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All Journal Majalah Kedokteran Bandung Paediatrica Indonesiana
Hindra Irawan Satari, Hindra Irawan
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Health Professions Medicine & Pharmacology

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PROFILE OF IMMUNIZATION PRACTICE BY GENERAL PRACTITIONERS AND PEDIATRICIANS IN PRIVATE SETTING Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Satari, Hindra Irawan; Singgih, Adrian Himawan; Yolanda, Natharina
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (66.572 KB) | DOI: 10.15395/mkb.v49n4.1153

Abstract

Basic immunization coverage in Indonesia in 2013 was still low (59.2%) (IBHS, 2013). Physicians? attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner?s (GP) and pediatrician?s attitude towards immunization and its coverage  in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians). Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians) while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices. Key words: Attitude, general practitioners, immunization practice, private setting, pediatriciansGambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek SwastaRiset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%). Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap dokter dan cakupan imunisasi di praktik swasta. Penelitian potong lintang dilakukan dengan menyebarkan kuesioner tentang sikap dan praktik imunisasi kepada responden, yaitu 29 dokter umum (DU) dan 65 dokter spesialis anak (DA) pada bulan November 2014. Mayoritas responden berpendapat bahwa vaksin program pengembangan imunisasi harus diberikan. Vaksin hepatitis B dosis I mayoritas diberikan dalam 12 jam setelah lahir (90% oleh DU dan 74% oleh DA). Vaksin polio oral mayoritas diberikan sebelum pulang perawatan (65% oleh DU dan 81% oleh DA), Vaksin DTwP-HB-Hib diberikan oleh 27% DU dan 21% DA kepada ?75% pasien. Penggunaan vaksin pneumokokus, rotavirus, hepatitis A, tifoid dan influenza pada >75% pasien adalah kurang dari 25%, kecuali vaksin influenza, yaitu 31% digunakan oleh DA. Pemberian vaksin MMR pada >75% pasien dilakukan oleh 16% DU dan 29% DA.  Penelitian imunisasi pada praktik swasta ini mungkin  merupakan laporan yang pertama dipublikasi di Indonesia. Penelitian lebih lanjut diperlukan untuk mengetahui hambatan imunisasi di praktik swasta.Kata kunci: Cakupan imunisasi, dokter,  imunisasi, praktik, spesialis
Profil Keamanan setelah Pemberian Dosis Primer Vaksin Pentabio® pada Bayi di Indonesia Sundoro, Julitasari; Rusmil, Kusnandi; Sitaresmi, Mei Neni; Arhana, Arhana; Djelantik, I.G.G.; Hadinegoro, Sri Rezeki; Satari, Hindra Irawan; Syafriyal, Syafriyal; Bachtiar, Novilia Sjafri; Sari, Rini Mulia
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n2.1052

Abstract

Vaksin Hib mulai digunakan pada Pogram Imunisasi Nasional sejak tahun 2013 secara bertahap dan di seluruh Indonesia mulai tahun 2014 dalam bentuk vaksin kombinasi DTP/HB/Hib (Pentabio®), yang memberikan  kekebalan terhadap difteria, pertusis, tetanus, hepatitis B, dan Haemophilus influenzae tipe b. Studi ini menilai reaksi sitemik, reaksi lokal, dan reaksi yang serius pascaimunisasi dengan Pentabio®. Sebanyak 4.000 bayi penerima vaksin Pentabio®bergabung dalam studi ini. Reaksi yang timbul dicatat pada kartu harian oleh petugas yang sudah dilatih. Vaksin Pentabio®yang diamati pada PMS ini menggunakan vaksin rutin dari Program Imunisasi Nasional dalam waktu pengamatan 28 hari di empat propinsi, yaitu Nusa Tenggara Barat, Bali, Yogyakarta, dan Jawa Barat pada periode Mei–Desember 2014. Sebanyak 3.978 data dapat dianalisis karena 22 di antaranya tidak memberikan informasi yang valid. Reaksi sistemik yang paling banyak timbul adalah demam 0,85% pada 30 menit pertama, dan meningkat menjadi 14,03% pada satu hari pascaimunisasi, kemudian sembuh pada hari berikutnya. Reaksi lokal yang paling sering timbul adalah nyeri pada tempat suntikan pada 67,6% subjek pada 30 menit setelah imunisasi, dan meningkat menjadi 87,23% pada 1 hari pascaimunisasi namun sembuh pada hari berikutnya. Mayoritas nyeri yang timbul adalah kategori ringan. Tidak ditemukan kejadian ikutan pascaimunisasi serius selama pengamatan. Simpulan, reaksi lokal dan sistemik pascaimunisasi dengan Pentabio® dapat ditoleransi pada bayi. [MKB. 2017;49(2):86–93]   Kata kunci: Bayi, Pentabio®, post marketing surveillance, reaksi lokal, reaksi sistemik   Safety Profile Following Pentabio® Primary Dose Vaccination in Indonesian Infants   Since 2013 Indonesian Expanded Program on Immunization (EPI) has  graduallyincluded Hib vaccine into routine EPI schedule in four provinces and has established the vaccine inclusion in the the nationwide program through integration of Hib vaccine into existing DTP/HB vaccine in the form of pentavalent vaccine (DTP/HB/Hib). Pentabio® vaccine is given to provide protection against diphtheria, tetanus, pertussis, hepatitis B, and Hib infection in infants and children under 5 years old.  The objective of this study was to assess the systemic reactions, local reactions, and any serious adverse event after Pentabio® immunization. About 4,000 infants were involved in this study. Systemic and local reactions were recorded on diary cards by trained health care provider. Pentabio® vaccines in this PMS were obtained from the National Immunization Program within 28 days of observation in four provinces, West Nusa Tenggara, Bali, Yogyakarta, and West Java in May–December 2014. In total, 3,978 infants were analyzed, while the other 22 forms were not included due to incomplete information. The most common systemic reaction was fever, found in 0.85% of the subjects at 30 minutes after injection, and increased to 14.03% at day 1 (one) after immunization, which disappeared the day after. The most common local reaction was pain, which was found in 67.6% subjects at 30 minutes after injection, and increased to 87.23% at day 1 (one) after immunization to disappear the day after. The intensity of the pain was mostly mild. No serious adverse event following immunization found during observation. [MKB. 2017;49(2):86–93]   Key words: Infants, local reactions, Pentabio®, post marketing surveillance, systemic reactions 
Community prevalence and distribution of dengue virus serotype based on antibody neutralization assay in Jakarta, Indonesia Karyanti, Mulya Rahma; Alam, Anggraini; Widyahening, Indah Suci; Hadinegoro, Sri Rezeki; Munasir, Zakiudin; Satari, Hindra Irawan; Sasmono, R. Tedjo
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.10-6

Abstract

Background Dengue infection is still rising globally despite the implementation of preventive efforts in many endemic countries. Monitoring the circulation of dengue virus (DENV) serotypes is not performed routinely in the Indonesian national surveillance program, primarily due to high cost and effort. Objective To evaluate the distribution of DENV serotypes based on serological profile and neutralizing antibody level against all four DENV serotypes in Jakarta, Indonesia. Methods This cross-sectional study was performed as part of a dengue vaccine effectiveness study, 10 years after a dengue vaccination program was initiated. It was conducted in five community public health centers in Jakarta in subjects aged 12 years and above who had not received the dengue vaccine. We collected serum samples and DENV neutralizing antibody titers were measured using a plaque reduction neutralization test (PRNT). Results Eighty healthy subjects with a median age of 15 (range 12-27) years were enrolled. The highest median antibody titer was that to DENV-2 [898 (range 29-91558) 1/dil], followed by that to DENV-3 [297.5 (range 10-36091); 1/dil], DENV-1 [288 (range 0-68237) 1/dil], and DENV-4 [164 (range 0-35812) 1/dil]. Neutralizing antibodies against the four DENV serotypes were found in all the 5 districts studied in Jakarta. A multitypic neutralizing antibody profile was observed in the majority (74/80 subjects; 92.5%). Three subjects were naïve. Conclusion All four dengue serotypes are widely circulating in Jakarta based on neutralizing antibody detection in the community, with the highest neutralizing antibody titer being against DENV-2, followed by DENV-3, DENV-1 and DENV-4.
Comparative analysis of COVID-19 incidence and neutralizing antibody response after primary COVID-19 vaccination and heterologous booster doses in adolescents vs. adults: the Indonesian experience Karyanti, Mulya Rahma; Satari, Hindra Irawan; Munasir, Zakiudin; Hadinegoro, Sri Rezeki; Widyahening, Indah Suci; Sasmono, R Tedjo
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.316-24

Abstract

Background The Indonesian COVID-19 immunization program has provided primary doses of a COVID-19 vaccine to adolescents and adults, while booster doses were given to adults only. Evaluation of this program is crucial to determine if boosters should be recommended for adolescents. Objective To compare COVID-19 incidence and SARS-CoV-2 IgG neutralizing antibody levels after COVID-19 vaccination in adolescents given a primary dose vs. adults given a primary dose and a booster. Methods: In this cross-sectional study, participants were given questionnaires on their COVID-19 history and evaluated for SARS-CoV-2 IgG neutralizing antibody titers. We included healthy individuals aged 12 years or older who resided in Jakarta and consented to participate, had received primary COVID-19 vaccine doses, and for adults, booster doses. Participants were stratified into two age groups, adolescents (12-17 years) and adults (18 years and above). We compared the incidence of COVID-19 and SARS-CoV-2 antibody titers between the two age groups. Results Out of 419 participants who met the inclusion criteria, 159 had blood specimens drawn for measurement of SARS-CoV-2 antibody titers. Before the widespread administration of the vaccine, the incidence of COVID-19 in was 4.9% in adolescents vs. 10.2% in adults (P=0.036). After widespread vaccination, the incidence of COVID-19 remained lower in adolescents than in adults (2.2% vs. 8.8%, respectively; P=0.005). The median SARS-CoV-2 antibody titer post-COVID-19 vaccination was 97.85 (range 46.46-98.23) U/mL in adults vs. 96.78 (range 22.08-98.23) U/mL in adolescents (P<0.05). Conclusion While the incidence of COVID-19 was significantly lower in vaccinated adolescents than in vaccinated adults, titers of SARS-CoV-2 IgG neutralizing antibody in adolescents were significantly lower compared to that of adults.
Co-Authors Anggraini Alam, Anggraini Arhana, Arhana Djelantik, I.G.G. Hartono Gunardi Indah S. Widyahening Julitasari Sundoro Kusnandi Rusmil Mei Neni Sitaresmi Mulya Rahma Karyanti, Mulya Rahma Natharina Yolanda, Natharina Novilia Sjafri Bachtiar Rini Mulia Sari Sasmono, R. Tedjo Singgih, Adrian Himawan Soedjatmiko Soedjatmiko Sri Rezeki Hadinegoro, Sri Rezeki Syafriyal Syafriyal, Syafriyal Zakiudin Munasir