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"Latar Belakang Indonesia memiliki insidern kasus TB tertinggi di dunia setelah India dan Cina serta prevalensi kasus DM yang semakin meningkat. Infeksi aktif TB sangat ditentukan oleh status imun. Pada kondisi imunokompromis seperti adanya diabetes melitus akan didapatkan risiko TB yang lebih tinggi. Penelitian ini ingin mendapatkan perbedaan respons IFN-y pada pasien TB dengan DM (TB-DM) dibandingkan dengan pasien TB tidak DM (TB) dan responden sehat.Metodologi Secara potong lintang, pada pasien TB paru kasus baru BTA positif, dilakukan penapisan adanya diabetes melitus dan didapatkan 23 orang pasien TB-DM, dari pasien TB-DM ini, didapatkan kontrol 34 orang pasien TB dan 37 orang responden sehat yang secara umur dan jenis kelamin. Pada seluruh pasien dilakukan pemeriksaan klinis dan laboratoriurn. Untuk mendapatkan respons IFN-y pasien TB-DM, TB, dan responden sehat dilakukan pengambilan darah pagi hari yang kemudian distimulasi secara in vitro dengan M.tuberculosis (MTB) yang mati, lipopolisakarida (LPS) dan phytohaemagglutinin (PHA). Setelah diinkubasi pada 37°C selama 22-24 jam, lalu dilakukan disentrifugasi dan kadar IFN-y diukur dari supernatan yang didapat dengan metode ELISA.Hasil Karakteristik klinis pasien TB-DM dan TB secara proporsi tidak berbeda bermakna. Didapatkan derajat infeksi TB pada pasien dengan DM lebih ringan dibandingkan pasien TB tidak DM. Respons IFN-y setelah stimulasi MTB didapatkan rendah pada pasien TB dibandingkan TB-DM dan responden sehat (secara statistik tidak bermakna), pada stimulasi PHA, sebagai kontrol positif didapatkan respons lebih rendah pada pasien TB-DM dibandingkan pasien TB dan responden sehat (berbeda bermakna antara ketiga kelompok yang diuji, p<4,41).Kesimpulan. Pasien TB-DM memiliki respons IFN-y lebih tinggi dibandingkan pasien TB, hal ini disebabkan oleh perbedaan derajat beratnya infeksi TB pasien DM dan tidak DM.

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Background Indonesia has the highest incidence of tuberculosis (TB) cases after India and China, also the fifth highest prevalence of diabetic cases in the world. Active tuberculosis infection is determined by host immune response, and in immunocompromized condition such as diabetic, the risk of having active TB is high. Our study objective looked on the response of IFN-y between diabetic lung TB patients compare to non diabetic lung TB and healthy controls.

Methodology Among new cases of lung TB patients with positive AFB, we performed screening of diabetes mellitus and included 23 TB-diabetic patients, thirty four lung TB patients and 37 healthy controls matched for age and sex. We perform clinical and laboratories examinations. To identify IFN-y response of diabetic lung TB patients, TB and healthy controls, we drain morning blood and stimulated in vitro with sonicated M. tuberculosis (MTB), lipopolysaccharide (LPS) and phytohaemagglutinin (PHA). After incubation at 37°C for 22-24 hours, we centrifuged and IFN-y response was evaluated from the supernatant with ELISA.

Results Clinical characteristic of TB-diabetic patients and TB patients was similar Severity of TB infections among diabetics were less severe compared to non diabetic. Lung TB patients have the lowest IFN-y response after MTB stimulation compared to diabetic lung TB and healthy controls (not statistically significant). And after PHA stimulation, diabetic lung TB patients have the lowest response compared to other groups (significant between all groups, p < 0.01).

Conclusions Diabetic lung TB patients have higher IFN-y response than non diabetic TB patients, this might due to difference of disease severity among TB infection of diabetics and non diabetic. This difference was statistically not significant and co-morbidity of diabetes mellitus among moderately ill TB patients showed similar response as advance ill TB patients."

"Latar belakang: Obat kotrimoksazol dan rifampisin telah lama diketahui memiliki efek anti mikotik. Peran kedua antimikroba ini terhadap candida belum diteliti, sehingga dirasa perlu untuk diteliti sehingga dapat dimasukkan dalam pedoman tatalaksana medis berbasis bukti untuk pasien HIV dan tuberkulosis.Metode: Studi prospektif pada pasien HIV dan tuberkulosis dengan metode quasi-experiment, dilakukan di poliklinik HIV dan Poliklinik Paru pada bulan Oktober 2009-Agustus 2011. Pada tiap pasien dilakukan pemeriksaan kumur rongga mulut sebanyak dua kali untuk melihat adanya kolonisasi Candida, yang diidentifikasi menggunakan Saboraud Dextrose Agar dan ChromAgar. Kumur dilakukan sebelum pasien diberikan obat kotrimoksazol untuk profilaksis PCP dan obat rifampisin untuk TB, kumur kedua dilakukan dua minggu setelah pengobatan. Proporsi, jenis dan jumlah kolonisasi kandida dirongga mulut pasien dibandingkan sebelum dan setelah pengobatan. Hasil: Didapatkan total 86 orang pasien terdiri dari 40 orang pasien HIV dan 46 orang pasien TB. Kolonisasi awal pada pasien HIV 57,5% dan 19,5% pada pasienTB, sebagian besar adalah candida albicans baik pada pasien HIV maupun TB (82,6% vs. 77,8%). Dua minggu mendapat kotrimoksazol pada pasien HIV dan rifampisin pada pasien TB didapatkan penurunan kolonisasi menjadi 47,5% vs. 12,5%). Penurunan ini bermakna pada kedua kelompok pasien, kotrimoksazol OR 0,2 (0,05-0,93; p<0,04) dan rifampisin 0,21 (0,08-0,58; p<0,01). Didapatkan juga penurunan jumlah hitung koloni secara absolut.Simpulan: Kotrimoksazol dan rifampisin menurunkan kolonisasi Candida rongga mulut pasien HIV dan TB pada pemakaian selama dua minggu

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Background: Cotrimoxazole and rifampicin are known as a broadspectrum antibiotics that have also antimicotic effect. However, limited data is available. This study aimed to provide data on role of these antibiotics to Candida species. Methods: A quasi experimental prospective study among HIV and tuberculosis

patient in HIV and TB clinic, evaluated from Ocotber 2009 and August 2011. Each patient received two times oral rinse, before and within 2-weeks cotrimoxazole treatment for HIV and rifampicin treatment for TB. Proportion, species and number of colonization were compared. Hasil: Of 86 patients, 40 were HIV seropositive patients and 46 were TB patients. HIV-seropositive patients was 57.5% colonized with candida and 19.5% for TB patients; in majority was C.albicans (82.6% vs. 77.8%). During 2-weeks treatment, colonization was decreased to 47.5% among HIV patients received cotrimoxazole and 12.5% in TB patients received rifampicin. The proportion of colonization reduced significantly during cotrimoxazole 0.2 (95%CI 0.05-0.93; p<0.04) and rifampicin 0.21 (95%CI 0.08-0.58; p<0.01). Number of colonization was also reduced. Conclusions: Cotrimoxazole and rifampicin reduced Candida colonization in HIV and TB patients within two weeks exposure."

"ABSTRACTVaccination is the administration of agent-specific, harmless antigenic components to someone that meant to induce protective immunity against the infectious agents. The term vaccination and immunization often use interchangeably. In general, vaccination is a highly effective method of preventing infectious diseases. Routine immunization programmes prove to protect many children in the world and saves millions of live each year. However, different understanding applied to adult, even though adults can be protected from 14 deadly diseases started with lesser losses work or school days due to Rubella, Diphteria, Hepatitis A and HPV infection. Decrease hospitalizations and deaths due to Hepatitis B, Shingles, and Pertussis. Minimize spreading diseases of Mumps, Tetanus, Influenza, Pneumococcal diseases. Avoid permanent disability due to Chicken pox, Measles, and Meningococcal disease. Children under the age of 5 years of age, more than 90% were received vaccines and this was contrast with adult immunization rates. Two possible explanations are adults do not aware their own risk and the nation do not have sustained commitment to vaccination for adults as for children. One of the most deteriorating diseases that could be prevented is varicella zoster virus. In initial, Shingles more common and severe in older persons. In addition to that, the long-term effects of the infection known as post-herpetic neuralgia (PHN), could lasting long and difficult to treat. The recommendation on how delivering herpes zoster vaccine will be discussed further. "

"ABSTRACTHuman immunodeficiency virus (HIV) is one example of an emerging infection with total of 386 district of all province in Indonesia reported having such infection; with cumulative number of HIV infected patient from the year 1987 to 2014 is 150,296 while AIDS is 55,799 patients. The access to care only available for 153,887 patients among all HIV/AIDS patients of whom 70% are eligible for anti-retroviral (ARV) treatment and of these only half adhered to ARV treatment. In addition to that, there is an increased risk of other emerging diseases such as Zika virus, Monkey pox or Hanta pulmonary syndrome since a sporadic cases were reported around the region. Beside new diseases, tuberculosis, dengue virus, malaria and diphteria are continuously reported in Indonesia and classified as re-emerging illnesses. On this edition data on diphteria epidemiology in Indonesia will be shown by Karyanti et al.6 A recent outbreak of diphteria in Indonesia which involved almost all province in the country has led to a response named ORI (outbreak response of Immunization). Regardless of immunization, proper treatment including the distribution of anti-toxin and antibiotics are needed to stop the spread of this particular bacteria, further decreasing the mortality rate. In conclusion, the author of this paper mentioned that immunization gap needs to be handle systematically. Immunization data released on 2017 showed that complete immunization was given only to 20% of targeted group, while almost 75% were either unvaccinated or unknown. During the outbreak of diphteria in Indonesia, the WHO also reported several countries with similar problem such as Bangladesh, Haiti and Yamen. It was shown that a coordination between doctors in clinic/hospital with public health officer to conduct an epidemiological investigation, in conjunction with giving prophylaxis and assuring the logistics of anti-diphteria toxin and antibiotics were accessible were the key of success in eliminating diphteria like it was in Bangladesh.Adherence to treatment are multifactorial for all illnesses. First, is the duration of treatment and the potential adverse event due to the medication. The Ministry of Health of the Republic of Indonesia has support the early diagnosis of HIV and delivering treatment as soon as possible, in order to avoid transmission of the disease. Second, looking at another side of the story for HIV infected patients, receiving ARV treatment as a long life treatment could possibly cause an adverse event somewhere along the line. Budiman et.al reported factors that might contribute to liver injury. His study shows that measuring baseline liver function test AST routinely might minimize the toxicity of ARV to patients particularly with a low body mass index. Last, despite the adherence to treatment and procedures in minimizing the risk of adverse event to medication, we are now facing the primary resistance virus that transmitted in the community as mentioned by Megasari et al.8 on her report regarding the transmission of drug resistance HIV virus to naïve patients in Bali.The Indonesian government through the Indonesian Ministry of Health has established a collaboration and one health approaches to tackle the threat of diseases in the country, particularly in infectious diseases."

"Sebagai negara tropis terbesar ketiga di dunia setelah Brazil dan Kongo, Indonesia dihadapkan pada berbagai masalah kesehatan khususnya di bidang penyakit tropik dan infeksi/ Meskipun terdapat penurunan jumlah kasus tropik infeksi dalam 10 tahun terakhir, namun masalah penyakit tropik infeksi tetap masih membutuhkan perhatian/ Komitmen Indonesia untuk mensejahterakan masyarakat melalui pencapaian target dalam Sustainable Development Goals (SDG) 2030 yaitu mengakhiri epidemi malaria, AIDS, tuberkulosis, hepatitis, penyakit tropis terabaikan dan penyakit infeksi lainnya seperti diare atau demam tifoid masih membutuhkan usaha keras dari semua pihak."