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Anti-hepatitis B surface (anti-HBs) seroprotection in children with acute lymphoblastic leukemia post hepatitis B vaccination in Indonesia Roni Naning, Yustinah Nenny Sri Mulyani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Universitas Gadjah Mada

Children with acute lymphoblastic leukemia (ALL) receiving chemotherapy are at high risk fordeveloping hepatitis B infection. Protective effect of hepatitis B vaccination in children withALL in Indonesia has not been investigated yet. The aim of study was to determine the proportiondifference of anti-HBs seroprotection between children with ALL and without malignancy posthepatitis B vaccination. We had conducted a case-control study from January to February 2012at Dr. Sardjito General Hospital, Yogyakarta. We ascertained 1-15 years old children with ALLreceiving chemotherapy and without malignancy who had hepatitis B vaccination. Sixty sevenchildren were included in this study. Anti-HBs seroprotection level was measured using anenzyme-linked immunosorbent assay (ELISA). The results were analyzed using Chi-square test.Twenty one children (65.6%) with ALL and 13 children (37.1%) without malignancy showedanti-HBs seroprotection. The difference was statistically significant with p-value of 0.020(prevalence ratio [PR]=0.3; 95% CI=0.11-0.84). Both groups showed no significantly differenceof anti-HBs seroprotection according to either female gender, risk classification, or phase ofchemotherapy with p-value of 0.38 (PR =4; 95% CI=1.05-15.2), 0.248 (PR =3.37; 95%CI=0.58-19.6) or 0.214, respectively. In conclusion, the proportion of anti-HBs seroprotectionin children with ALL is higher than those without malignancy.

Molecular Genotyping of HBV by using Nested PCR-RFLP among Hepatitis B Patients in Daerah Istimewa Yogyakarta Province and Surrounding Area Haryanto, Aris; Mulyani, Nenny Sri; Widowati, Titis; Wijayanti, Nastiti; Hadi, Purnomo
Indonesian Journal of Biotechnology Vol 13, No 2 (2008)
Publisher : Universitas Gadjah Mada

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Hepatitis B virus (HBV) can be classified into 8 genotypes, genotype A to H. Genotype of HBV is important for clinical and etiological investigations. Research for HBV genotyping, HBV transmission study using nested PCR and HBV genotyping based on RFLP using restriction enzymes have been reported. However, both of those methods have been not applied for HBV genotyping study among hepatitis B patients in endemic area, like Indonesia yet. Molecular genotyping of HBV will describe epidemiology, pathogenesis and clinical implication of HBV. Combination of nested PCR and RFLP (nested PCR-RFLP) method to determine HBV genotype in Indonesia is still less information. The objectives of study were to develop a system for HBV genotyping by nested PCR combined with RFLP (nested PCR-RFLP) method based on nucleotide sequence of surface protein encoding</div><div>gene (S gene) in HBV genome and to confirm HBV genotypes which predominantly found among hepatitis B patients in Daerah Istimewa Yogyakarta Province and surrounding area. Total of 149 sera from chronic hepatitis B patients from Daerah Istimewa Yogyakarta and surrounding areas were collected for in this work. Viral DNA were extracted from sera of hepatitis B patients and used as template for first round nested PCR amplification using outer primers set. Amplicons of first round PCR were used as template for second round amplification using inner primers set. Then, amplicons of second round nested PCR were restriction digested by Sty I and Bsr I enzymes. For HBV genotyping then the restriction products were analyzed by RFLP based on restriction pattern. Results showed that the first round nested PCR amplification generated DNA fragments of whole S gene in length 1.233 bp, and in second round nested PCR amplification using inner primer set generated DNA fragments 585 bp in length. Genotype analysis for all samples using nested PCR-RFLP methods by restriction digested of Sty I and Bsr I enzymes found only 2 HBV genotypes among hepatitis B patients, namely genotype B and C. Quantification</div><div>data showed that most of hepatitis B patients found infected by HBV genotype B (92,8%), genotype C (3,6%) and unidentified genotype (3,6%). Nested PCR-RFLP methods for HBV genotyping is simple and inexpensive for clinical diagnostic in large scale.

The effect of fructooligosaccharide (FOS) in Children With Diarrhea Yati Soenarto, Mohammad Juffrie Yunri Istari, Nenny Sri Mulyani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 01 (2007)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (540.182 KB)

Latar belakang: Penyakit diare masih merupakan penyebab penting kesakitan dan kematian bayi dan anak di negara berkembang. Penyakit diare ini disebabkan oleh ketidakseimbangan flora usus yang dipengaruhi oleh jumlah bakteria yang menguntungkan . FOS dapat menstimulasi pertumbuhan bakteri yang menguntungkna dan menghambat bakteri pastogen yang menyebabkan infeksi saluran cernaÂ Tujuan: Mengetahui efekFructooligosaccharide pada diareBahan dan cara: penelitina kendali acak dilakukan di 8 puskesmas di Yogyakarta. Seratus delapan belas sampel ikut dalam penelitian ini, 93 masuk dalam kelompok FOS yang mendapat FOS 2,5 gram atau 5 gram per hari sesuai umur, dan 25 masuk dalam kelompok plasebo. Lamanya diare dan keasaman tinja diukur selama penelitianHasil: Lama diare lebih pendek secara bermakna pada kelompok FOS dibanding plasebo p

Molecular Genotyping of HBV by using Nested PCR-RFLP among Hepatitis B Patients in Daerah Istimewa Yogyakarta Province and Surrounding Area Aris Haryanto; Nenny Sri Mulyani; Titis Widowati; Nastiti Wijayanti; Purnomo Hadi
Indonesian Journal of Biotechnology Vol 13, No 2 (2008)
Publisher : Universitas Gadjah Mada

Hepatitis B virus (HBV) can be classified into 8 genotypes, genotype A to H. Genotype of HBV is important for clinical and etiological investigations. Research for HBV genotyping, HBV transmission study using nested PCR and HBV genotyping based on RFLP using restriction enzymes have been reported. However, both of those methods have been not applied for HBV genotyping study among hepatitis B patients in endemic area, like Indonesia yet. Molecular genotyping of HBV will describe epidemiology, pathogenesis and clinical implication of HBV. Combination of nested PCR and RFLP (nested PCR-RFLP) method to determine HBV genotype in Indonesia is still less information. The objectives of study were to develop a system for HBV genotyping by nested PCR combined with RFLP (nested PCR-RFLP) method based on nucleotide sequence of surface protein encoding</div><div>gene (S gene) in HBV genome and to confirm HBV genotypes which predominantly found among hepatitis B patients in Daerah Istimewa Yogyakarta Province and surrounding area. Total of 149 sera from chronic hepatitis B patients from Daerah Istimewa Yogyakarta and surrounding areas were collected for in this work. Viral DNA were extracted from sera of hepatitis B patients and used as template for first round nested PCR amplification using outer primers set. Amplicons of first round PCR were used as template for second round amplification using inner primers set. Then, amplicons of second round nested PCR were restriction digested by Sty I and Bsr I enzymes. For HBV genotyping then the restriction products were analyzed by RFLP based on restriction pattern. Results showed that the first round nested PCR amplification generated DNA fragments of whole S gene in length 1.233 bp, and in second round nested PCR amplification using inner primer set generated DNA fragments 585 bp in length. Genotype analysis for all samples using nested PCR-RFLP methods by restriction digested of Sty I and Bsr I enzymes found only 2 HBV genotypes among hepatitis B patients, namely genotype B and C. Quantification</div><div>data showed that most of hepatitis B patients found infected by HBV genotype B (92,8%), genotype C (3,6%) and unidentified genotype (3,6%). Nested PCR-RFLP methods for HBV genotyping is simple and inexpensive for clinical diagnostic in large scale.

Immune Response against Hepatitis B Virus after Vaccination among Low Birth Weight and Preterm Newborns: A Retrospective Cohort Study in Magelang District Central Java Muhardison Muhardison; Hari Kusnanto; Nenny Sri Mulyani
Tropical Medicine Journal Vol 3, No 2 (2013): Tropical Medicine Journal
Publisher : Pusat Kedokteran Tropis

ABSTRACTIntroduction: Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality in the world. Over 2 billion people are infected with HBV and 378 million are carriers. The mortality rate is approximately 1-2 million and over 4 millions acute clinical cases are documented each year. The prevalence of HBV infection in Indonesia is 3-20%. Vertical and horizontal transmission in newborn and children occurs in 25-45%. Near 25-50% of children are infected before 5 years. The most effective approach to reduce the burden of HBV infection is mass vaccination of newborns and children.Objectives: To determine immune response against HBV after HBV vaccine among low birth weight (LBW) and preterm newborns after HBV vaccination, and factors related to the immune response i.e. gender and weight gain in the first 6 months of life.Methods: During May-July 2012, 106 infants aged 13-15 months were recruited after HBV vaccination. They were completed 4 doses of HBV basic vaccination in 0, 2, 3, and 4 months of life. Sera were examined for anti-HBs antibody titers using ELISA.Results: A total of 98 subjects (92.5%) completed the study. Immune response of LBW subjects were positive in 89.7%, newborns were 95.9%. The Relative Risk (RR) were 2.5 CI (0.50 to 12.2) p=0.2178. Gender was not related to immune response RR 0.6 CI (0.15 to 2.69) p=0.6996. Gestational age associated with immune response RR 8 CI (1.05 to 63.9) p=0.0399. The first 6 months weight was not related to immune response RR 3.6 CI (0.73 to 17.7) p=0.1178. Logistic regression analysis showed LBW was not correlated with the immune response OR 1 CI (0.16 to 7.17) p=0.929. Gestational age correlated with immune response OR 9 CI (1.05 to 79.3) p=0.044 and the first 6 months of weight was not correlated with immune response OR 3.7 CI (0.65 to 21.1) p=0.138.Conclusion: Immune response against HBV after vaccination was similar between LBW and NBW. Immune response was correlated with gestational age.Keywords: Hepatitis B vaccine, immune response, LBW and preterm.

The effect of fructooligosaccharide (FOS) in Children With Diarrhea Mohammad Juffrie Yunri Istari, Nenny Sri Mulyani Yati Soenarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 39, No 01 (2007)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (540.182 KB)

Latar belakang: Penyakit diare masih merupakan penyebab penting kesakitan dan kematian bayi dan anak di negara berkembang. Penyakit diare ini disebabkan oleh ketidakseimbangan flora usus yang dipengaruhi oleh jumlah bakteria yang menguntungkan . FOS dapat menstimulasi pertumbuhan bakteri yang menguntungkna dan menghambat bakteri pastogen yang menyebabkan infeksi saluran cerna Tujuan: Mengetahui efekFructooligosaccharide pada diareBahan dan cara: penelitina kendali acak dilakukan di 8 puskesmas di Yogyakarta. Seratus delapan belas sampel ikut dalam penelitian ini, 93 masuk dalam kelompok FOS yang mendapat FOS 2,5 gram atau 5 gram per hari sesuai umur, dan 25 masuk dalam kelompok plasebo. Lamanya diare dan keasaman tinja diukur selama penelitianHasil: Lama diare lebih pendek secara bermakna pada kelompok FOS dibanding plasebo p

Anti-hepatitis B surface (anti-HBs) seroprotection in children with acute lymphoblastic leukemia post hepatitis B vaccination in Indonesia . Yustinah; Nenny Sri Mulyani; Roni Naning
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 01 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Children with acute lymphoblastic leukemia (ALL) receiving chemotherapy are at high risk fordeveloping hepatitis B infection. Protective effect of hepatitis B vaccination in children withALL in Indonesia has not been investigated yet. The aim of study was to determine the proportiondifference of anti-HBs seroprotection between children with ALL and without malignancy posthepatitis B vaccination. We had conducted a case-control study from January to February 2012at Dr. Sardjito General Hospital, Yogyakarta. We ascertained 1-15 years old children with ALLreceiving chemotherapy and without malignancy who had hepatitis B vaccination. Sixty sevenchildren were included in this study. Anti-HBs seroprotection level was measured using anenzyme-linked immunosorbent assay (ELISA). The results were analyzed using Chi-square test.Twenty one children (65.6%) with ALL and 13 children (37.1%) without malignancy showedanti-HBs seroprotection. The difference was statistically significant with p-value of 0.020(prevalence ratio [PR]=0.3; 95% CI=0.11-0.84). Both groups showed no significantly differenceof anti-HBs seroprotection according to either female gender, risk classification, or phase ofchemotherapy with p-value of 0.38 (PR =4; 95% CI=1.05-15.2), 0.248 (PR =3.37; 95%CI=0.58-19.6) or 0.214, respectively. In conclusion, the proportion of anti-HBs seroprotectionin children with ALL is higher than those without malignancy.

Virus transfusion transmitted pada anak dengan transfusi berulang Nenny Sri Mulyani; . Sumadiono; Hijikata M; Mishiro S; . Mulyanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 38, No 04 (2006)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Trends of Rotavirus Diarrhea in Hospitalized Children in Yogyakarta Year 2013 –2015 Nenny Sri Mulyani; Dian Anggraini; Retno Palupi Baroto; Asal Wahyuni Erlin Mulyadi; Rizki Anindita; Yati Soenarto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Diarrhea, together with pneumonia, is accountable for 25% death of children under five globally (IVAC, 2017). In Indonesia, diarrhea is also among the top ten diseases of cause of death in children under five (WHO, 2015). Rotavirus diarrhea is responsible for 60% in 2006 (Soenarto et al, 2009) of children diarrhea in Indonesia. Rotavirus vaccine in Indonesia was introduced commercially in 2011, nonetheless its use was reportedly low. Despite the declining rate of rotavirus incidence, surveillance is important to show the burden of rotavirus diarrhea in children. Thus, this study aims to describe the incidence of rotavirus diarrhea in hospitalized children under five in Yogyakarta province. This was a prospective study, conducted in two participating hospitals in Yogyakarta: RSUP Sardjito Yogyakarta and RSUD Wates from January 2013 – December 2015. This study is a part of the Indonesia surveilance entitled “Hospital-based surveillance of rotavirus diarrhea in children in Indonesia”, enrolling children under five hospitalized due to acute watery diarrhea. The questionare was modified from the WHO generic protocol of rotavirus surveillance (WHO, 2002). Data collection was perfomed after informed consent was signed by parent or guardian. The stool samples were tested for rotavirus with the EIA test and tested for genotyping with RT-PCR. The data were analysed and presented using descriptive analytic method. Of 684 eligible patients hospitalized with acute watery diarrhea, 557 subjects were enrolled with 518 feces were tested for rotavirus. The percentage of rotavirus incidence in year 2013, 2014, and 2015 were 37%, 41% and 61 % respectively. The predominant rotavirus genotyping was G3P [8]. Rotavirus mostly found in children age 6 – 23 months (55 %), and was identified more in male than female (62 % vs 38%). During the 3 years study period, rotavirus occurred all year round, and showed to reach its peak on January 2015. Rotavirus positive diarrhea commonly presented with dehydration (79%) compare to negative rotavirus diarrhea (55%). It indicated that the incidence rate of rotavirus diarrhea in Yogyakarta is quite high and rotavirus diarrhea remains as significant contributor to hospitalized children with diarrhea. The trend of rotavirus diarrhea in children under 5 years increased over the years’ period. The rotavirus diarrhea mostly presented with dehydration, thus rotavirus diarrhea remains as significant contributor to hospitalized children with diarrhea. This shows an evidence that the burden of rotavirus diarrhea in children under 5 years remains prominent.

Korelasi Pengetahuan, Sikap dan Persepsi Bidan Terhadap Perilaku Pemberian Vaksin Hepatitis B Saat Lahir Lucia Nauli Simbolon; Nenny Sri Mulyani; Supriyati Supriyati
Sari Pediatri Vol 18, No 2 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Vaksinasi hepatitis B pada bayi baru lahir merupakan upaya paling efektif untuk menurunkan prevalensi virus hepatitisÂ B. Cakupan hepatitis dosis pertama yang rendah dipengaruhi oleh pengetahuan bidan saat menolong persalinan. KecenderunganÂ seseorang berperilaku sehat dipengaruhi oleh tingkat pengetahuan, sikap, dan persepsinya.Tujuan. Mengetahui apakah ada korelasi pengetahuan, sikap, dan persepsi bidan terhadap perilaku pemberian vaksin hepatitis B nolÂ hari di YogyakartaMetode. Penelitian dengan rancang bangun cross-sectional. Bidan penolong persalinan dari semua wilayah di Propinsi DI YogyakartaÂ diberikan kuisoner penelitian kemudian dilakukan analisis dengan korelasi Spearman untuk mengetahui korelasi antara pengetahuan,Â sikap, dan persepsi bidan terhadap perilaku pemberian vaksin hepatitis B nol hari.Hasil. Didapatkan 100 bidan menjadi responden penelitian yang diadakan sejak Maret sampai Mei 2013, 62 bidan di antaranyaÂ memberikan vaksin hepatitis B saat lahir. Terdapat 65 bidan yang memiliki pengetahuan baik, 52 bersikap positif, dan 55 memilikiÂ persepsi positif terhadap pemberian vaksin hepatitis B nol hari. Tidak ada korelasi antara pengetahuan bidan dengan pemberian vaksin(p=0,530), sikap bidan dengan pemberian vaksin (p=0,843), persepsi bidan dengan pemberian vaksin (p=0,585).Kesimpulan. Tidak ada korelasi pengetahuan, sikap, dan persepsi bidan terhadap perilaku pemberian vaksin hepatitis B nol hari.

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