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1.
Emerg Infect Dis ; 21(5): 741-9, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25897654

RESUMEN

During February 2013-March 2015, a total of 602 human cases of low pathogenic avian influenza A(H7N9) were reported; no autochthonous cases were reported outside mainland China. In contrast, since highly pathogenic avian influenza A(H5N1) reemerged during 2003 in China, 784 human cases in 16 countries and poultry outbreaks in 53 countries have been reported. Whether the absence of reported A(H7N9) outside mainland China represents lack of spread or lack of detection remains unclear. We compared epidemiologic and virologic features of A(H5N1) and A(H7N9) and used human and animal influenza surveillance data collected during April 2013-May 2014 from 4 Southeast Asia countries to assess the likelihood that A(H7N9) would have gone undetected during 2014. Surveillance in Vietnam and Cambodia detected human A(H5N1) cases; no A(H7N9) cases were detected in humans or poultry in Southeast Asia. Although we cannot rule out the possible spread of A(H7N9), substantial spread causing severe disease in humans is unlikely.


Asunto(s)
Subtipo H7N9 del Virus de la Influenza A , Gripe Aviar/epidemiología , Gripe Aviar/transmisión , Gripe Humana/epidemiología , Gripe Humana/transmisión , Animales , Asia Sudoriental/epidemiología , China/epidemiología , Brotes de Enfermedades , Geografía , Humanos , Subtipo H5N1 del Virus de la Influenza A , Gripe Aviar/virología , Gripe Humana/virología , Vigilancia de la Población , Aves de Corral
2.
Influenza Other Respir Viruses ; 9(2): 94-8, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25598475

RESUMEN

OBJECTIVE: In 2012, Lao PDR introduced seasonal influenza vaccine in pregnant women, persons aged ≥50 years, persons with chronic diseases, and healthcare personnel. We assessed adverse events following immunization (AEFI). METHODS: We used a multistage randomized cluster sample design to interview vaccine recipients. FINDINGS: Between April and May 2012, 355,902 were vaccinated. Of 2089 persons interviewed, 261 (12·5%) reported one or more AEFI. The most commonly reported AEFIs were local reactions. No hospitalizations or deaths were reported; 16% sought medical care. Acceptance and awareness of vaccination were high. CONCLUSIONS: Following the introduction of seasonal influenza vaccine in Lao PDR, self-reported adverse events were mild.


Asunto(s)
Vacunas contra la Influenza/efectos adversos , Gripe Humana/prevención & control , Vacunación/efectos adversos , Enfermedad Crónica , Femenino , Personal de Salud , Humanos , Programas de Inmunización , Laos , Masculino , Persona de Mediana Edad , Embarazo , Estaciones del Año , Autoinforme
3.
J Infect Dev Ctries ; 7(11): 781-7, 2013 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-24240034

RESUMEN

INTRODUCTION: We undertook a prospective community-based study in North Jakarta, Indonesia, to determine the incidence, clinical characteristics, seasonality, etiologic agent, and antimicrobial susceptibility pattern of enteric fever. METHODOLOGY: Following a census, treatment centre-based surveillance for febrile illness was conducted for two-years. Clinical data and a blood culture were obtained from each patient. RESULTS: In a population of 160,261, we detected 296 laboratory-confirmed enteric fever cases during the surveillance period, of which 221 (75%) were typhoid fever and 75 (25%)  were paratyphoid fever.  The overall incidence of typhoid and paratyphoid cases was 1.4, and 0.5 per thousand populations per year, respectively. Although the incidence of febrile episodes evaluated was highest among children under 5 years of age at 92.6 per thousand persons per year, we found that the burden of typhoid fever was greatest among children between 5 and 20 years of age. Paratyphoid fever occurred most commonly in children and was infrequent in adults. CONCLUSION: Enteric fever is a public health problem in North Jakarta with a substantial proportion due to paratyphoid fever. The results highlight the need for control strategies against enteric fever.


Asunto(s)
Salmonella paratyphi A/aislamiento & purificación , Salmonella typhi/aislamiento & purificación , Fiebre Tifoidea/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Niño , Preescolar , Femenino , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Estudios Prospectivos , Salmonella paratyphi A/efectos de los fármacos , Salmonella typhi/efectos de los fármacos , Estaciones del Año , Fiebre Tifoidea/microbiología , Fiebre Tifoidea/patología , Adulto Joven
4.
Am J Trop Med Hyg ; 86(1): 46-51, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22232450

RESUMEN

We conducted a prospective, inpatient fever study in malaria-endemic Papua, Indonesia to determine non-malaria fever etiologies. Investigations included malaria blood films, blood culture, paired serologic samples analysis for dengue, Japanese encephalitis, leptospirosis, scrub typhus, murine typhus, and spotted fever group rickettsia. During 1997-2000, 226 patients (127 males and 99 females) 1-80 years of age (median age = 25 years) were enrolled. Positive blood cultures (n = 34, 15%) were obtained for Salmonella Typhi (n = 13), Escherichia coli (n = 8), Streptococcus pneumoniae (n = 6), Staphylococcus aureus (n = 5), Streptococcus pyogenes (n = 1), and Klebsiella pneumoniae (n = 1). Twenty (8.8%) patients were positive for leptospirosis by polymerase chain reaction. Eighty (35.4%) of 226 patients had ≥ 1 positive serology, diagnostic for 15 rickettsial and 9 dengue cases. Acid-fast bacilli-positive sputum was obtained from three patients. Most common confirmed (81 of 226, 35.8%)/suspected diagnoses were typhoid fever (n = 41), pneumonia (n = 29), leptospirosis (n = 28), urinary tract infections (n = 20), rickettsioses (n = 19), dengue (n = 17), and meningitis/encephalitis (n = 15). There were 17 deaths, 7 (46.7%) were caused by meningitis/encephalitis. Multiple positive serologic results and few confirmed diagnoses indicate the need for improved diagnostics.


Asunto(s)
Infecciones Bacterianas/complicaciones , Fiebre/epidemiología , Fiebre/etiología , Virosis/complicaciones , Enfermedad Aguda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/complicaciones , Bacteriemia/epidemiología , Bacteriemia/microbiología , Bacteriemia/mortalidad , Infecciones Bacterianas/epidemiología , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/mortalidad , Infecciones del Sistema Nervioso Central/complicaciones , Infecciones del Sistema Nervioso Central/epidemiología , Infecciones del Sistema Nervioso Central/etiología , Infecciones del Sistema Nervioso Central/mortalidad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Papúa Nueva Guinea/epidemiología , Virosis/epidemiología , Virosis/mortalidad , Virosis/virología , Adulto Joven
5.
J Clin Microbiol ; 44(4): 1581-3, 2006 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-16597900

RESUMEN

Hepatitis E virus (HEV) is a major cause of hepatitis. We evaluated five HEV antibody diagnostic assays by using outbreak specimens. The Abbott immunoglobulin G (IgG), Genelabs IgG, and Walter Reed Army Institute of Research (WRAIR) IgM assays were about 90% sensitive; the Abbott IgG and WRAIR total Ig and IgM assays were more than 90% specific.


Asunto(s)
Brotes de Enfermedades , Anticuerpos Antihepatitis , Virus de la Hepatitis E/aislamiento & purificación , Hepatitis E/diagnóstico , Hepatitis E/epidemiología , Estudios Transversales , ADN Viral/análisis , Anticuerpos Antihepatitis/sangre , Hepatitis E/inmunología , Virus de la Hepatitis E/genética , Humanos , Técnicas para Inmunoenzimas/métodos , Técnicas para Inmunoenzimas/normas , Estudios Retrospectivos
6.
Southeast Asian J Trop Med Public Health ; 37(6): 1103-16, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17333762

RESUMEN

An extensive outbreak of dengue fever and dengue hemorhagic fever occurred in the city of Palembang, South Sumatra, Indonesia from late 1997 through March/April 1998. All surveyed administrative areas (kelurahan) in Palembang were found to be 'permissive' for dengue virus transmission; and all areas that had Aedes (subgenus Stegomyia) larval mosquitoes in abundance experienced increased cases of DHF during the epidemic. The Aedes House Index (HI) for combined Aedes aegypti and Aedes albopictus was recorded every 3 months before, during, and after the epidemic. Ten surveyed sentinel sites (October-December 1997) immediately preceding the epidemic peak had a combined HI of 25% (range 10-50.8%). Entomological surveys during the peak epidemic period (January-April) showed a combined HI of 23.7% (range: 7.6-43.8%). Kelurahans with the highest numbers of reported dengue cases had an HI exceeding 25%; however, there was no discernable relationship between elevated HI and increased risk of DHF incidence. Despite the unusual climatic conditions during late 1997 created throughout the region by the El Niño Southern Oscillation (ENSO), the house indices during both wet and dry months remained above 23% for the 4 quarterly (3-month) periods surveyed in the second half of 1997 and first half of 1998. Rainfall returned to near normal monthly levels shortly before the reported increase in human cases. However, mean ambient air temperatures continued above normal (+0.6 to 1.2 degrees C) and were sustained over the months leading up to and during the epidemic. Evidence suggests that an ENSO-driven increase in ambient temperature had a marked influence on increased virus transmission by the vector population. We explore the apparent associations of entomological and climatic effects that precipitated the epidemic before the influx of reported human cases.


Asunto(s)
Virus del Dengue/patogenicidad , Brotes de Enfermedades , Lluvia , Dengue Grave/epidemiología , Dengue Grave/transmisión , Temperatura , Clima Tropical , Animales , Vectores Artrópodos/crecimiento & desarrollo , Vectores Artrópodos/parasitología , Humanos , Incidencia , Indonesia/epidemiología , Conceptos Meteorológicos , Vigilancia de la Población
7.
BMC Infect Dis ; 5: 89, 2005 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-16242013

RESUMEN

BACKGROUND: In preparation of vaccines trials to estimate protection against shigellosis and cholera we conducted a two-year community-based surveillance study in an impoverished area of North Jakarta which provided updated information on the disease burden in the area. METHODS: We conducted a two-year community-based surveillance study from August 2001 to July 2003 in an impoverished area of North Jakarta to assess the burden of diarrhoea, shigellosis, and cholera. At participating health care providers, a case report form was completed and stool sample collected from cases presenting with diarrhoea. RESULTS: Infants had the highest incidences of diarrhoea (759/1,000/year) and cholera (4/1,000/year). Diarrhea incidence was significantly higher in boys under 5 years (387/1,000/year) than girls under 5 years (309/1,000/year; p < 0.001). Children aged 1 to 2 years had the highest incidence of shigellosis (32/1,000/year). Shigella flexneri was the most common Shigella species isolated and 73% to 95% of these isolates were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol and tetracycline but remain susceptible to nalidixic acid, ciprofloxacin, and ceftriaxone. We found an overall incidence of cholera of 0.5/1,000/year. Cholera was most common in children, with the highest incidence at 4/1,000/year in those less than 1 year of age. Of the 154 V. cholerae O1 isolates, 89 (58%) were of the El Tor Ogawa serotype and 65 (42%) were El Tor Inaba. Thirty-four percent of patients with cholera were intravenously rehydrated and 22% required hospitalization. V. parahaemolyticus infections were detected sporadically but increased from July 2002 onwards. CONCLUSION: Diarrhoea causes a heavy public health burden in Jakarta particularly in young children. The impact of shigellosis is exacerbated by the threat of antimicrobial resistance, whereas that of cholera is aggravated by its severe manifestations.


Asunto(s)
Cólera/epidemiología , Diarrea/epidemiología , Disentería Bacilar/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Cólera/microbiología , Disentería Bacilar/microbiología , Femenino , Humanos , Incidencia , Indonesia/epidemiología , Lactante , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Estaciones del Año , Factores de Tiempo
8.
Am J Trop Med Hyg ; 72(4): 488-94, 2005 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-15827293

RESUMEN

An outbreak of acute diarrheal disease was reported in Kupang, Nusa Tenggara, Indonesia, in August 2002. An investigative team carried out a retrospective historical review of records, and a case-control study involving data and specimen collections. Etiologic determination involving stool specimens was based on an enzyme-linked immunosorbent assay, with a reverse transcriptase-polymerase chain reaction performed for serotyping purposes. Two thousand six hundred probable cases were identified from hospital records during the outbreak months of June, July, August, and September 2002. Previous enteric outbreaks were recognized from the same months in the preceding years and all annual outbreak episodes following a period of prolonged, low rainfall. In contrast to previous outbreaks discerned from trend analysis, the overwhelming burden of disease fell upon the pediatric population versus the young and old in previous outbreak instances. Rotavirus was found to be the causative etiology, with serotype 1 predominating.


Asunto(s)
Brotes de Enfermedades , Infecciones por Rotavirus/epidemiología , Ensayo de Inmunoadsorción Enzimática , Humanos , Indonesia/epidemiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
9.
Trop Med Int Health ; 10(5): 489-96, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15860097

RESUMEN

OBJECTIVES: To conduct malaria surveillance near Jakarta where only imported malaria has been described over the past two decades and to characterize endemicity and risk to heavily populated peri-urban locations. METHODS: Standard cross-sectional malariometric surveys and mosquito collections at the Thousand Islands District and developing peri-urban areas of Jakarta. RESULTS: During October 2000 outbreak investigations in the Tidung Island group, the slide positive rate was 47% (38%Plasmodium falciparum, 7%P. vivax, and 2% mixed infections) among 733 persons screened. Very few parasitemic inhabitants were symptomatic (<1%), and native residents were more commonly infected than immigrants (odds ratio 1.72), consistent with endemic autochthonous transmission. Adult and larval mosquito collections detected Anopheles sundaicus. In June 2001, prevalence of parasitemia at Pari Island, where sampling was adequate for comparison, remained high, 32%vs. 43% previously. Among 1377 individuals screened at nearby Tangerang District, a heavily populated mainland suburb dominated by fishponds through which many islanders travel to Jakarta, only 19 malaria infections were identified, all imported from Pari Island. Entomological surveillance in Tangerang identified An. subpictus, An. vagus, and An. barbirostris, all considered minor malaria vectors on Java. CONCLUSIONS: Malaria is endemic in the Tidung Island group. Imported malaria occurs in the heavily populated Tangerang District where coastal development is increasing and vector breeding sites and demographic patterns lend increasingly to malaria importation and risk of emergent malaria. Careful attention to the impact of coastal development activities on vector populations and efforts to prevent introduction of An. sundaicus are warranted.


Asunto(s)
Brotes de Enfermedades , Enfermedades Endémicas , Malaria/epidemiología , Adolescente , Adulto , Distribución por Edad , Animales , Anopheles , Niño , Preescolar , Estudios Transversales , Emigración e Inmigración , Femenino , Humanos , Indonesia/epidemiología , Lactante , Insectos Vectores , Malaria Falciparum/epidemiología , Malaria Vivax/epidemiología , Masculino , Recuento de Huevos de Parásitos , Parasitemia/epidemiología , Vigilancia de la Población/métodos , Prevalencia , Distribución por Sexo
10.
Trans R Soc Trop Med Hyg ; 99(2): 128-41, 2005 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-15693148

RESUMEN

Twenty-four distinct outbreaks of probable chikungunya (CHIK) etiology were identified throughout Indonesia from September 2001 to March 2003, after a near 20-year hiatus of epidemic CHIK activity in the country. Thirteen outbreak reports were based on clinical observations alone, and 11 confirmed by serological/virological methods. Detailed epidemiological profiles of two investigated outbreaks in Bogor and Bekasi are presented. Human sera were screened using an ELISA for IgM and IgG anti-CHIK antibodies. Additionally, reverse transcriptase PCR and virus isolation were attempted for virus identification. The mean age of cases was 37 +/- 18 years in Bogor and 33 +/- 20 years in Bekasi. There was no outstanding case-clustering, although outbreak-affected households were observed to be geographically grouped within villages. The attack rates in Bogor and Bekasi were 2.8/1000 and 6.7/1000 inhabitants respectively. Both outbreaks started in the rainy season following increased Aedes aegypti and A. albopictus densities.


Asunto(s)
Infecciones por Alphavirus/epidemiología , Virus Chikungunya/aislamiento & purificación , Brotes de Enfermedades , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Infecciones por Alphavirus/inmunología , Anticuerpos Antivirales/sangre , Virus Chikungunya/inmunología , Niño , Preescolar , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Indonesia/epidemiología , Persona de Mediana Edad , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Factores de Riesgo , Estaciones del Año
11.
Clin Infect Dis ; 39(4): 443-9, 2004 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-15356802

RESUMEN

Although influenza is recognized for its worldwide importance, little is known about the disease from tropical countries like Indonesia. From August 1999 through January 2003, a surveillance study was conducted in clinics at 6 sentinel locations. Adults (age, >14 years) and children (age, 4-14 years) presenting with respiratory symptoms suggestive of influenza were asked to enroll in the study. Nasal and pharyngeal swabs were examined by virus isolation, polymerase chain reaction, and rapid immunochromatographic tests. A total of 3079 specimens were collected from 1544 participants. Influenza infection was confirmed in 172 volunteers (11.1%) presenting with influenza-like illness. Influenza A (H1N1 and H3N2) and B viruses were detected at all sites. Peak prevalence tended to coincide with the respective rainy seasons, regardless of location. In light of the recent epidemic of severe acute respiratory syndrome, continued influenza surveillance would be useful in strengthening the infrastructure of the Indonesian public health system.


Asunto(s)
Gripe Humana/epidemiología , Vigilancia de Guardia , Tiempo , Adolescente , Adulto , Animales , Antígenos Virales/inmunología , Antígenos Virales/aislamiento & purificación , Niño , Preescolar , Cromatografía/métodos , Perros , Femenino , Humanos , Pruebas Inmunológicas/métodos , Indonesia/epidemiología , Virus de la Influenza A/genética , Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/genética , Virus de la Influenza B/aislamiento & purificación , Gripe Humana/genética , Riñón/citología , Riñón/virología , Masculino , ARN Viral/genética , Juego de Reactivos para Diagnóstico/normas , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Sensibilidad y Especificidad
12.
Am J Trop Med Hyg ; 68(6): 666-70, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12887025

RESUMEN

The antimicrobial susceptibility patterns for 2,812 bacterial pathogens isolated from diarrheal patients admitted to hospitals in several provinces in the cities of Jakarta, Padang, Medan, Denpasar, Pontianak, Makassar, and Batam, Indonesia were analyzed from 1995 to 2001 to determine their changing trends in response to eight antibiotics: ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, tetracycline, cephalothin, ceftriaxone, norfloxacin, and ciprofloxacin. Vibrio cholerae O1 (37.1%) was the pathogen most frequently detected, followed by Shigella spp. (27.3%), Salmonella spp. (17.7%), V. parahaemolyticus (7.3%), Salmonella typhi (3.9%), Campylobacter jejuni (3.6%), V. cholerae non-O1 (2.4%), and Salmonella paratyphi A (0.7%). Of the 767 Shigella spp. isolated, 82.8% were S. flexneri, 15.0% were S. sonnei, and 2.2% were S. dysenteriae (2.2%). The re-emergence of Shigella dysenteriae was noted in 1998, after an absence of 15 years. Shigella spp. were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline. Salmonella typhi and Salmonella paratyphi A were susceptible to all antibiotics tested, while Salmonella spp. showed various resistance patterns according to species grouping. A small number of V. cholerae O1 were resistant to ampicillin, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline; however, they were still sensitive to ceftriaxon, norfloxacin, and ciprofloxacin. Similar results were shown for V. cholerae non-O1. Campylobacter jejuni showed an increased frequency of resistance to ceftriaxone, norfloxacin, and ciprofloxacin, but was susceptible to erythromycin. This study shows that except for C. jejuni and V. parahaemolyticus, which appeared to be resistant to ciprofloxacin, the majority of the enteric pathogens tested were still susceptible to fluoroquinolones.


Asunto(s)
Antibacterianos/farmacología , Diarrea/epidemiología , Diarrea/microbiología , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Bacterias Gramnegativas/patogenicidad , Infecciones por Bacterias Gramnegativas/epidemiología , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Indonesia/epidemiología , Lactante , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad
13.
Am J Trop Med Hyg ; 68(5): 529-35, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12812338

RESUMEN

In April 2001, a second suspected outbreak of dengue hemorrhagic fever in the easternmost region of Indonesia was investigated in Merauke, a town located in the southeastern corner of Papua, by the Indonesian Ministry of Health and the U.S. Naval Medical Research Unit No. 2. Principal case criteria of hemorrhagic disease provided for a study enrollment of 15 clinically acute and 37 convalescing subjects. Additionally, 32 comparable age/sex controls were selected from neighboring households. Laboratory diagnosis involved three testing methodologies: virus isolation by cell culture, a reverse transcriptase-polymerase chain reaction (RT-PCR) assay, and serologic assays. Antibody (IgM) to dengue virus was detected in 27% of the acute clinical cases, 30% of the convalescing cases, and only 3% of the matched controls. Dengue 3 was the only viral serotype detected from acute serum samples by the RT-PCR. The mean +/- SD age of the acute and convalescing cases was 7.8 +/- 5.4 years. Overall hospital records accounted for 172 suspected outbreak cases, all urban residents of Merauke with no recent travel history outside the area. The estimated outbreak-associated case fatality rate among all suspected dengue cases was 1.2%. A seven-year retrospective review of hospital records in Merauke showed negligible disease reporting involving hemorrhagic disease prior to the outbreak.


Asunto(s)
Brotes de Enfermedades , Dengue Grave/epidemiología , Adolescente , Adulto , Distribución por Edad , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Indonesia/epidemiología , Lactante , Masculino , Lluvia , Estudios Retrospectivos , Estaciones del Año , Dengue Grave/transmisión , Distribución por Sexo , Temperatura
14.
Diagn Microbiol Infect Dis ; 44(3): 227-34, 2002 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12493168

RESUMEN

Emerging or reemerging infections due to bacterial disease may be a local, regional or global problem. Bacterial acute gastroenteritis is a potential cause of substantial morbidity in travelers and deployed U.S. military personnel. A surveillance study was conducted over a two-year period in Indonesia among 6760 patients with debilitating diarrheal diseases. Of the 6,760 patients, 587 (9%) of the patient stools were positive for bacteria. The proportions of bacteria isolated from the 587 patients were: Shigella flexneri (39%), Salmonella spp. (26%), Vibrio spp. (17%), S. sonnei (7%), Campylobacter jejuni (4.4%), Salmonella typhi (3%) and S. dysenteriae (2.3%). Shigella flexneri was the most prevalent pathogen isolated, over Vibrio spp. No V. cholerae was isolated in the cities of Pontianak, Padang or Batam in Indonesia. Shigella dysenteriae reemergence was noted in Bali, Kalimantan, Batam and Jakarta after an absence of 15 years. Isolation of a high proportion of S. flexneri, and Vibrio spp. occurred during the rainy months. All bacterial isolates were susceptible to quinolones, with the exception of C. jejuni and Salmonella spp., which were resistant to ciprofloxacin, norfloxacin and nalidixic acid. Our findings highlight the decline of V. cholerae, the rise of S. flexneri and the reemergence of S. dysenteriae in Indonesia. The study also documents the emergence of quinolone-resistant Campylobacter spp. in the Indonesia archipelago.


Asunto(s)
Diarrea/epidemiología , Bacterias Gramnegativas/aislamiento & purificación , Infecciones por Bacterias Gramnegativas/epidemiología , Vigilancia de la Población , Adolescente , Campylobacter/aislamiento & purificación , Niño , Preescolar , Diarrea/microbiología , Femenino , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Indonesia/epidemiología , Lactante , Recién Nacido , Masculino , Salmonella/aislamiento & purificación , Estaciones del Año , Shigella/aislamiento & purificación , Vibrio/aislamiento & purificación
15.
Am J Trop Med Hyg ; 67(3): 278-86, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12408667

RESUMEN

The importance of leptospirosis in Southeast Asia was assessed in conjunction with other studies supported by the U.S. Naval Medical Research Unit No. 2 (US NAMRU-2), Jakarta, Republic of Indonesia. These included studies of hospital-based, acute clinical jaundice in Indonesia, Lao PDR, and Socialist Republic of Vietnam; nonmalarial fever in Indonesia; and hemorrhagic fever in Cambodia. Background prevalence estimates of leptospiral infection were obtained by a cross-sectional, community-based study in Lao PDR. Laboratory testing methods involved serology, microscopic agglutination test, and reverse-transcriptase polymerase chain reaction. Suggestive evidence of recent leptospiral infections was detected in 17%, 13%, and 3% of patients selected on the basis of non-hepatitis A through E jaundice, nonmalarial fever, and hemorrhagic fever (in the absence of acute, dengue viral infections). Leptospiral IgG antibody, reflective of prior infections, was detected in 37% of human sera, collected in Lao PDR. The predominant leptospiral serogroups identified from cases with clinical jaundice were Hurstbridge, Bataviae, and Icterohaemorrhagiae tonkini LT 96 69. Among the nonmalarial febrile cases, Bataviae was the most frequently recognized serogroup. Pyrogenes and Hurstbridge were the principal serogroups among the hemorrhagic fever case subjects. These findings further attest to the relative importance of clinical leptospirosis in Southeast Asia. The wide spectrum of clinical signs and symptoms associated with probable, acute, leptospiral infections contributes to the potential of significant underreporting.


Asunto(s)
Leptospirosis/epidemiología , Adolescente , Adulto , Asia Sudoriental/epidemiología , Secuencia de Bases , Estudios Transversales , Cartilla de ADN , Demografía , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Leptospira/genética , Leptospira/inmunología , Masculino , Persona de Mediana Edad , Epidemiología Molecular , Reacción en Cadena de la Polimerasa
16.
FEMS Immunol Med Microbiol ; 34(2): 139-46, 2002 Oct 11.
Artículo en Inglés | MEDLINE | ID: mdl-12381465

RESUMEN

The prevalence of bacteria, parasite and viral pathogens in 3875 patients with diarrhea in community and hospital settings from March 1997 through August 1999 in Jakarta, Indonesia was determined using routine bacteriology and molecular assay techniques. Bacterial pathogens isolated from hospital patients were, in decreasing frequency, Vibrio cholerae O1, Shigella flexneri, Salmonella spp. and Campylobacter jejuni, while S. flexneri, V. cholerae O1, Salmonella spp. and C. jejuni were isolated from the community patients. V. cholerae O1 was isolated more frequently (P<0.005) from the hospital patients than the community patients. Overall, bacterial pathogens were isolated from 538 of 3875 (14%) enrolled cases of diarrhea. Enterotoxigenic Escherichia coli were detected in 218 (18%) of 1244 rectal swabs. A small percentage of enterohemorrhagic E. coli (1%) and of Clostridium difficile (1.3%) was detected. Parasitic examination of 389 samples resulted in 43 (11%) positives comprising Ascaris lumbricoides (1.5%), Blastocystis hominis (5.7%), Giardia lamblia (0.8%), Trichuris trichiura (2.1%) and Endolimax nana (0.5%). Rotavirus (37.5%), adenovirus (3.3%) and Norwalk-like virus (17.6%) were also detected. Antimicrobial resistance was observed among some isolates. Bacterial isolates were susceptible to quinolones, with the exception of some isolates of C. jejuni which were resistant to ciprofloxacin, nalidixic acid and norfloxacin. Data obtained from this community- and hospital-based study will enable the Indonesian Ministry of Health to plan relevant studies on diarrheal diseases in the archipelago.


Asunto(s)
Diarrea/microbiología , Enfermedad Aguda , Adulto , Animales , Niño , Diarrea/epidemiología , Diarrea/parasitología , Sistema Digestivo/microbiología , Sistema Digestivo/parasitología , Sistema Digestivo/patología , Farmacorresistencia Bacteriana , Enfermedades Endémicas/clasificación , Enfermedades Endémicas/prevención & control , Enfermedades Endémicas/estadística & datos numéricos , Hospitalización , Humanos , Indonesia/epidemiología , Prevalencia , Estudios Prospectivos , Características de la Residencia
17.
Am J Trop Med Hyg ; 66(3): 317-20, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12139228

RESUMEN

Hepatitis C virus (HCV) prevalence among high-risk pediatric and adult patients was evaluated. The study included 269 adults and 150 children in a case-control research design. Risk factors of HCV exposure in Indonesia were assessed among adult renal dialysis patients and pediatric patients who received multiple blood transfusions. A high prevalence of anti-HCV was found among the adult renal dialysis patients, measured by second-generation electroimmunoassay tests. Family members of dialysis patients, who served as a comparison group for dialysis patients, were found to have a 9.0% seroprevalence. The prevalence of anti-HCV among pediatric patients with hematological disorders was found to be 39.0%. The comparison group seroprevalence (pediatric patients and family members) was 4.3% among sera available for confirmatory testing. Patients with history of hospitalization (odds ratio [OR] = 7.94, 95% confidence interval [CI]: 4.06-15.51, P = 0.0001), blood transfusion (OR = 6.85, 95% CI: 3.95-11.88, P = 0.0001), circumcision (OR = 2.39, 95% CI: 1.43-3.99, P = 0.0001), or marital partner/family member history of jaundice (OR = 3.62, 95% CI: 1.97-6.62, P = 0.0001) were found to have an increased odds of HCV exposure compared with individuals without similar histories.


Asunto(s)
Hepacivirus/inmunología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C/epidemiología , Diálisis Renal/efectos adversos , Reacción a la Transfusión , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Humanos , Indonesia/epidemiología , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios
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