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All Journal The Indonesian Journal of Public Health Sari Pediatri Paediatrica Indonesiana Journal of Community Empowerment for Health
Agung Triono, Agung
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Education Health Professions Medicine & Pharmacology Nursing Public Health

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Predictors for seizure relapse in children with epilepsy after antiepileptic drug withdrawal: case-control study Triono, Agung; Herini, Elisabeth Siti; Mangunatmaja, Irawan
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.120-5

Abstract

Background Epilepsy is defined as a neurologic condition caused by a pathological brain condition. Epilepsy patients who have stopped treatment and are seizure-free for two years are considered to have achieved complete remission. Relapse occurs when seizures return after anti-epileptic drug (AED) withdrawal. Several studies reported that frequent seizures, prolonged duration to control seizures, number of AEDs consumed, and abnormal electroencephalography (EEG) found during AEDs tapered, were reported as predictors of relapse. Methods This retrospective, case-control study was carried out from 2012 – 2016 using multisite medical record evaluation, followed by interviews and EEG examinations. The case group included children with epilepsy who had seizure relapse, while the control group included children with complete remission of epilepsy. Bivariate and multivariate analyses were performed to identify predictors of relapse. Results Relapse predictors in bivariate analysis were symptomatic etiology epilepsy (OR 5.000; 95%CI 2.345 to 10.660; P<0.001), time to seizure control ?1 year (OR 3.689; 95%CI 1.493 to 9.116; P=0.003), and worsened EEG evolution at pre-withdrawal compared to EEG at the time of diagnosis (OR 2.310; 95%CI 1.132 to 4.717; P=0.021). Statistically significant relapse predictors in multivariate analysis were symptomatic etiology epilepsy (OR 4.384; 95%CI 1.985 to 9.681; P<0.001) and slow (?1 year) time to seizure control (OR 4.355; 95%CI 1.753 to 10.817; P 0.002). Conclusion Symptomatic etiology epilepsy and time to seizure control ?1 year are independent predictive factors for seizure relapse in children with epilepsy. Therefore, children with these conditions require a longer period and careful, gradual dose reduction before antiepileptic drugs withdrawal.
ENHANCING KNOWLEDGE AND AWARENESS FOR MEASLES AND RUBELLA ELIMINATION TO PREVENT CONGENITAL RUBELLA SYNDROME IN KULON PROGO AND GUNUNGKIDUL REGENCIES Herini, Elisabeth Siti; Triono, Agung; Iskandar, Kristy; Indrawanti, Ratni; Sitaresmi, Mei Neni; Nuady, Albaaza; Prasetyo, Ashadi; Paramastuti, Avianti; Nugrahanto, Andika Priamas; Mooiindie, Khansadhia Hasmaradana; Damroni, Rais Aliffandy; Timoti, Joshua
The Indonesian Journal of Public Health Vol. 19 No. 3 (2024): THE INDONESIAN JOURNAL OF PUBLIC HEALTH
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijph.v19i3.2024.442-452

Abstract

Introduction: Measles-Rubella (MR) Vaccination coverage is important in eliminating Congenital Rubella Syndrome (CRS). In 2023, Kulon Progo and Gunungkidul Regencies recorded 98.59% and 97.63%, respectively. We conducted campaign activities, introduced the Measles-Rubella (MR) vaccine, and implemented educational efforts crucial for controlling measles, rubella and CRS. A collaborative educational program was organized to improve the quality of promotive and preventive education provided to health workers and elementary teachers. Aims: To enhance the knowledge of health workers and elementary teachers regarding measles, rubella, CRS and elimination strategies in Kulon Progo and Gunungkidul Regency. Methods: This study employed a quasi-experimental, non-randomized design with no control group. The participants were selected from all primary health care centers and selected elementary schools in Kulon Progo and Gunungkidul Regency. Before and after a multi-modal educational program, knowledge of participants was measured using questionnaire and analyzed using Wilcoxon signed-rank test. Results: We included 72 health workers and 8 elementary teachers in Kulon Progo and Gunungkidul Regency. The results indicated an increase in knowledge among health workers regarding these topics. However, elementary teachers did not demonstrate statistically significant improvements in knowledge level, likely due to the small number of participants and a general lack of knowledge about these subjects among teachers. Conclusion: Multi-modal intervention enhanced the knowledge of health workers and elementary teachers about measles, rubella, CRS, elimination strategies of these diseases in two regencies of the Special Region of Yogyakarta. Therefore, it is essential that public health authorities should prioritize continuous and accessible education programs for them
Penyusunan dan Validasi Registri Epilepsi Anak di Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta Triono, Agung; Siti, Elisabeth Siti; Mooiindie, Khansadhia Hasmaradana; Hadiyanto, Marissa Leviani; Diantika, Kania; Wijayanti, Veronica Wulan; Sanjaya, Guardian Yoki; Iskandar, Kristy
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.298-305

Abstract

Latar belakang. Epilepsi pada anak adalah kondisi medis yang memerlukan pemantauan intensif. Data epidemiologis terkait epilepsi anak di Indonesia masih terbatas sehingga registri epilepsi yang terstruktur diperlukan untuk mengidentifikasi pola penyakit, respons terapi, dan karakteristik pasien.Tujuan. Penelitian ini bertujuan untuk mengembangkan dan mendeskripsikan sistem registri epilepsi anak di RS Sardjito, Yogyakarta, serta untuk menganalisis data profil pasien epilepsi yang telah dimasukkan dalam registri tersebut.Metode. Penyusunan, pengembangan, dan pengisian registri klinis dilakukan pada tahun 2022 menggunakan formulir digital (eForm) berbasis platform District Health Information Software 2 (DHIS2) di RS Sardjito Yogyakarta. Validasi data dilakukan pada pasien epilepsi anak yang dirawat di rawat jalan pada periode April 2022 hingga Juli 2023.Hasil. Sebanyak 171 pasien epilepsi anak di RS Sardjito berhasil dimasukkan ke dalam sistem registri epilepsi anak dengan karakteristik onset usia terbanyak pada usia bayi berjumlah 75 anak (43,9%). Hasil analisis deskriptif juga menunjukkan terdapat 73 anak (42,7%) kejang tidak terkontrol dan 98 anak (57,3%) kejang terkontrol.Kesimpulan. Registri epilepsi anak di RS Sardjito telah berhasil mencatat data dari 171 pasien dan memberikan informasi penting mengenai karakteristik penyakit dan terapi. Meskipun terdapat beberapa tantangan dalam kelengkapan data dan integrasi dengan sistem rekam medis elektronik, sistem registri ini menawarkan potensi besar untuk penelitian lebih lanjut dan pengembangan kebijakan kesehatan di Indonesia.
Increasing knowledge and awareness of health workers and health cadres regarding congenital rubella syndrome in Imogiri II Bantul Primary Health Centre Herini, Elisabeth Siti; Triono, Agung; Iskandar, Kristy; Prasetyo, Ashadi; Nuady, Albaaza; Hadiyanto, Marissa Leviani; Diantika, Kania; Wijayanti, Veronica Wulan; Damroni, Rais Aliffandy; Paramastuti, Avianti
Journal of Community Empowerment for Health Vol 7, No 3 (2024)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.94085

Abstract

Introduction: Prevention through campaign activities, Measles-Rubella (MR) vaccine introduction, and education play an essential role in controlling rubella and, eventually, Congenital Rubella Syndrome. A Community Engagement program was arranged collaboratively to improve the quality of promotive, preventive education by health workers and cadres and to improve the advanced management of Congenital Rubella Syndrome for health workers. Methods: A multi-method engagement program was conducted in collaboration with Imogiri II Bantul Primary Health Centre from March to October 2023. The program aimed to implement various activities involving health workers and health cadres. A descriptive study using the survey method was conducted to assess the knowledge level about Congenital Rubella Syndrome among health workers and cadres before and after the program. The survey included multiple-choice yes-no questions, and the results were analyzed using the McNemar test for paired nominal data with SPSS version 27. Results: We included 25 health workers and 28 health cadres. The results showed a significant increase in health worker's knowledge regarding the impact of Congenital Rubella Syndrome on various organs, including the brain, eyes, ears, heart, and child growth and development (p-values: 0.004, 0.004, 0.0004, 0.021, and 0.008, respectively). There was a notable improvement in health cadres' knowledge concerning the impact of CRS on the brain, eyes, ears, heart, child growth and development, and the child's quality of life (p-values: 0.007, 0.000, 0.000, 0.001, and 0.000, respectively). Conclusion: The community engagement program helps to enhance the knowledge of health workers and cadres concerning the impact of Congenital Rubella Syndrome on patients. 
Co-Authors Albaaza Nuady Damroni, Rais Aliffandy Diantika, Kania Elisabeth Siti Herini Guardian Yoki Sanjaya Hadiyanto, Marissa Leviani Iskandar, Kristy Mangunatmaja, Irawan Mei Neni Sitaresmi Mooiindie, Khansadhia Hasmaradana Nugrahanto, Andika Priamas Paramastuti, Avianti Prasetyo, Ashadi Ratni Indrawanti Siti, Elisabeth Siti Timoti, Joshua Wijayanti, Veronica Wulan