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COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE TO CHILDREN WHO LIVE IN LOW AND HIGH ALTITUDE IN LOW LEPROSY ENDEMIC AREA OF SOUTH SULAWESI Agusni, Indropo; Iswahyudi, Iswahyudi; Wahyuni, Ratna; Adriaty, Dinar; Tabri, Farida; Amin, Safruddin; Adam, A. M.; Adam, Safruddin; Mataallo, Timurleng Tonang; Rachmawati, Rachmawati
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1373.847 KB)

Abstract

Background: The intensity of Mycobacterium leprae exposure to people who live in leprosy endemic area could be measured by serological study and detection of the bacilli in the nose cavity. Different geographical altitude might have some influences to this exposure since the bacilli prefer to live in warm areas. Aim: A combined serological and PCR study of leprosy was conducted in Selayar island, South Sulawesi to 80 school children (40 from low land and 40 from highland altitudes) in order to compare the exposure intensity between the two areas. Method: Anti PGL-1 IgM antibody (ELISA) and PCR study to detect M.leprae in the nasal cavity were performed simultaneously from each person. Result: Seropositive cases were found in 23/40 children from low land compared to 16/40 children from high land, but statistically no significant difference (p>0.05). PCR positive for M.leprae in the nasal cavity only found in 1/40 children, both in low and high altitude. Conclusion: It is concluded that although the existence of M.leprae in nasal cavity is minimal, the intensity of exposure to this bacilli still high as indicated by serological study.
DAPSONE RESISTANCE IN A Mycobacterium leprae ISOLATE WITH TWO POINT MUTATIONS IN folP GENE FROM A LEPROSY PATIENT Abdullah, Rasyidin; Izumi, Shinzo; Agusni, Indropo; Prakoeswa, Cita; Wahyuni, Ratna; Ardiaty, Dinar
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 2 (2012)
Publisher : Institute of Topical Disease

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Abstract

Drug resistance in leprosy is important for Leprosy Control Program, since the WHO-Multidrug regiment (MDT) has been used for global treatment of leprosy for more than two decades already. A Dapsone resistance case in a Multibacillary (MB) leprosy case is reported. The patient was diagnosed and treated in Tajuddin Chalid Hospital Makassar, South Sulawesi. Previously he was treated in a health center at South Sulawesi and was given a treatment for one year, before referred to the hospital. The leprosy skin lesions are still active with erythematous skin lesions and thickened ear lobe. Bacteriological examination was positive for Acid Fast Bacilli, the Bacterial Index was 3+ and the Morphological Index was 1%. The specimens of M.leprae isolation was sent to the Institute of Tropical Disease Surabaya for drug resistance study. Using the Lp1-2 and Lp3-4 nested primers, PCR test was positive for M.leprae.Sequencing result for folP gene showed a double mutation at codon 53 (ACC / Threonin ) which become (AGG / Arginine). Simultaneous mutation at two nucleotides at one codon has never been reported in Indonesia before and this phenomenon is important for leprosy control policy.
COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE BETWEEN HOUSEHOLD AND NONHOUSEHOLD CONTACT OF LEPROSY Adriaty, Dinar; Anwar, Anis Irawan; Agusni, Indropo; Iswahyudi, Iswahyudi; Wahyuni, Ratna; Amiruddin, Muhammad Dali; Jifanti, Friska; Arsyad, Yuniarti
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 1 (2012)
Publisher : Institute of Topical Disease

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Abstract

Leprosy stills a public health problem in West Sulawesi which has a Case Detection Rate (CDR) around 43.69/100.000 population. Household contacts of leprosy are a high risk group to be infected, due to droplet infection mode of transmission of the disease. A nose swab examination and serological study was conducted to detect exposure of M. leprae of people who live in leprosy endemic area. Detection of M. leprae in the nasal cavity will represent the exposure rate from outside and the measurement of specific antibody is represented the result of exposure to the immune system. Two group of inhabitants (30 household contacts of leprosy and 30 nonhousehold contacts) were involved in the study. They live in Banggae district, a leprosy endemic area of Majene Regency, West Sulawesi. Sixty nose swab samples and sixty capillary blood samples from the same invidividuals of the two groups were collected and sent to Leprosy laboratory of the Institute of Tropical Disease, Airlangga University Surabaya. A Polymerase Chain Reaction (PCR) was performed to the nose swab samples for detection of M. leprae. The blood samples were examined serologically to measure the level of anti PGL-1 antibody. PCR examination of nose swab samples showed 1/30 positive result in the household contact group and also 1/30 positive result in non-household contact of leprosy (statistically no significant difference, p > 0.05). Serological study showed higher sero-positive result in the household contact group (15/30 or 50%) compared to non-household contact (11/30 or 36%), but statistical calculation revealed no significant difference between the two groups (p > 0.05) on sero-positive results of leprosy. It is concluded that household and non-household contact in leprosy have the same risk to be affected by the disease. The term of household and non-household contact need to be redefined. The possible role of exposure from the environment was also discussed, especially from non-human resource of M. leprae.
Mycobacterium leprae BACILLEMIA IN BOTH TWINS, BUT ONLY MANIFEST AS LEPROSY IN ONE SIBLING Sukmawati, Netty; Agusni, Indropo; Listiawan, M. Yulianto; Prakoeswa, Cita Rosita S.; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 7 (2015)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v5i7.1206

Abstract

Leprosy in twins is rarely reported. A 19 years-old male student, from Lamongan district, was diagnosed as Multibacillary (MB) leprosy in the Skin and STD Clinic of Dr. Soetomo General Hospital Surabaya. Multiple anesthetic skin lesions were found, but the bacteriologic examination was negative for Acid Fast Bacilli (AFB). Histopathology examination support the diagnosis of BL type of leprosy. His twin brother that has been lived together since born until present seems healthy without any complaints of skin lesions and have no signs of leprosy. When a serologic examination for leprosy was performed, a high anti PGL-1 antibody level was found in patient (IgM anti PGL-1 2937 and IgG anti PGL-1 3080 unit/ml) while his healthy twin brother showed only low level (IgM 745 and IgG 0 unit/ml). Interestingly when a PCR study was performed to detect M.leprae in the blood, both of them showed positive results. Using the TTC method, a genomic study of for M.leprae, it is revealed that both samples were identic ( 27x TTC repeats). According to patient’s history, he had a traffic accident and got a wound in the knee seven years ago, while the skin lesions seems started from this area around three years ago before it spread to other parts of the body. The patient was treated with Multi-drug therapy (MDT) while his sibling got a prophylactic treatment for leprosy. After 6 months of treatment, the leprosy skin lesions were diminished and the serologic anti PGL-1 has been decreased. His healthy brother also showed a decrease in anti PGL-1 level and no skin signs of leprosy.
DAPSONE RESISTANCE IN A Mycobacterium leprae ISOLATE WITH TWO POINT MUTATIONS IN folP GENE FROM A LEPROSY PATIENT Dinar Ardiaty; Ratna Wahyuni; Cita Prakoeswa; Rasyidin Abdullah; Indropo Agusni; Shinzo Izumi
Indonesian Journal of Tropical and Infectious Disease Vol. 3 No. 2 (2012)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (713.052 KB) | DOI: 10.20473/ijtid.v3i2.218

Abstract

Drug resistance in leprosy is important for Leprosy Control Program, since the WHO-Multidrug regiment (MDT) has been used for global treatment of leprosy for more than two decades already. A Dapsone resistance case in a Multibacillary (MB) leprosy case is reported. The patient was diagnosed and treated in Tajuddin Chalid Hospital Makassar, South Sulawesi. Previously he was treated in a health center at South Sulawesi and was given a treatment for one year, before referred to the hospital. The leprosy skin lesions are still active with erythematous skin lesions and thickened ear lobe. Bacteriological examination was positive for Acid Fast Bacilli, the Bacterial Index was 3+ and the Morphological Index was 1%. The specimens of M.leprae isolation was sent to the Institute of Tropical Disease Surabaya for drug resistance study. Using the Lp1-2 and Lp3-4 nested primers, PCR test was positive for M.leprae.Sequencing result for folP gene showed a double mutation at codon 53 (ACC / Threonin ) which become (AGG / Arginine). Simultaneous mutation at two nucleotides at one codon has never been reported in Indonesia before and this phenomenon is important for leprosy control policy.
TTC Repeats Variation of Mycobacterium leprae Isolates for Analysis of Leprosy Transmission in Leprosy Endemic Area in East Java, INDONESIA Dinar Adriaty; Ratna Wahyuni; Iswahyudi Iswahyudi; Indropo Agusni; Shinzo Izumi
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1494.939 KB) | DOI: 10.20473/ijtid.v1i1.3722

Abstract

East Java province still has some pocket of leprosy endemic areas. In order to solve the problem, molecular typing will make it feasible to study the transmission pattern of Mycobacterium leprae in leprosy endemic area. The present study is to analyze the presence of M.leprae DNA in the environment and to study variation number of TTC repeats and their distribution. Poteran Island is located in Madura, East Java and was chosen because this island has a high prevalence of leprosy and remains stable for the last five years. All samples were analyzed by PCR and the numbers of TTC repeats were confirmed by direct sequencing. Of all collected samples, 26.4% isolates of water resources (24); 61.9% nasal swabs (26); and 35.3% skin tissues (24) are positives. No statistically difference in the pattern distribution of TTC repeats between skin tissues of patients and nasal swab of households contact (p=0.594); also distribution of TTC repeats between skin tissues of leprosy patients and those of water resources (p=0.441); and distribution of TTC repeats between nasal swab of households contact with water resources (p=0.906). It means that the transmission of M.leprae in leprosy endemic area has closely related in 3 aspects: agent, host & environment.
Variation of TTC Repeat Pattern In The Dna of Mycobacterium Leprae Isolates Obtained from Archeological Bones and Leprosy Patients From East Nusa Tenggara Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Aksono, Bimo; Koesbardiati, Toetik; Agusni, Indropo; Izumi, Shinzo
Journal of Tropical Life Science Vol 2, No 3 (2012)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.2.3.%x

Abstract

The existence of leprosy or kusta or Morbus Hansen or Hansens disease has been known for years, including in Indonesia. Starting from the discovery of Mycobacterium leprae isolates from ancient bone (about 1.000 years B.C), the archaeological excavations results in East Nusa Tenggara, interesting questions arise about how the development of leprosy in eastern Indonesia is. Biology molecular study would become a powerful tool to investigate the presence of leprosy bacillary whether there are similarities between the genomes of M. leprae isolates in the primeval and the present. PCR examinations were performed on mandibular bone fragments from ancient human who lived 1000 years B.C. discovered in archaeological surveys on the island of Lembata and three leprosy patients from East Nusa Tenggara. The DNA extraction was performed using a kit from Qiagen products and its TTC repeating pattern was seen with the method of direct sequencing. It turned out that the TTC profile obtained from samples of archaeological was as many as 13 copies, while the repetition of TTC in three samples of leprosy patients were 15, 17 and 26 copies. The different number of TTC repetition shows the different isolates of M. leprae between in the ancient times and the present. Further studies are needed to verify the differences in the genome that occur, for example from the study of SNPs (single nucleotide polymorphisms).
Profile of Mutation on Drug Resistance Mycobacterium leprae Isolates in Indonesia Collected During 2003-2011 RATNA WAHYUNI; DINAR ADRIATY; ISWAHYUDI ISWAHYUDI; CITA ROSITA SIGIT PRAKOESWA; INDROPO AGUSNI; SHINZO IZUMI
Microbiology Indonesia Vol. 6 No. 3 (2012): September 2012
Publisher : Indonesian Society for microbiology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.5454/mi.6.3.7

Abstract

Multidrug therapy (MDT) regiment has been used for leprosy all over the world for more than 20 years. Drug resistances of Mycobacterium have been reported from many areas. The resistance mostly occurred due to mutation on the gene coding protein targeted by anti-leprosy drugs. Two hundreds and seventy M. leprae isolates from some area in Indonesia were examined for studying the profile of mutation among isolates collected during 2003-2011. Drug resistance determining region of the folP1 gene and the rpoB gene was sequenced. The results showed 5 isolates of M. leprae harboured mutation only in the folP1 gene and another isolate harbored mutation in both the folP1 and rpoB gene. The point mutation in the folP1 gene that was found in 2 isolates occurred in codon 53 (ACC→GCC; Thr→Ala). Double point mutations on codon 53 that was found in two isolates were ACC→AGA (Thr→Arg) and ACC→AGG (Thr→Arg). The point mutation in the folP1 geneoccurred in codon 55 were found in two isolates were CCC→CTC (Pro→Leu) and CCC→CGC (Pro→Arg). Whereas mutation in the rpoB gene in one isolate occurred in codon 410 was GAT→TAT (Asp→Tyr). These mutations that altered the amino acids of the protein revealed that isolates of M. leprae were resistant to drug with variable profiles
Molecular Detection of Dapsone and Rifampicin Resistance on Mycobacterium leprae from Leprosy Patients in East Java DINAR ADRIATY; RATNA WAHYUNI; CITA ROSITA S. PRAKOESWA; NI PUTU SUSARI; INDROPO AGUSNI; SHINZO IZUMI
Microbiology Indonesia Vol. 3 No. 3 (2009): December 2009
Publisher : Indonesian Society for microbiology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.5454/mi.3.3.4

Abstract

The drug resistant problem of Mycobacterium leprae has been developing since the last decade and this has become a leprosy elimination problem in several countries, including Indonesia. Using biological on molecular methods, it is now possible to test for drug resistant cases in relatively simple and less time consuming ways. The purpose of the study is to analyze theprevalence of drug resistance M. leprae to dapsone and rifampicin in East Java based on the etection of mutations in the folP and rpoB genes. All samples were obtained from multibacillary leprosy patients in East Java, who have admitted to the Dr Sutomo Hospital Surabaya in 2003-2005. Isolates were analyzed by PCR, and the presence of nucleotide sequence of the folP and rpoB genes from M. leprae were confirmed by direct sequencing. Of 94 specimens which were collected, all were analyzed for their folP and rpoB genome. From 94 isolates, 70 showed a positive result by the folP1-folPR test and 77 out of 94 isolates showed positive by the rpoBF-rpoBR test. From 70 isolates for folP gene examination, there were 3 isolates which had mutation in the amino acid at codon 53; 2 cases Threonin (ACC) became Alanin (GCC) and 1 case Threonin (ACC) became Arginin (AGA). These mutations are responsible to dapsone resistance. For the rpoB gene, no mutation was found. The result suggested that 3 isolates (4.3%), 1 from a new case and 2 from relapse cases in this experiment, were resistant to dapsone and all isolates (100%) were susceptible to rifampicin.
COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE TO CHILDREN WHO LIVE IN LOW AND HIGH ALTITUDE IN LOW LEPROSY ENDEMIC AREA OF SOUTH SULAWESI Rachmawati Rachmawati; Timurleng Tonang Mataallo; Safruddin Adam; A. M. Adam; Safruddin Amin; Farida Tabri; Dinar Adriaty; Ratna Wahyuni; Iswahyudi Iswahyudi; Indropo Agusni
Indonesian Journal of Tropical and Infectious Disease Vol. 4 No. 4 (2013)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1373.847 KB) | DOI: 10.20473/ijtid.v4i4.220

Abstract

Background: The intensity of Mycobacterium leprae exposure to people who live in leprosy endemic area could be measured by serological study and detection of the bacilli in the nose cavity. Different geographical altitude might have some influences to this exposure since the bacilli prefer to live in warm areas. Aim: A combined serological and PCR study of leprosy was conducted in Selayar island, South Sulawesi to 80 school children (40 from low land and 40 from highland altitudes) in order to compare the exposure intensity between the two areas. Method: Anti PGL-1 IgM antibody (ELISA) and PCR study to detect M.leprae in the nasal cavity were performed simultaneously from each person. Result: Seropositive cases were found in 23/40 children from low land compared to 16/40 children from high land, but statistically no significant difference (p>0.05). PCR positive for M.leprae in the nasal cavity only found in 1/40 children, both in low and high altitude. Conclusion: It is concluded that although the existence of M.leprae in nasal cavity is minimal, the intensity of exposure to this bacilli still high as indicated by serological study.