OBJECTIVES: To study the association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years. METHODS: This cross sectional study was conducted in randomly selected presumed healthy children with good nutritional status aged 3-12 years in Central Jakarta, Indonesia ( RESULTS: The prevalence of lactose malabsorption in children aged 3-5 years and children aged 6-12 years was 20.8% (15/72) and 35.3% (36/102), respectively. There was no association between milk or milk product consumption and lactose malabsorption ( CONCLUSIONS There is no association between milk consumption and lactose malabsorption in Indonesian children aged 3-12 years, suggesting that genetic predisposition may be more important than adaptive mechanisms to lactose consumption.
Animals ; Breath Tests ; Child ; Cross-Sectional Studies ; Humans ; Indonesia/epidemiology* ; Lactose Intolerance/epidemiology* ; Milk

The weight, height and mid-upper-arm circumference (MUAC) were measured in 159 women of reproductive age between June and November 1991 in four remote valleys in the Eastern Central Highlands of Irian Jaya, Indonesia. The average weight was 42.3 +/- 5.2 kg and 26% weighed less than 40 kg. The average height was 141.3 +/- 9.1 cm and 30% were shorter than 140 cm. By the MUAC measurement, the nutritional status was considered to be inadequate (MUAC less than 23 cm) in 58% of the women. 8% of the women were observed to be visibly pregnant and 43% were lactating. In the same period 112 women in the Yamil valley were visited at home. They had given birth to 331 children, of whom 83 had died before the age of five years, i.e. a child mortality rate of 251 per 1000 births. Nearly half of the mortality (45%) occurred shortly after birth. PIP: To obtain baseline information to assist a new nurse-midwife, weight, height, and mid-upper-arm circumference (MUAC) were measured in 159 women of reproductive age in four remote valleys (Yamil, Hey, Moruman, and Bomela) in the Eastern Central Highlands of Irian Jaya, Indonesia, in 1991. Average weight was 42.3 +or- 5.2 kg; 26% weighed less than 40 kg. Height averaged 141.3 +or- 9.1 cm; 30% were shorter than 140 cm. The MUAC was less than 23 cm (indicative of inadequate nutrition) in 58% of the women and 20 cm or less (malnutrition) in 16%. The international reference standards for weight, height, and MUAC are 56.6 kg, 163.7 cm, and 26 cm. 8% of women appeared pregnant and 43% were lactating. Home visits to 112 women in the Yamil valley revealed they had given birth to 331 children, 83 of whom had died before 5 years of age (child mortality rate, 251/1000 births). Since maternal food supplementation aimed at increasing birth weight would lead to more complicated deliveries in stunted mothers, the most feasible strategy is a nutrition program for schoolchildren--the mothers of the next generation.
Adult ; Anthropometry ; Arm - anatomy & ; histology ; Body Height ; Child, Preschool ; Indonesia - epidemiology

Human, birds and other mammals can be infected by avian influenza A (H5N1) virus. Bird infections spread among continents in the last 2 years. Human infections become endemic in certain areas, characterized with young patients and high mortality. An unprecedented epizootic avian influenza A (H5N1) virus that is highly pathogenic has crossed the species barrier in Asia to cause many human fatalities and poses an increasing pandemic threat. This summary describes the features of human infection with influenza A (H5N1) in epidemiology and etiology and reviews recommendations for prevention.
Animals ; Birds ; China ; epidemiology ; Humans ; Indonesia ; epidemiology ; Influenza A Virus, H5N1 Subtype ; pathogenicity ; Influenza in Birds ; prevention & control ; transmission ; Influenza, Human ; epidemiology ; prevention & control ; transmission

Recently, PCR-based typing would be of great value for Epidemiological investigation to identify infectious source of leprosy, understand transmission pattern, and distinguish between relapse & re-infection. Variable TTC DNA repeats in non-coding region and 6bp(GACATC) tandem repeats in rpoT gene revealed PCR products of different size may be useful to investigate the epidemiology of leprosy. Authors have typed clinical isolates of M. leprae in Korea using difference of TTC DNA repeats in non-coding region and 6bp(ACATCG) tandem repeats in rpoT gene. Of the sequence analysis of isolates(M. leprae) of 52 patients(44 Koreans, 8 foreigners; Bangladesh, Indonesia, Philippine, Sri Lanka, Thailand) M. leprae with 12 TTC repeats was showed most common(13 cases, 29.5%) in 44 Korean isolates and 42 Koreans(95.5% of Korean isolates) isolates demonstrated four copies of 6bp(ACATCG) tandem repeats in rpoT gene and the isolates with three copies were found in 2 Koreans and 8 foreigners.
Bangladesh ; DNA ; Emigrants and Immigrants ; Epidemiology ; Humans ; Indonesia ; Korea* ; Leprosy ; Polymerase Chain Reaction ; Recurrence ; Sequence Analysis ; Sri Lanka ; Tandem Repeat Sequences

Congenital malaria is assumed to be a risk factor for infant morbidity and mortality in endemic areas like Maumere, Indonesia. Infected infants are susceptible to its impact such as premature labor, low birth weight, anemia, and other unspecified symptoms. The aim of this study was to investigate the prevalence of congenital malaria and the influence of mother-infant paired parasite densities on the clinical outcome of the newborns at TC Hillers Hospital, Maumere. An analytical cross sectional study was carried out in newborns which showed criteria associated with congenital malaria. A thick and thin blood smear confirmed by nested PCR was performed in both mothers and infants. The association of congenital malaria with the newborn's health status was then assessed. From 112 mother-infant pairs included in this study, 92 were evaluated further. Thirty-nine infants (42.4%) were found to be infected and half of them were asymptomatic. Infected newborns had a 4.7 times higher risk in developing anemia compared to uninfected newborns (95% CI, 1.3-17.1). The hemoglobin level, erythrocyte amount, and hematocrit level were affected by the infants' parasite densities (P<0.05). Focusing on newborns at risk of congenital malaria, the prevalence is almost 3 times higher than in an unselected collective. Low birth weight, anemia, and pre-term birth were the most common features. Anemia seems to be significantly influenced by infant parasite densities but not by maternal parasitemia.
Anemia/*etiology ; Blood/parasitology ; Cross-Sectional Studies ; Female ; Humans ; Indonesia/epidemiology ; *Infant, Low Birth Weight ; Infant, Newborn ; Malaria/*congenital/*epidemiology/pathology ; Male ; Microscopy ; Polymerase Chain Reaction ; Prevalence

The present study determined the genetic relationships between 41 Staphyloccocus (S.) aureus isolates from bovines, humans, and food using a single enzyme amplified fragment length polymorphism (AFLP) technique. We evaluated the prevalence of staphylococcal enterotoxin (SE) genes and other virulence gene determinants by PCR. The identification of S. aureus was based on culturing and biochemical tests, and by amplifying a specific section of the 23S rRNA gene. PCR amplification of the SE genes (sea, seb, sec, see, seg, seh, and sei) singly or in combination was observed. Most isolates of bovine origin harbored hla (84%) and cap5 (74%), while most isolates from humans harbored hla (73%), cap8 (91%), and fnbA (100%). Strains from food sources were positive for hla (100%), cap5 (100%), and cap8 (64%) unlike isolates from humans or bovines. A single enzyme AFLP analysis revealed a correlation between AFLP clusters of some strains and the source of the isolates The genotypic results of the present study might help to better understand the distribution of prevalent S. aureus clones among humans, bovines, and food and will help control S. aureus infections in Indonesia.
Amplified Fragment Length Polymorphism Analysis ; Animals ; Bacterial Proteins/genetics/metabolism ; Cattle ; Female ; *Food Microbiology ; Gene Expression Regulation, Bacterial ; Humans ; Indonesia/epidemiology ; Mastitis, Bovine/epidemiology/microbiology ; Phylogeny ; Staphylococcal Infections/epidemiology/microbiology/*veterinary ; Staphylococcus aureus/*genetics

OBJECTIVETo evaluate the sensitivity pattern of bacterial pathogens in the intensive care unit (ICU) of a tertiary care of Fatmawati Hospital Jakarta Indonesia.

METHODSA cross sectional retrospective study of bacterial pathogen was carried out on a total of 722 patients that were admitted to the ICU of Fatmawati Hospital Jakarta Indonesia during January 2009 to March 2010. All bacteria were identified by standard microbiologic methods, and their antibiotic susceptibility testing was performed using disk diffusion method.

RESULTSSpecimens were collected from 385 patients who were given antimicrobial treatment, of which 249 (64.68%) were cultured positive and 136 (35.32%) were negative. The most predominant isolate was Pseudomonas aeruginosa (P. aeruginosa) (26.5%) followed by Klebsiella pneumoniae (K. pneumoniae) (15.3%) and Staphylococcus epidermidis (14.9%). P. aeruginosa isolates showed high rate of resistance to cephalexin (95.3%), cefotaxime (64.1%), and ceftriaxone (60.9%). Amikacin was the most effective (84.4%) antibiotic against P. aeruginosa followed by imipenem (81.2%), and meropenem (75.0%). K. pneumoniae showed resistance to cephalexin (86.5%), ceftriaxone (75.7%), ceftazidime (73.0%), cefpirome (73.0%) and cefotaxime (67.9%), respectively.

CONCLUSIONSMost bacteria isolated from ICU of Fatmawati Hospital Jakarta Indonesia were resistant to the third generation of cephalosporins, and quinolone antibiotics. Regular surveillance of antibiotic susceptibility patterns is very important for setting orders to guide the clinician in choosing empirical or directed therapy of infected patients.

Anti-Bacterial Agents ; pharmacology ; Bacteria ; drug effects ; Bacterial Infections ; epidemiology ; microbiology ; Cross Infection ; epidemiology ; microbiology ; Cross-Sectional Studies ; Drug Resistance, Bacterial ; Humans ; Indonesia ; epidemiology ; Intensive Care Units ; Microbial Sensitivity Tests

INTRODUCTIONPeripheral arterial disease (PAD) is an important complication of diabetes mellitus (DM), significantly associated with increased morbidity and mortality secondary to amputations, strokes and coronary artery disease. Information on DM patients with PAD is limited in our ethnically diverse population in Singapore. We aimed to determine the prevalence, risk factors and co-morbidities of PAD in patients managed for DM in the primary care setting.

MATERIALS AND METHODSA cross-sectional study was conducted among 521 diabetics in 9 of the 18 government-aided clinics in the community. Data including demographics, presence of co-morbidities and vascular risk factors were collected using an interviewer-administered questionnaire, and Ankle-Brachial Index (ABI) was calculated from systolic ankle and brachial pressure measurements.

RESULTSThe prevalence of PAD, defi ned as resting ABI of <0.9 on either leg and/or a history of gangrene or non-traumatic amputation was 15.2% [95% confidence interval (CI), 12.3-18.5]. This prevalence of PAD was higher in patients with pre-existing microvascular and other macrovascular complications. In multivariate analysis, prevalence of PAD was positively associated with increasing age (OR, 1.08; 95% CI, 1.05-1.12), Malay versus Chinese ethnicity (OR, 2.27; 95% CI, 1.09-4.70), low HDL-cholesterol (OR, 1.87; 95% CI, 1.04- 3.37), and insulin treatment (OR, 2.98; 95%CI, 1.39-6.36).

CONCLUSIONPAD is an important cause of concern among patients with diabetes, with a high prevalence which further increases with increasing age and duration of DM, and exhibits ethnic variation. Risk factors identified in this study may improve early identification of PAD, allowing for prompt interventions, with a potential to reduce long-term morbidity and mortality.

Adult ; Age Distribution ; Aged ; Ambulatory Care Facilities ; statistics & numerical data ; China ; Diabetic Angiopathies ; epidemiology ; ethnology ; Female ; Humans ; India ; Indonesia ; ethnology ; Male ; Middle Aged ; Peripheral Arterial Disease ; epidemiology ; ethnology ; Prevalence ; Sex Distribution ; Singapore ; epidemiology

Trichomonad species inhabit a variety of vertebrate hosts; however, their potential zoonotic transmission has not been clearly addressed, especially with regard to human infection. Twenty-one strains of trichomonads isolated from humans (5 isolates), pigs (6 isolates), rodents (6 isolates), a water buffalo (1 isolate), a cow (1 isolate), a goat (1 isolate), and a dog (1 isolate) were collected in Indonesia and molecularly characterized. The DNA sequences of the partial 18S small subunit ribosomal RNA (rRNA) gene or 5.8S rRNA gene locus with its flanking regions (internal transcribed spacer region, ITS1 and ITS2) were identified in various trichomonads; Simplicimonas sp., Hexamastix mitis, and Hypotrichomonas sp. from rodents, and Tetratrichomonas sp. and Trichomonas sp. from pigs. All of these species were not detected in humans, whereas Pentatrichomonas hominis was identified in humans, pigs, the dog, the water buffalo, the cow, and the goat. Even when using the high-resolution gene locus of the ITS regions, all P. hominis strains were genetically identical; thus zoonotic transmission between humans and these closely related mammals may be occurring in the area investigated. The detection of Simplicimonas sp. in rodents (Rattus exulans) and P. hominis in water buffalo in this study revealed newly recognized host adaptations and suggested the existence of remaining unrevealed ranges of hosts in the trichomonad species.
Animals ; DNA, Protozoan/genetics ; DNA, Ribosomal Spacer/genetics ; Humans ; Indonesia/epidemiology ; *Mammals ; Protozoan Infections/epidemiology/*parasitology ; RNA, Protozoan/genetics ; RNA, Ribosomal, 18S/genetics ; Species Specificity ; Trichomonadida/*classification/*genetics/isolation & purification

Among all head and neck (H&N) cancers, nasopharyngeal carcinoma (NPC) represents a distinct entity regarding epidemiology, clinical presentation, biological markers, carcinogenic risk factors, and prognostic factors. NPC is endemic in certain regions of the world, especially in Southeast Asia, and has a poor prognosis. In Indonesia, the recorded mean prevalence is 6.2/100 000, with 13 000 yearly new NPC cases, but otherwise little is documented on NPC in Indonesia. Here, we report on a group of 1121 NPC patients diagnosed and treated at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia between 1996 and 2005. We studied NPC incidence among all H&N cancer cases (n=6000) observed in that period, focusing on age and gender distribution, the ethnic background of patients, and the disease etiology. We also analyzed most prevalent signs and symptoms and staging of NPC patients at first presentation. In this study population, NPC was the most frequent H&N cancer (28.4%), with a male-to-female ratio of 2.4, and was endemic in the Javanese population. Interestingly, NPC appeared to affect patients at a relatively young age (20% juvenile cases) without a bimodal age distribution. Mostly, NPC initiated in the fossa of Rosenmuller and spreaded intracranially or locally as a mass in the head. Occasionally, NPC developed at the submucosal level spreading outside the anatomic limits of the nasopharynx. At presentation, NPC associated with hearing problems, serous otitis media, tinnitus, nasal obstruction, anosmia, bleeding, difficulty in swallowing and dysphonia, and even eye symptoms with diplopia and pain. The initial diagnosis is difficult to make because early signs and symptoms of NPC are not specific to the disease. Early-age Epstein-Barr virus (EBV) infection combined with frequent exposure to environmental carcinogenic co-factors is suggested to cause NPC development. Undifferentiated NPC is the most frequent histological type and is closely associated with EBV. Expression of the EBV-encoded latent membrane protein 1(LMP1) oncogene in biopsy material was compared between NPC patients of <30 years old and those of ≥30 years old, matched for sex and tumor stage. Higher LMP1 expression in patients of <30 years old was observed, which was related to more locoregional progressivity. Increased medical awareness of prevailing early stage signs and symptoms coupled to use of EBV-related diagnostic tumor markers may lead to down-staging and timely treatment to improve survival of patients with this aggressive disease.
Adolescent ; Adult ; Age Distribution ; Aged ; Child ; Epstein-Barr Virus Infections ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Incidence ; Indonesia ; epidemiology ; ethnology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; epidemiology ; ethnology ; pathology ; virology ; Sex Factors ; Viral Matrix Proteins ; metabolism ; Young Adult