SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
As in other parts of Southeast Asia, efforts to achieve or sustain malaria elimination in Indonesia have been threatened by the emergence of human infection with the primate species P. knowlesi. To understand the transmission dynamics of this species, investigation of P. knowlesi genetic diversity and population structure is needed. A molecular surveillance study was conducted in two phases between June 2014 and September 2018 at five primary health facilities in Aceh Province, Indonesia, an area nearing malaria elimination. Dried blood spot samples were collected from patients presenting with suspected malaria and testing positive for malaria by microscopy. PCR was performed for molecular confirmation and species identification. Forty-six samples were confirmed to be P. knowlesi, of which 41 were amplified with genotyping targeting ten known P. knowlesi microsatellite markers. For samples within a site, nearly all (9 of 10 loci) or all loci were polymorphic. Across sites, multiple identical haplotypes were observed, though linkage distribution in the population was low (index of association (IAS) = 0.008). The parasite population was indicative of low diversity (expected heterozygosity [HE] =  0.63) and low complexity demonstrated by 92.7% monoclonal infections, a mean multiplicity of infection of 1.06, and a mean within-host infection fixation index (FST) of 0.05. Principal coordinate and neighbour-joining tree analyses indicated that P. knowlesi strains from Aceh were distinct from those reported in Malaysia. In a near-elimination setting in Indonesia, we demonstrate the first evidence that P. knowlesi strains were minimally diverse and were genetically distinct from Malaysian strains, suggesting highly localized transmission and limited connectivity to Malaysia. Ongoing genetic surveillance of P. knowlesi in Indonesia can inform tracking and planning of malaria control and elimination efforts.
BACKGROUND: The global transition toward patient-centered pharmaceutical care has exposed structural disparities in ASEAN pharmacy workforce training and deployment. This review examines four research questions: how pharmacy education systems and accreditation standards differ across Indonesia, Malaysia, Thailand, the Philippines, and Singapore (collectively, the ASEAN-5); the extent to which pre-registration education influences clinical service scope and professional confidence; how education reform and regulatory change have shaped pharmacist clinical roles; and what barriers and enablers exist for regional qualification harmonization. METHODS: A systematic literature review following PRISMA 2020 was conducted. Searches of PubMed/MEDLINE and Scopus, supplemented by grey literature, were completed in May 2026. Of 78 unique records screened, 46 studies published between 2005 and 2026 met inclusion criteria. Quality appraisal used an adapted Mixed Methods Appraisal Tool; synthesis employed narrative thematic analysis. RESULTS: The five countries represent four structurally distinct pharmacy education architectures: Thailand's standardized six-year Doctor of Pharmacy with dual specialization tracks; four-year Bachelor of Pharmacy programmes in Malaysia and the Philippines with institutional variation; Indonesia's clinically underdeveloped system despite rapid expansion; and Singapore's four-year Bachelor of Pharmacy followed by a nationally mandated one-year pre-registration pathway. Evidence links deeper clinical training to broader practice scope, higher confidence, and improved patient outcomes. Reform produced uneven results: Thailand's PharmD transition improved clinical recognition but exposed deployment paradoxes; Singapore achieved the strongest training-to-practice alignment; Indonesia's health insurance reforms were not absorbed by an underprepared workforce; the Philippines lacks a national competency framework. No binding mutual recognition arrangement was identified; divergent qualification structures, incompatible accreditation systems, and an asymmetric evidence base remain the primary barriers. DISCUSSION: These findings indicate that clinical service scope is bounded less by national policy ambition than by the depth and clinical orientation of the pre-registration education that precedes it, and that credentialing reforms which outpace a health system's capacity to absorb new clinical roles, or the reverse, do not by themselves translate into expanded practice. CONCLUSIONS: Pharmacy education across the ASEAN-5 remains nationally distinct and clinically uneven. Clinical service scope is directly bounded by pre-registration education quality. No country has fully closed the education-practice gap. Regional harmonization requires national-level educational reform as a prerequisite.
The distribution of human filariae in Indonesia has not changed significantly since initial reports of the disease were made in 1928. Wuchereria bancrofti and Brugia malayi are widely distributed but the newly described Brugia timori appears to be restricted to the Lesser Sunda Islands. W. bancrofti and B. timori in Indonesia are nocturnally periodic and B. malayi has nocturnally periodic and B. malayi has nocturnally periodic and nocturnally subperiodic strains.
Virus isolations from dengue hemorrhagic fever patients in Indonesia are reported from 1975 to 1978. All 4 dengue serotypes were endemic in Jakarta, but dengue 3 was the predominant virus isolated. This type was also the most frequently isolated virus from patients outside Jakarta and had the widest distribution in Indonesia. The sensitivity of the mosquito inoculation technique for isolation of dengue viruses is discussed.
In Indonesia, where a large percentage of the population lives in rural areas, the traditional midwife or dukun is essential in the field of obstetrics. Means to further her knowledge and improve her skills so that the population at large may benefit are discussed.
The amino acid sequences of the pancreatic ribonucleases from river-breed water buffaloes from Italy and swamp-breed water buffaloes from Indonesia differ at three positions. One of the differences involves a replacement of asparagine-34, with covalently attached carbohydrate on all molecules, in the river-breed enzyme by serine in the swamp-breed enzyme. The ribonuclease content of the pancreas differs considerably between breeds and is lower in river buffaloes. A ribonuclease preparation from two swamp buffaloes contained a minor glycosylated component. Preliminary evidence was obtained that the amino acid sequence of this component has factors in common with the main component of the swamp-breed ribonuclease and with the river-breed enzyme.
Japanese encephalitis virus was isolated from 11 pools of Culex tritaeniorhynchus and a single pool of C. gelidus mosquitoes at a pig-raising area near Jakarta, West Java, Indonesia, during 1972-74. Ten sentinel pigs placed in the area all developed haemagglutination-inhibition antibodies against Japanese encephalitis and the virus was isolated from the blood of 3.
Bartonella spp. and haemotropic Mycoplasma spp. are important vector-borne bacteria of veterinary and zoonotic relevance, yet information on their circulation in Indonesian island ecosystems remains limited. We investigated their occurrence and molecular diversity in 117 domestic and free-roaming cats from the Gili Islands, Indonesia, using full-length 16S rRNA nanopore metagenomics followed by targeted PCR, sequencing, phylogenetic analysis and multilocus sequence typing (MLST). Bartonella DNA was detected in 18/117 (15.4%) cats and haemotropic Mycoplasma DNA in 40/117 (34.2%). Sequence analysis identified Bartonella henselae as the predominant species together with Bartonella clarridgeiae. MLST of B. henselae revealed three sequence types (ST1, ST16 and ST42), with ST1, a lineage reported in both feline and human isolates, predominating. Comparison with the PubMLST database showed significant geographical differences in the distribution of ST1 and ST42, supporting regional variation in the circulation of B. henselae lineages. Haemoplasma characterization identified Candidatus Mycoplasma haemominutum, Mycoplasma haemofelis, Candidatus Mycoplasma turicensis and a Mycoplasma feliminutum-like organism, comprising ten distinct sequence variants. Haemoplasma positivity was significantly associated with age, with adults showing higher positivity than younger animals (P < 0.001), whereas Bartonella infection was not associated with age, sex or island of origin. The detection of zoonotically relevant B. henselae lineages and the genetic diversity of feline haemoplasmas provide evidence of the circulation of vector-borne bacteria among cats in this tropical island ecosystem. These findings provide the first molecular epidemiological baseline for this region and contribute to understanding the circulation and genetic diversity of feline vector-borne pathogens in Southeast Asia.
The distribution of phage types among 221 human strains of Salmonella paratyphi A in Indonesia was studied. Approximately 50% were phage type 5, a rare type elsewhere in the world. Most other isolates were the cosmopolitan phage type 1. The ratio of phage type 1-5 was compared for two cities on Java, Jakarta and Yogyakarta. The ratios were significantly different, phage type 5 predominating in Jakarta. The ratio of phage types among 10 S. paratyphi A strains isolated from Jakarta river water was similar to that found in Jakarta patients.
The haematological findings resulting from the interaction of Hb A2 Indonesia trait with beta-thalassaemia trait and HbA2 Ind trait with Hb E trait are discussed. A person doubly heterozygous for Hb A2 Ind and beta-thalassaemia had mild haematological abnormalities essentially similar to those found in persons with beta-thalassaemia trait alone. A carrier for both Hb A2 Ind trait and Hb E trait had essentially normal haematological findings.
In an area of severe endemic goiter in Central Java, Indonesia, clinical overt or mild hypothyroidism appeared to be present in 7 out of 20 cretins and also in 12 out of 94 non-cretinous subjects, all 5-20 years of age, living in the village of Sengi. Hypothyroidism was not found in a control group of 70 subjects of the same age living in Londjong just outside the edemia. In hypothyroid subjects the plasma PBI-concentration was 0.98+/-0.32 mug/100 ml (mean+/-SD) vs. 2.72+/-1.24 mug/100 ml in euthyroid subjects from Sengi and 4.86+/-0.80 mug/100 ml in controls from Londjong. Values for T3 were 56.3+/-3.17 ng/100 ml in hypothyroids, 140.5+/-38.5 ng/100 ml in euthyroids from Sengi and 121.6+/-27.4 ng/100 ml in controls. The TSH levels (geometric mean and range) in these 3 groups were, respectively, 210.1 (108.0-342), 15.6 (3.0-372) and 4.1 (0.8-7.0) muU/ml. The differences between the mean concentration of PBI, T3 and TSH in the hypothyroid and euthyroid groups were highly significant (P less than 0.001). These data strengthen the clinical diagnosis of hypothyroidism in cretins as well as in non-cretinous subjects. All hypothyroid subjects had a PBI less than 1.8 mug/100 ml and T3 less than 120 ng/100 ml and TSH greater than 100 muU/ml. In 8 hypothyroid subjects, restudied 18 months after iodized oil injection, hypothyroidism was either corrected or markedly improved. It therefore appears that iodine deficiency per se in postnatal life may lead to (juvenile) hypothyroidism, which can be corrected by iodine therapy. Our findings have implications for the definition and diagnosis of endemic cretinism. Not all hypothyroid subjects in an area of endemic iodine deficiency should be classified as cretins.
Hepatitis B e antigen (HBeAg) is widely used as a marker for active HBV replication and serves as a surrogate for HBV DNA > 200,000 IU/mL to determine eligibility for tenofovir disoproxil fumarate (TDF) prophylaxis to prevent vertical transmission, according to WHO guidelines. However, some HBeAg-negative patients still harbor high viral loads. Mutations in the precore (PC) and basal core promoter (BCP) regions may reduce or abolish HBeAg expression without necessarily suppressing viral replication. Next-generation sequencing (NGS)-based characterization of these mutations remains limited in Indonesia. This study aimed to analyze the mutation prevalence in the BCP and PC regions associated with HBeAg negativity in Indonesian patients. We conducted a cross-sectional study of 32 chronic HBV treatment-naïve, unvaccinated patients with HBV DNA > 200,000 IU/mL (16 HBeAg-negative, 16 HBeAg-positive) at Cipto Mangunkusumo General Hospital. BCP and PC mutations were analyzed using NGS, classifying mutations as major (mutation frequency index [MFI] ≥20%) or minor (MFI 1- < 20%). Associations were analyzed using the Chi-square or Fisher's exact test and p-values were adjusted using the Benjamini-Hochberg procedure. Among 29 major mutation sites, PC mutations A1846T/C and G1896A were more frequent in HBeAg-negative than HBeAg-positive patients (81.3% vs 6.3% and 75.0% vs 12.5%, respectively; all adjusted p = 0.019). Combined analysis showed higher mutation frequencies in HBeAg-negative patients (93.8%, 81.3%, and 62.5% for A1846T/C, G1896A, and G1899A, respectively; all adjusted p = 0.015). In conclusion, HBeAg-negative patients with high viral loads are strongly associated with PC mutations, particularly G1896A, A1846T/C, and G1899A. These exploratory findings provide regional NGS-based molecular evidence that established PC mutations may contribute to the coexistence of HBeAg negativity and continued high-level HBV replication in Indonesian patients. Larger studies incorporating broader virological and clinical comparison groups are required to determine the clinical significance of these findings.
Sera collected from people living along the slopes of Mt. Merapi and Mt. Merbabu (900-1900 m) in Boyolali Regency, Central Java, Indonesia were tested by indirect hemagglutination tests for antibodies to Entamoeba histolytica and Toxoplasma gondii. A total of 695 sera from 439 males and 256 females, 2 to 75 years of age were tested for amoebiasis and 17.6% had positive antibody titers of 1:128 or greater. The prevalence of antibodies was the same for males and females and increased with age. The seropositivity rate for Toxoplasma gondii antibodies among 438 males and 255 females was 2% at titers of 1:256 or greater. The prevalence was higher in females (2.7%) than in males (1.6%), and was highest in the oldest age groups.
A biomedical survey was conducted in several areas of Irian Jaya, Indonesia in July 1972 in association with an investigation of reports of a cholera outbreak. Stool specimens, blood smears and sera were collected and examined for evidence of parasitic as well as other infectious diseases. A total of 114 stools were examined and the most commonly found intestinal parasites were Trichuris trichiura (94%), Ascaris lumbricoides (74%), hookworm (58%), Entamoeba coli (15%), Endolimax nana (8%), Entamoeba histolytica (7), Entamoeba hartmanni (4%), Giardia lamblia (3%) and Chilomastix mesnili (3%). A total of 513 blood smears were examined and Wucheria bancrofti microfilariae were detected in 4% and malaria in 4% (Plasmodium falciparum 3%, Plasmodium vivax 2%). The malaria and filarial positive individuals lived in Beeuw, Waigeo and Arar, Sorong. These parasitic infections were not detected in people from Biak City and Sburia, Biak. Sera were collected from 357 persons and significant antibody titers were found for Entamoeba histolytica (4%) Toxoplasma gondii (7%), Influenza A2 Hong Kong 68 (65%), Influenza B Taiwan 68 (78%), Japanese encephalitis virus (87%) and Dengue 1 virus (79%).
A survey was carried out among persons residing in 8 villages in the Province of West Kalimantan, Indonesia to determine the prevalence of filariasis. Finger tip blood smears were obtained at night from over 3,000 people and microfilariae of Brugia malayi were found in 108 (3.5%) and Wuchereria bancrofti in 10 (0.3%). Most B. malayi (96 carriers) was found in Kakap, a village near the coast, 20 km from the provincial capital of Pontianak. Nine of 10 cases of W. bancrofti were located in Pahauman, a village 130 km northeast of the provincial capital. Periodicity studies indicate the strain of B. malayi to be subperiodic. In Kakap 18% of 226 persons examined had a clinical history of filariasis and elephantiasis was seen in 13%. This is the first report of rural bancroftian filariasis in the area. A few Mansonia species of mosquitoes were examined but none were infected with filarial larvae.
Over 1,000 stool specimens from residents of the Napu and Besoa Valleys, Central Sulawesi, Indonesia were examined. Schistosoma japonicum was detected in 31% of Napu Valley residents while in only 2% of the Besoa Valley residents. Hookworm infections were the most frequently encountered helminth parasitisms in both valleys. Other helminth parasites encountered were: Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Strongyloides stercoralis, Physaloptera sp., Diphyllobothrium sp., echinostome and heterophyid trematodes. Intestinal protozoa endemic to the area were: Entamoeba histolytica, E. coli, E. hartmanni, Iodamoebe bütschlii, Giardia lamblia, Chilomastix mesnili and Trichomonas hominis. Plasmodium falciparum was responsible for malaria parasitaemias in 5% of 1353 specimens examined and Brugia malayi microfilaraemias were detected in 10% of 972 specimens examined.
A biomedical survey was conducted in 9 villages in the Malili area of South Sulawesi, Indonesia. Blood specimens were examined for malaria and microfilariae; stool specimens were examined for intestinal parasites. Malaria parasitemias were rare; Plasmodium falciparum was detected in 10 and P. vivax in 11 of 985 blood smears. Malayan filariasis was endemic to all villages surveyed. The overall prevalence of detectable microfilaremias was 15%, varying from 34% in Kawata to 1% in Nuha. Microfilarial densities, expressed as MfD50 averaged 8.0 and varied from 1.1 in Timampu to 16.0 in Karabbe. Intestinal parasites were common. Although Schistosoma japonicum was not found, 97% of the examined had one or more intestinal parasites as follows: Ascaris lumbricoides (74%), Trichuris trichiura (65%), hookworm (62%), Entamoeba coli (38%), Endolimax nana (10%), Entamoeba histolytica (6%), Iodamoeba bütschlii (4%), Entamoeba hartmanni (3%), Giardia lamblia (2%) Chilomastix mesnili (1%) and Enterobius vermicularis (1%). Strongyloides stercoralis larvae and Hymenolepis nana eggs were detected once each and heterophyid-like eggs were detected twice.