Occult Amebiasis among Pediatric with Enterocolitis in National Referral Hospital in Indonesia.

BACKGROUND: Enterocolitis and gastroenteritis remain major health problems, particularly in children living in developing countries. Intestinal protozoa, such as Entamoeba histolytica, Blastocystis, and Cyclospora, are frequently associated with these conditions. Amebic colitis can cause serious complications, including fulminant necrotizing colitis, toxic megacolon, extraintestinal amebiasis, and stunting in children. The diagnosis of amoebiasis is challenging, relying on microscopic examination, which cannot distinguish E. histolytica from the nonpathogenic E. dispar and E. moshkovskii. Therefore, this study aimed to identify intestinal parasites, particularly Entamoeba, their prevalence, and the clinical characteristics of patients admitted for enterocolitis and gastroenteritis at a tertiary-referral hospital. MATERIAL AND METHODS: A cross-sectional, retrospective study was conducted at a national, tertiary-referral government hospital, in Jakarta. Of the 111 retrieved medical records from hospitalized patients with enterocolitis and gastroenteritis, for which parasitology feces were examined, 54 fecal samples (48.6%) were still available in the parasitology laboratory storage. All fecal samples underwent the following tests: 1) direct stool examination, after staining with 1% Lugol's solution, and using the water-ether concentration method; 2) modified acid-fast staining for coccidian parasites; 3) Jones' culture medium to detect Blastocystis; 4) copro-antigen assay to detect Cryptosporidium and Giardia; and 5) a polymerase chain reaction (PCR) assay to identify Entamoeba. Clinical and demographic data were obtained from the medical records. RESULTS: Largely, patients (44.1%) were from the cohort of young children ≤5 years old, followed by adults aged 19-60 years old (24.3%). Both cohorts exhibited polyparasitism. Intestinal parasites were detected in 17 out of the 54 samples (31.4%). These included 6 (11.1%), 2 (3.7%),5 (9.2%), 3 (5.5%), 2 (3.7%), and 1 (1.8%) samples that were positive for Blastocystis, E dispar, E. histolytica, E. moshkovskii, Cryptosporidium, and Dientamoeba fragilis, respectively. PCR analysis revealed that 10 samples were positive for Entamoeba infection, eight of which originated from pediatric patients. CONCLUSION: At a national tertiary-referral hospital in Indonesia, Entamoeba infection was the most prevalent parasite among pediatric patients with enterocolitis. E. histolytica and E. moshkovskii were the two main species identified by PCR. Therefore, PCR assays and fecal occult-blood tests are recommended in cases of enterocolitis and gastroenteritis.

First report on evaluation of commercial eugenol and piperine against Aedes aegypti L (Diptera: Culicidae) larvae: Mortality, detoxifying enzyme, and histopathological changes in the midgut.

Dengue fever is a worldwide public health problem, and efforts to eradicate it have focused on controlling the dengue vector, Aedes aegypti. This study aims to assess the toxicity and effect of commercial eugenol and piperine on Ae. aegypti larvae through enzyme detoxification and histopathological changes in the midgut. Laboratory-reared Ae. aegypti larvae were treated with various concentrations of commercial eugenol and piperine and observed after 24, 48, and 72 h. Biochemical methods were used to assess detoxification enzyme activity for acetylcholinesterase, glutathione S-transferase, and oxidase, and changes in the midgut were examined using routine histological examination. In terms of larvicidal activity, piperine exceeded eugenol. Piperine and eugenol had LC50 and LC90 values of 3.057 and 5.543 µM, respectively, and 6.421 and 44.722 µM at 24 h. Piperine and eugenol reduced oxidase activity significantly (p < 0.05), but increased acetylcholinesterase and glutathione S-transferase activity significantly (p < 0.05). After being exposed to piperine and eugenol, the food bolus and peritrophic membrane ruptured, the epithelial layer was interrupted and irregular, the epithelial cells shrank and formed irregularly, and the microvilli became irregular in shape. Commercial piperine and eugenol behave as potential larvicides, with processes involving altered detoxifying enzymes, specifically decreased oxidase function and increased GST activity, as well as midgut histological abnormalities.

Determinant of parasite clearance and density on uncomplicated falciparum malaria infections in malaria-endemic area of Lampung Province, Indonesia.

Lampung is a malaria-endemic region in Indonesia with an annual parasite incidence of 0.06 per 1,000 population. The socio-demographic factors, clinical conditions, and artemisinin combination therapy (ACT) types might affect parasite clearance and parasite density. This study aims to investigate factors that influence parasite clearance and parasite density in malaria patients. A retrospective analytic observational and a cross-sectional approach was used to conduct this study. A total of 66 malaria patients were examined to investigate parasite density and clearance, socio-demographic profiles, clinical conditions, and ACT types. To analyze data, univariate, bivariate, and multivariate tests were used. Age (P=0.045; r=0.238) and ACT type (P=0.021; r=0.273) were the only variables that had a significant correlation with parasite clearance. Age (P=0.003; r=0.345) had a significant correlation with parasite density. The most influential factors related to parasite clearance were the ACT type (dihydroartemisinin piperaquine) (P=0.017; odds ratio (OR) 0.109; 95.0% confidence interval (CI), 0.018-0.675) and age (P=0.030; OR 0.132; 95.0% CI, 0.021-0.823). Age (P=0.046; OR 0.320; 0.105-0.978, 95.0% CI) was the most significant variable associated with parasite density.

Assessment of susceptible Culex quinquefasciatus larvae in Indonesia to different insecticides through metabolic enzymes and the histopathological midgut.

Filariasis and virus diseases that are transmitted by Culex quinquefasciatus are still a global health problem. Control of mosquito vectors with synthetic insecticides causes resistance to these mosquitoes to insecticides so that detection of susceptibility of the mosquito larval stage to insecticides is important for evaluating mosquito control programs. The aim of this study was to evaluate the susceptibility of wild-caught Cx. quinquefasciatus larvae in Jakarta, Indonesia, following exposure to temephos, malathion, cypermethrin, and deltamethrin; this was done by examining the detoxifying enzyme activities and histological damage to the larval midgut. Cx. quinquefasciatus larvae were collected from five fields in Jakarta and exposed for 24 h to temephos (1.25, 6.25, 31.25, and 156.25 ppm), malathion (0.5 ppm), cypermethrin (0.25 ppm), and deltamethrin (0.35 ppm). The larvae were then examined for acetylcholinesterase (AChE), glutathione S-transferase (GST), and oxidase activities using biochemical methods. Histological damage to the larval midgut was examined using routine histopathological methods and transmission electron microscopy (TEM). After 24 h, temephos and deltamethrin led to 100% mortality in the Cx. quinquefasciatus larvae. Temephos and malathion significantly inhibited the activity of AChE, while cypermethrin and deltamethrin significantly inhibited oxidase activity. Histologically, all insecticides damaged the larval midgut, as indicated by irregularities in the epithelial cell (ECs), microvilli (Mv), food boluses (FBs), peritrophic membranes (PMs), and cracked epithelial layers (Ep). The TEM findings confirmed that temephos and cypermethrin damage to the midgut ECs included damage to the cell membrane, nucleus, nucleoli, mitochondria, and other cell organelles. Overall, Cx. quinquefasciatus larvae in Jakarta were completely susceptible to temephos and deltamethrin. Synthetic insecticides may kill Cx. quinquefasciatus larvae through their actions on the metabolic enzyme activities and histopathological midgut.

In vitro experiments of Pediculus humanus capitis (Phthiraptera: Pediculidae) resistance to permethrin and 6-paradol in East Jakarta: Detoxification enzyme activity and electron microscopic changes in lice.

BACKGROUND AND AIM: Pediculus humanus capitis, the human head louse, remains a global health problem. This study evaluated the resistance of head lice to permethrin and 6-paradol mediated by in vitro detoxification enzyme activity experiments and to describe physical changes in the lice using scanning electron microscopy (SEM). MATERIALS AND METHODS: The adult stages of P. h. capitis were collected from patients exposed to 1% permethrin and three different concentrations of 6-paradol (0.00005%, 0.0001%, and 0.00015%) using a filter paper diffusion bioassay. Healthy P. h. capitis adults served as the control. The in vitro bioassays were conducted after 10, 20, 30, and 60 min of exposure. The activities of acetylcholinesterase (AChE), glutathione S-transferase (GST), and oxidase were analyzed. Physical changes in the lice were analyzed using SEM. RESULTS: Permethrin and 6-paradol exhibited low toxicity against the lice. At 60 min, 1% permethrin had killed 36.7% of the lice present, while 6-paradol had killed 66.7-86.7%. Permethrin induced significantly elevated AChE, GST, and oxidase activity; 6-paradol also caused significantly elevated AChE, GST, and oxidase activity. Permethrin did not cause any ultrastructural morphological changes on the lice, while 6-paradol severely damaged the head, thorax, respiratory spiracles, and abdomen of the dead lice. CONCLUSION: This in vitro experimental of P. h. capitis is the first study to report P. h. capitis in East Jakarta shows complete resistance to permethrin and 6-paradol, and to describe the associated increase in AChE, GST, and oxidase activity. It was observed that 6-paradol severely damaged the head, thorax, respiratory spiracles, and abdomen of the dead lice.

High Toxoplasma antibody prevalence among inhabitants in Jakarta, Indonesia.

We examined IgG antibody to Toxoplasma in sera from 1,693 inhabitants aged 20-85 years in Jakarta. The seroprevalence rate was 70%, without any significant differences between males (71%) and females (69%). Some epidemiological factors contributing to the high prevalences of antibody to Toxoplasma in inhabitants of urban areas in Indonesia were discussed.