RESUMO
OBJECTIVES: The etiologies of nonsyndromic cleft lips with or without palate (NS CL/P) are multifactorial, which include consanguineous marriages. The incidence of NS CL/P is relatively high in Indonesia notably in one of Indonesia's tribes whose members frequently marry close cousins. Thus, the purpose of this study is to analysis consanguinity as risk factor of NS CL/P in Sasak tribe, East Lombok, Indonesia MATERIALS AND METHODS: An observational analysis was made of a collected database of NS CL/P patients treated in social services in regency hospital of Dr. Soejono Selong, East Lombok, Indonesia. Demographic data such as age, gender, address (urban/rural), parent's education, presence or absence of consanguinity, type of clefts, and a three-generation pedigree were collected by interview and hospital medical record. Before analysis, patient information was anonymized and deidentified. From 2016 to 2018, each of 100 cleft and normal subjects with their Sasak parent were audited. The risk factors were analyzed statistically using odds ratio (OR) and chi-squared test. RESULTS: Consanguineous marriages identified 54 cases (54%), and 10 cases (10%) out of a total each 100 NS CL/P and controls, respectively. The majority of consanguinity (53.7%) was discovered in marriages between first cousins. NS CL/P cases were statistically linked (p = 0.00) with consanguineous marriages (OR: 10; 95% confidence interval: 1.6-3.1); in which the most prevalent case is unilateral cleft lips. CONCLUSION: Consanguineous marriage increases the risk of NS CL/P in Sasak tribe, East Lombok, Indonesia. The development of strategies to educate communities on the impacts of culture-consanguineous marriage is required. The genetic inheritance from their ancestor may be responsible for the increased incidence of NS CL/P.
RESUMO
BACKGROUND AND OBJECTIVES: Anaemia in Human Immunodeficiency Virus (HIV) infection is multifactorial and an increasingly important variable to consider in the management. This is the first study of anaemia in HIV infection in the Javanese population, which constitutes the largest ethnic group in Indonesia. The aim of this study was to determine the factors which are associated with anaemia in Javanese patients with HIV infection. METHODS AND STUDY DESIGN: This study applied a cross-sectional design involving HIV patients in Dr Kariadi Hospital and Balai Kesehatan Paru Masyarakat (BKPM), Semarang, Indonesia. The characteristic data of the subjects were age, gender, BMI, duration of therapy and antiretroviral (ARV) drugs. Haematology tests were conducted using flow cytometry. RESULTS: The prevalence of anaemia in HIV-infected patients was 21 (38.88%). Macrocytic anemia was found as a majority (12; 57.1 %) in anaemic patients. The risk factors which were found to be associated with increase of anaemia were white blood cells (WBC) <5.0 x 109/L and CD4 >200.0 cells/µL (p<0.05). A correlation between anaemia and age (r=0.49, p<0.01), duration of treatment (r=0.35, p<0.01), CD4 count (r=-0.42, p<0.01), total bilirubin (r=-0.28, p<0.05), and unconjugated bilirubin (r=-0.29, p<0.05) was identified. Age (p=0.023) and CD4 count (p=0.07) were the dominant factors in the multivariate analysis. CONCLUSION: Age and CD4 count are the dominant factors in determining of anaemia in Javanese patients with HIV infection.