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All Journal Majalah Kedokteran Bandung Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana Makara Journal of Health Research
Hartono Gunardi
Department of Child Health, Medical School Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta.
Health Professions Medicine & Pharmacology

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PROFILE OF IMMUNIZATION PRACTICE BY GENERAL PRACTITIONERS AND PEDIATRICIANS IN PRIVATE SETTING Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Satari, Hindra Irawan; Singgih, Adrian Himawan; Yolanda, Natharina
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (66.572 KB) | DOI: 10.15395/mkb.v49n4.1153

Abstract

Basic immunization coverage in Indonesia in 2013 was still low (59.2%) (IBHS, 2013). Physicians? attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner?s (GP) and pediatrician?s attitude towards immunization and its coverage  in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians). Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians) while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices. Key words: Attitude, general practitioners, immunization practice, private setting, pediatriciansGambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek SwastaRiset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%). Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap dokter dan cakupan imunisasi di praktik swasta. Penelitian potong lintang dilakukan dengan menyebarkan kuesioner tentang sikap dan praktik imunisasi kepada responden, yaitu 29 dokter umum (DU) dan 65 dokter spesialis anak (DA) pada bulan November 2014. Mayoritas responden berpendapat bahwa vaksin program pengembangan imunisasi harus diberikan. Vaksin hepatitis B dosis I mayoritas diberikan dalam 12 jam setelah lahir (90% oleh DU dan 74% oleh DA). Vaksin polio oral mayoritas diberikan sebelum pulang perawatan (65% oleh DU dan 81% oleh DA), Vaksin DTwP-HB-Hib diberikan oleh 27% DU dan 21% DA kepada ?75% pasien. Penggunaan vaksin pneumokokus, rotavirus, hepatitis A, tifoid dan influenza pada >75% pasien adalah kurang dari 25%, kecuali vaksin influenza, yaitu 31% digunakan oleh DA. Pemberian vaksin MMR pada >75% pasien dilakukan oleh 16% DU dan 29% DA.  Penelitian imunisasi pada praktik swasta ini mungkin  merupakan laporan yang pertama dipublikasi di Indonesia. Penelitian lebih lanjut diperlukan untuk mengetahui hambatan imunisasi di praktik swasta.Kata kunci: Cakupan imunisasi, dokter,  imunisasi, praktik, spesialis
Iron Status, Prevalence and Risk Factors of Iron Deficiency Anemia Among 12- to 15-Year-Old Adolescent Girls from Different Socioeconomic Status in Indonesia Sumarlan, Eka S; Windiastuti, Endang; Gunardi, Hartono
Makara Journal of Health Research Vol. 22, No. 1
Publisher : UI Scholars Hub

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Abstract

Background: The aim of this study was to determine the iron status and the prevalence and risk factors of iron deficiency anemia (IDA) among adolescent girls in Central Jakarta, Indonesia. Methods: A cross-sectional study was conducted among 12- to 15-year-old girls studying in junior high schools that were categorized into high and low socioeconomic status (SES). Their menstrual and nutritional status, parents’ education level and income, and iron intake were assessed. Tuberculin test and assessments for C-reactive protein levels and hematologic and iron parameters were also conducted. Results: Iron status was normal in 69.3% of 163 subjects. The prevalence of non-anemic iron deficiency was higher (17.2%; 3.1% iron depletion and 14.1% iron deficiency) than that of IDA (13.5%). The prevalence of IDA was lower among girls from the high SES than that among girls from the low SES (11.5% and 15.8%, respectively). There was no significant relationship among IDA and nutritional status, menstrual status and characteristics, SES, iron intake, and parents’ education level and income; however, bioavailable iron intake in all subjects was found to be less compared to the recommended daily allowance (RDA). Conclusions: The higher prevalence of non-anemic iron deficiency than IDA is a potential risk factor for increasing the prevalence of IDA in the future. No significant relationship was found between IDA and its risk factors; however, iron intake was less compared to the RDA in all subjects, which requires further attention.
Functional gastrointestinal disorders in adolescents during online learning Simanjuntak, Sumardi F.; Prawitasari, Titis; Kadim, Muzal; Sari, Teny Tjitra; Gunardi, Hartono; Vandenplas, Yvan; Hegar, Badriul
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.353-60

Abstract

Background The COVID-19 pandemic necessitated the use of online schooling in order to comply with national and local lockdown guidelines. Online learning required students and teachers to adapt to a new method of schooling. The inability of adolescents to adapt to their environment can interfere with their psychosocial condition and become a risk factor for functional gastrointestinal disorders (FGID). Objective To determine the prevalence of FGID in adolescents and evaluate possible risk factors that existed during online learning. Methods This cross-sectional study was done in children aged 12-18 years who participated in online learning during the COVID-19 pandemic. The diagnosis of FGID was based on Rome IV criteria. Psychosocial problems were assessed using the Pediatric Symptom Checklist Questionnaire–17 (PSC-17) which includes internalization, externalization, and attention subscales. Subjects with a PSC-17 mixed subscale total score of >15 were considered as having an increased likelihood of having a behavioral health disorder. Data were collected by online questionnaires via Google Forms. Results Of 1,413 participants, 23% experienced FGID; of these, 32.6% had >2 FGID diagnostic criteria. Upon multivariate analysis, internalization psychosocial problems were the most common risk factors for FGID, followed by mixed subscale psychosocial problems, unstable internet connection, and not understanding of the material. ConclusionThe prevalence of FGID in adolescents in this study is 23%. Environmental and psychosocial conditions are interrelated as risk factors for FGID in adolescents during online learning in the COVID-19 pandemic.
Developing an online reproductive health module on sexually transmitted infections for Indonesian adolescents: a qualitative mixed methods study Nilasari, Hanny; Indriatmi, Wresti; Gunardi, Hartono; Kayika, I Putu Gede; Kekalih, Aria; Siregar, Kemal Nazaruddin; Kurniawan, Kristian; Lesmana, Elvira; Haswinzky, Rose Amalia
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247635

Abstract

BACKGROUND A notable rise in sexually transmitted infection (STI) cases among youth correlates with a lack of reproductive health awareness, affecting nearly 80% of Indonesian adolescents. Additionally, sociocultural taboo acts as a challenge to reproductive health implementation in Indonesia. Therefore, this study aimed to develop an online reproductive health module focused on STIs for Indonesian adolescents. METHODS This research was a mixed methods approach, integrating quantitative study using univariate analysis (survey and questionnaire) and qualitative study using the Delphi method (open discussion and focus group discussion). The study was conducted between March 2 and July 28, 2022. We began by conceptualizing a literature-based module, an online survey, and virtual discussions involving students, teachers, and parents. Then, we consulted with clinical psychologists and dermatovenereologists. Additionally, students completed an assessment to establish a baseline of their knowledge, attitudes, and behaviors (KAB) regarding reproductive health and STIs. RESULTS Of 327 high school students across Jakarta, analysis of the 129 completed KAB surveys showed that only 56.6% and 65.1% attained acceptable scores (>65) for knowledge and behavior, respectively, with 24.8% being at risk for STIs. Key recommendations included incorporating multimedia elements, ensuring clarity and simplicity in language, adopting non-judgmental tone, providing comprehensive explanations of STIs and their long-term impact, and supporting learning with face-to-face sessions and ongoing access to concise, cost-effective educational resources. CONCLUSIONS Adolescents need a comprehensive, interactive, instructive, accessible, non-discriminatory reproductive module that strengthens the self-concept that upholds Indonesian values and norms.
Mental health problems in children with chronic disease at the pediatric inpatient ward of Dr. Cipto Mangunkusumo Hospital Wangke, Lydia; Medise, Bernie Endyarni; Wirahmadi, Angga; Sekartini, Rini; Gunardi, Hartono; Soedjatmiko, Soedjatmiko
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.37-41

Abstract

Background Since the survival of a patient with chronic physical illness has improved, major concerns arise about their quality of life and functioning. Childhood and adolescence are critical periods for promoting mental health because more than half of mental health problems begin at this stage, and many of those mental health problems will persist into adult life. Objective To analyze the risk of mental health problems among children hospitalized with chronic disease. Method An analytic observational study with a cross-sectional design was conducted using secondary data of 754 children aged 4-18 years admitted to the pediatric inpatient ward of Cipto Mangunkusumo Hospital, Jakarta between June 2021 and August 2022. We collected the results of subjects’ mental health screening conducted by the Growth, Development, and Social Pediatrics Division, Department of Child Health, Cipto Mangunkusumo Hospital during the subjects’ admission. Mental health problems evaluated in this study included psychosocial dysfunction screened using the Pediatric Symptom Checklist 17 (PSC-17) and depression screened using the Children’s Depression Inventory (CDI). Results Of the 754 subjects included, 520 (69.0%) were classified as having a chronic disease. The prevalence of psychosocial dysfunction and depression in children with chronic diseases was 19.6% and 6.3%, respectively. Gender, nutritional status, and height had no significant association with psychosocial dysfunction and depression in children. Children with chronic disease were more likely to develop psychosocial dysfunction (OR 2.13; 95%CI 1.31 to 3.59; P<0.001) and depression (OR 2.57; 95%CI 1.04 to 7.62; P<0.03) compared with those who did not have chronic disease. Conclusion Children with chronic disease were more likely to develop psychosocial dysfunction and depression compared to those without a chronic disease. These results highlight the importance of mental health support in pediatric patients with chronic disease.
Educational intervention using the Complementary Feeding Practice Module on maternal knowledge and behavior Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Gunardi, Hartono; Timan, Ina Susianti; Syafiq, Ahmad; Sidiartha, I Gusti Lanang; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.71-7

Abstract

Background Correct complementary feeding practice can be a challenge for mothers. Our complementary feeding practice module provides practical information regarding evidence-based complementary feeding practices. Objective To assess the effect of educational intervention using the complementary feeding practice module on maternal knowledge and behavior and to compare the effect of video vs. printed delivery of the module. Methods This open label randomized controlled trial included mothers with babies aged 4 to 8 months in Pontianak, West Kalimantan, Indonesia, who engaged in complementary feeding. Subjects were randomized into an intervention group that received a printed booklet of the module, an intervention group that received a video of the module, or a control group that received the standard Indonesian mother and child health (MCH) handbook. Maternal knowledge and behavior regarding complementary feeding practice were assessed before and after the educational intervention using the PI-MPASI questionnaire. Results Of 360 mothers screened, 241 subjects were randomized into the video education group (n=76), the printed education group (n=84), and the control group (n=81). A total of 212 subjects completed the study by submitting both the pre- and post-test: 66 in the video group, 74 in the printed booklet group, and 72 in the control group. Subjects who received the module (video or printed) had significantly higher knowledge and behavior scores than those in the control group. Video education was associated with a greater increase in behavior score than printed education and control. The outcome of video education was not influenced by maternal educational level. Conclusion  Education using a simple and practical video or printed module improves maternal knowledge and behavior in complementary feeding practices. Video education is associated with a greater improvement in maternal complementary feeding behavior than printed education.
Quality of life in episodic hypoxic children after emergency department or PICU hospitalization Yuniar, Irene; Julianti, Julianti; Gunardi, Hartono; Dewi, Rismala; Wiguna, Tjhin; Lubis, Munar
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.357-63

Abstract

Background Studies on long–term outcomes of hypoxic children after being hospitalized are limited, even though hypoxia is known to affect their quality of life (QoL). Objective To assess the QoL of children with episodic hypoxia following hospitalization in the emergency department (ED) and Pediatric Intensive Care Unit (PICU). Methods A prospective cohort design study targeting pediatric patients aged 2–7 years with critical illness was conducted at Dr. Cipto Mangunkusumo Hospital. Inclusion criteria are hypoxia patients receiving oxygen therapy, defined from the ratio of partial arterial oxygen pressure and inspired oxygen (PaO2/FiO2). The PedsQLTM questionnaire was used to assess QoL at the time of admission and 3 months after hypoxia event. Patients with cerebral palsy, mental retardation, chromosomal abnormalities, liver transplantation, and length of stay ≤24 hours were excluded. Data distribution in numerical form was analyzed using the Kolmogorov–Smirnov test. Results Forty-six children with a median age of 4 (2–7) years had decreased QoL at 3 months after episodic hypoxia, based on PedsQLTM scores. The physical, emotional, and social domains were significantly decreased (P<0.01) compared to QoL at the time of admission. Prior to admission, 78.3% of children had already experienced impaired QoL. Conclusion Children with episodic hypoxia demonstrated a decline in QoL at 3 months after hypoxia event based on PedsQLTM scores. Specifically, the physical, emotional, and social domains were significantly decreased compared to at the time of admission.  
Jadwal Imunisasi Anak Usia 0-18 Tahun Rekomendasi Ikatan Dokter Anak Indonesia Tahun 2024 Kaswandani, Nastiti; Gunardi, Hartono; Prayitno, Ari; Kartasasmita, Cissy B.; Prasetyo, Dwi; Husada, Dominicus; Sarosa, Gatot Irawan; Oswari, Hanifah; Ismoedijanto, Ismoedijanto; Rusmil, Kusnandi; Maddepunggeng, Martira; Sitaresmi, Mei Neni; Raihan, Raihan; Handryastuti, Setyo; Soedjatmiko, Soedjatmiko; Hadinegoro, Sri Rezeki S.; Munasir, Zakiudin
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.328-36

Abstract

Satuan Tugas Imunisasi Ikatan Dokter Anak Indonesia secara periodik melakukan kaji ulang jadwal imunisasi dengan menyelaraskan dengan buku pedoman imunisasi di Indonesia edisi ke 7 tahun 2024, dan sumber-sumber lainnya. Jadwal imunisasi selalu dievaluasi ulang karena beredarnya vaksin baru yang telah disetujui oleh BPOM dan vaksin yang tidak tersedia lagi di Indonesia. Terdapat beberapa perubahan dalam jadwal imunisasi rekomendasi IDAI tahun 2024 yaitu ketersediaan jenis vaksin, seperti pada pneumococcal conjugate vaccine (PCV), vaksin rotavirus, vaksin varisela, vaksin dengue, dan vaksin human papillomavirus (HPV). Agar dalam pelaksanaan lebih mudah, disertakan juga tabel jadwal imunisasi tahun 2024 di akhir.
Co-Authors Ahmad Syafiq Alida R Harahap, Alida R Araysi, Leo Alfath Ari Prayitno, Ari Aria Kekalih Armeilia, Rilie Badriul Hegar Bambang Madiyono Bambang Supriyatno Bernie Endyarni Medise Cissy B. Kartasasmita Damayanti Rusli Sjarif Darmawan, Anthony C. David H Muljono, David H Dominicus Husada Dwi Prasetyo Endang Windiastuti Gatot Irawan Sarosa, Gatot Irawan Hanifah Oswari Hanny Nilasari Haswinzky, Rose Amalia Hindra Irawan Satari, Hindra Irawan I Gusti Lanang Sidiartha Ina Susianti Timan Irene Yuniar, Irene Ismet N. Oesman Ismoedijanto Jasin, Madeleine Ramdhani Julianti Julianti, Julianti Kayika, I Putu Gede Kemal N. Siregar Kurniawan, Kristian Kusnandi Rusmil Lesmana, Elvira Liza F Zaimi, Liza F Maddepunggeng, Martira Medise, Bernie E. Mei Neni Sitaresmi Munar Lubis Muzal Kadim Nadya, Ruth Nastiti Kaswandani Natharina Yolanda, Natharina Raihan Raihan, Raihan Rini Andriani Rini Sekartini Rismala Dewi Saharso, Ersal Rasyid Setyo Handryastuti, Setyo Simanjuntak, Sumardi F. Singgih, Adrian Himawan Soedjatmiko Soedjatmiko Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sudigdo Sastroasmoro Sukman T. Putra Sumarlan, Eka S Teny Tjitra Sari, Teny Tjitra Titis Prawitasari, Titis Tjhin Wiguna Turyadi Turyadi, Turyadi Ufairah, Kamilia Rifani Wangke, Lydia Wirahmadi, Angga Wresti Indriatmi B. Makes Yvan Vandenplas Zakiudin Munasir