Arief Mulyono
Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit Salatiga

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PENGUATAN KEBIJAKAN ONE HEALTH DAN JEJARING LABORATORIUM DALAM DETEKSI DINI LEPTOSPIROSIS DI INDONESIA Handayani, Farida Dwi; Pratamawati, Diana Andriyani; Widjajanti, Wening; Muhidin, Muhidin; Yuliadi, Bernadus; Safitri, Aprilia; Hidayati, Nur; Mulyono, Arief; Ristiyanto, Ristiyanto
Buletin Penelitian Kesehatan Vol 47 No 4 (2019)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (687.584 KB) | DOI: 10.22435/bpk.v47i4.1928

Abstract

Abstract International Leptospirosis Society stated Indonesia as a country with high leptospirosis incidence and ranked third in the world for mortality. Rikhus Vektora, in 2015 - 2017 in 25 provinces in Indonesia, showed that positive leptospirosis rats were found in all regions. However, Health Service Providers (PPK) both at the basic and advanced levels stated that they were unable to carry out a diagnosis of leptospirosis cases. Meanwhile, the data also showed that in the provinces where no leptospirosis cases reported, there were Leptospira bacteria found in captured rats both in settlements and remote areas. This condition causes leptospirosis like the phenomenon of the iceberg that is seen as no cases while the facts in the field of many people infected with late treatment. One Health approach in cross-sector leptospirosis data integration from a related department is needed in determining priorities for the prevention of leptospirosis. It is necessary to establish a laboratory network to obtain faster information regarding the enforcement of the diagnosis of leptospirosis cases. The proposed policy recommendations are the discovery of leptospirosis cases with capacity building for doctors and health workers through clinical lectures, cross-sector joint surveillance, and strengthening of laboratory networks for early enforcement of leptospirosis diagnose. Keywords: leptospirosis, one-health, laboratory, early detection, Indonesia Abstrak International Leptospirosis Society menyatakan Indonesia sebagai negara dengan insidens leptospirosis tinggi dan peringkat ketiga dunia untuk mortalitas. Hasil Riset Khusus Vektor dan Reservoir Penyakit (Rikhus Vektora) pada tahun 2015 - 2017 di 25 provinsi di Indonesia menunjukkan bahwa di setiap provinsi ditemukan persentase tikus positif bakteri Leptospira. Namun, penyedia Pelayanan Kesehatan (PPK) baik yang ada di tingkat dasar maupun lanjutan menyatakan belum mampu untuk melakukan penegakkan diagnosa kasus leptospirosis. Sementara itu, data juga menunjukkan bahwa pada beberapa provinsi yang menyatakan tidak ada kasus leptospirosis ditemukan adanya bakteri Leptospira pada tikus yang ditangkap baik pada ekosistem yang dekat dengan pemukiman maupun yang jauh dari pemukiman. Kondisi ini menyebabkan leptospirosis seperti fenomena gunung es yaitu terlihat tidak ada kasus sementara fakta di lapangan banyak orang terjangkit yang terlambat diobati. Pendekatan ?One Health? dalam integrasi data leptospirosis lintas sektor (Dinas Kesehatan, Dinas Peternakan, Dinas Pertanian) diperlukan dalam penentuan prioritas penanggulangan leptospirosis. Selain itu, perlu dibuat jejaring laboratorium agar didapatkan informasi lebih cepat terkait penegakan diagnosis kasus leptospirosis. Rekomendasi kebijakan yang diusulkan adalah penemuan kasus leptospirosis dengan capacity building dokter dan tenaga kesehatan dengan cara ceramah klinis, surveilans bersama lintas sektor dan penguatan jejaring laboratorium untuk penegakan dini diganosa leptospirosis. Kata kunci: leptospirosis, one-health, laboratorium, deteksi dini, Indonesia
LEPTOSPIROSIS CASE FINDING FOR DEVELOPMENT OF LEPTOSPIROSIS SURVEILLANCE IN SEMARANG CITY, CENTRAL JAVA, INDONESIA Ristiyanto, Ristiyanto; Handayani, Farida Dwi; Mulyono, Arief; Joharina, Arum Sih; Wibawa, Tri; Budiharta, Setyawan; Budiharta, Setyawan; Supargiono, Supargiono
Vektora : Jurnal Vektor dan Reservoir Penyakit Vol 10 No 2 (2018): Vektora : Jurnal vektor dan reservoir penyakit
Publisher : Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit (B2P2VRP) Salatiga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (453.719 KB) | DOI: 10.22435/vk.v10i2.284

Abstract

Leptospirosis is primarily a disease of wild and domestic animals, and may be transmitted to humans through direct or indirect contact with infected animal urine. Leptospirosis is endemic in part of Indonesia territory. This work aimed to find the leptospirosis cases in Semarang city, one of the endemic leptospirosis in Indonesia by active and passive case finding. The leptospirosis were screened in the community base active case finding and passive case finding in primary health care center and hospitals, by using modified WHO-SEARO criteria and laboratory confirmation test. There were 191 cases detected with modified WHO-SEARO criteria, and among those cases only 31 cases confirmed by laboratory test, either by using Rapid Detection Test (RDT), Microscopic Agglutinations Test (MAT) or Polymerase chained reaction (PCR). It was found that leptospirosis was not correlated with rainfall season. Fever, headache and myalgia were the most common symptoms experienced by >90% patients. Active case finding add no more than 7% probable leptospirosis and 14% confirmed cases to the traditional passive case finding.  It was conclude that leptospirosis case finding is still challenging in the endemic area, such as Semarang city. The application of modified WHO-SEARO criteria as diagnostic tool may be needed to be further evaluated.   Keywords: Leptospirosis, Surveillance,  Case finding,  Endemic, Detection 
CATATAN BARU KELELAWAR PEMAKAN NEKTAR (MACROGLOSSUS SOBRINUS) SEBAGAI RESERVOIR LEPTOSPIROSIS DARI INDONESIA Mulyono, Arief; Ristiyanto, Ristiyanto; Pujiyanti, Aryani; Joharina, Arum Sih; W.P, Dimas Bagus
Vektora : Jurnal Vektor dan Reservoir Penyakit Vol 10 No 2 (2018): Vektora : Jurnal vektor dan reservoir penyakit
Publisher : Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit (B2P2VRP) Salatiga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1366.033 KB) | DOI: 10.22435/vk.v10i2.581

Abstract

Epidemiologically bats are important sources of leptospirosis transmission because of their size, abundance, distribution, and their connectivity with domestic animals. The research objective was to detect and identify pathogenic Leptospira species from bats in Wonogiri Regency, Central Java and in Muaro Jambi Regency, Jambi. This research is a descriptive study with a cross-sectional design. The study was conducted from February to March 2017. Detection of Leptospira in bats by PCR technique using specific primers for the 16S rRNA gene. Identification of Leptospira species by comparing the sequence of research results with sequences from GenBank using the BLAST program. Results showed 68 caught bats consisting of 7 genera and 11 species. Bats that detected positive Leptospira were 8 bats consisting from 3 species (Macroglossus sobrinus, Cynopterus brachyotis and Eonycteris spelaela). Detection of pathogenic Leptospira in M. sobrinus is a new record in the world esspecially in Indonesia . Identification of Leptospira sequences from bats showed that one sequence had 98% homology with L. borgpetersenii and another sequence had 97% homology with L.kircheneri.
IDENTIFIKASI HEWAN RESERVOIR LEPTOSPIROSIS DI DAERAH PENINGKATAN KASUS LEPTOSPIROSIS DI DESA PAGEDANGAN ILIR, KECAMATAN KRONJO, KABUPATEN TANGERANG TAHUN 2015 Joharina, Arum Sih; Wicaksono Putro, Dimas Bagus; Ardanto, Aryo; Mulyono, Arief; Trapsilowati, SKM, M.Kes, Wiwik
Vektora : Jurnal Vektor dan Reservoir Penyakit Vol 10 No 1 (2018): Vektora : Jurnal vektor dan reservoir penyakit
Publisher : Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit (B2P2VRP) Salatiga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (468.346 KB) | DOI: 10.22435/vk.v10i1.969

Abstract

In Indonesia, leptospirosis often causes outbreaks. Three important sources of transmission of leptospirosis are the environment contaminated with leptospira, the presence of rats and presence of livestock as reservoirs. This study aims to determine the reservoir that plays a role in the leptospirosis transmission in increased case areas of leptospirosis in the Pagedangan Ilir Village, Kronjo Sub-district, Tangerang. Rat traping was done twice. Each trapping was done two times, in consecutive days. Livestock sampling was also conducted in the study area. Rat and livestock serum specimens were collected for leptospirosis detection using MAT, while rat kidneys were collected for PCR test. Leptospirosis detection was performed by PCR and MAT. The results of the first and second rat traping showed relative density of 17% and 20% in the houses, as well as 14% and 10% in outdoor area. Rat traped consist of two species, Rattus norvegicus and Rattus tanezumi. The prevalence of pathogenic leptospira in rat (with PCR assay) was 33% in the first trap and 26% in the second trap. The MAT test showed a positive 14% on R. norvegicus in the first trap, but negative in the second trap. While livestock did not show PCR positive, but one serological positive sample (by MAT) with low titers (1:20) was found against the serovar Robinsoni  
PENGETAHUAN PETUGAS KESEHATAN DAN LINTAS SEKTOR TENTANG LEPTOSPIROSIS DI KABUPATEN PATI Pujiyanti, Aryani; Wicaksono Putro, Dimas Bagus; Mulyono, Arief
Vektora : Jurnal Vektor dan Reservoir Penyakit Vol 11 No 1 (2019): Vektora : Jurnal vektor dan reservoir penyakit
Publisher : Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit (B2P2VRP) Salatiga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (596.776 KB) | DOI: 10.22435/vk.v11i1.1351

Abstract

Leptospirosis control in Pati Regency cannot rely on the general health sector alone, however, it is needed collaboration between the cross-program in leptospirosis control and the relevant sectors. This study aimed to describe the level of leptospirosis knowledge of the health and the cross-sectors officers in Pati Regency, Central Java Province through the assessment activity. A cross-sectional method was used in the present study. A total of 32 people consisting of the  the health and the cross-sectors officers was used as research subjects. They attended the dissemination of leptospirosis held in April 2018 . The instrument used was a questionnaire and the data collection was performed using the questionnaire technique. The data were analyzed descriptively using fisher exact analysis.  The results showed that most respondents had a good level of leptospirosis knowledge. There was no significant positive correlation between resondents' knowledge with age, education level, gender, and type of institution. Respondents understood that environmental factors and the presence of rats played a major role in leptospirosis transmission in Pati District. However, most respondents were lack of knowledge on the role of non-rats as leptospirosis reservoirs. The knowledge of leptospirosis prevention was focused on on self-protecting against bacterial contact from the environment  rather than efforts of rodents control and the use of gloves when treating animals. The District Health Office is recommended to provide the health education on leptospirosis issues for both the cross programs and across sectors officer, particularly how to control rats and the role of non-rats as   leptospirosis reservoirs.
DETEKSI VIRUS HEPATITIS E (HEV) DAN HANTAVIRUS PADA INANG RESERVOIR (TIKUS) DI KABUPATEN KLATEN DAN KENDAL, PROVINSI JAWA TENGAH Mulyono, Arief; Sari, Tika Fiona; Ristiyanto, Ristiyanto; Yuliadi, Bernadus; Royandi, Edi; Pratiwi, Ayu Pradipta
Vektora : Jurnal Vektor dan Reservoir Penyakit Vol 11 No 2 (2019): Vektora : Jurnal Vektor dan Reservoir Penyakit
Publisher : Balai Besar Penelitian dan Pengembangan Vektor dan Reservoir Penyakit (B2P2VRP) Salatiga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (449.615 KB) | DOI: 10.22435/vk.v11i2.2104

Abstract

Rats are animal reservoirs and harbours of several zoonotic pathogens diseases in humans. At least, there are 68 viruses of zoonotic agents that can be transmitted by rats. Two common types of viruses attackinghumans are Hepatitis E virus (HEV) and Hantavirus. Early detection of those viruses is fundamentally required in order to prevent disease transmissions to humans. The aim of the study was to detect and count the percentage of rats infected by HEV and Hantavirus in Kendal and Klaten Districts, Central Java Province. The research design used in this study was descriptive design with cross-sectional approach. The target population was rats distributed in Klaten and Kendal Districts. In addition, the research subject was trapped rats. Detection of Hantavirus was carried out using ELISA method and detection of HEV was conducted using nested reverse transcription PCR (nested RT-PCR). A total of 73 rats was successfully captured consisting of 2 genus and 4 species e.g. Rattus novergicus, R. tanezumi, R. tiomanicus and Bandicota indica. The trapped rats infected by HEV were 3.7% and 41.3% for Klaten and Kendal, respectively. However, the seropositive of Hantavirus was only found in Kendal District (20.5%). Rat control is necessary to prevent transmission of HEV and Hantavirus.