In Indonesia, the diagnosis of pulmonary tuberculosis relies primarily on an identification of acid-fast bacilli on sputum smears. However, microscopic device has several limitations. The sensitivity of microscopic examination is variable. The quality of smear microscopic results is heavily depend on the workload, and the skill of the technician’s reading the slide. TB antigen rapid test device (TB Ag) is fast, easy and does not either need skillness of the operator. The kit detects specific secreted antigen M.tuberculosis coded by: RD (Region of Difference) 1, RD2 and RD3. These RD1−3 were found deleted from BCG (Bacille Calmette-Guerine) vaccine strain. In the present study, the diagnostic value of TB Ag was assessed. Sputum samples were examined from 59 suspected tuberculosis patients and 22 non tuberculosis patients. The samples of the suspected tuberculosis patients were collected as three consecutive sputum specimens (spot, morning, spot). The total 199 specimens were examined by sputum smear microscopy and TB Ag. M.tuberculosis culture by using Lowenstein Jensen media, which was used as a gold standard. The sensitivity and specificity of microscopic sputum smear were 83.8% (95% CI: 70.0–89.4) and 96.3% (95% CI: 89.8–98.7), respectively. While, the sensitivity and specificity of TB Ag were 72.6% (95% CI: 63.9–79.9) and 90.9% (95% CI: 72.2–97.5), respectively. The concordance between microscopic sputum smear and TB Ag was 70.8%. TB Ag can be considered as a new diagnostic tool for the diagnosis of pulmonary tuberculosis, especially at the health services where there is no expert technician available for microscopic sputum smear examination.

Sepsis is one of the significant causes of global morbidity and mortality. One of the keystones of sepsis diagnosis and treatment is the Blood Culture (BC) test. BC performed after intravenous Antibiotic Administration (AA) appears to reduce the culture positivity rate. This study aimed to evaluate the influence of AA before obtaining blood culture samples on the positivity rate. This was a retrospective cohort study, conducted from January to February 2020 on patients with suspected sepsis at the Mataram General Hospital from January to December 2019. Patients with valid blood culture tests were included. Out of 178 suspected sepsis patients, 138 samples were culture-negative, and 40 samples were culture-positive. Out of 40 culture-positive patients, 23 (57.5%) samples were obtained before AA, whereas other 17 samples (42.5%) were obtained after AA. In addition, among 138 culture-negative patients, 101 (73.2%) subjects received antibiotics before sampling, and only 37 (26.8%) subjects received antibiotics after sampling. There was a significant difference in the blood culture positivity results between samples taken before and after AA (p=0.001). Samples were taken before AA had a 3.69 times greater possibility of positive culture results than samples taken after AA (OR 3.69; 95% CI 1.77-7.67; p= 0.0005). The percentage of positive culture results among subjects receiving antibiotics before sampling was highest (20%) in those whose samples were taken less than an hour before the next AA. Antibiotics administration of sepsis patients before blood culture sampling gives a lower positivity rate than AA after blood culture sampling.

Dengue IgM, IgG Capture ELISAs and NS1 Ag ELISA become the most widely used serological methods for dengue diagnosis untilnow. Previous studies reported a possible use of IgA antibodies for dengue virus as a new serologic marker to make dengue infectionactive. In the present study, the performance of IgA anti-dengue rapid test as a new marker of dengue infection was assessed. In thisstudy, the sera were obtained from 30 dengue virus infection patients and 30 non dengue virus infection patients. Thirty dengue pairedsera were collected twice, at the time of hospital admission (acute) and at discharge (convalescent). All sera samples were characterizedusing dengue reference ELISAs (NS1 Ag, Dengue IgM and IgG capture ELISAs). The results of IgA anti-dengue rapid test were comparedwith the corresponding dengue reference tests. The sensitivity and specificity of IgA anti-dengue rapid test respectively were 78.3% (95%CI: 65.5–87.5%), and 73.3% (95% CI: 55,6–85,8%). Meanwhile, from acute sera, sensitivity of IgA anti-dengue rapid test was 83.3%(95% CI: 64.5–93.7), higher than IgM (73.3%, 95% CI: 53.8–87.0), IgG (66.7%, 95% CI: 47.1–82.1) and NS1 Ag ELISAs (60%,95% CI: 40.7–76.8). Positive IgA anti-dengue rapid test results in acute sera was higher in the secondary (91%) than primary infection(57%). IgA anti-dengue rapid test can be considered as a new marker for dengue infection, because it gives a high sensitivity, especiallyin the acute phase and in the secondary infections as well.