Intestinal parasitic infections (IPIs), caused by helminths and/or protozoa, continue to be a significant public health concern in Indonesia. Water access, sanitation, and hygiene practices (WASH) are influential factors for IPIs, especially among children. The aim of this study was to investigate the association between WASH and IPIs among school-aged children. A cross-sectional study involving 338 school-age children in an urban slum area in North Jakarta, Indonesia, was conducted using stool specimens subjected to microscopic and real-time polymerase chain reaction (rt-PCR) examination. The children underwent a finger-prick blood test and anthropometric measurements to determine anemia and nutritional status. Parents whose children participated in stool and blood examinations were interviewed using a modified WASH questionnaire. Helminth infections were not found in this study, whereas the overall prevalence of intestinal protozoa parasitic infection (IPPI) was 18.3% and 52.4% by microscopy and rt-PCR, respectively. Blastocystis spp. was found to have the highest prevalence (microscopy: 12%; rt-PCR: 48.6%), followed by Giardia intestinalis (microscopy: 0.6%; rt-PCR: 6.7%), Cryptosporidium spp. (microscopy: 5.1%; rt-PCR: 1.6%), and Entamoeba histolytica/dispar (microscopy: 0.6%; rt-PCR: 3.2%). Additionally, Dientamoeba fragilis was detected by rt-PCR at 4.1%. Furthermore, the discrepancies between microscopy and rt-PCR were observed in 8.9% (n=28) of the examined specimens. The majority of the respondents had a low-risk category of WASH profile. School children aged 5–10 years old (OR=2.06; 95%CI=1.27–3.33) and those who drank unprocessed cooking water (OR=1.95; 95%CI=1.07–3.57) were significantly associated with IPPI. The present study demonstrated that rt-PCR provides a better understanding of IPI epidemiology and has potential as a monitoring strategy for managing IPIs. Even though this population exhibits an adequate WASH profile and is not directly associated with IPIs, conducting a more in-depth observation of WASH facilities and practices is recommended to ensure a comprehensive assessment of the WASH profile. Additionally, engaging stakeholders in health promotion programs to ensure the sustainability of a good WASH profile and awareness of parasitic infections will be advantageous in achieving optimal urban health.

The testing capacity of the laboratory is paramount for better control of the pandemic caused by SARS-CoV-2. The pooling method is promising to increase testing capacity, and the use of direct NAAT-based detection of SARS-CoV-2 on a non-invasive specimen such as saliva will ultimately accelerate the testing capacity. This study aims to validate the pooling-of-four method to quadruple the testing capacity using RNA-extraction-free saliva specimens. In addition, we intend to investigate the preferable stage of pooling, including pre- or post-heating. The compatibility of this approach was also tested on five commercial kits. Saliva specimens stored at −80 °C for several months were proven viable and were used for various tests in this study. Our findings revealed that pooling-of-four specimens had an overall agreement rate of 98.18% with their individual testing. Moreover, we proved that the pooling procedure could be conducted either pre- or post-heating, with no discordance and no significant difference in Ct values generated. When compared to other commercial detection kits, it demonstrated an overall agreement greater than 85%, which exhibits broad compatibility and ensures easy adaptability in clinical settings. This method has been proven reliable and increases the testing capacity up to fourfold.

The coronavirus disease-19 (COVID-19) pandemic has resulted in a significant global health crisis, causing hundreds of millions of cases and millions of deaths. Despite being declared endemic, SARS-CoV-2 infection continues to pose a significant risk, particularly for immunocompromised individuals, highlighting the need for a more sensitive and specific detection. Reverse transcription digital droplet polymerase chain reaction (RT-ddPCR) possesses a sensitive and absolute quantification compared to the gold standard. This study is the first to optimize RT-ddPCR for detecting SARS-CoV-2 in saliva specimens using a commercially available RT-qPCR kit. Optimization involved the assessment of the RT-ddPCR reaction mixture, annealing temperature adjustments, and validation using 40 stored saliva specimens. RT-qPCR was used as a reference method in this study. Compatibility assessment revealed that ddPCR Supermix for Probes (no dUTP) was preferable with an optimal annealing temperature of 57.6 °C. Although a 25% higher primer/probe concentration provides a higher amplitude in droplet separation of positive control, the number of copy numbers decreased. An inverse correlation between Ct value and copy number concentration was displayed, presenting that the lower the Ct value, the higher the concentration, for the N and E genes with r² values of 0.98 and 0.85, respectively. However, ORF1ab was poorly correlated (r² of 0.34). The sensitivity of targeted and E genes were 100% and 93.3%; as for the specificity, the percentage ranged from 80.8% to 91.3%. This study implicates the applicability of a modified method in the ddPCR platform for similar types of pathogens using saliva specimens.

Understanding COVID-19 transitions towards endemicity is vital by examining center-specific data within provincial and national contexts. This retrospective study aimed to enhance public health management and understanding of COVID-19 dynamics using data from Atma Jaya Catholic University of Indonesia (AJCUI) and open-source databases from Jakarta and Indonesia’s official websites from July 2020 to December 2022. Trends across data sources were compared, and correlations between positivity rates at AJCUI and Jakarta/Indonesia were assessed using linear regression. A total of 8,354,809 positive samples were analyzed nationally, showing similar trends and peaks of positivity rates across databases, with positive correlations between AJCUI–Jakarta (β = 1.154; p < 0.001; 95% CI = 0.86–1.45) alongside AJCUI–Indonesia (β = 1.262; p < 0.001; 95% CI = 0.74–1.79). Mobility restriction policies substantially reduced the positivity rate within the study period. Further analysis of AJCUI showed that higher proportions of low Ct value (≤30) were associated with increased contemporaneous positivity at AJCUI (β = 0.442; p < 0.001) and Jakarta (β = 0.319; p < 0.001), although inadequately reflected in Indonesia (β = 0.039; p = 0.589). This study highlights the potential of incorporating Ct value distributions as epidemiological indicators within surveillance systems. These findings support the importance of comprehensive laboratory data recording to better characterize COVID-19 transmission patterns across different surveillance levels, alerting policymakers to establish efficient policies.

Urbanization in Jakarta has led to the development of slum settlements characterized by poor sanitation and limited access to clean water. This environment significantly increases the risk of intestinal protozoan parasitic infections (IPPIs), which are known to cause diarrhea and adversely affect the growth and development of children—key factors in the success of Indonesia's Emas 2045 initiative. To address this, the community service team from FKIK UNIKA Atma Jaya conducted a free fecal examination program for students at a public school in the Penjaringan District, a slum area in North Jakarta. The program included several phases: preparation, education, microscopic examination, and evaluation, involving both the school and the students' parents or guardians. Diagnostic methods utilized were direct examination and a modified Ziehl-Neelsen (ZN) staining technique. Out of 223 participants, 16.6% were found to be infected with IPPIs. The analysis revealed no significant correlation between infection rates and grade levels (p=0.106). This initiative is expected to enhance awareness among parents and students about IPPIs, leading to improved personal hygiene and sanitation practices. It also provides valuable data to authorities for assessing and formulating preventive policies against IPPIs