Ramadan fasting (RF) is stressor that will be altered immune system. Macrophage is one of immune cell and IFN

Objective: The objective of this study was to determine whether Ramadan fasting (RF) alters the ability of serum, peripheral blood mononuclear cells (PBMC) and macrophages to kill Mycobacterium tuberculosis (M. tb). Methods: Thirty healthy male volunteers who fasted during Ramadan participated in the study. Blood sampling was conducted seven days before and on the seventh and 21 st day of Ramadan. The following parameters were measured by ELISA: Complement C3, inducible nitric oxide synthase (iNOS), superoxide dismutase (SOD) levels in serum and PBMC. The killing ability of immune components from these volunteers was determined by measuring colony-forming units (CFUs). Results: The CFU in PBMC infected with M. tb (PIM) and macrophages infected with M. tb (MIM) decreased on the seventh day of RF compared with that observed before RF. The CFUs in serum infected with M. tb (SIM) increased and CFUs in MIM decreased on the 21 st day of RF compared with before RF. The levels of iNOS in serum and the CFUs in MIM decreased and the CFUs in SIM and PIM increased on the 21 st day of RF compared with the seventh day of RF. The levels of iNOS in PBMC significantly increased (p<0.05) on the seventh and 21 st day of Ramadan compared with before RF. The other differences were not significantly different. Conclusions: This study suggests that RF has a beneficial effect on host defence against M. tb and decreases the risk of tuberculosis (TB) infection in healthy subjects.

Tuberculosis is one of 10 causes of death in the world. In 2018 TB sufferers in Indonesia reached 840 thousand people, the third-highest figure in the world after India and China. The purpose of this study was to analyze the relationship between contact with tuberculosis patients, occupancy density and ventilation area with tuberculosis’ incidence. This study used meta-analysis, the articles’ sources were from Google Scholar, PubMed and DOAJ published from 2011-2020. There were 12 articles that met the conditions for contact-free variables with tuberculosis patients, 12 articles of occupancy density, and 10 articles of ventilation area variable. The results were contacting with tuberculosis patients had 5.93 times more of getting tuberculosis compared to people who had no contact with tuberculosis patients, people who lived in densely populated areas were 2.41 times more getting tuberculosis compared to people living in occupancy that is not crowded, people who live in dwellings with a non-standard ventilation area were 2.14 times more getting tuberculosis when compared to people who live in an area where the ventilation area meets the standard. The conclusion of this study is tuberculosis patient contact, occupancy density, and ventilation area with the incidence of tuberculosis have a significant relationship.