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Munasir, Zakiudin
Departemen Ilmu Kesehatan Anak Universitas Indonesia, Jakarta
Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Nilai Diagnostik Neutrophil Gelatinase-Associated Lipocalin Urin, Kelainan Urinalisis, dan Kombinasi Keduanya pada Infeksi Saluran Kemih Anak Usia 2–5 Tahun Estetika, Citra; Pardede, Sudung O.; Munasir, Zakiudin; Supriyatno, Bambang; Prawitasari, Titis; Yanuarso, Piprim Basarah
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/sp26.3.2024.137-45

Abstract

Latar belakang. Infeksi saluran kemih (ISK) pada anak memiliki manifestasi klinis yang tidak khas sehingga sulit untuk diagnosis dini. Biakan urin memerlukan waktu hingga lima hari sehingga dapat menyebabkan keterlambatan terapi serta tingginya komplikasi ISK. Kelainan urinalisis yang saat ini digunakan masih memiliki spesifisitas yang rendah. Tujuan. Mengetahui nilai diagnostik Neutrophil gelatinase-associated lipocalin (NGAL) urin, kelainan urinalisis, dan kombinasi keduanya untuk mendiagnosis dini ISK pada anak usia 2-5 tahun.Metode. Uji diagnostik menggunakan biakan urin sebagai baku emas dengan desain potong lintang pada anak berusia 2-5 tahun dengan tersangka ISK dan dirawat di Rumah Sakit Dr. Cipto Mangunkusumo.Hasil. Pemeriksaan NGAL urin diketahui memiliki sensitivitas 85,7% (IK95%: 63,6-96,9%), spesifisitas 74,3% (IK95%: 57,8-86,9%), positive predictive value 64,3% (IK95%: 50,6–75,9%), dan negative predictive value 90,6% (IK95%: 76,9-96,5%) pada anak dengan minimal satu kelainan urinalisis. Pemeriksaan NGAL urin hanya meningkatkan spesifisitas kelainan urinalisis berupa leukosituria saja dan tidak meningkatkan spesifisitas pada yang telah memiliki tiga kelainan urinalisis. Kesimpulan. Neutrophil gelatinase-associated lipocalin urin tidak dianjurkan untuk meningkatkan spesifisitas urinalisis dalam diagnosis ISK pada anak usia 2–5 tahun. Gabungan tiga kelainan urinalisis tanpa NGAL urin sudah memiliki spesifisitas yang baik. Perlu dilakukan penelitian biomarker lain untuk mendiagnosis dini ISK dengan lebih baik.
Jadwal Imunisasi Anak Usia 0-18 Tahun Rekomendasi Ikatan Dokter Anak Indonesia Tahun 2024 Kaswandani, Nastiti; Gunardi, Hartono; Prayitno, Ari; Kartasasmita, Cissy B.; Prasetyo, Dwi; Husada, Dominicus; Sarosa, Gatot Irawan; Oswari, Hanifah; Ismoedijanto, Ismoedijanto; Rusmil, Kusnandi; Maddepunggeng, Martira; Sitaresmi, Mei Neni; Raihan, Raihan; Handryastuti, Setyo; Soedjatmiko, Soedjatmiko; Hadinegoro, Sri Rezeki S.; Munasir, Zakiudin
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.328-36

Abstract

Satuan Tugas Imunisasi Ikatan Dokter Anak Indonesia secara periodik melakukan kaji ulang jadwal imunisasi dengan menyelaraskan dengan buku pedoman imunisasi di Indonesia edisi ke 7 tahun 2024, dan sumber-sumber lainnya. Jadwal imunisasi selalu dievaluasi ulang karena beredarnya vaksin baru yang telah disetujui oleh BPOM dan vaksin yang tidak tersedia lagi di Indonesia. Terdapat beberapa perubahan dalam jadwal imunisasi rekomendasi IDAI tahun 2024 yaitu ketersediaan jenis vaksin, seperti pada pneumococcal conjugate vaccine (PCV), vaksin rotavirus, vaksin varisela, vaksin dengue, dan vaksin human papillomavirus (HPV). Agar dalam pelaksanaan lebih mudah, disertakan juga tabel jadwal imunisasi tahun 2024 di akhir.
Application of The JMF 10 Warning Signs for Early Detection of Primary Immunodeficiency among Children with Recurrent Infections in Indonesia Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Wati, Ketut Dewi Kumara
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.318

Abstract

Introduction: Limited awareness and diagnostic resources contribute to delayed recognition of primary immunodeficiency (PID). The Jeffrey Modell Foundation (JMF) 10 warning signs have been widely used for screening. However, their diagnostic performance has not been validated in Indonesia. Objective: To evaluate the diagnostic performance of the JMF 10 warning signs for early detection of PID among children with recurrent infections in Indonesia. Methods: This multicentre cross-sectional study was conducted across 10 hospitals in Jakarta involving 254 children aged 0–18 years who met the severe, persistent, unusual, and recurrent (SPUR) infection criteria. The diagnosis of PID was established based on clinical diagnosis by the European Society for Immunodeficiencies (ESID) Registry Working Definitions. Analysis was performed to determine the sensitivity, specificity, predictive values, and accuracy of the JMF 10 warning signs. Results: Diagnostic performance for PID improved with the number of warning signs, with overall accuracy increasing from 15% (1 sign) to 86.2% (≥5 signs). A total score of ≥3 signs was associated with higher occurrence of PID (PR 2.63; 95% CI 1.23–5.60; p = 0.008), providing an optimal balance of 75.7% sensitivity and 48.9% specificity. The two most specific indicators were recurrent severe sinus infections (99.5%) and ear infections (95%). All PID subjects required IV antibiotics. Conclusion: The JMF warning signs remain a valuable clinical screening tool for early detection of PID among Indonesian children. A threshold of three or more warning signs provides reasonable accuracy for screening and referral of PID in resource-limited settings.
Identifying primary immunodeficiency through the evaluation of severe, persistent, unusual, and recurrent infections in Indonesian children Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Kumara Wati, Ketut Dewi
Paediatrica Indonesiana Vol. 66 No. 2 (2026): March 2026
Publisher : Indonesian Pediatric Society

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

Abstract

Background Primary immunodeficiency (PID) is widely underdiagnosed in countries with high rates of infection and limited diagnostic facilities, such as Indonesia. It remains challenging to distinguish PID from other conditions predisposing children to severe, persistent, unusual, and recurrent (SPUR) infection. Such conditions include secondary immunodeficiency caused by human immunodeficiency virus (HIV) infection, allergic diseases, and chronic diseases with structural or anatomical abnormalities. Objective To evaluate children with SPUR infections for PID and to compare the clinical characteristics of children with PID to those with other underlying conditions. Methods We conducted a cross-sectional, analytic study of children aged 0-18 years presenting with SPUR infections at 10 hospitals in Jakarta, Indonesia, from July 2024 to September 2025. Clinical assessment and laboratory investigations, including immunological tests, were performed to identify the underlying cause of SPUR infections. Children were classified as healthy, PID, secondary immunodeficiency (HIV), allergy, or chronic disease/anatomical abnormalities. Results Two hundred fifty-four subjects (53% male) with a median age of 26 months were included in our study. Most of them had a history of pneumonia (72.1%), diarrhea (31.1%), and pulmonary tuberculosis (27.9%). Thirty-three (13%) subjects were diagnosed with PID, with the majority being male (60.6%). The most common PID found was antibody deficiency (27.3%), followed by immunodeficiencies combined with associated or syndromic features (24.2%), and immunodeficiencies affecting cellular and humoral immunity (21.2%). Median age of onset in the PID group was 12 (3–24) months. Severe malnutrition was most common in children with HIV. Gender, parental consanguinity, and adverse events following live vaccines did not differ significantly across groups. Conclusion The prevalence of PID among children with SPUR infection in this study was 13%, with the most common classification being antibody deficiency.
Soy Isolate Protein Formula: the usage beyond allergy indication Zakiudin Munasir; Rini Sekartini
World Nutrition Journal Vol. 4 No. S1 (2020): Special Issue : Soy Plant-based and Fiber in Children’s Gut Health, Growth & D
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V04.S1.0005

Abstract

The usage of soy isolate protein formula for infants was recommended by Indonesian Pediatrics Association (IDAI) through the recommendation of Cow’s Milk Protein Allergy (CMPA) management in 2014. Soy Infant Formula (SIF) has been being used for Infants with Cow’s Milk Protein Allergy (CMPA) as well as for several other related medical indications such as post diarrhea lactose intolerance, galactosemia and primary lactase deficiency1. At early stage of soy formula, it had several deficiencies, infant acceptability, growth, and incomparable with milk-base formula. Current SIF is made from soy protein isolate that contain 2,2 – 2,6 g of protein per 100 calories, it is higher than milk-based formula and both showed same growth and development in Infants2. It contains different fibers, phytate, digestibility, protease inhibitor and proteins. SIF is easily digestible and contain high amino acid content fortified with L-methionine, L-carnitine and taurine. High content of phytate is overcome with zinc and iron fortification as well as increased levels of calcium and phosphor3. American Academy of Pediatrics recommends isolated soy protein-based formulas as a safe and effective alternative for providing appropriate nutrition for normal growth and development for term infants whose nutritional needs are not being met from maternal breast milk or cow’s milk-based formulas3,4.
Co-Authors Abdul Latief Abhijeet J Bhanegaonkar Afifa Fahriyani Agus Firmansyah Agus Firmansyah Ahmad Suryawan Alam , Anggraini Alan R Tumbelaka Alan R. Tumbelaka Alan Roland Tumbelaka Aman B Pulungan Amy Diana Ruth Anang Endaryanto Anggraini Alam Anggraini Alam, Anggraini Anita Halim Antonius H. Pudjiadi Ari Prayitno Ari Prayitno, Ari Arini Setiawati Arwin A.P. Akib Arwin A.P. Akib Arwin Akib Arwin AP Akib Arwin AP Akib Arwin AP Akib Aryono Hendarto Astrid W Sulistomo Ayijati Khairina Badriul Hegar Badriul Hegar Bambang Supriyatno Bambang Tridjaja AAP, Bambang Tridjaja Batubara, Jose Bernie Endyarni Medise Bertha Soegiarto Brastho Bramantyo Budi Setiabudiawan Budiman Bela Caroline Mulawi Cissy B Kartasasmita Cissy B. Kartasasmita Citra Estetika Corry S Matondang Corry S. Matondang Darus, Febriansyah Dewi Kartika Suryani Dewi Wulandari Diana Aulia Dina Muktiarti, Dina Djajadiman Gatot Dominicus Husada Dwi Prasetyo Dwi Prasetyo Eka Laksmi Hidayati, Eka Laksmi Ellen P. Gandaputra EM Dadi Suyoko EM Dadi Suyoko Endang Windiastuti Erfi Prafiantini Erica G Horodniceanu Evy Yunihastuti Ferry Damardjati S.P. Ganda Ilmana Ganung Harsono Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Graham RR H.F. Wulandari Hanifah Oswari Harahap, Alida Roswita Hardiono D. Pusponegoro Hartono Gunardi HEM Dadi Suyoko Hindra I. Satari Hindra I. Satari, Hindra I. I Boediman I gusti Lanang Sidhiarta Ilmi, Ibnu Malkan Bakhrul Imral Chair Indah S. Widyahening Irene Irene Irma Rochima Puspita Ismoedijanto Ivo Novita Sah Bandar Johannes Hudyono Juandy Jo Julfina Bisanto Kartjito, Melissa Stephanie Katrin Roosita Kemas Firman Ketut Dewi Kumara Wati Kinesya, Edwin Knol, Klaas Kusnandi Rusmil Lenny S. Budi Levina Chandra Khoe Lily Irsa Maddepunggeng, Martira Marc F Botteman Maria Abdulsalam Martira Maddepunggeng Mei Neni Sitaremi Mei Neni Sitaresmi Melissa Gandi Melva Louisa Mia Kumiati Miesien Miesien Molly D. Oktarina Mulya Rahma Karyanti, Mulya Rahma Mulya Safri Mulya Safri Mulyadi Mulyadi Munar Lubis Naela Fadhila Nahrawi Nahrawi Nastiti Kaswandani Ni Putu Sudewi Ni Putu Sudewi Nia Kuniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nita Ratna Dewanti Novie Amelia Chozie Partini Pudjiastuti Trihono Patria Vittarina Sarisetyaningtyas Patrick Detzel Piprim Basarah Yanuarso, Piprim Basarah Pramita Gayatri, Pramita Pustika Amalia Wahidiyat Putri Maharani Tristanita Marsubrin Qatrah D. Seprida Raihan Raihan Raihan Raihan, Raihan Ratih D Palupi Ratih Dewi Palupi Ray Wagiu Basrowi Retno Asti Werdhani Rimbawan Rimbawan Rina A.C. Saragih, Rina A.C. Rinawati Rohsiswatmo Rini Sekartini Rita Evalina Rosalina Dewi Roeslani, Rosalina Dewi Rulina Suradi Rulina Suradi Rulina Suradi Saptawati Bardosono Sasmono , R. Tedjo Sasmono, R. Tedjo Setyo Handryastuti Siti D. Wisnuwardhani Siti Munawaroh Sjawitri P Siregar Sjawitri P Siregar Sjawitri P Siregar Sjawitri P. Siregar Soedjatmiko Soedjatmiko Soedjatmiko SRI LESTARI Sri Rejeki H Hadinegoro. Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sri S Nasar Sri Sudaryati Nasar Sudung O Pardede, Sudung O Sudung O. Pardede, Sudung O. Sumadiono Sumadiono Sundjaya, Tonny Supriyadi Bektiwibowo Syawitri P Siregar Taralan Tambunan Taralan Tambunan Tetty Yuniati Theresia Santi, Theresia Tina W. Wisesa Titi Sularyo Titis Prawitasari, Titis Tjhin Wiguna Tuty Mariana Wardhana Wardhana Wing Yu Tang Xiang Ji Yaulia Yanrismet Yuditiya Purwosunu Yuliarti, Klara Yvan Vandenplas