Doctor of Medical Sciences Has Successfully Identified Risk Factors for Leprosy Transmission in Household Contacts

Doctor of Medical Sciences Has Successfully Identified Risk Factors for Leprosy Transmission in Household Contacts

Taking place in the Postgraduate Meeting Room, Denpasar Postgraduate Building, a Doctoral Promotion exam was held with the promovenda candidate, dr. I Gusti Ayu Agung Dwi Karmila, Sp.KK., FINSDV., with the dissertation title "Polymorphism of the FOK-1 Vitamin D Receptor Gene, Levels of Vitamin D Receptor Protein and Low Cathelicidin Levels as Risk Factors for Subclinical Stage of Leprosy in Contributors in the Same House as Leprosy." (26/7/2023)

The target of eliminating leprosy has not been achieved with effective treatment of leprosy and early detection of new cases to stop transmission. Household contacts of multibacillary type leprosy who have not received treatment as individuals who have a high risk of contracting leprosy. This study aims to identify the role of the Fok-1 Vitamin D Receptor (VDR) polymorphism, VDR protein levels and cathelicidin levels in closest contacts of multibacillary leprosy patients. The aim of this study was to strengthen the theory of pathogenesis in subclinical leprosy in relation to the VDR Fok-1 gene polymorphism, VDR protein levels and cathelicidin levels and to develop a theory of the role of VDR polymorphisms, VDR and cathelicidin levels in close contacts of leprosy patients.

This research is a nested case control study with 23 sample case groups, namely contact persons living in leprosy households with seropositive IgM anti-PGL-1 test results and 47 subjects as controls, namely contact persons living in leprosy households who have seronegative anti-PGL-1 IgM test results. FokI VDR polymorphisms were detected by PCR and sequencing, for VDR protein levels and cathelicidin levels were detected by ELISA.

Data analysis for different proportions used Chi-Square and correlation analysis test with logistic regression. The results of this study showed that the highest FokI rs2228570 genotype in the case group was the Ff genotype, namely 10 (43.5%) subjects, as well as in the control group, the most Ff genotype was 25 (53.2%). The VDR genotype Fok1 rs2228570 polymorphism and VDR protein levels were not risk factors for subclinical leprosy in household contacts. Low cathelicidin (CAMP) levels as a risk factor for subclinical leprosy in household contacts of leprosy. The results of the logistic regression analysis found cathelicidin levels as a risk factor for subclinical leprosy after controlling for other variables in the analysis.

The novelty in this study is cathelicidin (CAMP) as a risk factor for subclinical leprosy in household contacts of leprosy compared to household contacts of leprosy with seronegative results of anti-PGL-1 IgM examination. Leprosy household contacts with low cathelicidin levels have a 3.6 times risk of developing subclinical leprosy. The VDR Fok1 rs2228570 polymorphism and VDR protein levels were not proven to be risk factors for subclinical leprosy in household contacts of leprosy.

The exam was led by the Deputy Dean for General Affairs and Finance of FK Unud, Dr. dr. Made Sudarmaja, M.Kes., with a team of examiners:

1. Dr. dr. I Made Bakta, Sp.PD-KHOM (Promoter)

2. Prof. Dr. dr. I Wayan Putu Sutirta Yasa, M.Si (Co-promoter I)

3.Dr. dr. Luh Made Mas Rusyati, Sp.KK(K) (Co-promoter II)

4. Dr. dr. I Made Jawi, M. Kes

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

6. drh. I Nyoman Mantik Astawa, Ph.D

7. Dr. dr. A.A Ngurah Subawa, M.Sc

8. Prof. Dr. dr. Ni Nyoman Sri Budayanti, Sp.MK (K)

9.Dr. err. nat. dr. Ni Nyoman Ayu Dewi, M.Sc

10. dr. I Made Winarsa Ruma, S.Ked.,Ph.D

While academic invitations are:

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

2.Dr. dr. Ni Putu Sriwidyani, Sp.PA(K)

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

4.Dr. dr. I Gusti Ayu Agung Elis Indira, Sp.KK(K)

5.Dr. dr. Nyoman Suryawati, M.Kes., Sp.KK(K)

In this exam, Dr. dr. I Gusti Ayu Agung Dwi Karmila, Sp.KK, FINSDV., was declared the 392nd Doctoral Graduate of the Doctoral Degree in Medical Sciences, Faculty of Medicine, Udayana University with a very satisfactory predicate.