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All Journal Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Indonesian Journal for Health Sciences (IJHS) Jurnal Biomedika dan Kesehatan Journal Integration of Management Studies Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Dedi Rachmadi
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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A Study of Hypoalbuminemia and Pleural Effusionin Pediatric Nephrotic Syndrome Perinandika, Tovan; Rachmadi, Dedi; Dwiyatnaningrum, Fenny
Althea Medical Journal Vol 4, No 2 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (155.886 KB) | DOI: 10.15850/amj.v4n2.1075

Abstract

Background: Nephrotic syndrome (NS) is a kidney disease that is most often found in children. Hypoalbuminemia in NS can cause a decrease in oncotic pressure causing extravasation of fluid into the interstitial space. In conditions of severe hypoalbuminemia, fluid extravasation may cause occurrence of pleural effusion. The objectives of this study was to analyze the correlation between hypoalbuminemia and pleural effusion in children with NS. Methods: An analytical study was conducted on 69 medical records of pediatric nephrotic syndrome from 1 January 2008–31 December 2013 in dr. Hasan Sadikin General Hospital. Inclusion criteria were pediatric patients between 1-14 years old with NS. Exclusion criteria were patients who already had albumin transfusion, malnutrition, patients with chronic disease, and incomplete medical record information. Contingency coefficient test was carried out to discover the correlation between variables. Results: Out of 89 samples, 69 samples were included. Characteristics of the included patients are male (n=48), female (n=21), age 1–5 (n=24), 6–10 (n=22), 11–14 (n=23), mild hypoalbuminemia (n=3), moderate hypoalbuminemia (n=27), severe hypoalbuminemia (n=39), patients with pleural effusion (n=23), and non-pleural effusion (n=46). There was a significant correlation between  hypoalbuminemia and pleural effusion with p=0.000 (p<0.05) and moderate correlation (r=0.437). Conclusions: Hypoalbuminemia has correlation with pleural effusion in pediatric nephrotic syndrome.Keywords: Hypoalbuminemia, pediatric nephrotic syndrome, pleural effusionDOI: 10.15850/amj.v4n2.1075
Correlation between Serum Ferritin, Serum Cystatin C, and Renal Function in Children with β Thalassemia Major Permadi, Suci Saptyuni; Renarti, Lelani; Rachmadi, Dedi
Majalah Kedokteran Bandung Vol 51, No 3 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n3.1666

Abstract

Renal dysfunction caused by iron overload is characterized by an increase in ferritin and cystatin C levels. The objective of this study was to determine the correlation between ferritin, cystatin C, and renal function in children with β thalassemia major. A cross-sectional observational analytic study was conducted in September 2018 on 34 children with β thalassemia major in Dr. Hasan Sadikin General Hospital. Ferritin and cystatin C levels were documented and the estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula. Statistical tests were performed using Rank Spearman and Point Biserial with p value of <0.05 considered significant. the median ferritin level, cystatin C level, and eGFR of the subjects were 2,818 ng/mL (95% CI: 2,505–3,977), 209.9±121.5 (95% CI: 167.5–252.3), and 185.5 mL/min /1.73 m2 (95% CI: 173.6–208.2), respectively. Correlations were sought between serum ferritin and eGFR (r=0.132, p=0.229), between cystatin C and eGFR: r=0.3012, p=0.041, and between ferritin and cystatin C: r=0.433, p=0.011. No correlation was found between ferritin and renal function whereas serum cystatin C presented a positive correlation with renal function. A strong correlation was found between ferritin and cystatin C. Serum ferritin and cystatin C are promising biomarkers to assist in monitoring renal function in children with β thalasemia major.Hubungan Feritin dan Cystatin C Serum dengan Fungsi Ginjal pada Anak Talasemia β Mayor Kelebihan besi pada anak talasemia β mayor mengganggu organ vital di antaranya ginjal. Gangguan fungsi ginjal karena kelebihan besi dapat ditandai dengan peningkatan kadar ferritin dan cystatin C. Penelitian ini bertujuan mengetahui hubungan kadar feritin dan cystatin C dengan fungsi ginjal pada anak talasemia β mayor. Penelitian observasional analitik dengan rancangan potong lintang, dilaksanakan bulan September 2018. Subjek penelitian adalah anak penderita talasemia β mayor di Rumah Sakit Dr. Hasan Sadikin Bandung. Dilakukan pemeriksaaan kadar feritin dan cystatin C. Penilaian fungsi ginjal menggunakan estimated glomerular filtration rate (eGFR) dengan formula Schwartz. Uji statistik menggunakan uji Rank Spearman dan Point Biserial dengan kemaknaan berdasar nilai p<0,05. Didapatkan jumlah sampel sebanyak 34 anak, dengan kadar feritin median 2818 ng/mL (IK95%:2505–3977), cystatin C 209,9±121,5 (IK95%:167,5–252,3) dan eGFR median 185,5 mL/menit per 1,73 m2(IK95%:173,6–208,2). Korelasi antara kadarferritin dengan eGFR: r=0,132, p=0,229, korelasi cystatin C dengan eGFR: r=0,3012; p=0,041 dan korelasi kadar feritin dengan cystatin C: r=0,433; p=0,011). Hasil penelitian ini tidak didapatkan korelasi antara feritin dan fungsi ginjal, sedangkan cystatin C memiliki korelasi positif dengan fungsi ginjal. Didapatkan korelasi kuat antara kadar feritin dan cystatin C serum. Pemeriksan kadar feritin dan cystatin C dapat membantu pemantauan fungsi ginjal pada anak talasemia β mayor.
Hubungan Kadar Seng Plasma dengan Derajat Penyakit Pneumonia Winarni, Paramita Diah; Rachmadi, Dedi; Sekarwana, Nanan
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pneumonia merupakan masalah kesehatan utama anak di dunia dan sebagai penyebab terbanyak morbiditas dan mortalitas anak di negara berkembang. Anak dengan defisiensi mikronutrien termasuk seng berisiko tinggi terjadi pneumonia, karena gangguan sistem imun. Penelitian ini bertujuan mengetahui hubungan kadar seng plasma dengan pneumonia, pneumonia berat, dan sangat berat pada anak usia 2–59 bulan. Penelitian observasi analitik dengan rancangan potong lintang dilakukan bulan Agustus sampai November 2009 di Departemen Ilmu Kesehatan Anak RS Dr. Hasan Sadikin Bandung, RS Ujung Berung, dan RS Cibabat. Subjek harus memenuhi kriteria diagnosis klinis pneumonia menurut World Health Organization (WHO) Indonesia dan berusia 2–59 bulan. Pengambilan sampel darah untuk pemeriksaan kadar seng plasma dilakukan saat penderita datang. Analisis data menggunakan uji eksak Fisher dan untuk melihat hubungan kadar seng plasma dengan derajat pneumonia menggunakan uji Mann-Whitney. Dari total 42 subjek yang memenuhi kriteria inklusi, didapatkan 1 (2%) anak pneumonia, 32 (76%) pneumonia berat, dan 9 (22%) pneumonia sangat berat. Terdapat perbedaan bermakna (p=0,032) kadar seng plasma antara kelompok pneumonia berat dan sangat berat dengan median 96,685 μg/dL (57,32–195,66 μg/dL) untuk penumoia berat dan 80,240 μg/dL (63,01–111,84 μg/dL) untuk pneumonia sangat berat. Penelitian ini menunjukkan bahwa bahwa kadar seng plasma memiliki hubungan dengan pneumonia berat dan sangat berat pada anak usia 2–59 bulan. [MKB. 2012;44(4):213–17].Kata kunci: Pneumonia, seng plasma, sistem imun Association Plasma Zinc Level with Severity of PneumoniaPneumonia is a major health problem affecting children all over the world and remains a major cause of childhood morbidity and mortality in developing countries. Children with micronutrients deficiency including zinc, which might cause immune system disorder, have higher risk to have pneumonia. The aim of this study was to investigate the association between plasma zinc level and pneumonia, severe, and very severe pneumonia in children aged 2–59 months. This observational analytic with cross-sectional study was performed at the Pediatric Department of Dr. Hasan Sadikin General Hospital, Ujung Berung Hospital and Cibabat Hospital, in August to November 2009. Subjects of this study were 2–59-month-old children who meet the WHO Indonesian classification for pneumonia. Blood samples for plasma zinc examination were collected on admission. Data were analysed using exact Fisherand Mann-Whitney test for the association between plasma zinc level and severity of pneumonia. A total of 42 subjects were enrolled, 1 (2%) child were classified as having pneumonia, 32 (76%) children with severe, and 9 (22%) with very severe pneumonia. There were significant differences (p=0.032) in plasma zinc levels between severe and very severe pneumonia with a median of 96.685 μg/dL (57.32–195.66 μg/dL) for severe pneumonia and 80.240 μg/dL (63.0–111.84 μg/dL) for very severe pneumonia. This study shows an association between plasma zinc levels and severe and very severe pneumonia in children aged 2–59 months. [MKB. 2012;44(4):213–17].Key words: Pneumonia, plasma zinc, immune system DOI: http://dx.doi.org/10.15395/mkb.v44n4.177
Aspek Genetik Sindrom Nefrotik Resisten Steroid Rachmadi, Dedi
Majalah Kedokteran Bandung Vol 42, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Sindrom nefrotik resisten steroid adalah sindrom nefrotik yang tidak mengalami remisi setelah diberikan terapi standar steroid. Sampai saat ini mekanisme resistensi terhadap steroid melalui dua hal, yaitu nongen yang berkaitan erat dengan dasar imunologis dan gen yang berupa defek primer pada barier filtrasi glomerulus. Dalam tulisan ini akan diungkapkan gen yang sudah diketahui terlibat dalam patogenesis terjadinya sindrom nefrotik resisten steroid. Gen ini menyandi protein yang membentuk struktur celah diafragma glomerulus. Bila terjadi mutasi gen ini akan mengakibatkan perubahan pada arsitektur celah diafragma glomerulus, yaitu terjadi pendataran foot processes podosit sehingga terjadi proteinuria berat. Sampai saat ini telah ditemukan delapan gen penyandi protein podosit, yaitu: NPHS1, ACTN4, NPHS2, CD2AP, WT1, TRPC6, LAMB2, dan yang paling ahir diketahui yaitu NPHS3. Protein yang disandi oleh gen-gen tersebut adalah: nefrin, á-aktinin-4, podosin, CD2-associated protein, Wilms' tumor, transient receptor potential 6, laminin â2 chain, dan phospholipase PLCE1. Manifestasi klinis sindrom nefrotik resisten steroid akibat adanya mutasi gen-gen ini umumnya lebih berat, onset terjadinya penyakit lebih awal, dan cepat mengalami perburukan menjadi gagal ginjal terminal. Aspek genetis sindrom nefrotik resisten steroid perlu diketahui untuk memperkirakan perjalanan dan prognosis penyakit.Genetic Aspect of Steroid Resistant Nephrotic SyndromeSteroid resistant neprotic syndrome are patients who showed no remission after standard therapy of steroid. Until now, steroid resistant mechanism occurs through two ways, that are non gene that related with immunologic based and gene related with primary defect on glomerular filtration barrier. This paper describes those genes known relate to the pathogenesis of steroid resistant nephrotic syndrome. These genes code glomerular slit diaphragm proteins. Mutation of these genes will cause changes on glomerular slit diaphragm architecture that is flattening of foot processes of podocyte which cause severe proteinuria. Recently, there are found 8 genes that code podocyte proteins: NPHS1, ACTN4, NPHS2, CD2AP, WT1, TRPC6, and LAMB2, last found is NPHS3 gene. Proteins coded by those genes are: nefrin, á-actinine-4, podosine, CD2-associated protein, Wilms' tumor, transient receptor potential 6, laminin â2 chain, and phospholipase PLCE1. Clinical manifestation of steroid resistant nephrotic syndrome caused by mutation of these genes generally severe, earlier onset of illness and worsen to end stage kidney failure. We need to know about genetic aspect of steroid resistant neprotic syndrome to predict the progression and prognosis of the disease. DOI: http://dx.doi.org/10.15395/mkb.v42n1.8
The Art of Management of Children with Steroid-Resistant and Cyclophosphamide-Resistant Nephrotic Syndrome in Indonesia Widiasta, Ahmedz; Ilman, Muhammad; Rachmadi, Dedi
Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Vol. 12 No. 2 (2024): JAMBI MEDICAL JOURNAL: Jurnal Kedokteran dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jmj.v12i2.29348

Abstract

Background: Steroid resistant nephrotic syndrome (SRNS) in Indonesia contributes to chronic kidney disease (CKD). Method: Data from several teaching hospitals in Indonesia states that the incidence of CKD which originates from inadequate therapy nephrotic syndrome and steroid resistant nephrotic syndrome is around 60 – 70%. Result: This figure is much higher than in developed countries. One of the causes is that the main treatment for SRNS is with a calcineurin inhibitor, namely cyclosporin A, which is not yet available. This case report discuss the management of SRNS with cyclosporine A as an effort to prevent CKD at one of the provincial referral hospitals in Indonesia. Conclusion: Administration of CyA is the therapy of choice for SNRS, because it has a higher remission rate than CPA. The speed of achieving remission was also higher in CyA than CPA. There are several obstacles in providing CyA to pediatric SNRS patients in Indonesia currently, the main obstacle is cost. Keywords: Children; Chronic Kidney Disease ;  Steroid Resistant Nephrontic Syndrome; Intensive Care; Cyclosporine
Tacrolimus Therapy Among Steroid-Resistant Nephrotic Syndrome Children: A Preliminary Study in West Java, Indonesia Widiasta, Ahmedz; Wahyudi, Kurnia; Rachmadi, Dedi
International Journal of Integrated Health Sciences Vol 12, No 2 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v12.n2.3663

Abstract

Objective: To explore the outcomes of Tac therapy for Steroid-Resistant Nephrotic Syndrome (SRNS) and its implication in reducing the number of CKD events.Methods: An open, prospective, cohort study was conducted at a tertiary hospital in Bandung, West Java, Indonesia. Children (age 1–18 years old) with steroid and cyclophosphamide resistant nephrotic syndrome were enrolled in this study. Blood pressure, urinary protein, serum ureum, and creatinine levels were measured every month, Tac and soluble urokinase plasminogen activator receptor (supaR) levels were assessed at the 0, third, and sixth months.Results: Ten of fifteen subjects enrolled in this study got better within 3–6 months with a trend of decreasing suPAR level and proteinuria, as well as stable blood pressure and serum creatinine and ureum level. During treatment, no side effects of the subjects were found with the Tac level maintain safely.Conclusion: Tac is an effective and safe agent in treating SRNS, especially for those do not respond well to an alkylating agent.
ALKYLATING AGENT TREATMENT IN CHILDREN WITH STEROID-RESISTANT NEPHROTIC SYNDROME IN WEST JAVA Widiasta, Ahmedz; Rachmadi, Dedi; Hilmanto, Dany
Indonesian Journal for Health Sciences Vol 9, No 1 (2025): March
Publisher : Universitas Muhammadiyah Ponorogo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24269/ijhs.v9i1.8383

Abstract

Objective: to evaluate SRNS therapy in children. Steroid-resistant nephrotic syndrome (SRNS) is one of the most common causes of chronic kidney disease in children. Kidney Disease Initiative for Global Outcome (KDIGO) no longer recommends an alkylating agent (AA) as the treatment protocol for SRNS, still in some developing countries, such as Indonesia, there are some limitations in obtaining immunosuppressive agents other than AA. Method: Data were collected from the medical records of SRNS children with SRNS aged between 1 and 18 years from January 2016 to December 2021. The data included time to remission, adverse effects, and relapse-free period after receiving AA treatment based on the lesion type.  Results: Among the 369 patients enrolled from January 2016 to December 2018, 244 patients (66.12%) had remission with AA, and 125 patients experienced persistent proteinuria. Most of them had remission during the fifth to seventh cycles of intravenous AA (after 6 – 8 months). None of the patients experienced severe adverse effects of AA. Only a small proportion of patients had chronic kidney disease (CKD) stage II–V during follow-up. Conclusions: AA is still effective in treating SRNS in children, with only a few and less harmful adverse effects
Comparison Of Steroid-Resistant Nephrotic Syndrome Therapy In Children Using Alkylating Agents, Calcineurin Inhibitors, And Monoclonal Antibodies: A Cost-effective Perspective Widiasta, Ahmedz; Rahadi, Raden Aswin; Bagaskara, Danang Pangestu Gusti; Rachmadi, Dedi; Hilmanto, Dany
Journal Integration of Management Studies Vol. 3 No. 1 (2025)
Publisher : Integrasi Sains Media

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58229/jims.v3i1.293

Abstract

Chronic kidney disease (CKD) poses significant medical and economic challenges, particularly in pediatric patients, with steroid-resistant nephrotic syndrome (SRNS) being a major contributor. Despite the financial support provided by Indonesia’s BPJS health insurance system, the rising prevalence of SRNS necessitates a reassessment of treatment strategies. This study retrospectively analyzed pediatric SRNS cases at Hasan Sadikin General Hospital, Bandung, from 2010 to 2019, focusing on the effectiveness and cost-efficiency of different treatment regimens, including calcineurin inhibitors (CNIs) and cyclophosphamide (CPA). Among 2,590 SRNS cases, CPA achieved a remission rate of 48.75%, whereas CNIs demonstrated superior efficacy, with tacrolimus (96.87%) and cyclosporine A (75.61%) achieving significantly higher remission rates in 2018–2019. Although CNIs incurred higher initial costs, they were more cost-effective in the long term. Rituximab (RTX) emerged as a promising alternative, with a 90% remission rate, offering potential savings by reducing disease progression and preventing more expensive treatments associated with advanced CKD. These findings highlight the necessity for a strategic shift in SRNS treatment protocols, emphasizing not only immediate costs but also long-term health outcomes and financial sustainability. Integrating RTX into standard treatment guidelines could enhance patient prognosis while optimizing healthcare expenditures. However, further research is needed to evaluate the long-term health impacts, expand the demographic scope, and refine cost-effectiveness analyses. A comprehensive approach to SRNS management, prioritizing both clinical efficacy and economic viability, is crucial to improving pediatric CKD outcomes and ensuring the sustainability of national healthcare resources.
Laporan Kasus Epidemiologi Infeksi cVDPV2 Tahun 2023 di Jawa Barat, Indonesia: Surveilans dan Respons Wabah Utoro, Sidik; Rachmadi, Dedi; Oktorina, Lenny; Feriandi, Yudi
Jurnal Biomedika dan Kesehatan Vol 8 No 2 (2025)
Publisher : Fakultas Kedokteran Universitas Trisakti

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Abstract

Polio eradication remains a global health concern within the World Health Organization (WHO) framework, with Indonesia as a committed member. On February 21, 2023, an acute flaccid paralysis (AFP) case was diagnosed and reported in a 4-year-old girl from a village in Purwakarta District, West Java. The paralysis began on February 16, 2023. The child had no travel history and had never received any polio vaccination. Laboratory analysis of fecal specimens from the case and two nearby children indicated local transmission, confirming the presence of circulating vaccine-derived poliovirus type 2 (cVDPV2). This was Indonesia's first confirmed cVDPV2 outbreak. This article aims to provide a detailed description and analysis of the efforts made by relevant stakeholders in Indonesia to address this outbreak. According to WHO and national guidelines, two rounds of Sub-National Immunization Days (sub-NIDs) were carried out across all districts in West Java, the affected province. These sub-NIDs reached a total population of 3,984,797 with the novel oral poliovirus vaccine type 2 (nOPV2), achieving coverage of 96.2% in the first round and 92.3% in the second. An Outbreak Response Assessment (OBRA) was conducted in July 2023 by a team of ten international, multi-institutional assessors. The assessment concluded that, although the response was appropriate, it was too early to declare the outbreak over, as fewer than six months had passed since the last confirmed cVDPV2 detection. A follow-up review showed no new cases and no additional rounds of response immunization were recommended. This experience highlights the importance of strong surveillance, risk-based immunization planning, and community-focused communication in preventing future outbreaks. Program managers are advised to prioritize localized risk assessments, ensure even vaccine distribution, and remain prepared for rapid response.
Role of Hearth Program with Undernutrition Incidence among Toddlers in Tangerang City Gizella, Gizella; Hilmanto, Dany; Rachmadi, Dedi
Kesmas Vol. 11, No. 1
Publisher : UI Scholars Hub

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Abstract

Kelompok yang rentan terhadap gizi kurang adalah balita. World Health Organization (WHO) menyatakan kematian anak bawah lima tahun (balita) akibat gizi kurang sebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% pada tahun 2010 menjadi 19,6% pada tahun 2013. Di Kota Tangerang, terdapat 1,43% balita yang mengalami gizi buruk pada tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan antara Program Pos Gizi yang meliputi perilaku pemberian makan, perilaku kebersihan balita, perilaku mencari pelayanan kesehatan dan perilaku pengasuhan balita dengan kejadian gizi kurang pada balita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta dianalisis secara univariat, bivariat, dan multivariat selama satu bulan pada bulan September 2015. Sampel diambil secara total sampling sebanyak 60 balita yang mengalami gizi kurang di Kota Tangerang. Hasil menunjukkan bahwa dari 60 balita yang mengalami gizi kurang, sebanyak 12 balita (20%) mengalami gizi sangat kurus dan sisanya sejumlah 48 balita (80%) mengalami gizi kurus. Terdapat hubungan antara perilaku pemberian makan dan perilaku mencari pelayanan kesehatan dengan gizi kurang pada balita. Variabel perilaku pemberian makan merupakan faktor dominan yang memengaruhi gizi kurang pada balita dengan OR = 4,655 (CI = 1,052 – 20,6) setelah dikontrol oleh variabel perilaku mencari pelayanan kesehatan. Perbaikan pemberian makan dan pencarian pelayanan kesehatan diharapkan mampu memperbaiki dan menurunkan gizi kurang pada balita. Toddler is a group at risk of undernutrition in which World Health Organization (WHO) stated that toddler mortality because of undernutrition was 54% in 2002. In Indonesia, the prevalence increased from 17.9% in 2010 to 19.6% in 2013. In Tangerang City, there was 1.43% of toddlers suffering from undernutrition in 2013. This study aimed to prove in valid the correlation between Hearth Program covering food-providing behavior, toddler’s hygiene behavior, health care seeking behavior and toddler parenting behavior with undernutrition incidence among toddlers. This study was quantitative, cross sectional, using primary data, analyzed in univariate, bivariate and multivariate in a month on September. Samples were taken by total sampling as many as 60 toddlers suffering from undernutrition in Tangerang City. Results showed that 12 (20%) of 60 toddlers suffered from very underweight nutrition and the remaining amounted to 48 toddlers (80%) suffered from underweight nutrition. There was a correlation between food providing behavior and health care seeking behavior with undernutrition among toddlers. Variable food-providing behavior was the dominant factor influencing undernutrition among toddlers with OR = 4.655 (CI = 1.052 – 20.6) after controlled by the variable health care seeking behavior. Improvement on food providing and health care seeking is hopefully able to improve and decrease undernutrition among toddlers.
Co-Authors Ahmedz Widiasta Bagaskara, Danang Pangestu Gusti Dany Hilmanto Fenny Dwiyatnaningrum, Fenny Gizella, Gizella Kurnia Wahyudi, Kurnia Muhammad Ilman, Muhammad Nanan Sekarwana Oktorina, Lenny Paramita Diah Winarni Perinandika, Tovan Permadi, Suci Saptyuni Rahadi, Raden Aswin Renarti, Lelani Sidik Utoro Yudi Feriandi