DETECTION AND IDENTIFICATION OF ARBOVIRUS AS THE CAUSE OF FEBRILE ILLNESS IN PATIENTS FROM TABANAN HOSPITAL, BALI

• Main Author: Nurfatimah Karim - Nim: 10613048, Andini
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/21050
• Institution: Institut Teknologi Bandung

Infection of arbovirus (arthropod-borne virus) is one of the most significant public health issues in the world. Clinical diagnosis is challenging as most of the cases shown to be asymptomatic, or symptomatic but resemble other viral/pathogenic infection. Bali, as the center of world tourism in Indonesia is endemic for dengue virus (DENV) from Flaviviridae and chikungunya virus (CHIKV) from Alphaviridae. This research is aimed to detect and identify arbovirus (Alphaviridae and Flaviviridae) as the cause of febrile illness in patients from Tabanan hospital, Bali, using molecular and serological assay. Blood plasma samples, with total 100 acute and 5 convalescence samples were collected from in- and outpatients of Tabanan local hospital, Bali, on January-March 2017. Criteria of inclusion was fever >38°C for less than 7 days with leukocyte count <10.000 cells/&#956;l. Molecular assay and virus isolation -as an addition- were conducted on acute samples, while serological assay was conducted on acute and convalescence samples. Molecular assay was started with RT-PCR in family level Alphaviridae and Flaviviridae and continued to RT-PCR specific level and/or DNA sequencing. Sequencing with envelope gene target was also conducted for phylogenetic analysis. Serological assay was divided into ELISA DEN, CHIK, and JE (Japanese Encephalitis) IgM. Virus isolation is conducted with vero81 cell culture. The RT-PCR results detected 3 positive samples of Alphaviridae and identified as CHIKV and 32 positive samples of Flaviviridae and identified as DENV (2 samples of DENV-1, 7 samples of DENV-2, 14 samples of DENV-3 and 9 samples of DENV-4). From ELISA test, found 1 positive sample of DEN IgM (positive RT-PCR) and 1 positive sample of JE IgM (negative RT-PCR). Vero81 cell culture results showed the cytopathic effect (CPE) on 23/36 positive samples of RT-PCR and ELISA. Through the phylogenetic analysis, 3 positive samples of CHIKV were belong the Asian genotype, 1 positive sample from each DENV-1 and DENV-3 was belong to genotype I, and from DENV-2 was belong to cosmopolitan genotype. It can be concluded, arbovirus which cause febrile illness in patients from Tabanan hospital, Bali were DENV (32%) and JEV (1%) from Flaviviridae and CHIKV (1%) from Alphaviridae. <br /> <br />