The prevalence of Helicobacter pylori infection in Indonesia is still controversial and mainly investigated in the largest ethnic group, Javanese. We examined the prevalence of H. pylori infection using four different tests including culture, histology confirmed by immunohistochemistry and rapid urease test. We also analyzed risk factors associated with H. pylori infection in five largest islands in Indonesia. From January 2014–February 2015 we consecutively recruited a total of 267 patients with dyspeptic symptoms in Java, Papua, Sulawesi, Borneo and Sumatera Island. Overall, the prevalence of H. pylori infection was 22.1% (59/267). Papuan, Batak and Buginese ethnics had higher risk for H. pylori infection than Javanese, Dayak and Chinese ethnics (OR = 30.57, 6.31, 4.95; OR = 28.39, 5.81, 4.61 and OR = 23.23, 4.76, 3.77, respectively, P <0.05). The sensitivity and specificity for RUT and culture were 90.2%, 92.9% and 80.5%, 98.2%, respectively. The patients aged 50–59 years group had significantly higher H. pylori infection than 30–39 years group (OR 2.98, P = 0.05). Protestant had significantly higher H. pylori infection rate than that among Catholic (OR 4.42, P = 0.008). It was also significantly lower among peoples who used tap water as source of drinking water than from Wells/river (OR 9.67, P = 0.03). However only ethnics as become independent risk factors for H. pylori infection. Although we confirmed low prevalence of H. pylori in Javanese; predominant ethnic in Indonesia, several ethnic groups had higher risk of H. pylori infection. The age, religion and water source may implicate as a risk factor for H. pylori infection in Indonesia.
Prisoners in correctional facilities are predisposed to chronic viral infections because of their high-risk behaviors or unsafe lifestyle. The economic and public health burden of chronic hepatitis B and C and its sequelae need to be addressed, such as by finding the risk factors and therefore reducing the spread of HCV and HBV infection in prisons. This study aimed to see the profile of Hepatitis B and C Virus Infection in prisoners in Lubuk Pakam Correctional Facilities. This cross-sectional study was in Lubuk Pakam Correctional Facilities in 2016. From 1114 prisoners in Lubuk Pakam correctional facility, we randomly examined 120 prisoners for HBV and HCV serology markers. From 120 prisoners, six prisoners were HBV positive, 21 prisoners were HCV positive and one prisoner positive for both HCV and HBV infection. The most common risk factors for prisoners getting HBV infection are tattoos and free sex (36.4% and 36.4%, respectively). The most common risk factors for HCV infection in prisoners are tattoos and free sex (40% and 35%, respectively).
AbstrakHepatitis B kronik merupakan masalah global dan Indonesia termasuk negara yang memiliki prevalensi tinggi. Keterbatasan biopsi hati untuk mendiagnosis fibrosis hati karena invasif membangkitkan penelitian metode noninvasif. Dilakukan penelitian uji diagnostik potong lintang untuk mengetahui akurasi rasio red cell distribution width (RDW) terhadap jumlah trombosit untuk memprediksi derajat fibrosis hati penderita hepatitis B kronik. Terhadap subjek penelitian dilakukan pemeriksaan HBsAg, darah rutin, dan fibroscan di RSUP H. Adam Malik, Medan sejak Januari sampai Maret 2015. Nilai rasio RDW terhadap trombosit dihitung dari hasil pemeriksaan darah rutin. Derajat fibrosis hati dinilai berdasarkan hasil fibroscan dari skala F0-F4. Prosedur analisis adalah receiver operating characteritic (ROC) dan area under the curve (AUC). Dari 34 kasus, 20 orang termasuk kelompok fibrosis hati ringan-sedang (F≤2) dan 14 orang kelompok fibrosis berat (F>2). Nilai akurasi sebesar 72,3% (IK 95%:84,1-97%). Dengan nilai cut-off 0,0591 didapatkan sensitivitas 71,4%; spesifisitas 60%; nilai prediksi positif (NPP) 55,6%; nilai prediksi negatif (NPN) 75%; rasio kemungkinan positif (RKP) 1,79; dan rasio kemungkinan negatif (RKN) 0,48. Simpulan, rasio RDW terhadap jumlah trombosit mampu memprediksi derajat fibrosis hati penderita hepatitis B kronik dengan tingkat akurasi sedang (72,3%). Kata kunci: Fibroscan, fibrosis hati, hepatitis B kronik, RDW, trombosit Diagnostic Accuracy of Liver Fibrosis based on Red Cell Distribution Width (RDW) to Platelet Count with Fibroscan in Chronic B Hepatitis AbstractChronic hepatitis B is a global problem and Indonesia has a high prevalence. Limitation of liver biopsy as an invasive method, initiates many studies on non invasive diagnosing method for liver fibrosis. The cross sectional study was conducted to determine the accuracy of red cell distribution width (RDW) to platelet count ratio (RPR) in predicting liver fibrosis degree in chronic hepatitis B. HBsAg, complete blood count, and fibroscan were examined in H. Adam Malik Hospital, Medan from January to March, 2015. RPR was calculated. The degree of liver fibrosis assessed by fibroscan on a scale of F0-F4. The accuracy was evaluated by constructing receiver operating characteritic (ROC) and area under the curve (AUC). From 34 cases, 20 subjects were in mild-moderate liver fibrosis (F≤2) and 14 subjects in severe liver fibrosis (F>2). The accuracy was 72.3% (95% CI: 84.1-97%) with a cut-off value 0.0591. Sensitivity was 71.4%, specificity 60%, positive predictive value (PPV) 55.6%, negative predictive value (NPV) 75%, positive predictive ratio (PPR) 1.79, and negative predictive ratio (NPR) was 0.48. RDW to platelet count ratio can predict liver fibrosis grade in chronic hepatitis B with a moderate degree of accuracy (72.3%).
Background: A great interest has been dedicated to the development of non-invasive predictive models in
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