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Paediatrica Indonesiana

paediatrica-indonesiana
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Published by Ikatan Dokter Anak Indonesia

ISSN : 00309311 EISSN : 2338476X DOI : -

Core Subject : Health,

Health Professions Medicine & Pharmacology

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of health practice throughout the world.

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Search results for , issue "Vol 48 No 2 (2008): March 2008" : 12 Documents clear

Lateral-flow immunoassay as a diagnostic test for influenza type A and B in children Ity Sulawati; Amalia Setyati; A. Samik Wahab; M. Juffrie
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background The diagnosis of influenza remains difficult toestablish because of its similar symptoms to those of respiratoryinfection caused by other viruses. The â€œgold standardâ€ for thediagnosis of influenza is viral culture, which takes time to gainthe result and is expensive as well. A simple, rapid, and easilyused tool for detection of influenza virus type A and B is needed.Objective To assess the accuracy of lateral-flow immunoassay withQuick Vue Influenza A+B Â® in detecting influenza virus of typeA and B.Methods This was an observational study designed for diagnostictest. The subjects were children aged 0-14 years old presentingwith acute respiratory infection in primary Health Care Jetis ,Godean I, Godean II and Prof. Dr. Sardjito Hospital Yogyakarta,from October 2005 to May 2007. Specimens were collected fromboth the anterior nares and the throat by physicians for lateral-flow immunoassay with Quick Vue Influenza A+B Â® and viralculture as gold standard. Lateral-flow immunoassay was done ineach study centre, nasal specimen was placed in an extractionreagent tube and sent to NAMRU II laboratory.Results There were 255 children enrolled in this study. Lateral-flow immunoassay by Quick Vue Influenza A+B Â® has sensitivity70% (CI95% 6;83%), specificity 93% (CI95% 90;97%), positivepredictive value 68% (CI95% 54;82%), negative predictive value94% (CI95% 91;97%), positive likelihood ratio 10,56 (CI95%6,14;18,19) and negative likelihood ratio 0,32 (CI95% 0,21; 0,51).Conclusion Lateral-flow immunoassay (Quick Vue InfluenzaA+B Â® ), nasal swab specimen is not accurate to detect influenzavirus A and B in children.

Differences of nucleotide and amino acid sequences of nucleoprotein (N) gene between wild-type measles virus and vaccine virus in Indonesia Made Setiawan; Agus Sjahrurachman; Fera Ibrahim; Agus Suwandono
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Measles virus is a member of genus morbiliviruswhich belongs to family paramyxovirus with negative, single-strand RNA genome. RNA is packed by nucleocapsid (N) protein.The N protein is very important for RNA replication andtranslation. Abnormality in N protein will induce abnormality invirus replication.Objective This study aimed to explore the differences ofnucleotide sequence of N gene and amino acid sequences of Nprotein between wild-type measles virus (G2, G3 and D9) andvaccine virus (CAM-70, Schwarz and Edmonston-wt)Methods The exctraction and amplification of the gene wereconducted in the laboratory using biomolecular technology. Thegene and protein analysis were conducted using the bioinformatictechnology.Results The results showed that more differences were foundbetween nucleotide sequences of N gene of wild-type measlesvirus against CAM-70 vaccine virus (77 â€“ 79 nucleotides)compared against Schwarz and Edmonston-wt vaccine virus (71-74 nucleotides). Likewise, more differences were also observedbetween amino acid sequences of N protein of wild-type measlesvirus against CAM-70 vaccine virus (18-24 residues) comparedagainst Schwarz and Edmonston-wt vaccine virus (17-23 residues).

Risk of early onset pneumonia in neonates with abnormal gastric aspirate IB. Mahendra; I Wayan Retayasa; I Made Kardana
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Early onset neonatal pneumonia is the risk factorfor neonatal sepsis that increases risk for neonatal deaths.Recognition, prevention, and treatment of this problem is majorfactors in the managemant of high risk neonates. Analysis ofgastric aspirate, collected soon after birth is a useful screeningtest for predicting pneumonia.Objective To evaluate the risk of early onset of neonatalpneumonia in neonates with abnormal gastric aspirate.Methods A case control study was done on infants with earlyonset neonatal pneumonia born in Sanglah Hospital during theperiod of July 2004 until November 2005. The control groupconsisted of high risk infants without early onset pneumonia.Multiple logistic regressions was performed to determine theconfounding effects of multiple variables that were considered asrisk factors for early-onset neonatal pneumonia.Results Forty-five infants with early onset neonatal pneumoniawere recruited. Multivariate analysis showed that abnormal gastricaspirate and low APGAR score were significant factors associatedwith early-onset of neonatal pneumonia with OR 4.05 (95%CI1.26;13,02), P=0.019, and OR 6.95 (95%CI 2.45;19.77),P<0.0001, respectively.Conclusion Abnormal gastric aspirate and low APGAR score arerisk factors for early onset neonatal pneumonia in high risk infants.

The accuracy of determining newbornâ€™s maturity between New Ballardâ€™s score, Ballardâ€™s score, and first day of last menstrual period Ferdy Limawal; Djauhariah A. Madjid; Dasril Daud
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Developing country such as Indonesia needs a toolto assess gestational age which is simple, practical, cheap, fast,and accurate. In 1991 the Ballard maturation score was refinedand expanded to achieve greater accuracy and called New Ballardscore.Objective The purpose of this study was to determine thecorrelation between gestational age assessed by New Ballard score,Ballard score, and by the first day of last menstrual period (LMP).Methods A cross sectional study has been carried out in Dr.Wahidin Sudirohusodo, Ibnu Sina, Labuang Baji, and St. FatimahHospitals in Makassar, from July 1 st , 2006 until January 31 st , 2007.This study included healthy newborns, aged 15 minutes to 24hours born to mothers who knew with certainty the first day oftheir LMP. Diagnostic test was used to analyze the data.Results There were 248 subjects included in this study. The resultsshowed that there was a strong correlation between gestationalage by LMP and New Ballard score (r=0.97), LMP and Ballardscore (r=0.95), as well as between New Ballard score and Ballardscore (r=0.99). New Ballard score was more accurate and had ahigher association coefficient (k=0.85) than did Ballard score(k=0.82) to LMP in identifying premature baby. The sensitivityof New Ballard score to identify premature baby was 87.7%,specificity 96.3%, positive predictive value 95.2% and negativepredictive value 90.2 %.Conclusions New Ballard score can be used to replace Ballardscore if LMP can not be assessed. Further study needs to be donewith bigger sample, involving other paramedics and unhealthynewborn babies.

Exhaled nitric oxide in acute exacerbation of pediatric asthma Ratnawati Ratnawati; V Nguyen; J Morton; R L Henry; P S Thomas
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Measurement of exhaled nitric oxide (eNO) is a non-invasive and easy method to monitor airway inflammation.Objectives To compare the levels of eNO during and after anexacerbation of asthma, to evaluate the effect of glucocor-ticosteroids (GCS) on the levels of eNO and to correlate eNOwith other markers of inflammation such as symptom scores, FEV 1and sputum eosinophils.Methods The observational study was performed over 24 monthsat a tertiary paediatric hospital. Subjects underwent eNOmeasurement, spirometry and sputum induction during an asthmaexacerbation and then two weeks later. A symptom score wasrecorded everyday for two weeks. All subjects were treated withÃŸ 2 -adrenergic agonists and an oral glucocorticosteroid (GCS).Results Fifteen subjects with acute asthma exacerbation aged 5and 16 years old participated in the study. The mean level ofeNO during the acute exacerbation was significantly higher thaneNO levels at the follow-up visit, 11.2 (95%CI 9.2;13.2) vs. 8.0(95%CI 5.0;11.1) ppb, P=0.03. In the acute exacerbation, eNOcorrelated with sputum eosinophils (P=0.04), but no correlationcould be found between eNO and the other markers ofinflammation during exacerbation or follow up.Conclusions eNO level increased during asthma exacerbation anddecreased after two weeks of glucocorticosteroid therapy.Measurement of eNO is a practical monitoring method inemergency management of asthmatic children.

Effect of egg avoidance diet by nursing mothers on the incidence of atopic dermatitis in infants Neti Nurani; Endy Paryanto Prawirohartono; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background The prevalence of allergic and atopic diseases hasincreased rapidly and remains a social as well as an economicproblem for the patients on account of its chronic nature. In orderto decrease the atopic diseases, especially atopic dermatitis ininfants, nursing mothers should avoid allergenic foods as apreventive sensitization. Egg allergy is the most common cause offood allergy, and is closely related to atopic dermatitis in children.Objective To determine whether egg avoidance diet by nursingmothers could decrease the incidence of atopic dermatitis ininfants.Method We conducted a parallel randomized-controlled trial.Seventy-nine subjects eligible for the study were divided into twogroups: egg avoidance and non-egg avoidance group. Blockrandomization is used for random allocation. Intervention startedsince mothers had had delivery until their children were 4 monthsold. The primary outcomes were clinical atopic dermatitis.Result Atopic dermatitis incidence in maternal egg avoidancegroup was significantly lower than non-avoidance group. Non-avoidance, family history of asthma, and maternal allergy are thefactors significantly influencing atopic dermatitis incidence (OR6.17; OR 4.73; OR 0.14), respectively.Conclusion Egg avoidance by nursing mothers could decrease theincidence of atopic dermatitis in infants. Non-egg avoidance andasthma in the families are factors significantly inducing the incidenceof atopic dermatitis.

Prevalence of underweight, stunting and wasting in under five years old children based in the WHO-2006 and CDC-2000 growth standard on Kintamani, Bangli I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Healthy children will have normal growth according totheir age and gender. To assess and monitor the growth of children, agrowth standard is needed. The WHO and CDC released a newgrowth standard to replace the 1977 NCHS growth standard in April2006 and May 2000 respectively.Objective To obtain the prevalence of underweight, stunting andwasting in less than five years old children based on the WHO-2006and CDC-2000 growth standard and compared the results.Methods A cross-sectional study was conducted in Songan Village,District of Kintamani, Bangli on December 2006. Healthy childrenaged 0-59 months who visited the study site were enrolled.Anthropometric data including weight and length/height were obtainedusing standard anthropometrics procedures by trained doctor assistants.Nutritional status was determined by calculating Z-score values (cut-off point -2SD) weight-for-age (underweight), length/height-for-age(stunting) and weight-for-length/height (wasting) using WHO-2006and CDC-2000 growth standard. McNemar test was done to compareboth results and P<0.05 was considered as a statistically significant.Results There were 264 children, consisted of 139 (52.7%) male and125 (47.3%) female. The prevalence of underweight, stunting andwasting based on WHO 2006 was 20.5%, 20.1% and 45.1%respectively and based on CDC 2000 was 26.5%, 12.1% and 52.3%.The difference was statistically significant (P<0.0001).Conclusion The prevalence of underweight and wasting in childrenless than five years old based on the WHO-2006 was lower comparedto that based on CDC-2000, while the prevalence of stunting washigher.

Higher G allele frequency of RET C2307t>G polymorphism in female patients with Hirschsprung disease in Yogyakarta, Indonesia Ahmad Hamim Sadewa; Saryono Saryono; Rochadi Rochadi; Wiryatun Lestariana; Wayan T Artama
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Hirschsprung disease (HSCR) is a heterogenouscongenital disorder and the current research show that the RETgene is a major locus involved in its pathogenesis. However,whether these genes take a part in sporadically Indonesian HSCRhave not been fully understood.Objective The aim of this study was to analyze the association ofRET gene c2307T>G polymorphism among HSCR patient inYogyakarta population.Methods Genomic DNA was extracted from bowel tissues of 34patients with sporadic HSCR which were removed by surgery ascase group and blood DNA from 46 healthy persons as controlgroup without history of genetic disorder. Exon 13 of RET genewas amplified by polymerase chain reaction (PCR) and wasanalyzed by restriction fragment length polymorphism (RFLP).Results Of 34 patients, 22 were males and 12 were females, givingmale to female ratio of 1.83:1. The c2307T>G polymorphism inRET exon 13 was not significantly difference between patientand control group (chi-square test P=0.17). However, there wasa significant difference in female patient compare with control(chi-square test P=0,04).Conclusion The RET gene c2307T>G polymorphism was foundamong HSCR patient in Yogyakarta population. This poly-morphism can be used as predictor for development of HSCRamong female individual.

Neurodevelopmental disorder risk in babies with history of hyperbilirubinemia Baginda Hutahaean; Alifiani Hikmah Putranti; Kamilah Budhi Rahardjani
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Neurodevelopmental disorder (ND) is defined asfailure to attain normal neurological function. Indirect bilirubinhas essential role because its neurotoxic properties. Neonates withhyperbilirubinemia carry the risk to develop ND.Objective To determine the association between neonatal indirecthyperbilirubinemia and the risk of ND.Methods Neonates with indirect serum bilirubin (SIB) level >10mg/dL, admitted in the period of October 2004-August 2005, wereincluded in this study. They were followed-up and screened usingBayley Infant Neurodevelopmental Screener (BINS) at three, sixand nine months. Mann-Whitney test was used to test thehypothesis.Results Forty-eight neonates were included in the study. MeanSIB level of subjects with ND risk was 20.5 mg/dL (SD=6.06;p<0.001). Mean SIB level of subjects who developed ND at three,six and nine months was 31.6 mg/dL (SD=4.02), 18.4 mg/dL(SD=2.92) and 18.4 mg/dL (SD=5.41), respectively. There wasstatistically significant correlation between SIB level and NDrisk (R=+0.64; P<0.001). There was also statistically significantcorrelation between SIB level and the onset of ND (R=-0.63;P< 0.001).Conclusion There is a correlation between neonatal SIB leveland the risk of ND in babies.

Cryptosporidiosis in children less than three years old in Ciliwung Riverside, Kampung Melayu Village, Jakarta, Indonesia Herbowo A. Soetomenggolo; Agus Firmansyah; Agnes Kurniawan; Partini P. Trihono
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Cryptosporidium infection is often found in children,especially children below three years old. Many risk factors canaffect cryptosporidiosis prevalence. At this moment, the prevalenceand risk factors of cryptosporidiosis in children in Jakarta areunknown.Objectives To determine the cryptosporidiosis prevalence, clinicalmanifestations, and risk factors in children below three years old.Methods This cross sectional study involved 474 subjects betweenthe age of 0 to 35 months in Ciliwung riverside, Kampung Melayuvillage, from December 2005 until April 2006. Stool specimenswere examined using modified acid-fast staining. Nutritional statuswas measured based on actual body weight over ideal body weightratio (NCHS-CDC 2000).Results Cryptosporidium cysts were found in stool sample of 10/474 subject (2.1%). Most of the cases used ground water as asource for drinking and washing. All positive cases lived in houseswith bad sanitation, flooded house and 9/10 cases had a crowdedhousehold. Cat and mice were the two most frequently foundanimals around the house. We found five asymptomatic cases andall of the cases were undernourished.Conclusions The prevalence of cryptosporidiosis in this study is2.1%. Due to small number of cases no risk factor could beidentified. Use of groundwater as a water source, bad sanitation,cat and mice around the house, flooded house, crowded householdand undernourishment might be related to cryptosporidiosisprevalence. Half of the infected children were asymptomatic.

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