Hasri Salwan
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Sriwijaya Palembang

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Journal : Paediatrica Indonesiana

Scoring system to distinguish between rotavirus and non-rotavirus diarrhea in children Atika Akbari; Hasri Salwan; Achirul Bakri; Erial Bahar
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (284.103 KB) | DOI: 10.14238/pi56.6.2016.338-42

Abstract

Background Distinguishing rotavirus from non-rotavirus diarrhea is helpful for managing the illness. However, definitively diagnosing rotavirus diarrhea from serology is difficult and expensive.Objectives To distinguish between the clinical manifestations of rotavirus and non-rotavirus diarrhea, and to assess the accuracy of using such clinical manifestations to predict the type of diarrhea in children.Methods A cross-sectional study was performed from April to October 2015 in all children less than five years of age who presented with acute diarrhea at the Pediatric Outpatient Clinic of the Department of Child Health and Emergency Department, Dr. Mohammad Hoesin and Bari Hospitals, Palembang, South Sumatera. Clinical manifestations were collected from history and physical examinations; stool specimens were examined by immunochromatography. Clinical parameters were analyzed by multivariate analysis, and scores given to each significant parameter. The accuracy of the scoring system based in these parameters was analyzed by means of receiver-operating characteristic (ROC) area under the curve (AUC).Results Of 184 children, 92 had rotavirus and 92 had non-rotavirus diarrhea. Multivariate analysis showed 3 clinical parameters commonly seen in the rotavirus diarrhea cases: male sex (OR 2.718; 95%CI 1.373 to 5.382), cough (OR 3.500; 95%CI 1.788 to 6.582), and yellow-greenish stool (OR 4.009; 95%CI 2.061 to 7.797). A scoring system was constructed based on the parameters: male (score of 1), cough (score of 2), and yellow-greenish stool (score of 3). From ROC analysis, the AUC was 0.755. Using a cut-off score of > 3, the sensitivity was 81.5%, specificity 51.1%, and PPV 62.5%.Conclusion Cough, yellow-greenish stool, and male are significant parameters for differentiating rotavirus from non-rotavirus diarrhea. A scoring system from these parameters is sensitive for predicting rotavirus vs. non-rotavirus diarrhea in children less than five years of age.
Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea Hasri Salwan; Isnada Isnada; Achirul Bakri; Rusdi Ismail; Erial Bahar
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (403.767 KB) | DOI: 10.14238/pi47.6.2007.265-9

Abstract

Background Oral rehydration solution (ORS) has been provensuccessfully to overcome dehydration in diarrhea. The improvementof the effectiveness of ORS is still needed to overcome some failures.Gum Arabic (GA), an indigestable starch, can enhance ORSabsorption in mice with diarrhea. It is worthy to explore its benefitsin human. Since GA is non toxic to human being, it is regardedethical to conduct effectiveness study directly in clinical setting.Objective To evaluate the effectiveness of GA supplementationto ORS in managing inpatients diarrheal cases .Methods A double blind clinical trial was conducted during Marchto September 2004 in the Department of Child Health of M. HoesinHospital, Palembang. The subjects were randomly enrolled to GA-ORS (GA) group or ORS (SO) group. Indirect measurements wereconducted on ORS absorptive enhancement by evaluating theduration of diarrhea after hospitalization, frequency of defecationduring hospitalization, ORS consumption during hospitalization,and time laps of stool consistency conversion. The effectivenessanalysis was controlled for confounders.Results Supplementation of 0.5 gram GA to 200 ml ORS could decreasethe duration of diarrhoea 15.65 hours (P=0.000) during hospitalisation,frequency of defecation during hospitalization 1.171 times/days(P=0.002), ORS consumption 38.39 ml/kg BW (P=0.029), time ofstool consistency to become semisolid 15.84 hours (P=0.000), andbecome solid 14.45 hours (P=0.002). Vomiting during hospitalizationand aged group of 6-11 months were significant confounder. However,after controlling the outcome with these confounding factors, thebenefits of GA supplementation were still significant.Conclusions GA supplementation to ORS significantly shortenthe duration of diarrhea, decreases the frequency of defecation,consumption of ORS, time of stool consistency to becomesemisolid and solid in inpatients diarrheal cases.