Dengue disease is still a major health problem in Indonesia. Surabaya, the second largest city in the country, is endemic for dengue. We report here on dengue disease in Surabaya, investigating the clinical manifestations, the distribution of dengue virus (DENV) serotypes, and the relationships between clinical manifestations and the genetic characteristics of DENV. A total of 148 patients suspected of having dengue were recruited during February-August 2012. One hundred one (68%) of them were children, and 47 (32%) were adults. Dengue fever (DF) and Dengue hemorrhagic fever (DHF) were equally manifested in all of the patients. We performed DENV serotyping on all of the samples using real-time RT-PCR. Of 148, 79 (53%) samples were detected as DENV positive, with DENV-1 as the predominant serotype (73%), followed by DENV-2 (8%), DENV-4 (8%), and DENV-3 (6%), while 5% were mixed infections. Based on the Envelope gene sequences, we performed phylogenetic analyses of 24 isolates to genotype the DENV circulating in Surabaya in 2012, and the analysis revealed that DENV-1 consisted of Genotypes I and IV, DENV-2 was of the Cosmopolitan genotype, the DENV-3 viruses were of Genotype I, and DENV-4 was detected as Genotype II. We correlated the infecting DENV serotypes with clinical manifestations and laboratory parameters; however, no significant correlations were found. Amino acid analysis of Envelope protein did not find any unique mutations related to disease severity.

Diagnostic tests based on detection of dengue virus (DENV) genome are available with varying sensitivities and specificities. The Simplexa Dengue assay (Focus Diagnostics) is a newly developed real-time RT-PCR method designed to detect and serotype DENV simultaneously. To assess the performance of the Simplexa Dengue assay, we performed comparison with conventional RT-PCR and SYBR Green real-time RT-PCR on patients sera isolated from eight cities across Indonesia, a dengue endemic country. A total of 184 sera that were confirmed using NS1 and/or IgM and IgG ELISA were examined. Using conventional and SYBR Green real-time RT-PCR, we detected DENV in 53 (28.8%) and 81 (44.0%) out of 184 sera, respectively. When the Simplexa Dengue assay was employed, the detection rate was increased to 76.6% (141 out of 184 samples). When tested in 40 sera that were confirmed by virus isolation as the gold standard, the conventional RT-PCR yielded 95% sensitivity while the sensitivity of SYBR Green real-time RT-PCR and Simplexa Dengue assay reached 97.5% and 100%, respectively. The specificities of all methods were 100% when tested in 43 non-dengue illness and 20 healthy human samples. Altogether, our data showed the higher detection rate of Simplexa Dengue compared to conventional and SYBR Green real-time RT-PCR in field/surveillance setting. In conclusion, Simplexa Dengue offers rapid and accurate detection and typing of dengue infection and is suitable for both routine diagnostic and surveillance.

Introduction: Dengue is endemic and affects people in all Indonesian provinces. Increasing dengue cases have been observed every year in Sukabumi in West Java province. Despite the endemicity, limited data is available on the genetic of dengue viruses (DENV) circulating in the country. To understand the dynamics of dengue disease, we performed molecular and serological surveillance of dengue in Sukabumi. Methodology: A total of 113 patients were recruited for this study. Serological data were obtained using anti-dengue IgM and IgG tests plus dengue NS1 antigen detection. Dengue detection and serotyping were performed using real-time RT-PCR. Viruses were isolated and the envelope genes were sequenced. Phylogenetic and evolutionary analyses were performed to determine the genotype of the viruses and their evolutionary rates. Results: Real-time RT-PCR detected DENV in 25 (22%) of 113 samples. Serotyping revealed the predominance of DENV-2 (16 isolates, 64%), followed by DENV-1 (5 isolates, 20%), and DENV-4 (4 isolates, 16%). No DENV-3 was detected in the samples. Co-circulation of genotype I and IV of DENV-1 was observed. The DENV-2 isolates all belonged to the Cosmopolitan genotype, while DENV-4 isolates were grouped into genotype II. Overall, their evolutionary rates were similar to DENV from other countries. Conclusions: We revealed the distribution of DENV serotypes and genotypes in Sukabumi. Compared to data obtained from other cities in Indonesia, we observed the differing predominance of DENV serotypes but similar genotype distribution, where the infecting viruses were closely related with Indonesian endemic viruses isolated previously.

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AbstrakLatar belakang : Dampak pandemi Human Immunodefiency Virus (HIV) di dunia akan menambah permasalahan Tuberkulosis (TB). Koinfeksi TB dengan HIV merupakan tantangan besar dalam program pengendalian kedua penyakit tersebut. Kedua penyakit ini dan penyebabnya dapat saling berinteraksi dan mempengaruhi epidemiologi masing-masing. Maka diperlukan beberapa penelitian untuk mengetahui besarnya angka kejadian koinfeksi TB-HIV dan juga profil dari pasien koinfeksi TB-HIV.Metode : Penelitian ini adalah penelitian diskriptif dengan desain potong lintang. Pengambilan data primer dengan instrument Case Report Form (CFR) dilakukan selama 3 bulan sejak September – November 2015. Sampel dalam penelitian ini adalah pasien suspek TB pada HIV dan HIV non TB sebanyak 38 pasien yang memenuhi kriteria inklusi dan eksklusi.Hasil : Jumlah pasien HIV pada periode September – November 2015 hanya 10 pasien yang TB-HIV. Dari 38 pasien suspek TB-HIV sebagian besar berusia < 35 tahun (52,6%) dan berjenis kelamin laki-laki (73,7%), menunjukkan Gejala klinis pasien suspek TB-HIV terbanyak adalah demam (94.7%), batuk (100%), batuk berdahak (89,5%), berkeringat malam hari (86,8%), mudah lelah (97,4%), gangguan tidur (86,8%), berat badan turun (100%), infeksi opportunistik candidiasis oral (60.5%) dengan hasil foto rontgen terbanyak yaitu Tb Paru (44,7%). Hasil apusan sputum pertama 84,2% BTA negative, apusan kedua 76,3% BTA negative dan apusan ketiga 86,8% BTA negative. Gambaran CD4 pada pasien TB-HIV 73,7% dengan CD4 < 100 sel/mm3.Kesimpulan : Sulit menentukan pasien koinfeksi TB pada pasien HIV tanpa dilengkapi pemeriksaan penunjang Foto Rontgen dan pemeriksaan CD4.