[Delayed anaphylaxis after ingestion of meat. Carbohydrate epitope galactose-α-1,3-galactose as cause of severe anaphylactic reactions]. / Verzögerte Anaphylaxie nach Fleischverzehr. Kohlenhydratepitop Galaktose-α-1,3-Galaktose als Auslöser schwerer anaphylaktischer Reaktionen.

The correlation between anaphylaxis after consumption of meat and the carbohydrate epitope galactose-α-1,3-galactose (α-Gal) was first described in oncologic patients treated with cetuximab. An association with tick bites and parasitosis is suspected. We report on a healthy patient who developed sudden anaphylactic reactions after the ingestion of meat. Serologic and skin tests confirmed sensitization to α-Gal. Avoiding the consumption of mammalian meat led to a complete absence of symptoms.

Tuberculosis mortality differentials in Indonesia during 2007-2008: evidence for health policy and monitoring.

BACKGROUND: Indonesia bears the third highest tuberculosis (TB) burden in the world. Current mortality estimates are based on notification and case fatality rates derived from the National TB Control Programme. OBJECTIVE: To report TB mortality measures for 2007-2008 based on death registration systems in selected populations in five provinces of Indonesia. METHODS: Data were compiled from sites in Central Java, Lampung, Gorontalo, West Kalimantan and Papua in 2007-2008, covering 2.5 million people. Overall mortality levels and TB mortality indicators were computed. Data quality was assessed in terms of completeness of death registration and strength of evidence in verbal autopsy questionnaires. RESULTS: A total of 1547 TB deaths were diagnosed in the five provinces. There was direct or indirect evidence of incomplete death registration at all sites. More than 90% of TB diagnoses from verbal autopsies were based on strong evidence. The results demonstrate high TB death rates in Papua, and significant mortality differentials across provinces. CONCLUSIONS: The measurement of cause-specific mortality is feasible by strengthening death registration in Indonesia. Observed TB mortality rates from five sites are baseline evidence for monitoring TB control programmes. Sustained efforts are required to develop death registration as a routine annual source of mortality data for Indonesia.

Three-fold reduction in the prevalence of tuberculosis over 25 years in Indonesia.

BACKGROUND: Tuberculosis (TB) remains the principal cause of death from a curable infectious disease. Indonesia is estimated to have the third highest case load worldwide, but TB prevalence has not been measured for 25 years. METHODS: In 2004, 20000 households were selected in all 30 provinces. All adults (aged >/=15 years) in every household were screened for symptoms of pulmonary tuberculosis (PTB). Among those with symptoms, TB was diagnosed by sputum smear microscopy and sputum culture. RESULTS: Eighty adults were positive on at least two sputum smears (104 per 100000 population, 95%CI 66-142). Prevalence was lower in Central Indonesia (Java-Bali, 59/100000) than in the Western (Sumatra, 160/100000) or Eastern regions (189/100000), but the estimated 225000 prevalent cases were distributed evenly among the three regions. The national per capita prevalence in 2004 was lower than in 1979-1982 by a factor of three (3.1, 95%CI 1.2-4.9), and the total number of cases was lower by a factor of two. CONCLUSIONS: Although the 2004 national survey may have underestimated the prevalence of smear-positive TB in Indonesia, there is strong evidence that it fell markedly between 1979-1982 and 2004.

[Infant and maternal mortality rates in Indonesia]. / Angka kematian bayi dan angka kematian maternal di Indonesia: variasi dan kecenderungannya.

"Infant Mortality Rate (IMR) and Maternal Mortality Rate (MMR) are usually used as indicators of social development. This paper reviews the situation of both indicators in Indonesia, based on various methods and data resources. The result of the study shows the high inequality of interregional mortality indicated by the trend of IMR and the differentials in IMR and MMR." (SUMMARY IN ENG)