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Journal : Paediatrica Indonesiana

Persistent proteinuria as an indicator of renal disease in HIV-infected children Yuni Hisbiiyah; Risky Vitria Prasetyo; Dwiyanti Puspitasari; Ninik Asmaningsih Soemyarso; Ismoedijanto Moedjito; Mohammad Sjaifullah Noer
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (104.857 KB) | DOI: 10.14238/pi56.6.2016.343-9

Abstract

Background Persistent proteinuria (microalbuminuria) has been reported to be a precursor of HIV-related renal disease. Screening allows for early management in order to prevent the progression of renal disease and decrease morbidity and mortality associated with chronic kidney disease in HIV. Several studies have been done on renal manifestation in HIV-infected children from American and African regions, but similar studies from Asia are lacking.Objective To determine the prevalence of persistent proteinuria in HIV-positive children on antiretroviral therapy (ARV) in Dr. Soetomo Hospital, Surabaya.Methods A cross-sectional study on children with HIV and treated with  highly active antiretroviral therapy (HARRT) was done from August 2014 to February 2015. Microalbuminuria was measured by the ratio of urine albumin to creatinine (ACR), while proteinuria was measured by dipstick. Measurements were performed 3 times in 4-8 weeks. All subjects underwent complete evaluation of blood tests, serum creatinine, blood urea nitrogen (BUN), CD4 counts, and urinalysis. Data were analyzed using Chi-square and logistic regression tests.Results Of 38 children on HARRT enrolled in this study, 2 subjects developed acute kidney injury (AKI), 4 subjects were suspected to have urinary tract infection (UTI), and 1 subject was suspected to have urinary tract stones. The prevalence of persistent microalbuminuria was 2.6%. There was no correlation between immunological status, WHO clinical stage, or duration of ARV and the incidence of persistent proteinuria (P>0.05).Conclusion The prevalence of persistent proteinuria is  lower in younger HIV-infected children at a non-advanced stage and HIV-infected children with normal immunological status who are on HAART. We provide baseline data on the renal conditions of HIV-infected children in the era of HAART, before tenovofir is  increasingly used as an antiretroviral therapy regimen in Indonesia.
Impact of an antimicrobial resistance control program: pre- and post-training antibiotic use in children with typhoid fever Elfrida A. Rachmah; Maftuchah Rochmanti; Dwiyanti Puspitasari
Paediatrica Indonesiana Vol 56 No 4 (2016): July 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.992 KB) | DOI: 10.14238/pi56.4.2016.205-10

Abstract

Inappropriate use of antibiotics may lead to antimicrobial resistance. In 2012, Dr. Soetomo Hospital conducted training for pediatric residents on the proper use of antibiotics to limit antimicrobial resistance.Objective To evaluate the impact of a rational, antibiotic-use training program for pediatric residents on their antibiotic prescriptions for patients with typhoid fever.Methods A cross-sectional, analytic study was conducted. We collected data from children with typhoid fever who were hospitalized in Dr. Soetomo Hospital, pre- and post-training on antibiotic prescriptions. Children with other known bacterial infections or who were discharged on request were excluded. Antibiotic prescriptions were evaluated using Gyssens algorithm based on the local protocol. Chi-square test was used to compare the quality of antibiotic prescriptions, before (year 2012) and after (year 2013) the training.Results Forty-nine patients with 67 prescriptions in 2012 and 34 patients with 48 prescriptions in 2013 fulfilled the inclusion criteria. Patients’ ages ranged from 1-18 years. Diagnoses of uncomplicated and complicated typhoid were found in 74% and 26% of subjects, respectively. First line (chloramphenicol, thiamphenicol, ampicillin, trimetroprim and sulfametoxazol) and second line (ceftriaxone and cefixime) use were 72% and 28%, respectively. All patients were discharged in good condition. Appropriate use of antibiotics was noted in 61% of subjects in 2012 and in 81% of subjects in 2013 (P=0.036). The most common type of error in 2012 and 2013 was dosage imprecision (25% and 17%, respectively).Conclusion Training on appropriate use of antibiotics significantly improved the quality of antibiotics prescribed in children with typhoid fever in Dr. Soetomo Hospital.
Correlation between immunization status and pediatric diphtheria patients outcomes in the Sampang District, 2011-2015 Kevin Sastra Dhinata; Atika Atika; Dominicus Husada; Dwiyanti Puspitasari
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (335.279 KB) | DOI: 10.14238/pi58.3.2018.110-15

Abstract

Background The number of diphtheria cases recently increased, such that an outbreak was declared in East Java Province, which includes the Sampang District. Immunization completion status is a determining factor for diptheria infection. Objective To investigate for correlations between immunization status and outcomes (severity level, fatality, and complications) of diphtheria patients in the Sampang District. Methods This analytic, cross-sectional study used secondary data from the East Java Provincial Health Office on diphteria patients aged 0-20 years during the 2011-2015 outbreak in the Sampang District and interviews with diphtheria patients in that region. The Diphtheria Research Team of Soetomo Hospital collected data on immunization status, diphtheria severity (mild, moderate, or severe), case fatality (died or survived), and complications in the patients (with or without complications). Spearman’s, Chi-square, and Fisher’s exact tests were used for data analyses, accordingly. Results Seventy-one patients with clinical diphtheria were identified, 17 of whom were confirmed with positive culture results. The case fatality rates were 7% in patients with clinical and 5.9% in confirmed diphtheria. There were no correlations between patient immunization status and severity (P=0.469 clinical, P=0.610 confirmed), or fatality (P=0.618 clinical, P=0.294 confirmed) of diphtheria in the clinical and confirmed diphtheria patients. However, there was a correlation between patient immunization status and the emergence of complications in clinical (P=0.013), but not in confirmed (P=0.620) diphtheria patients. Conclusion There is a correlation between immunization status and complications in clinical diphtheria patients. Such a correlation is not found in confirmed diphtheria cases because none of the patients had complete immunization status.
Co-Authors A.A.W., I Wayan Putra Abu Rohiman Alifadiningrat, Dianira Hanum Febia Alpha Fardah Athiyyah Amanah Fatmadani Suwarno Amor Peraten Ginting Andy Darma Annisa Fira Salsabila Arguni, Egi Arina Setyaningtyas Aris Wiji Utami Aryati Aryati Atika Atika Auliya, Arsya Ayu Citra Gestari AYU WULANSARI Ayuningtyas, Jayanti Febry Ayush Khangai Baiduri, Senja Bangkit Putrawan Basuki, Setio Catarina Rani Desy Primayani Devi Maya Arista Dewi, Maharani Sita Dharmawati, Ira Dhasih Afiat Dwi Pawestri Dominicus Husada Edward Adijaya Rusli Egi Arguni Elfrida A. Rachmah Erna Supatmini Ernawati Ernawati Esti Yunitasari Eveline Irawan Ferisca Maya Kurnia Wardhani Firdaus, Hema Rizkyana Hammam Izza Rofiqi Hanik, Elya Umi Haq, Arini Hartono Kahar, Hartono Hilwana, Lutifta Husada, Dominicius I Gusti Made Reza Gunadi Ranuh Ida Fitriawati Ida Safitri Laksanawati Inna Fairuuza Firdaus Innayah, Reza Nidaul Irwanto Irwanto Ismoedijanto Januarti, Catur Ifda Juniastuti Juniastuti Jusak Nugraha Kartina, Leny Kevin Sastra Dhinata Khadijah Rizky Sumitro Khadijah Rizky Sumitro Kristina Marbun Kuntaman Kuntaman Linda Astari, Linda Lutfi Dewanda Nugroho Maesarah Maesarah ManikRetno Wahyunitisari Medhi Denisa Alinda, Medhi Denisa Mohammad Sjaifullah Noer Muhammad Faizi Muhammad Faizi, Muhammad Muhammad Miftahussurur Mustikasari, Rahma Ira Mutahhar, Alif Nadya Khuswatun Khasanani Nesa, Ni Nyoman Metriani Ni Nyoman Metriani Nesa Ni Nyoman Metriani Nesa Ningrum, Astika Gita Ninik Asmaningsih Soemyarso Ninik Darsini Parwati S. Basuki Parwati Setiono Basuki Perwitasari, Yulinda Ayu Prastiya Indra Gunawan Pratiwi, Maurin Pudji Lestari Purnama Sari, Yulia Purwanta, Marijam Puspa Wardhani Putri, Ardelia Savinka Anandrian Raissa Manika Purwaningtias Ratni Indrawanti Rebekah Setiabudi, Rebekah Regitha Adit Pramesty Reza Gunadi Ranuh Reza Gunadi Ranuh Risa Etika, Risa Risky Vitria Prasetyo Riza Noviandi Rizkiya Candra Sari Rochmanti, Maftuchah Rochmanti Rokhmah Ayu Suliasih Rusli, Musofa Sacharissa Zerlina Tsarwah Thirafi Safitri, Emilia Samira - Assegaf Saraswati Dewi Sari, Gadis Meinar Sri Utami Sri Utami Steven Christian Susianto Steven Christian Susianto Steven Christian Susianto Sudarmo, Subijanto Marto Sulistiawati Sulistiawati Sulistiawati Sulistiawati Sumitro, Khadijah Rizky Sunny Mariana Samosir Susianto, Steven Christian Tirthaningsih, Ni Wajan Tri Yeni Fahmawati Tuksin Jearanaiwitayakul Wahyu, Agung Dwi Wahyul Anis Wahyuni Mahmud Date Widati Fatmaningrum Widodo Darmowandowo Winni Aprillia Putri Woro Setia Ningtyas Yetti Hernaningsih Yuni Hisbiiyah Zaky Firmawan El-Hakim