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All Journal Sari Pediatri Paediatrica Indonesiana Jurnal Respirologi Indonesia Archives of Pediatric Gastroenterology, Hepatology, and Nutrition

Nastiti Kaswandani

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia/Rumah Sakit Cipto Mangunkusumo, Jakarta

Author-ID : 3212895

Health Professions Medicine & Pharmacology

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Adverse events following immunization (AEFI) reports of extended program immunization (EPI) in Indonesia during 1998-2002 Nastiti Kaswandani; Sri Rezeki Hadinegoro; Rulina Suradi
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background The incidence of adverse events following immuni-zation (AEFI) increased in correlation with the number of vaccinedoses. Meanwhile AEFI reports should be managed properly tomaintain the compliance and immunization coverage.Objectives The aims of this study were to investigate the inci-dence and profile of AEFI, its onset, severity, classification, andoutcome.Methods This study was a passive surveillance of AEFI reportsreceived by the National Committee on AEFI, Ministry of Health ofIndonesia, during 1998 to 2002.Results Two hundreds and four AEFI cases were reported; 4 casesas zero reports, 182 cases as individual reports, and 18 clusterreports. The AEFI incidence was 0.44 per 1 million doses of vac-cines. Vaccine reaction rate was 1 per 2.3 million vaccine doses.The most common vaccines reported as the causes of AEFI wereDTP, Polio, and TT. Among 182 reported cases, local or mild AEFIreactions were observed in 45, moderate in 49, and severe in 88.Based on WHO field classification, this study reported that 84 casesbelonged to coincidence, 72 to vaccine reactions, 13 to program-matic errors, 7 to injection reactions, and 6 to unclassified reac-tions. Forty-seven patients died, 12 had some sequelae, and 123completely recovered. Meanwhile, among the death cases, 70%occurred coincidently, 17% due to vaccine reactions, and 6 wereunclassified.Conclusions The incidence of AEFI in the extended program im-munization (EPI) in Indonesia during the period of 1998-2002 were182 cases, thus vaccine reaction rate was 1 per 2.3 million vac-cine doses. The most common vaccine which caused AEFI wasDTP. Most AEFI with severe symptoms happened in 4-24 hoursafter immunization.

Clinical manifestations and prognosis of tuberculous spondylitis in an adolescent with disseminated tuberculosis: a case report Handryastuti, Setyo; Kaswandani, Nastiti; Hendriarto, Andra; Tobing, Singkat Dohar Apul Lumban; -, Pebriansyah; Rafli, Achmad
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.176-83

Indonesia is one of the countries with the highest number of tuberculosis (TB) cases globally. Around 10-20% of adolescents with TB infection progress to pulmonary TB, and less than 0.5% develop miliary or central nervous system TB. TB spondylitis occurs in only 5.6% of extrapulmonary TB patients. The clinical manifestations of disseminated and TB spondylitis are heterogeneous and insidious, with several potential risk- and prognostic factors. We report the case of a 16-year-old male admitted with abdominal distension, paraplegia, and urinary retention. He was diagnosed with disseminated TB with TB spondylitis. This case was unique because the patient had no classic symptoms of pulmonary TB. This report focuses on the diagnosis, comprehensive management, and prognosis of TB spondylitis, as well as the risk factors for disseminated TB. The management consisted of antituberculous agents and surgery. The prognosis is influenced by the patient’s age, severity of kyphosis deformity, number of vertebrae involved, lesion site, and patient’s health status, including nutritional status.

Therapeutic reassessment of first-line antiepileptic drugs in pediatric patients unresponsive to second-line agents: a randomized trial in Jakarta Perdani, Roro Rukmi Windi; Arozal, Wawaimuli; Mangunatmadja, Irawan; Kaswandani, Nastiti; Handryastuti, Setyo; Medise, Bernie Endyarni; Wardani, Amanda Saphira; Thandavarayan, Rajarajan Amirthalingam; Oswari, Hanifah; Lee, Hee Jae
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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

Background Epilepsy has a significant incidence in children, with 20-25% resistance to standard antiepileptic drugs (AEDs). Drug-resistant epilepsy (DRE) refers as the failure of two or more AEDs, either as monotherapies or in combination, to achieve seizure freedom, which includes the absence of all seizure types, even auras. Treatment algorithms for children with epilepsy range from starting with the lowest effective dose to using add-on or substitution therapy of AEDs. It usually started from using first-line AEDs (valproic acid, phenytoin, phenobarbital, carbamazepine) with titrated dose based on the patient condition, if seizure persist, another first-line AEDs may be added or substituted. Second-line AEDs (topiramate, levetiracetam, oxcarbazepine) are introduced when seizure persist despite optimal doses of first-line drugs with good compliance. Epilepsy treatment response is a dynamic process, not a fixed state. In some cases, repeating the medication cycle remains an option, as patient may initially appear drug-resistant but later respond to treatment. Thus, first-line AEDs may also serve as substitution therapy in children unresponsive to second-line agents as studies show comparable effectiveness between the two regimens. Objective To evaluate the efficacy and safety of first-line AEDs as substitution therapy (intentional replacement of patient’s current medication) in children resistant to second-line AEDs. Methods This 12-week, open-label, multicenter, randomized controlled trial was conducted in 91 epileptic children. Children aged 1 – 18 years with DRE, were randomized into the intervention (patients who received substitution therapy: one AEDs was changed to first-line of AEDs) and control (patients who got standard therapy: one AEDs was changed to second-line of AEDs) groups. The primary outcome was the difference in the proportion of responders between the two groups. Secondary outcomes were analyzing the different improvements in quality of life (QoL), EEG feature, and time to achieve seizure reduction in both groups. The QoL was assessed by Quality of Life in Childhood Epilepsy Questionnaire 55 (QOLCE-55) to assess cognitive, emotional, social, and physical functions. Results There were no significant differences in the proportion of responders between the substitution therapy group (62.5%) and the standard therapy group (68.4%). Both groups experienced substantial reductions in seizure frequency, ranging from 78% to 80%. For further analysis, the average difference of seizure frequency before and after intervention was statistically significant in each group, it was P=0.000 in substitution group and P=0.00 in standard group. The analysis of quality of life showed the mean of total score in both groups was low even though the score was higher in the substitution group. For spesific function of quality of life, the cognitive and social function, was improved significantly in the group p<0.05). However, there were no significant differences of EEG improvement, seizure duration, time to achieve seizure frequency reduction, or adverse effects between the two groups. Conclusions First-line AEDs have comparable efficacy as second-line AEDs with mild to moderate adverse effects in DRE children. Thus, the repeated use of first-line AEDs as substitution therapy might be an option for children who resistant to second line AEDS.

Co-Authors -, Pebriansyah Aman Bhakti Pulungan Amelia, Safira Angela Kimberly Tjahjadi Ari Prayitno Ari Prayitno, Ari Arwin AP Akib Ayuningtyas, Talitha Rahma Bambang Supriyatno Bambang Tridjadja Bernie Endyarni Medise Cissy B Kartasasmita Cissy B. Kartasasmita Cynthia Utami Damayanti Rusli Sjarif Darmawan B Setyanto Darmawan B Setyanto Darmawan B. Setyanto Dhyniek Nurul FLA Dominicus Husada Dwi Prasetyo Dwi Prasetyo Dwi Putro Widodo Finny Fitry Yani Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Gufron Nugroho Hanifah Oswari Hanifah Oswari Hartono Gunardi Hartono Gunardi Hartono Gunardi Hendriarto, Andra Irawan Mangunatmadja Irawan Mangunatmadja Ismoedijanto Jasin, Madeleine Ramdhani Jose RL Batubara Karina Sugih Arto Kusnandi Rusmil Kusnandi Rusmil Lee, Hee Jae Maddepunggeng, Martira Mardjanis Said Martira Maddepunggeng Mei Neni Sitaremi Mei Neni Sitaresmi Murti Andriastuti, Murti Nastiti Noenoeng Rahajoe Nia Kurniati Nurul Iman Nilam Sari Rafli, Achmad Raihan Raihan Raihan Raihan, Raihan Roro Rukmi Windi Perdani, Roro Rukmi Rulina Suradi Setyo Handryastuti Soedjatmiko Soedjatmiko Soedjatmiko Sri Rejeki H Hadinegoro. Sri Rezeki Hadinegoro Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sukman Tulus Putra Talitha Rahma Ayuningtyas Thandavarayan, Rajarajan Amirthalingam Tobing, Singkat Dohar Apul Lumban Wahyuni Indawati Wahyuni Indawati Wahyuni Indawati, Wahyuni Wardani, Amanda Saphira Wawaimuli Arozal Widodo Tirto Zakiudin Munasir Zakiudin Munasir

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Journal : Paediatrica Indonesiana