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All Journal Majalah Kedokteran Bandung Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana eJournal Kedokteran Indonesia Makara Journal of Health Research

Hartono Gunardi

Department Of Child Health, Faculty Of Medicine, Universitas Indonesia, Indonesia

Author-ID : 270702

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Prevalence of urinary tract infection in 2-8-week-old infants with jaundice Partini Trihono; Arfianti Chandra Dewi; Hartono Gunardi; Hanifah Oswari
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Urinary tract infections (UTI) in infants may manifest in various ways and often appear without symptoms.Â Previous studies have reported that j aundice has been observed inÂ infants aged less than 8 weeks 'With UTIs. However, a prospectiveÂ study on the prevalence of UTI in infants with jaundice aged 2ô€‚8weeks is warranted in order to improve diagnosing capability andÂ provide prompt treatment.Objective To investigate the prevalence and profiles of UTI inÂ infants with jaundice aged 2ô€‚8 weeks.Methods This crossô€‚sectional study was carried out in June-December 2011 in infants with jaundice aged 2ô€‚8 weeks. Subjects were patients from the Department of Child Health,Â Cipto Mangunkusumo Hospital (CMS), as well as the PediatricÂ Polyclinics ofBudi Kemuliaan and Thamrin Hospitals. All subjectsÂ underwent total, direct and indirect bilirubin examinations,Â urinalyses and urine cultures.Results Of the 110 subjects recruited, the prevalence of UTIÂ was 18.2%. More boys than girls had UTIs (13 boys, 7 girls). TheÂ microorganisms found in subjects v.ith UTIs were Escherichia coliÂ (10/20), Klebsiella pneumoniae (8/20), and Enterobacter aerogenesÂ (2120). Indirect hyperbilirubinemia was found in 5/20 subjects.Â There were more subjects with UTIs in the nonô€‚exclusivelyÂ breastfed (8/20) and nonô€‚breastfed (8/20) groups than in theÂ exclusively breastfed group (4/20), the full term gestational ageÂ (GA) group (17/20) than the pretenn GA group (3/20), and theÂ normal birth weight group (15/20) than the low birth weight group (5/20). The median age of jaundice onset was 3.5 daysÂ (range lAO days), and the median duration of jaundice was 13.5Â days (range 3-56 days).Conclusion The prevalence of UTI in infants aged 2ô€‚8 weeksÂ v.ith jaundice was 18.2%. More boys than girls had UTIs. TheÂ most common infecting microorganism found in our subjects wasÂ Escherichia coli. In daily medical practice, infants with prolongedÂ jaundice of more than 2 weeks should be tested byurin alysisÂ and urine cultures for the presence of UTIs. [Paediatr Indones.2012;52:304-8].

Adolescent rape: Characteristics and short-term impact Titis Prawitasari; Hartono Gunardi; Bambang Madiyono; Rosdiana S Tarigan
Paediatrica Indonesiana Vol 45 No 6 (2005): November 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.6.2005.246-50

Background Data in Indonesia show that adolescents still havethe highest rate for rape and other sexual assaults among agegroup. There are gender differences in adolescent rape and sexualassault, with female victims exceeding males with a ratio of 3:1.Sexual assault and rape can affect numerous children and oftenlead to short-term and long-term consequences.Objectives To determine the characteristics and short-term im-pacts of adolescent rape.Methods A cross-sectional study was conducted on 31 adoles-cents who had been raped 1-9 months previously. Subjects andparents were assessed using Child Behavior Checklist, Draw aPerson, House Tree Person, and Ravenâ€™s Progressive Matrices todetermine psychological problems. History and physical examina-tion findings at the time of rape were reviewed.Results Thirty out of 31 female adolescents were 13-18 years old.Almost half of them came from low income families and large fam-ilies, two-thirds of all subjects were living with their parents. Nine-teen of 31 perpetrators were friends or acquaintances, only 4 wererelatives. Tears of hymen were found in 21 subjects and only 8 ofthem had non-genital injuries. Nine of 31 subjects had a high aver-age range in non-verbal processing. Most subjects had a greattendency to feel insecure, anxiety, depression, and had interper-sonal relationship problems. Regression and aggressiveness werefound in almost half of the subjects. All subjects felt that theirmothers were protective and half of them had dominant fathers.Conclusion Almost half of the adolescent victims come from low-economic status and large families, most of the assailants werefriends or acquaintances. Adolescent rape victims have ongoingbehaviour problems. The most common problems are anxiety,depression, and relationship problems

The role of hearing capability test as a screening test for the possibility of hearing disorder in children with speech delay Fatmawaty Fatmawaty; Hartono Gunardi; Ronny Suwento; Abdul Latief; Rulina Suradi; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Hearing disorder may cause speech delay so thatevery child with speech delay should undergo hearing test. Thegold standard for audiometric test is otoacustic emission (OAE)and brainstem evoked response audiometry (BERA). They havehigh sensitivity and specificity, but the availability is limited andexpensive. Hence, both tests are not available at the primary healthcare centers. In 1997, the Department of Health, Republic of Indo-nesia, established a simple subjective test instrument, i.e. the hear-ing capability test (HCT).Objective To asses the accuracy of HCT compared to the goldstandard hearing tests (OAE and/or BERA).Methods This study was a cross sectional study on 89 childrenaged less than 5 years who had speech delay and came to theGrowth and Development Outpatient Clinic or the General Outpa-tient Clinic, Pediatric Neurology Clinic of the Department of ChildHealth, Cipto Mangunkusumo (CM) Hospital; and Center for EarCare and Communicative Disorders (CECCD), Department of ENT,CM Hospital, during March to August 2005.Results HCT sensitivity and specificity were 92.9% and 27.7%,respectively. Positive predictive value (PPV), negative predictivevalue (NPV), positive likelihood ratio (PLR), and negative likehoodratio (NLR) were 84%, 50%, 1.9, and 0.7, respectively.Conclusion The sensitivity and specificity of HCT as a screeningtest of hearing disorder in children with speech delay were 93%and 28%, respectively. Based on this result, HCT should only beused as screening test and not as a diagnostic test

Influence of Hepatitis B immunization to prevent vertical transmission of Hep-B virus in infants bam from Hep-B positive mother Liza Fitria; Hartono Gunardi; Arwin A. P. Akib
Paediatrica Indonesiana Vol 50 No 6 (2010): November 2010
Publisher : Indonesian Pediatric Society

Background Hepatitis B is one of the most common infectious diseases worldv.ide. Indonesia has moderate-high endemicity for hepatitis B infection. Perinatal transmission increases the risk for chronic hepatitis B. Infants from HBsAg-positive mothers should receive hepatitis B immunoglobulin (HBIG) and vaccination within 12 hours of birth, but this practice is not routinely done in Indonesia due to financial constraints.Objectives To detennine the influence of Hep-B immunization on preventing Hepatitis B vertical transmission. Methods A descriptive cohort study was conducted from May 2009 - January 2010. Subjects were term infants born from HBsAg-positive mothers v.ith no history of HBIG administration. They had received complete hepatitis B immunization and 1 month after the last dose were evaluated for HBsAg and anti-HBs. Cord blood was also taken during labor to measure HBsAg.Results There were 22 infants born from HBsAg-positive mother who met the inclusion criteria. HBsAgwas positive in 6 of22 cord blood specimens. There were 15 infants who completed this study. One of 15 infants had positive HBsAg after completed hepatitis B immunization and 12 of 15 infants had protective level of anti-HBs. Effectiveness of hepatitis B immunization to prevent vertical transmission in this study was 70-90%.Conclusion Hepatitis B immunization can prevent vertical transmission of hepatitis B in infants born to mothers who are HBsAg-positive even without administration of HBIG.

Knowledge and behavior of mothers about the way of suckling their babies Titi S. Sularyo; Rini Sekartini; Soedjatmiko Soedjatmiko; Hartono Gunardi; Corrie Wawolumaya
Paediatrica Indonesiana Vol 42 No 9-10 (2002): September 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi42.5.2002.201-5

Background A good and proper knowledge and behavior of mothers as to how they breast-feed their young is supposed to enhance the health of the community.Objective To find out the knowledge and behavior of mothers of under-fives about the technique of nursing and its related factors.Methods The study was perionned from September 20 to October 15, 1999 at Kelurahan Pisangan Baru, East Jakarta. The respondents were 101 mothers owning under-fives, attained by the multi-stage cluster random sampling method. Questionnaires were used and observation was made only on mothers who were suckling their child during the interview.Results Mother's knowledge about the way of suckling was found unsatisfactory in 46.5% although 51.5% of mothers revealed a good behavior. Statistical analysis showed no significant relationships between factors such as age, educational level, occupation, family income and mother's activity with mother's knowledge and behaviorabout the way of nursing their child.Conclusions There was no significant relationship between mother's knowledge and behavior about breastfeeding. Other factors beyond this studied factors should be taken into account.

Maternal attitude and child interest in various play activities before and after mother-child play sessions Soedjatmiko Soedjatmiko; Hartono Gunardi; Rini Sekartini; Bernie Endyarni Medise; Ikhsan Johnson; Yulianti Wibowo; Ray Wagiu Basrowi
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Play stimulates children's growth and development. When mothers and their children play, a positive attitude from the mother and adequate interest from the child is required. Little is known about the play activities that effectively stimulate such positive maternal attitude and child interest. Objective To assess for associations between various play activities with maternal attitude and child interest before and after mother-child play sessions. Methods Pre-post intervention questionnaires were distributed to mothers before and after playing with their children. Children were aged 1-5 years, from two play sites (in Surabaya and Makassar), and included using purposive sampling. Eight types of toys/play activities were provided. The allocated time for answering the 17-question survey was 15 minutes. Average scores before and after the mother-child play sessions were analyzed using paired T-test. Results We collected 264 valid questionnaires, 235 in Surabaya and 29 in Makassar. Improvement of maternal attitude after the mother-child play session was found in 132 mothers [mean diff. 0.07 (SD 0.42); 95%CI -0.117 to -0.015; P=0.011]. Play activities with significant improvements in maternal attitude were jigsaw puzzle [mean diff. 0.09 (SD 0.66); 95% CI 0.007 to 0.167;P= 0.033), Lego blocks (mean diff.-0.10 (SD 0.69); 95%CI -0.186 to -0.018; P=0.017), mini-gardening (mean diff. -0.15 (SD 0.75); 95%CI -0.238 to -0.057; P=0.002), sandbox [mean diff.-0.24 (SD 0.83); 95%CI -0.339 to â€“ 0.138; P < 0.001], fishing [mean diff. -0.17 (SD 0.68); 95%CI -0.253 to -0.088; P < 0.001], and animal figurines [mean diff. -0.21 (SD 0.75); 95%CI -0.3 to -0.117;P <0.001]. Improvement of child interest was found in 161 children [mean diff. 0.20 (SD 0.52); 95%CI -0.264 to -0.116; P<0.001]. Play activities with significant improvements in child interest were jigsaw puzzle, Lego blocks, origami, mini-gardening, fishing, and animal figurines. Conclusion Some mother-child play activities, but not all, significantly improve both maternal attitude and child interest toward play.

Growth and developmental delay risk factors among under-five children in an inner-city slum area Hartono Gunardi; Resyana P. Nugraheni; Annisa R. Yulman; Soedjatmiko Soedjatmiko; Rini Sekartini; Bernie E. Medise; Angga Wirahmadi; Elizabeth Melina
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Growth and developmental delays are common among children under the age of five years (under-five children), especially in slum areas. Early detection and intervention may give better prognoses. Objective To detect growth and developmental delays and related risk factors among under-five children living in an inner-city slum area of the Indonesian capital. Methods This cross-sectional study was conducted from October to November 2018 in Tanah Tinggi, Johar Baru District, an inner-city slum area in Central Jakarta. Subjects were healthy children aged 3â€“60 months. Socioeconomic profile was obtained through questionnaires, anthropometric data through measurements, and developmental status through the Kuesioner Pra Skrining Perkembangan (KPSP) instrument. Development was considered to be delayed for KPSP scores <9. Data were analyzed using Chi-square test. Results Of 211 subjects, prevalence of underweight, stunting, and wasting were 35.1%, 28.0%, and 20.9%, respectively, meanwhile low maternal education, and low family income were 57.9% and 75%. The prevalence of developmental delay was 10%, while suspected developmental delay was 26.1%. The prevalence increased from age 21 months and peaked at 36 months. Associated risk factors were low maternal education, low family income, underweight weight-for-age, stunted height-for-age, and microcephalic head circumference-for-age. Conclusion Low education and low income were significant risk factors for growth and developmental delay.

Stimulation and cognitive function in short-stature preschoolers Ika Citra Dewi; Rini Sekartini; Hartono Gunardi; Asrawati Nurdin
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.74-81

Background Normal-height children generally have better cognitive function than growth-stunted, short-stature children. Childrenâ€™s cognitive function reportedly improves with stimulation. However, a correlation between stimulation and cognitive function in children with a history of short stature remains unclear. Objective To assess correlation between stimulation and cognitive function in normal-height vs. short-stature preschool children. Methods A cross-sectional study with consecutive sampling was performed in four sub-district areas in Jakarta. Preschool-aged children and their primary caregivers from previous studies on short stature were eligible for inclusion. An Indonesian version of a questionnaire was used to assess stimulation. A psychologist assessed verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ) with the Indonesian version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data were analyzed using Pearsonâ€™s correlation and Chi-square tests, and P values <0.05 were considered to be significant. Results Of 62 subjects, 64.5% had normal height and 35.5% had short stature. Both normal-height and short-stature children had similar IQ outcome and history of stimulation. The stimulation was significantly correlated with FSIQ in normal-height children (r= 0.316; P=0.047), but not short-stature children (r=0.049; P=0.828). However, the percentage differences in VIQ, PIQ, and FSIQ between normal-height and short-stature children were not significant (P=0.409, 0.119 and 0.877, respectively). Conclusion There is a significant correlation between stimulation and IQ in normal-height children. Short-stature preschoolers were not worse in terms of IQ than normal-height preschoolers. Parents and caregivers should be encouraged to provide regular and adequate stimulation to their young children.

Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy Yuni Astria; Hindra Irawan Satari; Hartono Gunardi; Hikari Ambara Sjakti
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-90

Background Post-chemotherapy febrile neutropenia results in high morbidity and mortality in children with malignancy. Many prognostic factors, such as microorganism patterns, as well as the use of antibiotics and antifungals can affect the outcomes. However, limited study is available in Indonesia. Objective To determine the microbial profiles, antibiotic sensitivity, and other factors that influence mortality from febrile neutropenia in pediatric malignancies with infections. Methods This retrospective cohort and descriptive study of 180 children with 252 episodes of neutropenic fever was done in Cipto Mangunkusumo Hospital, Jakarta, between 2015 and 2017. Medical history of possible predictive prognostic factors, including microorganism patterns and antibiotic sensitivity, were recorded. Prognostic factors were analyzed using multivariate logistic regression tests. Results The most common bacteria was Gram-negative (54.5%), while Candida sp. was the most common fungal infection (82.5%). Klebsiella sp. was mainly sensitive to amikacin (85.71%), while Pseudomonas aeruginosa was sensitive to ceftazidime (75%), as well as amikacin and gentamicin (100% sensitivity in combination). Staphylococcus sp. was mainly sensitive to amoxi-clav and ampi-sulbactam (76.9%). Almost all fungal groups were susceptible to fluconazole, ketoconazole, voriconazole (80-100%). Prognostic factors that increased mortality risk were central venous cannulation (RR 1.947; 95%CI 1.114 to 3.402), wasting (RR 1.176; 95%CI 1.044 to 1.325), severe wasting (RR 1.241; 95%CI 0.975 to 1.579), and hematologic malignancies (RR 0.87; 95%CI 0.788 to 0.976). Conclusion Central venous cannulation and wasting are significant prognostic factors of increased mortality in children with febrile neutropenia. Gram negative bacteria along with Candida sp. is the most common pathogen in such condition.

Visual acuity assessment of preschool children in the inner city area in Jakarta Dian Estu Yulia; Yulinda Arty Laksmita; Julie Dewi Barliana; Laura Agnestasia Djunaedi; Lia Amanda; Hartono Gunardi
Paediatrica Indonesiana Vol 62 No 1 (2022): January 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.1.2022.1-6

Background Visual acuity (VA) assessment is an important ocular examination to identify children with vision problems. Such early identification allows for early intervention to prevent childhood blindness. Objective To describe and compare visual acuity measurements in preschool children using two different visual acuity charts. Methods This cross-sectional study in children aged 36-60 months was done in a low-income area in the Central Jakarta District as a collaboration between Department of Ophthalmology and Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta. All children underwent visual acuity examinations using Lea symbols and Tumbling E charts. The VA results from two charts were analyzed with Bland-Altman plot for limits of agreement. Statistical analyses were performed to determine the differences between vision charts. Results A total of 113 children enrolled, but only 38 children completed the examinations. The mean age of subjects was 50.5 (SD 6.4) months. Overall, subjectsâ€™ mean VA was 0.29 (SD 0.18) for Lea symbols and 0.37 (SD 0.14) for Tumbling E. The mean difference of VA between Lea symbols and Tumbling E was 0.07 (SD 0.22) logMAR units, with upper and lower limits of agreement at 0.36 and 0.51, respectively. There was no statistical difference in VA score using Lea symbols and Tumbling-E based on gender and age. Conclusion Most preschool children in our study have normal visual acuity. Lea symbols and Tumbling E chart are comparable and can be used to efficiently measure VA in preschool children.

Co-Authors Abdul Latief Adji Suranto Adra Firmansyah Ahmad Syafiq Alan R Tumbelaka Alan R. Tumbelaka Alida R Harahap, Alida R Aman B. Pulungan Annisa R. Yulman Araysi, Leo Alfath Arfianti Chandra Dewi Ari Prayitno Ari Prayitno, Ari Aria Kekalih Arie Dian Fatmawati Arini Ika Hapsari Armeilia, Rilie Arwin A. P. Akib Arwin A.P Akib Arwin AP Akib Aryono Hendarto Asrawati Nurdin Badriul Hegar Badriul Hegar Bambang Madiyono Bambang Madiyono Bambang Supriyatno Bambang Tridjadja Batubara, Jose Bernie E. Medise Bernie Endyarni Medise Bonny Tjongjono Cissy B Kartasasmita Cissy B. Kartasasmita Cissy B. Kartasasmita Corrie Wawolumaya Damayanti Rusli Sjarif Darmawan B. Setyanto Darmawan, Anthony C. David H Muljono, David H Diana Mettadewi Jong Dominicus Husada Dwi Prasetyo Dwi Prasetyo Elina Waiman Elizabeth Melina Endang Windiastuti Eva Devita Harmoniati Fathy Pohan Fatmawaty Fatmawaty Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Hanifah Oswari Hanny Nilasari Hardiono D Pusponegoro Haswinzky, Rose Amalia Hikari Ambara Sjakti, Hikari Ambara Hindra I. Satari I Gusti Lanang Sidiartha I Putu G Kayika Ika Citra Dewi Ika Karlina Idris Ikhsan Johnson Ikhsan Johnson Imam Budiman Ina Susianti Timan Irawan Mangunatmadja Irene Yuniar, Irene Ismet N. Oesman Ismoedijanto Jasin, Madeleine Ramdhani Jeane Roos Ticoalu Julianti Julianti, Julianti Julie Dewi Barliana Kemal N. Siregar Kurniawan, Kristian Kusnandi Rusmil Laura Agnestasia Djunaedi Lesmana, Elvira Lia Amanda Lily Rahmawati Liza F Zaimi, Liza F Liza Fitria M. Tatang Puspanjono Maddepunggeng, Martira Martira Maddepunggeng Medise, Bernie E. Mei Neni Sitaremi Mei Neni Sitaresmi Mulya Rahma Karyanti, Mulya Rahma Munar Lubis Munasir, Zakiuddin Muzal Kadim Nadya, Ruth Nastiti Kaswandani Natharina Yolanda, Natharina Nia Niasari Nurul Iman Nilam Sari Partini Trihono Piprim B Yanuarso Pustika Amalia Wahidiyat, Pustika Amalia Pustika Efar Raihan Raihan Raihan Raihan, Raihan Ranto, Huminsa Ray Wagiu Basrowi Ray Wagiu Basrowi Resyana P. Nugraheni Rini Andriani Rini Andriani Rini Sekartini Rismala Dewi Ronny Suwento, Ronny Rosdiana S Tarigan Rossy Agus Mardani Rulina Suradi S Ferius Saharso, Ersal Rasyid Sendy Tjahjowargo Setyo Handryastuti Shirley Mansur Simanjuntak, Sumardi F. Singgih, Adrian Himawan Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Soedjatmiko Sreshta Mukhi Sri Rejeki H Hadinegoro. Sri Rezeki Hadinegoro Sri Rezeki S Harun Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sudigdo Sastroasmoro Sudigdo Sastroasmoro Sudigdo Sastroasmoro Sudigdo Sastroasmoro Sudung O Pardede, Sudung O Sukman T. Putra Sukman Tulus Putra Sumarlan, Eka S Teny Tjitra Sari, Teny Tjitra Titi S. Sularyo Titis Prawitasari, Titis Tjhin Wiguna Tjhin Wiguna Toto Wisnu Hendrarto Turyadi Turyadi, Turyadi Ufairah, Kamilia Rifani Wangke, Lydia Wirahmadi, Angga Wresti Indriatmi B. Makes Yoga Devaera Yulianti Wibowo Yulianti Wibowo Yuliarti, Klara Yulinda Arty Laksmita Yuni Astria Yvan Vandenplas Zakiudin Munasir Zakiudin Munasir

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