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All Journal The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Cardiology Narra J Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Aryono Hendarto
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RS Dr. Cipto Mangunkusumo Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Application of The JMF 10 Warning Signs for Early Detection of Primary Immunodeficiency among Children with Recurrent Infections in Indonesia Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Wati, Ketut Dewi Kumara
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): 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.v9i-.318

Abstract

Introduction: Limited awareness and diagnostic resources contribute to delayed recognition of primary immunodeficiency (PID). The Jeffrey Modell Foundation (JMF) 10 warning signs have been widely used for screening. However, their diagnostic performance has not been validated in Indonesia. Objective: To evaluate the diagnostic performance of the JMF 10 warning signs for early detection of PID among children with recurrent infections in Indonesia. Methods: This multicentre cross-sectional study was conducted across 10 hospitals in Jakarta involving 254 children aged 0–18 years who met the severe, persistent, unusual, and recurrent (SPUR) infection criteria. The diagnosis of PID was established based on clinical diagnosis by the European Society for Immunodeficiencies (ESID) Registry Working Definitions. Analysis was performed to determine the sensitivity, specificity, predictive values, and accuracy of the JMF 10 warning signs. Results: Diagnostic performance for PID improved with the number of warning signs, with overall accuracy increasing from 15% (1 sign) to 86.2% (≥5 signs). A total score of ≥3 signs was associated with higher occurrence of PID (PR 2.63; 95% CI 1.23–5.60; p = 0.008), providing an optimal balance of 75.7% sensitivity and 48.9% specificity. The two most specific indicators were recurrent severe sinus infections (99.5%) and ear infections (95%). All PID subjects required IV antibiotics. Conclusion: The JMF warning signs remain a valuable clinical screening tool for early detection of PID among Indonesian children. A threshold of three or more warning signs provides reasonable accuracy for screening and referral of PID in resource-limited settings.
Co-Authors Abdul Latief Alan R Tumbelaka Ali Khomaini Alhadar Ali Khomaini Alhadar Aman B Pulungan Anggia Widyasari Anjar Setiani Annang Giri Moelyo Antonius H. Pudjiadi Ardi Findyartini, Ardi Aria Kekalih Arwin A. P. Akib Atut Vebriasa Bambang Tridjaja AAP, Bambang Tridjaja Cut Nurul Hafifah Dadi Suyoko Dahlan Ali Musa Dalima Ari Wahono Astrawinata Damayanti Rusli Sjarif Darmawan B Setyanto Dewi Wulandari Dilawar, Ismail Dina Muktiarti, Dina Djajadiman Gatot Endang Windiastuti Fathy Pohan Frieda Handayani Kawanto Hartono Gunardi Henny Adriani Puspitasari Heri Wibowo Herlina Dimiati Hindra Irawan Satari I Dewa Gede Ariputra Irawan Mangunatmadja Irma Annisa Jeanne Vidianty Kemas Firman Ketut Dewi Kumara Wati Lisnawati Rachmadi Ludi Dhyani Rahmartani Luh Karunia Wahyuni, Luh Karunia Marsubrin, Putri Maharani Tristanita Merry Angeline Halim Mulya Rahma Karyanti, Mulya Rahma Mulyadi M. Djer Murni, Indah K. Muzal Kadim Najib Advani Najib Advani Ni Ketut Prami Rukmini Nia Kurniati Nina Dwi Putri Novie Amelia Chozie Partini P Trihono Piprim B. Yanuarso, Piprim B. Pramita Gayatri Primo Parmato Reni Fahriani Retno Asti Werdhani Rhyno Febriyanto Riki Alkamdani Rinawati Rohsiswatmo Risma K. Kaban RR Putri Zatalini Sabila Rubiana Sukardi, Rubiana Rumaisha Hasnah Ibrahim Santoso, Dara Ninggar Saptawati Bardosono Soedjatmiko Sondang Sidabutar Sri S Nasar Sri Sudaryati Nasar Stanislaus Djokomuljanto Stephen Diah Iskandar Sudigdo Sastroasmoro Sudigdo Sastroasmoro Sudung O. Pardede Sukman Tulus Putra Sukman Tulus Putra Supriatna, Novianti Susanti, Dhama S. Tania Paramita Teny Tjitra Sari, Teny Tjitra Tety Nidiawati Velanie Frida Batubara Yessi Yuniarti Yogi Prawira, Yogi Zakiudin Munasir