Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients. Methods: This study is a retrospective cohort study, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results. Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%). Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented.

Background: Data on the prevalence of bacterial co-infections among COVID-19 patients are limited, especially in our country, Indonesia. We aimed to assess the rate of bacterial co-infections in hospitalized COVID-19 patients and report the most common microorganisms involved and the antibiotic use in these patients. Methods: This study is a cross sectional study with retrospective approach, among COVID-19 adult patients admitted to Universitas Airlangga Hospital Surabaya from 14 March-30 September 2020. The bacterial infection is defined based on clinical assessment, laboratory parameters, and microbiology results. Results: A total of 218 patients with moderate to critical illness and confirmed COVID-19 were included in this study. Bacterial infection was confirmed in 43 patients (19.7%). COVID-19 patients with bacterial infections had longer hospital length of stay (17.6 ± 6.62 vs 13.31±7.12), a higher proportion of respiratory failure, intensive care treatment, and ventilator use. COVID-19 patients with bacterial infection had a worse prognosis than those without bacterial infection (p<0.04). The empirical antibiotic was given to 75.2% of the patients. Gram-negative bacteria were commonly found as causative agents in this study (n = 39; 70.37%). Conclusion: COVID-19 patients with bacterial infection have a longer length of stay and worse outcomes. Healthcare-associated infections during intensive care treatment for COVID-19 patients must be carefully prevented.

A high incidence of diphtheria cases in children in East Java province, Indonesia, has been observed since the beginning of this century. Despite many efforts, the outbreaks continue. This study aims to explain the high incidence of diphtheria in children in East Java province since 2013. This cross-sectional surveillance report-based study used data from 38 districts in East Java since 1 January 2013. Collected data included demographics, clinical information, additional examinations, immunization history, and close contact management. Over eleven years, there were 4009 diphtheria patients, of whom 2921 (72.86%) were under 18 years of age. Boys (59.77%) outnumbered girls, and the most common age category was >60–144 months (51.66%). Most cases had incomplete or zero immunization (76.16%). Tonsillopharyngeal diphtheria was the most common type (69.60%). The five top districts with the most cases were Surabaya, Sidoarjo, Kabupaten Blitar, Kota Malang, and Kabupaten Malang. The eleven-year case fatality rate (CFR) was 2.36% (69/2921). This study shows that diphtheria cases in children and adolescents in East Java have consistently been high, and low immunization coverage might still be the leading cause. There has also been a shift in the district distribution. Diphtheria outbreaks require complete and sustainable efforts, not just outbreak response immunizations.

Previous studies have yielded inconsistent results on whether glycated hemoglobin (HbA1c) and random blood glucose (RBG) are associated with mortality of coronavirus disease 2019 (COVID-19) patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the association of HbA1c and RBG with mortality among COVID-19 patients with T2DM. A retrospective study was conducted on 237 patients with COVID-19 and T2DM (survival (n = 169) and non-survival groups (n = 68)). Data on socio-demography, comorbidities, clinical symptoms, laboratory examination, and mortality were collected. Patients in the non-survival group had an older age range as compared with those in the survival group (60 (52.3–65.0) vs. 56.0 (48.5–61.5) years, p = 0.009). There was no statistical gender difference between the two groups. After matching was done, chronic kidney disease, NLR, d-dimer, procalcitonin, and random blood glucose were higher in the non-survival group compared to the survival group (p < 0.05). HbA1c levels were similar in survivors and non-survivors (8.7% vs. 8.9%, p=0.549). The level of RBG was independently associated with mortality of COVID-19 patients with T2DM (p = 0.003, adjusted OR per 1-SD increment 2.55, 95% CI: 1.36–4.76). In conclusion, RBG was associated with the mortality of COVID-19 patients with T2DM, but HbA1c was not.

Background: Tuberculosis (TB) is still one of the major health problems in the world, especially in countries with dense populations. Indonesia is listed among the top three countries with the highest burden of tuberculosis worldwide. The low coverage of case detection in Indonesia is one of the reasons for ineffective TB control. Therefore, this disease remains a threat to spread in today’s Indonesian society. Digital technology can be used to increase the effectiveness and efficiency of case detection. This study aims to create a new paradigm for detecting new cases of tuberculosis using a self-assessment website-based application. Methods: This descriptive quantitative research used univariate analysis. Respondents for this research were sampled from all East Java people who filled out the E-TIBI application. Result: In total, there were 4,658 E-TIBI users in East Java, with 20.80% suspected of tuberculosis. The most frequent symptoms found in the respondents were fatigue, cough for > 2 weeks, and weight loss. Discussion: A self-assessment paradigm based on digital technology was applied to the design of this E-TIBI application. From this application, the public can quickly determine whether they or others are suspected of having tuberculosis. This result shows that the whole community can easily access the E-TIBI application for initial tuberculosis screening. Conclusion: Through this application, direct community participation can increase the detection of new cases to support the government and WHO programs in eliminating tuberculosis by 2030.

Context: Dengue is one of the most common infectious diseases found in tropical and subtropical regions, particularly in urban and semi-urban areas. Management dengue until now has not had a specific therapy. The development of dengue therapy using traditional plants as the main source of dengue therapy is needed. Sterculia quadrifida R. Br stem bark is one of the traditional plants in Indonesia, widely used by local people to treat various diseases. Aims: To identify the potency of S. quadrifida stem bark extract against the envelope protein and NS5 RdRp (RNA-dependent RNA polymerase) in dengue infection through in silico approach. Methods: All ligands from S. quadrifida stem bark extract from the previous study and protein preparations were retrieved from the PubChem and RSCB data bank database, respectively. Drug-likeness using Lipinski’s rule of five methods. Pyrx, PyMOL, and Discovery Studio 2.0 were used to analyze and visualize the potency of S. quadrifida stem bark-specific compounds against the envelope and NS5 RdRp. Results: Epicatechin and scopoletin have the lowest affinity bond, some noncovalent interaction, and also similarity in the position of the amino acid interaction to the reference control ribavirin. Conclusions: Epicatechin and scopoletin from S. quadrifida have antiviral potential against dengue by disposing of envelope protein and NS5 RdRp.