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All Journal Sari Pediatri Paediatrica Indonesiana Jurnal RSMH Palembang
Fifi Sofiah
Departemen Ilmu Kesehatan Anak RSUP Dr. Mohammad Hoesin/ Unsri Palembang
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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Peningkatan Sensitivitas Dua Kali Uji Tuberkulin untuk Mendeteksi Infeksi Tuberkulosis pada Anak dengan Penyakit Keganasan Arismunanto Kurniawan; Fifi Sofiah; Dian Puspita Sari; Yuwono Yuwono
Sari Pediatri Vol 19, No 5 (2018)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp19.5.2018.245-51

Abstract

Latar belakang. Pasien imunokompromais lebih berisiko terinfeksi kuman Mycobacterium tuberculosis. Sensitivitas uji tuberkulin pada pasien anak dengan keganasan berkurang karena penurunan T helper 1 (Th 1). Diperlukan dua kali uji tuberkulin untuk meningkatkan sensitivitas uji tuberkulin pada anak dengan keganasan.Tujuan. Mengetahui penggunaan dua kali uji tuberkulin lebih sensitif mendeteksi infeksi tuberkulosis pada anak dengan keganasan dibandingkan satu kali uji tuberkulin.Metode. Penelitian cross sectional dilakukan Juli 2016 sampai 31 Maret 2017 pada pasien anak yang baru terdiagnosis penyakit keganasan, usia 6 bulan sampai 18 tahun di Rumah Sakit Dr. M. Hoesin (RSMH). Uji tuberkulin dilakukan pada semua subjek. Anak dengan hasil uji tuberkulin negatif saat uji tuberkulin pertama, dilakukan uji tuberkulin kedua setelah 2 sampai 4 minggu uji tuberkulin pertama. Hasil positif bila indurasi ≥5 mm.Hasil. Lima puluh pasien anak dengan keganasan ikut dalam penelitian. Tigapuluh dua subjek laki-laki, 18 subjek perempuan. Jenis penyakit keganasan terbanyak adalah leukemia limfoblastik akut 27 (54%). Pada uji tuberkulin pertama didapatkan hasil positif pada 4 subjek dan pada uji tuberkulin kedua didapatkan hasil positif pada 7 subjek. Terdapat perbedaan signifikan (p<0,001) antara indurasi hasil uji tuberkulin pertama dan kedua. Terdapat peningkatan sensitivitas dua kali uji tuberkulin dibandingkan satu kali uji tuberkulin.Kesimpulan. Penggunaan dua kali uji tuberkulin pada anak dengan keganasan lebih sensitif untuk mendeteksi infeksi tuberkulosis dibandingkan satu kali uji tuberkulin.
Evidence-based case report: Coinfection of COVID-19 in children and administration of antibiotics Fifi Sofiah; Marselya Ulfa; Azwar Aruf; Raden Muhammad Indra
Jurnal RSMH Palembang Vol. 1 No. 2 (2020): Jurnal RSMH Palembang
Publisher : RSUP Dr Moh Hoesin Palembang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (805.872 KB) | DOI: 10.37275/jrp.v1i2.8

Abstract

A B S T R A C TBackground. COVID-19 in childrenalthoughmostly mild,but can also cause seriousillness and even death. Coinfection, especially bacterialcan increase the severity of thedisease. There is yet sufficient evidence about the role of antibiotics in childhoodCOVID-19 with coinfection.Objective. To review the available evidence on thecoinfection in childhood COVID-19 and the role of antibiotic administration.Method.Online literature search using Pubmed database, google scholar dan Cohcranelibrary Results.No study was found that directly evaluate the efficacy of antibiotic inchildhood COVID-19 with coinfection. Three meta-analyses found rates of coinfectionof 5.6%-14% and one case series identified a very high rate (94.2%). Most frequentpathogens included Mycoplasma pneumonia, Streptococcus pneumonia,andinfluenza/parainfluenza viruses. Two RCTsandone case series on antibioticadministration, but all three studies did not address coinfection status.All threestudies evaluated the combination of azithromycin and hydroxychloroquine. Nochanges in illness severity or mortality attributed to the medications, one studyindicated more rapid viral load clearance associated with azithromycin. ConclusionThere is a lack of evidence on the role of antibiotics in the management of childhoodCOVID-19with coinfection. Azithromycin can be considered in some cases.
Tingkat Kesesuaian antara Rontgen Toraks dengan Genexpert MTB/RIF pada Kasus Dugaan Tuberkulosis Paru pada Anak Anggraini, Diah; Sofiah, Fifi; Faisal, RM; Bakri, Achirul
Sari Pediatri Vol 26, No 3 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.3.2024.176-82

Abstract

Latar belakang. Diagnosis tuberkulosis (TB) paru pada anak sering kali sulit dilakukan. Sifat pausibasiler dari TB pada anak kerap seringkali menyulitkan konfirmasi bakteriologis. Oleh karena itu, rontgen toraks menjadi modalitas penting ketika didapatkan hasil negatif pada pulasan bakteri. Tujuan. Penelitian ini bertujuan untuk melihat tingkat kesesuaian antara hasil rontgen toraks dan GeneXpert MTB/RIF pada kasus TB paru pada anak.Metode. Penelitian ini merupakan studi potong lintang yang dilakukan dengan menelusuri rekam medis pasien anak dengan dugaan TB paru di Rumah Sakit dr. Mohammad Hoesin Palembang pada tahun 2018-2020. Subjek penelitian dikelompokkan sebagai terdeteksi atau tidak terdeteksi TB berdasarkan hasil GeneXpert MTB/RIF dan sugestif atau non-sugestif TB berdasarkan rontgen toraks. Data kemudian dianalisis menggunakan uji Cohen’s Kappa (k).Hasil. Terdapat 207 kasus dugaan TB paru pada anak dengan sebagian besar subjek berusia 0- <5 tahun (56,0%), dengan usia median 48 bulan (rentang usia 4-209 bulan). Berdasarkan hasil rontgen toraks, 68,5% pasien dinyatakan sugestif TB, sedangkan 31,4% dinyatakan non-sugestif TB. Berdasarkan GeneXpert MTB/RIF, 16,9% pasien terdeteksi TB dan 83,0% tidak terdeteksi TB. Tingkat kesesuaian antara rontgen toraks dan GeneXpert MTB/RIF adalah k= 0,108 (p=0,005).Kesimpulan. Tingkat kesesuaian antara rontgen toraks dan GeneXpert MTB/RIF tergolong rendah. 
Rate of administration of tuberculosis preventive treatment to pediatric household contacts and influencing factors Ridwan, Ivani; Sofiah, Fifi; Rismarini, Rismarini
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/pi65.5.2025.422-30

Abstract

Background Providing tuberculosis preventive treatment (TPT) to household contacts is an important measure for preventing disease transmission. Various child-, parent-, and healthcare-related factors influence TPT provision. Objective To determine the rate of pediatric TPT administration in household contacts of pulmonary TB patients and its influencing factors. Methods An observational analytical study was conducted from May-August 2024 at primary healthcare facilities in Palembang, Indonesia. We included children in household contact with bacteriologically-positive pulmonary TB patients confirmed by molecular rapid diagnostic test  who were registered for treatment in community health centers in Palembang that had a TB treatment program. Results Among 364 household contacts of 114 TB cases, only 3.3% received TPT. The majority of parents or guardians were <35 years of age, were biological parents of the included children, had sub-minimum wage incomes, demonstrated good understanding of TPT, and had completed at least secondary education. The majority of children were female, over 5 years of age, and well-nourished according to parent or caregiver subjective perception. At the participating community health centers, healthcare workers in charge of the TB treatment programs were mostly paramedical staff and had good TPT knowledge, and drug availability was adequate. Children with caregivers aged ≥35 years were 12 times more likely not to receive TPT (aOR=12,093; 95%CI 1,544 to 94,713; P=0.018). Caregiver role in the family, economic status, knowledge level, education, travel distance, child factors, and health facility factors showed no significant association with TPT provision. Conclusion The rate of TPT provision in Palembang is low, far below the national target of 50-90%. Guardian age of ≤35 years was the only factor significantly associated with TPT provision.
Co-Authors Achirul Bakri, Achirul Arismunanto Kurniawan Azwar Aruf Diah Anggraini, Diah Dian Puspita Sari Faisal, RM Marselya Ulfa Raden Muhammad Indra Ridwan, Ivani Rismarini Rismarini, Rismarini Yuwono Yuwono