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Nutrient intake and stunting in children aged 2-5 years in a slum area of Jakarta Ratnayani, Ratnayani; Sunardi, Diana; Fadilah, Fadilah; Hegar, Badriul
Paediatrica Indonesiana Vol 64 No 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.132-8

Background Stunting is one of the problems that occurs in children who live in slum areas. Inadequate nutrient intake has been associated with stunting in children. Objective To assess nutrient intake and analyze the differences between stunted and non-stunted children aged 2-5 years. Methods This comparative cross-sectional study compared nutrient intake and stunting among children 2-5 years in slum areas in Kebon Bawang Village North Jakarta. Subjects’ nutrient intake was assessed using the Semiquantitative-Food Frequency Questionnaire (SQ-FFQ). To analyze differences in subject characteristics and nutrient intake in the stunted and non-stunted groups, Chi-square, Mann-Whitney test, and independent T-test were used. Results From a total of 42 respondents, the characteristics of subjects were not significantly different between the stunted and non-stunted groups, in age (P=0.120), gender (P=0.126), maternal occupation (P=0.729), or maternal education (P=0.127). The stunted group had significantly lower intake of energy (P=0.003), carbohydrates (P=0.024), protein (P=0.005), and fat (P=0.001) than that of the non-stunted group. However, the majority of subjects had protein adequacy above the sufficiency level in both groups (P=0.638), while significantly more subjects in the stunted group had insufficient carbohydrate adequacy than in the non-stunted group (P=0.032). Conclusion Overall, nutrient intake in the stunted group is lower than that of the non-stunted group. Protein adequacy is above sufficient for most subjects in both groups, while the significantly more stunted subjects have insufficient carbohydrate adequacy. In carrying out interventions, it is necessary to consider fulfilling a balance of nutrients, especially macronutrients.

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

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.

Perceptions, practices, and associated factors towards expressed breastfeeding among mothers in Jakarta, Indonesia Pambudi, Wiyarni; Dewanto, Naomi Esthernita Fauzia; Yusra, Yusra; Werdhani, Retno Asti; Endaryanto, Anang; Fahmida, Umi; Alatas, Fatima Safira; Hegar, Badriul
Paediatrica Indonesiana Vol 64 No 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.168-75

Background Expression of breast milk is a strategy to ensures continuous breastfeeding during temporary separation of infant from the mother. Handling and storage of expressed breast milk (EBM) should be based on established recommendations because these practices can affect milk quality and safety. Objective To describe perceptions and practices of EBM handling and storage, compare with commonly used recommendations and associated factors influencing these practices among mothers in Jakarta, Indonesia, Methods Mothers who practiced expressed breastfeeding (EBF) to their 6-12 weeks-old infants completed questionnaires about their peceptions and practices on how they handle and storage EBM. The differences in perceptions and practices about expressed breastfeeding management were analyzed using the Chi-square or Fisher's exact test. Results Among 30 mothers, 14/30 gave EBF exclusively, 19/30 used breast pump, and 26/30 expressed ³6 times/day. Infants in this study received expressed milk 5-10 times per day. Maternal age and resource of information were factors significantly associated with mother’s perceptions, while maternal age, education, and parity were significantly associated with the practices of EBM handling and storage. Conclusion This study reveals inconsistent perceptions and practices on expressed milk handling and storage by the mothers. They have good knowledge about the theoretical aspects of expressed breastfeeding, but some other techniques are poor, which can be detrimental to the health of the infants. Further study is needed to find more efficient and optimal methods of expressed milk handling and storage, necessitating thoughtful consideration of better practices and recommendations.

Evaluation of the Knowledge and Behavior of Indonesian Mothers about Infantile Colic Hegar, Badriul
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 1 (2024): VOLUME 25, NUMBER 1, April, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/251202434-39

Introduction: Infantile colic is a functional gastrointestinal disorder (GSCF) found in 20-30% of infants aged 5 months which is characterized by recurrent prolonged periods of infant irritability, fussing, or crying without obvious cause and cannot be prevented or resolved by parents. Infantile colic is often associated with higher mothers depression and lower quality of life. Mothers' knowledge and behavior of infantile colic varies greatly. This research to investigate the knowledge and behavior of Indonesian mothers regarding infantile colic and related factorMethods: A cross-sectional analytic observational study with the target of 100 mothers with babies aged 0-12 months was performed using an electronic questionnaire in Google forms. The questionnaire consists of multiple-choice questions regarding the mothers' knowledge and behavioral to infantile colic.Results: As many as 82% of mothers understand that infantile colic as recurrent prolonged periods of crying that occur without obvious cause and cannot be prevented or resolved by parents, however only 12% of mothers know that most infantile colic will disappear by the age of 5 months. Forty percent mothers had babies with infantile colic; 97.5% of them were worried about their baby's condition and 7.5% of the mothers gave them medication. There was no significant difference between mothers' age and number of children with inadequate mother-infant interaction (P = 0.770 and P = 0.647)Conclusion: The knowledge and behavior of mothers in Indonesia regarding infantile colic is quite good, however parental reassurance still needs to be improved, especially to reduce maternal anxiety.

Optimizing Gram-Negative Bacteria Isolation from Children Diarrheal Stool Samples in Jakarta: A Comparative Analysis of Six Culture Media Abdelrazig, Omnia Amir Osman; Fadilah, Fadilah; Prasetyo, Dimas Seto; Saharman, Yulia Rosa; Hegar, Badriul
Al-Hayat: Journal of Biology and Applied Biology Vol 7, No 1 (2024)
Publisher : Fakultas Sains dan Teknologi, UIN Walisongo Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21580/ah.v7i1.20528

The prevalence of diarrheal illnesses in Indonesia remains a significant concern among children under the age of five, evident through diagnostic findings and symptomatic manifestations, leading to increased rates of mortality and morbidity. This study aimed to identify, isolate, and culture gram-negative bacteria responsible for childhood diarrhea. Twenty stool samples were collected from children under the age of 5 with acute diarrhea in Jakarta health centres and hospitals between October 2023 to January 2024. These samples were inoculated onto selective agars to facilitate the growth of gram-negative bacteria. After a 24-hour incubation period, colonies suspected to be E. coli, K. pneumoniae, Salmonella, Shigella, or Vibrio were identified using the Vitek-2 compact system. The results revealed a notable presence of Gram-negative bacteria in all the fecal samples from diarrheal children, with Escherichia coli (E. Coli) and Klebsiella pneumoniae (Klebsiella p) as the predominant species. In conclusion, our study, utilizing various cultures and the Vitek-2 compact system, elucidates the microbial landscape driving diarrheal morbidity in Indonesian children under five, with E. Coli and klebsiella pneumoniae emerging as prevalent contributors to childhood diarrhea in this population.

Evaluation of anti-diphtheria toxoid antibody persistence in school-age children in Jakarta, Indonesia Santi, Theresia; Prayitno, Ari; Munasir, Zakiudin; Hadinegoro, Sri Rezeki S.; Harahap, Alida Roswita; Werdhani, Retno Asti; Sah Bandar, Ivo Novita; Jo, Juandy; Hegar, Badriul
Paediatrica Indonesiana Vol 64 No 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.447-53

Background Diphtheria can be effectively prevented by adequate immunization. A combined vaccine against diphtheria toxoid, pertussis, and tetanus toxoid (DPT) is currently used in routine pediatric immunizations. Outbreaks of diphtheria could emerge in Indonesia as a consequence of declining routine vaccination during the COVID-19 pandemic. Objective To analyze the impact of the first (administered at 18-24 months of age ) and second diphtheria boosters (administered at 5-7 years of age ) in retaining protective levels of anti-diphtheria toxoid antibodies. We also investigated for relevant factors associated with anti-diphtheria toxoid antibody titers. Methods This cross-sectional study was conducted in the Senen District of Jakarta, Indonesia. The inclusion criteria were healthy children aged 6 to 7 years with documented history of DPT vaccination. Primary vaccination defined as 3 doses of DPT at age less than 1 year , first booster was DPT vaccination at 18-24 years of age, and second booster was diphtheria-tetanus (DT) vaccination received at 5 to 7 years of age. Peripheral blood specimens were obtained from participating children, after informed consent was provided by their parents. Antibodies against diphtheria in sera specimens were assessed by commercial anti-diphtheria toxoid immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results There were 154 children included in the study, with a female majority (61%). Overall, specific humoral immunity against diphtheria was observed in 113 children (73.4%). There was no statistical difference in immunity level between genders. Importantly, children who received the first and second diphtheria booster had significantly higher anti-diphtheria antibody level than those who did not receive both diphtheria booster (P<0.001). Conclusion Booster vaccinations are crucial among school-age children in Indonesia to improve their anti-diphtheria immunity and to minimize a risk of diphtheria outbreaks.

Profile of Anti-Diphtheria Toxoid Immunoglobulin G among Pre-School Children in the Senen District, Jakarta, Indonesia Santi, Theresia; Jo, Juandy; Prayitno, Ari; Munasir, Zakiudin; Hegar, Badriul
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.189

Background: Diphtheria is a re-emerging disease in Indonesia that can be prevented by vaccination. This study evaluates the anti-diphtheria toxoid immunoglobulin G levels among healthy children aged 6 – 7 years old who had not received the second booster immunization for Diphtheria, Tetanus, and Pertussis (DTP) commonly administered at 5 – 7 years old. Methods: This cross-sectional study was conducted in the Senen district of Jakarta, Indonesia. All subjects had been vaccinated with three doses of immunization for DTP during the first year of life, and subsequently classified into a group of children who received the first booster immunization of DTP at 18 – 24 months old and who had not received it yet. Antibody against Diphtheria toxoids within the sera samples was assessed by commercial Anti-Diphtheria toxoid IgG Enzyme-Linked Immunosorbent Assay and classified in four groups: no protection (< 0.01 IU/ml), uncertain (0.01 – 0.09 IU/ml), full protection (0.10 – 1 IU/ml) and long-term protection (>1 IU/ml). Results: Eighty-nine children were included in this study; only 71 subjects (79.7%) had received the first DTP booster at 18–24 months old. The specific humoral immunity against diphtheria was observed among 57 children (64%). Notably, among the 89 subjects, only two subjects not receiving the first DTP booster still had antibody protection for diphtheria (p=0.001, OR 27.5, 95% CI: 5.71 – 132.42). Conclusion: The first diphtheria booster vaccination at 18 – 24 months old is crucial to protect pre-school children against diphtheria.

Optimizing Gram-Negative Bacteria Isolation from Children Diarrheal Stool Samples in Jakarta: A Comparative Analysis of Six Culture Media Abdelrazig, Omnia Amir Osman; Fadilah, Fadilah; Prasetyo, Dimas Seto; Saharman, Yulia Rosa; Hegar, Badriul
Al-Hayat: Journal of Biology and Applied Biology Vol. 7 No. 1 (2024)
Publisher : Fakultas Sains dan Teknologi, UIN Walisongo Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21580/ah.v7i1.20528

The prevalence of diarrheal illnesses in Indonesia remains a significant concern among children under the age of five, evident through diagnostic findings and symptomatic manifestations, leading to increased rates of mortality and morbidity. This study aimed to identify, isolate, and culture gram-negative bacteria responsible for childhood diarrhea. Twenty stool samples were collected from children under the age of 5 with acute diarrhea in Jakarta health centres and hospitals between October 2023 to January 2024. These samples were inoculated onto selective agars to facilitate the growth of gram-negative bacteria. After a 24-hour incubation period, colonies suspected to be E. coli, K. pneumoniae, Salmonella, Shigella, or Vibrio were identified using the Vitek-2 compact system. The results revealed a notable presence of Gram-negative bacteria in all the fecal samples from diarrheal children, with Escherichia coli (E. Coli) and Klebsiella pneumoniae (Klebsiella p) as the predominant species. In conclusion, our study, utilizing various cultures and the Vitek-2 compact system, elucidates the microbial landscape driving diarrheal morbidity in Indonesian children under five, with E. Coli and klebsiella pneumoniae emerging as prevalent contributors to childhood diarrhea in this population.

Optimizing Gram-Negative Bacteria Isolation from Children Diarrheal Stool Samples in Jakarta: A Comparative Analysis of Six Culture Media Abdelrazig, Omnia Amir Osman; Fadilah, Fadilah; Prasetyo, Dimas Seto; Saharman, Yulia Rosa; Hegar, Badriul
Al-Hayat: Journal of Biology and Applied Biology Vol. 7 No. 1 (2024)
Publisher : Fakultas Sains dan Teknologi, UIN Walisongo Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21580/ah.v7i1.20528

The prevalence of diarrheal illnesses in Indonesia remains a significant concern among children under the age of five, evident through diagnostic findings and symptomatic manifestations, leading to increased rates of mortality and morbidity. This study aimed to identify, isolate, and culture gram-negative bacteria responsible for childhood diarrhea. Twenty stool samples were collected from children under the age of 5 with acute diarrhea in Jakarta health centres and hospitals between October 2023 to January 2024. These samples were inoculated onto selective agars to facilitate the growth of gram-negative bacteria. After a 24-hour incubation period, colonies suspected to be E. coli, K. pneumoniae, Salmonella, Shigella, or Vibrio were identified using the Vitek-2 compact system. The results revealed a notable presence of Gram-negative bacteria in all the fecal samples from diarrheal children, with Escherichia coli (E. Coli) and Klebsiella pneumoniae (Klebsiella p) as the predominant species. In conclusion, our study, utilizing various cultures and the Vitek-2 compact system, elucidates the microbial landscape driving diarrheal morbidity in Indonesian children under five, with E. Coli and klebsiella pneumoniae emerging as prevalent contributors to childhood diarrhea in this population.

Autonomic function based on heart rate variability in children with laryngopharyngeal reflux Yunizaf, Rahmanofa; Restuti, Ratna Dwi; Rachmawati, Elvie Zulka Autzia; Putranto, Rudi; Kusumayati, Agustin; Hegar, Badriul
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.273-8

Background The pathophysiology of laryngopharyngeal reflux (LPR) is yet to be completely understood, but autonomic dysregulation may have a role in the opening of esophageal sphincters controlled by the parasympathetic nervous system, especially the vagal nerve. Autonomic dysregulation can be detected through heart rate variability (HRV). Currently, studies that identify autonomic nerve dysfunction through HRV in LPR patients are few, especially in the pediatric population. Objective To identify autonomic nerve dysfunction in pediatric LPR patients with HRV components. Method This study involved 74 pediatric patients, 35 with LPR and 39 without LPR, from Dr. Cipto Mangunkusumo Hospital, Jakarta, from September 2023 to April 2024. Diagnostics for LPR included endoscopy and Reflux Symptom and Sign Instrument (RSSI) scoring, while measurement of autonomic nerve dysfunction was determined by HRV. The HRV was evaluated by standard deviation normal to normal (SDNN) assessment of the heart’s interbeat interval (IBI) and low frequency/high frequency ratio (LF/HF). Results Neither HRV measurement, SDNN or LF/HF, were significantly associated with autonomic nerve dysfunction in pediatric patients with LPR. Conclusion Autonomic nerve dysfunction measured by HRV was not associated with LPR in pediatric patients.

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