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All Journal Sari Pediatri Paediatrica Indonesiana JOURNAL LA MEDIHEALTICO Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Mulya Rahma Karyanti, Mulya Rahma
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo
Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Diagnostic Comparison of Elevated Fecal Leukocytes and sTREM-1 in Children with Acute Diarrhea Caused by Bacterial Infection Yudiyanto, Ade Rachmat; Firmansyah, Agus; Karyanti, Mulya Rahma
Journal La Medihealtico Vol. 6 No. 3 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i3.2153

Abstract

Diarrhea is a health problem that most often occurs in children. Various etiologies of diarrhea can cause prolonged diarrhea and become malnourished (malnutrition). The etiology of diarrhea can be caused by a bacterial infection and requires antibiotics, so that detection is needed as early as possible. Examination of soluble triggering expressed receptors on myeloid cells-1 (sTREM-1) can predict bacterial infection in children with acute diarrhea. The study aims to know how much the diagnostic value of fecal leukocytes test compared to sTREM-1. A cross-sectional study of children aged 6-60 months with acute diarrhea without complications and other diseases. In the subjects, clinical manifestation was performed (fever, vomiting, abdominal pain), fecal leukocyte test and sTREM-1 test as a standard reference. Children, aged 6-60 months with acute diarrhea due to bacterial infections with sTREM-1 > 470 pg/mL as many as 2 of 64 subjects and fecal leukocytes > 10/HPF as many as 14 of 64 subjects, most male, normal nutritional status and had clinical manifestation of fever, vomiting and without abdominal pain. Increased fecal leukocytes > 10 / HPF has a sensitivity of 50%, specificity 79.1%, positive predictive value 7.1%, negative predictive value 98%, accuracy 78%, positive likelihood ratio 2.18 and negative likelihood ratio 0.63. Fecal leukocyte test > 10/HPF as a diagnostic confirmation is not good in diagnosing acute diarrhea due to bacterial infection.
CMV-Positive Biliary Atresia in Infants: A Review of Prognosis and Therapeutic Impact Rahmadiena, Qonita; Rahmah, Nailah; Karyanti, Mulya Rahma; Rahman, Himawan Aulia
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 2 (2025): APGHN Vol. 4 No. 2 May 2025
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.4.2.2025.83-96

Abstract

Background: Biliary atresia (BA) is a progressive cholangiopathy of infancy that can lead to end-stage liver disease and is the leading indication for pediatric liver transplantation. Among various proposed etiologies, cytomegalovirus (CMV) infection has emerged as a significant factor, giving rise to a distinct clinical subset known as CMV-positive BA. Discussion: CMV-positive BA is frequently associated with delayed diagnosis, increased incidence of postoperative cholangitis, and advanced liver fibrosis at initial presentation. These features contribute to lower rates of jaundice clearance and native liver survival. Mortality is also higher in CMV-positive patients than in their CMV-negative. Diagnostic methods include performing polymerase chain reaction (PCR) tests on saliva, urine, or dried blood spot samples, as well as conducting abdominal ultrasound examinations that focus on identifying specific indicators, such as the triangular cord sign, which is commonly observed in patients with BA. Antiviral therapy, particularly with ganciclovir or valganciclovir, shows promise in improving native liver outcomes in CMV-positive BA patients. Early surgical intervention remains critical, yet CMV-positive BA often presents later, worsening prognosis. Preventive strategies are under investigation, including maternal CMV screening and neonatal testing. Conclusion: Early identification and tailored antiviral intervention may play a critical role in altering the disease trajectory. Increased awareness of CMV-positive BA is essential for timely diagnosis and optimal management. This review emphasizes the need to recognize CMV-positive BA as a clinically important biliary atresia subset with distinct pathophysiology and worse prognosis, underscoring the importance of early CMV screening and targeted antiviral therapy.
Comparative analysis of COVID-19 incidence and neutralizing antibody response after primary COVID-19 vaccination and heterologous booster doses in adolescents vs. adults: the Indonesian experience Karyanti, Mulya Rahma; Satari, Hindra Irawan; Munasir, Zakiudin; Hadinegoro, Sri Rezeki; Widyahening, Indah Suci; Sasmono, R Tedjo
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/pi65.4.2025.316-24

Abstract

Background The Indonesian COVID-19 immunization program has provided primary doses of a COVID-19 vaccine to adolescents and adults, while booster doses were given to adults only. Evaluation of this program is crucial to determine if boosters should be recommended for adolescents. Objective To compare COVID-19 incidence and SARS-CoV-2 IgG neutralizing antibody levels after COVID-19 vaccination in adolescents given a primary dose vs. adults given a primary dose and a booster. Methods: In this cross-sectional study, participants were given questionnaires on their COVID-19 history and evaluated for SARS-CoV-2 IgG neutralizing antibody titers. We included healthy individuals aged 12 years or older who resided in Jakarta and consented to participate, had received primary COVID-19 vaccine doses, and for adults, booster doses. Participants were stratified into two age groups, adolescents (12-17 years) and adults (18 years and above). We compared the incidence of COVID-19 and SARS-CoV-2 antibody titers between the two age groups. Results Out of 419 participants who met the inclusion criteria, 159 had blood specimens drawn for measurement of SARS-CoV-2 antibody titers. Before the widespread administration of the vaccine, the incidence of COVID-19 in was 4.9% in adolescents vs. 10.2% in adults (P=0.036). After widespread vaccination, the incidence of COVID-19 remained lower in adolescents than in adults (2.2% vs. 8.8%, respectively; P=0.005). The median SARS-CoV-2 antibody titer post-COVID-19 vaccination was 97.85 (range 46.46-98.23) U/mL in adults vs. 96.78 (range 22.08-98.23) U/mL in adolescents (P<0.05). Conclusion While the incidence of COVID-19 was significantly lower in vaccinated adolescents than in vaccinated adults, titers of SARS-CoV-2 IgG neutralizing antibody in adolescents were significantly lower compared to that of adults.
Antibiotic use in children before and after an e-learning intervention Rosyady, Maulana; Karyanti, Mulya Rahma; Chozie, Novie Amelia
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/pi65.5.2025.373-81

Abstract

Background Antibiotic resistance is a global health threat. E-learning can be used to increase the knowledge of medical staff and the effectiveness of antibiotic use. Objective To evaluate the impact of e-learning intervention for pediatric doctors and residents on antibiotic use in pediatric patients. Methods This single-arm intervention study involved all pediatric doctors and residents from the Department of Child Health, Faculty of Medicine at Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI-CMH). Staff and residents underwent e-learning intervention on the topic of antimicrobial stewardship (AMS) via the E-learning Management System Universitas Indonesia (EMAS UI) website, followed by comparison of their pre- and post-intervention knowledge. The appropriate use of antibiotics pre- and post-intervention at October and December 2022, respectively, by was assessed by Gyssen's flowchart. Results A total of 135 (54.4%) antibiotic uses in the pre-intervention period and 170 (72.24%) in the post-intervention period were considered appropriate. A significantly greater proportion of subjects received appropriate antibiotic use after the intervention compared to before (95%CI 0.363 to 0.795; P=0.002). Forty-two out of 56 pediatricians and 119 out of 123 pediatric residents participated in the e-learning program. There was a significant improvement in knowledge levels between the pre- and post-intervention periods among pediatricians, with more passing the post-intervention assessment compared to the pre-intervention assessment (1 vs. 29, respectively; P=0.001). Similarly, a significant increase was observed among pediatric residents (10 vs. 66, respectively; P=0.001). Conclusion There was a significant increase in appropriate antibiotic use in pediatric patients at CMH after pediatric doctors and residents underwent e-learning interventions.
Penerimaan Orangtua terhadap Pemberian Vaksin Rotavirus pada Anak Usia di Bawah Lima Tahun Shahab, Muhammad Rayyan Faher; Karyanti, Mulya Rahma
Sari Pediatri Vol 25, No 6 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.6.2024.385-92

Abstract

Latar belakang. Rotavirus adalah penyebab utama gastroenteritis pada anak di bawah usia lima tahun dan dapat dicegah melalui vaksinasi. Namun, penerimaan vaksinasi rotavirus masih menjadi perhatian utama dalam upaya pengendalian penyakit ini. Tujuan. Mengevaluasi penerimaan orangtua terhadap vaksinasi rotavirus bagi anak berusia di bawah lima tahun.Metode. Sampel penelitian merupakan orangtua yang dipilih secara consecutive sampling. Uji yang digunakan adalah metode uji Chi-square untuk mengetahui hubungan antara karakteristik responden, pengetahuan, sikap, perilaku terhadap rotavirus, dan penerimaan vaksinasi rotavirus. Penelitian ini dilakukan di Poliklinik Departemen Anak Rumah Sakit Cipto Mangunkusumo dan Taman Pengembangan Anak Makara Universitas Indonesia pada bulan Oktober sampai November 2020. Data primer dikumpulkan melalui kuesioner kertas atau e-questionnaire yang diisi oleh orangtua.Hasil. Dari 108 responden, 13 (12%) menolak pemberian vaksinasi rotavirus. Persebaran data menunjukkan 54 responden dengan usia < 30 tahun (50%), 96 berpendidikan terakhir Sekolah Menengah Atas (89%), 51 responden bekerja (53%), 77 dengan pengetahuan terhadap rotavirus baik (71%), 93 dengan sikap terhadap rotavirus baik (86%), dan 100 dengan perilaku terhadap rotavirus baik (93%). Didapatkan hubungan yang signifikan antara sikap orangtua terhadap vaksinasi dengan penerimaan orangtua terhadap vaksinasi rotavirus (p=0,000) dengan rincian 87 responden (93,5%) memiliki sikap positif terhadap vaksinasi dan 6 (6,5%) negatif terhadap vaksinasi. Tidak terdapat hubungan yang signifikan antara usia (p=0,375), pendidikan (p=0,636), pekerjaan (p=0,500), penghasilan (p=0,290), pengetahuan (p=1,000), sikap (p=0,689), dan perilaku terhadap rotavirus (p=0,592) dengan penerimaan vaksinasi rotavirus. Kesimpulan. Mayoritas responden memiliki pengetahuan, sikap, dan perilaku baik terhadap infeksi rotavirus dan vaksinasi rotavirus. Meskipun demikian, tidak terdapat hubungan signifikan antara faktor sosiodemografi orangtua dengan penerimaan vaksinasi rotavirus, kecuali pada sikap orangtua terhadap vaksinasi.
Co-Authors Abdul Latief Agus Firmansyah Agus Firmansyah Amalia Almira Andi Annisa Rusyda Khafiyani Anggraini Alam, Anggraini Anis Karuniawati Annisa Putri Ari Prayitno Aryono Hendarto Athiyatul Aufie Bambang Supriyatno Bermanshah, Evita Karianni Dadi Suyoko Damayanti Rusli Sjarif Deasy Grafianti Delly Chipta Lestari Desti Handayani Dewi Kartika Suryani Dewi Murniati Oman Dina Muktiarti, Dina Dion Darius Samsudin Djajadiman Gatot Eka Laksmi Hidayati, Eka Laksmi Hanifah Oswari Hindra Irawan Satari Hindra Irawan Satari Hindra Irawan Satari Hindra Irawan Satari, Hindra Irawan I Wayan Gustawan Imanadhia, Ashfahani Indah S. Widyahening Irawan Mangunatmadja Irene Yuniar, Irene Karina Faisha Lucyana Alim Santoso Nabila Maudy Salma Nagrani, Dimple Gobind Nanda Asyura Rizkyani Nia Kurniati Nia Kurniati Nia Kurniati Nicolas Gunawan Nina Dwi Putri Novie Amelia Chozie Novie Homenta Rampengan Novie Homenta Rampengan Partini Pudjiastuti Trihono Partini Pudjiastuti Trihono, Partini Pudjiastuti Pinka Nurashri Setyati Pramita Gayatri Pramita Gayatri, Pramita Pratama Wicaksana Puspaningtyas, Niken Wahyu Putra, Reynaldo Rahima Putri, Dewi Andini Rahmadiena, Qonita Rahmah, Nailah Rahman, Himawan Aulia Rhodia, Lia Rifan Fauzie, Rifan Rizqi Amalia Rosalina Dewi Roeslani Rosyady, Maulana Sarita, Raisa Cecilia Sasmono, R. Tedjo Shahab, Muhammad Rayyan Faher Shindy Claudya Aprianti Soedjatmiko Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S Hadinegoro Sri Sulastri Katarnida Sudung O Pardede, Sudung O Sukman Tulus Putra Tania Paramita Taralan Tambunan Taralan Tambunan Yessi Yuniarti Yoga Devaera Yudiyanto, Ade Rachmat Yusticia Katar Zakiudin Munasir