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"Pemeriksaan tinja secara mikroskopik merupakan metode yang paling banyak dilakukan dalam mendiagnosis infeksi Entamoeba histolytica. Hasil positif dinyatakan jika ditemukan kista atau trofozoit. Namun, karena kista dan trofozoit berada dalam tinja secara intermiten, cara pemeriksaan ini dapat memberikan hasil negatif palsu. Oleh karena itu dianjurkan dilakukan pengambilan spesimen secaraberulang. Penelitian ini bertujuan untuk mengetahui berapa kali pengambilan spesimen tinja yang terbaik untuk melakukan pemeriksaan mikroskopik infeksi E. histolytica. Selain itu, penelitian ini juga bertujuan untuk mengetahui prevalensi infeksi E.histolytica asimtomatis pada populasi anak usia 2-12 tahun di Kelurahan Kampung Melayu, Jakarta Timur. Penelitian dilakukan dengan desain potong lintang. Pengambilan spesimen tinja subyek dilakukan sebanya satu hingga tiga kali, kemudian diperiksa di Laboratorium Parasitologi FKUI. Pada studi ini didapatkan bahwa pengambilan spesimen tinja dua kali meningkatkan hasil positif dibandingkan pengambilan spesimen satu kali (5.3% vs 3.2%) (p = 0.001).Namun, pemeriksaan spesimen tinja tiga kali tidak meningkatkan hasil positif dibandingkan pengambilan spesimen dua kali. Oleh karena itu frekuensi pengambilan spesimen tinja yang terbaik untuk pemeriksaan mikroskopik infeksi Entamoeba histolytica adalah dua kali. Prevalensi infeksi E. histolytica asimtomatik pada anak usia prasekolah (2 - 6 tahun) adalah 5.8%, sedangkan pada anak usia sekolah (6 - 12 tahun) adalah 3.9%.

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Microscopic stool examination is the most common method used worldwide to detect Entamoeba histolytica infection. Positive result is considered when examiner find cyst or trophozoit. However, as cyst and trophozoit are shed intermetently in stool, this examination could yield high number of false negative result. Thus, examination of multiple stool specimen is recommended. The purpose of this is to know the best number of repetitive specimen needed for a

microscopic stool examination in diagnosing E. histolytica infection. This study also aimed to know the prevalence of E.histolytica asymptomatic infection among children aged between 2-12 years in Kampung Melayu District, East Jakarta. This research was conducted by using cross sectional design. Specimens were collected from the subject in one to three times, then examined at Parasitology

Laboratorium, Faculty of Medicine University of Indonesia. This study found that examination of two independent stool specimens yields a higher positive results than using only one stool specimen (5.3% vs 3.2% respectively) (p = 0.00). However, examination of three independent specimens cannot increase positive results yield, compared to examination of two independent specimens. Thus, this

study found that collection of two independent stool specimens is enough to detect Entamoeba histolytica infection. Prevalence of asymptomatic E. histolytica infection among preschool children (2 - 6 years old) is 5.8%, while prevalence among school children (6 - 12 years old) is 3.9%."

"Latar belakang. Diare merupakan penyebab kematian anak ketiga di Indonesia. Salah satu penyebabnya adalah infeksi Entamoeba histolytica. Deteksi E.histolytica pada individu asimtomatis penting untuk langkah pencegahan, karena kista E.histolytica sebagai penyebabnya, mudah ditularkan lewat fekal maupun oral. Selama ini, metode deteksi yang tersedia telah berkembang hingga molekuler. Namun deteksi secara mikroskopik tetap digunakan secara luas karena murah. Salah satu kelemahan metode ini adalah pada pemeriksaan langsung, organisme dalam jumlah sedikit tidak dapat terdeteksi. Salah satu cara untuk meningkatkan sensitivitas dalam pemeriksaan mikroskopik adalah dengan metode konsentrasi sampel tinja pasien. Tujuan. Penelitian ini bertujuan untuk mengetahui peningkatan sensitivitas pemeriksaan mikroskopik dengan metode konsentrasi, dan mengetahui prevalensi infeksi E.histolytica asimtomatis pada populasi anak sekolah di Kampung Melayu. Metode. Penelitian dilakukan dengan desain potong lintang. Pengambilan sampel dilakukan dengan cara mengambil spesimen tinja subyek penelitian untuk diperiksa di laboratorium Parasitologi FKUI. Hasil. Didapatkan 673 sampel pemeriksaan mikroskopik dengan metode langsung, dan 540 sampel dengan metode konsentrasi. Frekuensi infeksi E.histolytica/E.dispar asimtomatik adalah 2,5% dengan menggunakan metode langsung, sedangkan dengan metode konsentrasi 6,3%. Sensitivitasnya adalah 38,5% sedangkan spesifisitasnya 94,6%. Nilai prediksi positif 15,2% dan nilai prediksi negatif 98,4%. Rasio kemungkinan positif 11,67 dan rasio kemungkinan negatif 0,64. Nilai p = 0,001. Kesimpulan. Terdapat peningkatan sensitivitas pemeriksaan mikroskopik dengan metode konsentrasi dibandingkan metode langsung.

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Background. Diarrhea is the third cause of mortality among children in Indonesia. One of the cause of diarrhea is Entamoeba histolytica. E.histolytica detection in asymptomatic individual is important for prevention, because E.histolytica cyst as the cause is easy to infect either orally or fecally. Recently, detection methods have been developing until molecular. But microscopic detection still used widely because of its ease. The disadvantage of microscopic detection is unability to detect organism in small amount when we use direct stool examination. One of ways to increase the sensitivity in microscopic detection is by concentration method for patient’s stool. Objective. This research is aimed to know the sensitivity raising of microscopic detection by concentration method, and to know the prevalence of E.histolytica asymptomatic infection in school children in Kampung Melayu. Methods. This research was done by cross sectional design. Sample were gained by taking stool of research subjects then examined in Parasitological laboratory FMUI. Results. 673 samples for direct stool examination, and 540 samples for concentration method. Frequency of E.histolytica/E.dispar asymptomatic infection was 2,5% by direct examination, then 6,3% by concentration. Sensitivity is 38,5% and specificity is 94,6%. Positive predictive value is 15,2% and negative predictive value is 98,4%. Positive likelihood ratio is 11,67 and negative likelihood ratio is 0,64. P value is 0,001. Conclusion. There is sensitivity raising of E.histolytica microscopic detection by concentration method."

"ABSTRAKFrekuensi pengambilan sampel tinja dalam pemeriksaan mikroskopik mempengaruhi hasil pemeriksaan, namun sampai saat ini belum ada pedoman jumlah pengambilan sampel tinja untuk deteksi infeksi parasit usus. Penelitian ini bertujuan untuk mengetahui frekuensi pengambilan sampel tinja yang lebih efektif untuk deteksi infeksi parasit usus dengan pemeriksaan mikroskopik. Penelitian dilakukan dengan desain cross sectional. Data pada penelitian merupakan hasil pemeriksaan dari sampel tinja yang dikirim ke Laboratorium Parasitologi FKUI tahun 2006-2015. Teknik sampling yang digunakan ialah non probability sampling yaitu consecutive sampling dengan mengambil sampel tinja dari subjek yang memeriksakan tinjanya 3 kali di hari yang berbeda dengan dengan interval pemeriksaan sampel pertama dan ketiga kurang dari 10 hari. Pada penelitian ini didapatkan bahwa pemeriksaan dengan pengambilan sampel tinja dua kali meningkatkan hasil positif dibandingkan pengambilan sampel tinja satu kali 30,9 vs 34,1 uji Fisher

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ABSTRAKThe sampling frequency of obtaining stool from patient rsquo s samples will determine the microscopic examination result, however the frequency of taking stool samples from a patient for detecting intestinal parasites has not been standardized. The aims of this study was to determine the most effective frequency of stool sampling for intestinal parasites detection by microscopic examination. The study was conducted by using cross sectional design. Data of this study were obtained from the examination result of stool samples sent to the Laboratory of Parasitology, FKUI from 2006 2015. The sampling technique used was consecutive sampling, which was done by taking stool samples from subjects being examined for three different days. The examination of three samples should not exceed ten days. This study showed that examination of stool samples taken twice increased positive outcomes compared to samples taken once 30.9 vs 34.1 Fisher 39 s exact test"

"Indonesia mengalami Kejadian Luar Biasa (KLB) polio pada tahun 2005. Di tiga kabupaten Lebak, Serang dan Sukabumi merupakan 58,9% kasus KLB nasional. Tujuan penelitian ialah diketahuinya besar risiko spesimen yang tidak memenuhi ketepatan waktu ambiI terhadap risiko basil pemeriksaan negatif virus polio di laboratorium nasional polio di Bandung dan Jakarta.Pada studi potong lintang (cress-.seclionalO terhadap semua sampel spesimen yang pertama yang diambiI dari kasus acute fkrcid paralysis (AFP) selama tahun 2005 dari tiga kabupaten. Data berasal dari laboratorium nasional polio tentang identitas kasus AFP, tanggal lumpuh, tanggal' ambil spesimen, tanggal kirim, tanggal diterima, kondisi diterima, tanggal proses, tanggal dan basil uji. Di samping itu dilakukan konf rmasi lapangan untuk data tempat pengambilan spesimen, fasilitas, dan tenaga surveilans. Analisis faktor-faktor risiko terhadap risiko relatif (RR) basil pemeriksaan negatif virus polio menggunakan regresi Cox.Prevalensi basil negatif dari sampel adalah 31,46%, Hasil negatif pada masa awal KLB Februari-April (60%) dan akhir KLB Juli-Desember 2005 (66,2%), dan yang terendah pada bulan Mei-Juni (15,5%). Faktor-faktor yang berkaitan secara signifikan terhadap risiko basil pemeriksaan negatif virus polio pada spesimen meliputi faktor tidak tepat waktu ambit spesimen, kabupaten asal spesimen, dan periode bulan pengambilan. Keterlambatan pengambilan spesimen mempertinggi risiko basil pemeriksaan negatif virus polio sebesar 70% dibandingkan dengan spesimen yang diambil tepat waktu [risiko relatif suaian (RN = 1,70; 95% interval kepercayaan (CI): 1,01 - 2,88).Selama masa awal dan akhir KLB, perhatian khusus harms diberikan terhadap ketepatan waktu pengambilan spesimen dan kabupaten asal spesimen untuk memperkecil risiko basil pemeriksaan negatif virus polio.

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In 2005 Indonesia had a polio outbreak of positive wild polioviruses (WPV). The three districts namely Lebak, Serang and Sukabumi contributed 59.% of total national cases. The aim of this study was to identify the risk of late collection of stool specimen for negative detection of poliovirus.

A cross sectional study conducted on all acute flaccid paralysis (AFP) surveillance's stool speciment from the three districts tested for polio virus in Bandung and Jakarta national polio laboratory in 2005. Data derived from laboratory registry books for case identity, date of paralysis onset; spesiment collection: sent; recieved; testing process; and result of test. In addition, field visits were conducted to the three districts for confirmation on data collecting methods, and human resources. Analysis was using Cox regression method for relative risk (RR).

The prevalence of negative results was 31,46%. Negative results during early stage of outbreak in February -April was 60% and late stage July- December was 66.2%, while in May -June was Ioweer (15.5%). Factors that significantly associated with the risk of poliovirus negative results were late of speciment collection, district origin of speciment and period of month speciment collection. Late than on time collection for first stool speciment had 70% increased risk to be negative results (adjusted relative risk =-1.70; 95% confidence intervals = 1.01 - 2.88).

During early and late stage of polio outbreak, special attention should be taken for timing of speciment collection and district origin of speciment to minimize risk of negative detection of poliovirus."

"ABSTRAKAmebiasis merupakan penyakit yang umum yang banyak ditemukan di negara berkembang. Namun hanya sedikit yang bermanifestasi klinis menjadi kolitis amuba. Komplikasi yang paling sering dijumpai adalah abses hati amuba. Abses hati selain disebabkan oleh amuba dapat disebabkan oleh bakteri yang dikenal sebagai abses hati piogenik. Untuk dapat menegakkan penyebab abses hati yang disebabkan oleh amuba maka selain anamnesis dan pemeriksaan fisik, dibutuhkan pemeriksaan penunjang seperti pemeriksaan serologi antigen dan antibodi Entamoeba histolytica. Namun pada praktek klinis, jarang sekali pemeriksaan serologi ini dilakukan. Oleh karena itu penelitian ini mencoba untuk melihat profil pasien dengan dugaan abses hati amuba yang sampelnya dikirimkan ke laboratorium parasitologi FKUI untuk pemeriksaan antibodi E. histolytica serta menilai hubungan antara gejala klinis/tanda tersebut dengan hasil serologi. Sampel diambil dari data pasien RSCM yang sampelnya dikirimkan ke laboratorium parasitologi FKUI dengan dugaan abses hati berupa keluhan utama, pemeriksaan fisik dan hasil laboratorium dan hasil serologinya diambil dari hasil pemeriksaan ELISA antibodi Entamoeba histolytica. Hasil penelitian menunjukkan bahwa sebagian besar pasien yang positif serologi antibodi E. histolytica adalah pasien dari kelompok umur 26-45 tahun dan berjenis kelamin laki-laki. Sedangkan manifestasi klinis yang ditemukan pada pasien tersebut dari yang terbanyak adalah hepatomegali, klinis abses hati, nyeri perut, abdominal discomfort, berat badan turun, diare, muntah, efusi pleura dan mual. Yang memiliki hubungan signifikan dengan hasil serologi positif antibodi E. histolytica hanya hepatomegali. Dari data laboratorium ditemukan sebagian besar pasien memiliki hasil laboratorium normal. Namun ada beberapa pasien yang mengalami penurunan hemoglobin dan hematokrit, leukositosis, peningkatan laju endap darah serta peningkatan fungsi hati SGOT dan SGPT.

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ABSTRACTAmebiasis is a common disease that is found in many developing countries. Yet few have clinically manifested as amoebic colitis. The most common complication is an amoebic liver abscess. A liver abscess other than caused by amoeba can be caused by a bacterium known as a pyogenic liver abscess. To be able to determine the cause of liver abscess caused by amoeba, beside anamnesis and physical examination, laboratory examination such as serological antigen and antibody of Entamoeba histolytica is needed. However, in clinical practice, this serology test is hardly performed. Therefore, this study attempted to look at the profile of the patient with suspected liver abscess whose sample was sent to the parasitology laboratory FMUI for E. histolytica antibody examination and assess the association between the clinical signs with serology results. Samples data were taken from Cipto Mangunkusumo hospital patient whose samples were sent to parasitology laboratory FMUI with suspected liver abscess in the form of main complaint, physical examination and laboratory result. Additionally, serology result was taken from antibody of Entamoeba histolytica ELISA examination. The results showed that most of the positive serologically patients of E. histolytica antibodies were patients at the 26 45 age group and from male group. While the clinical manifestations found in these patients subsequently are hepatomegaly, clinical liver abscess, abdominal discomfort, weight loss, diarrhea, vomiting, pleural effusion and nausea. It is only hepatomegaly that has a significant association with serologic positive results for E. histolytica antibodies. From the laboratory data, most patients have normal laboratory results. However, there were some patients who experienced decreased of hemoglobin and hematocrit, leukocytosis, increased blood sedimentation rate and increased liver function of AST and ALT."

"Pendahuluan: COVID-19 telah dilaporkan menyebabkan berbagai gejala, termasuk gejala pernapasan dan gejala gastrointestinal seperti mual, muntah, dan diare. Standar emas untuk pengujian COVID-19 adalah RT-PCR menggunakan koleksi swab nasofaring. Namun, beberapa penelitian menunjukkan bahwa pengambilan swab nasofaring memiliki beberapa keterbatasan, terutama untuk mendeteksi gejala gastrointestinal. Salah satu variabel dalam pengujian RT-PCR adalah Nilai CT yang diketahui dapat meningkatkan spesifisitas pengujian. Namun, belum ada penelitian yang menghubungkan Nilai CT pasien dengan pengambilan sampel swab anal dengan gejala gastrointestinal terkait COVID-19. Metode: Penelitian ini menggunakan desain penelitian analitik, khususnya penelitian potong lintang. Data sekunder diperoleh dan diolah yang berisi data pribadi, pekerjaan, dan hasil CT Value. Analisis lebih lanjut dilakukan pada hubungan antara gejala gastrointestinal dan tingkat Nilai CT pada swab anal. Hasil: Distribusi tingkat Nilai CT responden berdasarkan cut off >25 untuk tinggi, dan <25 untuk rendah dan sedang. Dari 37 subjek, 1 orang (2,7%) memiliki Nilai CT rendah dan 36 pasien memiliki Nilai CT tinggi. Distribusi gejala subjek didapatkan 15 pasien (40,5%) tidak mengalami gejala gastrointestinal dan sebanyak 22 pasien (59,5%) mengalami gejala gastrointestinal. Gejala gastrointestinal umum yang dilaporkan pada pasien meliputi: mual (54,1%), muntah (18,9%), sakit perut (16,2%) dan diare (13,5%). Namun, tidak ada hubungan yang signifikan (p>0,05) antara Nilai CT pada pengambilan anal swab dengan gejala gastrointestinal pada pasien COVID-19. Kesimpulan: Hubungan antara Nilai CT pada pengambilan anal swab dengan gejala gastrointestinal pada pasien COVID-19 tidak menunjukkan hubungan yang signifikan. Penelitian lebih lanjut tentang faktor risiko yang mempengaruhi hasil nilai CT direkomendasikan.

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Introduction: COVID-19 has been reported to cause a range of symptoms, including respiratory symptoms and gastrointestinal symptoms such as nausea, vomiting, and diarrhea. The gold standard for COVID-19 testing is RT-PCR using nasopharyngeal swab collection. However, several studies have shown that taking nasopharyngeal swabs have some limitation, particularly to detect gastrointestinal symptoms. One of the variables in RT-PCR testing is CT Value, which known can increase specifity of the test. However, there has been no study linking the CT Value of patients with anal swab sampling with COVID-19 related gastrointestinal symptoms. Methods: This study used an analytical research design, particularly a cross-sectional study. Secondary data were obtained and processed which contained personal data, work, and CT Value results. Further analysis was conducted on the relationship between gastrointestinal symptoms and the level of CT Value on anal swabs. Result: The distribution of respondents' CT Value levels were based on a cut off of >25 for high, and <25 for low and moderate. From 37 subjects, 1 person (2.7%) had a low CT Value and 36 patients had a high CT Value. The distribution of the subject's symptoms found 15 patients (40.5%) had no gastrointestinal symptoms and as many as 22 patients (59.5%) had gastrointestinal symptoms. Common gastrointestinal symptoms reported in patients include: nausea (54.1%), vomiting (18.9%), abdominal pain (16.2%) and diarrhea (13.5%). However, there was no significant relationship (p>0.05) between CT Value in anal swab taking and gastrointestinal symptoms in COVID-19 patients. Conclusion: The association between CT Value in anal swab taking and gastrointestinal symptoms in COVID-19 patients did not show a significant relationship. Further research on risk factors affecting the CT value results are recommended"

"[ABSTRAKLatar belakang. Kolitis infeksi adalah proses inflamasi pada usus besar yang disebabkan oleh infeksi bakteri patogen, seperti Shigella, Salmonella, E.coli, dan Campylobacter. Dibuktikan dengan pemeriksaan kultur tinja, tetapi biayanya cukup mahal, perlu waktu dan tidak selalu tersedia di semua fasilitas kesehatan. Rekomendasi WHO jumlah lekosit lebih dari 10 per LPB untuk Shigella disentriae dengan klinis disentri dan merupakan indikasi pemberian antibiotika. Sering ditemukan anak diare dengan lekosit kurang dari 10/LPB tetapi hasil kultur positif bakteri patogen. Mencari hubungan jumlah lekosit tinja dengan kejadian diare yang disebabkan infeksi bakteri patogen yang memerlukan terapi antibiotika.Tujuan. Mengetahui prevalensi, sebaran bakteri patogen, nilai leukosit mikroskopik tinja pada anak dengan kolitis infeksi bakteri. Mengetahui hubungan leukosit tinja dengan kultur tinja dan pola sensitivitas antibiotika pada kolitis infeksi bakteri.Metode. Penelitian deskriptif dengan metode potong lintang dan uji diagnostik untuk menilai sensitivitas hitung leukosit tinja untuk mendiagnosis kolitis infeksi bakteri. Penelitian dilakukan di Rumah Sakit Umum Pusat Rujukan Nasional Cipto Mangunkusumo, Jakarta, dari bulan Januari- Juni 2015.Hasil. Dari 45 subjek penelitian ditemukan kultur positif pada 19 subjek (42,2%). Bakteri terbanyak yang ditemukan adalah E.coli (79%), Salmonella sp. (10,5%), dan C.difficille (10,5%). Pada titik potong ROC ditemukan nilai lekosit >8 per LPB dengan sensitivitas 0,654 dan spesifisitas 0.632. E.coli masih memperlihatkan sensitivitas cukup tinggi terhadap kloramfenikol dan siprofloksasin tetapi tidak terhadap sefiksim. Salmonella sp. sensitif terhadap kloramfenikol, sefiksim, dan seftriakson, sedangkan C. difficile sensitif terhadap Seftriakson.Simpulan. Pada penelitian ini ditemukan sebanyak 19 (42,2%) subyek penderita diare hasil kultur tinja positif bakteri patogen dan pada titik potong ROC ditemukan nilai lekosit > 8 per LPB dengan sensitivitas 65.4% dan spesifisitas 63.2%. Pada pola sensitivitas antibiotika, E.coli sensitif terhadap kloramfenikol dan siprofloksasin dan Salmonella dan C.difficile sensitif terhadap seftriakson.

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ABSTRACTBackground. Infective colitis is an inflammatory process in the colon caused by pathogenic bacterial infection, such as Shigella, Salmonella, E.coli, and Campylobacter. Diagnosis is made by fecal culture, but the cost is relatively expensive, time-consuming, and not readily available in every health facility. WHO recommends that fecal leukocyte more than 10 per HPF for the diagnosis of Shigella disentriae with clinical symptom of dysentriae and indicated for antibiotic treatment. Often there are diarrheic children with leukocyte less than 10/HPF but the culture is positive for pathogenic bacteria. This study would like to look for the relationship between fecal leukocyte and incidence of diarrhea caused by pathogenic bacteria infection that requires antibiotic therapy.Objective. To study the prevalence, distribution of pathogenic bacteria, leukocyte count in fecal microscopic test in children with bacterial infective colitis. To study the relationship between fecal leukocyte and fecal culture with sensitivity pattern of antibiotics in bacterial infective colitis.Methods. Descriptive, cross-sectional study and diagnostic test to study the sensitivity of fecal leukocyte count in diagnosing bacterial infective colitis. Study was performed in the Cipto Mangunkusumo Hospital, Jakarta, from January to June 2015.Results. From 45 study subjects, positive culture was found in 19 subjects (42.2%), and the most common bacteria were E.coli (79%), Salmonella sp. (10.5%), and C. difficille (10,5%). At the ROC we found leukocyte count >8 per HPF as cutoff point with 0.654 sensitivity and 0.632 specificity. E. coli still showed relatively high sensitivity to chloramphenicol and ciprofloxacin, but not to cefixime. Salmonella sp. were sensitive to chloramphenicol, cefixime, and ceftriaxone, while C. difficile were sensitive to ceftriaxone.Conclusion. In this study there were 19 (42.2%) subjects with diarrhea, with positive fecal culture for pathogenic bacteria. At the ROC cutoff point we found leukocyte count > 8 per HPF with 65.4% sensitivity and 63.2% specificity. On the antibiotic sensitivity pattern, E. coli was sensitive to chloramphenicol and ciprofloxacin, while Salmonella dan C.difficile were sensitive to ceftriaxone, Background. Infective colitis is an inflammatory process in the colon caused by pathogenic bacterial infection, such as Shigella, Salmonella, E.coli, and Campylobacter. Diagnosis is made by fecal culture, but the cost is relatively expensive, time-consuming, and not readily available in every health facility. WHO recommends that fecal leukocyte more than 10 per HPF for the diagnosis of Shigella disentriae with clinical symptom of dysentriae and indicated for antibiotic treatment. Often there are diarrheic children with leukocyte less than 10/HPF but the culture is positive for pathogenic bacteria. This study would like to look for the relationship between fecal leukocyte and incidence of diarrhea caused by pathogenic bacteria infection that requires antibiotic therapy.Objective. To study the prevalence, distribution of pathogenic bacteria, leukocyte count in fecal microscopic test in children with bacterial infective colitis. To study the relationship between fecal leukocyte and fecal culture with sensitivity pattern of antibiotics in bacterial infective colitis.Methods. Descriptive, cross-sectional study and diagnostic test to study the sensitivity of fecal leukocyte count in diagnosing bacterial infective colitis. Study was performed in the Cipto Mangunkusumo Hospital, Jakarta, from January to June 2015.Results. From 45 study subjects, positive culture was found in 19 subjects (42.2%), and the most common bacteria were E.coli (79%), Salmonella sp. (10.5%), and C. difficille (10,5%). At the ROC we found leukocyte count >8 per HPF as cutoff point with 0.654 sensitivity and 0.632 specificity. E. coli still showed relatively high sensitivity to chloramphenicol and ciprofloxacin, but not to cefixime. Salmonella sp. were sensitive to chloramphenicol, cefixime, and ceftriaxone, while C. difficile were sensitive to ceftriaxone.Conclusion. In this study there were 19 (42.2%) subjects with diarrhea, with positive fecal culture for pathogenic bacteria. At the ROC cutoff point we found leukocyte count > 8 per HPF with 65.4% sensitivity and 63.2% specificity. On the antibiotic sensitivity pattern, E. coli was sensitive to chloramphenicol and ciprofloxacin, while Salmonella dan C.difficile were sensitive to ceftriaxone]"

"Latar belakang: Infeksi C. diphtheriae toksigenik memerlukan penanganan segera karena dapat mengancam nyawa. Pemeriksaan kultur sebagai uji baku emas hanya dapat dilakukan di laboratorium rujukan dan memakan waktu lama. Pemeriksaan awal yang dapat dilakukan adalah menggunakan teknik pewarnaan. Pewarnaan khusus difteri seperti Albert atau Neisser dapat menggambarkan granul metakromatik yang spesifik terhadap Corynebacterium sp., namun laboratorium yang mampu mengerjakannya sangat terbatas. Oleh karena itu, berbagai laboratorium menggunakan teknik pewarnaan Gram sebagai alternatif untuk menunjang diagnosis dini difteri.Tujuan: Evaluasi pemeriksaan mikroskopik langsung yang rutin dilakukan pada spesimen swab tenggorok untuk menunjang diagnosis dini difteri.Metode: Uji diagnostik dengan desain potong lintang. Pemeriksaan mikroskopik Gram dan pewarnaan khusus Albert serta Neisser dibandingkan dengan kultur sebagai baku emas untuk mendapatkan nilai sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, dan akurasi. Uji kesesuaian antara kedua teknik pewarnaan dan PCR dinilai menggunakan koefisien Kappa. Analisis multivariat dilakukan pada variabel independen data faktor risiko dan gambaran klinis. Nilai probabilitas yang dihasilkan dimasukkan ke dalam kurva Receiver Operating Characteristic (ROC). Pertambahan luas Area Under Curve (AUC) dinilai setelah menambahkan pemeriksaan mikroskopik ke dalam model.Hasil: Pewarnaan khusus difteri dan Gram memiliki sensitivitas 70% dan 20%, spesifisitas 83,72% dan 79,06%, nilai duga positif 33,33% dan 10%, nilai duga negatif 96% dan 89,47% serta akurasi 82,29% dan 72,92%. Kesesuaian minimal antara kedua metode pewarnaan (reliabilitas 4-15%). Pewarnaan khusus difteri memiliki kesesuaian yang lebih baik dengan uji PCR,dibandingkan dengan pewarnaan Gram. Pewarnaan khusus difteri menunjukan penambahan nilai diagnostik sebesar 3,8% pada model faktor risiko dan gambaran klinis yang bermakna untuk menunjang diagnosis dini difteri.Kesimpulan: Pewarnaan khusus difteri pada spesimen klinis langsung untuk diagnosis dini difteri tidak dapat digantikan dengan pewarnaan Gram. .....Background: Infection caused by toxigenic C. diphtheriae requires immediate treatment because it can be life threatening. Culture examination as gold standard can only be done in a reference laboratory and is time-consuming. The initial examination can be performed using the staining technique. Diphtheria special staining such as Albert or Neisser can characterize metachromatic granules that are specific to Corynebacterium sp., but the availability of these stains in many laboratories are limited. Therefore most laboratories use Gram staining technique as an alternative to support early diagnosis of diphtheria.Objective: Evaluation of the direct microscopic examination commonly used on throat swab specimens to support the early diagnosis of diphtheria.Methods: Diagnostic test with a cross-sectional design. Gram microscopic examination and special staining of Albert and Neisser were compared with culture examination as the gold standard to obtain sensitivity, specificity, positive predictive value, negative predictive value, and accuracy. The realibility test between the two staining and PCR techniques was assessed using the Kappa coefficient. Multivariate analysis was performed on the independent variables of risk factors and clinical features data. The resulting probability value was entered into the Receiver Operating Characteristic (ROC) curve. The improvement of the area under the curve (AUC) was assessed after microscopic examination was added on the model.Results: Diphtheria and Gram staining had a sensitivity of 70% and 20%, specificity 83.72% and 79.06%, positive predictive value 33.33% and 10%, negative predictive value 96% and 89.47% and accuracy 82.29 % and 72.92%. Minimal concordance was found between the two staining methods (4-15%). Diphtheria-specific staining have better realibility result, compared to the PCR test, than Gram staining. Diphtheria special staining showed an additional 3.8% diagnostic value, in the significant of risk factors and clinical features model, to support the early diagnosis of diphtheria.Conclusion: Diphtheria special staining directly on clinical specimens for early diagnosis of diphtheria cannot be replaced by Gram staining."

"Penyakit infeksi amuba di keiurahan Kampung Melayu menempati urutan 9 dari I0 besar penyakit di wilayah tersebut, diduga disana banyak terdapar kasus infeksi amuba asimptomatik yang dapat menular ke orang lain. Selain itu kondisi sanitasi Iingklmgan dan higiene yang buruk juga mempakan faktor risiko unruk penyakit infcksi amuba. Penelitian ini hertujuan untuk mendapatkan ganmbanm hubungan kontanninasi air oleh Iihistobftica dcngan kejadian infcksi amuba asimptcmatik pada anak usia sekolah. Desain penelitiau case comrol, jumlah sampel 92 terdiri dari 46 kasus dan 46 kontrol. Pengumpulan data melalui pemeriksaan laboratorium , wawancara dan observasi. Analisa data dengan disuibusi fnekuensi, uji chi square dan regresi logistik. Prevalensi kejadian infcksi amuba asimptomatik dengan pemeriksaan antigen Elhistolyrica pada tinja anak usia sekolah adalah 9,6 %. Faktor yang bcrhubungan dengan kejadian infeksi amuba asimptomatik pada anak usia sekolah adalah sarana sanitasi (jamban) dengan OR=5,27l (95% CI: 1,753 - IS,855) dan kebiasaan cuci tangan dengan OR=2,438 (95% CI: 1.051 » 5,654). Faklor risiko dorninan yang b¢rpenga.ruh terhadap kcjadian infcksi amuba asimptomatik pada anak usia sekolah adalah sarana sanicasi (iamban). Faktor risiko yang berpengaruh terhadap kejadian infeksi amuba asimptomatik pada anak usia sekolah adalah sarana sanitasi (iamban) dan kcbiasaan cuci tangan anak. Membangzm sarana jamban umum dan sarana jamban pribadi yang mcmenuhi syarat. Meningkatkan penyuluhan pada orang tua., anak usia sekolah, guru SD, kadcr dan tokoh masyarakat tentang pcnyakit infeksi amuba dan faktor-faktor yang mempcngaruhinya. Juga memberi pengobatan pada anak usia sekolah yang antigen E. histobdica positif pada tinja.

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Amoeba infection disease in Kampung Mclayu chief village placed 9"` grade from l0"? highest disease in that area. estimated that in the area tbund many asymptomatic amoeba infections that contagious to others. Besides, bad condition of environment sanitation and bad hygiene also become risk factor for amoeba infection disease.

This research purpose is to obtain description of relation between water contaminations by Iihislogwxica and asymptomatic amoeba infection cases in school age children _ Research design is case controI,.total samples are 92 people that consist of 46 cases and 46 controls. Data gathering are through laboratory check-up, interview and observation. Data analysis is frequency distribution, chi-square test and logistic regression.

Case prevalence of asymptomatic amoeba infection with examination of lihiszolvrica antigen feces of school age children is 9_6 %_ Factor that related with asymptomatic amoeba infection cases in school age children is sanitation medium (toilet) with OR=5,27l and 95 % C|:l.753-15.855 and children rinse habit with OR=2,438 and 95% CI:l,05l-5,654 Dominant risk factor that affecting asymptomatic amoeba infection cases in school age children is sanitation medium (toilet).

Risk factor that affecting asymptomatic amoeba infection cases in school age children is sanitation medium (toilet) and children rinse habit. The building general toilet medium and building qualified toilet medium. Increase counseling to parents, school age children, SD teacher, cadre and public figure toward amoeba infection disease and affecting factors. Give medication to school age children that have positive histolytica antigen feces."