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EVALUASI PENEGAKAN DIAGNOSIS TUBERKULOSIS ANAK BERDASARKAN PETUNJUK TEKNIS TUBERKULOSIS ANAK 2016 DI RSU BMC PADANG Resti Ayu Safitri; Finny Fitry Yani; Al Hafiz; Rinang Mariko; Rima Semiarty; Elmatris Elmatris
SINERGI : Jurnal Riset Ilmiah Vol. 3 No. 6 (2026): SINERGI : Jurnal Riset Ilmiah, Juni 2026
Publisher : Lembaga Pendidikan dan Penelitian Manggala Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62335/sinergi.v3i6.2639

Background: Tuberculosis (TB) is a contagious infectious disease that is still the main cause of health problems and one of the main causes of death in children in the world. The main problem in diagnosing TB in children is that it has not been properly socialized, understood, and implemented by most general practitioners and pediatric specialists, according to the 2016 Technical Guidelines for the Management and Management of Childhood Tuberculosis. Objective: The diagnosis of TB is mostly based on clinical considerations without making efforts to search for bacteriological confirmation, so evaluation is needed towards the implementation of the diagnosis of TB in children based on the 2016 Technical Guidelines for the Management and Management of Childhood Tuberculosis algorithm at RSU BMC Padang. Methods: This type of research is a descriptive study with a cross-sectional retrospective study design using medical record data from pediatric TB patients recorded at the children's clinic at RSU BMC Padang in 2022. The research was conducted at RSU BMC Padang for six months. The sampling technique used was total sampling with a sample size of 137 data. Results: Most patients had symptoms of chronic cough (76.6%), more than half had fever for ≥ 2 weeks (62.8%), weight loss (67.2%), and general malaise (90.5%). Only a small portion (8%) of pediatric TB patients underwent TCM examination, and the majority (89.8%) underwent chest x-rays, and generally (97.1%) underwent tuberculin. All patients were diagnosed with clinical pediatric TB. Conclusion: From the research that has been carried out, it can be concluded that almost all children's TB is diagnosed positively, without implementing the complete diagnosis algorithm in the 2016 Technical Guidelines for the Management and Management of Childhood Tuberculosis. Completeness of supporting examinations, especially TCM, must be paid attention to by the clinician so that all algorithms are fulfilled.

Performance of health workers in implementing the healthy Indonesia application Mutiara Miftahul Jannah; Firdawati Firdawati; Rinang Mariko; Yuniar Lestari; Afdal Afdal; Eka Nofita
Malahayati International Journal of Nursing and Health Science Vol. 9 No. 3 (2026): Volume 9 Number 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v9i3.3064

Background: My Healthy Indonesia Application is a cornerstone of Indonesia's health system digital transformation, designed to streamline vaccination recording and reporting. However, its implementation at community health centers in Padang City faces challenges, marked by data discrepancies and suboptimal vaccination coverage. Purpose: To identify healthcare worker performance in implementing the healthy Indonesia application. Method: A mixed-methods study was conducted in five Community Health Center in Padang City. The quantitative phase employed a cross-sectional design with total sampling of 127 health workers. Data were collected using validated questionnaires and analyzed using chi-square and multivariate logistic regression. The qualitative phase involved in-depth interviews with 13 key informants, analyzed using thematic analysis. This study investigates factors associated with health workers' performance in using My Healthy Indonesia Application and explores underlying reasons behind these challenges. Results: Quantitative analysis revealed that motivation (p=0.014), leadership (p=0.018), and workload (p=0.009) were significantly associated with performance, with motivation as the most dominant factor (OR 0.254; p=0.011). Knowledge (p=0.602) was not significantly associated. Qualitative findings generated seven themes: complex motivational dynamics dominated by professional responsibility; significant infrastructure limitations (reliance on personal devices/internet); persistent application bugs (data loss, duplication); increased administrative workload; a digital generation gap; adaptive strategies (time management, team collaboration); and a clear recommendation for a single, integrated application. Conclusion: Health worker performance in using My Healthy Indonesia Application presents a paradox: good performance persists despite significant systemic barriers, primarily driven by strong intrinsic motivation. However, this reliance on individual resilience is unsustainable. Improving My Healthy Indonesia Application effectiveness requires holistic interventions addressing technical issues, reducing workload, bridging the digital divide, and nurturing the professional dedication of health workers.

Enzyme-Inducing Antiseizure Medications and Hypovitaminosis D in Children with Epilepsy: A Cross-Sectional Study in West Sumatera, Indonesia Trisna Yunita; Rahmi Lestari; Nice Rachmawati Masnadi; Eva Chundrayetti; Amirah Zatil Izzah; Indra Ihsan; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i8.1642

Background. Long-term antiseizure-medication (ASM) therapy can accelerate vitamin D catabolism via hepatic cytochrome P450 induction, predisposing children with epilepsy to hypovitaminosis D and its skeletal consequences; Indonesian tertiary-centre data remain scarce. Methods. This cross-sectional study examined the association between ASM class, number and duration and serum 25-hydroxyvitamin D [25(OH)D] in children aged 1–18 years at Dr. M. Djamil General Hospital, Padang, West Sumatera, between April and October 2025. Of 82 records screened, 77 were eligible; 25(OH)D was measured by enzyme-linked fluorescent assay, with hypovitaminosis D defined as <30 ng/mL. Associations were tested with Fisher–Freeman–Halton exact and chi-square tests, odds ratios, ANOVA, multivariable logistic regression and ROC analysis. Results. Hypovitaminosis D affected 48 children (62.3%; 95% CI 51.2–72.3), with mean 25(OH)D of 18.3±6.7 versus 41.6±11.2 ng/mL in deficient versus replete children. ASM class was significantly associated with vitamin D status (exact p=0.037; Cramér's V=0.283): all nine enzyme-inducing users were deficient, versus 56.0% non-enzyme-inducing and 58.1% combination (ANOVA p=0.045, η²=0.080). Neither ASM number (p=0.642) nor duration (p=0.348) was associated. Enzyme-inducing exposure carried the largest adjusted odds (adjusted OR 5.66, 95% CI 0.62–52.06), and the model discriminated moderately (AUC 0.685). Conclusion. Hypovitaminosis D is prevalent in Indonesian children with epilepsy and is most strongly linked to enzyme-inducing ASMs, supporting early routine 25(OH)D monitoring and supplementation from treatment initiation.

Faktor-Faktor Yang Berhubungan Dengan Responsive Feeding Pada Balita Stunting Lisa Ramadhani; Desmawati Desmawati; Rinang Mariko
Jurnal Ners Vol. 10 No. 3 (2026): JULI 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v10i3.59101

Abstrak Stunting adalah kondisi dimana tinggi badan/panjang badan anak menurut umur (TB/U atau PB/U) dibawah -2 Standar Deviasi (SD). Penyebab stunting antara lain meliputi kekurangan gizi oleh karena itu diperlukan upaya peningkatan gizi dengan responsive feeding. Responsive feeding dipengaruhi oleh berbagai faktor antara lain pekerjaan, variasi asuhan dan dukungan sosial. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan praktik responsive feeding pada balita stunting di wilayah kerja Puskesmas Dadok Tunggul Hitam. Penelitian ini merupakan penelitian kuantitatif dengan pendekatan cross-sectional. Sampel penelitian berjumlah 71 ibu yang memiliki balita stunting dan dipilih menggunakan teknik consecutive sampling. Pengumpulan data dilakukan menggunakan kuesioner, sedangkan analisis data dilakukan dengan uji chi-square dan regresi logistik. Hasil uji chi-square menunjukkan adanya hubungan yang signifikan antara pekerjaan (p-value = 0,000), variasi asuhan (p-value = 0,001) dan dukungan sosial (p-value = 0,000). Faktor yang paling dominan adalah pekerjaan dengan nilai OR = 6,997. Kesimpulan penelitian ini adalah status pekerjaan merupakan faktor paling dominan yang berhubungan dengan responsive feeding pada balita stunting. Disarankan agar puskesmas memberikan edukasi kepada orang tua terkait pertimbangan pekerjaan dan praktik responsive feeding guna mendukung tumbuh kembang anak secara optimal. Kata Kunci: Asupan makan, Balita, Gizi, responsive feeding, stunting Abstract Stunting is a condition in which a child’s height/length-for-age (HFA/LFA) is below -2 Standard Deviations (SD). One of the causes of stunting is malnutrition; therefore, efforts to improve nutrition through responsive feeding are needed. Responsive feeding is influenced by various factors, including employment status, caregiving variation, and social support. This study aimed to determine the factors associated with responsive feeding practices among stunted toddlers in the working area of the Dadok Tunggul Hitam Community Health Center. This study was a quantitative study using a cross-sectional approach. The sample consisted of 71 mothers with stunted toddlers selected using a consecutive sampling technique. Data were collected using questionnaires, while data analysis was performed using the chi-square test and logistic regression. The results of the chi-square test showed significant relationships between employment status (p-value = 0.000), caregiving variation (p-value = 0.001), and social support (p-value = 0.000) with responsive feeding practices. The most dominant factor was employment status with an OR value of 6.997. In conclusion, employment status was the most dominant factor associated with responsive feeding among stunted toddlers. It is recommended that community health centers provide education to parents regarding employment considerations and responsive feeding practices to support optimal child growth and development. Keywords: Intake, Toddlers, Nutrition, Responsive feeding, Stunting

Hubungan Parenting Stress Dengan Perkembangan Anak Usia 6-59 Bulan di Wilayah Kerja Puskesmas Belimbing Christina Desbella B. Putriani; Rinang Mariko; Rini Gusya Liza; Afdal Afdal; Yuniar Lestari; Netti Suharti
Jurnal Ners Vol. 10 No. 3 (2026): JULI 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v10i3.59172

Usia 6–59 bulan merupakan periode krusial dalam tumbuh kembang anak yang dipengaruhi oleh faktor lingkungan dan psikososial keluarga. Parenting stress merupakan faktor pascakelahiran yang dapat dimodifikasi dan berperan penting terhadap kualitas perkembangan anak. Penelitian ini bertujuan menganalisis hubungan parenting stress. Penelitian ini menggunakan desain metode campuran dengan pendekatan kuantitatif (cross sectional) dan kualitatif (wawancara mendalam). Penelitian ini menggunakan two stage sampling (proportional random sampling untuk pemilihan posyandu dan konsekutif sampling untuk mendapatkan 206 pasangan ibu-anak usia 6-59 bulan). Data dikumpulkan melalui instrumen Denver II dan wawancara dengan kuesioner. Penelitian kualitatif dengan wawancara mendalam yang dilakukan kepada 11 informan. Uji kuantitatif menggunakan chi-square dan uji kualitatif menggunakan triangulasi. Hasil penelitian menunjukkan bahwa ada hubungan stres pengasuhan dengan perkembangan anak diperoleh nilai p<0,05. Dalam penelitian ini, parenting stress memiliki peluang 2,234 kali lebih besar untuk mengalami perkembangan tidak sesuai. Hasil kualitatif dari faktor dominan menghasilkan tiga tema utama, yaitu gangguan interaksi akibat stres pengasuhan, persepsi beban dalam pengasuhan anak serta dampak yang terlihat pada perilaku dan perkembangan anak. Temuan ini memperkuat bahwa stres pengasuhan mempengaruhi kualitas interaksi dan praktik pengasuhan sehari-hari. Kesimpulan penelitian ini terdapat hubungan antara stres pengasuhan dengan perkembangan anak usia 6-59 bulan secara kuantitatif dan kualitatif. Oleh karena itu, diperlukan intervensi yang fokus pada dukungan psikososial ibu dan optimalisasi praktik pengasuhan. Kata Kunci: Stres Pengasuhan; Stimulasi Anak; Perkembangan balita; penelitian campuran

Histamine-2 Receptor Antagonist for Gastric Bleeding Prophylaxis in Low-Risk Critically Ill Children: A Randomized Trial of Ranitidine Sylvetri Lestari; Mayetti; Yusri Dianne Jurnalis; Eva Chundrayetti; Rusdi; Rahmi Lestari; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1397

Background: The utility of stress ulcer prophylaxis (SUP) in critically ill children is a subject of ongoing debate, particularly in patients who do not present with classic high-risk features for stress-related mucosal disease (SRMD). This study aimed to evaluate the efficacy of ranitidine for preventing gastric bleeding in a heterogeneous cohort of critically ill children. Methods: A single-center, prospective, open-label, randomized controlled trial was conducted in a tertiary Pediatric Intensive Care Unit (PICU) in Indonesia. Children aged 1 month to 18 years admitted to the PICU were randomized to receive either intravenous ranitidine (1 mg/kg/dose twice daily) or standard care without prophylaxis for five days. The primary outcome was the incidence of overt gastric bleeding. Post-hoc power analysis and multivariable logistic regression were performed to contextualize the findings. Results: From 243 patients screened, 60 were randomized (30 per group). The cohort was predominantly composed of infants (60.0%) with respiratory distress. Overt gastric bleeding occurred in 1 of 30 patients (3.3%) in the ranitidine group versus 3 of 30 patients (10.0%) in the control group. This difference was not statistically significant (Relative Risk [RR] 0.33; 95% CI 0.04–3.11; p=0.612). After adjusting for a baseline imbalance in age, the odds of bleeding remained non-significantly lower in the ranitidine group (Adjusted Odds Ratio [aOR] 0.29; 95% CI 0.03–3.20). The study was found to be severely underpowered (16% power), and none of the bleeding events were clinically significant. Conclusion: In this small, underpowered trial of predominantly low-risk critically ill children, ranitidine did not significantly reduce the incidence of overt gastric bleeding. These findings, while limited by significant methodological weaknesses, do not support the routine use of SUP in similar pediatric populations and underscore the critical need for larger, more definitive trials to inform evidence-based risk-stratification strategies.

Vascular Architecture Alterations Independent of Lipid Profiles: The Paradoxical Dissociation between Dyslipidemia and Carotid Intima-Media Thickness in Obese Adolescents Yenny Astari; Didik Hariyanto; Eka Agustia Rini; Eva Chundrayetti; Nice Rachmawati Masnadi; Anggia Perdana Harmen; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 4 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i4.1564

Background: Adolescent obesity is a global epidemic that initiates subclinical atherosclerosis. While lipid profiles are traditional markers, their correlation with structural vascular changes in the pediatric population remains a subject of intense academic debate. This study evaluates the relationship between traditional lipid parameters and carotid intima-media thickness (CIMT) in obese high school students. Methods: An observational cross-sectional study was conducted between January 2025 and January 2026 involving 45 obese adolescents aged 15 to 18 years in Padang, Indonesia. Nutritional status was determined using the CDC 2000 growth charts, specifically targeting those with a body mass index at or above the 95th percentile. CIMT was measured via high-resolution B-mode ultrasonography. Lipid profiles, including total cholesterol, triglycerides, HDL, and LDL, were analyzed through laboratory testing. Statistical analysis utilized Fisher’s exact test through SPSS version 22. Results: The subjects, of whom 68.9 percent were female, had a median BMI of 29.34 ± 2.03 kg/m². Remarkably, 68.9 percent exhibited CIMT thickening above the 75th percentile. Bivariate analysis revealed no significant association between CIMT and total cholesterol (p=0.402), triglycerides (p=0.696), HDL (p=0.563), or LDL (p=1.000). Conclusion: Vascular remodeling in obese adolescents occurs independently of circulating lipid levels, suggesting that chronic inflammation may drive early atherosclerosis before clinical dislipidemia manifests.

Enzyme-Inducing Antiseizure Medications and Hypovitaminosis D in Children with Epilepsy: A Cross-Sectional Study in West Sumatera, Indonesia Trisna Yunita; Rahmi Lestari; Nice Rachmawati Masnadi; Eva Chundrayetti; Amirah Zatil Izzah; Indra Ihsan; Rinang Mariko
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 8 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i8.1642

Background. Long-term antiseizure-medication (ASM) therapy can accelerate vitamin D catabolism via hepatic cytochrome P450 induction, predisposing children with epilepsy to hypovitaminosis D and its skeletal consequences; Indonesian tertiary-centre data remain scarce. Methods. This cross-sectional study examined the association between ASM class, number and duration and serum 25-hydroxyvitamin D [25(OH)D] in children aged 1–18 years at Dr. M. Djamil General Hospital, Padang, West Sumatera, between April and October 2025. Of 82 records screened, 77 were eligible; 25(OH)D was measured by enzyme-linked fluorescent assay, with hypovitaminosis D defined as <30 ng/mL. Associations were tested with Fisher–Freeman–Halton exact and chi-square tests, odds ratios, ANOVA, multivariable logistic regression and ROC analysis. Results. Hypovitaminosis D affected 48 children (62.3%; 95% CI 51.2–72.3), with mean 25(OH)D of 18.3±6.7 versus 41.6±11.2 ng/mL in deficient versus replete children. ASM class was significantly associated with vitamin D status (exact p=0.037; Cramér's V=0.283): all nine enzyme-inducing users were deficient, versus 56.0% non-enzyme-inducing and 58.1% combination (ANOVA p=0.045, η²=0.080). Neither ASM number (p=0.642) nor duration (p=0.348) was associated. Enzyme-inducing exposure carried the largest adjusted odds (adjusted OR 5.66, 95% CI 0.62–52.06), and the model discriminated moderately (AUC 0.685). Conclusion. Hypovitaminosis D is prevalent in Indonesian children with epilepsy and is most strongly linked to enzyme-inducing ASMs, supporting early routine 25(OH)D monitoring and supplementation from treatment initiation.

Analysis of Factors Related to Nutritional Status of Toddlers Aged 12-59 Months Rizkiyah Novianti; Rinang Mariko; Yantri Maputra
Indonesian Journal of Global Health Research Vol. 8 No. 3 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i3.1630

The nutritional status of toddlers is influenced by factors such as immunization history, exclusive breastfeeding history, maternal knowledge, socioeconomic status, and parenting patterns. This study aims to identify risk factors associated with the nutritional status of toddlers aged 12-59 months in the working area of the Padang Pasir Community Health Center. This is an observational analytical study with a cross-sectional design. This study aims to determine the relationship between the history of exclusive breastfeeding, maternal knowledge, socioeconomic status, and parenting patterns with nutritional status in toddlers in the Padang Pasir Community Health Center work area. The sample consisted of 351 mothers with toddlers aged 12-59 months, selected using proportional sampling. Data collection used a questionnaire. Data were analyzed using chi-square analysis, logistic regression multinomial. The results of the quantitative research using chi-square test showed a relationship between exclusive breastfeeding (p=0.032), maternal knowledge (p=0.010), parental income (p=0.003), feeding parenting patterns (p=0.008) with the nutritional status of toddlers aged 12-59 months. The most dominant factor was feeding parenting patterns (OR=1.302). The study concluded that parenting and feeding patterns were the most closely related factor to the nutritional status of toddlers aged 12-59 months. Community health centers are expected to improve parenting through routine counseling, information media, and direct information on the importance and negative impacts of inadequate parenting and feeding patterns on children's nutritional status.

Critical Factors Influencing ASIK Itilization: A Mixed-Methods Study of Health Worker Performance in Primary Health Centers Mutiara Miftahul Jannah; Firdawati Firdawati; Rinang Mariko; Yuniar Lestari; Afdal Afdal; Eka Novita
Napande: Jurnal Bidan Vol. 5 No. 2 (2026): August
Publisher : Poltekkes Kemenkes Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33860/njb.v5i2.4331

Background: ASIK is a key component of Indonesia’s health digital transformation for immunization recording and reporting. However, its implementation in Community Health Centers (Puskesmas) in Padang City faces challenges, including data discrepancies and suboptimal immunization coverage. This study examines factors associated with health workers’ performance in using ASIK and explores the underlying reasons for these challenges. Method: A mixed-methods study was conducted in five Puskesmas in Padang City. The quantitative phase included 127 health workers using a cross-sectional design, validated questionnaires, chi-square tests, and multivariate logistic regression. The qualitative phase involved in-depth interviews with 13 key informants and thematic analysis. Result: Quantitative analysis showed that motivation (p = 0.014), leadership (p = 0.018), and workload (p = 0.009) were significantly associated with performance, while knowledge was not (p = 0.602). In multivariate logistic regression, motivation was the dominant factor (Exp(B) = 0.254; 95% CI: 0.088–0.734; p = 0.011), indicating that health workers with poor motivation had approximately 74% lower odds of achieving good performance after controlling for leadership and workload. The final model explained 19.5% of performance variance (Nagelkerke R² = 0.195). Qualitative findings identified seven themes: professional responsibility-driven motivation, infrastructure limitations, application bugs, increased administrative workload, digital generation gaps, adaptive strategies, and the need for a single integrated application. Conclusion: Health workers’ performance in using ASIK was relatively good (79.5%) despite systemic barriers, mainly supported by intrinsic professional motivation. However, relying on individual resilience may be unsustainable. Improving ASIK requires addressing technical problems, reducing workload, bridging the digital divide, and strengthening health workers’ professional dedication.

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