Identifying Adult Population at Risk for Undiagnosed Diabetes Mellitus in Medan City, Indonesia Targeted on Diabetes Prevention.

Background: Diabetes mellitus is a health problem in Indonesia, where its prevalence rises annually. The condition may negatively impact one's quality of life and lead to significant complications-over 50% of patients with type 2 diabetes mellitus, the most common diabetes type worldwide. To implement diabetic prevention interventions and achieve effective diabetes mellitus control, screening for undiagnosed diabetes mellitus in high-risk populations is essential. Objective: This study aimed to identify people at risk for undiagnosed diabetes mellitus using the Finnish Diabetes Risk Score (FINDRISC) and oral glucose tolerance test (OGTT). Methods: This cross-sectional study was carried out, which involved 300 people in Medan City between the ages of 30-75. The study was conducted between July 14 and October 20, 2020. The Finnish Diabetes Risk Score and anthropometric measurements (weight, height, and waist circumference) were used to evaluate each respondent. Low, medium, and high-risk outcome categories were created. All responders underwent oral glucose tolerance tests, with results classified as normal, prediabetes, or diabetes. The Chi-square test was used to examine the data and identify potential risk variables for diabetes mellitus. Results: Of 300 individuals, 91.7% were female, and 8.3% were male. 33.7% of participants had a low risk of acquiring diabetes, 55.0% had an intermediate risk, and 11.3% had a high risk. 70% of participants who took an oral glucose tolerance test had blood glucose levels that were normal (less than 100 mg/dl), 18.7% had blood glucose levels suggestive of prediabetes (between 100 and 125 mg/dl), and 11.3% had blood glucose levels suggestive of diabetes (126 mg/dl or higher). Ages 54 to 64 years and older, high body mass index and central obesity, a lack of vegetables and fruits in the daily diet, inactivity, uncontrolled hypertension, a history of hyperglycemia, and a family history of diabetes were all linked to a significant increase in the risk of developing diabetes. Most respondents at low risk of developing type 2 diabetes had normal blood sugar levels, while those at high risk of developing type 2 diabetes had high blood glucose levels (p = 0.005). Conclusion: Oral glucose tolerance testing and the FINDRISC questionnaire may be used to identify individuals who are at high risk for developing diabetes and to encourage them to adopt healthy behaviours.

The trend of paediatric cases during the first year of the COVID-19 pandemic in North Sumatra, Indonesia.

Objective: The aim of the study was to describe the epidemiology of coronavirus disease 2019 (COVID-19) cases in children in North Sumatra Province during the period June 2020 to July 2021. Methods: This study included samples from children in North Sumatra Province aged 0-17 years, suspected to have COVID-19. A case of COVID-19 was confirmed by RT-PCR in the Microbiology Laboratory, Faculty of Medicine, Universitas Sumatera Utara, Indonesia. Data were collected from June 2020 to July 2021. Demographic data including age, sex, and date of diagnosis were collected. A descriptive statistical analysis was performed, and ratios or percentages were compared. Results: A total of 117 650 people were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and 2222 (1.9%) children were positive. The age group 6-11 years had the highest proportion of cases with 679/2222 cases (30.6%). Overall, the number of positive COVID-19 cases peaked in July 2021, with 650 cases and a positivity rate of 3.0%. In 2020, the greatest proportion of cases occurred in the age group of 12-14 years; however, this changed to the age group 6-11 years in 2021. Conclusions: COVID-19 was detected in all paediatric age groups in North Sumatra during the study period. Incidence peaks occurred due to mass gatherings, public holidays, and the introduction of a new variant in Indonesia. Children accounted for a much higher proportion of SARS-CoV-2 infection compared to those reported in other studies and could have played a role as the source of transmission in society.

SARS-CoV-2 lineages circulating during the first wave of the pandemic in North Sumatra, Indonesia.

Objectives: To determine the lineage distribution of the virus during the first wave of the pandemic in North Sumatra, Indonesia. Methods: A total of 20 samples with positive results based on reverse transcription-polymerase chain reaction were selected for virus culture and then performed whole-genome sequence analysis using next-generation sequencing which was applied by the Illumina MiSeq instrument. Results: Whole-genome sequence analysis revealed that the majority of our samples belong to lineages B.1.468 (n = 10), B.1 (n = 5), B.1.1 (n = 2), B.1.1.398 (n = 2), and B.6 (n = 1). Other unique amino acid mutations found in our samples were present in A58T on non-structural protein (NSP3) (70%), P323L on NSP12 (95%), Q57H on NS3 protein (75%), and D614G on S (100%). Conclusion: The SARS-CoV-2 lineage B.1.468 may be the main virus variant circulating in North Sumatra at the beginning of the emergence of COVID-19 cases in this province.

Use of saliva as an alternative diagnostic method for diagnosis of COVID-19.

Background: Mass population testing has been recommended to contain the spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. However, the use of nasopharyngeal swab specimens has caused many logistic challenges. This study investigated the sensitivity and specificity of saliva as a non-invasively-obtained specimen for molecular detection of SARS-CoV-2 RNA. Methods: In total, 153 patients with confirmed coronavirus disease 2019 (COVID-19) who had been admitted to the regional referral hospital or who self-isolated at home were included in this study. Nasopharyngeal swab specimens and saliva samples were collected on the same day, and were tested for SARS-CoV-2 infection using reverse transcriptase polymerase chain reaction. Results: The sensitivity and specificity of saliva samples were 81.5% and 76.4%, respectively, in cases that had been confirmed as COVID-19 using nasopharyngeal swab samples. Positive predictive values and negative predictive values were 92.3% and 54.1%, respectively. The highest detection rates were found among samples collected 4-7 days since symptom onset. Conclusion: Saliva samples showed comparable performance to nasopharyngeal swab specimens for the diagnosis of COVID-19 in adults. The performance of saliva as a diagnostic specimen for COVID-19 testing is particularly significant during the first week of symptoms.

Open Clinical Trial of Sambiloto (Andrographis paniculata) Ethanolic Extract Capsules in Treatment of Malaria Patients in Batubara District, Indonesia.

Introduction: Malaria infection is still a public health problem in Indonesia. One of the problems in combating malaria in Indonesia is the limited kind of antimalarial drugs provided by the government. Sambiloto (Andrographis paniculata) extract has been shown to have antimalarial activity in human clinical trials. Aim: To assess the ability of a single A. paniculata ethanolic extract capsule to treat malaria in humans caused by Plasmodium falciparum or P. vivax alone or mixed infections of both. Methods: An open clinical trial was conducted in Batubara District, Sumatra Utara Province, Indonesia, a malaria-endemic area. Sixty-nine malaria patients found in the field were diagnosed microscopically as malaria vivax, malaria falciparum, and mixed infections uncomplicated malaria with 12 years old and above. Previously all patients signed informed consent. All patients have been treated with A. paniculata ethanolic extract capsules 250 mg thrice a day for five days. Parasite density was calculated from D0, D1, D2, D3, D7, D14, and D28. Results: The efficacy of A . paniculata ethanolic extract capsules 250 mg thrice a day for five days against malaria vivax, malaria falciparum, and mixed malaria patients was 94.2%. There are no side effects were found during treatment. Conclusion: A. paniculata ethanolic extract can be used as an alternative antimalarial candidate derived from native Indonesian medicinal plants or as an adjunct in standard treatment for malaria.