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Objective To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia. Methods A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge. Results A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%). Conclusion The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
ABSTRACT
OBJECTIVE@#To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia.@*METHODS@#A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge.@*RESULTS@#A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%).@*CONCLUSION@#The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
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Exposure to the dengue virus CDENV [evokes a variety of genetically controlled immunological vesporses. Geneti c variants involued in viral enry, replication and innate immunity path wasys play an important role in the causal pathway of dengue hemorrhagic fever/ dengue shoch syndrome DHF/DSS]. Here we have reviewed implications of some genetic polymorphisms of the pathways related to DENV infection susceptibility, protection and severity. Large case-control studies examining a variety of single-nucleotide polymorphisms [SNPs] in a variety of genes have been performed in DENY patients in some countries. SNP gene candidates that have shown associations with DENV infection are mannose-binding lectin [MBL], interleukin [IL]-4, IL-6, IL-10, interleukin-1 receptor antagonist [IL-1RA], toll-like receptor 4 [TLR4], cytotoxic T-lymphocyte antigen 4 [CTLA-4], tumor necrosis factor [TNF]-alpha, transforming growth factor [TGF]-beta1, Fc gamma receptor II [FcgammaRII], vitamin D receptor [VDR], interferon [IFN]-gamma, human platelet antigens [HPA], transporters associated with antigen processing [TAP], dendritic cell-specific ICAM3-grabbing non-integrin [DC-SIGN] and Janus kinase 1 [JAK1], although some of these genes failed to show statistical significance. Briefly, polymorphism in TNF-alpha, Fc gamma RII, CTLA-4, TGF-beta1, HPA, DC-SIGN, TAP and JAK1 genes has been associated with DHF/DSS development. Polymorphism in MBL2 gene was shown to be associated with thrombocytopenia and increased risk of DHF development. In contrary, polymorphism in VDR gene shows moderate associations with resistance to the most severe form of DHF. However, neutral associations have been reported for IL-4 promoters, IL-1RA, IFN-gamma, IL-6, TLR4 and IL-10 gene polymorphism. In conclusion, there are strong evidences from several epidemiological studies indicating host genetic factors as important components in DENV infection susceptibility, protection and severity
Subject(s)
Polymorphism, Genetic , HLA Antigens/immunologyABSTRACT
Sepsis and its sequelae are still a major cause of morbidity and mortality in intensive care units [ICU]. The evidence that endogenous mediators actually mediate the individual's response to infection has led to various approaches to assess the individual's contribution to the course of the disease. The role of an individual's genetic background and predisposition for the extent of inflammatory responses is determined by variability of genes encoding endogenous mediators that constitute the pathways of inflammation. Pro- and anti-inflammatory responses contribute to the susceptibility and outcome of patients with systemic inflammation and sepsis. Therefore, all genes encoding proteins involved in the transduction of inflammatory processes are candidate genes to determine the human genetic background that is responsible for interindividual differences in systemic inflammatory responses. Polymorphism of TNA alpha, TNFB, IL-10, IL-6, IL-1beta, IL-1RN, HMGB1, TLR, PAI-1, DEFB1, HSP and MMP-9 has contribution to susceptibility and outcome of sepsis in some research. Examination of the association between genetic polymorphisms and sepsis promises to provide clinicians with new tools to evaluate prognosis, to intervene early and aggressively in treating high risk persons, and to avoid the use of therapies with adverse effects in treating low risk persons. Genomic information may be useful to use to identify groups of patients with a high risk of developing severe sepsis and multiple organ dysfunctions