Wisman Dalimunthe
Department of Child Health, University of Sumatera Utara Medical School/H. Adam Malik Hospital, Medan, North Sumatera

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Mantoux tests of children in household contact with adult acid fast bacilli-positive or -negative pulmonary tuberculosis Wardah Wardah; Ridwan Muktar Daulay; Emil Azlin; Wisman Dalimunthe; Rini Savitri Daulay
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4004.609 KB) | DOI: 10.14238/pi57.6.2017.310-5

Abstract

Background Tuberculosis (TB) is the leading cause of mortality and morbidity in developing countries. In children, the major source of TB transmission is adults with pulmonary TB who have acid fast bacilli (AFB)-positive sputum. However, tuberculosis infection can also occur in children in household contact with adults who have AFB-negative pulmonary TB. Objective To compare Mantoux test results and induration diameters in children with adult pulmonary TB household contact who were either positive or negative for AFB, and to assess for possible associations between Mantoux test results with age, family income, and house ventilation in both groups. Methods A cross-sectional study was conducted from January to March 2014. Mantoux test was performed in children aged 3 months to 18 years who had household contact with either AFB-positive or -negative adult pulmonary TB patients. Results A total of 106 children were enrolled in the study. All subjects had household contact with adult pulmonary TB patients who were either AFB-positive (54 children) or AFB-negative (52 children). Mean Mantoux test induration diameters were significantly different between groups (10.9 (SD 6.55) mm vs. 6.2 (SD 5.91) mm, respectively; P=0.001). In addition, there was significantly higher risk of positive Mantoux test in children in contact with adult AFB-positive TB patients than in the AFB-negative group (OR 5.66; 95%CI 2.36-13.59; P=0.0001). However, there were no significant differences in positive Mantoux test results in each of the AFB-positive and -negative groups, with regards to age, family income, or house ventilation. Conclusion Mean Mantoux test induration diameter in children who had household contact with AFB-positive adults is significantly larger than that of the AFB-negative group. Positive Mantoux test results in children are associated with AFB-positive adult TB in the household. There is no association between positive Mantoux test results and age, family income, or house ventilation in both groups. Â
Decreased peak expiratory flow in pediatric passive smokers Fitri Yanti; Muhammad Ali; Ridwan M. Daulay; Wisman Dalimunthe; Rini Savitri Daulay
Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.4.2011.198-201

Abstract

Background Indonesia ranks fifth among countries with the highest aggregate levels of tobacco consumption in the world. Infants and children exposed to environmental tobacco smoke have increased rates of asthma, respiratory and ear infections, as well as reduced lung function. The effects of tobacco smoke exposure on lung function in children have been reported to be dependent on the source of smoke and the length and dose of exposure. Lung function may also be affected by a child’s gender and asthma status.Objective To compare peak expiratory flow (PEF) in pediatric passive smokers to that of children not exposed to second hand smoke, and to define factors that may affect PEF in passive smokers.Methods In August 2009 we conducted a cross-sectional study at an elementary school in the Langkat district. Subjects were aged 6 to 12 years, and divided into two groups: passive smokers and those not exposed to secondhand smoke. Subjects’ PEFs were measured with a Mini-Wright peak flow meter. Measurements were performed in triplicate with the highest value recorded as the PEF. Demographic data including age, sex, weight, height, family income, parental education levels and occupations were obtained through questionnaires.Results Of the 170 participants, 100 were passive smokers and 70 were not exposed to secondhand smoke. Age distribution, weight and height were similar in both groups. We observed a significant difference in PEFs between the group of passive smokers and the group not exposed to secondhand smoke, 211.3 L/minute (SD 61.08) and 242.7 L/minute (SD 77.09), respectively (P < 0.005). The number of years of exposure to smoke (P = 0.079) and the number of cigarettes smoked daily in the household (P = 0.098) did not significantly influence PEF.Conclusion The PEF in pediatric passive smokers was significantly lower than that of children not exposed to secondhand smoke. PEF in passive smokers was not influenced by the number of years of smoke exposure or the number of cigarettes smoked daily in the household.
Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact Nora Hajarsjah; Ridwan M. Daulay; Oke Rina Ramayani; Wisman Dalimunthe; Rini Savitri Daulay; Fathia Meirina
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.689 KB) | DOI: 10.14238/pi58.2.2018.66-70

Abstract

Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients.Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%)] or the control group [TB score <6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.