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"Antibodi yang diproduksi oleh sel plasma sebagai respon terhadap vaksin COVID-19 terdiri dari antibodi netralisasi dan antibodi non-netralisasi. Antibodi netralisasi penting untuk perlindungan terhadap infeksi SARS-CoV-2. Standar baku untuk mengukur tingkat antibodi netralisasi melalui uji Plaque Reduction Neutralization Test (PRNT) yang membutuhkan patogen hidup dan fasilitas Biosafety Level 3 (BSL3). Metode lain yang mudah dilakukan untuk mengukur IgG Anti-S1 RBD ataupun total antibodi representasi netralisasi melalui uji ELISA. Penelitian ini bertujuan untuk mengetahui hubungan titer IgG Anti-S1 RBD dengan total antibodi representasi SARS-CoV-2 pada subjek yang divaksinasi serta kaitannya dengan umur dan jenis kelamin. Titer IgG Anti-S1 RBD ditentukan menggunakan ujiindirect ELISA. Pengukuran persen inhibisi dari antibodi netralisasi menggunakan metode sVNT. Studi cross-sectional dilakukan pada 20 sampel plasma yang diimunisasi dengan seri primer CoronaVac dan 36 sampel plasma pasca-vaksinasi booster (dosis ketiga) dengan mRNA-1273. Hasil penelitian ini menunjukkan tidak terdapat perbedaan titer IgG Anti-S1 RBD dan total antibodi representasi netralisasi pada pria dan wanita maupun pada kelompok usia. Sementara itu, didapatkan korelasi kuat antara IgG Anti-S1 RBD dan total antibodi representasi netralisasipada kelompok sampel yang menerima vaksin inaktif (r = 0,720, p-value <0,0001) maupun pada kelompok subjek booster mRNA (r = 0,821, p-value < 0,0001).

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Antibodies produced by plasma cells in response to the COVID-19 vaccine consist of neutralizing antibodies and non-neutralizing antibodies. Neutralizing antibodies are important for protection against the SARS-CoV-2 infection. The standard for measuring the level of neutralizing antibodies is the Plaque Reduction Neutralization Test (PRNT), which requires live pathogens and Biosafety Level 3 (BSL3) facilities. Another easy method to measure IgG Anti-S1 RBD or total surrogate neutralizing via ELISA. This study aims to determine the relationship between anti-S1 RBD IgG titer and total surrogate neutralizing antibody in vaccinated subjects, as well as its relationship with age and gender. Anti-S1 RBD IgG titer were determined using an indirect ELISA assay. Measurement of percent inhibition of neutralizing antibodies using the sVNT method. A cross-sectional study was conducted on 20 plasma samples immunized with the CoronaVac primer series and 36 post-vaccination booster (third dose) plasma samples with mRNA-1273. The results of this study showed no difference in anti-S1 RBD IgG titer and total surrogate neutralizing antibody between men and women or in age groups. Meanwhile, a strong correlation was found between Anti-S1 RBD IgG titer and total surrogate neutralizing antibody in the sample group that received the inactivated vaccine (r = 0.720, p-value <0.0001) and also in the mRNA booster subject group (r = 0.821, p-value < 0.0001)."

"ABSTRAK Tuberkulosis (TB) merupakan penyakit infeksi kronis yang disebabkan oleh Mycobacterium tuberculosis dengan angka kematian yang tinggi diseluruh dunia. Vaksin pencegah yang tersedia saat ini adalah Bacillus Calmette-Guerin (BCG) yang berasal dari Mycobacterium bovis. BCG memiliki beberapa kelemahan yakni efikasi yang berbeda pada setiap individu, tidak memberikan perlindungan TB paru pada individu dewasa serta reaktivasi subsekuen. Hal ini mendorong penelitian terkait perlunya vaksin jenis baru untuk TB. Protein yang terbentuk dari gen resuscitation promoting factors B (rpfB) M. tuberculosis memiliki karakteristik biologi dan imunologi tertinggi diantara protein lain dalam famili Rpfs. Protein ini mampu menginduksi proliferasi bakteri TB dorman pada infeksi laten TB. Oleh karena itu protein ini kemudian banyak dikembangkan sebagai kandidat vaksin TB. Pada penelitian ini gen rpfB M. tuberculosis strain Beijing diamplifikasi dengan PCR kemudian diklon kedalam plasmid pcDNA3.1. Kemampuan plasmid rekombinan pcDNA3.1-rpfB dalam menginduksi respon imun humoral diuji dengan memberikan imunisasi plasmid rekombinan pada mencit Balb/C jantan. Hasil western blot menggunakan serum mencit hasil imunisasi menunjukkan bahwa gen rpfB berhasil menginduksi respon imun humoral mencit dengan adanya pita spesifik pada kisaran 66 kDa, sedangkan transfeksi plasmid rekombinan pada sel CHO-K1 memperlihatkan protein RpfB berhasil terekspresi pada sel mamalia berdasarkan uji imunostaining. Dengan demikian penelitian ini berhasil memperlihatkan bahwa protein RpfB M. tuberculosis strain Beijing mampu diekspresikan pada sel mamalia serta terbukti merupakan antigen yang dapat menginduksi respon imun humoral pada mencit.

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ABSTRACT

Tuberculosis (TB) is a chronic infection disease caused by Mycobacterium tuberculosis and has a high death-rate worldwide. Bacillus Calmette-Guerin is the only TB vaccine which is currently available with several drawbacks, such as its different efficacy for different individuals, lack of protection for lung TB in adults and subsequent reactivation which lead the research for novel TB vaccine approach. Resuscitation-promoting factor (rpf) protein in M. tuberculosis is a protein cluster which play a big role in TB dormancy during latent infection. Member from this cluster protein is RpfB which shows the greatest biological and immunological characteristics among other proteins in the rpf family, now is widely explored as novel TB vaccine candidate. In this study, the rpfB gene of the M. tuberculosis Beijing strain was amplified using PCR and then cloned into pcDNA3.1 plasmids. The ability of recombinant pcDNA-rpfB to induce humoral immune response was tested through Balb/C mice immunization. A positive recombinant RpfB protein ~66 kDa was detected through western blot analysis using immunized mice sera. Meanwhile, recombinant pcDNA-rpfB was transfected in to CHO-K1 mammalian cell line and recombinant rpfB antigen expression was confirmed through immunostaining. Therefore, we have succesfully express the recombinant RpfB proten of M. tuberculosis strain Beijing in mammalian expression system which proven to be antigenically induced humoral immune response in mice model."

"ABSTRACTBackground BCG vaccine is a compulsory immunization issued by the government to protect children from tuberculosis disease. Although it is highly accessible, there are some children in Jakarta who did not get vaccinated from one of the deadliest disease in Indonesia. Parents are said to be the biggest possible factors that influence to the administration of BCG vaccine to children, especially their knowledge, environments, beliefs, and attitude towards immunization. Therefore, this research aim is to know the association between parents knowledge, attitude, and practice towards immunization and BCG vaccination for their children. Method Cross sectional design was used in this research, Questionnaire was given to parents in preschools and kindergartens in Jakarta.  Each completed questionnaire will be analyzed using SPSS program and chi-square method with significance value of p less than 0,05 to know the association between parents knowledge, attitude, and practice towards BCG vaccine. From 130 data obtained, almost 90% of them have vaccinated their children with BCG vaccine. Chi-square test results revealed a p value below 0.05 relating parental knowledge and BCG vaccination practice p 0.001, together with attitude and BCG vaccination practice p 0.001. Other factors, such as parents educational status, residence, and partners involvement also has an association with the practice of BCG vaccination for their children. Significant relationship concluded regarding parents knowledge and practice of BCG vaccine, parents knowledge and their attitude, as well parents attitude and BCG vaccination practice in Jakarta.

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ABSTRACTVaksin BCG merupakan imunisasi wajib yang diisukan oleh pemerintah untuk melindungi anak dari penyakit tuberkulosis. Walaupun gratis dan mudah untuk didapatkan, namun tidak semua anak di Jakarta divaksinasi BCG. Selain itu, Indonesia merupakan salah satu Negara dengan penyakit tuberkulosis tertinggi di dunia. Hal tersebut telah diakui oleh The World Health Organization (WHO). Salah satu faktor kemungkinan terbesar yang mempengaruhi pemberian vaksin BCG pada anak adalah orang tua, khususnya pengetahuan dan sikap mereka terhadap imunisasi anak. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan, lingkungan sekitar, pandangan, kepercayaan dan sikap orang tua terhadap imunisasi dan vaksin BCG dengan keputusan akhir mereka untuk memberikan vaksin kepada anak mereka. Metode penelitian ini akan dilakukan dengan metode cross-sectional dengan cara menyebarkan angket kepada orang tua di beberapa TK dan PAUD di daerah Jakarta Utara dan Selatan untuk menggambarkan DKI Jakarta dengan keseluruhan yang dapat dilihat dari perbandingan Indeks Pembangunan Masyarakat dari kedua daerah Jakarta tersebut. Kemudian, data yang terkumpul akan dianalisis menggunakan program SPSS dan metode chi-square dengan nilai kemaknaan Hasil Dari 130 data yang diteliti, hampir 90% responden memberikan vaksin BCG pada anaknya. Test chi-square menunjukan nilai kemaknaan p kurang dari 0.05 dalam menghubungkan pengetahuan, sikap, dan perilaku orangtua terhadap vaksinasi BCG. Faktor lain seperti tingkat pendidikan, tempat tinggal, dan dukungan pasangan juga dapat berhubungan dengan praktik BCG vaksinasi. Kesimpulan Terdapat hubungan signifikan antara pengetahuan dengan sikap, pengetahuan dengan praktik, dan juga sikap dengan praktik vaksinasi BCG pada anak di Jakarta. "

"Latar Belakang: COVID-19 menyebar secara global dengan cepat. Keadaan darurat kesehatan masyarakat yang serius dan memberikan risiko tinggi kematian terutama pada populasi lansia atau penderita yang mempunyai berbagai komorbid. Dengan besarnya penyebaran COVID-19 secara global dan adanya deklarasi oleh WHO sebagai pandemi darurat kesehatan masyarakat, maka timbul kebutuhan mendesak akan diagnosa yang cepat, vaksin, dan terapi COVID-19. Beberapa merk vaksin kemudian berhasil dikembangkan, namun, respon penerimaan akan melakukan vaksinasi belum banyak diketahui sehingga penelitian ini bertujuan untuk menganalisis penerimaan vaksinasi COVID-19 dengan pendekatan teori Health Belief Model pada masyarakat Indonesia. Metode: Menggunakan metode studi analitik dengan jenis penelitian cross sectional, dengan online survey yang disebar ke masyarakat luas yang kemudian di analisis univarit, bivariat dan multivariat hubungannya dengan penerimaan vaksin COVID-19. Hasil: Dari 472 responden diketahui ada 439 (93%) responden yang menyatakan akan melakukan vaksin apabila vaksin tersedia. Penerimaan vaksin COVID-19 di Indonesia memiliki hubungan yang signifikan dengan persepsi kerentanan (khawatir tertular COVID-19 dan tertulae COVID adalah hal yang mungkin) dengan nilai p = 0.028 dan p = 0.001, persepsi keparahan (COVID-19 menyebabkan komplikasi serius dan takut tertular COVID-19) dengan nilai p = 0.048 dan p = 0.040, persepsi manfaat (vaksinasi mengurangi kemungkinan infeksi/komplikasi dan mengurangi rasa khawatir) dengan nilai p =0.0005 untuk keduanya, persepsi hambatan (khawatir tidak manjur, kemampuan membayar, efek samping, dan kehalalan) dengan nilai p = 0.0005 untuk semua kecuali kemampuan membayar p = 0.032, dan informasi yang memadai dengan nilai p = 0.0005. Kesimpulan: Persepsi hambatan mengenai kekhawatiran tentang efek samping memiliki pengaruh paling besar dengan penerimaan vaksin COVID-19 di Indonesia (OR = 9.7). Diperlukan sosialisasi informasi mengenai efek samping vaksin dan manfaat yang dirasakan setelah vaksin. Diperlukan juga kerjasama dengan media dalam upaya peningkatan penerimaan vaksin COVID-19 di Indonesia.

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Background: COVID-19 is spreading globally rapidly. A serious public health emergency and a high risk of death, especially in the elderly population or those with multiple comorbidities. With the magnitude of the global spread of COVID-19 and the declaration by WHO as a public health emergency pandemic, there has been a need for rapid diagnosis, vaccines and therapies for COVID-19. Several vaccines have been successfully developed, however, the response to vaccination acceptance is not widely known, so this study aims to analyze the acceptance of COVID-19 vaccination using the Health Belief Model theory approach in Indonesian society.

Methods: This study is an analytical study method that uses a cross sectional type of research, by conducting an online survey that is distributed to the wider community which is then analyzed by univariate, bivariate and multivariate analysis by receiving the COVID-19 vaccine as the dependent variable.

Results: From 472 respondents, 439 (93%) stating they will take the vaccine if available. Acceptance of the COVID-19 vaccine in Indonesia has a significant relationship with susceptibility (worried about infected COVID-19 and infected COVID-19 is possible) with p values = 0.028 and p = 0.001, perceived severity (COVID-19 causes serious complications and afraid of getting infected with COVID-19) with p value = 0.048 and p = 0.040, perceived benefits (vaccination reduces the likelihood of infection/complications and reduces worry) with p-value = 0.0005 for both, perceived barriers (worried about effectiveness, ability to pay, side effects , and halalness) with a value of p = 0.0005 for all except the ability to pay p = 0.032, and sufficient information with a value of p = 0.0005.

Conclusion: The role of the HBM component is considered important in determining the acceptance of the COVID-19 vaccine in Indonesia. In terms of strength, perceived barriers regarding concerns about side effects had the most effect on the acceptance of the COVID-19 vaccine in Indonesia (OR = 9.7). It is necessary to promote information about the side effects of the vaccine and the perceived benefits of taking the vaccine. Cooperation with the media is also needed in an attempt to increase the acceptance of the COVID-19 vaccine in Indonesia."

"COVID-19 merupakan penyakit menular yang disebabkan oleh SARS-CoV-2 dan ditetapkan sebagai pandemi global pada 11 Maret 2020 oleh WHO. Pemerintah Republik Indonesia mulai melaksanakan program vaksinasi booster untuk meningkatkan durabilitas sistem imun, khususnya pada tenaga kesehatan untuk memicu reaksi imunogenitas pada tubuh melalui produksi antibodi netralisasi (NAb). Namun, NAb memiliki durabilitas tertentu dan mungkin akan mengalami penurunan yang turut dipengaruhi oleh adanya SARS-CoV-2 varian baru yang muncul seperti varian Delta dan Omicron. Tujuan dari penelitian ini adalah mengevaluasi antibodi netralisasi yang dihasilkan oleh tenaga kesehatan di Jakarta sebelum dan setelah 12 bulan vaksinasi booster COVID-19, mengevaluasi antibodi netralisasi setelah 12 bulan vaksinasi booster COVID-19 terhadap 4 varian SARS-CoV-2 berupa varian wild type, Delta, Omicron (B.1.1.529), dan Omicron (BA.2), dan mengevaluasi antibodi netralisasi pada partisipan yang mengalami breakthrough infection dengan partisipan yang tidak mengalami breakthrough setelah 12 bulan vaksinasi booster COVID-19. Metode yang digunakan dalam penelitian ini adalah uji Surrogate Virus Neutralization Test (sVNT) yang sesuai untuk digunakan dalam mendeteksi antibodi netralisasi karena memiliki hasil yang baik dengan waktu deteksi singkat. Hasil penelitian yang diperoleh adalah terdapat kenaikan antibodi netralisasi yang signifikan pada saat 12 bulan pascavaksinasi booster dibandingkan dengan saat pravaksinasi booster. Selain itu, terdapat perbedaan kadar antibodi netralisasi antara keempat varian dengan penurunan antibodi netralisasi yang cukup signifikan sekitar 10—20% pada varian Omicron (B.1.1.529 dan BA.2). Tidak terdapat perbedaan antibodi netralisasi yang signifikan pada partisipan yang mengalami breakthrough infection dengan partisipan yang tidak mengalami breakthrough infection, namun, seluruh partisipan breakthrough infection memiliki tingkat keparahan COVID-19 kategori ringan. Kesimpulan penelitian ini adalah vaksinasi booster pertama pada partisipan menunjukkan durabilitas imun pada bulan ke-12 pascavaksinasi booster pertama yang masih tergolong baik dan kemungkinan berpengaruh terhadap rendahnya tingkat keparahan gejala COVID-19 pada partisipan yang mengalami breakthrough infection. Varian baru SARS-CoV-2 seperti Omicron (B.1.1.529 dan BA.2) menyebabkan penurunan respons kekebalan tubuh sehingga perlu dilaksanakan vaksinasi booster lanjutan.

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COVID-19 is an infectious disease caused by SARS-CoV-2 and was declared as global pandemic on 11 March 2020 by WHO. The Government of the Republic of Indonesia has started implementing a booster vaccination program to increase the durability of the immune system, especially for healthcare workers to trigger an immunogenic reaction in the body through the production of neutralizing antibodies (NAb). However, NAb has a certain durability and may experience a decrease which is also influenced by the emergence of new SARS-CoV-2 variants such as the Delta and Omicron variants. The purpose of this study was to evaluate the neutralization antibodies produced by healthcare workers in Jakarta before and after 12 months of the COVID-19 booster vaccination, to evaluate the neutralization antibodies after 12 months of the COVID-19 booster vaccination against 4 variants of SARS-CoV-2 in the form of wild type variants, Delta, Omicron (B.1.1.529), and Omicron (BA.2), and evaluated neutralizing antibodies in participants who experienced a breakthrough infection with participants who did not experience a breakthrough after 12 months of the COVID-19 booster vaccination. The method used in this study is the Surrogate Virus Neutralization Test (sVNT) which is suitable for detecting neutralizing antibodies because it has good results with a short detection time. The results of the study were that there was a significant increase in neutralizing antibodies 12 months after the booster vaccination compared to the prevaccination booster. In addition, there were differences in neutralizing antibody levels between the four variants with a significant decrease in neutralizing antibodies of around 10—20% in the Omicron variants (B.1.1.529 and BA.2). There was no significant difference in neutralizing antibodies in participants who experienced a breakthrough infection and participants who did not experience a breakthrough infection. However, all breakthrough infection participants had a mild level of COVID-19 severity. The conclusion of this study is that the first booster vaccination in participants shows immune durability at the 12th month after the first booster vaccination which is still relatively good and may have an effect on the lower severity of COVID-19 symptoms in participants who experience a breakthrough infection. New variants of SARS-CoV-2 such as Omicron (B.1.1.529 and BA.2) cause a decrease in the body's immune response so that further booster vaccinations are necessary."

"Latar Belakang: Reseptor ACE2 tidak hanya terdapat pada paru-paru, tetapi juga pada saluran pencernaan yang memungkinkan terjadinya infeksi SARS-COV-2 pada enterosit, menimbulkan manifestasi klinis gastrointestinal, dan terdeteksinya RNA virus pada pemeriksaan swab anal. Studi lain di seluruh dunia menunjukkan hasil yang berbeda-beda serta belum didapatkan penelitian serupa di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui luaran klinis infeksi COVID- 19 pada pasien yang dilakukan swab anal, mendapatkan hubungan hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal dan derajat keparahan pada pasien COVID-19 di Indonesia. Metode: Merupakan cabang penelitian dari penelitian utama yang berjudul “Nilai RT-PCR Swab Anal untuk Diagnosis COVID-19 pada Orang Dewasa di Indonesia”. Penelitian ini merupakan studi analitik dengan desain potong lintang. Sampel penelitian merupakan pasien COVID-19 yang menjalani rawat inap di RSUPN dr. Cipto Mangunkusumo (RSCM), RS Mitra Keluarga Depok, RS Mitra Keluarga Kelapa Gading, dan RS Ciputra selama periode April 2020 sampai dengan Januari 2021. Dikumpulkan data demografi, manifestasi klinis, derajat keparahan, dan hasil swab anal PCR SARS-CoV-2.Hasil: 136 subjek penelitian dengan swab nasofaring positif dianalisis. 52 pasien (38,2%) dengan swab anal PCR SARS-CoV-2 positif dan 84 pasien (61,8%) dengan swab anal negatif. Manifestasi klinis saluran cerna tersering, yaitu: mual-muntah 69 pasien (50,7%), nafsu makan menurun sebanyak 62 pasien (45,6%), dan nyeri perut sebanyak 31 pasien (22,8). Terdapat 114 pasien (83,8%) tergolong dalam derajat ringan-sedang dan 22 pasien (16,2%) tergolong dalam berat-kritis. Terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual-muntah (nilai p 0,031). Tidak terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan derajat keparahan (nilai p 0,844).Simpulan: Terdapat hubungan antara hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual- muntah dan tidak terdapat hubungan antara variabel hasil pemeriksaan PCR SARS- CoV-2 swab anal dengan derajat keparahan infeksi COVID-19.

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Background: ACE2 receptor is not only found in the lungs, but also in the digestive tract, which allows the occurrence of enterocyte infection, gastrointestinal clinical manifestations, and detection of viral RNA on anal swab PCR. Studies around the world show various results, yet there has been no similar study to be found in Indonesia.

Objective: This study aims to determine the clinical outcome of COVID-19 patients with gastrointestinal manifestations who were tested by anal swab, the relationship between anal swab PCR for SARS-CoV-2 test result with gastrointestinal clinical manifestations as well as the severity of COVID-19 patients in Indonesia.

Methods: This research is a branch of study titled. The Value of Anal Swab RT- PCR for COVID-19 Diagnosis in Adult Indonesian Patients. This is an analytical study with cross-sectional design. Samples were obtained from hospitalized COVID-19 patients at RSUPN dr. Cipto Mangunkusumo (RSCM), Mitra Keluarga Hospital Depok, Mitra Keluarga Kelapa Gading Hospital, and Ciputra Hospital from April 2020 to January 2021. Demographic data, clinical manifestations, severity, and SARS-CoV-2 PCR anal swab were collected.

Results: 136 subjects with positive nasopharyngeal swab were analyzed. Result showed that 52 patients (38.2%) had positive anal swabs PCR SARS-CoV-2 and 84 patients (61.8%) had negative anal swabs. Common gastrointestinal clinical manifestations were: nausea and vomiting in 69 patients (50.7%), anorexia in 62 patients (45.6%), and abdominal pain in 31 patients (22.8). There were 114 patients (83,8%) classified as mild-moderate and 22 patients (16,2%) as severe-critical. There was a statistically significant relationship between anal swab PCR for SARS- CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea- vomiting) (p value 0.031). There was no statistically significant relationship found between anal swab PCR for SARS-CoV-2 test result with the severity of COVID- 19 infection (p value 0.844).

Conclusions: There is a relationship between anal swab PCR SARS-CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea-vomiting) and there is no relationship between anal swab PCR SARS-CoV-2 test result with severity of COVID-19 infection."

"Latar Belakang: Melihat potensi tingginya jumlah virus didalam rongga mulut, dengan bukti bahwa SARS-CoV-2 ditemukan pada reseptor ACE2, perlu upaya untuk mencegah penularan dari pasien ke praktisi melalui saliva yang terkontaminasi. Virus ini menyebar lebih cepat karena SARS-CoV-2 bereplikasi disaluran pernapasan bagian atas dengan melepaskan patogen yang berpindah dari satu orang ke orang lain saat bersin dan batuk melalui penyebaran pernapasan. Diperkirakan waktu penularan bisa terjadi sebelum gejala muncul (sekitar 2,5 hari lebih awal dari munculnya gejala). Berkumur dengan hidrogen peroksida dapat menghilangkan lapisan permukaan epitel pada mukosa mulut yang diketahui terdapat reseptor ACE2 tempat terikatnya SARS- CoV-2 dan dapat menginaktivasi virus tersebut. Pedoman sementara American Dental Association (ADA) menyarankan penggunaan 1,5% Hidrogen peroksida sebagai pilihan untuk pembilasan mulut preoperatif sebagai obat kumur antiseptik. Nilai cycle threshold yang diperoleh RT – PCR bersifat semi-kuantitatif dan mampu membedakan antara viral load tinggi dan rendah. Tujuan Penelitian: Mengevaluasi perbedaan pengaruh penggunaan obat kumur diantara berkumur hidrogen peroksida 1,5% dan hidrogen peroksida 3% terhadap nilai cycle threshold RT-PCR pada pasien COVID - 19. Metode Penelitian: 42 subjek penelitian diambil dari pasien RSUP Persahabatan yang terinfeksi SARS-CoV-2 sesuai dengan kriteria inklusi dan ekslusi. Setelah dilakukan informed consent, subjek penelitian dibagi menjadi 3 kelompok, yaitu kelompok hidrogen peroksida 1,5%, kelompok hidrogen peroksida 3% dan kelompok kontrol. Subjek penelitian berkumur 30 detik di rongga mulut dan 30 detik di tenggorokan belakang dengan 15 ml sebanyak 3 kali sehari selama 5 hari. Analisis menggunakan nilai cycle threshold pada pemeriksaan RT-PCR pada hari ke-1, hari ke-3 dan hari ke-5 setelah berkumur. Hasil: Terdapat perbedaan bermakna pada hasil uji Friedman dan peningkatan nilai cycle threshold RT-PCR dari awal, hari ke-1, hari ke-3 dan hari ke-5 di keseluruhan kelompok dan masing – masing kelompok perlakuan. Peningkatan tertinggi nilai cycle threshold RT-PCR awal hingga hari ke-1 ditemukan pada kelompok hidrogen peroksida 3%, kemudian antara hari ke-1 hingga ke-3 dan hari ke-3 hingga hari ke-5 ditemukan pada kelompok hidrogen peroksida 1,5%. Kesimpulan: Berkumur hidrogen peroksida 1,5% dan hidrogen peroksida 3% berpengaruh terhadap peningkatan nilai cycle threshold RT-PCR SARS-CoV-2. Kedua konsentrasi hidrogen peroksida 1,5% dan hidrogen peroksida 3% memberikan pengaruh positif dalam menurunkan jumlah virus di rongga mulut, sehingga pilihan penggunaan konsentrasi hidrogen peroksida yang lebih kecil bisa menjadi pilihan untuk digunakan untuk berkumur.

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Background: Given the potential high number of viruses in the oral cavity, with evidence that SARS-CoV-2 is found at the ACE2 receptor, efforts are needed to prevent transmission from patient to practitioner through contaminated saliva. This virus spreads faster because SARS-CoV-2 replicates in the upper respiratory tract by releasing pathogens that are passed from one person to another when sneezing and coughing through respiratory spread. It is estimated that the time of transmission can occur before symptoms appear (about 2.5 days earlier than the onset of symptoms). Mouth rinse and gargling with hydrogen peroxide can remove the epithelial surface layer on the oral mucosa which is known to have ACE2 receptors where SARS-CoV-2 binds and can inactivate the virus. Interim guidelines of the American Dental Association (ADA) recommend the use of 1.5% hydrogen peroxide as an option for preoperative oral rinse as an antiseptic mouth rinse. The cycle threshold value obtained by RT-PCR is semi-quantitative and able to distinguish between high and low viral loads.

Objective: To evaluate the difference in the effect of using mouth rinse between 1.5% hydrogen peroxide and 3% hydrogen peroxide mouth rinse and gargling on the RT-PCR cycle threshold value in COVID-19 patients.

Methods: 42 subjects were patients recruited from Persahabatan General Hospital infected with SARS-CoV-2 according to the inclusion and exclusion criteria. Following informed consent procedure, the research subjects were divided into 3 groups, namely the 1.5% hydrogen peroxide group, the 3% hydrogen peroxide group and the control group. The subjects were instructed to rinse their mouths for 30 seconds and gargle for 30 seconds at the back of the throat with 15 ml of the mouth rinse 3 times a day for 5 days. Analysis of cycle threshold values was carried out using RT-PCR on day 1, day 3 and day 5 after mouth rinse and gargling.

Results: There were significant differences in the results of the Friedman test and an increase in the RT-PCR cycle threshold value starting from the beginning, day 1, day 3 and day 5 in the whole group and each treatment group. The highest increase RT-PCR cycle threshold value at day 1 was found in the 3% hydrogen peroxide group, while the increase between day 1 to 3 and day 3 to day 5 was found in the 1.5% hydrogen peroxide group.

Conclusion: Mouth rinse and gargling with 1.5% hydrogen peroxide and 3% hydrogen peroxide has an effect on increasing the cycle threshold value of the SARS-CoV-2 RT-PCR. Both 1.5% and 3% hydrogen peroxide concentration have a positive effect in reducing the number of viruses in the oral cavity, so the choice of using a lower hydrogen peroxide concentration can be an option to use for mouth rinse and gargling."

"Golongan usia anak merupakan golongan usia yang paling ringan terdampak infeksi COVID-19. Salah satu kemungkinan penyebab keadaan tersebut adalah perlindungan dari efek nonspesifik vaksinasi rutin yang diterima anak sebelumnya. Vaksinasi rutin yang diterima anak dapat memodulasi sistem imun anak terhadap infeksi lain di luar target imunisasi yang dituju melalui mekanisme imunitas heterolog. Bukti-bukti penelitian terdahulu menimbulkan hipotesis antigen vaksin DTP berpotensi menimbulkan imunitas heterolog dengan SARS-CoV-2. Hal ini berdasarkan kemiripan epitop antara antigen SARS-CoV-2 dengan antigen pada vaksin DTP. Belum diketahui bagaimana pengaruh vaksinasi DT booster terhadap respons imun (antibodi S-RBD SARS-CoV-2 dan IFN-ɤ-sel T spesifik SARS-CoV-2) pascavaksinasi COVID-19 inaktif pada anak usia 6–7 tahun. Penelitian ini bertujuan mengetahui pengaruh pemberian vaksinasi DT booster pada anak yang mendapat vaksinasi COVID-19 inaktif terhadap respons imun humoral dan selular anak.Studi potong lintang dilakukan dengan didahului tahapan pengambilan data pada orang tua subjek penelitian di wilayah Senen, Jakarta Pusat. Pengambilan data menggunakan kuesioner yang disebarkan secara luring kepada orang tua melalui guru sekolah anaknya. Dari kuesioner didapatkan data status vaksinasi anak, yang dibedakan dalam 4 kelompok yaitu COVID+/DT+, COVID+/DT–, COVID–/DT+ dan COVID–/DT–, dan diukur antibodi S-RBD, IFN-ɤ-sel T spesifik SARS-CoV-2 dan IgG antidifteri.Hasil penelitian menunjukkan 113 dari 154 subjek penelitian (73,4%) telah memiliki status relative immune terhadap difteri, dengan hasil IgG antidifteri > 0,1 IU/mL. Terdapat imunitas heterolog vaksinasi DT booster terhadap COVID-19 dengan adanya perbedaan bermakna kadar antibodi S-RBD SARS-CoV-2 antara anak yang sudah mendapat vaksin DT booster dibanding yang belum (1182 U/mL vs. 612,5 U/mL, p = 0,026), dan perbedaan bermakna IFN-ɤ-sel T spesifik SARS-CoV-2 pada anak COVID+/DT+ dibanding COVID+/DT– (560,87 mIU/mL vs. 318,03 mIU/mL, p = 0,03). Tidak didapatkan korelasi antara IgG antidifteri dan S-RBD SARS-CoV-2. Selain hasil penelitian data laboratorium, didapatkan pula data keinginan orang tua untuk vaksinasi COVID-19 bagi anaknya adalah sebesar 69,7%.Disimpulkan vaksin DT booster dapat berperan menguatkan respons imun spesifik SARS-CoV-2 pada anak yang menerima vaksin COVID-19 inaktif.

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Corona Virus Disease 2019 (COVID-19) in children tends to be mild. A possible cause is existing protection from the routine vaccination previously received by children. Routine vaccinations can modulate the child's immune system against other pathogen, presumably through a mechanism of heterologous immunity. Previous research had suggested that the Diphtheria-Tetanus-Pertussis (DTP) vaccine antigen has potential to incite heterologous immunity towards SARS-CoV-2, due to similarities between SARS-CoV-2 epitopes and various epitopes found within the DTP vaccine. It was not known whether the Diphtheria-Tetanus (DT) vaccination could modulate the SARS-CoV-2-specific immune response among children aged 6–7 years who received inactivated COVID-19 vaccine.

This study thus aimed to assess the impact of DT booster immunization in SARS-CoV-2-specific humoral and cellular immune responses among children who received two doses of CoronaVac.

A cross-sectional study was performed on children aged 6–7 years old in the Senen area, Central Jakarta. This study was started with data collection from parents of eligible subjects using questionnaire that was distributed to parents via their children’ school teachers. Based on the collected demographic data and the child's vaccination status, eligible subjects were further screened. The participating subjects were subsequently classified into 4 groups, i.e., COVID+/DT+, COVID+/DT-, COVID-/DT+ and COVID-/DT-. Blood collections were performed to determine anti-diphtheria toxoid antibodies, anti-S-RBD antibodies and SARS-CoV-2-specific T cell-produced IFN-ɤ.

The results showed that 113 of 154 subjects (73.4%) had relative immune-status against diphtheria as the result of the anti–diphtheria toxoid antibodies was > 0.1 IU/mL. There was a heterologous immunity of DT booster and COVID-19 vaccine, as there was significant difference in anti-S-RBD antibody titers between the group with DT booster compared to non-DT booster (1182 U/mL vs. 612.5 U/mL, p = 0.026), and a significant difference in IFN-ɤ concentration between the group of COVID+/DT+ and COVID+/DT- (560.87 mIU/mL vs. 318.03 mIU/mL, p = 0.03). No correlation was found between anti-diphtheria and anti-S-RBD antibodies. In addition, our data indicated that parental intention to vaccinate their children against COVID-19 in the Senen area was 69.7%.

In conclusion, our results suggested that DT booster vaccine might able to enhance SARS-CoV-2-specific immune responses among children who received inactivated COVID-19 vaccine."

"Akhir-akhir ini dunia dihebohkan dengan merebaknya wabah penyakit COVID19 yang menyerang seluruh dunia. Virus SARS-CoV-2 menyebabkan penyakit COVID19. Saat ini, 600 juta orang telah terjangkit penyakit ini di seluruh dunia, dengan 6 juta kasus menyebabkan kematian. Bagian dari virus yang disebut spike (S) glycoprotein berperan dalam perlekatan, fusi, dan masuknya virus ke dalam sel inang. Penghambatan proses ini bisa menjadi salah satu cara pengobatan COVID-19. Pada penelitian ini, senyawa alkaloid alami telah digunakan sebagai dasar dalam perancangan obat COVID19 dengan melihat interaksinya dengan glikoprotein S target multivariat SARS-CoV-2 dengan metode simulasi Molecular Docking dengan varian yang digunakan dalam penelitian ini adalah varian Alpha, Beta, Delta, dan Omicron. Tidak ada senyawa alkaloid alami yang dapat berinteraksi dengan keempat varian tersebut berdasarkan hasil yang diperoleh. Namun, telah ditemukan bahwa beberapa senyawa alkaloid alami dapat berinteraksi dengan glikoprotein S lebih dari satu varian, seperti senyawa axelopran sulfat dapat berinteraksi dengan baik dengan Glikoprotein S dalam varian alfa dan beta, dengan nilai pengikatan energi masing-masing sebesar -6,4049 kkal/mol dan -6,5135 kkal/mol. Sebaliknya, benztropine dapat berinteraksi dengan baik dengan varian delta dan omicron dengan nilai energi binding masing-masing sebesar -6,6719 kkal/mol dan -8,9244 kkal/mol.

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Recently, the world has been shocked by the spread of the COVID-19 disease outbreak that has attacked throughout the world. The SARS-CoV-2 virus causes the COVID-19 disease. Currently, 600 million people have contracted this disease worldwide, with 6 million cases causing death. A part of the virus called the spike (S) glycoprotein plays a role in viruses' attachment, fusion, and entry into host cells. Inhibition of this process can be one way of treating COVID-19. In this study, natural alkaloid compounds have been used as a basis in the design of COVID-19 drugs by looking at their interaction with the S glycoprotein target of multivariate SARS-CoV-2 with the Molecular Docking simulation method with variants used in this study are the Alpha, Beta, Delta, and Omicron variants. No natural alkaloid compounds can interact with the four variants based on the result obtained. However, it has been found that some natural alkaloid compounds can interact with S glycoprotein in more than one variant, such as axelopran sulfate compound can interact well with the S Glycoprotein in alpha and beta variants, with the energy binding values of -6.4049 kcal/mol and -6.5135 kcal/mol, respectively. In contrast, benztropine can interact well with delta and omicron variants with the energy binding values of -6.6719 kcal/mol and -8.9244 kcal/mol, respectively."

"Latar Belakang: Pandemi COVID-19 menyebabkan mortalitas dan morbiditas yang tinggi khususnya pada tenaga kesehatan di Indonesia, Studi mengenai manfaat dari vaksin booster mRNA-1273 yang diawali vaksinasi primer Coronavac masih minim sehingga diperlukan penelitian lebih lanjut.Tujuan: Penelitian ini dilakukan untuk mengetahui faktor yang berhubungan dengan insiden COVID-19 pasca vaksinasi booster mRNA-1273 yang diberikan vaksinasi primer Coronavac sebelumnya serta profil antibodi pada tenaga kesehatan di Indonesia.Metode: Penelitian ini menggunakan gabungan desain kohort retrospektif dan potong lintang pada 300 tenaga kesehatan yang dipilih secara acak dari data penerima vaksin booster mRNA-1273 di salah satu RS tersier (RSCM). Subjek yang terpilih kemudian dilakukan wawancara mendalam mengenai riwayat vaksinasi COVID-19, riwayat terinfeksi COVID-19, komorbiditas dan dilakukan pengambilan sampel darah untuk menilai kadar antibodi IgG sRBD. Dari hasil wawancara kemudian dinilai faktor-faktor yang berhubungan terhadap kejadian COVID-19 pasca vaksinasi booster mRNA-1273 serta profil antibodi subjek.Hasil: 56 orang (18,6%) mengalami COVID-19 setelah divaksinasi booster dalam 5 bulan. Incidence rate per person per month sebesar 3,2%. Median antibodi IgG sRBD dalam 8 bulan 6627 AU/ml (min-max, 729-20374 AU/ml) dan tidak berhubungan dengan variabel usia, jenis kelamin, komorbiditas, KIPI pasca booster ataupun riwayat infeksi pasca booster. Usia, jenis kelamin, diabetes melitus tipe 2, hipertensi, obesitas dan KIPI pasca booster tidak berhubungan terhadap insiden COVID-19 pasca booster. Riwayat COVID-19 sebelum vaksinasi booster berhubungan signifikan terhadap penurunan kejadian COVID-19 pasca vaksinasi booster dengan RR 0,20 (95 % CI: 0,09-0,45).Simpulan: Insiden COVID-19 mencapai 18,6% dalam 5 bulan pasca vaksinasi booster dengan riwayat COVID-19 sebelum vaksinasi booster berperan dalam menurunkan risiko kejadian COVID-19 pasca vaksinasi booster.

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Background: COVID-19 pandemic has caused high mortality and morbidity especially among healthcare workers in Indonesia. Studies on the benefits of the mRNA-1273 booster vaccine preceded with Coronavac primary vaccine are still minimal so further studies are needed.

Purpose: Knowing the factors associated with the incidence rate of SARS-CoV-2 infection after mRNA-1273 booster vaccination starting with the Coronavac primary vaccination and the antibody profile of healthcare workers in Indonesia.

Method: This study used combined design of retrospective cohort and cross sectional study. Three hundreds healthcare workers at one of tertiary hospital in Indonesia that obtain mRNA-1273 booster vaccine minimal after 5 months were randomly selected. Subjects were then interviewed regarding their history of COVID-19 vaccination, history of SARS-CoV-2 infection, comorbidities and blood samples were taken to assess IgG sRBD antibody levels. Factors related to antibody profile and incidence of SARS-CoV-2 infection after the mRNA-1273 booster vaccination were then analyzed.

Results: 56 subjects (18.6%) experienced SARS-CoV-2 infection after mRNA-1273 booster vaccination. Median antibody IgG sRBD in 8 months was 6627 AU/ml (min-max, 729-20374 AU/ml) and not related to age, gender, comorbidities, AEFI after booster and infection after booster. Age, gender, diabetes type 2, hypertension, obesity, AEFI after booster were not related to COVID-19 incidence after booster. History of SARS-CoV-2 infection before booster vaccination was significantly associated with reduced risk of SARS-CoV-2 infection after booster vaccination with RR 0,20 (95 % CI: 0,09-0,45).

Conclusion: Cumulative incidence of SARS-CoV-2 infection in 5 months was 18,6% with history of COVID-19 before booster correlated with reduced risk of COVID-19 after booster."