Limitations of immunization registers at community health centers for measuring immunization coverage: a case study of the Japanese encephalitis mass immunization program in Bali Province, Indonesia.

OBJECTIVE: The aim of this study was to compare the coverage of Japanese encephalitis (JE) immunization obtained from a recall survey and immunization registers at community health centers (CHCs) in Bali Province, Indonesia. METHODS: A population-based survey was conducted, and random 2-staged selection of clusters of sub-villages was performed. The sample consisted of households with children aged 9 months to 15 years old. Interviews were carried out with carers to recall JE immunization status. The recall immunization status was considered valid when name, date, and confirmation of immunization were available in an immunization register at a CHC. Descriptive analysis was performed. The completeness of the information within immunization registers at CHCs was assessed. RESULTS: The coverage of JE immunization obtained from the recall survey was 93.8% (95% confidence interval [CI], 92.8-94.9). It decreased to 74.9% (95% CI, 72.8-77.2) after being validated against immunization registers. The recall coverage of JE immunization was significantly higher than immunization register data suggested. This discrepancy varied from 6.5% to 36.4% across 6 districts; however, none of these districts achieved the recommended target coverage of 95%. The quality of immunization registers varied across CHCs. CONCLUSION: The use of an immunization register may result in underestimating the true coverage of vaccination programs, and its utilization for measuring immunization coverage requires further consideration.

Limitations of immunization registers at community health centers for measuring immunization coverage: a case study of the Japanese encephalitis mass immunization program in Bali Province, Indonesia

Objectives@#The aim of this study was to compare the coverage of Japanese encephalitis (JE) immunization obtained from a recall survey and immunization registers at community health centers (CHCs) in Bali Province, Indonesia. @*Methods@#A population-based survey was conducted, and random 2-staged selection of clusters of sub-villages was performed. The sample consisted of households with children aged 9 months to 15 years old. Interviews were carried out with carers to recall JE immunization status. The recall immunization status was considered valid when name, date, and confirmation of immunization were available in an immunization register at a CHC. Descriptive analysis was performed. The completeness of the information within immunization registers at CHCs was assessed. @*Results@#The coverage of JE immunization obtained from the recall survey was 93.8% (95% confidence interval [CI], 92.8–94.9). It decreased to 74.9% (95% CI, 72.8–77.2) after being validated against immunization registers. The recall coverage of JE immunization was significantly higher than immunization register data suggested. This discrepancy varied from 6.5% to 36.4% across 6 districts; however, none of these districts achieved the recommended target coverage of 95%. The quality of immunization registers varied across CHCs. @*Conclusion@#The use of an immunization register may result in underestimating the true coverage of vaccination programs, and its utilization for measuring immunization coverage requires further consideration.

Limitations of immunization registers at community health centers for measuring immunization coverage: a case study of the Japanese encephalitis mass immunization program in Bali Province, Indonesia

Objectives@#The aim of this study was to compare the coverage of Japanese encephalitis (JE) immunization obtained from a recall survey and immunization registers at community health centers (CHCs) in Bali Province, Indonesia. @*Methods@#A population-based survey was conducted, and random 2-staged selection of clusters of sub-villages was performed. The sample consisted of households with children aged 9 months to 15 years old. Interviews were carried out with carers to recall JE immunization status. The recall immunization status was considered valid when name, date, and confirmation of immunization were available in an immunization register at a CHC. Descriptive analysis was performed. The completeness of the information within immunization registers at CHCs was assessed. @*Results@#The coverage of JE immunization obtained from the recall survey was 93.8% (95% confidence interval [CI], 92.8–94.9). It decreased to 74.9% (95% CI, 72.8–77.2) after being validated against immunization registers. The recall coverage of JE immunization was significantly higher than immunization register data suggested. This discrepancy varied from 6.5% to 36.4% across 6 districts; however, none of these districts achieved the recommended target coverage of 95%. The quality of immunization registers varied across CHCs. @*Conclusion@#The use of an immunization register may result in underestimating the true coverage of vaccination programs, and its utilization for measuring immunization coverage requires further consideration.

Antioxidant and antibacterial activities of multiflora honey extracts from the Indonesian Apis cerana bee.

OBJECTIVES: Honey is an apiary product with various medicinal properties resulting from its bioactive compounds. Here, we aimed to determine the antioxidant and antibacterial properties of the Indonesian Apis cerana honey extracts and their correlation with total phenolic content (TPC) and total flavonoid content (TFC). METHODS: We extracted ethyl acetate-n-hexane and two types of ethanolic extracts from crude honey. Phenols and flavonoid content were calculated using spectroscopy. The antioxidant activity was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric ion reducing antioxidant power (FRAP) assays, and it was reflected via the antioxidant activity index (AAI). An agar diffusion test was used to test the antimicrobial activity. RESULTS: The ethyl acetate extract of the Karangasem honey provided the highest amount of phenolic and flavonoid content, and the strongest antioxidant activity using DPPH and FRAP assays. The ethanolic honey extracts were active against Bacillus subtilis and Escherichia coli; in this regard, the strongest effect was noticed from the Singaraja honey extract. The positive significant correlations between TPC and AAI were observed in all samples. Similar results also appeared between phenolic and flavonoid compounds and their antibacterial activity in most of the tested samples. CONCLUSIONS: In our study, honey extracts possessed antioxidant and antibacterial activities that were mostly related to the qualitative and quantitative properties of phenols and flavonoids. Geographical origin brought variations in the phytochemical profiles and bioactivities of honey.

Cigarette retailer density around schools and neighbourhoods in Bali, Indonesia: A GIS mapping.

INTRODUCTION: The presence and density of tobacco retailers is associated with the perception of high availability of cigarettes and ease of purchase. Indonesia is the second largest cigarette market in the world with an increasing smoking rate among young people aged 10-18 years. Our study aims to assess density of cigarette outlets in neighbourhoods and around schools, and to evaluate correlation between retailer proximity to schools and retailer selling practices. METHODS: We conducted a geographical mapping and then an audit survey of 1000 randomly selected cigarette retailers in Denpasar, Bali, Indonesia. We measured neighbourhood retailer density, and retailer proximity to schools. We linked the coordinate data to the audit data to assess the association between retailer distance from schools with likelihood of selling tobacco to young people and selling single cigarette sticks. RESULTS: We mapped 4114 cigarette retailers in Denpasar, the most common type was a kiosk, 3199 (77.8%), followed by mini market/convenience stores, 606 (14.7%). Retailer density was 32.2/km2 and 4.6/1000 population. We found that 37 (9.7 %) of the 379 schools in Denpasar have at least one cigarette retailer within a 25 m radius and 367 (96.8%) within a 250 m radius. Of the 485 audited retailers within a 250 m radius of a school, 281 (57.9%) admitted selling cigarettes to young people and 325 (67.0%) sold cigarettes as single sticks. Cigarette retailers were less likely to sell cigarettes to young people based on distance from schools, but this was only significant at the furthest distance of more than 500 m from schools. CONCLUSIONS: In an unregulated retailer setting such as Indonesia, cigarette retailers are ubiquitous and selling to young people is commonplace. The Indonesian government should enforce the prohibition on selling to young people and should regulate cigarette retailers to reduce youth access to cigarettes.

Validation of EN ISO method 15216 - Part 1 - Quantification of hepatitis A virus and norovirus in food matrices.

Hepatitis A virus (HAV) and norovirus are important agents of food-borne human viral illness, with common vehicles including bivalve molluscan shellfish, soft fruit and various vegetables. Outbreaks of viral illness due to contamination of the surfaces of foods, or food preparation surfaces by for example infected food handlers are also common. Virus analysis of food matrices can contribute towards risk management for these hazards and a two-part technical specification for determination of Hepatitis A virus and norovirus in food matrices (ISO/TS 15216:2013) was published jointly by the European Committee for Standardisation and the International Organization for Standardization in 2013. As part of the European Mandate No. M381 to validate 15 standards in the field of food microbiology, an international validation study involving 18 laboratories from 11 countries in Europe was conducted between 2012 and 2014. This study aimed to generate method characteristics including limit of detection, limit of quantification, repeatability and reproducibility for ISO 15216 - Part 1, the method for quantification, in seven food matrices. The organization and results of this study, including observations that led to improvements in the standard method are presented here. After its conclusion, the method characteristics generated were added to the revised international standard, ISO 15216-1:2017, published in March 2017.

Comparative Effect of Curcumin and Nanocurcumin on Nephroprotection at Cisplatin-induced Rats.

BACKGROUND: Cisplatin is a first-line chemotherapeutic agent for various solid tumors including ovarian and breast cancer. Thereby, it has been proven effective as an antineoplastic agent, but its clinically use is limited because of its nephrotoxicity side effect. AIMS AND OBJECTIVES: This study aimed to investigate curcumin as a renoprotector agent against cisplatin nephrotoxicity. MATERIALS AND METHODS: The samples used were curcumin and its nanoparticles formulated using ionic gelation method. The nephrotoxicity was investigated through several parameters such as serum creatinine, blood urea nitrogen, serum albumin, kidney weight ratio, and histopathology. These parameters were tested on rats and divided into the following four groups: normal group, negative control group that administered cisplatin with doses amount of 7 mg/kg body weight (BW) intraperitoneally, nanocurcumin group (cisplatin + nanocurcumin) and curcumin group (cisplatin + curcumin). The agents were administered at a dose of 100 mg/kg BW every day in 9 days before cisplatin administration. The sample of blood serum and kidneys organ were taken 48h after cisplatin administration. RESULTS: The negative control group showed a significant increase in serum creatinine, blood urea nitrogen, and kidney weight ratio, whereas it showed a significant decrease in serum albumin. The administration of sample agents showed a significant decrease in serum creatinine, blood urea nitrogen, and kidney weight ratio and an increase in the albumin level as compared to negative control group. CONCLUSION: Nanocurcumin showed significant improvement in kidneys more than curcumin. In contrast, histopathological examination verified the necrosis in negative control group, suggesting the renoprotection effect of nanocurcumin against nephrotoxicity on cisplatin-induced rats.

Characterization of a Yersinia enterocolitica biotype 1A strain harbouring an ail gene.

AIMS: The chromosomal ail gene (attachment and invasion locus) is commonly used as target gene for the detection of pathogenic Y. enterocolitica strains in food testing. The ail PCR does not detect strains of biotype 1A (BT1A), which are regarded as non-pathogenic because BT1A strains lack the virulence plasmid and chromosomally encoded virulence genes. In some recent reports, however, BT1A strains were discovered that harboured the ail gene. We isolated an ail-positive strain and characterized this strain with phenotypic and genotypic methods to study its possible relation to pathogenic Y. enterocolitica strains. METHODS AND RESULTS: The ail region of the BT1A strain was sequenced and compared with the corresponding region of nonpathogenic BT1A strains and pathogenic strains. Pulsed field gel electrophoresis (PFGE) analysis was applied revealing no similarity of the PFGE pattern of this strain to the patterns of pathogenic strains. Virulence-gene-based PCR analyses showed the strain to be positive for ystB, but negative for virulence genes ystA, virF and yadA. Whole-cell MALDI-TOF MS combined with a shrinkage discriminant analysis approach was applied and clearly classified the ail-positive biotype 1A strain within the cluster of BT1A strains. CONCLUSIONS: PCR detection of ail sequences in food matrices should be followed by the isolation of the responsible strain and its characterization using phenotypic or genotypic methods. SIGNIFICANCE AND IMPACT OF THE STUDY: The ail gene may be present in Y. enterocolitica BT1A strains, which are commonly considered as nonpathogenic. Efficient methods such as PCR typing of other virulence genes or rapid MALDI-TOF MS-based bacterial profiling allow a more comprehensive assessment of the pathogenicity potential of Yersinia strains.

[Investigations on the red blood cell count in mother sows]. / Untersuchungen zum roten Blutbild der Muttersau.

Investigations have been conducted to the factors which have influence on the red blood count in postparturient sows. 147 blood samples of sows have been collected for the analysis of the influence of the number of lactations and puerperal diseases and 87 samples out of the collected blood samples were of healthy sows used to the analysis for the influence of the week of lactation. With rising number of lactations decrease the number of erythrocytes, packed cell volume and haemoglobin concentration, whereas mean corpuscular volume and mean corpuscular haemoglobin concentration rise. No significant changes of red blood count occur in the course of lactation. The number of erythrocytes and the packed cell volume decrease due to puerperal diseases. Hematological values of healthy postparturient sows are: erythrocytes: 5.8 +/- 0.6 T/l; packed cell volume: 0.41 +/- 0.03 l/l; hemoglobin concentration: 7.64 +/- 0.67 mmol/l; mean corpuscular volume: 71.4 +/- 5.8 fl; mean corpuscular hemoglobin: 1.30 +/- 0.9 fmol; mean corpuscular hemoglobin concentration: 18.3 +/- 0.8 mmol/l.

[Investigations of raw milk for Shiga-like toxin producing Escherichia coli by the polymerase chain reaction]. / Untersuchung von Rohmilch auf Shiga-like Toxin bildende Escherichia coli durch Polymeraseketten-reaktion.

This is a report about the occurrence of Shiga-like toxin (SLT) producing Escherichia coli in milk in southern Sachsen-Anhalt. Samples were taken from tanks of milk at the farms. The samples were investigated by polymerase chain reaction as recommended by the "Bundesinstitut für gesundheitlichen Verbraucherschutz und Veterinärmedizin". Using PCR, in 11% of the tank samples sequences coding for SLT I and/or SLT II were detected. 75% of the as positive detected samples had eae gen. Some cows in these farms spread potentially enterohemorrhagic E. coli. These farms should not sell milk for raw consumption.

[Leukocyte count of puerperal sows]. / Untersuchungen zum weissen Blutbild der Muttersau.

147 blood samples of postparturient sows of a secluded housing were taken. The samples were conserved with ACD-solution. The influence of the number and week of the lactation and the health of the sow, determined by puerperal diseases was studied. Hematological values of healthy postparturient sows are: leucocytes 12.6 +/- 2.2 G/l; basophile granulocytes 0.1 +/- 0.1 G/l, eosinophile granulocytes 0.5 +/- 0.4 G/l; banded neutrophile granulocytes 1.3 +/- 0.6 G/l, segmented neutrophile granulocytes 5.2 +/- 1.4 G/l; lymphocytes 5.5 +/- 1.4 G/l, monocytes 0.3 +/- 0.3 G/l. The leucocyte number is lower in the investigated herd compared with quotations in the literature. This is based on the good health conditions in the herd. Changes due to the number and week of the lactation have no clinical relevance. Health status, here described by puerperal diseases is the significant influencing factor of the leucocyte number. The severity of puerperal diseases is significant. Due to puerperal diseases the leucocyte number rises quickly after a short drop about 2 G/l. The number of the neutrophile granulocytes increases, but the lymphocyte number is reduced at the beginning of the illness. The application of ACD-solution for stabilizing of great amounts of blood samples under practical conditions is demonstrated. It is possible to stabilize pigs blood well.

[The stabilization of swine blood for hematologic studies]. / Untersuchungen zur Stabilisierung von Schweineblut für hämatologische Untersuchungen.

Blood samples of 13 sows were preserved with ACD stabilizer with adenine, ACD stabilizer A (DAB) and heparin respectively and were stored in a refrigerator at 4 degrees C over a period of 18 days. During this time the number of erythrocytes and leucocytes, the hematocrit and the hemoglobin concentration were determined 10 times. The best preservation of erythrocytes was observed in ACD stabilizer with adenine. Compared to other stabilizers, preservation of leucocytes was best in ACD stabilizer A. The lysis of the white blood cells follows the exponential function y = ae-bt. ACD-stabilizers permit the preservation of erythrocytes and leukocytes for hematological examinations of swine blood over a period of up to five days.