Knowledge of coronavirus disease 2019(COVID-19) among healthcare providers: A cross-sectional study in Indonesia

Objective:To assess healthcare workers’knowledge of novel coronavirus disease 2019(COVID-19)in the early phase of the outbreak in Indonesia.Methods:A cross-sectional survey was conducted in 12 hospitals in Indonesia from March 6 to March 25,2020.Healthcare workers’knowledge on COVID-19 was assessed,and demographic data,workplace characteristics,and medical professional characteristics as well as the current local situation of COVID-19 were collected.To characterize determinants associated with knowledge,a logistic regression analysis was employed.Results:Out of 288 healthcare workers who completed the interview-assisted questionnaire,149(51.7%)respondents had a good knowledge.Nurses and other types of healthcare workers had lower odds of having good knowledge compared to doctors:adjusted odds ratio(aO R):0.38;95%CI:0.20-0.72 and aO R:0.31;95%CI:0.13-0.73,respectively.Compared to healthcare workers who had medical practice experience less than 5 years,those who had worked for more than 10 years had lower knowledge(a OR:0.43;95%CI:0.20-0.90).Healthcare workers who worked in the infection department had higher knowledge compared to those in the emergency room(aO R:14.33;95%CI:3.67-55.88).Conclusions:The knowledge of COVID-19 among surveyed healthcare workers was relatively low.The COVID-19 response in Indonesia will require further education and enhancement of the capacity of healthcare workers in the emergency room where COVID-19 patients may be treated the earliest.

Prevalence and Antimicrobial Susceptibility Status of Gram-Negative and Gram-Positive Bacteria on Handheld Shopping Trolleys and Baskets in Supermarkets in Ndola, Zambia

Background: Supermarkets are a place visited by individuals with different health conditions daily where microbiological contaminants through touch onto fomites such as trolleys and baskets can be passed on to other people hence potentially spreading infectious diseases. This study aimed to investigate the presence of Gram-negative and Gram-positive bacteria on handheld shopping trolleys and baskets and their antimicrobial susceptibility status against commonly used antibiotics in Zambia. Methods: A cross-sectional study was conducted. Trolleys and basket handles were swabbed and standard microbiological methods were used to identify the bacteria and disc diffusion to determine their antimicrobial susceptibility status. Data was collected from December 2021 to April 2022. Data was analysed using IBM Statistical Package for Social Sciences (SPSS) Version 22. Results: Twenty-eight percent of the 200 total samples were found to be culture-positive and predominant isolates were Staphylococcus aureus (17.3%), Pseudomonas species (4.5%), Escherichia coli (2%), Corynebacterium species (2%), Staphylococcus species (1.5%) and Enterobacter aerogenes (0.5%). Staphylococcus aureus showed the most resistance to azithromycin (17%) followed by ciprofloxacin (2.8%), nitrofurantoin (2.8%) and chloramphenicol (2.8%). Escherichia coli showed 100% resistance to amoxicillin, cloxacillin and ampicillin, 75% resistance to ciprofloxacin and the least resistance to azithromycin (25%) while it was susceptible to nitrofurantoin. Staphylococcus species, Corynebacterium species, Enterobacter aerogenes and Pseudomonas species showed no resistance to any antibiotics. Conclusion: The study showed the presence of microorganisms with considerable antimicrobial resistance to antibiotics in Zambia on trolley and basket handles indicating the need for more initiatives to address proper hygiene in public environmental sites for better infection prevention and control.

Novel pharmaceutical rationale against human lymphatic filarial parasite:An oxidative premise

Objective:Mandate from WHO has boosted up anti-filarial drug research.Diethylcarbamazine citrate（DEC） was not known for any direct effect on filarial parasites.However,recent report proposed its direct apoptotic effect.Oxidative stress has been implicated in apoptotic impact.A study was designed to explore the possibility of oxidative rationale to be operative in the direct anti-filarial effect of DEC.Methods:Various doses of DEC and potent oxidant H2O2 alone were used in vitro to check for the effects on B.malayi microfilariae,followed by the use of DEC in combination with H2O2.Reversal of the oxidative impact of the drug was tested using the antioxidant,vitamin C and also lipid peroxidation levels in the post incubation culture supematants were assayed.Result:As expected,DEC alone failed to record any anti-filarial effect.H2O2 alone also failed to show any significant effect until a very high dose was used.However,in combination significant anti-filarial effect was noticed,which allowed even 44%reduction in the dose of H2O2.Any significant lipid peroxidation was not found.Vitamin C demonstrated 30%inhibitory effect.Conclusion:DEC and H2O2 combination being able to educe synergistic anti-filarial effect and inhibition of the same by vitamin C hinted towards covert oxidative component in the mechanism of DEC.Further implication of non-significant lipid peroxidation was addressed in the perspective of subtle oxidative nexus that seems to be operative in observed anti-filarial effect. Exploration of such rationale might lead to novel drug development.

Prospective study of SEVA TB peroxidase assay for cocktail antigen and antibody in the diagnosis of Tuberculosis in suspected patients attending a tertiary care hospital located in rural area

Objective:To evaluate inhouse developed SEVA TB peroxidase enzyme immunoassay using cocktail of mycobacterial excretory-secretory antigens(ES-31,ES-43 & EST-6) for antibody detection and their affinity purified antibodies for antigen detection in tuberculosis suspected patients.Methods:Inhouse developed SEVA TB peroxidase enzyme immunoassay was evaluated prospectively in 73 suspected pulmonary and 46 extra-pulmonary tuberculosis patients during November 2008~March 2009 in a tertiary hospital located in rural area.Results:Assay on prospective analysis showed 100% correlation of pulmonary tuberculosis(PTB) and extrapulmonary tuberculosis(EPTB) acid fast bacilli positivity and antitubercular treatment in 11 cases.Thirty nine PTB and 12 EPTB cases showed negative for EUSA test and were also not given antitubercular therapy.However 30 PTB and 27 EPTB cases showing ELISA positivity were neither acid fast bacilli positive nor antitubercular therapy treated.These cases may possibly have dormant infection and need further diagnosis.In EPTB cases ELISA was observed to be more useful than AFB smear test.Conclusions:This inhouse developed user-friendly peroxidase ELISA can be used as an adjunct test of smear microscopy or culture techniques for routine screening of patients suspected of PTB or EPTB.

Novel drug designing rationale against Brugia malayi microfilariae using herbal extracts

Objective:To explore the effect of herbal polyphenolics on filariasis in vitro.Methods:Two herbal extracts,methanolic extracts of roots of Vitex negundo Linn.（Nirgundi） and leaves of Aegle marmelos Juss.（Beal） in different concentrations ranging from 40-80 ng/mL were tested for their antifilarial activity either alone or in combination with diethyl carbonate（DEC）（300μg/mL） and/or H2O2（0.5 mM）.Results:Combination of DEC and each extract had significant anti-filarial effect.And fractions of both extracts were not effective as crude herbal extract.Conclusions: Such unique pharmacodynamics reported in this study might provide new drug development stratagem against filariasis.

Modifiable determinants of attitude towards dengue vaccination among healthy inhabitants of Aceh,Indonesia:Findings from a community-based survey

Objective:To explore and understand the attitude towards dengue vaccination and its modifiable determinants among inhabitants of Aceh(northern Sumatra Island,Indonesia),the region that was most severely affected by the earthquake and tsunami of 26 December 2004.Methods:A communitybased,cross-sectional study was conducted among 535 healthy inhabitants in nine regencies(Kabupaten or Kotamadya) of Aceh that were selected randomly from November 2014 to March 2015.A set of validated,pre-tested,structured questionnaires was used to guide the interviews.The questionnaires covered a range of explanatory variables and one outcome variable(attitude to dengue vaccination).Multi-step logistic regression analysis and Spearman's rank correlation were used to test the role of explanatory variables for the outcome variable.Results:More than 70%of the participants had a poor attitude towards dengue vaccination.Modifiablc determinants associated with poor attitude to dengue vaccination were low education level,working as farmers and traditional market traders,low socioeconomic status and poor knowledge,attitude and practice regarding dengue fever(P<0.05).The KAP domain scores were correlated strongly with attitude to dengue vaccination,r_s=0.25,r_S=0.67 and r_s=0.20,respectively(P<0.001).Multivariate analysis found that independent predictors associated with attitude towards dengue vaccination among study participants were only sex and attitude towards dengue fever(P<0.001).Conclusions:This study reveals that low KAP regarding dengue fever,low education level and low socioeconomic status are associated with a poor attitude towards dengue vaccination.Therefore,inhabitants of suburbs who are working as larmers or traditional market traders with low socioeconomic status are the most appropriate target group for a dengue vaccine introduction program.

Healthcare workers' knowledge towards Zika virus infection in Indonesia:A survey in Aceh

Objective:To assess the knowledge on Zika virus(ZIKV) 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 ZIKV 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 ZIKV 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 ZIKV infection.In addition,three significant source of information regarding ZIKV were online media(60%),medical article or medical news(16.2%) and television(13.2%).Conclusion:The knowledge of the doctors in Aceh regarding ZIKV infection is relatively low.Doctors who have a good knowledge on ZIKV infection are more confident to established ZIKV disease as differential diagnosis in their clinical setting.Therefore,such program to increase healthcare providers' knowledge regarding ZIKV infection is needed to screen potential carriers of ZIKV infection.

卢旺达复发结核病的分子学研究

背景:入选病例为来自卢旺达4个省市的肺结核(TB)病人。目的:确定复发TB的原因。方法:分离2002年1月—2005年9月复发TB的一系列结核分枝杆菌菌株,进行spoligotyping(间隔区寡核苷酸分型法)和MIRU-VNTR(数目可变的串联重复序列和结核分枝杆菌散在分布重复单位)基因型分析。通过表型药敏检测和rpoB、katG、inhA、embB基因的测序来确定耐药状态。结果:纳入研究的710例痰培养阳性的TB病人中,638例获得初次发病的药敏结果,其中69例为耐多药结核(MDR-TB),569例为非MDR- TB。在MDR-TB病人中,22例得到多株分离株,其中12例为治愈后复发,10例为迁延不愈。12例治愈后复发的病人中,4例病人前后分离株的DNA指纹型不同,说明为再感染,其余8例及10例慢性病人的前后分离株DNA指纹型相同,复发原因分别为复燃和治疗失败导致。非MDR-TB病人中,1例复发,复发原因为初发时混合克隆感染的单克隆复燃。结论:上述结果说明MDR-TB的治疗失败率/复燃率均很高,依此推测2年以内的再感染并不是本地区复发TB的普遍原因。