Molecular Rapid Tests Research Articles

The Concordance between GeneXpert MTB/RIF and Isothermal Amplification Assay for Detecting Mycobacterium tuberculosis

Tuberculosis (TB) is an infectious disease and one of the biggest causes of death worldwide. The main problem today is the lack of accurate and rapid tests to detect Mycobacterium tuberculosis (MTB). Several molecular methods have been developed to detect MTB. GeneXpert MTB/RIF® can detect MTB and rifampicin resistance simultaneously in <2 hours. Cross Priming Amplification (CPA) is one of the isothermal amplification assay methods that can detect MTB. Both of these methods are molecular rapid tests so they can detect MTB faster. This study aims to evaluate the concordance of GeneXpert MTB/RIF® results with CPA to detect MTB at Hasan Sadikin General Hospital, Bandung. This is an observational cross-sectional study. The subjects were patients with suspected pulmonary TB and examined with GeneXpert MTB/RIF® then CPA (Ustar EasyNAT MTC™) was also examined. This study used total sampling with 50 subjects and analyzed with Cohen's Kappa test. The results of GeneXpert MTB/RIF® and Ustar EasyNAT MTC™ in detecting MTB obtained Kappa of 0.662 (good agreement) with p-value <0.001. Of the 11 low positive samples on GeneXpert MTB/RIF® as many as 6 subjects (54.55%) had positive results, and 5 subjects (45.45%) had negative results on UStar EasyNAT MTC™. Meanwhile, of the 4 very low positive samples, there was only 1 sample with positive results on UStar EasyNAT MTC™. There is a match results between high and medium positive GeneXpert MTB/RIF® and UStar EasyNAT MTC™. However, there is a difference between low and very low positive results on GeneXpert MTB/RIF® and UStar EasyNAT MTC™.

Correlation Of Neutrophil Lymphocyte Ratio (NLR) Value With Incidence Of Tuberculosis Disease In Patients With Diabetes Mellitus

Diabetes mellitus is a non-communicable disease (PTM) that is chronic and can weaken the immune system so that sufferers are 3 times more likely to suffer from pulmonary TB. In chronic infection there is continuous inflammation which is characterized by the presence of neutrophils themselves and will be followed by low lymphocyte values due to immune system pathways that do not work perfectly. The purpose of this study was to determine the correlation between the Neutrophil Lymphocyte Ratio (NLR) and the incidence of Tuberculosis in Diabetes Mellitus patients at the Jorongan Health Center, Probolinggo Regency. This research is a correlative analytic study with a cross sectional approach. A total of 30 samples of diabetes mellitus patients at the Jorongan Health Center from January to April 2023. The NLR examination method was with a hematology analyzer and tuberculosis patients were examined using Molecular Rapid Test. The statistical test uses Spearman's nonparametric test. The results showed that there was a correlation between NLR values and the incidence of tuberculosis in diabetes mellitus patients at the Jorongan Health Center, p = 0.003 and r = 0.521. Further research needs to be carried out involving larger samples and other laboratory tests related to the immune system in patients with diabetes mellitus.

Analysis of Risk Factors on the Performance of Tuberculosis Control Program Officers in the Working Area of the Lubuk Kambing Health Center, Jambi, Indonesia

Indonesia is ranked 2nd in the country with the highest burden of tuberculosis (TB). In Jambi, the detection rate for pulmonary TB cases is still low (19%), and at the Lubuk Kambing Health Center, it only reaches 53%. This study aims to analyze the factors associated with the low rate of TB case detection in the Lubuk Kambing Health Center working area. Cross-sectional research design with 65 respondents. Data analysis uses logistic regression. There is a relationship between level of knowledge, motivation, workload, training, length of service, availability of TCM (molecular rapid test) facilities, active screening of pulmonary TB suspects, honorarium, family support, and evaluation of TB prevention and control officers and TB cadres with low detection capabilities d TB in the Lubuk Kambing Health Center working area. Availability of facilities is the dominant factor related to the low number of TB cases in the Lubuk Kambing Health Center working area. Efforts to increase knowledge, motivation, training, length of service, active screening, honorarium, and family support, as well as providing TCM facilities and regular evaluations, need to be carried out to increase the TB case detection rate.

Molecular Rapid Test for Identification of Tuna Species.

Tuna is an excellent food product, relatively low in calories, that is recommended for a balanced diet. The continuously increasing demand, especially for bluefin-tuna-based food preparations, and its relatively high market price make adulteration by intentionally mixing with other lower-priced tunas more prospective. The development of rapid methods to detect tuna adulteration is a great challenge in food analytical science. We have thus developed a simple, fast, and low-cost molecular rapid test for the visual detection of tuna adulteration. It is the first sensor developed for tuna authenticity testing. The three species studied were Thunnus thynnus (BFT), Thunnus albacares, and Katsuwonus pelamis. DNA was isolated from fresh and heat-treated cooked fish samples followed by PCR. The PCR products were hybridized (10 min) to specific probes and applied to the rapid sensing device. The signal was observed visually in 10-15 min using gold nanoparticle reporters. The method was evaluated employing binary mixtures of PCR products from fresh tissues and mixtures of DNA isolates from heat-treated tissues (canned products) at adulteration percentages of 1-100%. The results showed that the method was reproducible and specific for each tuna species. As low as 1% of tuna adulteration was detected with the naked eye.

Comparison of Tuberculosis Examination Using Ziehl-Neelsen Method and Molecular Rapid Test

Tuberculosis is an infectious disease of the respiratory tract caused by infection with the bacteria Mycobacterium tuberculosis. Fast and accurate diagnostic methods are very important for diagnosing and controlling pulmonary TB disease in Indonesia. TB examination using the Zn method is very commonly used even though it has lower sensitivity than TCM. The aim of this study was to compare the results of TB examination using BTA staining with the Molecular Rapid Test. This type of research uses analytical observational methods with a cross-sectional approach. The sample was 40 respondents taken using purposive sampling technique. The results of tuberculosis examination using the Ziehl-Neelsen (ZN) BTA staining method and the Moluker rapid test tool (TCM) method showed that the microscopic results of the Ziehl-Neelsen method of BTA smear staining showed negative results in 31 people (75%), 1 respondent (2 .5%) with scanty results and 9 respondents (22.5%) with 1+ results. The results of the TB BTA examination using the TCM method resulted in MTB Not Detected with a total of 30 people (75%), MTB Detected Medium obtained a result of 6 people (15%), MTB Detected Low obtained a result with a total of 3 people (7.5%), MTB Detected Very Low results were obtained with the number of 1 person (2.5%) and in the SPSS results using the t-test the results obtained were p value <0.05 (0.012 <0.05) which means there is a comparison of the BTA staining tuberculosis examination using the Ziehl-Ziehl method. neelsen and Molecular Rapid Tests. Based on the research results, it was found that there was a significant difference between the Ziehl-Neelsen BTA staining tuberculosis examination method and the Molecular Rapid Test Tool with a p value <0.05 (0.012 <0.05)

Drug-resistant Tuberculosis in Pediatric

Introduction: Drug-resistant tuberculosis (DR TB) is a condition where Mycobacterium tuberculosis is resistant to isoniazid, rifampicin or resistant to isoniazid and rifampin as well as other first-line anti-tuberculosis drugs (OAT). Tuberculosis (TB) is a contagious infectious disease, caused by Mycobacterium tuberculosis germs where the source of transmission is through droplets containing TB germs. Case Report: A 10 years 7 months girl, came to the MDR Polyclinic at the Haji Adam Malik Medan Central General Hospital (RSUP HAM Medan) on March 21 2023 bringing the results of the TB Molecular Rapid Test (TCM-TB) examination from the Teladan Barat Health Center with Rifampicin results were resistant and on March 24 2023 the patient was hospitalized. Currently, the patient is complaining of a cough that has been experiencing for ± 3 weeks. Cough with the impression of a dry cough and is continuous so that it interferes with daily activities. The cough does not improve even though the patient has taken cough medicine. There is no fever, there is also no history of previous fever. According to the anamnesis from the patient's parents, there has been a weight loss in the last 2 months, around ± 4 kg. There is no family history of long-term cough, but according to parents, there is a neighbor of the patient who suffers from pulmonary TB and is undergoing treatment. Discussion: After the diagnosis of drug-resistant tuberculosis is confirmed, an evaluation is carried out whether the patient meets the criteria for drug-resistant TB treatment guided by short-term or long-term oral drug-resistant tuberculosis. Patients who meet the evaluation criteria for treatment can immediately be given short-term oral drug-resistant tuberculosis therapy. If the patient does not meet the criteria for short-term treatment, long-term drug-resistant tuberculosis treatment is given. Routine evaluations are carried out during treatment and when the results of drug sensitivity tests are available, treatment is adjusted according to the examination results. Conclusion: A case of drug-resistant tuberculosis in a girl aged 10 years 7 months has been reported which was diagnosed based on anamnesis, physical examination, and supporting examinations, there was also a history of close contact with TB sufferers, and the results of TCM examination of sputum fluid showed rifampicin resistant MTB growth. Patients are treated as drug-resistant TB cases with a short-term regimen with regular monitoring of treatment response and side effects.

Performance of clinical scoring and microscopic combinations for diagnosing pulmonary tuberculosis with the GenXpert criteria

Pulmonary tuberculosis is a prominent health issue in Indonesia, which ranks second in the world regarding the number of patients. Rapid tuberculosis detection is crucial for early treatment, a better prognosis, and a reduction in disease transmission; however, the availability of molecular rapid tests is limited. Cross-sectional design and retrospective analyses of pre-pandemic data from 723 patients with suspected pulmonary tuberculosis from 2017 to 2019 were conducted in this study. The study aimed to assess the performance of clinical scoring and microscopic examination in tuberculosis diagnosis at RSUD Sayang Cianjur. The effectiveness of sequential (two-stage) and simultaneous combinations of clinical scoring and sputum smear microscopic were investigated. Performance assessments consisted of 2x2 tables, calculation according to Gordis, and Receiver Operator Characteristic (ROC) analysis, with GenXpert results as the gold standard. The results showed lower performance of the individually performed scoring system, with clinical scoring having a sensitivity of 34.44% and a specificity of 97.15%. Microscopic Acid Fast Bacteria (AFB) had a sensitivity of 70.20% and a specificity of 98.57%. The net sensitivity of the sequential combination was 28.48%, and the specificity was 99.05%. The net sensitivity of the simultaneous combination was 77.15%, and the specificity was 95.72%. The area under the curve from the sequential diagnostic method was 0.728, and the area under the curve of the simultaneous diagnostic was 0.884. The sequential and simultaneous combinations of clinical scoring and the AFB microscopy improved the test performance. The simultaneous combination performed slightly better than the sequential combination.

Comparison of Purity and Concentration Values of Mycobacterium tuberculosis DNA Extraction Result from the Boiling and Spin Column Method

The Polymerase Chain Reaction (PCR) technique is extensively employed in molecular biology to precisely detect Mycobacterium tuberculosis. Prior to conducting PCR, extracting of high-quality genomic Deoxyribonucleic Acid (DNA) is crucial to ensure accurate and reliable results. The primary objective of this study is to conduct a comparative analysis of the purity and concentration of M. tuberculosis DNA acquired through the utilization of the boiling method and the spin column extraction methods. A descriptive comparative research design was employed, utilizing a sample of 16 sputum specimens that had previously been confirmed as positive for M. tuberculosis through Acid-Fast Bacteria (AFB) examination and Molecular Rapid Test (MRT). The extraction of DNA was carried out using the boiling method and the spin column method. Subsequently, the concentration and purity of the extracted DNA were assessed using the NanoDrop Spectrophotometer, and the results were compared. The obtained yield of M. tuberculosis DNA isolates through the boiling method ranged from 9.6 ng/µL to 1258.7 ng/µL, with an average purity value of 1.23. Conversely, for the spin column method, the concentration of M. tuberculosis DNA isolates ranged from 8.7 ng/µL to 207.8 ng/µL, with an average purity value of 1.83. In conclusion, there is a significant difference between the purity and concentration of M. tuberculosis DNA extraction results using the boiling method and spin column methods.

The Relationship Between Blood Glucose Levels To The Results Mycobacterium Tuberculosis Examination In Tuberculosis Patients

Tuberculosis (TB) is still high. 10.4 million new cases of TB occur and 1.4 million die from the disease is found The World Health Organization (WHO). Elevated blood glucose can lead to more severe tuberculosis infection, reactivation of dormant tuberculosis foci, and poor treatment outcomes. Determine the relationship of blood glucose levels to the results of Mycobacterium tuberculosis examination in suspected tuberculosis patients in Ketapang Banyuwangi area is the purpose of this of research study. The method was correlational analytic design of this study. The results conducted on 118 people who performed tuberculosis screening examinations, 32 people who qualified as a population. And 30 (thirty) people who meet the inclusion requirements as research samples. The results of the patient's molecular rapid test showed 6 (six) people were positive (+), and the results of the patient's culture showed 3 (three) people were positive (+) and 3 (three) other people were negative (-). While the results of fasting blood glucose level examination in 3 (three) tuberculosis patients conducted periodically (every week) for 5 (five) weeks were in the range of 78mg/dL - 150mg/dL. The conclusion is that there is a significant relationship between blood glucose levels and results of Mycobacterium tuberculosis examination of tuberculosis patients in the first, second and third patients in Ketapang Banyuwangi area.

Correlation Between HIV Rapid Test and HIV Viral Load in HIV Patients at Haji Hospital in Surabaya

HIV (Human Immunodeficiency Virus) is a virus that causes decreased immunity. Examinations that can be done for HIV testing include a rapid HIV test and HIV viral load. The rapid HIV test is a test that is used to find out the antibodies in the sample, while the viral load test is to find out the amount of HIV. The purpose of this study was to compare HIV using a rapid test with HIV viral load in people with HIV. This type of research is observational with a cross-sectional approach. The sample in this study were 30 samples from HIV sufferers who carried out an HIV viral load examination using the Molecular Rapid Test (TCM) method at the RSUD Haji Provinsi Jawa Timur, then a rapid HIV test was carried out using the immunochromatography method. The results of the HIV rapid test and HIV viral load were processed in the form of a bar chart and tested with the McNemar statistical test. The results of the McNemar test can be concluded that there is a significant difference between the results of the HIV viral load examination of HIV viral load by the Molecular Rapid Test (TCM) method is superior to the HIV rapid test. However, rapid tests can be used in diagnosing HIV infection.

Association Between Soluble Cluster of Differentiation 14 Levels and Active Tuberculosis Infection in Human Immunodeficiency Virus Patients

BACKGROUND: Tuberculosis is the major opportunistic infection and the leading cause of death among the HIV population worldwide. Indonesia is included among the countries seriously affected by both TB and HIV. HIV increases the lifetime risk of TB infection. One of the parameters related to TB infection in HIV patients is the level of sCD14, which is part of monocytes and macrophages and can bind to lipoarabinomannan in Mycobacterium tuberculosis. METHODS: This study uses cross-sectional analysis. The research subjects were determined by the purposive consecutive method at the Sanglah Hospital, Bali, in 2021–2022. The sCD14 level was measured by the ELISA method. The diagnosis of active tuberculosis was confirmed by examining patient specimens using the molecular rapid test method RT-PCR GeneXpert MTB/RIF. RESULTS: There were 60 subjects with HIV infection, consisting of 42 (70%) men and 18 (30%) women. The mean age was 39.13 ± 11.734 years. The median body mass index was 18.8 (16.3–23.4), clinical stage 1–2 was 17 (28.3%), and stage 3–4 was 43 (71.7%). A total of 46 (76.7%) people had other opportunistic infections besides TB. The cut-off point for sCD14 levels was 2900 ng/mL. Subjects with active TB infection were 18 (30%) people and 42 (70%) people without TB. The results of bivariate analysis using the Chi-Square test found a significant relationship between sCD14 levels and active tuberculosis infection in HIV patients (p < 0.001). Multivariate analysis with logistic regression showed that high sCD14 levels were independently associated with active tuberculosis infection in HIV patients (AOR 13.64; 95% CI: 2.89–64.42; p = 0.001), while other confounding factors were not significantly associated with active tuberculosis infection in HIV patients. CONCLUSION: sCD14 levels are associated with active tuberculosis infection in HIV patients.

Comparison of SARS-CoV-2 virus detection using the Xpert Xpress rapid molecular test on Abbott M2000 Real-Time System: a cross-sectional study.

Determining the diagnostic capabilities of the Xpert Xpress SARS-CoV-2 rapid molecular test in detecting the SARS-CoV-2 virus in the Indonesian population. A cross-sectional study was conducted with consecutive sampling, in which participants were diagnosed with coronavirus disease 2019 (COVID-19) infection using the RT-PCR Abbott M2000 SARS-CoV-2 System. A molecular rapid test examination was carried out using the Xpert Xpress SARS-CoV-2 kit. Assessing the correlation between the cycle threshold (CT) value of Xpert Xpress SARS-CoV-2 and the Abbott M2000 SARS-CoV-2 System using the Pearson and Spearmen test with P<0.05. Molecular rapid test using Xpert Xpress has a compatibility of 100% with RT-PCR using Abbott M2000 SARS-CoV-2 and a sensitivity and specificity value of 100%. The Xpert Xpress SARS-CoV-2 CT value had a significant correlation with the Abbott M2000 SARS-CoV-2 System CT value, with moderate correlation strength for the CT protein E value (r=0.444; P=0.007) and robust correlation for CT value of protein N2 (r=0.829; P<0.001). The negative predictive and positive predictive values were 100% each. The Xpert Xpress SARS-CoV-2 molecular rapid test has a sensitivity and specificity of 100% and can be recommended for diagnosing COVID-19.

The Relative Lymphocyte Count is Lower when the Etiological Agent in Pott Disease is Successfully Isolated.

Objective To describe the clinico-epidemiological, laboratory, and radiological characteristics of tuberculous spondylodiscitis in the Brazilian population, and to assess whether there are differences between patients in whom the etiological agent in Pott disease was isolated or not. Methods Patients diagnosed with tuberculosis (TB) of the spine (Pott disease) underwent follow-up between 2009 and 2019 at a quaternary hospital and were divided into 2 groups: successful isolation (SI) of the etiological agent (through bacilloscopy, culture, or positive molecular rapid test) and unsuccessful isolation (UI) of the etiological agent. Results From a total of 26 patients diagnosed with TB of the spine, 21 (80.7%) were male, with a mean age of 40 ± 22.5 years. The average lymphocyte counts were higher in the UI group (25.35 ± 13.08; p = 0.025) compared to the SI group (14.18 ± 7.48). Moreover, the monocyte/lymphocyte ratio was lower in the UI group (0.39 ± 0.22; p = 0.009) than in the SI group (0.89 ± 0.65). Relative lymphocyte counts higher than or equal to 16.7 had a sensitivity of 76.9% and specificity of 62.5% in the UI group. Values higher than or equal to 0.58 for the monocyte/lymphocyte ratio showed a sensitivity of 84.6% and specificity of 75.0% in the UI group. Conclusion No differences were observed regarding the clinico-epidemiological and radiological characteristics of the two experimental groups. However, the UI group had higher lymphocyte counts and a lower monocyte/lymphocyte ratio.

COVID-19 MOLECULAR-BASED TESTING CAPACITY IN FIVE CUSTOMARY AREAS OF PAPUA

Background: COVID-19 (Corona Virus Disease-19) is a disease that emerged at the end of December 2019 and was declared a world pandemic by the WHO (World Health Organization) in March 2020. The gold standard for testing for covid-19 until now is molecular-based virus detection with RT-PCR (Real Time-Polymerase Chain Reaction) and TCM (Molecular Rapid Test). In the early of this pandemic, Indonesia, especially Papua, still had difficulty examining COVID-19 due to limited laboratories that could carry out these tests. Aims: This study aimed to see the laboratory's ability from various regencies representing five customary Papuan areas Methods: This research was a descriptive study that uses primary data and secondary data collected from the Provincial and Regency Papua COVID-19 Response Acceleration Task Force and the representative hospitals of 5 customary Papuan areas (Saireri, Ha anim, Mee Pago, Lapago, Mamta) Results: There are several challenges and things that need to be considered by all stakeholders involved in examining COVID-19 in Papua so that the examination capacity can be maximally increased. Conclusion: Regency that only has GeneXpert are recommended to have qPCR so that the acceleration of COVID-19 testing in Papua Province can be carried out. The qPCR can be procured in several cities/regencies within one customary area so that sample delivery can be done more quickly without having to send samples to Jayapura City

Spatial Distribution of Drug-Resistant Tuberculosisin Makassar City, South Sulawesi Province, Indonesia

This study aims to determine the domicile distribution, find out the high-risk areas, and determine the risk of drug-resistant tuberculosis patients based on patient location in 15 districts of Makassar City from Tuberculosis register data of South Sulawesi Provincial Health Office in December 2017 – April 2019 period. Gen Xpert rapid or drug sensitivity examinations were used to define drug-resistant tuberculosis. The domicile location of patients was geocoded by maps in Google Earth and aggregated per area by using Kernel Density analysis using ArcView GIS 10.3 software. We found that drug-resistant tuberculosis cases tended to be clustered in the western part of Makassar City, an area with a fairly high population density. There were areas with the highest concentration of predicted cases as a high risk of transmission of drug-resistant TB, around the Bontoala District, Makassar District, and Mamajang District. Healthcare facilities located in hot spots area need to be equipped with molecular rapid test facilities and conduct drug sensitivity tests for all suspected tuberculosis patients. Further research needs to be carried out to determine the distribution of tuberculosis patients who are sensitive and resistant to drugs.

The Validity of Cross Priming Amplification to Detect SARS-CoV-2 Virus

The standard molecular technique to detect the SARS-CoV-2 virus is The Real-Time Reverse-Transcription Polymerase Chain Reaction (rRT-PCR). It requires sophisticated equipment and a time-consuming sample process. The Cross Priming Amplification (CPA) is a nucleic acid amplification technique that amplifies DNA with high specificity and efficiency under constant thermal conditions. This technique is faster than rRT-PCR and doesn't require a biosafety level-2 (BSL-2) facility. The study aimed to determine the validity of CPA with rRT-PCR as a gold standard and to evaluate its performance as molecular rapid tests for detecting SARS-CoV-2 RNA from nasopharyngeal swab specimens. This study was a descriptive diagnostic test by using data retrospectively from swab nasopharyngeal patient samples who were treated at Palabuhan Ratu Hospital with COVID-19 from 01 January to 31 December 2021. The CPA was performed on a total of 52 nasopharyngeal samples at Pelabuhan Ratu Laboratory and rRT-PCR at Provincial Health Laboratory. The validity and correlation tests were performed. The majority of subjects were female between the ages of 34-50 years. The cut-off Tt-value is 3.25, 0.84 Area Under Curve (AUC), with a p-value &lt;0.001. The CPA has good validity for COVID-19 diagnosis with 77% sensitivity, 94% specificity, 96% PPV, and 71% NPV. The sensitivity was increasing with Ct-value &lt;30 (82%) and Ct-value &lt;25 (87%). The CPA had a good validity for the COVID-19 diagnostic test. The CPA could be used as a rapid molecular test for detecting SARS-CoV-2 viral RNA from nasopharyngeal swab specimens.

Diagnostic Performance of Molecular Rapid Test in Establishing Diagnosis of MDR-TB

Tuberculosis (TB) is a global health problem and is the leading cause of morbidity and mortality in many developing countries. Multi Drug Resistant Tuberculosis (MDR TB) becomes one burden of health problems considering the high morbidity and mortality rates. Establishment of MDR TB diagnosis is still a challenge, related to the tools and methods used, while cultural examination as gold standard is expensive and takes a long time. This study aims to evaluate diagnostic performance of Molecular Rapid Test or MRT (GeneXpert) in establishing diagnosis of MDR TB using Mycobacteria Growth Indicator Tube (MGIT) culture as gold standard. Using a cross sectional design, this study involved 51 subjects, a total of 26 (51%) male and 25 (49%) female, adult patients suspected TB, treated at dr. Ario Wirawan Lung Hospital (RSPAW) Salatiga. Mean age 48.2 + 16.35 years, (17-79 years). The MRT for TB and MDR TB detection showed 13 and 7 true positives, 32 and 43 true negatives; obtained 68.4% and 87.5% Sensitivity, 100% and 100% Specificity, 100% and 100% Positive Predictive Value (PPV), 84.2% and 97.7% Negative Predictive Value (NPV), respectively. A specific analysis to diagnose MDR TB by MRT on TB patient groups showed 7 true positives, 0 false positives, 11 true negatives and 1 false negative; obtained 87.5% Sensitivity, 100% Specificity, 100% PPV and 91.7% NPV. For establishing diagnosis of MDR TB, MRT provides perfect specificity. One false negative MDR TB in MRT results is likely resistant to other than rifampicin.

Analysis of The Effectiveness of Mycobacterium Tuberculosis Through Resistant Bacterial Staining and Molecular Rapid Tests

The diagnosis of TB can be confirmed by microscopic examination of smear on the sputum of the patient. However, because this method requires very expensive equipment, it is difficult to implement it in health facilities with simple facilities. Therefore, the Ziehl Neelsen staining method is a fairly simple method of choice and provides high sensitivity and specificity. In the research of Eka Kurniwan, et al. 2016, from the results of examining 40 samples with the Molecular Rapid Test (TCM), 16 people (40%) were found to be positive. The research objective was to know Mycobacterium tuberculosis through sputum examination through Ziehl Nelssen's acid-resistant bacteria staining and Molecular Rapid Test (TCM) of Puskesmas Dempo Palembang based on volume, odor, color and consistency. This type of research is a diagnostic test with a cross sectional study approach. Population and sample of 85 patients. The sampling technique in this study is using the total sampling method. Conclusion There is no effect based on volume, there is an effect based on the smell, color and consistency of sputum, there are differences in the results of Mycobacterium tuberculosis through sputum examination through Ziehl Nelssen's Acid-Resistant Bacteria Staining and Molecular Rapid Test (TCM) at Puskesmas Dempo Palembang.

Droplet precautions on-site (DroPS) during the influenza season 2018/2019: a possible alternative to single room isolation for respiratory viral infections

BackgroundThe guideline-driven and widely implemented single room isolation strategy for respiratory viral infections (RVI) such as influenza or respiratory syncytial virus (RSV) can lead to a shortage of available hospital beds. We discuss our experience with the introduction of droplet precautions on-site (DroPS) as a possible alternative.MethodsDuring the 2018/19 influenza season we introduced DroPS on several wards of a single tertiary care center, while other wards maintained the traditional single room isolation strategy. On a daily basis, we evaluated patients for the development of respiratory symptoms and screened those with a clinical diagnosis of hospital-acquired respiratory viral infection (HARVI) for influenza/RSV by molecular rapid test. If negative, it was followed by a multiplex respiratory virus PCR. We report the concept of DroPS, the feasibility of the strategy and the rate of microbiologically confirmed HARVI with influenza or RSV infection on the DroPS wards compared to wards using the traditional single room isolation strategy.ResultsWe evaluated all hospitalised patients at risk for a HARVI, 741 (72%) on the DroPS wards and 293 (28%) on the regular wards. The hospital-acquired infection rate with influenza or RSV was 2/741 (0.3%; 1× influenza A, 1× RSV) on the DroPS wards and 2/293 (0.7%; 2× influenza A) on the regular wards.ConclusionsDroplet precautions on-site (DroPS) may be a simple and potentially resource-saving alternative to the standard single room isolation strategy for respiratory viral infections. Further studies in a larger clinical context are needed to document its safety.

Comparison of clustering in tuberculosis using fuzzy c-means and k-means methods

Tuberculosis (TB) is a health problem that has yet to be resolved in Indonesia. Based on WHO data, in 2021 Indonesia will still be in the third rank of the highest TB cases in the world. This study aims to determine how many groups of TB patients are based on age, gender, HIV status, history of diabetes mellitus, chest X-ray, and the results of the Molecular Rapid Test (TCM). The data used in this study were 985 from 2017 to 2020. The method used in this research is K-Nearest Neighbor (KNN) in carrying out the imputation process, as well as comparing the k-means and Fuzzy C-Means (FCM) methods in classifying TB data. Before doing the grouping, the data cleaning process is carried out by an imputation process which is useful for filling in the missing data in this case, using the KNN method. To produce maximum results of data grouping or clustering, it is necessary to determine the right number of clusters. For this reason, this study tries to compare the elbow, silhouette coefficient, and Davies Bouldin Index (DBI) methods. The application of the KNN method in the data imputation process in this study is to use k=5. The application of the K-Means algorithm is to form groups of TB patients based on six features. Determination of the optimal number of clusters using the K-means and FCM methods shows the optimal number of clusters, namely K = 2 but with different values. The results of the clustering test using the elbow method with the K-means and FCM methods are 93288.49. The DBI value for the K-means and FCM methods is 0.4937. Meanwhile, the clustering trial with the silhouette coefficient on K-means yields a value of 0.6318 which is better than the FCM which produces a value of 0.6321. This shows that the results of clustering k-means with silhouette coefficients produce better cluster quality because they have a lower silhouette coefficient value than FCM.