Background Despite abundant data on mental health during the COVID-19 pandemic, 3 important knowledge gaps continue to exist, i.e., 1) studies from low-/middle income countries (LMICs); 2) studies in the later period of the COVID-19 pandemic; and 3) studies on non-hospitalized asymptomatic and mild COVID-19 patients. To address the knowledge gaps, we assessed the prevalence of and the risk factors for mental health symptoms among non-hospitalized asymptomatic and mild COVID-19 patients in one LMIC (Indonesia) during the later period of the pandemic. Methods This cross-sectional study was conducted in September 2020 in East Java province, Indonesia. Study population consisted of non-hospitalized asymptomatic and mild COVID-19 patients who were diagnosed based on reverse transcriptase-polymerase chain reaction results from nasopharyngeal swab. Mental health symptoms were evaluated using the Depression Anxiety Stress Scale-21. Results From 778 non-hospitalized asymptomatic and mild COVID-19 patients, 608 patients were included in the analysis. Patients’ median age was 35 years old and 61.2% were male. Of these, 22 (3.6%) reported symptoms of depression, 87 (14.3%) reported symptoms of anxiety, and 48 (7.9%) reported symptoms of stress. Multivariate logistic regression analysis showed that females were more likely to report symptoms of stress (adjusted odds ratio (aOR) = 1.98, p-value = 0.028); healthcare workers were more likely to report symptoms of depression and anxiety (aOR = 5.57, p-value = 0.002 and aOR = 2.92, p-value = 0.014, respectively); and those with a recent history of self-quarantine were more likely to report symptoms of depression and stress (aOR 5.18, p = 0.004 and aOR = 1.86, p = 0.047, respectively). Conclusion The reported prevalence of mental health symptoms, especially depression, was relatively low among non-hospitalized asymptomatic and mild COVID-19 patients during the later period of the COVID-19 pandemic in East Java province, Indonesia. In addition, several risk factors have been identified.

Klebsiella pneumoniae Extended-spectrum β-lactamase (ESBL) was one of the microorganism that cause nosocomial infection which resistant to beta-lactams antibiotics. Orange Jessamine (Murraya paniculata) was traditional medicine which believed has antibacterial components, such as: fl avonoids, alkaloids, essential oils, coumarins, terpenoids, tannins, and saponins. In the previous studies, there was antibacterial activity in ethanolic extract of Murraya paniculata againsts E.coli, K.pneumoniae, S.typhi, E.faecalis, P.aeruginosa, S.fl exneri, S.aureus, and S.sonneii with concentration 200 mg/ mL. There has not experiment about ethanolic extract of Murraya paniculata against Klebsiella pneumoniae ESBL yet. The aim of this study was to fi nd out the in vitro antibacterial activity of ethanol extracts of Murraya Paniculata against Klebsiella pneumoniae ESBL Broth dilution method with concentration 200 mg/mL, 100 mg/mL, 50 mg/mL, 25 mg/mL, 12,5 mg/mL, 6,25 mg/mL, and 3,125 mg/mL were used for the determination of the Minimal Inhibitory Concentration (MIC). While the Minimal Bacterial Concentration (MBC) was assessed using streaking method in Nutrient Agar Plate. The highest concentration in this study was obtained from 100 g of Murraya paniculata leaves dissolved in 500 mL of 40% ethanol. The study was carried out 4 times replication. At the time of the sterility test extract, germ growth appeared on Nutrient Agar Plate media, so the extract was fi ltered before being used for research. After incubation at 37 °C for 24 hours, growth of bacterial colonies on all agar plates was observed. The concentration of the ethanol extract of Murraya Paniculata (200 mg/mL) did not inhibit the growth of Klebsiella pneumoniae ESBL. The ethanol extracts of Murraya paniculata in concentration 200 mg/mL had no antibacterial activity against Klebsiella pneumoniae ESBL.

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