Publications by authors named "Alisjahbana B"

Introduction: The COVID-19 pandemic created unprecedented challenges in the field of global health. Nigeria, Indonesia and India are three high tuberculosis (TB) burden countries with large private health sectors. Both TB and the private health sector faced challenges in these countries because of COVID-19.

View Article and Find Full Text PDF

Some individuals, even when heavily exposed to an infectious tuberculosis patient, do not develop a specific T-cell response as measured by interferon-gamma release assay (IGRA). This could be explained by an IFN-γ-independent adaptive immune response, or an effective innate host response clearing Mycobacterium tuberculosis (Mtb) without adaptive immunity. In heavily exposed Indonesian tuberculosis household contacts (n = 1347), a persistently IGRA negative status was associated with presence of a BCG scar, and - especially among those with a BCG scar - with altered innate immune cells dynamics, higher heterologous (Escherichia coli-induced) proinflammatory cytokine production, and higher inflammatory proteins in the IGRA mitogen tube.

View Article and Find Full Text PDF
Article Synopsis
  • Hyponatremia is a common condition among patients with tuberculous meningitis (TBM), occurring in 86.8% of a study cohort; 26% of these cases were classified as severe.
  • Severe hyponatremia was associated with younger males, lower Glasgow Coma Scale scores, and increased markers of disease severity, but did not independently predict death in patients with HIV.
  • One-year mortality was 46.5%, linked to factors such as age, HIV status, and neurological severity, indicating that treating hyponatremia aggressively might not significantly improve outcomes.
View Article and Find Full Text PDF

Objectives: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the presence of autoantibodies against nuclear antigens and immune complex deposition. The pathogenesis of SLE is not fully understood; however, there are alterations in neutrophils and lymphocytes. Recent parameters assessing both neutrophil activations (Neut-RI, Neut-GI, IG) and activated lymphocytes (Re-Lymp, As-Lymp) can be used to assess the activation of immune cells.

View Article and Find Full Text PDF

Introduction: In high tuberculosis (TB) burden countries, the private sector manages a large proportion of initial visits by presumptive patients with TB. In Indonesia, the second largest contributor of TB cases globally, private practitioners (PPs) often do not adhere to national TB guidelines. A district public-private mix programme to mitigate this issue was started in 2019, yet engagement remains low.

View Article and Find Full Text PDF

Purpose: We aim to analyze the proportion and level of coronavirus disease 2019 (COVID-19) seropositivity in patients with systemic lupus erythematosus (SLE) and explore factors associated with lower anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike receptor-binding domain (S-RBD) antibody levels.

Materials And Methods: A cross-sectional study involving patients with SLE was conducted. We included those aged 18-60 years, either unvaccinated or had received inactivated vaccine (CoronaVac; Sinovac Biotech Ltd.

View Article and Find Full Text PDF

Introduction: COVID-19 pandemic changed many aspects of healthcare services and deliveries, including among private healthcare providers (i.e., private healthcare facilities [HCFs] and private practitioners [PPs]).

View Article and Find Full Text PDF

Indonesia has the third highest number of tuberculosis (TB) patients infected with Mycobacterium tuberculosis (MTB) Lineage 1 (L1). Most of these MTB L1 cases can be found in Indonesia's remote easternmost province of Papua, one of Indonesia's most underdeveloped provinces with a particularly high burden for TB. In this study, we sequenced and described 42 MTB L1 isolates from a well-characterized cohort of patients.

View Article and Find Full Text PDF

COVID-19 infection in high-risk populations is fatal and has a poor prognosis, necessitating a test to determine the protectiveness of immune response. Antibody testing is necessary to determine the body's immune response to COVID-19 infection and also vaccination strategies. Among the various methods available, the chemiluminescent immunoassay (CLIA) test is more widely used and accessible to determine antibody levels.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to examine the prevalence of non-communicable diseases, particularly diabetes, among household contacts of individuals with tuberculosis (TB).
  • A systematic review identified 39 studies, with 14 providing individual participant data and 25 offering aggregated data; the results showed a pooled diabetes prevalence of 8.8% among those tested properly.
  • Findings indicate that diabetes prevalence among household contacts is likely underestimated, highlighting the importance of targeted interventions during TB contact investigations to identify and address these health issues.
View Article and Find Full Text PDF
Article Synopsis
  • Accurate diagnosis of enteric fever is difficult in low- and middle-income countries due to overlapping symptoms with other illnesses; this study evaluated the effectiveness of the TUBEX TF test in Indonesia.
  • Out of 301 patients clinically diagnosed with enteric fever, only 16.6% were confirmed through blood culture or PCR, with common symptoms including fever and abdominal pain predominantly in school-aged children.
  • The TUBEX TF test showed mixed results, with high sensitivity but low specificity, leading to over-diagnosis; acute IgG testing proved more reliable for identifying true cases of enteric fever.
View Article and Find Full Text PDF

Existing genotype imputation reference panels are mainly derived from European populations, limiting their accuracy in non-European populations. To improve imputation accuracy for Indonesians, the world's fourth most populous country, we combined Whole Genome Sequencing (WGS) data from 227 West Javanese individuals with East Asian data from the 1000 Genomes Project. This created three reference panels: EAS 1KGP3 (EASp), Indonesian (INDp), and a combined panel (EASp+INDp).

View Article and Find Full Text PDF

Objectives: We aimed to compare the clinical severity and outcome among laboratory-confirmed Omicron variant cases admitted between January and December 2022.

Methods: This is a cross-sectional study conducted in Hasan Sadikin General Hospital between January and December 2022. We enrolled patients aged ≥18 years with laboratory-confirmed Omicron infection.

View Article and Find Full Text PDF

In Indonesia, government-owned Community Health Centers (CHCs) spearhead tuberculosis (TB) care at the primary level, but a substantial proportion of individuals with pulmonary TB also seek care from Private Practitioners (PPs). However, little is known about PPs' practice in managing patients with TB-associated symptoms. To avoid bias associated with self-administered surveys, we used standardized patients (SPs) to evaluate PPs' adherence to the national TB guidelines.

View Article and Find Full Text PDF

The presence of the anti-SARS-CoV-2-RBD antibody (anti-RBD) prevents severe COVID-19. We aimed to determine the accuracy of a point-of-care anti-RBD testing implemented in persons living with HIV (PLWH), systemic lupus erythematosus (SLE), and chronic kidney disease (CKD). We enrolled 182 non-comorbid subjects and 335 comorbid subjects (PLWH, SLE, CKD) to test the anti-RBD assay compared to the surrogate viral neutralization test (sVNT) as the reference test.

View Article and Find Full Text PDF

Background: Osteoporosis is a major problem in transfusion-dependent thalassemia patients (TDT) patients. Osteoprotegerin (OPG) is one of several bone markers that are closely associated with osteoporosis in TDT patients. OPG is a glycoprotein that functions as a feedback receptor for the Receptor Activator of Nuclear Factor kappa B Ligand (RANKL), which is an alpha tumor necrosis factor receptor.

View Article and Find Full Text PDF

Background: No gold standard diagnostic test exists for latent tuberculosis infection (LTBI). The intra-dermal tuberculin skin test (TST) has known limitations and Interferon-gamma release assays (IGRA) have been developed as an alternative. We aimed to assess agreement between IGRA and TST, and risk factors for test positivity, in Indonesian healthcare students.

View Article and Find Full Text PDF
Article Synopsis
  • * Results from 27 studies showed a global TB disease prevalence of 4% and TB infection prevalence of 18% in SLE patients, with higher rates linked to glucocorticoid (GC) use.
  • * The findings highlight the need for increased awareness of TB in SLE patients and suggest reducing GC doses to help mitigate the risk of TB infection.
View Article and Find Full Text PDF
Article Synopsis
  • The study in Indonesia reveals that less than one-third of drug-resistant TB (DR-TB) cases are identified and tested, with only 9.8% of true cases diagnosed.
  • More than half of those diagnosed (45.1%) did not receive treatment based on proper drug susceptibility testing, and only 25.5% completed the treatment process successfully.
  • There are significant delays in treatment, especially for patients referred from primary care and those with specific demographic factors, indicating a need for better access and optimization of care strategies.
View Article and Find Full Text PDF

Background: Little is known about the etiology, clinical presentation, management, and outcome of central nervous system (CNS) infections in Indonesia, a country with a high burden of infectious diseases and a rising prevalence of HIV.

Methods: We included adult patients with suspected CNS infections at two referral hospitals in a prospective cohort between April 2019 and December 2021. Clinical, laboratory, and radiological assessments were standardized.

View Article and Find Full Text PDF

Background: Indonesia has the second highest incidence of tuberculosis in the world. While 74% of people with tuberculosis in Indonesia first accessed the private health sector when seeking care for their symptoms, only 18% of tuberculosis notifications originate in the private sector. Little is known about the impact of the COVID-19 pandemic on the private sector.

View Article and Find Full Text PDF

The COVID-19 pandemic is thought to have undone years' worth of progress in the fight against tuberculosis (TB). For instance, in Indonesia, a high TB burden country, TB case notifications decreased by 14% and treatment coverage decreased by 47% during COVID-19. We sought to better understand the impact of COVID-19 on TB case detection using two cross-sectional surveys conducted before (2018) and after the onset of the pandemic (2021).

View Article and Find Full Text PDF

Patients with end-stage kidney disease on hemodialysis (ESKD-HD) have a high risk of contracting severe COVID-19. Vaccination can help reduce disease severity, but the immune dysregulation observed in these patients may result in an inadequate antibody response. Therefore, we aimed to evaluate the immune response postvaccination in ESKD-HD patients.

View Article and Find Full Text PDF

Quantitative determination of anti-SARS-CoV2-S-RBD is necessary for the evaluation of vaccination effectiveness. The surrogate viral neutralization test (SVNT) is approved for measuring anti-SARS-CoV2-S-RBD, but a point-of-care platform is needed to simplify anti-SARS-CoV-2-S-RBD measurement. We aimed to evaluate the performance of a rapid fluorescent immunoassay-based kit, FastBio-RBD, compared to the SVNT.

View Article and Find Full Text PDF

Central nervous system (CNS) viral infections are critical causes of morbidity and mortality in children; however, comprehensive data on etiology is lacking in developing countries such as Indonesia. To study the etiology of CNS infections in a pediatric population, 50 children admitted to two hospitals in Bandung, West Java, during 2017-2018 were enrolled in a CNS infection study. Cerebrospinal fluid and serum specimens were tested using molecular, serological, and virus isolation platforms for a number of viral and bacteriological agents.

View Article and Find Full Text PDF