Prevalence and treatment of intestinal helminthic infections among children in orphanages in Jakarta, Indonesia.

A survey was carried out in three orphanages in Jakarta for intestinal helminthic infections. Stool samples and anal swabs of 158 children were examined. The prevalences of intestinal helminthic infections in the Putra Utama, Muslimin and Van der Steur orphanages were respectively as follows: a lumbricoides 70.0%, 76.6% and 50.8%, T. trichiura 78.0% 93.6% and 70.5%, hookworm 20.0%, 12.7% and 3.2% and E. vermicularis 34.0% 29.8%, 59.0%. Treatment with Trivexan (100 mg of pyrantel pamoate and 150 mg of mebendazole), one tablet as a single daily dose for 3 consecutive days resulted in cure rates for A. lumbricoides 96.0%, 100% for T. trichiura 78.0%, 80.9% and 86.9% for hookworm 98.0%, 100% and 100% and for E. vermicularis 82.3% 92.9% and 97.2%. No side effects were observed, except in one child who complained of nausea.

The implementation of community participation in the control of malaria in rural Tanjung Pinang, Indonesia.

A study was undertaken to involve a hyperendemic community in Berakit village near Tanjung Pinang to participate actively in the control of malaria. Weekly chemoprophylaxis with chloroquine was given to all villagers of RK I with a population of about 700 for a period of one year. Nine cadres were selected from the community by the villagers for the distribution of the drug and coordinated by the head of the village. About 14-19 families were supervised by one cadre who was responsible for the weekly distribution of the drug to these families. The weekly dosage of the drug was adjusted according to age. The drug was taken in the presence of the cadres to assure the intake, and recorded by each cadre. The results showed that 93.7% of the villagers have taken the drug regularly. The remaining 6.3% of them showed refusal and irregular intake, or moved to another village during the period of prophylaxis. Although the drug has a bitter taste, most of the children were able to tolerate it. In general, mild side effects were reported and infrequently observed. Implementation of community participation to control malaria in this village showed good results which was reflected in the results of the malariometric surveys carried out before and after one year chemoprophylaxis. The spleen rate of about 600 villagers of RK I examined was 54.3% and the parasite rate 13.2% before the drug intervention. After one year chemoprophylaxis the spleen rate decreased to 21.7% and the parasite rate to 4.5% showing a significant difference.

Ivermectin and diethylcarbamazine trials in leaf monkeys (Presbytis cristatus) infected with Wuchereria kalimantani.

Clinical trials of Ivermectin in single oral doses of 200, 400, and 1,000 mg/kg body weight or in multiple doses of 200 mg/kg body weight for 5 consecutive days were performed in leaf monkeys (Presbytis cristatus) infected with Wuchereria kalimantani. Optimal microfilaricidal effect occurred at 200 mg/kg body weight. The drug was less effective than diethylcarbamazine in this animal model for human filariasis but had no adverse effects.

Decrease of malaria morbidity with community participation in central Java.

Malaria is still a problem in Java-Bali, although the Malaria Eradication Program started in the 1950's. In the First National Five Year Development Plan it was changed to the Malaria Control Program with the aim to reduce the morbidity and mortality rates through surveillance and spraying interventions using the primary health care approach. In 1984 in Central Java there were malaria areas with an average annual parasite incidence (API) between 1 and 7.5 promille covering about six million population, nearly one third of the population of Central Java. In this study an intervention alternative was carried out with weekly chloroquine prophylaxis to children below 10 years of age in 3 malaria areas of central Java, namely the villages Bedono Kluwung and Kalikutes in Purworejo Regency and Pablengan in Karang Anyar Regency. Health education about malaria with a learning module was conducted by key persons as an element of community participation. The activities of the key persons increased the ongoing surveillance. After one and a half years intervention (July 1985-February 1987) the spleen rates, parasite rates and fever cases dropped to nearly zero in the three study villages. From the results of this study it was recommended that in a malaria risk area with an API of more than 1 promille, intervention with collective chloroquine protection to children below 10 years of age could reduce the API to 1 promille or less. This intervention should be carried out if there is an increase of cases in the area to prevent small outbreaks.(ABSTRACT TRUNCATED AT 250 WORDS)

Diarrhoea among infants in a crowded area of Djakarta, Indonesia. A longitudinal study from birth to two years.

Diarrhoeal diseases are common in Djakarta, Indonesia, especially among infants and young children. A study has been made of possible bacterial and parasitic causes of outbreaks in a group of 156 infants in a crowded area of the city. Before the study was complete, 60 infants had left the area and 30 had died; diarrhoea was probably the direct or indirect cause of 13 of the deaths.Diarrhoea was associated with pathogenic Escherichia coli in about 20% of the cases studied; other causes of diarrhoea were Shigella, less frequent, and rare among infants below the age of 6 months; Salmonella, insignificant; Giardia lamblia, common, but not usually associated with diarrhoea; Entamoeba histolytica and Isospora belli, relatively rare. The role of Trichuris trichiura was probably important, but was difficult to assess.Many diarrhoea cases were not associated with either pathogenic bacteria or parasites. Other potential causes, not considered in this study, include enteropathogenic virus infection, parenteral infections, faulty diet and malnutrition. Further investigation is considered desirable.