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All Journal Majalah Kedokteran Bandung Sari Pediatri Paediatrica Indonesiana Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Hindra I. Satari
Department Of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology Neuroscience Public Health

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Occurrence of Covid-19 in Children Who Have Received Live-Attenuated Dengue Vaccination Rahma Karyanti, Mulya; Alam , Anggraini; Widyahening , Indah Suci; Hadinegoro, Sri Rezeki; Munasir , Zakiudin; Sasmono , R. Tedjo; Satari , Hindra Irawan
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-.188

Abstract

Background: Possible cross-reactions/ false positives were reported in rapid dengue serology tests because antigenic similarities between SARS-CoV-2 and DENV. The study aims to evaluate the occurrence of COVID-19 in children who received chimeric-yellow fever tetravalent dengue vaccine. Methods: A case-control study was conducted in five districts primary healthcares in Jakarta aged 12 years and above through history of COVID-19 questionnaire. Clinical and laboratory confirmation were obtained, and blood draw was performed to measure neutralization RBD IgG SARS-CoV-2 antibody titer. The dengue vaccine group consists of subjects who have received CYD-TDV in 2011-2012 and are willing to participate. The non-dengue vaccine group were matched; all have not received dengue vaccine. Results: This study included 207 cases and 212 controls, with median age in cases 19 years (IQR 5) and control 15 years (IQR 4). Nineteen subjects in the dengue vaccine group have already been infected with COVID-19 before being given COVID-19 vaccine, compared to 11 subjects in the non-dengue vaccine group (P=0.131). The occurrence of COVID-19 in the dengue vaccine group was significantly higher (16 subjects) than the non-dengue vaccine group (4 subjects)(P=0.005) after COVID-19 vaccinations were given. Neutralization RBD IgG SARS-CoV-2 antibody titer was 71.96 U/ml (IQR 39.47) in the dengue vaccine group and 51.92 U/ml (IQR 49.03) in the non-dengue vaccine group(P=0.361). Conclusion: Our study showed that the occurrence of COVID-19 in the dengue vaccine group was higher than in the non-dengue vaccine group, which may suggest no cross reaction from dengue antibodies towards COVID-19, more studies are warranted.
Community prevalence and distribution of dengue virus serotype based on antibody neutralization assay in Jakarta, Indonesia Karyanti, Mulya Rahma; Alam, Anggraini; Widyahening, Indah Suci; Hadinegoro, Sri Rezeki; Munasir, Zakiudin; Satari, Hindra Irawan; Sasmono, R. Tedjo
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.10-6

Abstract

Background Dengue infection is still rising globally despite the implementation of preventive efforts in many endemic countries. Monitoring the circulation of dengue virus (DENV) serotypes is not performed routinely in the Indonesian national surveillance program, primarily due to high cost and effort. Objective To evaluate the distribution of DENV serotypes based on serological profile and neutralizing antibody level against all four DENV serotypes in Jakarta, Indonesia. Methods This cross-sectional study was performed as part of a dengue vaccine effectiveness study, 10 years after a dengue vaccination program was initiated. It was conducted in five community public health centers in Jakarta in subjects aged 12 years and above who had not received the dengue vaccine. We collected serum samples and DENV neutralizing antibody titers were measured using a plaque reduction neutralization test (PRNT). Results Eighty healthy subjects with a median age of 15 (range 12-27) years were enrolled. The highest median antibody titer was that to DENV-2 [898 (range 29-91558) 1/dil], followed by that to DENV-3 [297.5 (range 10-36091); 1/dil], DENV-1 [288 (range 0-68237) 1/dil], and DENV-4 [164 (range 0-35812) 1/dil]. Neutralizing antibodies against the four DENV serotypes were found in all the 5 districts studied in Jakarta. A multitypic neutralizing antibody profile was observed in the majority (74/80 subjects; 92.5%). Three subjects were naïve. Conclusion All four dengue serotypes are widely circulating in Jakarta based on neutralizing antibody detection in the community, with the highest neutralizing antibody titer being against DENV-2, followed by DENV-3, DENV-1 and DENV-4.
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.
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.
Biomarker Inflamasi (IL1?, IL6, TNF?, CRP) dan Mikronutrien (Zat Besi, Seng) pada Anak dengan Stunting Usia 6-59 Bulan: Sub Analisis SEANUTS II Ranto, Huminsa; Yuliarti, Klara; Munasir, Zakiuddin; Gunardi, Hartono; Wahidiyat, Pustika Amalia; Satari, Hindra Irawan; Sekartini, Rini
Sari Pediatri Vol 27, No 5 (2026)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp27.5.2026.316-22

Abstract

Latar belakang. Stunting memengaruhi 19,8% anak Indonesia usia di bawah lima tahun, menurut Survei Status Gizi Nasional tahun 2024. Sitokin proinflamasi (IL-1?, IL-6, TNF-?) dan defisiensi mikronutrien (zat besi, seng) diduga berperan dalam terjadinya stunting, terutama di negara berpendapatan menegah ke bawah, karena perannya dalam penghambat pertumbuhan tulang dan fungsi imun.Tujuan. Untuk mengetahui hubungan kadar sitokin proinflamasi, C-reactive protein (CRP), zat besi, dan seng dengan status stunting pada anak Indonesia usia 6-59 bulan.Metode. Data dikumpulkan dari sampel darah 100 anak Indonesia usia 6–59 bulan, dengan analisis statistik menggunakan uji chi-square, uji t, atau uji Mann-Whitney (p<0,05 dianggap bermakna).Hasil. Dari 100 subjek, 49 mengalami stunting dan 51 memiliki status gizi normal. Tingkat pendidikan dan pendapatan orang tua lebih rendah pada kelompok stunting (masing-masing p=0,019 dan p<0,001). Kadar median sitokin (IL-1?: p=0,344; IL-6: p=0,121; TNF-?: p=0,213), CRP (p=0,320), serta kadar mikronutrien (feritin: p=0,087; seng: p=1,000) tidak menunjukkan perbedaan bermakna antara kedua kelompok. Kesimpulan. Tidak ditemukan hubungan bermakna antara sitokin proinflamasi dan defisiensi mikronutrien yang diteliti dengan kejadian stunting, kemungkinan karena ukuran sampel yang terbatas dan bias perkotaan. Faktor sosial ekonomi berpengaruh signifikan terhadap stunting. Diperlukan penelitian longitudinal dengan sampel yang lebih besar untuk memperjelas hubungan tersebut.
Identifying primary immunodeficiency through the evaluation of severe, persistent, unusual, and recurrent infections in Indonesian children Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Kumara Wati, Ketut Dewi
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background Primary immunodeficiency (PID) is widely underdiagnosed in countries with high rates of infection and limited diagnostic facilities, such as Indonesia. It remains challenging to distinguish PID from other conditions predisposing children to severe, persistent, unusual, and recurrent (SPUR) infection. Such conditions include secondary immunodeficiency caused by human immunodeficiency virus (HIV) infection, allergic diseases, and chronic diseases with structural or anatomical abnormalities. Objective To evaluate children with SPUR infections for PID and to compare the clinical characteristics of children with PID to those with other underlying conditions. Methods We conducted a cross-sectional, analytic study of children aged 0-18 years presenting with SPUR infections at 10 hospitals in Jakarta, Indonesia, from July 2024 to September 2025. Clinical assessment and laboratory investigations, including immunological tests, were performed to identify the underlying cause of SPUR infections. Children were classified as healthy, PID, secondary immunodeficiency (HIV), allergy, or chronic disease/anatomical abnormalities. Results Two hundred fifty-four subjects (53% male) with a median age of 26 months were included in our study. Most of them had a history of pneumonia (72.1%), diarrhea (31.1%), and pulmonary tuberculosis (27.9%). Thirty-three (13%) subjects were diagnosed with PID, with the majority being male (60.6%). The most common PID found was antibody deficiency (27.3%), followed by immunodeficiencies combined with associated or syndromic features (24.2%), and immunodeficiencies affecting cellular and humoral immunity (21.2%). Median age of onset in the PID group was 12 (3–24) months. Severe malnutrition was most common in children with HIV. Gender, parental consanguinity, and adverse events following live vaccines did not differ significantly across groups. Conclusion The prevalence of PID among children with SPUR infection in this study was 13%, with the most common classification being antibody deficiency.
Co-Authors Abdullah Reza Afaf Susilawati Agus Firmansyah Agus Firmansyah Alam , Anggraini Alan R Tumbelaka Alan R Tumbelaka Alan R. Tumbelaka Amalia Almira Andi Annisa Rusyda Khafiyani Anggraini Alam, Anggraini Angky Budianti Anis Karuniawati Antonius H. Pudjiadi Arhana, Arhana Ari Prayitno Arwin A.P. Akib Arwin AP Akib Arwin AP. Akib Aryono Hendarto Badriul Hegar Batubara, Jose Bock H Cissy B. Kartasasmita Corry S Matondang Corry S. Matondang Cynthia Rindang Dalima AW Astrawinata Damayanti Rusli Sjarif Delly Chipta Lestari Dewi Wulandari Diana Mettadewi Jong Dimas Seto Prasetyo Dina Muktiarti, Dina Djelantik, I.G.G. E.M. Dady Suyoko Emelyana Permatasari Emi Yulianti Endang Windiastuti Endang Windiastuti Gortap Sihotang Graham RR Hana Paraswati Putri Hanifah Oswari Hardiono D Pusponegoro Hardjono Abdoerrachman Hardjono Abdoerrachman Hartono Gunardi Hikari Ambara Sjakti, Hikari Ambara Htay H Han I Wayan Gustawan Idham Amir Imral Chair Indah S. Widyahening Irene Irene Julitasari Sundoro Kemas Firman Ketut Dewi Kumara Wati Kusnandi Rusmil Laila Fitri Ibbibah Mardjanis Said Martin Hartiningsih Mei Neni Sitaresmi Mohd Andalas Mulya Rahma Karyanti, Mulya Rahma Mulyadi Mulyadi Munasir, Zakiuddin Munasir, Zakiudin Nabila Maudy Salma Natharina Yolanda, Natharina Nia Kuniati Nina Dwi Putri Novilia Sjafri Bachtiar Piprim B Yanuarso Pramita Gayatri, Pramita Pratama Wicaksana Pustika Amalia Pustika Amalia Pustika Amalia Wahidiyat, Pustika Amalia Raihan Raihan Ranto, Huminsa Retno Asti Werdhani Riamin Sitorus Rinang Mariko Rinawati Rohsiswatmo Rini Mulia Sari Rini Sekartini Rita Andriyani Rossy Agus Mardani Rulina Suradi Santya Fatma Dewi Sari Wiraswasty Sasmono , R. Tedjo Sasmono, R. Tedjo Sharfina Fulki Adilla Shindy Claudya Aprianti Sidik Utoro Singgih, Adrian Himawan Siti D. Wisnuwardhani Sjawitri P. Siregar Soedjatmiko Soedjatmiko Soedjatmiko Soepardi Soedibyo Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Suharyono Suharyono Sumarmo Soedarmo Syafriyal Syafriyal, Syafriyal Teny Tjitra Sari, Teny Tjitra Theresia Theresia Toto Wisnu Hendrarto Yuliarti, Klara Yuni Astria