled in the study. Obese mothers tended to have obese children [odds ratio/OR 252.48; 95%CI 33.4 to 1908.4]. Children who ate fast food 6–8 times/week, had low physical activity, and watched TV more than 8 hours/week had significantly higher risk for obesity [OR 12.94, 95%CI 1.7 to 100.7; and OR 266.94, 95% CI 7.8 to 9137.7; OR 21.44, 95%CI 2.68 to 171.61; respectively]. Maternal education, eating breakfast, and playing video games were not significant risk factors for childhood obesity. Conclusion Maternal obesity, eating fast food 6-8 times per week, low physical activity and watching TV more than 8 hours/ week are risk factors for childhood obesity.