Doctoral Research in Medical Sciences Reveals Risk Factors for Subclinical Leprosy in House Contacts

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• Senin, 23 Desember 2024
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Located in the Postgraduate Hall room, Lt. III Postgraduate Building, Udayana University, an open examination for Doctoral Promotion took place with the promovenda candidate, dr. Ni Luh Putu Ratih Vibriyanti Karna, Sp.DVE, Subsp.DT, FINSDV, FAADV, with the dissertation title "Foxp3 Levels, High Transforming Growth Factor-Β1 and Low Interleukin 10 as Risk Factors for Subclinical Leprosy in House Contact Patients with Multibacillary Leprosy". (23/12/2024)

Leprosy is one of the 20 neglected diseases set by WHO. WHO has launched 4 pillars to achieve zero auto-autochthonous cases, one of the 2nd pillar strategies is the tracing of non-contacts in new cases and the provision of preventive chemotherapy. Subclinical leprosy in leprosy narcontacts is suspected to be the cause of the continued emergence of new manifest leprosy cases. The aim of this study was to determine the role of high levels of FoxP3, TGF- β1 and IL-10 as risk factors for subclinical leprosy in multibacillary leprosy household contacts.

The study design was case control, with 24 samples of seropositive multibacillary leprosy household contacts and 24 samples of seronegative multibacillary leprosy household contacts. FoxP3, TGF-β1 and IL1-0 levels were measured by Elisa technique. Data were analyzed using chi square and logistic regression for association analysis. Cut of point was determined by ROC curve.

The results of this study showed high levels of FoxP3, TGF-β1 and low IL-10 as risk factors for subclinical leprosy in multibacillary leprosy household contacts. In the case group, most of the FoxP3 levels were high (≥8.315 ng/ml) 70.8%, while in the control group only 37.5% were high (Cut of Point foxP3 determined using ROC curve is 8.315 ng/ml). This FoxP3 difference was statistically significant with a p value = 0.020, OR 4 and CI95% 1.210 - 13.538. The high and low levels of TGF-β1 were determined by ROC curve and obtained a cut-off point value of 711.11 ng/L. Transforming Growth Factor β1 was high (≥711.11 ng/L) 62.5% in cases and 8.3% in the control group. P value; 0.000, OR 18, 95% CI 3.462 - 97.080. IL-10 levels with a cut of point of 100 pg/ml, low (< 100 pg/ml) in most cases, namely 19 (79.2%) and high in most controls 20 (83.3%) p = 0.000, OR 18, 95% CI 3.462 - 97.080. Based on multiple logistic regression analysis, it was found that high TGFβ1 levels, high FoxP3 levels and low IL.10 levels among household contacts with multibacillary leprosy were risk factors for subclinical leprosy after controlling for other variables in the analysis.

Multibacillary leprosy household contacts with high FoxP3 and TGF-β1 levels and low IL-10 had a higher risk of subclinical leprosy.

This examination was chaired by the Coordinator of the FK Unud Doctor of Medical Sciences Study Program Prof. Dr. dr. I Made Jawi, M.Kes, with a team of examiners:

1. Prof. Dr. Komang Januartha Putra Pinatih, M.Kes (Promoter)

2. Prof. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si (Copromoter I)

3. Dr.dr.Luh Made Mas Rusyati, Sp.KK(K), FINSDV, FAADV (Copromoter II)

4. Prof. Dr. Ir. Ida Bagus Putra Manuaba, M.Phil

5. Prof. drh. I Nyoman Mantik Astawa, Ph.D.

6. Dr. dr. I Nyoman Wande, S.Ked., Sp.PK

7. Dr. dr. I Gusti Ayu Agung Praharsini, Sp.KK., FINSDV, FAADV

8. Dr.dr.Ni Putu Sriwidyani, Sp.PA., Subsp.S.M.(K)

9. Dr. dr. Ni Made Adi Tarini, Sp.MK(K)

10. Dr. dr. I Gusti Nyoman Darmaputra, Sp.KK(K), FINS-DV, FAA-DV.

While academic invitations are :

1. Dr. dr. Ketut Kwartantaya Winaya, Sp.KK(K).,FINSDV.,FAADV

2. Dr. dr. Ari Andayani, Sp.M(K), MH.Kes

3. Dr. dr. Nyoman Suryawati, M.Kes.,Sp.D.V.E.,Subsp.D.I.,FINSD V,FAADV

4. dr. I Gusti Ayu Agung Elis Indira, Sp.D.V.E.,Subsp. Ven, FINSDV,FAADV

5. Dr. Pande Made Wisnu Tirtayasa, Sp.U(K), Ph.D.

In this exam, Dr. dr. Ni Luh Putu Ratih Vibriyanti Karna, Sp.DVE, Subsp.DT, FINSDV, FAADV, was declared to have passed as the 438th Doctoral Graduate of the Doctor of Medical Sciences Study Program, Faculty of Medicine, Udayana University with a Very Satisfactory predicate.