Tropical Health and Medical Research

The Effect of Sputum Delivery Time on the Sensitivity of Culture and AFB Microscopy in the Diagnosis of Drug-Resistant TB

Risa Rizkiyah — 2025-08-15

Drug-resistant tuberculosis (DR-TB) is a major challenge in TB control in Indonesia. Early detection using liquid and solid media cultures is crucial due to the limited sensitivity of Acid-Fast Bacilli (AFB) microscopic examination. In addition, the time of sputum specimen delivery can also affect bacterial viability. This study aims to determine the relationship between liquid and solid media culture results with AFB microscopic results in immediate and delayed sputum in patients with DR-TB. This is an observational analytical study with a cross-sectional design, involving 40 sputum samples from DR-TB patients examined at the South Kalimantan Provincial Health Laboratory from January to April 2025. Samples were grouped based on the time of sputum delivery (<7 days = immediate; ?7 days = delayed), and examined using AFB microscopic methods, Mycobacterium Growth Indicator Tube liquid culture, and Lowenstein-Jensen solid culture. Data analysis was performed using the Spearman correlation test. Of the 40 sputum samples examined, 2 (5%) were positive by AFB microscopy, 8 (20%) were positive by liquid culture (MGIT), and 6 (15%) were positive by solid culture (Lowenstein-Jensen). The results showed that in immediate sputum, Mycobacterium tuberculosis (MTB) was detected in 7 samples using liquid media and in 5 samples using solid media. In contrast, in delayed sputum, only one sample was positive in both media. Most samples with negative AFB microscopy still yielded MTB growth in culture, particularly in immediate sputum. There was no significant correlation between AFB and liquid culture results in immediate sputum (p=0.172), but there was a substantial correlation between AFB and solid culture (p=0.025). In delayed sputum, both liquid and solid cultures showed a significant correlation with AFB results (p=0.046). Liquid culture was proven to be more sensitive than AFB microscopic examination, especially for immediately examined sputum. MTB viability and accuracy of results decreased in late-delivered sputum, so optimal specimen delivery management is necessary to maintain diagnostic quality.

Effectiveness of HEPA Filters in Reducing Airborne Bacteria in Public Health Laboratory Rooms in Bontang City, Indonesia

Nurul Laili Sya’adah — 2025-08-15

Air is a basic human need whose quality needs to be maintained, especially in closed environments such as laboratories. Several factors, such as temperature, humidity, lighting, occupancy density, and ventilation systems, affect the presence of microorganisms in the room. Laboratory users can control microorganisms that cause air contamination by using High Efficiency Particulate Air (HEPA) filters. This study aims to determine the effect of HEPA filter use on the number of airborne germs in laboratory rooms. This type of research is an analytical observational study with a cross-sectional design, with nine rooms as research objects. Air samples were taken six times in each room, namely twice before the use of the HEPA filter (0 hour), twice after the use of the HEPA filter for 3 hours without activity, and twice after the use of the HEPA filter for 3 hours with laboratory service activities. Statistical tests used one-way ANOVA to analyze the data. The results showed that the average number of airborne germs before the use of the HEPA filter was 357,667 CFU/m³. After 3 hours of use of the HEPA filter without activity, the number decreased to 177,444 CFU/m³. After 3 hours of active HEPA filter use, the number of airborne bacteria decreased to 124 CFU/m³. The statistical test results showed a significance value of 0.000 (p < 0.05), which means there was a significant difference between groups. The conclusion is that the use of HEPA filters has a substantial effect on reducing the number of airborne bacteria in the Bontang City Health Laboratory room. Future researchers are advised to increase the duration of HEPA filter use and identify the types of bacteria in the laboratory room.

Comparison of TCM GeneXpert MTB/RIF Ultra Examination Results with AFB Microscopic Examination in Pulmonary TB Patients with MTB Detected

Putriana Ulfah — 2025-08-15

Tuberculosis (TB) is a disease in Indonesia with the second largest number of cases in the world after India. One of the TB-free strategies is early diagnosis with bacteriological laboratory examination for rapid treatment, thereby reducing the incidence rate. WHO recommends the GeneXpert molecular rapid test for confirming the diagnosis of TB. The TB diagnosis is confirmed by Acid-Fast Bacilli (AFB) microscopic examination for laboratories with difficulty accessing rapid molecular tests. The study aims to compare the rapid molecular test GeneXpert MTB/RIF Ultra examination with Ziehl-Neelsen stained AFB microscopic examination in diagnosing lung patients who have been detected with Mycobacterium tuberculosis very low, low, medium, and High (MTB detected)—the type of observational analytical study, with a cross-sectional design to understand the differences. The sampling technique is a total sampling of 30 samples, and data analysis using the Wilcoxon statistical test. Of the 30 samples tested for Mycobacterium tuberculosis (MTB), the Molecular Rapid Test identified all samples as positive (100%). In contrast, AFB microscopy detected only 23 positive cases (76.67%) and failed to detect MTB in 7 samples (23.33%). Based on bacterial load classification, three samples (10%) were categorized as very low, with AFB results showing two negatives (6.67%) and one scanty (3.33%). Among the nine low-load samples (30%), five were AFB-negative (16.67%) and four were positive (1+) (13.33%). In the seven medium-load samples (23.33%), microscopy detected five samples as 1+ (16.67%), two as 2+ (6.67%), and one as 3+ (3.33%). Of the 11 high-load samples (36.67%), AFB identified three as 2+ (10%) and eight as 3+ (23.33%). The conclusion of the results of the Molecular Rapid Test examination with AFB microscopic there shows a significant difference (P < 0.025) < ? (0.05). It is recommended that further research be conducted to compare three bacteriological examinations, namely rapid molecular test, AFB microscopic, and culture, as a gold standard examination.

Family Socioeconomic Factors as a Risk Factor for ARI Incidence in Toddlers in Pekauman Dalam Village, Banjar Regency, Indonesia

Ratih Dewi Dwiyanti — 2025-08-15

Acute Respiratory Tract Infections (ARI) remain a leading cause of infant mortality worldwide, including in Indonesia. Banjar Regency, South Kalimantan, has the highest infant pneumonia mortality rate in the province, despite its lower prevalence. This situation necessitates a study of the risk factors contributing to the incidence of ARI, particularly from a family's socioeconomic perspective. This study aims to determine the relationship between the incidence of ARI in toddlers and family socioeconomic risk factors in Pekauman Dalam Village, Banjar Regency. This study used an analytical study design with a cross-sectional approach. A sample of 28 toddlers was selected using total sampling. Data were collected through structured questionnaires completed by the toddlers' mothers/caregivers. Data analysis was performed bivariately using simple binary logistic regression, with further analysis using the Chi-Square test and Fisher's Exact Test on significant variables. The results of the study showed that among the 28 toddlers examined, six toddlers (21.4%) exhibited symptoms of acute respiratory infections (ARI). Statistical analysis revealed that, among all variables tested, only the toddler's age had a significant association with ARI incidence (p = 0.001; Fisher's Exact Test = 0.011). Toddlers aged ?1 year had a higher proportion of ARI cases than toddlers aged >1 year. Other variables such as family income, home ownership, residential density, cooking fuel, and maternal education did not show statistically significant relationships, although some had p-values approaching the significance threshold. Toddler age was the main risk factor influencing ARI cases in this study. Although most other socioeconomic factors were not statistically significant, these aspects are still important to consider in ARI prevention efforts. This study can form the basis for more targeted preventive interventions in areas with high socioeconomic vulnerability.

Determinants of Household COVID-19 Cases: The Role of Personal Hygiene, Environment, Individual Characteristics, and Mobility in Gading Village, Surabaya

Bunga Devita Putri Kusnadi — 2025-08-15

COVID-19 is a disease caused by the SARS-CoV-2 virus and attacks the human respiratory system. As of 2021, the virus has spread to 226 countries, including Indonesia. East Java Province has the fourth-highest number of cases in Indonesia, while Surabaya City has the highest number of cases in East Java. This study aims to analyze the relationship between Personal hygiene, environmental conditions, individual characteristics, and mobility with COVID-19 cases in households in Gading Village, Tambaksari District, Surabaya City. This study is an observational analytic study using a case-by-case approach. Cross-sectional. The study was conducted in Gading Village, Tambaksari District, Surabaya City, from September 2022 to December 2022. The sample consisted of 85 households selected through a simple random sampling. Data collection was carried out using questionnaires and observations. The results were tested using the chi-squared and Fisher's Exact Test with a significance level of 0.05. The results of the study showed that home ventilation (p=0.036) and residential density (p=0.04) had a significant relationship with COVID-19 cases in households. Meanwhile, no significant association was found with the incidence of COVID-19 in the variables of age (p=0.603), gender (p=0.405), comorbidities (p=0.924), handwashing behavior with soap (p=1.000), mask use (p=0.294), social distancing behavior (p=0.341), environmental cleanliness (p=0.414), and work/learning systems of household respondents (p=0.751). The conclusion shows that home ventilation factors and residential density have a significant relationship with cases of COVID-19 transmission. Therefore, efforts to prevent COVID-19 transmission in the household environment need to focus on improving home ventilation and reducing residential density. In addition, education regarding other risk factors is still necessary to increase public awareness in maintaining overall health and environmental cleanliness.

Oral Candida spp. Density as a Blood Glucose Marker in Diabetes Mellitus Patients

Aima Insana — 2025-08-15

Candida spp. is a commensal fungus in the oral cavity that can become an opportunistic pathogen when there is a decrease in the immune system or metabolic disorders such as diabetes mellitus. Hyperglycemia in people with diabetes increases salivary glucose levels, which can be a nutrient source for Candida, thus triggering increased density, biofilm formation, and antifungal resistance. This study aims to analyse the relationship between blood glucose levels and oral Candida spp. density in patients with diabetes mellitus. The study used a cross-sectional design in 29 Guntung Manggis Banjarbaru Community Health Centre patients. Saliva samples were collected by mouthwash and planted on Hichrome Candida Differential Agar (HCDA) media to calculate colony density. At the same time, blood glucose levels were measured spectrophotometrically using the GOD-PAP method. The results showed abnormal blood glucose levels (?200 mg/dL) were found in 16 respondents (55.2%), and abnormal Candida spp. density (>500 CFU/mL) was also found in 16 respondents (55.2%). The growth of Candida spp. detected in 24 samples (82.8%). The Chi-square test showed a significant association between hyperglycemia and increased oral Candida spp. density (p = 0.017). These findings suggest that hyperglycemia plays a role in increased Candida density in the oral cavity. Hence, monitoring blood glucose levels and oral Candida density is important for preventing fungal infection complications in patients with diabetes mellitus.