International conference Molecular and Clinical Aspect of HIV AIDS, TUBERCULOSIS and MALARIA ( ICMCA ATM )

16 February 2009

MALARIA IN PREGNANCY a molecular in sight by Rintis Novianti

Susceptibility to malaria in pregnancy ( ( MIP) is a molecular base: - discovery of Chondroitin Sulfat A ( CSA) - support the accumulation of IE by Pf in the placenta - Maternal anemia, low BW baby - Adhesion of IE is mediated by PfEMP1 and encoded by var2 CSA dominantly exspressed by the parasite adhered to placenta - Ab reactivity to CSA binding isolate expressing var2 CSA is higher in falciparum infected pregnant women than the non infected pregnant women and the non pregnant ones - Placental histology analysis demonstrated 35% infected peripheral blood of pregnant women have no or scanty parasites in their placenta - P.v is not found to be sequestered in high quantity in the placenta but rather in scanty distribution

A preliminary study of P.v infection in pregnant women moleclar detection of parasite By Rintis Novianti Compared to Pf inf in pregnancy, the impact of Pv is less striking. Sequestration of Pf IE in the placenta play a major role in the pathogenesis of malaria in pregnancy. Little is known about the mechanism underlying the impact of Pv inf in pregn leading to maternal anemia and low birth weight, since Pv does not adhere in the placenta

Failure of Mefloquine Artesunate treatment of uncomplicated Pf malaria in Southern Cambodia by Roger Spread of drug resistant Pf complicates malarial control Chloroquine resistance near universal Resistance to second line drugs ( Fansidar, Mefloquine, Quinine ) is common is Southeast Asia Artemisinin combination therapy ( ACT ) is new foundation of malaria treatment Unrealistic to hope that Artemisinin resistance will not emerge Many new drug resistant strain of Pf have emerge from Thailand and Cambodia ACT resistance most likely where Mefloquine resistance is common Some failure may be due to emerging Artesunate resistance in context of pre- existing Mefloquine resistance

Therapeutic effect combination of Artemisinin and N acetyl Cystein to the Malondialdehide ( MDA ) and Peroxide Radical ( H2O2) level of Erythrocyte Balb/c Mice infected with Pberghei by Dorta Simamora Malaria infection can cause the change of oxidant and anti oxidant status intra erythrocyt Degradation of Hb by parasite intra erythrocyte cause free radical forming like O2 and H2O2. Free radical will react with fat component of cell membrane producing MDA NAC is a precusor of glutathion ( GSH ) GSH it self can decrease H2O2. Combination of Artemisinin and NAC therapy in tappering dose group decrease MDA and H2O2 erythrocytes more effective Artemisinin mono therapy on Balb/c mice infected with Pb

New malarial effect from Physalis angulata leaves against Plasmodium berghei in vivo by Mari Nindatu

New malarial effect test from ceplukan leaf Physalis angulata has been done The dried leaves material was ground and extracted with aquadest, doses 200, 100,10,1 mg/ kg mice b.w and untreated group with five replication. The study used infected mice with P.b Balb/c male mice , age 8 weeks, body weight 20 g were used Result: Water extract of ceplukan leaves exhibited potent anti malaria activities against P.bl

Effect therapy combination of earth worm powder ( Lumbricus rubellus ) and Chloroquine on Swiss mice infected with p.b ANKA byJava. The reason increasing morbidiy and Malaria still a major health problem in East mortality of malaria is severe complication by P.f such as cerebral malaria and Paramasari
malarial hepatitis. Lumbricus rubellus a cosmopolit eath worm has been reported of having a potent fibrinolytic activity and promoting immune system. Extract powder of L.r has been used widely in treating typhoid fever and stroke. Thirty five divided into 5 groups, negative control group, positive control group, Chloroquine group, Chloroquine Lumbricus group, and Lumbricus group. Lumbricus powder was given orally 13 mg/ 20g BW in solution Evaluated the effect of combinationtherapy by measuring survival rate, parasitemia index and histopathological change of liver and brain tissues between groups. The result: The significant differences histopathological appearance was found between experimental groups and negative control ( p =0 ) but was not found among experimental groups ( p = 0). Addision of L.r powder together with Chloroquine had significant effect on survival rate, brain and liver histopathological apperarance of Swiss mice infected by P.b ANKA.

Study on biological vector in relation to malaria transmission aaafter outbreaks of malaria in three sub- village at Belaras village, Tembilahan sub-district, Indragiri district, Indragiri district, Riau province by Subagyo Notopranoto

To identifyt the vectors in three selected sub-villages of Belaras, the vectors bionomic in relation to malaria transmission in order to help and in designing appropriate malaria control program. Anopheles sundaicus, A. lesteri, A. baezai and A. tesselatus were observed by indoor and outdoor landing collection. A. sundaicus might act as the suspected major vector in these study site, where as were consistent with the presence of abundant A.sundaicus larvae in the persistent stagnant canal. It supposed malaria transmission could occur in these area.

Tuberculosis Diagnosis and its problem by Ni Made Mertaniasih

Effective Tuberculosis ( TB ) controls achieved through some effort, include increasing case finding, determining accurate and rapid diagnosis, adequate and prompt treatment. TB Dx initially with: - case finding - contact tracing - identifying clinically sign and symptoms - Dx of infectious agent Technology of TB agent detection and identification have been developing such as AFB microscopy, culture methode on broth or solid media, immunodiagnosic and nucleic acid amplification using PCR. Many problem in TB Dx related to chronic infection as the manifestation of the chain reaction between Mycobact.TB molecular complexity and diversity of immunity, the Dx problem are TB in children, latent infection, extra pulmonary TB, TB co infection- HIV, anti TB resistance.

An overview of TB control in Indonesia by Firdosi Indonesia is ranked as having the third highest TB burden in the world The estimated prevalence among TB cases is low nationally. The case detection rate increase rapidly from 30% in 2002 to 74% in 2006 Indonesia was the first high TB burden country in the South East Asia region to achieve the global target for case detection and cure The National TB program has begun implementation of the second strategic plan ( 2006 2010 ), which build on a solid DOTS foundation and aims to strengthen: - the quality of service delivery - increase the participation of hospital both public and private New strategies such as : - Hospital DOTs linkage - laboratoratory improvement

A man with pulmonary and knee Tuberculosis by Magy Satolom

Bone and joint TB is one of an extra pulmonary TB manifestation, involving 10% of overall cases with extra pulmonary TB. History of the patient: - cough and sputum for 2 month duration, acid fast bact positive - weight loss, fever -the left knee swelling and pain,so he can not walk, - knee biopsy: granulomatous inflamation and necrotic caseosa - Chest X ray: fibro infiltrates and multiple cavities on both side of the lung. - Treatment: anti TB and arthrodesis