Parental engagement in research on paediatric lower respiratory tract infections in Indonesia.

BACKGROUND: Lower respiratory tract infections (LRTIs) in children are a major concern in Indonesia as it is the leading cause of morbidity and mortality. Therefore, research on LRTIs is crucial to improve children's health. However, clinical research in children is challenging due to parental concerns. This study aims to understand parental considerations for taking part in clinical studies on LRTI in the Indonesian context. METHODS: A cross-sectional study using a validated online questionnaire was conducted from November 2021 to March 2022. This study included parents from two public elementary schools and two private primary schools in Semarang, Indonesia. A total of 1236 responses were analysed. RESULTS: There was a significant association between educational attainment and willingness to participate in general health and LRTI-related research requiring specimen collection; respondents with an advanced educational level were more likely to refuse participation in research. A similar pattern was observed among respondents with smaller families and younger children against participation in LRTI research. Most respondents who indicated not to participate explained that they did not perceive the necessity to take part and expressed their concerns about endangering their child's health as a consequence of the specimen collection. Most respondents expected a personal benefit and prioritized access to the study results for their child. CONCLUSION: Parents' educational background and family composition are important determinants of parental engagement in research on LRTI in Indonesia. Notably, parents with a lower educational level, having large families, and older children were more inclined to participate. The emphasis on concerns about potential harm and personal benefit underscores the need for a targeted communication strategy.

Bacterial colonization of the upper airways of children positive and negative for SARS-CoV-2 during the COVID-19 pandemic.

BACKGROUND: Our understanding of the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on bacterial colonization in the children's upper nasopharyngeal tract during the coronavirus infectious disease (COVID-19) pandemic is limited. This study aimed to determine whether there were any differences in bacterial colonization between asymptomatic children with or without a positive SARS-CoV-2 quantitative reverse transcriptase-polymerase chain reaction (RT-qPCR) results in the community setting. METHODS: A cross-sectional community-based exploratory study was conducted from March to May 2021 in Semarang, Central Java Province, Indonesia. Using stored nasopharyngeal swabs collected from children under 18 years as a contact tracing program, we performed a real-time quantitative (qPCR) for the most important bacterial colonizing pathogens: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Klebsiella pneumoniae. RESULTS: Swabs from a total of 440 children were included in this study, of which 228 (51.8%) were RT-qPCR-confirmed SARS-CoV-2 positive. In the 440 children, colonization rates were highest for H. influenzae (61.4%), followed by S. pneumoniae (17.5%), S. aureus (12.0%), and K. pneumoniae (1.8%). The co-occurrence of both S. pneumoniae and H. influenzae in the upper respiratory tract was significantly associated with a SARS-CoV-2 negative RT-qPCR. In contrast, colonization with only S. aureus was more common in SARS-CoV-2-positive children. CONCLUSION: Overall, this exploratory study concludes that there is a significant difference in the bacterial nasopharyngeal colonization pattern between SARS-CoV-2 positive and negative in asymptomatic children in the community in Indonesia.

The burden and etiology of lower respiratory tract infections in children under five years of age in Indonesia.

INTRODUCTION: Lower respiratory tract infections (LRTI) are a substantial threat for children worldwide. Currently, there is a lack of knowledge about the burden and etiology of LRTI in children under five years of age in Indonesia. METHODOLOGY: We have systematically searched the available English and Indonesian scientific literature to review and summarize data on LRTI and LRTI-associated invasive disease, and bacterial carriage in the upper respiratory tract in children under five years of age in Indonesia. RESULTS: Overall, data on the burden and etiology of LRTI in children under five years of age in Indonesia is very limited. The data are primarily collected in Java. Data from other parts of Indonesia, including Sumatra, Kalimantan, and Sulawesi, are scarce. The case fatality rate (CFR) of LRTI in children under five years of age in Indonesia was 0.11%. Influenza was the most commonly reported viral etiological agent of LRTI in children under five years of age in Indonesia. Klebsiella pneumoniae was the most frequently reported bacterial agent of LRTI. Streptococcus pneumoniae showed the highest carriage rates. CONCLUSIONS: Surveillance and diagnostic studies are urgently needed and should be conducted in different parts of Indonesia to improve insight in the burden and etiology of LRTI in Indonesia. These data are pivotal to increase the effectiveness of public health strategies, including vaccination and prevention of antimicrobial resistance.

Effects of different sterilization methods of herbal formula on phytochemical compounds and antibacterial activity against mastitis-causing bacteria.

BACKGROUND AND AIM: The current phytobiotic industry is struggling to determine a proper sterilization method for an herbal formula that comprises multiple plant extracts. Hence, this study aims to investigate the effects of two sterilization methods of herbal formula on phytochemical compounds and antibacterial activity against mastitis-causing bacterial isolates. MATERIALS AND METHODS: The herbal formula comprised the extracts of Piper betle leaves, Curcuma domestica, and Curcuma zanthorriza. We applied two sterilization methods - sterilization using 0.45 µM syringe filter and sterilization using an autoclave at 121°C for 15 min. After sterilization, we measured phytochemical contents (phenol and flavonoid) of the herbal formula. Using the disk diffusion method, the antibacterial susceptibility test of the sterilized herbal formula against mastitis-causing bacterial isolates was conducted. Tetracycline, erythromycin, and penicillin - common antibiotics for mastitis therapy in dairy farms - were used as standard antibiotics. RESULTS: Compared with autoclave sterilization, syringe filter sterilization resulted in less (p<0.05) phenolic and flavonoid contents. Against Escherichia coli and Staphylococcus aureus, the filter sterilized herbal formula (E. coli: 65.9%-73%; S. aureus: 6.2%-18.1%) markedly reduced the antibacterial activity than the autoclave-sterilized herbal formula (E. coli: 2.1%-3%; S. aureus: 4.5%-10.7%). CONCLUSION: This study establishes that autoclave sterilization of the herbal formula is the best sterilization method that exerts minimal adverse effects on the phytochemical compounds and could sustain the antibacterial efficacy against mastitis-causing bacteria. Hence, the herbal formula could be used as an alternative treatment for bovine mastitis.