BackgroundDengue virus (DENV) infection is a major cause of acute febrile illness in Indonesia. Diagnostic inaccuracy may occur due to its varied and non-specific presentation. Characterization of DENV epidemiology, clinical presentation, and virology will facilitate appropriate clinical management and public health policy.Methodology/Principal findingsA multicenter observational cohort study was conducted in Indonesia to assess causes of acute fever requiring hospitalization. Clinical information and specimens were collected at enrollment, 14–28 days, and 3 months from 1,486 children and adults. Total of 468 (31.9%) cases of DENV infection were confirmed by reference laboratory assays. Of these, 414 (88.5%) were accurately diagnosed and 54 had been misdiagnosed as another infection by sites. One hundred initially suspected dengue cases were finally classified as ‘non-dengue’; other pathogens were identified in 58 of those cases. Mortality of DENV infection was low (0.6%). Prior DENV exposure was found in 92.3% of subjects >12 years. DENV circulated year-round in all cities, with higher incidence from January to March. DENV-3 and DENV-1 were the predominant serotypes. This study identified DENV-1 with TS119(C→T) substitution in the serotyping primer annealing site, leading to failure of serotype determination.Conclusions/SignificanceDENV is a common etiology of acute febrile illness requiring hospitalization in Indonesia. Diagnostic accuracy at clinical sites merits optimization since misdiagnosis of DENV infection and over-estimation of dengue can negatively impact management and outcomes. Mutation at the annealing site of the serotyping primer may confound diagnosis. Clinicians should consider following diagnostic algorithms that include DENV confirmatory testing. Policy-makers should prioritize development of laboratory capacity for diagnosis of DENV.

BackgroundChikungunya virus (CHIKV) is often overlooked as an etiology of fever in tropical and subtropical regions. Lack of diagnostic testing capacity in these areas combined with co-circulation of clinically similar pathogens such as dengue virus (DENV), hinders CHIKV diagnosis. To better address CHIKV in Indonesia, an improved understanding of epidemiology, clinical presentation, and diagnostic approaches is needed. Methodology/Principal findingsAcutely hospitalized febrile patients �1-year-old were enrolled in a multi-site observational cohort study conducted in Indonesia from 2013 to 2016. Demographic and clinical data were collected at enrollment; blood specimens were collected at enrollment, once during days 14 to 28, and three months after enrollment. Plasma samples negative for DENV by serology and/or molecular assays were screened for evidence of acute CHIKV infection (ACI) by serology and molecular assays. To address the co-infection of DENV and CHIKV, DENV cases were selected randomly to be screened for evidence of ACI. ACI was confirmed in 40/1,089 (3.7%) screened subjects, all of whom were DENV negative. All 40 cases initially received other diagnoses, most commonly dengue fever, typhoid fever, and leptospirosis. ACI was found at five of the seven study cities, though evidence of prior CHIKV exposure was observed in 25.2% to 45.9% of subjects across sites. All subjects were assessed during hospitalization as mildly or moderately ill, consistent with the Asian genotype of PLOS NEGLECTED TROPICAL DISEASES

Latar belakang. Penggunaan antibiotik untuk populasi anak perlu memperoleh perhatian khusus karena kecenderungan berlebihan. Peningkatan penggunaan antibiotik telah menimbulkan peningkatan resistensi bakteri, meningkatkan morbiditas dan mortalitas serta biaya pengobatan, akhirnya menurunkan kualitas pelayanan kesehatan. Salah satu cara mengatasinya dengan melakukan evaluasi penggunaan antibiotik secara kualitatif.Tujuan. Melakukan evaluasi penggunaan antibiotik di ruang perawatan anak RS Penyakit Infeksi Sulianti Saroso secara kualitatif menggunakan alur Gyssens.Metoda. Telah dilakukan penelitian deskriptif, retrospektif dari status rekam medis pasien anak non-bedah, yang mendapat antibiotik dan dirawat di ruang Melati RSPIi Sulianti Saroso pada periode tahun 2010. Evaluasi dilakukan menggunakan alur Gyssens dan penghitungan diolah dengan program SPSS versi 19.0.Hasil penelitian. Di antara 619 (41,7%) subjek penelitian yang mendapat antibiotik, terbanyak kelompok bayi umur 1 bulan-1 tahun 234 (37, 8%). Penggunaan antibiotik secara tepat 338 (40,9%), tidak tepat 362 (43,8%) dan tidak berdasarkan indikasi 119 (14,4%). Penggunaan antibiotik secara empirik 821 (99,4%), terapi definitif 4 (0,5%) dan terapi profilaksis 1 (0,1%). Antibiotik yang paling banyak digunakan sefotaksim 308 (37,3%), seftriakson 189 (22,9%) dan kloramfenikol 131 (15,9%). Sefotaksim digunakan secara tepat 106 (34,4%), tidak tepat 144 (46,8%) dan tanpa indikasi 55 (17,9%).Kesimpulan. Dari semua pasien anak yang dirawat dan mendapat antibiotik, penggunaan antibiotik secara tepat 40,9%, pemberian tidak tepat 43,8%, dan pemberian tanpa indikasi 14,4%. Sebagian besar terapi secara empirik 99,4%, terapi definitif hanya 0,4%. Sefotaksim paling banyak digunakan, sebagian besar digunakan tidak tepat 46,8%.

Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia. Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for Rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for Rickettsia IgM and IgG by IFA and Rickettsia genomes using primers for Rickettsia (R.) sp, R. typhi, and Orientia tsutsugamushi. Testing was performed retrospectively on stored specimens; results did not inform patient management. Results: R. typhi, R. rickettsii, and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of samples, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea (72%), headache (69%), vomiting (43%), lethargy (33%), anorexia (32%), arthralgia (30%), myalgia (28%), chills (28%), epigastric pain (28%), and rash (17%). No acute rickettsioses cases were suspected during hospitalization. Discharge diagnoses included typhoid fever (44), dengue fever (20), respiratory infections (7), leptospirosis (6), unknown fever (6), sepsis (5), hepatobiliary infections (3), UTI (3), and others (9). Fatalities occurred in 7 (6.8%) patients, mostly with co-morbidities. Conclusions: Rickettsial infections are consistently misdiagnosed, often as leptospirosis, dengue, or Salmonella typhi infection. Clinicians should include rickettsioses in their differential diagnosis of fever to guide empiric management; laboratories should support evaluation for rickettsial etiologies; and public policy should be implemented to reduce burden of disease.

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Undergraduate students are categorized as Generation Z. They prefer learning using video rather than the book. Demonstration videos are suitable for productive courses because they show step by step of product making.  This study aimed to 1) develop a video of pickled fruit production for the Food Preservation Technology course, Universitas Negeri Yogyakarta (UNY), Indonesia and 2) determine the video's feasibility. This study was a research and development (R&D) performed by ten steps, namely information collecting, planning, developing initial products, preliminary field testing, main product revision, main field testing, operational product revision, operational field testing, final product revision, as well as dissemination and implementation. Data analysis was performed descriptively. The video feasibility analysis was conducted by one material expert, one media expert, two teachers, two peer reviewers, four students in one-on-one testing, and 36 students in classroom testing. Based on the feasibility test, the video was declared very feasible as learning media. Text, images, animations, and effects appeared in several parts of the video, making it easier for the students to understand the content. This video can be embedded in the learning management system (LMS) such as Google Classroom, Moodle, and others to facilitate mobile learning, and implemented in a flipped classroom design. Pre-test and post-test were then performed on 29 students in operational field testing. The post-test was significantly higher than the pre-test (p<0.05), so the video was able to improve the students' cognitive skills.

Miskonsepsi siswa merupakan salah satu perhatian penting dalam penelitian pendidikan karena bersifat mengganggu siswa untuk memahami konsep ilmiah dalam pembelajaran. Miskonsepsi sering terjadi pada pembelajaran Kimia, salah satunya pada konsep Larutan Penyangga. Penelitian ini bertujuan untuk mengidentifikasi miskonsepsi siswa pada konsep Larutan Penyangga menggunakan instrumen tes four-tier multiple-choice (4TMC) di SMA Negeri Se-Tangerang Selatan. Metode penelitian yang dilakukan adalah deskriptif kuantitatif. Waktu penelitian dilaksanakan pada 07 Agustus sampai dengan 05 September 2019. Subjek penelitian ini adalah kelas XII MIPA SMA Negeri Se-Tangerang Selatan tahun ajaran 2019/2020 dengan jumlah sampel sebanyak 134 siswa yang diambil dari empat kelas menggunakan teknik Cluster Random Sampling. Data penelitian diperoleh dari jawaban siswa pada soal tes 4TMC. Data tersebut diolah berdasarkan pola jawaban siswa yang kemudian dikelompokkan ke dalam kategori pemahaman siswa yaitu miskonsepsi, kurang paham konsep, kesalahan, dan paham konsep. Hasil penelitian menunjukkan bahwa terjadi miskonsepsi sebesar (48,51%), dan miskonsepsi signifikan yang teridentifikasi pada 2 dari 5 subkonsep Larutan Penyangga yang diteliti yaitu subkonsep Perhitungan Larutan Penyangga (14,92%) dan Peran Larutan Penyangga dalam Tubuh Makhluk Hidup (15,67%). Hasil penelitian identifikasi miskonsepsi siswa ini diharapkan dapat mengidentifikasi miskonsepsi yang terjadi pada siswa untuk dapat ditangani lebih cepat agar tidak menghambat siswa dalam pembelajaran. Kata kunci: Miskonsepsi, Larutan Penyangga, Four-Tier Multiple-Choice Test

Penelitian ini bertujuan untuk mengembangkan buku pengayaan kimia berbasis kontekstual pada konsep elektrokimia dan mengetahui respon siswa terhadap buku tersebut. Proses pengembangan terdiri dari tiga tahap yaitu tahap perancangan, tahap produksi, dan tahap evaluasi. Pada tahap persiapan dihasilkan indikator buku pengayaan yang telah diintegrasikan dengan tujuh komponen kontekstual untuk dijadikan acuan dalam mengembangkan buku pengayaan. Pada tahap evaluasi produk dihasilkan buku pengayaan yang telah divalidasi oleh 4 orang ahli. Buku pengayaan diuji cobakan di kelas XII IPA I SMAN 18 Kabupaten Tangerang. Hasil uji coba terbatas mendapatkan skor respon siswa sebesar 82,49% termasuk dalam kategori layak dengan predikat baik.