This document discusses recent developments in the clinical diagnosis of leprosy. While leprosy prevalence in Indonesia is declining, the rate of new cases remains relatively stable. Most new cases are of the multi-bacillary type, which can now be detected earlier in the subclinical phase using serological tests. New serological tests have been developed that detect protein antigens rather than polysaccharide antigens. Molecular biology techniques like polymerase chain reaction (PCR) can detect M. leprae DNA and identify viable bacteria. DNA sequencing allows detection of mutations that cause drug resistance in the bacteria. Genomic mapping of M. leprae is now complete, enabling study of strains and sub-strains to better understand disease transmission.
This document discusses recent developments in the clinical diagnosis of leprosy. While leprosy prevalence in Indonesia is declining, the rate of new cases remains relatively stable. Most new cases are of the multi-bacillary type, which can now be detected earlier in the subclinical phase using serological tests. New serological tests have been developed that detect protein antigens rather than polysaccharide antigens. Molecular biology techniques like polymerase chain reaction (PCR) can detect M. leprae DNA and identify viable bacteria. DNA sequencing allows detection of mutations that cause drug resistance in the bacteria. Genomic mapping of M. leprae is now complete, enabling study of strains and sub-strains to better understand disease transmission.
This document discusses recent developments in the clinical diagnosis of leprosy. While leprosy prevalence in Indonesia is declining, the rate of new cases remains relatively stable. Most new cases are of the multi-bacillary type, which can now be detected earlier in the subclinical phase using serological tests. New serological tests have been developed that detect protein antigens rather than polysaccharide antigens. Molecular biology techniques like polymerase chain reaction (PCR) can detect M. leprae DNA and identify viable bacteria. DNA sequencing allows detection of mutations that cause drug resistance in the bacteria. Genomic mapping of M. leprae is now complete, enabling study of strains and sub-strains to better understand disease transmission.
Dokumen Artikel Penelitian ini milik penulis/peneliti yang diserahkan sebagian (judul dan Abstrak) hak ciptanya kepada
Universitas Airlangga untuk
digunakan referensi dalam penulisan artikel ilmiah. Tim Peneliti : Prof.Dr.Indropo Agusni, dr.,Sp.KK (K) Shinzo Izumi, Perkembangan terakhir dalam diagnosa klinik penyakit kusta Abstrak :
ABSTRACT (ENGLISH) : RECENT DEVELOPMENT IN THE CLINICAL DIAGNOSIS OF LEPROSY Leprosy prevalence in Indonesia is continuously declined, but the new incidence rate of leprosy is relatively stable. The trend of leprosy shows the prevalence rate became similar with the incidence rate. Majority of new detected cases are the Multi-bacillary (MB) type, which could be detected in the sub-clinical phase by serological test. Besides the ELISA test for anti Phenolic Glycolipid-1 (PGL-1) antibody which is based on polysaccharide antigen, a new serological test based on the protein antigen has been developed. Using molecular biological techniques, several Polymerase Chain Reaction (PCR) methods has been introduced. These methods are used for many purposes i.e. detection of specific DNA of M.leprae and detection of viable M.leprae (Reverse Transcriptase - PCR). Using DNA-sequencing method, it is now possible to detect mutation that caused drug-resistant of the bacilli. Although leprosy bacilli still uncultivated until present time, by DNA sequencing genomic mapping of leprosy bacilli has been completed. Study of strains or sub-strains of M. leprae are in progress, that will be useful for the study of transmission of the disease. Key words : leprosy diagnosis, serology, molecular biology ABSTRAK (INDONESIA) : PERKEMBANGAN TERAKHIR DALAM DIAGNOSA KLINIK PENYAKIT KUSTA Angka prevalensi kusta di Indonesia terus menurun, namun penemuan kasus kusta baru tidak berkurang sehingga kini prevalensi dan insiden kusta hampir sama. Mayoritas penderita kusta baru adalah tipe Page 1 Dokumen Artikel Penelitian ini milik penulis/peneliti yang diserahkan sebagian (judul dan Abstrak) hak ciptanya kepada Universitas Airlangga untuk digunakan referensi dalam penulisan artikel ilmiah. Tim Peneliti : Prof.Dr.Indropo Agusni, dr.,Sp.KK (K) Shinzo Izumi, multibasiler, dimana dalam fase subklinik sudah bisa dideteksi lewat pemeriksaan serologik. Selain uji ELISA anti Phenolic Glycolipid-1 (PGL-1) yang secara biokimiawi suatu polisakarida, kini tengah dikembangkan uji serologi terhadap antigen protein dari M.leprae. Dengan tehnik bio-molekuler kini telah dikembangkan berbagai uji Reaksi Rantai Polimerase (RRP) selain untuk mendeteksi DNA spesifik dari M.leprae, juga untuk mengetahui kuman hidup atau mati berdasarkan masih adanya RNA basil kusta dalam spesimen yang diperiksa (RT-PCR). Dengan metode sekuensing DNA, kini urutan nukleotida pembentuk DNA bisa diketahui. Selanjutnya dapat dideteksi pula adanya mutasi yang berakibat resistensi kuman terhadap obat kusta. Meskipun hingga kini basil kusta belum bisa ditumbuhkan dalam media buatan, dengan tehnik biomolekuler pemetaan genomik secara lengkap telah diselesaikan. Dari sini bisa dipelajari adanya strain atau sub-strain dari M.leprae, yang sangat berguna untuk mempelajari transmisi penyakit kusta. Kata kunci : diagnosa kusta , serologi, bio-molekuler Keyword : leprosy, diagnosis, management, early detection Page 2
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