MATERIALS AND METHODS: A single-centre, prospective, casecontrol study involving 32 subjects of preterm neonates was conducted at a tertiary care hospital in Malang, East Java, Indonesia between January to June 2022. A total of 15 preterm neonates with NEC and 17 preterm neonates without NEC were enrolled in this study. Data on demographic, clinical and laboratory findings were collected. Multiple logistic regression test was performed to analyse the risk factors for NEC development. Further profiling within 15 subjects with NEC, i.e., NEC grade ≥ II, were conducted to collect systemic, abdominal, laboratory, abdominal x-ray (AXR) and blood culture findings.
RESULTS: The risk factors related to NEC development in preterm infants were multi-morbidity (adjusted OR = 11.96; 95% CI 1.85 168.38; p = 0.046), antibiotic exposure (OR = 15.95; 95% CI 1.54 165.08; p = 0.020) and requiring advanced neonatal resuscitation at birth (OR = 10.04; 95% CI 1.09 92.11; p = 0.041). Further profiling within NEC cohorts highlighted respiratory distress (86.7%), (oro)gastric retention (80.0%), thrombocytopenia (53.3%), gastrointestinal dilatation in AXR (53.3%), and positive blood culture Klebsiella pneumoniae (40.0%) were most common findings.
CONCLUSION: Preterm neonates with multimorbidity, prolonged antibiotic exposure, and requiring advanced resuscitation at birth were more likely to develop NEC. Early detection of the risk factors and determinant factors for survival may help to improve the clinical outcome.
AIMS: This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia.
METHODS: 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory.
RESULTS: Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment.
CONCLUSIONS: Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.
AIMS OF THE STUDY: This study had three aims: (i) to assess the global trade in H. isora fruits; (ii) to study the H. isora trade from West Timor to Java in terms of actors and prices along the value chain and (iii) to get a better understanding of the potential of this species to improve household income in eastern Indonesia.
MATERIALS AND METHODS: This study uses historical records, a contemporary analysis of global trade data (2014-2016) and field assessments of value chains and the biological factors influencing H. isora fruit production.
RESULTS: Globally, the major exporter of H. isora fruits is India, which exports H. isora fruits to 19 countries, far beyond the natural geographical distribution of this species. Over a 36-month period (January 2014-December 2016), India exported 392 t of H. isora fruits, with a Free-On-Board (FOB) value of Indian rupiah (INR) 18,337,000 (US$ 274,055). This represents an average annual export quantity of about 130,526 kg/year. Over this three year period, most of these exports (85.5%) were to Indonesia (346.58 t), followed by Thailand (6.85%). Indian H. isora exports are also used in many other medical systems, including Kurdish and Zulu "traditional" medicines in Iraq and South Africa. Formation of an Indian diaspora in Bahrain, Mauritius, South Africa, Tanzania and Trinidad and Tobago over the past 130 years is one of the drivers of H. isora fruit trade outside the natural geographic distribution of the species. In Indonesia, demand for H. isora fruits is supplemented by an intra-island trade in Java and an inter-island trade from East Nusa Tenggara. West Timor, for example, exports around 31-37 t of air-dried H. isora fruits per year to Java. At the farm gate, local harvesters in West Timor get 4000 IDR (c. 0.3 US$) per kg, with businesses in Java paying 25,000 IDR (c.US$2) per kg for H. isora fruits. This is similar to the price paid for H. isora fruits imported from India to Java.
CONCLUSIONS: India is the major exporter of whole dried H. isora fruits, including to countries where this species has never been in traditional use. In Indonesia, H. isora fruit extracts are used in the cosmetic industry as well as in jamu herbal medicines, including "Tolak Angin", the country's most popular commercial "jamu" preparation. Indonesia also is the major importer of H. isora fruits from India. In eastern Indonesia, improved income to local villagers from the H. isora fruit trade could come from improved H. isora fruit quality due to better drying techniques. This would also reduce health risks along the supply chain from to mycotoxins that have been recorded on poorly dried H. isora fruits. There also is an opportunity for cultivation of H. isora in small-holder teak plantations in Indonesia, with harvest of H. isora fruits as well as the medicinal bark.
AIM: The purpose of this study was to determine the relationship between Soil Transmitted Helminth infection on levels of eosinophils among primary school children. In addition, this study also aimed to determine the prevalence of different types of worm infections and the levels of eosinophils in children infected with worms.
MATERIAL AND METHODS: This study was analytic observational using a cross-sectional method. The sampling technique was consecutive and in total 132 samples was obtained. The study involved primary school children in Amplas Medan and Hamparan Perak, Deli Serdang through May to October 2016. Univariate analysis was performed to determine STH infection prevalence and bivariate analysis was used to find the correlation between STH infection and eosinophil levels through a Chi square (χ2) test.
RESULTS: The results showed that the prevalence of Soil Transmitted Helminth was 7.6%. The most common types of STH infection were 3.8% with Trichuris trichiura and 3% with Ascaris lumbricoides. A significant correlation was found between Parasite infection and eosinophil levels (Contingency Coefficient (C) = 0.2, χ2 = 5.3, p = 0.021) and the risk of STH infection that caused eosinophilia or increased eosinophil levels in the children with a Prevalence Ratio (PR) of 1.56 (Confidence Interval (CI) 95%: 1.10-2.22).
CONCLUSION: It is recommended that schools at similar risk improve and maintain hygiene and healthy behaviour in the school environment and that parents and teachers pay greater attention to the cleanliness of their children.