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Background: Sepsis‐associated acute kidney injury (AKI) is a condition that increases in‐hospital mortality and the risk of progression to CKD. The current method of detecting AKI, which relies on increased serum creatinine levels or a decrease in urine output, has low sensitivity. Early diagnosis and appropriate intervention in AKI can lead to improved patient outcomes. Several low molecular weight proteins and microRNAs detected in AKI are considered early biomarkers of AKI, such as miR‐10a‐5p and miR‐210‐3p. Method: A cross‐sectional study was conducted among 62 participants, consisting of 26 sepsis patients with AKI, 26 sepsis patients without AKI, and 10 healthy controls. AKI was determined according to KDIGO criteria. MicroRNA expression was analyzed using reverse transcription quantitative polymerase chain reaction (RT‐qPCR). Statistical analysis was obtained using the Kruskal–Wallis test, Spearman's correlation coefficient, and ROC curve analysis. Result: The median miR‐10a‐5p expression of the healthy controls versus sepsis with AKI versus sepsis without AKI groups was 10.38 (5.50–33.82) versus 10.32 (3.32–31.53) versus 9.76 (0.32–97.36), while the median miR‐210‐3p expression was 0.20 (0.03–0.41) versus 0.38 (0.04–1.24) versus 0.29 (0.06–1.67), respectively, with p = 0.721 for miR‐10a‐5p and p = 0.013 for miR‐210‐3 p. A significant increase in miR‐210‐3p expression was found in the sepsis with AKI compared to the healthy controls (p = 0.013) and sepsis without AKI (p = 0.034). miR‐210‐3p significantly correlated with creatinine and urea serum level (p < 0.05); miR‐10a‐5p did not have a significant correlation. The sensitivity and specificity of miR‐10a‐5p were 61.5% and 47.2%, and miR‐210‐3p were 84.6% and 63.9% for determining AKI. Conclusion: The study's findings revealed a significant increase in miR‐210‐3p expression in sepsis patients with AKI, indicating its potential as a promising biomarker for determining AKI. This discovery demonstrates that the diagnostic performance of miR‐210‐3p surpasses that of miR‐10a‐5p, providing a more accurate biomarker for diagnosing AKI in sepsis patients. [ABSTRACT FROM AUTHOR]

Introduction: Telehealth has improved promotive and preventive health care through enhanced access to health-care services. Existing literature on telehealth in Indonesia has primarily concentrated on telemedicine in the curative area. However, there is a lack of research exploring telehealth in Indonesia that focuses on promotive and preventive. Therefore, this review examines the existing literature concerning the types and implementation of telehealth in promotive and preventive care within Indonesia over the past decade. Methods: A scoping review based on Arksey and O'Malley's framework was used in this study. A literature search was performed in March 2023 across seven databases: PubMed, Scopus, Embase, CINAHL, Medline, Health Internetwork Access to Research Initiative, and Garba Digital Reference. The data were extracted, categorized, and synthesized using narrative descriptions, tables, and graphics. Results: A total of 532 articles were identified, and 29 articles were included. Telehealth programs concern maternal and child health, communicable diseases, noncommunicable diseases, and nutrition. Modality using telehealth for health services is done in the form of video, remote monitoring, storing and forwarding, and others. Important aspects highlighted in the implementation of telehealth include patient acceptance, health worker acceptance, policy, technology, organization, and financing. Conclusion: Telehealth for promotive and preventive health care has evolved in Indonesia over the past decade. Successful implementation hinges on positive reception, supportive policies, reliable technology, efficient organizational structures, and adequate financing. A holistic approach considering these factors is crucial for maximum impact, with government support in policy formulation, technology provision, and funding essential for successful telehealth in promotive and preventive health-care services. [ABSTRACT FROM AUTHOR]

Background Clot waveform analysis can be used to evaluate clot formation profiles. This waveform can be obtained from activated partial thromboplastin time (APTT) assays without additional reagents and shows different patterns in hemophilia patients with coagulation factor VIII (F VIII) deficiency or abnormality. Objective To determine the clot wave pattern and its process in clot formation phases (pre-coagulation, coagulation, and post-coagulation) in normal and hemophilia A subjects, analyze for possible correlations between clot wave parameters and F VIII activity, and obtain the pattern of coagulation curves in hemophilia subjects as a step to assess clot waveform analysis as a possible screening tool for hemophilia. Methods In this cross-sectional study, we performed clot wave analysis in 145 adult and pediatric subjects with hemophilia to obtain the clot wave pattern in this condition. Clot wave analysis was also done in 160 subjects with normal hemostasis to obtain reference clot wave parameters. Results In this study, the starting point of coagulation phase in normal subjects was between 30-40 seconds, with a shorter precoagulation phase and steeper slope. Hemophilia patients had a longer pre-coagulation phase and flatter slope, especially in severe hemophilia A patients, who had longer and more variable coagulation starting points (P<0.001). The absolute values of maximum coagulation velocity (Min1), maximum coagulation acceleration (Min2), and maximum coagulation deceleration (Max2) of hemophilia A patients were also lower than those of normal hemostasis patients, with lower absolute value seen in severe than in mild-moderate hemophilia A patients. A moderate correlation was found between Min1, Min2, and Max2 with F VIII activity (P<0.001). Conclusion Clot wave analysis may be considered as a method for screening hemophilia patients to distinguish mild-moderate and severe hemophilia A patients in health facilities that lack the ability to perform F VIII assays. [ABSTRACT FROM AUTHOR]

Introduction: Although Indonesia is not a signatory to the World Health Organization Framework Convention on Tobacco Control, 84% of local governments have adopted Smoke-Free Areas (SFAs) as a national policy. This study examines exposure to secondhand smoke (SHS) in adolescents who have never smoked after 8 years of SFA implementation. Methods: We used data from the 2019 Global Youth Tobacco Survey and a cross-sectional research design to find 6121 students from 148 schools in 30 provinces in Indonesia who met the research inclusion criteria. To identify risk factors regarding SHS exposure, multivariable logistic regression analysis was performed. Results: Although the local government had adopted an SFA policy, 61.1% of adolescents aged 11–17 years, especially middle and high school students, have relatively high exposure to SHS. School environments had the highest prevalence of SHS exposure (50.5%), followed by public places (49.9%) and at home (46.2%). A significant risk factor for exposure to SHS in the school environment is observed in teachers smoking inside school buildings (odds ratio [OR] =4.32, 95% confidence interval [CI]: 3.81–4.89); exposure to SHS at home and in public place (OR = 3.29, 95% CI: 2.93–3.70), and exposure to tobacco advertising, promotion, and sponsorship on offline and online media (OR = 2.07, 95% CI: 1.70–2.52). Conclusion: SFA policies must be evaluated and strengthened before they can be implemented to reduce smoking-related illnesses and economic losses. In addition, it is important to educate families and society about implementing SFA in school environments, public places, and at home. [ABSTRACT FROM AUTHOR]

The distribution and spatial analysis of public healthcare in Indonesia are rarely discussed, with most studies predominantly focusing on quantity and quality. Therefore, this study aims to investigate the relationship between health facilities selection and geographic conditions by integrating medical facilities data and the number of doctors using spatial analysis approach. The selected study areas were referral health facilities chosen by Dengue Hemorrhagic Fever (DHF) patients in Purwosari District, Gunungkidul Regency. Furthermore, data were collected through interviews, field measurements (altitude and location plotting), and secondary sources (hospital type, number of doctors, and number of beds). The data collection and analysis employed GPS, Altimeter, ArcGIS, and SPSS. Spatial analysis method included kernel density, buffer, ruler, and altitude of each facility. Meanwhile, the medical analysis approach used Pearson's correlation and multinomial logistic regression in SPSS. Spatial analysis results showed that DHF patients in Purwosari dominantly chose hospitals located in Bantul Regency due to closer proximity, relatively short travel time, lower elevation, and the availability of numerous health facilities centers. Puskesmas Purwosari (Sub-district level Primary Health center) was primarily chosen as an early reference and a place for treating mild dengue patients. In addition, distance, duration of travel time, and the number of doctors exhibited a strong relationship based on Pearson's correlation. These three variables demonstrated strong linear relationship with the response variable. Some variables like elevation, number of doctors, hospital type, and number of beds were considered by patients in choosing a hospital, as revealed by multinomial logistic regression analysis. [ABSTRACT FROM AUTHOR]

Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA. Objective To evaluate the influence of OSA on quality of life in children with asthma. Methods This cross-sectional study in asthmatic children aged 7-15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Results Using the ISAAC questionnaire distributed through techers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects' mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA. Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life. [ABSTRACT FROM AUTHOR]

Molecular rapid test may provides an alternative to time-consuming PCR tests. There is a continuing need for reliable molecular rapid test detection methods to be quick and easy applied to individuals with acute SARS-CoV-2 infection. Features ability of molecular rapid test should be considered and compared with the gold standard Real-time-Polymerase Chain Reaction (RT-PCR) test for diagnosis of COVID-19 cases. In this research, the goal was to analyze the ability of ID Now. Molecular rapid test (ID Now) was compared with the real-time RT-PCR test for diagnosis of SARS-CoV-2 in nasopharyngeal. ID NOW works with isothermal nucleic acid amplification for the qualitative detection of the Rdrp gene. Otherwise, RT-PCR detects gene N, gene E, and Orf1ab from SARS-CoV-2 for virus identification or quantification of viral load. One hundred thirty six (from nasopharyngeal swabs) were get from COVID-19 suspected cases and exposed individuals in three hospitals: Universitas Brawijaya Hospital Malang, Baptis Hospital, and Regional Hospital Lawang, east Java, Indonesia, during May 2021. A total of 136 samples, 66 samples were positive, and 70 sampels were negative for SARS-CoV-2 RNA by ID Now. Comprehensively, sensitivity and specificity were 98.4% (95% confidence interval 91 - 100%) and 92% (95% confidence interval 85-92%), respectively, PPV 90,9% NPV 98,6% with a diagnostic accuracy of 94% and Kappa coefficient of 0.89. Molecular rapid test (ID Now) showed good sensitivity and specificity. This test can be used for the early detection and rapid diagnosis of SARS CoV-2. [ABSTRACT FROM AUTHOR]

Background. Genetic studies of end-stage renal disease (ESRD), including those of human leukocyte antigen (HLA) genes, have been reported in several populations but have not yet been evaluated in Indonesia. Some studies have reported that these genes had a substantial role in ESRD. This study aims to analyze the association between HLA genes and ESRD within the Indonesian community. Method. A retrospective study to investigate HLA class I and II alleles to find out the distribution of HLA-A, -B, -C, -DPB1, -DQB1, and -DRB1 in renal transplant recipients and to ascertain their role in susceptibility to ESRD was performed on totally 149 subjects, consisting of 69 ESRD patients and 80 healthy controls. HLA typing was determined using Luminex techniques. The allele and haplotype frequencies were compared between ESRD patients and controls. Result. High-frequency alleles were HLA-A ∗ 24 (43.6%), B ∗ 15 (38.2%), C ∗ 08 (30.8%), DRB1 ∗ 12 (47.3%), DQB1 ∗ 03 (50.6%), and DPB1 ∗ 13 (22.5%). HLA-A ∗ 24 p = 0.01 and HLA-B ∗ 35 p = 0.02 were associated with a protective effect, with OR 0.537 (95%CI 0.34–0.86) and 0.316 (95%CI 0.11–0.88), respectively. There were some two-locus haplotypes associated with susceptibility to ESRD, such as B ∗ 15-DRB1 ∗ 12, B ∗ 13-DRB1 ∗ 15, A ∗ 02-B ∗ 15, A ∗ 02-C ∗ 08, and B ∗ 13-DQB1 ∗ 05. HLA-A ∗ 02-B ∗ 15-DRB1 ∗ 12 and A ∗ 24-B ∗ 13-DRB1 ∗ 15 appear to be associated with susceptibility to ESRD. Conclusion. The allele groups of HLA-A ∗ 24 and HLA-B ∗ 35 are associated with protection from ESRD. Meanwhile, HLA-B ∗ 13-DRB1 ∗ 15 and A ∗ 24-B ∗ 13-DRB1 ∗ 15 are the most frequent HLAs associated with ESRD in two-locus and three-locus haplotype, respectively. [ABSTRACT FROM AUTHOR]

Background: This study was aimed to explore the association of vitamin D in the risk of coagulopathy in coronavirus disease-19 (COVID-19). Methods: Clinical and laboratory findings were obtained from 50 confirmed COVID-19 patients hospitalized in Saiful Anwar General Hospital, Malang, Indonesia, from September to November 2020. Thrombotic events during hospitalization were recorded, and the ISTH disseminated intravascular coagulation (DIC) score was used to classify overt DIC. Hypovitaminosis D was defined by serum vitamin D level <49.92 nmol/L. Results: Among 50 patients, 42 (84%) had hypovitaminosis D, and 6 (12%) developed thrombotic events. Vitamin D levels were lower in patients with thrombotic events (p=0.015), D-dimer >2 mg/L(p= 0.006), ISTH DIC score >5 (p=0.020), admitted on ICU (p=0.002), and non-survivor groups (p=0.007). Multivariate analysis for the risk in increased D-dimer levels showed low vitamin Das the only significant risk factor with OR 1.8 (1.2-4.4), p=0.034. Low vitamin D also increased the risk for developing overt DIC with OR. 5.4 (1.0-30.2), p= 0.039. Vitamin D level had negative correlations with ferritin (R=-0.316, p=0.044) and CRP (R=-0.530, p=0.000). Conclusions: In conclusion, a low level of vitamin D was found in most hospitalized COVID-19 patients and might be associated with the development of coagulopathy. [ABSTRACT FROM AUTHOR]

Background: Serum vascular endothelial growth factor (VEGF) and infarct volume detected by brain imaging have been associated with stroke outcome. However, the relationship of these two variables with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to investigate the association between acute serum VEGF levels and infarct volume with PSCI in ischemic stroke patients. Methods: Fifty-six first-ever ischemic stroke patients who were hospitalized in Dr. Sardjito General Hospital Yogyakarta, Indonesia were prospectively recruited. Serum VEGF level was taken on day 5 of stroke onset and measured by ELISA. Infarct volume was calculated manually from head CT scan by expert radiologist. PSCI was assessed after 3 months follow up by using Montreal Cognitive Assessment-Indonesian version (MoCA-INA). We performed a ROC curve analysis to determine the cut-off point of VEGF level and infarct volume. Multivariate logistic regression analysis was performed to measure the contribution of VEGF level and infarct volume to PSCI after controlling covariates (demographic and clinical data). Results: The mean age of PSCI and non-PSCI patients was 61.63% ± 8.47 years and 58.67% ± 9.01 years, respectively (p = 0.221). No differences observed for vascular risk factors, infarct location, and NIHSS in both groups. Multivariate logistic regression showed that patients with higher VEGF level alone (≥519.8 pg/ml) were 4.99 times more likely to have PSCI than those with lower VEGF level (OR = 4.99, 95% CI = 1.01–24.7, p = 0.048). In addition, patients with larger infarct volume alone (≥0.054 ml) were also more frequently associated with PSCI (OR = 7.71, 95% CI = 1.39–42.91, p = 0.019). Conclusions: Acute ischemic stroke patients with higher serum VEGF level (≥519.8 pg/ml) and larger infarct volume (≥0.054 ml) were more likely to have PSCI 3 months after stroke. These findings may contribute to predict PSCI earlier and thus better prevention strategy could be made. [ABSTRACT FROM AUTHOR]

From 2014 to 2016, the number of prevalence of Dengue Hemorrhagic Fever (DHF) and deaths associated with DHF in Indonesia increased. DHF fatal cases were also reported from three administrative units in the Special Region of Yogyakarta, namely Bantul Regency, Gunungkidul Regency, and Yogyakarta City. Two related deaths in Purwosari, a district in Gunungkidul, raised the status of DHF to an outbreak. This study was designed to characterize the spread pattern of DHF in its endemic areas in Purwosari District using the retrospective method, anamnesis, in-depth interviews, Geographic Information System (CIS), and environmental analysis. The kernel density estimation revealed that in 2011-2017, DHF was concentrated in four villages, namely Giriasih, Giricahyo, Giritirto, and Giripurwo. There was a correlation between DHF incidents and physical geographical features of these villages, including proximity to water sources, high vegetation density, elevation, humidity, and rainfall, which created habitats for mosquito growth. A high incidence of DHF has been observed in children (50.8%) and students (57.4%), with most cases (78.7%) showing typical symptoms of the disease. A few of the 61 cases in the district developed into dengue shock syndrome (DSS) and led to death (4.9%), mainly because the public was unable to recognize the warning signs of DHF early and had limited knowledge of required management therapy. Moreover, the preventive or precautionary measures known as the 3M-Plus were not fully implemented yet. [ABSTRACT FROM AUTHOR]

BACKGROUND Fetal growth restriction (FGR) has multifactorial etiology, including nutrition. Fetal nutrient status depends not only on an adequate supply of key nutrients but also optimal delivery, served by the placenta as a major metabolic and transport organ. This study aimed to evaluate the status of placental oxygen and nutrient concentration and their transporters between appropriate for gestational age (AGA), small for gestational age (SGA), and FGR. METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Jakarta, from July 2018 to December 2020. Patients were divided into 3 groups, namely AGA, SGA, and FGR. The placental samples were taken following delivery. Placental concentration of glucose, amino acids (AAs), and fatty acids (FAs) were measured by calorimetric assay, liquid chromatography-tandem mass spectrometry, and gas chromatography-mass spectrometry, respectively. Placental concentration of vascular endothelial growth factor (VEGF), glucose transporter 1 (GLUT1), system y+ L, and fatty acid transport protein 1 (FATP1) were examined using enzyme-linked immunosorbent assay. RESULTS A total of 57 subjects participated in the study. Compared with the AGA group, the SGA and FGR groups had lower placental AA concentration (p = 0.004), higher placental FA concentration (p = 0.048), higher placental expression of VEGF (p = 0.003), system y+ L (p = 0.07), and FATP1 (p = 0.021). No difference in placental glucose and GLUT1 concentration was observed among all groups (p = 0.301). CONCLUSIONS The similar profile of macronutrient concentration with increased expression of oxygen and several nutrient transporters in SGA and FGR groups might indicate similar pathogenesis between these groups. [ABSTRACT FROM AUTHOR]

BACKGROUND Exocrine pancreatic insufficiency (EPI) is one of the most challenging cases to be diagnosed accurately in Indonesia because of the unavailability of the fecal elastase-1 (FE-1) test, which is the primary indirect diagnostic tool till date. Stool analysis and steatocrit test are feasible alternatives as they can detect nutrient malabsorption, a consistent feature in EPI. Despite the common practice of using both tests, no study has ever been conducted in Indonesia to evaluate their accuracy. METHODS This cross-sectional diagnostic study was conducted in 182 children aged 6-60 months. Study subjects were divided into children with persistent diarrhea (PD), those with malnutrition, and healthy children. Children with PD and malnutrition were selected on the basis of clinical criteria and the WHO z-score. FE-1 test was used as the gold standard to detect EPI. Primary endpoints of this study were sensitivity and specificity of the stool analysis and the steatocrit test. The accuracy of both tests, represented by area under the curve (AUC) values, was also evaluated individually and in combination. RESULTS Each component of stool analysis and steatocrit test in each subgroup of patients generally had higher specificity than sensitivity. The specificity of both tests among healthy and malnourished children was good (≥70%), but among children with PD, the specificity of some components was <70%. The individual and combined AUC values of both tests in each subgroup of subjects were poor (<0.7). CONCLUSIONS Stool analysis and steatocrit test cannot be used as alternative methods for FE-1 to detect EPI. [ABSTRACT FROM AUTHOR]

BACKGROUND Genomic medicine has great potential for diagnoses, disease prediction, and targeted treatment. Buccal swabs are a suitable non-invasive method for neonates to obtain DNA samples. Due to Indonesia's geographical conditions, samples require a prolonged time to reach the genetic laboratory. This study aimed to compare the DNA quality of buccal swabs in neonates between immediate and after-storage extraction. METHODS This study was part of a study about the profile of human milk oligosaccharide and FUT2 genotype in Indonesian mother-infant dyads consisting of 20 neonates. 1 swab stick for each participant was taken using a standardized buccal swabbing protocol and divided into 2 isovolume aliquots, which were grouped into the immediate (extraction was performed within 3 days after sampling) and storage groups (extraction was performed on the 14th day after storage in 4°C). DNA yield and purity A260/280 ratio were measured by spectrophotometry. The PCR amplification and Sanger sequencing were performed to validate the DNA isolate quality for downstream application. RESULTS The DNA yield for the immediate group was similar compared with the storage group (9.50 [4.89] versus 9.10 [5.05] µg), p = 0.659, as well as DNA purity A260/280 (1.58 [0.24] versus 1.56 [0.28]), p = 0.785. PCR and sequencing of FUT2 results also showed similar quality between both groups. CONCLUSIONS The similar DNA quality and sequencing results between immediate and storage extraction confirmed that buccal swabs could be stored for 2 weeks, allowing ample time for sample shipping from remote areas to the laboratory. [ABSTRACT FROM AUTHOR]

Acute heart failure (AHF) is a serious condition that requires prompt diagnosis and management. To optimize patient care, clinicians need a reliable, non-invasive method to assess hemodynamic parameters and total body congestion. Currently, no standardized technology is widely used for this purpose. However, NICaS technology, which measures hemodynamic parameters based on regional bioimpedance, has shown promise in monitoring AHF patients in a non-invasive and reliable manner. In this study, researchers aimed to evaluate the usefulness of NICaS technology in predicting patients' outcome in Caucasian and Asian AHF patients presenting to the emergency department (ED). The study included 40 Caucasian patients from Italy (group A) and 71 Asian patients from Indonesia and Singapore (group B) with a diagnosis of AHF in the ED. The study compared data from NICaS parameters, clinical findings, laboratory, and radiological results with short-term events. In group A, NICaS data at ED arrival significantly predicted 30-day cardiovascular mortality and rehospitalization. At discharge, a value of cardiac output obtained using NICaS was a significant predictor for 30-day rehospitalization. In group B, NICaS variables, total peripheral resistance index on admission and during 48–72 ​h had prominent AUC compared to clinical congestion score and NT-proBNP in predicting mortality and rehospitalization. The results indicate that NICaS technology offers a simple, non-invasive, and reliable method of assessing cardiac hemodynamics and congestion in AHF patients. These measurements may enhance diagnosis, tailor management plans, stratify risk, and predict outcomes in both Caucasian and Asian patients. [ABSTRACT FROM AUTHOR]

BACKGROUND Lipid malabsorption causes many health problems, for example stunting, a major worldwide issue. There has not been any assessment on the effectivity of lipid microscopic test in diagnosing lipid malabsorption. This research was aimed to study the effectivity of lipid microscopic test in detecting lipid malabsorption in children. METHODS This was a cross-sectional diagnostic study that evaluated the effectivity of lipid microscopic test using Sudan III against steatocrit test as the gold standard in diagnosing lipid malabsorption. The study was done in 68 children aged 6-60 months in Cipto Mangunkusumo Hospital, Jakarta. Results of lipid microscopic test were compared with that of steatocrit test among children with lipid malabsorption and normal children. The primary endpoints of this study are the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS A total of 68 children consisting of 41 boys and 27 girls were included, with a median age of 14.3 months. The most frequently found stool consistency was mushy (50%). The most common result of microscopic test, found in 42% of subjects, was positive 1. Sensitivity, specificity, PPV, and NPV of lipid microscopic test were 49.15%, 66.67%, 90.63%, and 16.67%, respectively. CONCLUSIONS Lipid microscopic test has a moderate sensitivity in diagnosing fat malabsorption and needs to be complemented with other methods such as steatocrit. [ABSTRACT FROM AUTHOR]

CoronaVac is one of the most widely administered COVID-19 vaccines in Indonesia. Previous studies have documented its effectiveness in protecting against COVID-19 in several countries. This study aimed to assess the long-term immunogenicity of CoronaVac in individuals with comorbidities or a history of SARS-CoV-2 infection. The total anti-N Ig and anti-S-RBD Ig levels at 7 and 26 weeks after the second dose of vaccine were documented in 194 health workers. The participants were divided into groups based on their comorbidities and history of SARS-CoV-2 infection. The antibody titers did not differ according to comorbidity status or history of SARS-CoV-2 infection. The total anti-nucleocapsid Ig and total anti-S-RBD Ig levels were significantly lower in individuals without a history of SARS-CoV-2 infection. These results indicate that CoronaVac induces a lower specific antibody response than natural infection and less long-term immunogenicity.