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"Investigate which recent infection could have caused the present dengue-like symptoms, in adult patients clinacally fulfilling the WHO criteria for dengue, in which serologically were not confirmed for dengue virus infections...."

"Latar belakang. Kasus demam berdarah dengue (DBD) masih tinggi di Indonesia dan hingga tahun 2014 mengenai 34 propinsi di Indonesia dengan penderita 71.668 orang. Kasus yang meninggal mencapai 641 orang disebabkan oleh SSD dan perdarahan. Kasus-kasus DBD berat sering dirujuk ke Rumah Sakit rujukan dengan sepsis karena indikator sepsis yaitu Prokalsitonin (PCT) yang tinggi. Tujuan. Untuk mengetahui profil PCT pada infeksi virus dengue pada anak dengan mengukur kadar PCT pada pasien Demam Dengue (DD), DBD, Sindrom syok dengue (SSD), dan SSD dengan koinfeksi.Metode. Penelitian prospektif observasional dengan metode potong lintang, di Rumah Sakit Umum Pusat Fatmawati dan Rumah Sakit Umum Pusat Rujukan Nasional Cipto Mangunkusumo, Jakarta, dari bulan April - Mei 2015. Diagnosis infeksi virus dengue berdasarkan kriteria WHO 2011.Hasil. Didapatkan 34 subjek penelitian. Laki-laki lebih banyak daripada perempuan dengan rasio1,13 : 1. Kelompok usia mempunyai rentang 1 bulan sampai dengan 18 tahun dengan median 10,50 tahun. Diagnosis infeksi virus dengue paling banyak kelompok DBD yaitu DBD 21 subjek, DD 7 subjek, SSD 4 subjek, dan 2 subyek SSD dengan koinfeksi. Kadar PCT 0,5 ng/ml terdapat pada 15 (34) subjek yaitu terdiri dari 2 (7) dengan diagnosis DD, 9 (21) dengan diagnosis DBD, 4 (6) dengan diagnosis SSD.Simpulan. Profil PCT pada infeksi dengue memperlihatkan adanya pola peningkatan nilai PCT sesuai dengan derajat berat manifestasi klinis infeksi virus dengue pada anak. Tampaknya nilai PCT 2ng/ml dapat dipakai sebagai titik potong adanya koinfeksi pada SSD, dengan klinis infeksi yang jelas.

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Background. Dengue haemorrhagic fever (DHF) cases in Indonesia are still very prevalent ; in 2014, 34 provences in Indonesia reported 71.668 cases. Death toll reaches 641 people caused by dengue shock syndrome and bleeding. Severe DHF cases referred to hospital due to indication of sepsis base of high Procalcitonin (PCT) profile.

Objectives. To measure PCT profile in dengue virus infection, in children ; Dengue Fever (DF), DHF, Dengue shock syndrome (DSS), and DSS with cases of coinfection. Methods. The study were conducted in Fatmawati general hospital and Dr Cipto Mangunkusumo general hospital, in conjunction with Cipto mangunkusumo referral centre, Jakarta. Result collected from April to May 2015. Dengue fever diagnosis based on criteria of WHO 2011.

Result. In 34 cases, there are more male cases compare to female by a ratio of 1.13 : 1. In child cases from 1 month years old until 18 years of age with the median of 10 and half years of age. In most common cases found; 21 DHF subject, 7 DF subject, 4 DSS subject, and 2 SSD subject with coinfection. In this cases the level of PCT 0,5 ng/ml in 15 out of 34 subject, which consist of DD 2(7), DHF 9(21), and DSS 4(6). Two SSD subject with coinfection have PCT >2ng/ml.

Conclusion. PCT profile in dengue infections show increased PCT profile in corelation with the severity of dengue fever on children. Procalcitonin 2ng/ml can be used to cut-off coinfection in SSD along with clear clinical infections."

"Latar Belakang: Kebocoran plasma merupakan salah satu penanda dari derajat keparahan penyakit infeksi virus dengue (DENV). Kadar fibrinogen mengalami perubahan seiring dengan terjadinya kebocoran plasma. Tujuan: Mengetahui hubungan kadar fibrinogen pada pasien infeksi DENV dengan derajat keparahan penyakit.Metode: Peneliti menggunakan desain studi kohort dari data sekunder komunitas di Jakarta pada tahun 2010. Jumlah sampel penelitian adalah 43 orang dengan total 38 orang yang memenuhi kriteria inklusi. Kadar fibrinogen yang digunakan yaitu data pada demam hari ketiga dan keempat dari total tujuh hari ke tiga pemeriksaan, karena merupakan perkiraan hari terjadinya kebocoran plasma. Derajat keparahan penyakit infeksi DENV ditentukan berdasarkan klasifikasi WHO 1997 dan dibagi menjadi dua kelompok yaitu Demam Dengue (DD) dan Demam Berdarah Dengue (DBD). Hasil pemeriksaan kadar fibrinogen pada demam hari ketiga dan keempat dianalisis menggunakan Uji T Independen.Hasil: Hasil pemeriksaan demam hari ketiga menunjukkan tidak ada perbedaan bermakna pada kelompok DD dan DBD (p=0,993), namun rata-rata kadar fibrinogen kelompok DBD (253,8 mg/dL) lebih rendah dibandingkan kelompok DD (253,9 mg/dL). Hasil pemeriksaan kadar fibrinogen demam hari keempat juga menunjukkan tidak ada perbedaan bermakna pada kelompok DD dan DBD (p=0,437), namun rata-rata kadar fibrinogen DBD (218,7 mg/dL) lebih rendah dibandingkan DD (235,4 mg/dL).Kesimpulan: Kadar fibrinogen DBD lebih rendah dibandingkan DD namun tidak menunjukkan perbedaan yang bermakna sehingga tidak terdapat hubungan antara kadar fibrinogen dengan derajat keparahan penyakit pada pasien infeksi DENV.

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Background: Plasma leakage is one of the degree of severity disease determinants in patients with dengue virus (DENV) infection. Fibrinogen levels changes due to plasma leakage in DENV infection. Objective: Investigate the association of fibrinogen level and the degree of severity disease in patients with DENV infection in Jakarta, Indonesia. Methods: Author used a cohort study from secondary data on community in Jakarta at the year of 2010. The total sample is 43 persons, of whom 38 persons met the inclusion criteria. Next, author chose the third and fourth days of a total of seven days fever examination of fibrinogen levels because these days are the estimated days of plasma leakage. The severity of DENV infection is determined based on the 1997 WHO Classification which is divided into two group namely Dengue Fever (DF) and Dengue Haemorrhagic Fever (DHF). The results of examination of fibrinogen levels on the third and fourth day of fever were analyzed using the Independent T Test Results: The results in the third day of fever were no significant difference in the DD and DHF groups (p = 0.993), but the fibrinogen levels in the DHF group (253.8 mg/dL) were lower than those in the DF group (253.9 mg/dL). The results of the examination of fibrinogen levels on the fourth day of fever were also analyzed using the Independent T Test, the results were no significant difference in the DF and DHF groups (p = 0.437), but DHF fibrinogen levels (218.7 mg / dL) were lower than DF (235.4 mg / dL). Conclusion: Fibrinogen levels in DHF were lower than DF but did not show a significant difference so there was no association between fibrinogen levels with the severity of the disease in patients with DENV infection.

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"Latar Belakang: Infeksi virus dengue (DENV) dapat menyebabkan manifestasi klinis seperti demam berdarah (DD) dan demam berdarah dengue (DBD). Kedua kelompok tersebut dapat dibedakan melalui terjadinya kebocoran plasma sehingga kebocoran plasma dapat menjadi salah satu penanda dari derajat keparahan penyakit infeksi DENV. Kebocoran plasma ini dapat mempengaruhi kadar elektrolit, seperti kalium, dalam darah.Tujuan: Mengetahui hubungan kadar kalium pada pasien infeksi DENV dengan derajat keparahan penyakit.Metode: Peneliti menggunakan desain studi kohort dari data sekunder komunitas di Jakarta pada tahun 2010. Sampel merupakan populasi usia ≥ 14 tahun dengan riwayat demam ≤ 48 jam, didiagnosis demam dengue berdasarkan klasifikasi WHO 1997, dan memiliki hasil uji NS1 postif. Besar sampel adalah 43 orang dengan total 38 orang yang memenuhi kriteria inklusi. Data kadar kalium yang digunakan yaitu data pada demam hari ke-3 dan ke-4. Hasil pemeriksaan dianalisis menggunakan Uji T Independen.Hasil: Hasil analisis hubungan antara kadar kalium serum hari ke-3 dan hari ke-4 pada kelompok DD dan DBD menunjukkan perbedaan yang tidak bermakna (hari ke-3, p = 0,487) (hari ke-4, p = 0,614).Kesimpulan: Tidak terdapat hubungan antara kadar kalium serum dengan derajat keparahan penyakit pada pasien infeksi DENV.Background: Dengue virus infection (DENV) can cause clinical manifestations such as dengue fever (DF) and dengue hemorrhagic fever (DHF). The two groups can be distinguished by the occurrence of plasma leakage so that plasma leakage can be a marker of the severity of DENV infection. Plasma leakage can affect electrolyte levels, such as potassium, in the blood.Objective: Knowing the association of potassium levels in patients with DENV infection with the disease severity.Methods: Author used a cohort study design from secondary community data in Jakarta in 2010. The sample was a population aged ≥ 14 years with a history of fever ≤ 48 hours, diagnosed with dengue based on WHO 1997 classification, and had positive NS1 test results. The sample size was 43 people with a total of 38 people who met the inclusion criteria. Potassium levels data used are data on the 3rd and 4th day fever. The examination results were analyzed using an Independent T Test.Results: The results of the analysis of the association between serum potassium levels on day 3 and day 4 in the DD and DHF groups showed insignificant difference (day 3, p = 0.487) (day 4, p = 0.614).Conclusion: There is no association between serum potassium levels with the disease severity in patients with DENV infection."

"ABSTRAKLatar belakang. Di Sumatera Barat didapatkan peningkatan kasus infeksi virus dengue. Beberapa kasus juga terjadi pada bayi ≤ 1 tahun. Bayi mempunyai karakteristik klinik yang unik dan tidak banyak penelitian mengenai hal ini di Indonesia.Tujuan. Mengetahui profil klinis, laboratorium dan serologi infeksi virus dengue pada bayi yang di rawat di RSUP Dr. M Djamil Padang dari tahun 2012-2014Metode. Penelitian cross-sectional, menggunakan data rekam medic bayi IVD yang dirawat di RSUP Dr M Djamil Padang dari 1 Januari 2012-31 Desember 2014. Data yang dianalisis mencakup usia, jenis kelamin, hari demam saat diagnosis, suhu, demam, batuk, diare, muntah, kejang, hematemesis, melena, syok, ptekie, and hepatomegali.Hasil. 12 bayi digunakan sebagai sampel. Usia termuda bayi DBD adalah 3 bulan, dengan usia terbanyak 5 bulan (5 bayi). Muntah merupakan gejala tambahan yang paling banyak ditemukan (9 dari 12 bayi), diikuti oleh ptekie dan syok (masing-masing 6 bayi), serta batuk (5 bayi). 8 dari 12 bayi menunjukkan infeksi primerKesimpulan. Rerata usia dan kelompok usia terbanyak setara dengan penelitian sebelumnya.

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ABSTRACTBackground. In West Sumatera, cases of dengue virus infection is increasing. Some occur in infants below 1 year old. Babies has unique clinical characteristic and only few researchs take place on this subject in Indonesia.Objection. Describing the clinical, laboratory, and serology profile of dengue virus infection in infants taken care at Dr. M Djamil Hospital in Padang, West Sumatera from 2012 to 2014.Methods. This is a cross-sectional study based on medical record data on baby who were treated in Dr M Djamil Padang from January 1st, 2012 to December 31st, 2014. The data analyzed were age, gender, fever duration at diagnosis, body temperature, fever, cough, diarrhea, vomit, seizure, hematemesis, melena, shock, ptekie, and hepatomegaly.Results. 12 babies were collected as sample. Youngest baby had DHF was 3 months old, while the oldest was 5 months old (5 infants). Vomit is the additional symptom most commonly found (9 of 12 infants), followed by ptekie and shock (6 babies each), and cough (5 infants). Eight of 12 infants showed primary infection.Conclusion. The mean for age and mode for age group were similar to previous studies"

"Latar Belakang: Kebocoran plasma merupakan penanda derajat keparahan penyakit infeksi virus dengue. Kadar natrium menurun seiring dengan terjadinya kebocoran plasma.Tujuan: Mengetahui hubungan natrium pada pasien infeksi DENV dengan derajat keparahan penyakit.Metode: Jumlah sampel pada penelitian ini sebesar 43 pasien. Sebanyak lima pasien di eksklusi sehingga 38 sampel yang dapat digunakan pada penelitian ini. Sampel berasal dari data sekunder pasien infeksi DENV pada komunitas di Jakarta. Kadar natrium diambil pada hari ketiga dan keempat demam pada pasien, karena kebocoran plasma yang signifikan terjadi pada hari tersebut sebagai awal fase kritis pasien. Penegakan derajat infeksi DENV menggunakan klasifikasi WHO tahun 1997 yang terbagi atas Undifferentiated fever, DD, dan DBD. Namun, pada penelitian ini kelompok infeksi DENV yang diteliti terbagi atas DD dan DBD. Kadar natrium dan derajat keparahan penyakit akan dianalisis menggunakan uji nonparametrik yaitu Uji Mann-Whitney.Hasil: Nilai median kadar natrium hari ketiga demam pada kelompok pasien DBD (132 mEq/L) lebih rendah dibandingkan kelompok pasien DD (135 mEq/L). Secara statistik tidak ada perbedaan bermakna kadar natrium pada pasien DD dan DBD di hari ketiga demam (p=0,057). Hasil yang sama didapatkan pada hari keempat demam yaitu nilai median kadar natrium kelompok pasien DBD (133 mEq/L) lebih kecil dibandingkan kelompok pasien DD (136 mEq/L). Namun, secara statistik terdapat perbedaan bermakna pada kelompok DD dan DBD (p 0,011).Kesimpulan: Kadar natrium mengalami penurunan pada kelompok pasien DBD dibandingkan dengan DD yaang signifikan pada hari keempat demam tetapi tidak bermakna pada hari ketiga. Sehingga terdapat hubungan antara kadar natrium dengan derajat keparahan penyakit pasien infeksi virus dengue.

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Background: Plasma leakage is used to determine the severity of dengue virus infection. Natrium level decreases along with plasma leakage.

Objective: To understand the association of Natrium level in patients with DENV infection to the degree of disease severity.

Methods This study used 43 samples. Five patients excluded, there are 38 samples remained in this study. Samples derived from secondary data of patients with DENV infection in the community in Jakarta. Natrium level had taken at the third and fourth days of fever, due to a significant plasma leakage that occurred as the beginning of a critical phase of the patient. Enforcement degree of DENV infection using the 1997 WHO classification, divided into an undifferentiated fever, Dengue Fever (DF), and Dengue Haemmorrhagic Fever (DHF). However, this study examined groups of DENV infection that divided into DF and DHF. Natrium Level and the degree of disease severity will be analyzed using a nonparametric test, the Mann-Whitney test.

Results: The median value of the natrium level on the third day of fever in the DHF patient group is (132 mEq/L) lower than the DF patient group (135 mEq/L). There is no statistically significant difference in natrium levels in DF and DHF patients on the third day of fever (p = 0,057). The same results obtained on the fourth day of fever is the median value of the natrium DHF group (133 mEq/L) is smaller than the group of DF (136 mEq/L). However, there is a significant difference between the DF and DHF group (p 0,011).

Conclusion: Natrium levels decreased in the DHF patient group compared to the DF group which indicate significance on the fourth day of the Fever, but not on the third day. So, there is a association between Natrium Level and the degree of Disease Severity in Patients with Dengue Virus Infection in Jakarta, Indonesia."

"BackgroundProdromal factors of Guillain-Barre syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS.Case ReportWe report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM ami HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period.DiscussionThe incidence of HAV in GBS patients during 5 years of observation was 2%. This corresponds with the case reported by Verona et al, 1996 and Pelletier et al, 1985, i.e. the presence of peripheral neuropathy (n. facialis and n. occulomotorius). Possible alternative pathways for hepatitis virus complicating as GBS are perivascular and endometrial peripheral nerve infiltration by mononuclear cells, T cell sensitization, stimulation of IL-2 growth factor surface receptor, and B cell stimulation. All of the conditions mentioned above causes necrotizing arteritis, vascular occlusion, and at the end, segmental demyelinization. Hepatitis virus may replicate in the central nervous system or peripheral nervous system, subsequently developing into multiple neuropathy disorder and poly arteritis.ConclusionThe diagnoses of HAV and GBS in both cases were established. HAV is one of several viruses that may trigger GBS. In both cases, HAV infection was sub-clinical and sporadic. Symptoms of hepatitis infection subsided along with improvements in the patient's neurological status. Acute viral hepatitis has a wide clinical spectrum and laboratory manifestation that is in accordance with the severity, varying from unclear symptom (anicteric) to jaundice. Acute hepatitis A, B, C infections have the same symptoms in general. However, hepatitis B and C tend to be more severe. The mildest symptoms are transaminase enzyme level increment, no jaundice, gastrointestinal symptoms, flu-like symptoms, and sometimes it can not be diagnosed. The more severe symptoms are jaundice with obvious generalized symptoms.' The incidence of hepatitis A is difficult to be determined accurately because of its characters, i.e. sporadic, endemic, and has a high rate of asymptomatic infection.23-4"

"ABSTRAKLatar Belakang : Demam berdarah dengue (DBD) dicirikan dengan terdapatnya kebocoran plasma yang signifikan. Sejauh ini metode yang tersedia untuk menilai kondisi tersebut dengan pemeriksaan serial hematokrit, USG, dan kadar albumin darah, yang pada kenyataannya masih sulit untuk menilai kebocoran plasma secara dini. Kebocoran plasma yang terjadi sejak fase awal dapat menimbulkan gangguan mikrosirkulasi, hipoperfusi jaringan, dan berakibat asidosis yang ditandai dengan penurunan kadar bikarbonat (HCO3-) dan base excess (BE) darah.Tujuan : Mengevaluasi peran bikarbonat dan base excess vena sebagai prediktor dan deteksi terjadinya kebocoran plasma pada pasien DBD saat akhir fase akut dan fase kritis.Metode : Penelitian ini menggunakan desain kohort retrospektif untuk menilai perbedaan rerata kadar bikarbonat dan BE vena pada pasien DBD dan DD (demam dengue) pada akhir fase akut dan fase kritis. Data yang diolah berdasarkan data rekam medis dan data penelitian sebelumnya pada pasien yang dirawat dengan diagnosis demam dengue (DD) dan demam berdarah dengue (DBD) di bangsal Penyakit Dalam RSUP Persahabatan dan RSUPN Cipto Mangunkusumo dari Maret 2014 sampai April 2015.Hasil : Dari 66 sampel, proporsi pasien pria lebih banyak yang dengan diagnosis DBD (59,4%), dengan kelompok usia 21-30 tahun merupakan yang terbanyak (p > 0,05). Rerata kadar BE lebih rendah pada pasien DBD dibandingkan DD pada hari ke-3 (p 0,014) dan hari ke-5 (p 0,005). Rerata bikarbonat juga diperoleh lebih rendah pada kelompok DBD dibandingkan DD pada hari ke-3 (p 0,004) dan hari ke-5 (p 0,003).Simpulan : Rerata bikarbonat dan base excess vena lebih rendah pada pasien DBD dibandingkan DD pada akhir fase akut dan fase kritis dan dapat membantu untuk memprediksi dan mendeteksi terjadinya kebocoran plasma pada dengue.

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ABSTRACTBackground: Dengue infection tends to cause plasma leakage. Serial hematocrit, USG, and serum albumin are methods used for monitoring dengue infection. Yet, those methods are still lack in detecting early plasma leakage. It is important to determine plasma leakage, thus early management and monitoring could be conducted before severe stage. Plasma leakage occurs at acute phase of infection and causes microcirculation disturbance, tissue hypoperfusion, and acidosis based on reduction of bicarbonate and base excess.Objective: To evaluate the role of vein bicarbonate and base excess in predicting and detecting plasma leakage in adult patients with dengue infection during end stage of acute phase and critical phase.Methods: It is a cohort retrospective study to evaluate the mean difference of vein bicarbonate and base excess during the end stage of acute phase and critical phase, between dengue hemorrhagic fever (DHF) and dengue fever (DF) groups. The data being used, derived from medical record and previous study of hospitalized patients diagnosed with DF and DHF in Internal Medicine Ward RSUP Persahabatan and RSUPN Cipto Mangunkusumo from March 2014 until April 2015.Results: From 66 samples, there was higher number of male patients with DHF (59.4 %) and most of them was in age group 21-30 years (p > 0.05). In DHF group, mean of hematocrit was higher compared to DF group at the end of prodromal phase (p 0.059), then tended to reduce at acute phase (p 0.308). Mean of thrombocyte ( p < 0.05) in DHF group were lower at the end of prodromal phase and critical phase than in DF group. Most of the serotype found was DENV2 (30.3 %). Mean of BE on the 3rd day (p 0.014) and 5th day (p 0.005) of fever was lower in DHF group than DF group. Mean of bicarbonate on the 3rd day (p 0.004) and 5th day (p 0.003) of fever was also lower in DHF vs DF groups.Conclusion: Mean of vein bicarbonate and base excess was lower in DHF group compared to DF group at the end of prodromal phase and critical phase. Moreover, bicarbonate and base excess can be used for predicting and detecting plasma leakage in dengue infection."

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Indonesia adalah negara tropis dengan transmisi infeksi DENV yang tinggi dan sebuah ancaman kesehatan di dunia tanpa terapi spesifik yang dapat bekerja secara tunggal. Rakyat Indonesia memiliki kepercayaan tinggi atas obat herbal, salah satunya yang berasal dari Kunyit dengan senyawa utama, Kurkumin dengan efek antioksidan, pencegah kanker dan anti-inflamasi yang sudah terbukti melalui uji in vivo dan in vitro. Beberapa penelitian membuktikan bahwa kurkumin bekerja sebagai antivirus DENV-2 namun mekanisme yaitu waktu dimana kurkumin bekerja paling efektif, belum diketahui. Penelitian ini dilakukan secara in vitro dengan Sel Vero yang diinfeksikan DENV-2. Fokus pada penelitian ini adalah membandingkan mekanisme penghambatan replikasi DENV-2 sekaligus persentase viabilitas sel pada pre-post (whole) dan post infeksi setelah diberikan Kurkumin dengan dosis 20 ug/mL. Infektivitas hambatan dan viabilitas sel diteliti melalui metode focus assay dan MTT assay. Berdasarkan penelitian yang dilakukan, hasil penghambatan inefektivitas pada mekanisme pre-post (whole) dan post infeksi adalah 99,74% ± 3,90 dan 51,31% ± 8,97 secara berurutan. Penelitian untuk viabilitas sel mendapatkan hasil 73,21% dan 81,66% untuk pre-post (whole) dan post infeksi secara berurutan. Hasil penelitian menunjukan kurkumin memiliki efektivitas dalam mengambat DENV-2 lebih tinggi pada mekanisme pre-post infeksi (whole), dengan persentase penghambatan lebih tinggi serta toksitas rendah dengan viabilitas diatas 50%.

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In Indonesia, DENV infection remains a global health threat without an effective therapy available. One of Indonesian’s herbal medicine, turmeric with Curcumin as its main compound is believed to have antioxidant, cancer-preventing and anti-inflammatory effects through in vivo and in vitro trials. Previous studies have shown that curcumin act as DENV-2 antivirus. However, its mechanism, namely the time at which curcumin work effectively, is not known. This research was conducted using DENV-2 infected Vero cells through in vitro method. The focus of this study was to compare the mechanism of DENV-2 replication inhibition as well as the viability of Cell in the pre-post (whole) and post-infection phases after administrating curcumin with a dose of 20 ug/mL. Focus assay and MTT assay methods were used in the experiment. Based on the research conducted, the results of ineffectiveness inhibition on the pre-post and post infection mechanisms were 99.74% ± 3.90 and 51.31% ± 8.97, respectively. The results for cell viability showed 73.21% and 81.66% for the pre-post (whole) and post-infection mechanisms, respectively. The results showed that curcumin is more effective in inhibiting DENV-2 in the pre-post infection mechanism (whole), with a higher percentage of inhibition and less toxicity with viability above 50%.

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"Virus dengue merupakan virus kelas Flaviviridae yang ditularkan melalui gigitan nyamuk Aedes aegypti yang sebelumnya telah terinfeksi oleh virus dengue. Diagnostik dini dilakukan dalam upaya menekan penyebaran virus ini agar pasien yang terinfeksi bisa ditangani lebih cepat. NS1 merupakan protein yang terdapat pada virus dengue dapat ditemukan di darah pasien satu hari setelah gejala infeksi primer maupun sekunder. Hal ini menjadikan NS1 penanda biologis serta target nanobodi yang tepat dalam diagnosis infeksi virus dengue. Nanobodi yang mengenali antigen NS1 pada DENV menjadi potensi alat uji diagnostik dengue karena sifatnya yang lebih unggul daripada antibodi konvensional. Penelitian ini berfokus pada pembuatan prototipe tes diagnostik cepat berbasis uji aliran lateral untuk mendeteksi NS1 pada virus dengue menggunakan nanobodi anti-NS1. Pada penelitian ini, nanobodi anti-NS1 klon DD7 dan DD5 diekspresikan pada E. coli BL21(DE3). Dalam pembuatan prototipe, dilakukan optimasi formulasi konjugasi antara nanopartkel emas dengan nanobodi anti-NS1. Sebanyak tiga optimasi dilakukan dalam mendapatkan konjugasi nanopartikel emas dengan nanobodi yang optimal, yaitu optimasi pH buffer, konsentrasi nanobodi, dan diameter nanopartikel emas. pH buffer optimal untuk klon DD5 dan DD7 adalah buffer borat pH 9, konsentrasi nanobodi optimal untuk klon DD5 dan DD7 adalah 10 ng, dan diameter optimal nanopartikel emas untuk klon DD5 dan DD7 adalah 40 nm. Pada pembuatan prototipe, konjugasi antara nanopartikel emas dan nanobodi klon DD5 belum berhasil mendeteksi antigen yaitu berupa virus dengue pada bagian test line prototipe dan untuk konjugasi antara nanopartikel emas untuk klon DD7 menghasilkan reaksi false positive pada prototipe.

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Dengue virus is a class of Flaviviridae virus transmitted through the bite of Aedes aegypti mosquitoes that have previously been infected by the dengue virus. Early diagnostics are carried out in an effort to suppress the spread of this virus so that infected patients can be treated faster. NS1 is a protein found in the dengue virus that can be found in the patient's blood one day after symptoms of primary or secondary infection.This makes NS1 a biosensor as well as a precise target for nanobodies in the diagnosis of dengue virus infection. Nanobodies that recognize NS1 antigens in DENV are potential dengue diagnostic test kits because they are superior to conventional antibodies. This research focuses on making rapid diagnostic tests based on lateral flow assay to detect NS1 in dengue viruses using anti-NS1 nanobodies as an alternative diagnostic test on dengue virus. In this study, anti-NS1 nanobodies of DD7 and DD5 clones were expressed in E. coli BL21(DE3). In making prototypes, optimization of conjugate formulations between gold nanoparticles and anti-NS1 nanobodies was carried out. A total of three optimizations were carried out in obtaining the conjugation of gold nanoparticles with optimal nanobodies, namely optimization of buffer pH, nanobody concentration, and diameter of gold nanoparticles. The optimal buffer pH for DD5 and DD7 clones is pH 9 borate buffer, the optimal nanobody concentration for DD5 and DD7 clones is 10 ng, and the optimal diameter of gold nanoparticles for DD5 and DD7 clones is 40 nm. In making the prototype, the conjugation between gold nanoparticles and DD5 clone nanobodies has not succeeded in detecting antigens in the form of dengue virus in the prototype test line and for conjugation between gold nanoparticles for DD7 clones resulting in false positive reactions in the prototype."