Djatnika Setiabudi
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Hasan Sadikin, Bandung

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Journal : Paediatrica Indonesiana

Clinical risk factors for dengue shock syndrome in children Jujun Junia; Herry Garna; Djatnika Setiabudi
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.26 KB) | DOI: 10.14238/pi47.1.2007.7-11

Abstract

Background Dengue shock syndrome (DSS) is a seriouscomplication of dengue hemorrhagic fever (DHF) which maycause death in more than 50% cases if not treated properly andpromptly. Clinical, viral, and epidemiological risk factorsdetermine the occurrence of DSS. Identifying risk factors for thedevelopment of shock in patients with DHF can increase theawareness of clinicians to perform a close monitoring.Objective To determine the clinical risk factors for DSS.Methods This case control study was conducted on DHF andDSS patients admitted to the Department of Child Health,Medical School, University of Padjadjaran, Dr. Hasan SadikinHospital Bandung from January 2004 to December 2005. Thesubjects were patients aged less than 14 years who fulfilled WHOcriteria (1997). The exclusion criteria were history of asthma,diabetes mellitus, sickle cell anemia, typhoid, sepsis, and measles.The risk factors for DSS were analyzed using chi-square test,calculation of odds ratio, and logistic regression analysis.Results Of 1,404 patients with suspected DHF, 600 met the studycriteria; 200 patients of DSS and 400 patients of DHF as controlgroup were identified. Univariate analysis showed that there wasassociation between DSS and age 5-9 years (OR=1.67, 95%CI1.08;2.58), overweight (OR=1.88, 95%CI 1.22;2.90), vomiting(OR=1.44, 95%CI 1.02;2.04), abdominal pain (OR=2.07,95%CI 1.46;2.92), and severe bleeding (OR=13.6, 95%CI5.96;31.03). By logistic regression analysis, it was found that age5-9 years (OR=1.62, 95%CI=1.03–2.53), overweight (OR=1.97,95%CI=1.29–3.08), and persistent abdominal pain (OR=2.08,95%CI =1.44–2.99) were independent risk factors for DSS.Conclusion Age 5-9 years, overweight, and persistent abdominalpain are the risk factors for DSS.
Comparison of bone age in small-for-gestationalage children vs appropriate-for-getational-age children Lionardus Edward; Sjarif Hidajat Effendi; Djatnika Setiabudi
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (209.18 KB) | DOI: 10.14238/pi50.2.2010.73-9

Abstract

BackgroundAbout 10-15% small-for-gestational-age children are in higher risk for having linear growth retardation due to growth hormone-insulin like growth factor 1 axis defect (GH-IGF 1) which causes bone age delay.ObjectivesTo compare bone age in 24-36 month old children born small-for-gestational-age (SGA) to that in children born appropriate-for-gestational-age (AGA).MethodsA cross-sectional study was conducted in Hasan Sadikin General Hospital, Bandung, from January to April 2009.Subjects consisted of50 healthy children of 24-36 months old (25 children born at term, SGA, 25 children born at term, AGA). We compared the appropriateness and delay of bone age between the two groups. ResultsMean bone age in the SGA group was 20.8 (SD 7.7) months, and in the AGA group was 25.7 (SD 7.1) months (P=0.022). Mean bone age deficit was -10.5 (6.5) months in the SGA group and -5.5 (SD 5.7) months in the AGA group (P=0.009). The prevalence ratio was 1.77 (95% CI: 1.19–2.62). Bone age delay was found to be higher in children born SGA than that in children of the other group (23 vs 13). On the contrary, appropriate bone age was found more in children born AGA (12 vs 2) (P=0.002).Conclusion Bone age delay in 24-36 months old children born small-for-gestational-age was found to be higher than in those born appropriate-for-gestational-age.
Case report of a COVID-19 family cluster originating from a boarding school Citra Cesilia; Silvia Sudarmaji; Djatnika Setiabudi; Heda Melinda Nataprawira
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.53-60

Abstract

Since it was first identified in Wuhan City, Hubei Province, China in December 2019, SARS-CoV-2 has spread to 195 countries and infected more than 8 million people globally. Indonesia, an archipelago consisting of thousands of islands and 34 provinces, has the largest number of confirmed cases and mortality in Southeast Asia. A total of 464 districts/cities in Indonesia have been affected by COVID-19, of which 189 districts/cities are considered to be local transmission areas. Riau Province, located in Sumatra Island, consists of 12 districts/cities with a population of more than 6.8 million. This province has the 1st largest number of COVID-19 cases on Sumatra Island. Currently, more than 3000 childrens have been infected with case fatality rate <0.3% and recovery rate >90%. In May 2020, the public health office of Riau reported that just 34 children were confirmed to have COVID-19, with symptoms varying from asymptomatic to moderate with only a few family clusters identified. During the pandemic, contact tracing is the main approach to detect and isolate sources of infection in order to reduce viral transmission. This method has also been used to control transmission of other respiratory diseases such as tuberculosis (TB), MERS, and SARS. We report here on a familial cluster of COVID-19 in the Meranti Island Regency, which is located 145 km from the city of Pekanbaru (Riau Province). The island can only be reached in four hours by speed boat.
Virologic and immunologic status of children with HIV-TB co-infections Djatnika Setiabudi; Citra Cesilia; Almira Aliyannissa; Heda Melinda Nataprawira
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.94-9

Abstract

Background Studies about virologic and immunologic status of HIV children are lacking. Tuberculosis (TB) is the most common opportunistic infection in HIV patients and co-infection is associated with much worse prognosis. Objective To describe the virologic and immunologic status of patients with HIV and TB co-infection, before and after HIV and TB treatment. Methods A prospective study was conducted in HIV co-infected with TB patients in an Indonesian tertiary hospital between November 2016—December 2018. Viral load and CD4 levels were performed at diagnosis and after 6 months of HIV and TB treatment. Results Of 44 children hospitalized due to HIV, 15 newly diagnosed HIV cases had TB co-infection. Thirteen were included as subjects. Most patients (10/13) were under 5 years of age, with similar female and male proportions (7/13 vs. 6/13, respectively). All were diagnosed with stage 4 HIV. Six patients had respiratory problems at admission. First examinations revealed severe immunodeficiency (CD4+ <20%) in all patients, and high viral loads (>105 copies/mL) in most (9/13) patients. Despite good compliance to medications, 8/13 patients died before the sixth month follow-up. Deterioration of virologic and immunologic status was seen in 3/4 of the followed-up patients. Conclusion Children with HIV-TB coinfections have severe immunodeficiency and high viral loads. Most such patients die before 6 months, while survivors experience virologic and immunologic status deterioration. Future study must take into account for HIV drug resistance investigation.
Neutrophil-lymphocyte count ratio correlation to procalcitonin and PELOD-2 score in pediatric sepsis Desak Gede Arie Yudhantari; Dadang Hudaya Somasetia; Eddy Fadlyana; Djatnika Setiabudi
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.211-6

Abstract

Background Sepsis is a leading cause of children’s mortality worldwide. Procalcitonin (PCT) is a widely used infection marker, but has limitations in terms of cost and availability. The neutrophil-lymphocyte count ratio (NLCR) is easy to perform, low-cost, and widely used as a diagnostic and prognostic marker of various inflammatory processes. Objective To investigate possible correlations of NLCR to PCT and Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score among pediatric sepsis patients. Method A retrospective study was conducted by reviewing the Pediatric Sepsis Registry at Dr. Hasan Sadikin General Hospital, Bandung, West Java, from January 2019–June 2020. We recorded patients’ characteristics, PELOD-2 score, NLCR, and PCT results. Correlation analysis was conducted using Spearman’s Rank test with significance value of P<0.05. Results Ninety patients were included in the study. Most patients were male (56.7%), under 2 years of age (57.8%), and had lower respiratory tract infection (67.8%) as the most common source of infection. The NLCR value had significant, positive correlations to PCT (r=0.642; P<0.001) and PELOD-2 score (r=0.233; P=0.027) in pediatric sepsis patients. Conclusion The NLCR is directly proportional to PCT in pediatric sepsis patients. This result suggents that NLCR may have a potential role as an alternative marker for sepsis in emergency setting.
Profiles of diphtheria cases in children in Hasan Sadikin Hospital, West Java Iskandar, Safira Atya; Setiabudi, Djatnika; Tarigan, Rodman; Alam, Anggraini; Afriandi, Irvan
Paediatrica Indonesiana Vol. 64 No. 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.305-10

Abstract

Background Diphtheria cases continue to be reported in Indonesia, which has long been one of the countries with the highest number of diphtheria cases worldwide. One of Indonesia's province with the highest annual diphtheria cases is West Java. Dr. Hasan Sadikin General Hospital (RSHS) is one of the tertiary referral hospitals in Bandung, West Java, that treats several diphtheria cases annually. No study focused on the clinical characteristics of diphtheria cases in children admitted to RSHS between 2017 and 2021 yet. Therefore, this study sought to analyze that. Objective To find out the profiles of children < 18-year-old with diphtheria admitted in RSHS between 2017-2021. Methods This descriptive, cross-sectional study reviewed the medical records of diphtheria patients 0 to 18-year-old who were admitted to RSHS between year 2017 and 2021. Results Out of 45 subjects, 76% were males. The median of age was eight years old, ranging from 2 to 17 years. Most patients lived in urban areas and had normal anthropometry status, although some showed abnormal findings. The data showed that 44% had more than 3 days of onset until admission to the hospital, and the median length of stay was 9 days. The clinical characteristics showed that 91% of patients had pseudomembrane, also present with cough, common cold, hoarseness, stridor, and bull’s neck. As many as 44% of patients did not have complete basic immunization status. Complications found were airway obstructions, myocarditis, and sepsis, and 2 deaths were reported. Conclusion Pseudomembrane was found in the majority of patients. Most patients were over five years of age, and almost half number of the patients did not have complete basic immunization status, indicating the need for improved immunization and booster coverage.