Azithromycin is one of the antibiotics used to treat syphilis, especially in the context of penicillin allergy. Resistance to azithromycin is widely reported associated with one and/or two point mutations on the 23S rRNA gene but has yet to be described in Indonesia.Specimens were collected from 220 patients diagnosed with secondary syphilis. A multiplex nested PCR testing system using the 23S rRNA target gene of Treponema pallidum was designed using three pairs of primers. The first step used PCR pairs of primers to detect T. pallidum. In the second step of PCR using 2 pairs of primers were achieved to identify azithromycin resistant T. pallidum based on A2058G and A2059G point mutations. There was no T.pallidum identified resistant to azithromycin in Jakarta and Bandung. T. pallidum resistance to azithromycin were found in Makassar, Medan, and Bali. The majority of azithromycin resistance was found among heterosexual males and in patients living with HIV. This study has demonstrated T. pallidum resistance to azithromycin in Indonesia appears to be a novel variant of resistance, containing both the A2058G and A2059G mutations that was found in Medan and Makassar.

UNIVERSA MEDICINAMultiplex nested polymerase chain reaction for Treponema pallidum using blood is more sensitive than using serum Ida Effendi* , **, Yeva Rosana**, Andi Yasmon**, and Wresti Indriatmi*** BACKGROUND Syphilis is a multistage disease transmitted primarily through sexual intercourse. Nowadays, the polymerase chain reaction (PCR) test for Treponema pallidum has been widely used and is expected to overcome problems in diagnostic tests for syphilis. The Treponema pallidum PCR is influenced by type of specimens, PCR methods and target genes. This study aimed to assess the use of blood and serum in multiplex nested PCR for Treponema pallidum, targeting the 23S rRNA. METHODSA cross-sectional study was conducted from April 2015 -April 2016. Sampling was carried out consecutively among patients with clinical features of secondary syphilis who came to Sexually Transmitted Disease (STD) clinics in Jakarta. All sera were also tested with Rapid Plasma Reagin (RPR) and Treponema pallidum Hemagglutination Assay (TPHA) assay, which was considered as the gold standard for this study. We determined the sensitivity and specificity of the multiplex nested PCR for Treponema pallidum using blood and serum. RESULTS PCR test was performed on 122 clinical specimens (61 blood and 61 serum).The positive results of PCR test on blood was 22.95% and serum was 6.56%, while the positive results of serology was 68.85%. The sensitivity of Treponema pallidum multiplex nested PCR on blood was 30.95% compared to serum 9.52% (p=0.006). PCR test on blood is able to detect 3.25 times higher than serum. CONCLUSIONThe use of blood has a higher proportion of positives compared to serum in Treponema pallidum multiplex nested PCR using 23S rRNA target gene.

BACKGROUNDSyphilis is a global health problem, especially in developing countries including Indonesia. Treponema pallidum, the etiologic agent of syphilis, cannot be cultured in vitro. Syphilis has several clinical manifestations, making laboratory testing a very important aspect of diagnosis. Microscopic examination may support the diagnosis but is rarely used in Indonesia. The aim of this study was to evaluate negative staining using the light microscope to detect T. pallidum in syphilitic lesions. METHODSA cross-sectional study was conducted involving 27 subjects who came to several dermato-venereology clinics in Jakarta. Exudates were collected from genital ulcers, condylomata lata, and dry mucocutaneous rash on palms and soles of syphilis patients. Negative staining using one drop of Indian ink was used to examine for treponemas under the light microscope at 10x100 magnification. RESULTSMicroscopic examination using negative staining showed a few clusters of small and spiral shaped bacteria. Of the 39 specimens from 27 subjects, microscopic examinations were successfully done on 10 specimens. Observations could only be conducted on 5 specimens, 3 (60.0%) of which showed the morphology of spirochetes. This examination is the easiest method for detecting the bacteria. Moreover, the bacteria that were isolated from painless genital ulcers could be observed more clearly than those from erythematous maculopapular lesions. CONCLUSIONTreponema pallidum was successfully detected by microscopic examination in all moist lesions, but was difficult to detect in dry lesions. Negative staining under the light microscope appears to be simple, affordable, and available in most microbiology laboratories in Indonesia.

Treponema pallidum adalah bakteri penyebab sifilis. Sifilis ditemukan pada abad ke XV di dataran Eropa, menyebar ke seluruh dunia dan menjadi isu global sampai saat ini. Sifilis dikenal dengan sebutan raja singa merupakan salah satu penyakit infeksi menular seksual yang penularannya tidak hanya melalui hubungan seksual. Infeksi lokal yang disebabkan oleh masuknya Treponema pallidum akan berkembang cepat menjadi sistemik dan bahkan dapat mengancam nyawa. Treponema pallidum tidak dapat dikultur secara in vitro. Pemeriksaan penunjang untuk menegakkan diagnosis mengandalkan uji serologi. Saat ini, pemeriksaan standar untuk sifilis menggunakan mikroskop lapangan gelap sulit dilakukan. Pemeriksaan baru untuk mendeteksi Treponema pallidum menggunakan uji molekuler sudah mulai dikembangkan sejak abad XX. Penulisan ini mengambil ulasan dari beberapa jurnal penelitian yang menggunakan PCR sebagai alat diagnostik Treponema pallidum untuk membandingkan metode-metode pemeriksaan molekuler PCR Treponema pallidum. Spesifisitas PCR Treponema pallidum mencapai 100%. Sensitivisitas PCR bervariasi untuk setiap gen target dan jenis spesimen yang digunakan. Metode multiplex PCR banyak digunakan karena dapat mendeteksi Treponema pallidum dan patogen lain secara bersamaan. Pemeriksaan molekuler PCR Treponema pallidum masih perlu dikembangkan lebih lanjut di Indonesia. Kata kunci : Treponema pallidum, sifilis, uji serologi, mikroskop, pemeriksaan molekular

Jakarta is listed as one of the cities in the world with the most polluted air quality, with an annual average PM 2.5 of 49.4 g/m³ in 2019. The sources of air pollution in Jakarta among others are the large number of motor vehicles that are not in accordance with the guidelines of safe vehicles for the environment. Not to mention air pollution from industries and factories fueled by coal or other fossils. Online motorcycle taxi drivers are a profession that is at risk of experiencing the effects of this air pollution. Respiratory disorders that can occur such as acute respiratory infections, chronic obstructive pulmonary disease (COPD), decreased lung function and lung malignancy. To reduce the risk of respiratory problems that can arise in online motorcycle taxi drivers, efforts are being made to prevent and stop exposure to air pollutants through counseling activities which carried out on November 12, 2023. This activity was attended by 42 online motorcycle taxi drivers. Participants' knowledge was assessed by pre-test and post-test using the Google form to assess participants' cognitive changes. From the results of the pre-test and post-test evaluation, it was found that there was an increase in knowledge about the risks and respiratory tract disorders that could arise, namely 25.5%, with an increasing percentage of correct answers of pre-test and post-test ranging from 4.8 % - 40.5%. It is hoped that this increased knowledge will change the behavior of online motorcycle taxi drivers to always pay attention of prevention and stop exposure to air pollutants.

Rawa Buaya Village is one of the villages in the West Jakarta. This village is a densely populated village with a limited number of health facilities. Based on the 2018 DKI National Basic Health Research (RISKESDAS) data, the proportion of the population aged over 10 years in West Jakarta who behaved properly in washing their hands was only 49.11%. Hand washing is the most important basic technique in the prevention and control of infection transmission because it mechanically removes dirt and dust from the skin surface and reduces the number of pathogenic microorganisms. Because knowledge of clean and healthy living behavior (PHBS) by washing hands with soap is a determining factor in the transmission of infectious diseases such as diarrhea, respiratory infections including Covid-19, education is needed to increase this knowledge. Education by counseling and training activities are carried out online through the Zoom teleconference on April 23, 2022, followed by 45 village residents. Participants' knowledge was assessed by pre-test and post-test using Google Form. From the post-test’s results, there is an increase in the participants’s knowledge by 22.9% with an increase in the percentage of correct answers from the pre and post test ranging from 6.6% - 35.6%, which is also expected to change in habits or behavior.

Penyakit infeksi HIV- AIDS telah menjadi masalah darurat global. Data yang diperoleh pada tahun 2021 menunjukkan sebanyak 38.4 juta penduduk di seluruh dunia  terinfeksi HIV. Sebagian besar orang dengan HIV-AIDS tidak mampu melakukan aktivitas keseharian dengan baik sehingga membutuhkan orang yang dapat mendampingi serta memberi dukungan psikososial, yaitu caregiver.  Ketergantungan orang dengan HIV-AIDS terhadap caregivernya dapat menimbulkan beban pada caregiver. Keadaaan ini bilamana berlangsung jangka panjang dapat berdampak pada kualitas hidup caregiver. Penelitian bertujuan untuk mengetahui hubungan antara beban perawatan ODHA dengan kualitas hidup caregiver/keluarga ODHA. Metode yang digunakan adalah studi potong lintang dilakukan pada caregiver ODHA. Data yang diperoleh dari 56 responden menunjukkan terdapat hubungan yang bermakna antara beban perawatan dengan kualitas hidup pada domain overall quality of life (p=0,025) dan domain psikologis (p=0,035). Beban perawatan ODHA mempengaruhi kualitas hidup caregiver ODHA

The prolonged state of the COVID-19 pandemic has a huge impact on all sectors, one of which is the education sector. Since pandemic stated, educational institutions have applied distance learning (PJJ) from pre-school to university level. In its implementation, PJJ is considered effective enough to be carried out in accordance with pandemic conditions. The negative impact of PPJ on student is difficulty in self development and hard to catch up so that limited face-to-face learning (PTM) begins. The purpose of community service activities (PkM) is to increase understanding and awareness of being obedient to health protocols during PTM consistently to prevent the transmission of COVID-19. The activity was given in the form of webinar counseling for students, parents and teachers of SMPIT Al Madinah, Bogor, West Java. Submission of material through presentations and interactively with questions and answers. The result of this PkM activity is an increase in knowledge and behavior in obeying health protocols during PTM. This service activity is needed and provides benefits to the community.