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Abstrak :
Alergen menyebabkan penyakit alergi,. Alergen yang terpenting ialah tungau Dermatophag oides pteronyssinus. Masalah dalam penelitian ini ialah adanya penemuan bahwa kadar igE total dan IgG- total yang kontroversial, pada penderita alergi atopik dan orang yang tidak menderita alergi. Tujuan penelitian ini ialah untuk meneliti kadar IgE total dan IgG total penderita asma bronkial dan/atau rinitis atopik yang rentan terhadap D. pteronyssinxis, dan belum mendapat pengobatan secara disensibilisasi. Penentuan kadiar IgE total dilakukan dengan teknik ELISA ("Enzyme Linked Immuno Sorbent Assay"), dan IgG total dengan teknik RID ("Radial Immuno Diffusion"). Dari u^i Mann-Whitney pada

Abstrak :
Vaksin konjugat pneumokokus 13-valen berperan penting dalam upaya mengurangi penyakit invasif pneumokokus pada anak terinfeksi HIV. Tujuan studi retrospektif ini untuk mengevaluasi respon imun humoral pada anak terinfeksi HIV pra dan pasca vaksinasi PCV13 di Jakarta, Indonesia. Penelitian ini menggunakan sampel serum bahan biologis tersimpan (BBT) dari 66 anak sebelum, 12 dan 18 bulan setelah vaksinasi. ELISA dan uji bakterisidal serum digunakan untuk mengukur konsentrasi antibodi dan antibodi fungsional pasca vaksinasi, secara berurutan. IgG total 13 serotipe S. pneumoniae 12 bulan pasca vaksinasi PCV13 menunjukkan peningkatan konsentrasi yang signifikan dibandingkan dengan pra vaksinasi (p=0.01). Konsentrasi IgG spesifik serotipe 4, 14 dan 23F pasca vaksin 18 bulan terjadi penurunan siginifikan dibandingkan pra vaksinasi (p<0.05) sedangkan IgG spesifik serotipe 6B terjadi peningkatan konsentrasi antibodi (p=0.03). Tidak terjadi perubahan konsentrasi IgG spesifik serotipe 3 yang efektif setelah vaksinasi. Konsentrasi IgG serotipe 19F tidak ada perbedaan signifikan (p>0.05) setelah vaksinasi. Tidak ada korelasi signifikan antara jumlah sel T CD4 dengan konsentrasi IgG total 13 serotipe S. pneumoniae. Rerata konsentrasi IC50 serum bactericidal assay adalah 275,2 U/mL. Kesimpulannya, satu dosis PCV13 untuk anak terinfeksi HIV mampu menghasilkan tingkat antibodi yang kuat dan fungsional terhadap S. pneumoniae. ......The 13-valent pneumococcal conjugate vaccine plays an important role in efforts to reduce pneumococcal invasive disease in HIV-infected children. The aim of this retrospective study was to evaluate the humoral immune response in HIV-infected children before and after PCV13 vaccination in Jakarta, Indonesia. This study used serum samples of biologically stored material from 66 children before, 12 and 18 months after vaccination. ELISA and serum bactericidal assays were used to measure post-vaccination antibody and functional antibody concentrations, respectively. IgG total of 13 serotypes of S. pneumoniae 12 months after PCV13 vaccination showed a significant increase in concentration compared to pre- vaccination (p=0.01). The concentration of specific IgG serotypes 4, 14 and 23F after the vaccine 18 months decreased significantly compared to pre-vaccination (p<0.05) while the concentration of specific IgG for serotype 6B increased (p=0.03). There was no change in effective serotype 3 specific IgG concentration after vaccination. There was no significant difference (p>0.05) in serotype 19F IgG concentrations after vaccination. There was no significant correlation between the number of CD4 T cells and the total IgG concentration of 13 serotypes of S. pneumoniae. The mean concentration of IC50 serum bactericidal assay was 275.2 U/mL. In conclusion, a single dose of PCV13 for HIV-infected children appears to produce strong and functional antibody levels against S. pneumoniae.

Abstrak :
Latar belakang: Indonesia memiliki beban tuberkulosis (TB) paru tinggi. Aspergilosis paru kronik (APK) sering ditemukan pada pasien TB. Diagnosis APK menjadi tantangan di Indonesia karena keterbatasan sumber daya. Diperlukan alat diagnostik yang mudah, murah, dan memberikan hasil cepat dengan akurasi baik untuk membantu menegakkan diagnosis APK. Penelitian ini bertujuan untuk mengetahui nilai diagnostik ICT Aspergillus pada pasien TB paru. Metode: Penelitian ini berdesain potong lintang dan merupakan bagian dari penelitian payung tentang diagnosis APK pada pasien TB paru di Jakarta. Serum pasien TB paru yang memenuhi kriteria inklusi diperiksa menggunakan ICT Aspergillus (LDBio, Diagnostics, Lyon, France) dan IgG Spesifik Aspergillus ELISA (Bordier affinity products, Crissier, Switzerland) sesuai protokol di Laboratorium Mikologi Departemen Parasitologi FKUI pada Februari-November 2021. Hasil: Dari 105 subjek penelitian yang memenuhi kriteria inklusi, sebanyak 58,1% adalah laki-laki. Rerata usia pasien 47,1617,1 tahun. Proporsi hasil positif ICT Aspergillus adalah 10,5% dan IgG spesifik Aspergillus ELISA 43,8%. Sensitivitas ICT Aspergillus 23,9%, dengan spesifisitas 100%, nilai duga positif 100%, dan nilai duga negatif 62,8%. Kesimpulan: Kemampuan diagnostik ICT Aspergillus belum optimal sebagai alat skrining, tetapi dapat dipertimbangkan sebagai alat diagnosis pasien TB paru suspek APK pada daerah dengan sumber daya terbatas. ......ackground: Indonesia has high pulmonary tuberculosis (TB) burden. Chronic pulmonary aspergillosis (CPA) is common in pulmonary TB patients. Diagnosing CPA is challenging in Indonesia because of the limited resources available. A new rapid and robust diagnostic tool is needed. This research aims to evaluate the diagnostic value of the ICT Aspergillus in pulmonary TB patients. Methods: This cross-sectional study is a part of the CPA diagnostic research of pulmonary TB patients. Pulmonary TB patients' serum fulfilling the inclusion criteria were assessed using ICT Aspergillus (LDBio, Diagnostics, Lyon, France) and Aspergillus-specific IgG ELISA (Bordier affinity products, Crissier, Switzerland) in Mycology Laboratory of Parasitology Department FMUI in February-November 2021. Results: From 105 subjects included, the proportion of men 58,1% with 47,1617,1 years age means. The Aspergillus IgG was positive in 10,5% patients with ICT, and 43,8% with ELISA. The sensitivity of ICT Aspergillus was 23,9%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 62,8%. Conclusion: ICT Aspergillus has a fair diagnostic capacity in pulmonary TB patients as screening tools for CPA. However, the usage of ICT Aspergillus as point-of-care test in limited-resource settings needs to be considered.

Abstrak :
Latar belakang: Tuberkulosis paru (TB) merupakan salah satu faktor risiko terjadinya aspergillosis paru kronik (APK). Keduanya sulit dibedakan karena gejala APK tidak spesifik dan mirip dengan TB. Diagnosis APK ditegakkan berdasarkan gejala klinis, pemeriksaan pencitraan dan laboratorium mikologi. Pemeriksaan serologi dengan metode presipitasi atau Immunodiffusion test (IDT) sudah dikembangkan sejak lama, murah dan mudah dilakukan, tetapi dianggap kurang akurat. Pemeriksaan deteksi antibodi immunoglobulin G (IgG) spesifik Aspergillus dengan metode enzyme-linked immunosorbent assay (ELISA) merupakan salah satu metode diagnosis APK. Metode ini cukup mahal dan belum dilakukan rutin di daerah dengan sumber daya terbatas. Tujuan: Penelitian ini bertujuan untuk mengetahui perbandingan hasil pemeriksaan IDT Aspergillus dengan pemeriksaan IgG spesifik Aspergillus pada pasien bekas TB di RSUP Persahabatan. Metode: Penelitian dengan desain uji diagnostik ini dilakukan sejak April 2019 – November 2020 dengan metode consecutive sampling. Pasien yang direkrut merupakan pasien bekas TB dari RSUP Persahabatan Jakarta. Pemeriksaan IDT dan IgG spesifik Aspergillus dilakukan di Laboratorium Departemen Parasitologi FKUI. Hasil: Dari 80 pasien bekas TB di RSUP Persahabatan sesuai kriteria inkulsi, sebanyak 57 pasien laki-laki (71,3%) dan 23 pasien perempuan (28,7%). Rerata usia pasien adalah 50,98±2,79 tahun, median indeks massa tubuh pasien sebesar (IMT) 18,37. Proporsi hasil pemeriksaan IDT pada pasien bekas TB adalah 36,25%, sedangkan IgG spesifik Aspergillus metode ELISA sebesar 48,75%. Nilai akurasi diagnostik IDT dibandingkan terhadap IgG spesifik Aspergillus metode ELISA menunjukkan sensitivitas 30,77%, spesifisitas 58,54%, nilai prediktif positif 41,38%, nilai prediktif negatif 47,06% dan nilai measurement of agreement dengan cohen’s kappa sebesar -0,108. Simpulan: Metode IDT memiliki akurasi lebih rendah dibandingkan IgG spesifik Aspergillus metode ELISA, sehingga penggunaan IgG spesifik Aspergillus lebih direkomendasikan. Teknik IDT dapat digunakan jika sumber daya terbatas, namun perlu dilakukan standarisasi antigen untuk pemeriksaan tersebut. ......Background: Lung Tuberculosis (LTB) is a risk factor of developing chronic pulmonary aspergillosis (CPA). Both diseases are still difficult to differentiate because clinical presentation of CPA is not specific and similar to LTB. Diagnosis of CPA is confirmed by clinical presentation, radiographic examination and mycology laboratory tests. Serological testing using the precipitation method or immunodiffusion test (IDT) has long been conducted. It is a cheap and easy-to-do method, however the accuracy is not satisfied. Detection of the Aspergillus specific immunogobulin G (IgG) using enzyme-linked immunosorbent assay (ELISA) is one of the keys in diagnosing CPA. However, this method is more expensive and has not been conducted routinely in areas with limited resources. Aim: This study aimed to determine the results of IDT Aspergillus compare to Aspergillus-specific IgG with ELISA in previous TB patients at Persahabatan Hospital. Method: This diagnostic study was conducted from April 2019 – November 2020 and recruitment was performed by consecutive sampling. Patients recruited were previous TB patients from Persahabatan General Hospital; while IDT and specific Aspegillus IgG tests were conducted at Laboratory of Parasitology Dept, FMUI. Conclusion: From 80 previous TB patients from the Persahabatan Hospital that met the inclusion criteria, 57 patients were male (71,3%) and 23 were female (28,7). Mean age was 50,98±2,79 years, median of patients body mass index (BMI) was 18,37. The proportion of old TB patients with positive IDT results was 36,25% and patients with positive IgG results was 48,75%. The diagnostic accuracy of IDT compared to IgG ELISA was 30,77% sensitivity, 58,54% spesificity, 41,38% positive predictive value, 47,06% negative predictive value and the measurement of agreement using cohen’s kappa was -0,108. Summary: IDT Aspergillus is less accurate compared to Aspergillus-specific IgG ELISA. Therefore the use of Aspergillus-specific IgG ELISA is recommended as a serological test. The IDT method can be used at limited resources facilities, but it is necessary to standardize the antigen for the test.

Abstrak :
ABSTRAK
Toksoplasmosis okular adalah infeksi yang menyerang satu atau kedua mata, yang disebabkan oleh coccidia Toxoplasma gondii. Infeksi dapat diperoleh selama kehamilan dari ibu atau melalui konsumsi daging yang tidak dimasak dan yang terinfeksi, sayuran atau air yang terkontaminasi. Konfirmasi toksoplasma sebagai etiologi masih bergantung pada uji serologi toksoplasma dan pemeriksaan oftalmologi. Penelitian ini bertujuan untuk menganalisis penggunaan IgG anti toksoplasma pada cairan mata untuk diagnosis toksoplasmosis okular. Metode Penelitian yang digunakan adalah studi potong-lintang, retrospektif terhadap 46 sampel serum untuk pemeriksaan serologi IgG dan IgM anti toksoplasma, serta IgG anti toksoplasma dan PCR toksoplasma dari cairan mata. Hasil penelitian berupa keluhan utama pasien adalah kabur. Dari data sekunder hasil pemeriksaan pada serum 43 93,5 positif IgG anti toksoplasma, 2 4,3 positif IgM anti toksoplasma, serta terdapat hasil IgG dan IgM anti toksoplasma keduanya positif pada 2 sampel. Dari dua keadaan hasil positif serologi serum IgG dan IgM ini ternyata hasil pemeriksaan serologi IgG cairan mata dan deteksi DNA dengan menggunakan PCR hasilnya negatif. Dilihat dari hasil pemeriksaan serologi cairan mata 23 50,0 IgG anti toksoplasma yang terdeteksi pada cairan mata positif dan 6 13 PCR positif. Terdapat korelasi sedang antara serologi mata dan serum. Pemeriksaan serologi dan PCR pada cairan mata dapat digunakan untuk membantu diagnosis toksoplasmosis okular.

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ABSTRACT
Ocular toxoplasmosis is an ophthalmology infectious disease affecting one or both eyes, caused by the coccidia Toxoplasma gondii. Infections may be acquired during pregnancy from the mother or through the ingestion of uncooked and infected meat, contaminated vegetables or water. Confirmation of Toxoplasma as the aetiology still relies on the Toxoplasma serology test and the ophthalmology examination. This study aims to analyze the use of anti Toxoplasma IgG in vitreus humor for the diagnosis of ocular toxoplasmosis. Methods of this study is a cross sectional, retrospective from 46 serum samples examined for IgG and IgM anti Toxoplasma and IgG anti Toxoplasma and PCR Toxoplasma from aquous humor. Chief complaint was loss of vision. From 46 sample of secondary data serum 43 93,5 positive IgG, 2 4, negative IgM anti Toxoplasma. We also found IgG and IgM anti Toxoplasma results were both positive 2 sample. Althought results positive for serological serum both IgG and IgM but the result for IgG aquous humor serology and detection of DNA by using PCR was a negative. Result for serologic examination aquous humor 23 50.0 IgG anti Toxoplasma detected in positive aquous humor and 6 13 PCR Toxoplasma positive. There are correlation beetwen aquous and serum serologic. Serologic examination of aquous humor and PCR could be used to help diagnose ocular toxoplasmosis.

Abstrak :
Latar belakang: Aspergilosis paru kronik (APK) merupakan penyakit paru destruktif yang bersifat progresif terutama disebabkan infeksi Aspergillus fumigatus. Penyakit ini dapat menjadi komplikasi infeksi tuberkulosis (TB) dan menyebabkan morbiditas serta mortalitas signifikan. Diagnosis APK masih menjadi tantangan karena gejala klinis tidak khas, serta belum ada alat diagnosis yang cepat dan akurat. Deteksi IgG Aspergillus berbasis lateral flow assay (LFA) menggunakan metode imunokromatografi (ICT) merupakan uji cepat dan sederhana untuk membantu diagnosis APK. Penelitian ini bertujuan untuk mengetahui hubungan uji ICT Aspergillus dengan karakteristik klinis dan radiologis APK pada pasien terkait TB paru. Metode: Penelitian berdesain potong lintang ini dilaksanakan pada April 2019-Juli 2023 dan merupakan bagian dari penelitian sebelumnya tentang diagnosis APK di Indonesia. Serum pasien APK diperiksa di Laboratorium Mikologi Departemen Parasitologi FKUI untuk deteksi ICT Aspergillus, kemudian dilanjutkan dengan analisis hasil penelitian. Hasil: Sebanyak 29 dari 54 (54%) serum pasien yang diteliti menunjukkan hasil uji ICT Aspergillus positif. Proporsi jenis kelamin perempuan (63%) lebih banyak dibandingkan laki-laki, sedangkan usia terbanyak 30-60 tahun (74%). Gejala klinis terbanyak adalah fatigue (57%), batuk ≥ 3 bulan (42%), hemoptisis (41%) diikuti sesak napas (24%), dan nyeri dada (20%). Adapun penyakit penyerta terbanyak adalah diabetes melitus (20%), penyakit kardiovaskular (11%), dan PPOK (9%). Gambaran radiologi paling dominan adalah kavitas (94%), diikuti infiltrat (72%), dan penebalan pleura (55%). Analisis statistik menunjukkan kaitan bermakna antara hasil ICT Aspergillus positif dengan gambaran radiologi berupa infiltrat, fibrosis parakavitas, fibrosis, efusi pleura, konsolidasi dan bronkiektasis (p <0,005). Hasil ICT Aspergillus tidak menunjukkan kemaknaan statistik dengan karakteristik klinis. Simpulan: Deteksi IgG spesifik Aspergillus metode ICT pada 54 pasien APK pada penelitian ini menunjukkan hasil positif 54%. Pada penelitian ini hasil ICT Aspergillus menunjukkan kaitan bermakna secara statistik dengan gambaran radiologi, tetapi tidak menunjukkan kaitan bermakna dengan karakteristik klinis pasien. ......Background: Chronic pulmonary aspergillosis (CPA) is a progressive, destructive lung disease mainly caused by Aspergillus fumigatus infection. The disease can be a complication of tuberculosis (TB) infection and cause significant morbidity and mortality. Diagnosis of CPA is still challenging because the clinical symptoms are not typical, and there are no fast and accurate diagnostic tools. Detection of IgG-specific Aspergillus using the immunochromatography (ICT) method is a quick and simple test to assist CPA diagnosis. The study aimed to determine the correlation between the ICT Aspergillus test and the clinical and radiological characteristics of CPA in TB-related patients. Method: This cross-sectional study was carried out in April 2019-July 2023 and was part of a previous study on CPA diagnosis in Indonesia. All sera of CPA patients were examined at the Clinical Parasitology Laboratory, Faculty of Medicine Universitas Indonesia for ICT Aspergillus detection, followed by analysis of the study results. Result: Twenty-nine of the 54 patient sera showed positive results of ICT Aspergillus. There were more female (76%) than male patients, with the majority aged 30–60 years (74%). The most common clinical symptoms were fatigue (57%), cough ≥3 months (42%), hemoptysis (41%), shortness of breath (24%), and chest pain (20%). The most common comorbidities were diabetes mellitus (20%), cardiovascular diseases (11%), and COPD (9%). The dominant of radiological features were cavities (94%), followed by infiltrates (72%), and pleural thickening (55%). The statistical analysis showed a significant correlation between positive ICT Aspergillus results and radiological features, including infiltrates, paracavity fibrosis, fibrosis, pleural effusion, consolidation, and bronchiectasis. However, the ICT Aspergillus did not show statistical significance with clinical characteristics. Conclusion: The ICT Aspergillus detection in this study showed positive results of 54%. There was a significant correlation between ICT Aspergillus positive result with radiology features, but no significant correlation with clinical characteristics.

Abstrak :
Tuberkulosis (TB) merupakan penyakit infeksi yang disebabkan oleh kuman Mycobacterium tuberkulosis. WHO memperkirakan lebih dari sepertiga populasi di dunia terinfeksi oleh kuman ini dengan angka kematian mencapai 1.3 juta orang per tahunnya. Usaha pencegahan terhadap TB sangat penting, salah satunya melalui penggunaan vaksin. Vaksin BCG adalah satu satunya vaksin TB yang ada dan digunakan saat ini, walaupun demikian vaksin ini memiliki beberapa kekurangan diantaranya daya proteksi yang berbeda pada setiap individu, tidak memberikan perlindungan dari infeksi TB paru serta perlindungan dari reaktivasi infeksi TB laten. Hal ini mendorong dikembangkannya alternatif vaksin selain vaksin BCG. Protein RpfD M. tuberculosis merupakan protein berukuran 16 kDa yang diekspresikan pada tahapan resusitasi dan terbukti bersifat imunogenik serta telah banyak dikembangkan sebagai antigen TB untuk tujuan vaksin maupun diagnostik. Penelitian ini mengkaji mengenai respon imunitas humoral yang diberikan oleh plasmid rekombinan pcDNA3.1-rpfD menitik beratkan pada sub-kelas imunoglobulin-G (IgG) pada hewan coba mencit Balb/C melalui pendekatan metode serologi. Hasil dari penelitian ini menunjukan bahwa sub-kelas IgG2a merupakan respon IgG tertinggi yang berhasil diinduksi oleh pcDNA3.1-rpfD yang mengindikasikan adanya potensi proteksi terhadap infeksi M.tuberculosis. ......Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. WHO predicts more than one-third of the worlds population is infected by this bacteria with mortality rate of 1.3 million per year. Therefore, prevention of tuberculosis is very important, one of which is through the use of vaccines. Now, the BCG vaccine is the only TB vaccine available and used, but the vaccine has disadvantages like doesnt provide pretection from pulmonary TB infection in adults as well as protection from reactivation of latent TB infection which encourages the development of TB vaccine alternative to BCG. The RpfD M. tuberculosis protein is a 16 kDa protein expressed at the resuscitation stage and immunogenic so it has been widely developed as a TB antigen for vaccine and diagnostic purposes. This study examines the humoral immune response induced by recombinant plasmid pcDNA3.1-rpfD (plasmid pcDNA3.1 that carries rpfD gene from M. tuberculosis Beijing strain, Aprilia, 2017), Immunoglobulin-G (IgG) subclasses were detected by serological method. The results of this study indicate that the IgG2a sub-class is the highest IgG response successfully induced by pcDNA3.1-rpfD which indicates the potential for protection against M. tuberculosis infection.

Abstrak :
Kanker paru sebagai salah satu kanker terbanyak di dunia merupakan faktor risiko dari infeksi oportunistik, seperti mikosis paru. Mikosis paru masih jarang dikenali akibat diagnosis yang masih menjadi tantangan karena gejala dan radiologis yang tidak spesifik dan uji diagnosis yang tidak invasif masih belum diketahui kepastian tingkat akurasinya. Studi ini dilakukan untuk mengetahui nilai akurasi hasil pemeriksaan immunodiffusion test (IDT) yang menggunakan crude antigen dibandingkan dengan profil immunoglobulin G (IgG) spesifik Aspergillus sebagai baku emas yang menggunakan kit Dynamiker dengan hasil positif jika absorbansi di atas 120 AU/mL. Penelitian dilakukan melalui uji laboratorium dengan desain studi potong lintang. Prevalensi aspergillosis berdasarkan IgG spesifik Aspergillus didapatkan 25,7% dan nilai akurasi IDT didapatkan sensitivitas 44,4% (IK95% 21,5%-67,4%), spesifisitas 57,7% (IK95% 44,3%-71,1%), nilai duga positif 26,7% (IK95% 10,8%-42,5%), dan nilai duga negatif 75,0% (IK95% 61,6%-88,4%) dengan nilai Kappa sebesar 0.017. Selain itu, terdapat perbedaan yang bermakna secara statistik antara jenis kelamin dan indeks Brinkmann terhadap hasil pemeriksaan IDT Aspergillus (p<0,05). Oleh karena itu, IDT bukan merupakan metode diagnosis yang baik dan perlu adanya perbaikan terhadap antigen yang digunakan. ......Lung cancer as one of the most common cancers in the world is a risk factor for opportunistic infections, such as pulmonary mycoses. Pulmonary mycoses is still rarely recognized due to the challenging diagnosis because the symptoms and radiology are not specific and the accuracy value of diagnostic tests that are not invasive is still not yet known. This study was conducted to determine the accuracy of immunodiffusion test (IDT) using crude antigen compared to the Aspergillus-specific immunoglobulin G (IgG) as the gold standard using Dynamiker kit with the positive result if the absorbance value is above 120 AU/mL. The method of this research is laboratory test with a cross-sectional study design. The prevalence of aspergillosis based on Aspergillus-specific IgG is 25.7% and the accuracy values of IDT are sensitivity 44.4% (95% CI 21.5%-67.4%), specificity 57.7% (95% CI 44.3%-71.1%), positive predictive value 26.7% (95% CI 10.8%-42.5%), and negative predictive value 75.0% (95% CI 61.6%-88.4%) with Kappa value 0.017. Besides, there was a statistically significant difference between gender and the Brinkmann Index on the results of IDT examination (p>0.05). Therefore, IDT is not a good or reliable diagnostic method and there is a need for improvement or correction of the antigen used.

Abstrak :
Hepatitis E sudah dua kali menimbulkan kejadian luar biasa di Kabupaten Sintang tahun 1987 dan 1991. Telah diketahui bahwa hepatitis E erat hubungannya dengan penggunaan air sungai yang tercemar tinja. Lebih dan 60% masyarakat Sintang menggunakan air sungai untuk keperluan sehari-hari. Sehingga perlu diketahui faktor-faktor resiko yaitu penggunaan air sungai yang berhubungan dengan timbulnya IgG anti REV. Penelitian dilakukan di 4 desa yang pernah terjadi kejadian luar biasa dan mudah dijangkau. Penelitian ini menggunakan 165 orang yang mempunyai IgG anti HEV positif dan 609 orang yang mempunyai IgG anti HEV negatif. Berhasil dijadikan kasus 148 orang IgG anti REV positif dan 165 orang dan kontrol 128 orang anti HEV negatif didapat secara random dari 609 orang. Analisis regresi logistik multivariat menghasilkan: menggunakan air sungai sebagai sumber air minum mempunyai OR = 1,05 (95% CI = 0,37 - 2,93) p = 0,9198. Cuci alat makan/dapur OR = 2,88 (95% CI = 1,16 - 7,12) p = 0,0216. Gosok gigi OR = 0,73 (95% CI 0,28 - 1,88) p = 0,5185. Denis kelamin OR = 1,65 (95% CI = 0,99 - 2,74) p = 0,0519. Umur OR= 1,01 (95% CI = 0,99 -- 1,03 p = 0,1388. Setelah dilakukan penilaian terhadap interaksi dan konfonding didapatkan model persamaan rnatematis sebagai berikut : Logit IgG anti HEV positif = -1,1359 + 0,9333 (cuci alat makan/dapur) + 0,4273 (jenis kelamin). Berdasarkan hasil penelitian di atas hendaknya Dinas Kesehatan menginformasikan kepada masyarakat bahwa menggunakan air sungai untuk mencuci alat makant dapur dapat meningkatkan resiko terjangkit hepatitis E. Untuk penelitian selanjutnya diupayakan memperluas populasi penelitian, dengan mengikutsertakan daerah di luar tempat terjadinya kejadian luar biasa. Penentuan kasus menggunakan sampel darah pada fase penyembuhan dan kontrol belum pernah mengidap hepatitis apapun. Dafar bacaan 24 (1981-1996)

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The Risk Factors Associated with IgG Anti HEV in 4 Villages District of Sintang - West Kalimantan in 1996In Sintang district Hepatitis E Virus (REV) was the causative agent in an outbreak reported for sub districts along side the Pinoh River from September 1987 to March 1988. A second outbreak of HEV infection was recognized from sub districts along side the Kayan River in September 1991. Hepatitis E Virus is thought to be spread by ingestion of contaminated substances, especially water. Over 80 percent of the population live along the river in Sintang district. Coverage of save drinking water was only 30 percent of the population. The aim of this study is to know the risk factors associated with IgG Anti HEV. This study was do in 4 villages that was outbreak and easy to come. The design of this study is case control. There are 148 cases IgG anti HEV (+) and 128 controls IgG Anti HEV (-). The result of multivariate logistic regression analysis for each variable : River as source of water for drinking OR = 1,05 (95% CI = 0,37 - 2,93) p = 0,9198. Washing dinner set and kitchen set OR = 2,88 (95% CI = 1,16 - 7,12) p = 0,0216. Brushing in the river OR = 0,73 (95% CI = 0,28 -- 1,88) p = 0,5185. Sex OR = 1,65 (95% CI = 0,99 - 2,74) p = 0,0519. Age OR = 1,01 (95% CI = 0,99 - 1,03) p = 0,1388. And then conduct by stepwise method, interaction and confounding analysis resulted the mathematical model as Logit IgG Anti HEV positive = - 1,1359 + 0,9333 (washing dinner or kitchen set) + 0,4273 (sex). References : 24 (1981 -1996)

Abstrak :
[ABSTRAK
Kemampuan Mycobacterium tuberculosis yang dapat memanipulasi dan menghindari respon imun adalah tantangan dalam mencari terapi dan vaksinasi efektif. Penelitian ini untuk menguji potensi ekstrak metanol akar Eurycoma longifolia Jack dalam memodulasi peningkatan IgA dan IgG mencit putih jantan yang divaksinasi BCG, sekaligus untuk menganalisis peningkatan sitokin proinflamasi yang berhubungan dengan produksi IgA dan IgG. Plasma diambil sebelum dan setelah vaksinasi BCG pada 18 ekor mencit yang dibagi ke dalam 2 kelompok; perlakuan dan kontrol. Kadar IgA, IgG, TNF-! dan IL-10 diukur dengan metode ELISA. Hasil menunjukkan bahwa peningkatan IgA kelompok air (0,33±0,16) lebih tinggi dibandingkan kelompok pasak bumi (0,30±0,30), sedangkan peningkatan IgG kelompok pasak bumi (0,38±0,25) terlihat lebih tinggi dibandingkan kelompok air (0,29±0,35). Rasio TNF-!/IL-10 kelompok pasak bumi (0,46±0,07) lebih tinggi dibandingkan kelompok air (0,41±0,05). Terdapat korelasi antara TNF-! dengan IgA pada kelompok air (r=0,601, p=0,035) juga dengan IgG pada kelompok pasak bumi (r=0,559, p=0,059). Disimpulkan, pemberian pasak bumi cenderung berpotensi memodulasi peningkatan IgG, tetapi tidak IgA. Selain itu, pemberian pasak bumi juga cenderung meningkatkan sitokin proinflamasi yang mempengaruhi produksi IgA dan IgG.

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ABSTRACT
The ability of Mycobacterium tuberculosis to manipulate and evade host?s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production.;The ability of Mycobacterium tuberculosis to manipulate and evade host’s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production., The ability of Mycobacterium tuberculosis to manipulate and evade host’s immune response is a challenge in finding an effective therapy and vaccination. The purpose of this research were to investigate the potency of methanol extract of the roots of Eurycoma longifolia Jack as immunomodulators for male white mice vaccinated with BCG, as well as to analyze the increase of proinflammatory cytokines associated with IgA and IgG production. Plasma were taken before and after BCG vaccination from 18 mice, that were divided into 2 groups; treatment and control. IgA, IgG, TNF-! and IL-10 levels were measured by using ELISA. The results showed that the enhancement of IgA group with water (0,33±0,16) was higher than group with pasak bumi (0,30±0,30). On the other hand the enhancement of IgG group with pasak bumi (0,38±0,25) was higher than group with water (0,29±0,35). The ratio of TNF-!/IL-10 group with pasak bumi (0.46±0.07) was higher than group with water (0.41±0.05). There are correlarions between TNF-! and IgA in the group with water (r=0.601, p=0.035) as well as between TNF- ! and IgG in group with pasak bumi (r=0.559, p=0.059). As the conclusion, methanol extract of pasak bumi root tend to potentially modulate the increase IgG production, but not IgA. In addition, it also tends to increase the proinflamasi cytokines associated with IgA and IgG production.]