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All Journal Jurnal Kedokteran Brawijaya Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Jurnal Respirologi Indonesia Jurnal Respirasi (JR) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia JOURNAL OF COMMUNITY MEDICINE AND PUBLIC HEALTH RESEARCH Indian Journal of Forensic Medicine & Toxicology Jurnal Ilmu Medis Indonesia MEDICINUS Asian Journal of Social and Humanities

Retno Asih Setyoningrum

Departement Of Pediatric, Faculty Of Medicine, Universitas Airlangga, Surabaya, Indonesia

Author-ID : 3211101

Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Earth & Planetary Sciences Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Public Health Other

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Analysis of Mortality Risk Factors in Children with Pneumonia in RSUD Dr Soetomo Surabaya Tutwuri Handayani; Retno Asih Setyoningrum
MEDICINUS Vol. 35 No. 1 (2022): MEDICINUS
Publisher : PT Dexa Medica

Background: Pneumonia is one of the leading causes of under-five morbidity and mortality. We carried out a comprehensive study to identify risk factors contributing to both mortality and morbidity rate in children less than 5 years of age that were hospitalized with pneumonia. Objective: To evaluate mortality risk factors in children with pneumonia in RSUD Dr. Soetomo Surabaya. Methods: This is an analytic observational study using secondary data that was taken from medical record of hospitalized children with pneumonia between 2015-2018. Data was analysed using Chi-square test or Fisher’s exact test and logistic regression (p<0.05). Results: A total of 817 children with pneumonia were enrolled in this study. In children aged 2–59 months, the risk factors significantly associated with death included age, low birth weight, prematurity, breastfeeding status, pleural effusion, atelectasis, and comorbidity. Logistic regression revealed status of breastfeeding, pleural effusion, and comorbidities, influenced the mortality outcome of pneumonia. Conclusion: Nonexclusive breastfeeding, pleural effusion and comorbidities are the independent predictors of mortality in children with pneumonia. Thus, early identification and prompt management of these simple clinically recognizable predictors of death may help reduce mortality rate in such population.

Flipchart and Booklet As Media to Increase Cadre's Knowledge About Latent Tuberculosis Prevention in Children Retno Asih Setyoningrum; Arda Pratama Putra Chafid; Rika Hapsari; Amrina Rosyada; Muhammad Helmi Imaduddin; Khoirunnisa Shafira Deshpande; Nabila Annisa Harum
Journal of Community Medicine and Public Health Research Vol. 4 No. 1 (2023): Journal Community Medicine and Public Health Research
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jcmphr.v4i1.42323

Educating and empowering the community through tuberculosis cadres is crucial in the early detection of latent tuberculosis infection (LTBI) in primary healthcare settings. From the wide variety of educational media that can be used, flipcharts and booklets have a strong impact on engaging the participants through visual media. Therefore, this community service aims to determine the effect of education through flipcharts and booklets on TB cadres to increase LTBI finding in children. A total of 20 TB cadres of Dr. Soetomo Primary Health Care Surabaya participated in this study. Statistical analysis to evaluate the difference between the pre-test and post-test was used with the Wilcoxon test. The result of the pretest showed insufficient knowledge about latent tuberculosis with an average score of 74%. The post-test average score of 91% indicated a 17% increase in score. There was a significant difference in the score of the test before and after giving the material (p=0.001), indicating an increase in LTBI knowledge of the TB cadres after giving health education using flipchart and booklet as evidenced by the increase in average score between pre-test and post-test.

Prevalence and Risk Factors of Latent Tuberculosis Infection (LTBI) at Madura Boarding School as a High-Risk Congregate Setting Ananto, Muhammad Arif; Setyoningrum, Retno Asih; Lestari, Pudji
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 15 No. 2 (2024): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V15I22024.76-82

Highlights: Boarding school is a high-risk location for tuberculosis transmission. Therefore, stricter early prevention measures are required. Gender and knowledge level were significantly related to latent tuberculosis infection, but there was no significant relationship between age and nutritional status. Low level of knowledge was the highest risk factor compared to other factors, with a five times greater risk of contracting latent tuberculosis infection. Abstract Introduction: Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is a highly contagious airborne disease. High-risk environments with frequent close interactions contribute to the spread of TB. This study examined latent TB infection (LTBI) epidemiology in such settings to inform public health interventions and strategies to curb TB transmission in similar environments. Methods: This cross-sectional observational study, conducted from January to August 2022 at two boarding schools in Bangkalan, involved 100 adolescents aged 10-18 years old tested for latent tuberculosis infection using interferon-gamma (IFN-γ) release assay (IGRA). Data were collected via questionnaires. Bivariate analysis was used to determine the correlation between latent tuberculosis infection prevalence and each research variable using Pearson Correlation and odds ratio (OR) to find risk factors for each variable. A p<0.05 was considered statistically significant. Results: This study found that 30% of 100 adolescents in boarding schools had latent tuberculosis infection. Risk analysis showed a significant association between gender and LTBI (p=0.000), with males having a higher risk with an odds ratio (OR) of 1.02 times. Additionally, lower education levels were significantly associated with a higher risk of LTBI (p=0.021) with an odds ratio of 5.2 times. Conclusion: Boarding schools pose a tuberculosis transmission risk. Early latent tuberculosis infection screening is essential for tuberculosis eradication in Indonesia, and these findings emphasize the need to improve latent tuberculosis infection detection and prophylaxis therapy as a preventive measure against tuberculosis outbreaks.

Faktor Risiko Kegagalan Antibiotika Empirik pada Pneumonia Anak (Studi Retrospektif) Retno Asih Setyoningrum; Dewi Rahmawati
Majalah Kedokteran Indonesia Vol 70 No 10 (2020): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.70.10-2020-294

Introduction: The aetiologies of childhood pneumonia were varies. Initial therapy of pneumonia based on clinical assessment, empirical antibiotic is unavoidable. Observation of the responses to empirical antibiotic therapy are needed, because not all children showed good response to those therapy. Objective to analyse the risk factors associated with empirical antibiotic treatment failure of childhood pneumonia.Methods: The study was conducted as observational analytic study with a retrospective research approach from 1 January 2014 - 31 December 2016 in the inpatient ward of Dr. Soetomo Hospital. Subjects were children aged 2-59 months with initial therapy of ampicillin and gentamicin, then assessed at 2-3 days of treatment.Results: There were 297 children with pneumonia aged 2-59 months, 42 (14%) subjects had empirical antibiotic treatment failure. The nine of variables studied, multivariate logistic regression analysis obtained pleural effusion (PR 7.25; p less than 0.001), atelectasis (PR 4.56; p 0.008), and thrombocytosis (PR 3.32; p 0.008) statistically significantly affected responses failure to empirical antibiotic.Conclusion: Pleural effusion, atelectasis and thrombocytosis are associated with the empirical antibiotic treatment failure in childhood pneumonia in Dr. Soetomo Hospital.

White Blood Cell Count and Neutrophil-Lymphocyte Ratio in Children with Complicated and Uncomplicated Pneumonia Setyoningrum, Retno Asih; Lestari, Sally Rizkita; Sari, Ratih Kumala; Visuddho, Visuddho; Hapsari, Rika; Chafid, Arda Pratama Putra
Jurnal Ilmu Medis Indonesia Vol. 4 No. 1 (2024): September
Publisher : Penerbit Goodwood

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35912/jimi.v4i1.3560

Purpose: Community-acquired pneumonia (CAP) remains one of the leading causes of morbidity and mortality among children, particularly those under the age of five. This study aimed to compare white blood cell (WBC) count and neutrophil-lymphocyte ratio (NLR) between children with complicated and uncomplicated pneumonia hospitalized at Dr. Soetomo Hospital Surabaya. Research methodology: This retrospective study evaluated 49 children hospitalized with CAP from January to October 2021. Pneumonia was diagnosed based on symptoms (fever, cough, dyspnea) and physical findings (tachypnea, chest indrawing, rales). The comparison of WBC count and NLR of children with and without pneumonia complications was made using the Mann-Whitney U test. Results: Of the 49 patients, 28 (57.1%) were male and 40 (81.6%) were under five years old. The median hospital stay was 7 (Interquartile Range [IQR] 4.5 – 9) days. Nine patients (18.4%) had complications, including pneumothorax (33%) and sepsis (22%). Patients with complications had higher median WBC counts (19.5 [IQR 7.2 – 25.1] vs. 12.7 [IQR 10.7 – 15.7] x103/mm3, p=0.224). Similarly, the median NLR was found higher in the complicated pneumonia group (2.9 [IQR 1.5 – 10.8]) than uncomplicated group (1.7 [IQR 0.9 – 4.4], p=0.178). Limitations: The few sample size and retrospective nature of the study limits the generalizability of the findings. Future studies with larger sample sizes and the inclusion of additional biomarkers are warranted to confirm our findings. Contribution: These trends suggest potential utility of WBC count and NLR as biomarkers for pneumonia severity, warranting further research with larger cohorts.

Low Birth Weight as Risk Factor of Pneumonia Child in Primary Health Care of Surabaya Puspamaniar, Vania Ayu; Setyoningrum, Retno Asih; Susanti, Dwi
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 10 No. 2 (2019): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Introduction: Pneumonia is an infectious disease attacking lower respiratory tract. It has one of the highest number of world's mortality and morbidity in children. Many risk factors are suspected as the reasons why the disease still occur a lot. One of the major risk factors is birth weight which makes their immune system immature and easier to get various complications and infections. The aim of this study is to analyze birth weight as risk factor of pneumonia in children under 5 years old. Methods: This was an analytical study with case control design. This study was held in Primary Health Care of Tambakrejo, from August to December 2017. The sample size was 22 respondents for each case and control group. Technique of sampling was total sampling. Secondary data were collected by medical records at the health center and Kartu Menuju Sehat (KMS). Data were entered into Microsoft Excel then statistically analyzed using IBM SPSS 22. The data were analyzed by Fisher's Exact Test.Results: During August to December 2017, there were 22 respondents which were diagnosed with pneumonia in Tambakrejo Primary Health Center. Two of them (4.55%) had low birth weight and the rests had normal birth weight (95.45%). The analyze result stated that there is no significant correlation between pneumonia incidence and birth weight. Conclusion: Birth weight is one of pneumonia risk factors without significant impact.

BCG Vaccination and Spinal Tuberculosis in Non-Malnourished and/or Non-HIV Infected Children at Dr. Soetomo General Academic Hospital, Surabaya Albarok, Muhammad Abdir Rahman; Faris, Muhammad; Endaryanto, Anang; Setyoningrum, Retno Asih
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 16 No. 1 (2025): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V16I12025.83-88

Highlights: The Bacillus Calmette-Guérin (BCG) vaccination has been widely implemented in Indonesia, but cases of spinal tuberculosis (TB) in children can still be found. There are significant and moderate relationships between BCG vaccination and the occurrence of spinal TB in children. Abstract Introduction: Spinal tuberculosis (TB) is an extrapulmonary form of TB that affects the spine. The Bacillus Calmette-Guérin (BCG) vaccination program, which has been implemented to prevent TB, should have prevented this type of TB. However, cases of this disease in children can still be found. This study aimed to determine whether there was a relationship between BCG vaccination and the occurrence of spinal TB in children. Methods: This case-control analytic observational study was performed based on medical record data. The study subjects of each group, both case and control, were taken from pediatric TB patients at Dr. Soetomo General Academic Hospital, Surabaya, from 2017 to 2021. Patients with malnutrition and/or human immunodeficiency virus (HIV) infection were excluded. Statistical analyses were performed using Fisher’s exact test. Results: There were 9 patients in total within each group. Most were 12-17 years old, and the ratio of male by female was 1.25:1. There were 4 out of 9 (44%) spinal TB patients and 9 of 9 (100%) patients with no spinal TB who all received BCG vaccination. The statistical test indicated a significant (p=0.029) and moderate (C=0.527) relationship between BCG vaccination and the occurrence of spinal TB in children. Conclusion: The Bacillus Calmette-Guérin vaccination should be able to prevent the new occurrence of spinal TB in children.

Role of Clinical Features and GeneXpert MTB/RIF Assay in Diagnosing Tuberculosis Among Toddler Patients in Surabaya Prasanti, Siva Allysha; Setiabudi, Rebekah Juniati; Setyoningrum, Retno Asih; Purwanto, Satiti Palupi
Indonesian Journal of Tropical and Infectious Disease Vol. 13 No. 1 (2025)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v13i1.66523

Tuberculosis (TB) is a leading cause of global morbidity and mortality, mainly in the age of 0-5 years old (toddlers). Several risk factors make toddlers more prone to TB infection. Although it commonly depends on clinical evidence, diagnosis of toddler TB can be done using microbiological confirmation like GeneXpert MTB/RIF Assay. However, this is still challenging to perform due to the low bacterial loads and difficulties in obtaining specimens. While prior studies focused more on the clinical aspects, this study will determine both the clinical and microbiological profiles of toddler TB patients at Dr. Soetomo General Academic Hospital Surabaya. This study was conducted using a retrospective approach. Samples were obtained using a total sampling technique from electronic medical records from January 2018 to September 2023. Variables collected include age, gender, type of TB, BCG vaccination status, history of household contact, nutritional status, symptoms, and GeneXpert MTB/RIF examination specimens and results. Among 125 toddler TB patients, the majority being female (57%), between the ages of 1–2 (45%), had BCG vaccination (86%), and without a history of household contact (63%). Most of the samples were malnourished (56%) and had cough as the symptom (62%). In GeneXpert MTB/RIF examination, gastric aspirate was the most collected specimen (52%) and the most common result found was negative (70%). In addition, two toddler patients were found to have DR-TB. In conclusion, while GeneXpert MTB/RIF assay predominantly resulted in negative, clinical features become the essential evidence to establish a diagnosis of tuberculosis among toddler patients.

The Effect of Vitamin D3 Supplementation on Interleukin-6 and PRESS Score in Children with Pneumonia and Vitamin D Deficiency Setyoningrum, Retno Asih; Kristianto, Wigit; Chafid, Arda Pratama Putra; Hapsari, Rika; Syafa'ah, Irmi
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.107-113

Introduction: Pneumonia is a significant health issue in children under 5 years old. Vitamin D may help to reduce childhood mortality, morbidity, and interleukin-6 (IL-6) levels in children with pneumonia, but the evidence is still limited and controversial. This study aimed to evaluate the effect of vitamin D3 supplementation on IL-6 levels and clinical manifestations in children with pneumonia and vitamin D inadequacy. Methods: This was a randomized, placebo-controlled, and double-blinded trial study. Twenty-eight children diagnosed with pneumonia and vitamin D deficiency were enrolled and divided into a supplementation (n=15) or placebo group (n=13). Children were given a single dose (100,000 international units/IU) of vitamin D3 or placebo on the first day of hospitalization. Clinical manifestations were assessed by the Pediatric Respiratory Severity Score (PRESS). Results: The level of 25-hydroxyvitamin D (25-OH D3), IL-6, and PRESS score at baseline showed no significant difference between groups. Seven days post-supplementation, only the PRESS score showed a significant difference between groups (p=0.025). Analysis of the vitamin D3 group showed a significantly increased 25-OH D3 level and a reduced PRESS score (p=0.039 and p=0.02, respectively). Conclusion: A single high dose of vitamin D3 supplementation in children with pneumonia and inadequate vitamin D levels helps elevate 25-OH D3 levels and reduce clinical manifestations, as indicated by the PRESS score.

Positivity Proportion of Xpert MTB/RIF in Suspected Pediatric Pulmonary Tuberculosis Patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia Salsabila, Sabila; Mertaniasih, Ni Made; Setyoningrum, Retno Asih
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 16 No. 2 (2025): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V16I22025.142-147

Highlights: This study utilized Xpert MTB/RIF result data from children using both sputum and gastric lavage specimens, which is different from previous studies that relied solely on sputum specimens. “Mycobacterium tuberculosis not detected” was the most common result on the Xpert MTB/RIF examination in suspected pediatric TB cases. Abstract Introduction: The difficulty of diagnosing tuberculosis (TB) is the most significant challenge in pediatric pulmonary TB cases. More accurate and faster diagnostic tools are essential for detecting TB infections, enabling the implementation of appropriate therapy and treatment management more effectively and promptly. This study aimed to determine the proportion of positive results using the Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) assay as a rapid molecular method in suspected pediatric pulmonary TB patients at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Methods: This study employed a descriptive-retrospective design, utilizing data obtained from medical records. The total number of samples included in this study was 373 samples (n=373). The data was analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26.0 for Windows. Results: The most commonly used specimen from pediatric TB patients in the Xpert MTB/RIF examination was sputum, accounting for 59.2%. The most common result from the Xpert MTB/RIF examination was “MTB not detected,” with a prevalence of 88.2%. Conclusion: The most commonly used specimen for the Xpert MTB/RIF examination of pediatric pulmonary TB was sputum. The majority of results found with the Xpert MTB/RIF examination were “MTB not detected” both in sputum and gastric aspirate specimens.

Co-Authors Abdul Latief Azis Agoes Boediono Ahmad Suryawan Aida Fahira Rachma Aisah, Nurul Albarok, Muhammad Abdir Rahman Aldise Mareta, Aldise Alpha Fardah Athiyyah Amrina Rosyada Anang Endaryanto Ananto, Muhammad Arif Andri Kurnia Wahyudhi Andy Darma Arda Pratama Putra Chafid Arina Setyaningtyas Budi Utomo Budi Utomo Budi Utomo Chafid, Arda Pratama Putra Clarissa Cita Magdalena Darto Saharso Deasy Fetarayani Deby Kusumaningrum Dewi Rahmawati Dharmawati, Ira Didik Didik Handijatmo, Didik Diska Hanifah Nurhayati Djoko Poetranto, Djoko Dominicus Husada Dwi Putri Lestari Dwi Susanti Edith Frederika, Edith Eka Sri Handayani Ergia Latifolia Far-Far, Imanuel Ferry Sandra Gatot Soegiarto Hapsari Widya Ningtiar Hapsari, Rika Hedi Mustiko Hidajat, Boerhan Hubah Asyiroh I Dewa Gede Ugrasena I Gusti Made Reza Gunadi Ranuh I Gusti Ngurah Twi Adnyana Ismoedijanto Khoirunnisa Shafira Deshpande Kristianto, Wigit Laksmi Wulandari Lestari, Sally Rizkita Litiya Parahita Putri Firnadi Lucia Landia Setyowati, Lucia Landia Maharani, Rizky Arisanti Manillaturrochmah Manillaturrochmah Maranatha, Daniel Masaoki Yamaoka, Masaoki Mohammad Yamin Sunaryo Suwandi Muhammad Faris, Muhammad Muhammad Helmi Imaduddin Mustiko MD, Hedi Nabila Annisa Harum Neurinda Permata Kusumastuti Ni Made Mertaniasih Prananda Surya Airlangga Prasanti, Siva Allysha Pratista Oktafia Pudji Lestari Purwanto, Satiti Palupi Puspamaniar, Vania Ayu Ranti Dewanti Oktaviani Rarome, Berlian Beatrix Ratih Kumala Sari, Ratih Kumala Rebekah Setiabudi, Rebekah Resti Yudhawati Rifah Zafarani Soumena Rika Hapsari Salsabila, Sabila Sembiring, Yan Efrata Setiabudi, Rebekah Juniati Shofia Ihtasya SITI NURUL HIDAYATI Subijanto Marto Sudarmo Syafa'ah, Irmi Tia Harelina Tutwuri Handayani Umiastuti, Pirlina Utariani, Arie Visuddho, Visuddho Widati Fatmaningrum Wigit Kristianto Wiharjo Hadisuwarno Wiweka Merbawani Wungu, Citrawati Dyah Kencono Yuli Astika

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