Tropical Health and Medical Research

Optimization of Urine Storage with the Addition of 40% Formalin at a Temperature of 2–8°C: Stability of the Amount and Morphology of Sediment Elements

2025-09-20T16:50:38+07:00

Urine sediment examination is an essential component of urinalysis used to detect various renal and urinary tract disorders. However, sediment elements in urine are prone to rapid degradation, requiring a preservation method that maintains both their quantity and morphology. This study aimed to evaluate the effect of urine storage with 40% formalin at 2–8°C for 3, 6, and 9 days on the mean count and morphology of erythrocytes, leukocytes, squamous epithelial cells, and transitional epithelial cells. A quasi-experimental design with a pretest–posttest control-group approach was used with six urine samples selected through purposive sampling. Data were analyzed descriptively, followed by repeated measures ANOVA and pairwise comparison tests. The results showed that erythrocytes (p=0.185) and transitional epithelial cells (p=0.775) did not exhibit significant differences across storage durations. Squamous epithelial cells showed significant differences in the ANOVA test (p=0.010), but the pairwise comparison did not yield consistent results. Leukocytes demonstrated significant differences in the ANOVA test (p=0.000), with a notable decrease observed on days 6 and 9 (p<0.05). Despite this, the morphology of all sediment elements remained well-preserved (score 2), with clearly distinguishable cell structures observable up to day 9. These findings suggest that urine preservation using 40% formalin at 2–8°C can maintain the count of erythrocytes, squamous epithelial cells, and transitional epithelial cells, while preserving the morphology of all four sediment elements for up to nine days. This has important implications for research requiring medium-term sample storage. The developed protocol can serve as a reference for standardizing urine preservation procedures.

Substitution of Diluent Solution in Semi-Quantitative Examination of C-Reactive Protein

2025-10-04T15:01:24+07:00

The C-Reactive Protein (CRP) test using the agglutination method is performed through qualitative and semi-quantitative examinations. However, the diluent solution required for the semi-quantitative stage is not provided in the CRP reagent kit. The absence of this solution requires the laboratory to find an alternative diluent in order for the test to be conducted properly. This study aims to compare the effectiveness of 0.9% NaCl solution from table salt and 0.9% NaCl infusion solution with PBS as a diluent in semi-quantitative CRP examination and to provide an alternative diluent that is cheaper and easier to obtain. The study was conducted in the Immunology Laboratory, Health Polytechnic of the Ministry of Health Banjarmasin, using a true experimental design with a post-test only control group. Experimental groups included 0.9% NaCl from table salt and 0.9% NaCl infusion solution, while the control group used PBS. Nine positive CRP serum samples were used. Friedman test results showed no significant difference between the three diluent types (significance value 0.607 > ? 0.05). It was concluded that 0.9% NaCl solution from infusion and table salt can be used as diluents for semi-quantitative CRP examination. Further research is recommended to test storage stability and application in similar tests, such as Anti-Streptolysin O and Rheumatoid Factor.

Food Consumption Patterns and Hypertension in Communities in the Martapura River Basin, Indonesia

2025-10-04T15:06:12+07:00

Hypertension is a major risk factor for cardiovascular disease and remains a public health problem in Indonesia, including South Kalimantan. Diet plays a significant role in the development of hypertension, particularly in communities living in river basins characterized by high sodium and low fiber consumption. This study aims to analyze the relationship between dietary patterns and the incidence of hypertension in communities along the Martapura River Basin, South Kalimantan. The study, conducted in 2025, used a cross-sectional design with 260 purposively selected respondents. Data were collected through interviews using a structured questionnaire and blood pressure measurements. The Spearman test showed a significant association between the consumption of fatty foods (Rho=0.323; p=0.000), salty foods (Rho=0.341; p=0.000), fruit (Rho=0.575; p=0.000), and vegetables (Rho=0.477; p=0.000) and the incidence of hypertension. High sodium consumption and low fruit and vegetable consumption are determinants contributing to the high prevalence of hypertension in the Martapura River Basin community. This study emphasizes the need for contextual public health interventions through nutrition education and increased access to healthy foods to reduce the burden of hypertension in the region.

The Value of the TB IgG/IgM Rapid Test and Erythrocyte Sedimentation Rate in Relation to Xpert MTB/RIF Tests in the Diagnosis of Pulmonary Tuberculosis

2026-02-07T07:01:10+07:00

Tuberculosis (TB) remains a global health problem, requiring healthcare workers to have accurate and effective diagnostic methods. The Xpert MTB/RIF-based Molecular Rapid Test is recommended as the standard for TB diagnosis, but in clinical practice, healthcare workers still frequently use the TB IgG/IgM Rapid Test and the Erythrocyte Sedimentation Rate (ESR) as complementary tests. This study aimed to determine the relationship between Xpert MTB/RIF test results and the TB IgG/IgM Rapid Test and ESR in pulmonary tuberculosis patients at Pertamina Hospital, Balikpapan. This study used a retrospective, observational analytical study design utilizing secondary data from laboratory tests from January–December 2024. Researchers analyzed data from 250 patients who met the inclusion criteria. They analyzed the relationship between variables using the Spearman correlation test. The results showed that 16.4% of patients had MTB detected on the Xpert MTB/RIF test. Statistical analysis showed a significant positive correlation between Xpert MTB/RIF results and the TB IgG/IgM Rapid Test, with a moderate correlation strength (r = 0.562; p < 0.001). Furthermore, the analysis also showed a significant correlation between Xpert MTB/RIF results and ESR (r = 0.183; p = 0.004), but with a very weak correlation strength. The majority of patients with MTB detected by Xpert MTB/RIF had positive TB IgG/IgM Rapid Test results and abnormal ESR values. This study shows that the TB IgG/IgM Rapid Test and ESR are associated with Xpert MTB/RIF results. However, both tests have limited specificity and can therefore only be used as supporting tests and cannot replace molecular testing in the diagnosis of pulmonary tuberculosis.

The Role of Biological and Environmental Factors in Infant Pneumonia: Findings from the 2023 Indonesian Health Survey

2026-02-07T09:12:11+07:00

Pneumonia continues to be a leading cause of morbidity and mortality in infants, particularly in developing countries, making risk factor analysis crucial to support evidence-based prevention efforts. This study analyzed factors associated with pneumonia in 28,610 infants aged one year and under using data from the 2023 Indonesian Health Survey to provide a national overview of the distribution of cases and their determinants. This study used a cross-sectional design and analyzed demographic variables, health characteristics, and environmental factors using descriptive analysis, chi-square tests, and odds ratios. The study results showed a pneumonia prevalence of 0.9%, with an increased risk in low birth weight infants (OR 2.425; 95% CI: 1.688–3.483) and infants with a history of diarrhea (OR 2.051; 95% CI: 1.211–3.475), while breastfeeding reduced the risk of pneumonia (OR 0.590; 95% CI: 0.447–0.778). The data also showed greater susceptibility among male infants and those living in urban areas. These findings confirm that pneumonia in infants is influenced by a combination of biological, environmental, and behavioral factors, so public health interventions need to strengthen monitoring of at-risk infants, increase the coverage and quality of breastfeeding, prevent diarrhea, and control exposure to air pollution, especially in urban areas. These findings provide an empirical basis for developing more targeted and effective infant health policies.

Monocyte, Lymphocyte, and Monocyte–Lymphocyte Ratio Responses to Treatment Phases in Pulmonary Tuberculosis Patients

2026-02-07T14:18:24+07:00

Pulmonary tuberculosis is a chronic infectious disease that affects the balance of innate and adaptive immune responses, reflected in changes in hematological parameters, particularly monocyte and lymphocyte counts, and the monocyte-lymphocyte ratio (MLR). This study aimed to analyze differences in lymphocyte and monocyte counts and MLR values ??in pulmonary tuberculosis patients based on treatment phase. This cross-sectional analytical survey study involved 60 pulmonary tuberculosis patients divided into 0-month treatment groups, the intensive phase, and the continuation phase in Loa Kulu District from January to April 2025. Peripheral blood smears were stained with Giemsa to determine the percentage of lymphocytes and monocytes, and then the MLR value was calculated. Statistical analysis using one-way ANOVA showed significant differences in lymphocyte and monocyte counts between treatment groups (p<0.05). The mean lymphocyte count increased with treatment duration, while the mean monocyte count decreased, resulting in a decrease in the MLR value from 0.64 in the pre-treatment group to 0.29 in the intensive phase and 0.22 in the continuation phase. The decrease in MLR reflects an improved immune response balance and decreased systemic inflammation during tuberculosis therapy. The results of this study indicate that MLR demonstrated variation across treatment phases, suggesting its potential relevance in the clinical assessment of TB patients.

Diagnostic Performance of Rapid Diagnostic Tests and Microscopy for Malaria Detection in Jayapura, Indonesia: A Pilot Study

2026-02-21T08:49:55+07:00

Malaria remains a major public health concern in Jayapura, Indonesia. Limited microscopy availability in primary healthcare facilities has increased reliance on rapid diagnostic tests (RDTs) for early case detection. This study aimed to evaluate the diagnostic performance of two malaria RDTs, AllCheck® and Orient Gene®, using microscopy as the reference standard. A cross-sectional study was conducted at a primary healthcare center in Jayapura in December 2025, involving 49 patients with clinical symptoms suggestive of malaria. Capillary blood samples were collected for RDT testing and preparation of thick and thin blood smears. Diagnostic accuracy was assessed by calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), as well as agreement analysis using Cohen’s Kappa and McNemar test. Both RDTs demonstrated comparable diagnostic performance, with sensitivities of 93.75% (95% CI: 69.77–99.84) and specificities of 100% (95% CI: 89.42–100.00). The PPV was 100% (95% CI: 78.20–100.00), and the NPV was 97.06% (95% CI: 84.67–99.93). Agreement analysis showed almost perfect concordance between each RDT and microscopy (? = 0.953; p < 0.001). No significant difference was observed between AllCheck® and Orient Gene® results based on the McNemar test (p = 1.000). No significant association was found between diagnostic outcomes and patient sex or age group (p > 0.05). The RDTs showed good performance in detecting Plasmodium falciparum and Plasmodium vivax, but reduced sensitivity for Plasmodium malariae. In conclusion, AllCheck® and Orient Gene® RDTs demonstrate strong diagnostic performance and almost perfect agreement with microscopy, supporting their suitability for malaria screening and initial diagnosis in primary healthcare settings in Jayapura. Nevertheless, microscopy remains essential for confirming non-falciparum infections and ensuring comprehensive case detection.