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All Journal JURNAL ILMIAH KESEHATAN KEPERAWATAN Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Kesehatan Reproduksi The Indonesian Journal of Public Health Sari Pediatri Paediatrica Indonesiana Belitung Nursing Journal Jurnal Gizi Klinik Indonesia Jurnal Kesehatan Reproduksi Media Ilmu Kesehatan Journal of Community Empowerment for Health Jurnal Aisyah : Jurnal Ilmu Kesehatan Berita Kedokteran Masyarakat Jurnal Kebidanan dan Keperawatan Aisyiyah Academic Hospital Journal Jurnal Ilmiah Kesehatan Keperawatan Indonesian Journal of Pharmacology and Therapy

Mei Neni Sitaresmi

Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta

Author-ID : 382474

Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Paternal and maternal age at pregnancy and autism spectrum disorders in offspring Luh Putu Rihayani Budi; Mei Neni Sitaresmi; I Gusti Ayu Trisna Windiani
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Background The prevalence of autism spectrum disorders (ASDs) has increased 10 times over the past half century, while paternal and maternal age at pregnancy has also increased. Studies looking for an association between paternal or maternal age at pregnancy and ASDs in offspring have not been conclusive. Objective To assess for possible associations between paternal and maternal age at pregnancy and ASDs in offspring. Methods This case-control study had 50 case and 100 control subjects, each case was matched for age and gender to two controls. Case subjects were obtained by consecutive sampling of patients aged 18 months to 7 years who visited the Developmental Behavioral & Community Pediatrics Outpatient Clinic and private growth and development centers from January to April 2013, while control group were children of the same age range and same gender who visited pediatric outpatient clinic at Sanglah Hospital mostly due to acute respiratory tract infection, without ASDs as assessed by the DSM-IV-TR criteria. We interviewed parents to collect the following data: maternal and paternal age at pregnancy, childâ€™s birth weight, history of asphyxia, hospital admission during the neonatal period, pathological labor, maternal smoking during pregnancy, paternal smoking, and gestational age. Data analysis was performed with Chi-square and Fisherâ€™s exact tests. Results Multivariable analysis showed that higher paternal age at pregnancy was associated with ASDs in offspring (OR 6.3; 95%CI 2.0 to 19.3; P 0.001). However, there was no significant association between maternal age during pregnancy and the incidence of ASDs. Asphyxia and paternal smoking were also associated with higher incidence of ASDs in the offspring (OR 10.3; 95%CI 1.9 to 56.5; P 0.007 and OR 3.2; 95%CI 1.5 to 6.9; P 0.003, respectively). Conclusion Paternal age >=40 years increased the risk of ASDs in offspring by 6.3 times. In addition, paternal smoking increased the risk of ASDs in offspring by 3.2 times and asphyxia increased the risk of ASDs in offspring by 10.3 times.

Accuracy of the Indonesian child development pre-screening questionnaire Syahperlan Wendi Simangunsong; Soeroyo Machfudz; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Early stimulation, detection and intervention areimportant for child development and are recommended in theearly years of childhood for optimal results. The Indonesianchild development pre-screening questionnaire, Kuesioner PraSkrining Perkembangan (KPSP), has been widely used in publichealth centers (PHC) and community health centers (CHC)in the country. Howevei; the accuracy of this test has not beenadequately assessed.Objective To assess the diagnostic value of KPSP as a prescreeningtool for child development compared to that of theDenver II developmental screening test.Methods We conducted a KPSP diagnostic study, using theDenver II test as a gold standard for comparison. Subjects werechildren aged 3 to 60 months. They were recruited from one ofthree settings: hospital, community (child care centers) or schools(kindergarten).Results Of 210 children recruited, 182 were included in ourstudy. The overall sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV) and accuracy of KPSPwere 68.8%, 86.6%, 64.7%, 88.6% and 81.9%, respectively. Thecomparison of diagnostic value based on age groups showed betterresults in the 3 - 24 month group than that of the older group.Sensitivity, specificity and accuracy of the younger group vs. theolder group were 92.3% vs. 60.0%, 78.6% vs. 87.5% and 85.2%vs. 81.3%, respectively.Conclusion The accuracy of KPSP compared to Denver II testwas good for the 3 - 24 month age group. However, this toolshould be revised for the older age group. [Paediatr lndones.2012;52:6-9].

Risk factors of developmental delay: a community-based study Mei Neni Sitaresmi; Djauhar Ismail; Abdul Wahab
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Developmental delay is a common problem inchildren. Early detection of this disorders is mandatory in orderto provide early interventions. Identification of the risk factors isimportant for strategic intervention.Objective To identify risk factors of developmental delay inchildren under five years old.Metlwds A community-based study of developmental screeningwas conducted, in Bambanglipuro, Bantul district, Province ofYogyakarta, between September and October 2007. Developmentalscreening was performed using a Kuesioner Pra Skrining Perkembangan(KPSP).Results Out of 632 children aged 3 to 60 months, 407 (64%) hadnormal development, 81 (28%) doubtful and 43 (8%) suspecteddevelopmental delay. A number of factors identified as the riskof suspected developmental delay were undernourished (OR 2.3,95%CI 1.1 ; 4.8) , low birth weight (OR 2.6, 95%CI 1.1 ; 6.1), loweducational level of mother (O R 2.5, 95%CI 1.3; 4.9) , workingmother (O R 1.8, 95%CI 1; 3.5), and poor socio-economic status(SES) families (OR 2.7, 95%CI 1.3; 5.4). Multivariate logisticregression analysis showed that poor SES was the strongest riskfactor of suspected developmental delay (adjusted OR 2.8, 95%CI1.4;5.7) .Conclusions Poverty, low maternal educational level andintrauterine malnutrition during as well as malnutrition duringinfant period are risk factors of developmental delay. Integratedstrategies should be conducted to solve the problems to preventmore children suferred from developmental delay.

Lipid profiles in smoking and non-smoking male adolescents Sigit Prastyanto; Mei Neni Sitaresmi; Madarina Julia
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Background The prevalence of smoking in adolescentstends to increase. Smoking is associated with a higher risk ofdyslipidemia.Objective To compare the lipid profiles of tobacco-smoking andnon-tobacco-smoking male adolescents.Methods We performed a cross- sectional study in three vocationalhigh schools in Yogyakarta from January to April 2011. Dataon smoking status, duration of smoking and number cigarettesconsumed per day were collected by questionnaires. We randomlyselected 50 male smokers and 50 male non-smokers as the studysubjects.Results Mean differences between smokers and non-smokerswere 44.5 (95%CI 28. 7 to 60.1) mg/dL for triglyceride levels; 8.0(95% CI 1.0 to 14.9) mg/dL for low density lipoprotein (LDL)cholesterol; 11.8 (1.1 to 22.4) mg/dL for total cholesterol and -5.7mg/dL (95% CI -8.8 to -2.6) for high density lipoprotein (HDL)cholesterol. Mean differences (95% CI) between smokers whohad engaged in smoking for > 2 years and those who had smokedfor :S:2 years were -18.1 (95% CI -33 .9 to -2.3) mg/dL for totalcholesterol; -49.4 (95% CI -67.2 to -3 1.5) mg/dL for triglycerides.Mean differences between those who smoked > 5 cigarettes/dayand :s:5 cigarettes per day were -18 .4 (95% CI -32.8 to -4.1) mg/dL for total cholesterol and -29.1 (95% CI -53.6 to -4.6) mg/dLfor triglycerides.Conclusion Smoking more than 5 cigarettes/day significantlyincreases total cholesterol, LDL cholesterol, and triglyceridelevels, as well as reduces HDL cholesterol levels; while smokingmore than 2 years significantly increases total cholesterol andtriglyceride levels

Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake Neti Nurani; Mei Neni Sitaresmi; Djauhar Ismail
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.327-31

Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children.Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake.Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards.Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8) and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8)Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.

Behavioral parent training for ADHD children: a mixed methods study Hari Wahyu Nugroho; Mei Neni Sitaresmi; Indria Laksmi Gamayanti
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Background Management of ADHD requires multimodal treatments. Parental participation is one of the most important factors for effective ADHD treatment.Objective To investigate the effectiveness of behavioral parent training combined with routine clinical care, in reducing ADHD symptoms in children.Methods Quantitative and qualitative methods were combined in this study. This study was conducted at 3 growth and developmental clinics in Central of Java, on June-July 2016. The quantitative aspect was assessed by comparing ADHD quotient scores at pre- and post-intervention, while the qualitative aspect by intensive parental interviews. Parents of children with ADHD were randomized with block random sampling. In the treatment group, parents received behavioral training for 7 weeks, along with weekly routine clinical care for their children. The control group received only routine clinical care of the children. Six parents in the treatment group were randomly selected for intensive interviews.Results A total of 67 parents with their children were involved. Both groupsâ€™ ADHD quotient scores improved post-intervention. The treatment group ADHD quotient score was reduced from 120.53 to 116.41 (effect size Cohenâ€™s d 0.68). The control group ADHD quotient score was reduced from 121.74 to 119.83 (effect size Cohenâ€™s d 0.23). Mean difference post-intervention in both group was not significant (p=.161). After behavioral parent training, communication between parents and children increased and parentsâ€™ capability in directing their childrenâ€™s daily activity increased.Conclusion Behavioral parent training can not enhacing effectiveness of routine clinical care to reduce ADHD symptoms in children.

Sleep disorders in children with attention-deficit/hyperactivity disorder Medina Permatawati; Agung Triono; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral abnormality that commonly occurs among children. Sleep disorders are comorbid with ADHD. Sleep disorders in Indonesian children with ADHD have not been widely studied.Objective To understand the proportion and factors that influence sleep disorders in children with ADHD. Methods This cross-sectional study involved 54 children aged 3-14 years who had been diagnosed with ADHD by a pediatric growth and development consultant using DSM-5 criteria. The subjects were consecutively selected from March to August 2017 at the Child Development Polyclinic, Dr. Sardjito Hospital, Yogyakarta. Sleep data were collected using the Sleep Disturbances Scale for Children (SDSC) and the Childrenâ€™s Sleep Hygiene Scale (CSHS).Results Of the 54 children with ADHD (46 males and 8 females), 35 (64.8%) experienced sleep disorders. The majority (26 subjects, 48.1%) had the disorder of initiating and maintaining sleep. Children with the combined (inattention and hyperactive-impulsive) type of ADHD experienced significantly greater sleep disturbance compared to the inattention type or hyperactive-impulsive type (OR=3.750; 95% CI 1.133 to 12.41; P=0.027). Poor sleep hygiene was also significantly associated with more severe sleep disorders (r=-0.383, P=0.004).Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

Hypovitaminosis D as a risk factor for severe autism spectrum disorder Diyah Rakanita Undang; Mei Neni Sitaresmi; Roni Naning
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/pi61.2.2021.82-8

Background Vitamin D is an important risk factor for autism spectrum disorder (ASD). However, research on hypovitaminosis D as a risk factor for severe ASD has been limited. To our knowledge, no such studies have been done in Indonesia. Objective To evaluate hypovitaminosis D as a risk factor for severe ASD. Methods This cross-sectional study included children aged 2-18 years who fulfilled the ASD DSM-5 diagnostic criteria. Subjects were consecutively sampled from April - June 2019 at the Child Growth and Polyclinic, Dr. Sardjito General Hospital, Yogyakarta. Assessment of ASD severity was carried out using the Childhood Autism Rating Scale Second Edition (CARS-2) questionnaire. Serum 25(OH)D examination was done in the Clinical Laboratory, Dr. Sardjito General Hospital. Results Of 36 children with ASD, 36.1% had hypovitaminosis D (<30 ng/mL) and 69.4% had severe ASD, based on the CARS-2 questionnaire (â‰¥37-60). Bivariate analysis revealed that children with hypovitaminosis D had more severe CARS-2 values â€‹â€‹(92.3%) compared to those with normal vitamin D levels (56.5%) (PR 1.633; 95%CI 1.10 to 2.42; P=0.031). Multivariate analysis with logistic regression revealed that hypovitaminosis D increased the risk of severe ASD (PR 1.65; 95%CI 1.06 to 2.56; P=0.037). However, other variables such as gender, parental education, attention deficit and hyperactivity disorder (ADHD), epilepsy, sleep disorders, pharmacotherapy and non-pharmacotherapy had no significant relationships with severe ASD. Conclusion Children with ASD and hypovitaminosis D have a 1.65 times higher risk of severe ASD compared to children with ASD and sufficient vitamin D levels. We recommend that children with ASD undergo serum 25(OH)D monitoring.

Growth and development in an extremely low birth weight infant with osteopenia of prematurity: a case report Syifa Armenda; Tunjung Wibowo; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.143-8

Caring for extremely low birth weight (ELBW) infants remains a challenge in developing countries due to high morbidity and mortality rates. In Dr. Sardjito Hospital, Yogyakarta, the ELBW survival rate was 39.3%.1 Expected outcomes of these ELBW survivors are increased risk of mortality during the infant period and short term as well as long term complications.2 Osteopenia of prematurity is a comorbidity that can interfere with longterm growth and neurodevelopment.3 Osteopenia of prematurity is found in approximately 55% of babies with ELBW.4 Antenatal demineralization is aggravated by improper nutritional interventions during perinatal care and post-discharge care. This comorbidity is asymptomatic in the infantâ€™s early life, but later contributes to linear growth failure, delayed teeth eruption, respiratory problems, and bone fractures in ELBW babies.3 Early detection and prompt management of osteopenia of prematurity are needed for all ELBW infants. Here we present a case of an ELBW infant with osteopenia of prematurity who we observed for 18 months. The child underwent multidisciplinary interventions for modifiable prognostic factors to support optimal achievement of growth and neurodevelopment.

Maternal knowledge and attitudes towards rotavirus diarrhea and vaccine acceptance in Yogyakarta, Indonesia: a qualitative study Mei Neni Sitaresmi; Holly Seale; Anita E. Heywood; Retna Siwi Padmawati; Yati Soenarto; Chandini Raina MacIntyre; Jarir Atthobari
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.333-40

Abstract Background Rotavirus is a leading cause of hospitalized diarrhea cases in Indonesia. Despite the rotavirus vaccine being recommended by the Indonesian Pediatric Society since 2011, it has yet to be been included in the Indonesian national immunization program (NIP) schedule. Objective To explore maternal knowledge of and attitudes towards rotavirus diarrhea, as well as barriers to vaccine acceptance in Yogyakarta, Indonesia. Methods We conducted 26 in-depth interviews in two districts (rural and urban areas) of Yogyakarta Province, Indonesia. Participants included women in their third trimester of pregnancy and mothers of infants younger than 14 weeks. We then proceeded with thematic analysis. Results Participants did not perceive diarrhea as being a priority health problem. Very few had heard of rotavirus diarrhea or were aware of vaccine availability. While participants would accept vaccinating their children against rotavirus, some key barriers impacted vaccine use. As the rotavirus vaccine is not included in the Indonesian NIP, parents perceived it as not essential. Parents were concerned about the safety and benefit of the vaccine due to its perceived newness. Other concerns were cost and halal status. Participants expressed a need for more information on the vaccine's effectiveness and safety, with their primary healthcare providers (HCPs) considered to play the most important role in vaccine acceptance. Conclusions In Yogyakarta, Indonesia, awareness of the seriousness of rotavirus disease and the availability of the rotavirus vaccine is low. Its newness, safety, efficacy, and cost, and doubts about its halal status, were barriers to vaccine acceptance. Information and recommendations from HCPs play an essential role in vaccine acceptance.

Co-Authors Abdul Wahab Ade Febrina Lestari Afrilia Intan Pratiwi Agung Triono Agung Triono, Agung Akhmadi Akhmadi Albaaza Nuady Albayani, Melati Inayati Albayani, Melati Inayati Alifah Anggraini, Alifah Anggraeni Budi Lestari Anita E. Heywood Anjarsari Haspitaningrum Arhana, Arhana Ari Prayitno, Ari Arief Tarmansyah Iman Aries Suparmiati Azwar Aruf Barida, Iram Budi Santosa Chandini Raina MacIntyre Cissy B. Kartasasmita Cissy B. Kartasasmita Damroni, Rais Aliffandy Dewi Mutiati Ratnasari Dina Rismawati Diyah Rakanita Undang Djauhar Ismail Djauhar Ismail Djauhar Ismail Djauhar Ismail Djauhar Ismail Djauhar Ismail Djauhar Ismail Djelantik, I.G.G. Dominicus Husada Dwi Prasetyo Dwi Prasetyo Elisabeth Siti Herini Elsa Maimon Ema Madyaningrum Endah Mayang Sari Faisal Husien Ferry Andian Sumirat Firda Ridhayani Fithia Dyah Puspitasari Fithia Dyah Puspitasari, Fithia Dyah Fitri Haryanti Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Hanifah Oswari Hari Wahyu Nugroho Hartono Gunardi Haspitaningrum, Anjarsari Hindra Irawan Satari Holly Seale I Gusti Agung Trisna Windiani Indria Laksmi Gamayanti Indria Laksmi Gamayanti Iram Barida Iskandar, Kristy Ismoedijanto Jamil, Muhammad Dawam Jarir Atthobari Julitasari Sundoro Kartika Handayani Kartika Handayani Kurniasari, Yulinda Kurniasari, Yulinda Kurniawati Arifah Kusnandi Rusmil Kusuma Ayu Rachmasari Laksono, Bima Adi Lely Lusmilasari, Lely Lestari, Ade Febrina Luh Putu Rihayani Budi Madarina Julia Maddepunggeng, Martira Mayae Hugo Mayae Hugo Medina Permatawati Mohammad Juffrie Mohammad Juffrie Mohammad Juffrie, Mohammad Mooiindie, Khansadhia Hasmaradana Muhammad Dawam Jamil N Nurlaila Nastiti Kaswandani Nenny Sri Mulyani Neti Nurani Novilia Sjafri Bachtiar Nugrahanto, Andika Priamas Nurlaila, N Ova Emilia Paramastuti, Avianti Pradipta, Afradilla Hanum Prasetyo, Ashadi PUJI LESTARI Puji Lestari Purwanta Purwanta Rachmasari, Kusuma Ayu Raihan Raihan, Raihan Ramdaniati, Sri Ratih Wulandari Ratih Wulandari Ratni Indrawanti Retna Siwi Padmawati Ridhayanti, Firda Rini Mulia Sari Risalia Reni Arisanti Roni Naning Rosana, Elvira Sari, Endah Mayang Sari, Shinta Kusumalarna Setyo Handryastuti Shinta Kusumalarna Sari Shyrien Amalina Sigit Prastyanto Siti Helmyati Soedjatmiko Soedjatmiko Soedjatmiko Soeroyo Machfudz Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S. Hadinegoro Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sulistyaningsih Sulistyaningsih Sulistyaningsih Sulistyaningsih Sulistyaningsih Sulistyaningsih, Sulistyaningsih - Sumadiono Sumadiono Sunartini Sunartini, Sunartini Sundari, Ririn Isma Supriyati Susetyowati Syafriyal Syafriyal, Syafriyal Syahperlan Wendi Simangunsong Syawitri P. Siregar Syifa Armenda Timoti, Joshua Tony Arjuna Tunjung Wibowo Tunjung Wibowo Wahyu Damayanti Wibowo, Anton Sony Widyaningrum, Rahmah Yati Soenarto Zakiuddin Munasir Zakiudin Munasir Zulala, Nuli Nuryanti

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