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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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Articles 11 Documents

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Search results for , issue "Vol 52 No 1 (2012): January 2012" : 11 Documents clear

Surveillance of rotavirus diarrhea Titis Widowati; Yati Soenarto; Achirul Bakrie; Hera Nirwati
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Rotavirus is a major cause of severe diarrhea anddehydration in children worldwide. Data on the burden of diseasein Indonesia is limited.Objective To provide an epidemiological profile of rotavirusinfection among children hospitalized for diarrhea in MohammadHoesin Hospital, Palembang.Methods In January- December 2006, a prospective, hospitalbasedsurveillance was carried out in children aged less thanfive years, presenting with diarrhea. Stool samples wereexamined for rotavirus using enzyme immunoassay (EIA).G- and P-typing were performed on specimens confirmed tobe positive by EIA.Results A total of 513 fecal specimens from 534 children weretested for rotavirus. Rotavirus was detected in 64% of thespecimens, mostly of the G9 type (62.5%). Incidence ofrotavirusdiarrhea was highest in the 6 month to 2 years age group (60.4%).Children with rotavirus diarrhea were more likely to present withdehydration, compared to those with non-rotavirus diarrhea (94%vs 70%, respectively, P=0.03).Conclusion Rotavirus was the most common pathogen foundin children with diarrhea. Rotavirus was detected in 64% ofpediatric diarrheal specimens tested in our study. This findingwarrants the use of a large-scale program to prevent disease,such as vaccination against rotavirus. [Paediatr lndones.2012;52:22-7].

Breastfeeding and decreased risk for childhood obesity Aspri Sulanto; Setya Wandita; Madarina Julia
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Breast milk promotes infant growth and appropriateweight gain, minimizing the risk for malnutrition, and possiblyfor obesity.Objective To determine the influence of infant breastfeedingpractices on the risk for obesity in children aged 6 to 8 years.Methods We conducted a case-control study comparingbreastfeeding practices between obese and non-obese children.Subjects were selected from two elementary schools in Yogyakarta.Case subjects had body mass index (BMI)-for-age <::: + 2 SD(WHO 2007 growth reference curve). Control subjects had BMIfor-age SD between-2and+1 SD, and were matched for age andgender to the case subjects. Subjects' mothers filled questionnaireson their breastfeeding practices.Results We recruited 68 pairs of obese and non-obese subjects,4 7 (69%) pairs of boys and 21 (31 %) pairs of girls. The meanduration of breastfeeding in the obese group was shorter thanthat of the non-obese group, 12.9 months (SD 9.78) vs. 16.1months (8.39), respectively, a mean difference of 3.24 months(95% CI 0.14 to 6.32). Partially breastfed and formula-fed childrenhad significantly higher odds for obesity compared to that ofexclusively breastfed children, OR4.70 (95% CI 3.96 to 5.43) forpartial breastfeeding and 6.20 (95% CI 4.67 to 7.73) for formulafeeding. The risk for obesity also declined with longer durationsof breastfeeding.Conclusion Exclusive infant breastfeeding and longer durationof breastfeeding lowered the risk for childhood obesity in childrenaged 6-8 years. [Paediatr lndones. 2012;52: 1-5].Â

Role of Denver II and Development Quotients in the management of several pediatric developmental and behavioral disorders Titi Sularyo; Bernie Endyarni; Tri Lestari H; Tirza Z. Tamin; Gitayanti Gitayanti
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Autism spectrum disorder (ASD) and attention deficitand hyperactivity disorder (ADHD) are nowadays becoming moreand more frequently found. Parents are worried of the possibilitythat their children suffer from them. Growth and developmentclinics (GDC) should be able to deliver professional services. Thusa practica~ applicable, objective, valid, reliable, and able to measuredevelopment quotient (DQ) values instrument is needed.Objective To find out whether the Denver II instrument andDQ values can be used in the management of children with ASDandADHD.Methods A study was carried out on cases of children withASD, multisystem development disorder (MSDD), pervasivedevelopment disorder - n ot otherwise specified (PDD-NOS), andattention deficit and hyperactivity disorder (ADHD), consistingof history taking, physical examination, establishing diagnosis,therapy, evaluation, and follow-up. The Denver II instrumentwas used and DQ values in all development streams established.The study was done at the GDC of Hermina Depok Hospital inJuly 2008 - June 2009.Results It revealed that results of the Denver II as seen on thefilled Denver II form showed "typical" features related to kind ofdisorder as far as category ofDQ value, dissociation, global delayeddevelopment (GDD) as well as abnormality of the test behaviorwere concerned. It also revealed that establishing the diagnosesby the use of the Denver II and DQ values gave exactly the samediagnoses as when using the conventional way by the expert.Conclusion The Denver II instrument with DQ values can beused in the management of ASD and ADHD cases. [Paediatrlndones. 2012;52:51-6].

Pertussis-like syndrome or pertussis: a delay diagnosis Heda Melinda Nataprawira; Finia Cahayasari; Arifin Kashmir
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Recent reports of pertussis epidemiology from Asia,Africa and South America have been limited, but the WorldHealth Organization estimates indicate that these regions havethe highest disease burden. Difficulty in estimating the prevalenceof pertussis is due to lack of access to diagnostic methods,misdiagnoses, under-reporting, and different countries' reportingcriteria. A syndrome characterized by severe episodes of coughingresembling whooping cough (pertussis) has also been defined aspertussis-like syndrome.Objective To report eleven cases of pertussis or pertussis-likesyndrome in the pediatric ward of Hasan Sadikin Hospital.Methods This retrospective study was conducted by reviewingmedical records from 2008-2010. Characteristics of 11 pertussislikesyndrome patients were documented including age, gender,history of pertussis immunization, clinical manifestations,laboratory findings, initial diagnosis, treatment and clinicalresponse. Isolation of Bordetella pertussis using Bordet-Gengouagar was also noted. Pertussis diagnoses were grouped based ontwo classifications: probable and confirmed.Results Eleven patients were diagnosed with pertussis-likesyndrome, including 5 boys and 6 girls. Most subjects were lessthan 6 months of age. Only one subject had received previouspertussis immunization. Dyspnea, paroxysmal cough, and feverwere the most common symptoms. All were initially diagnosedto have had severe bacterial pneumonia, and later changed toprobable pertussis. Three subjects exhibited post-tussive vomitingand cyanosis, while none had apneic symptoms. All B. pertussisisolations yielded negative results. Ampicillin or cephalosporinwas initially administered. Patients receiving subsequentclarithromycin showed good clinical responses.Conclusion All infants were likely considered to have pertussis,as most had no pertussis immunizations. However, B. pertussisisolation was unsuccessful in all cases. As such, diagnoses couldnot be confirmed. [Paediatr In don es. 2012;5 2: 28-31].

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].

Artesunate-amodiaquine treatment for children with uncomplicated malaria in Kalimantan and Sulawesi: clinical complaints, tolerability and compliance Retno Gitawati; Ani Isnawati; Emiliana Tjitra; Mariana Raini; Ondri Dwi Sampurno; Indri Rooslamiati
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Artesunate-amodiaquine combination (AS+ AQ)is one type of artemisinin-based combination therapy (ACT) andhas been used in Indonesia since 2004 for uncomplicated malaria,both in adults and children. However, its use in the IndonesiaMalaria Program has not yet been evaluated.Objective To evaluate the clinical complaints and tolerabilityto AS+AQ treatment, as well as compliance in children withuncomplicated malaria.Methods This was a cross-sectional study, conducted in sentinelpuskesmas (primary health centers) in Kalimantan and Sulawesi.Subjects were 126 children aged under 15 years, with P. falciparum,P. vivax, or mixed falciparum-vivax malaria infections. All subjectswere treated with a single dose of AS+AQ for three consecutivedays and followed-up 3 times (D3, D7 and D28) to record clinicalcomplaints and tolerability after drug administration. Parents/guardians underwent in-depth interviews on the knowledge,attitudes and practices of the ACT used as well as clinicalcomplaints following AS+ AQ treatment.Results Of the 126 subjects evaluated, 30 were infected with P.falciparum, 5 9 with P. vivax, and 3 7 with both species. About 84% ofthe subjects reported clinical complaints after AS+ AQ administration(DO-DZ), most commonly lethargy, nausea and vomiting, similar tothe clinical symptoms of malaria. All complaints were reported to bemild and tolerable. Only one subject was lost to follow-up.Conclusion Clinical complaints experienced by malaria-infectedchildren following AS+AQ treatment were relatively tolerable.Subjects' compliance to AS+ AQ treatment was satisfactory.[Paediatr lndones. 2012;52:10-5).

Calcium and vitamin D supplementation in children with frequently relapsing and steroid-dependent nephrotic syndrome Ayi Dilla Septarini; Taralan Tambunan; Pustika Amalia
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Children with frequently relapsing and steroiddependentnephrotic syndrome (FRNS/SDNS) are at riskfor osteoporosis due to impaired metabolism of calcium andvitamin D.Objective To determine the effect of calcium and vitamin Dsupplementation on bone mineral density, serum ionized calciumlevels and serum 25-hydroxy-vitamin D levels in children withFRNS and SDNS.Methods A clinical trial with a before and after design wasperformed. Subjects were SDNS or FRNS pediatric patients 2: 5years of age. Subjects received 800 mg elemental calcium and 400IU vitamin D supplementation for 8 weeks. Serum ionized calcium,serum 25-hydroxy-vitamin D [25(0H)D], and bone mineral density(BMD) were determined before and after the supplementation.Results Of the 30 subjects, 28 completed the study. However,only 20 subjects underwent BMD determination before and aftersupplementation. Of the 28 subjects, 22 had hypocalcemia and 26had low vitamin D levels. Osteopenia was found in 14/20 subjects andosteoporosis was in 2/20 subjects. After 8 weeks of supplementation,mean serum ionized calcium increased from low [1.15 mmol/L (SDO.oJ)] to normal [1.18 mmol/L (SD 0.04)] (P< 0.001) levels, butmean serum 25(0H)D only increased from vitamin D deficiencycategory [20 ng/mL (SD 7 .7)] to vitamin D insufficiency category[25.5 ng/mL (7.7)] (P=0.010). Mean z-score BMD increased from-1.1 (SD 0.9) to -0.7 (SD 0.2) after supplementation (P<0.001).Conclusion Calcium vitamin D supplementation effectively increasedserum ionized calcium, serum 25 (OH)D, and BMD in subjectswith FRNS and SDNS. [Paediatr lndones. 2012;52:16-21].

Television watching time and cognitive development in young children Anak Agung Ayu Windi Antari; I Gusti Ayu Trisna Windiani; Djauhar Ismail
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Television viewing for children is prevalent. Therehave been few Indonesian studies on the association betweenduration of television watching and cognitive development inyoung children.Objective To assess cognitive development in young children whowatched < 1 hour, 1-2 hours, or > 2 hours of television daily.Methods We conducted a cross-sectional study at 6 prekindergartensin Denpasar, Bah. We included 135 subjects in thisstudy. Cognitive development was measured by the Mullen ScalesofEarly Learning (MSEL). Data was analyzed by one-way analysisof variance (ANOVA) test, post-hoc test, and univariate analysisof covariance (ANCOVA) with significance level of P < 0.05.Results There were significant differences among compositestandard score in children who watched television < 1 hour, 1-2hours, and> 2 hours per day (P=0.035). The mean compositestandard score in children who watched television 1-2 hours dailywas 6.087 points higher than in those who watched television< 1 hour daily (P=0.013, 95%CI 1.29 to 10.88) and 4.213points higher than in those who watched television > 2 hoursdaily (P=0.045, 95%CI 1.08 to 8.51). There was an associationbetween television watching time and cognitive development(P=0.001).Conclusion Television watching time was statistically associatedwith cognitive development in young children, where thoseviewing television 1-2 hours daily scoring significantly higher thanthose viewing < 1 hour and > 2 hours daily. [Paediatr lndones.2012;52:32-7].

Correlation between C--reactive protein and serum iron levels in children with pneumonia I Gd. Oki Novi Purnawan; Ida Bagus Subanada; Sri Mulatsih
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Pneumonia is an infectious disease often occuringin children under five years of age. At the time of infection,pro-inflammatory cytokines are released. It is thought that thesepro-inflammatory cytokines cause changes to iron homeostasisin the body.Objective To determine a correlation between CRP and serumiron levels in children with pneumonia.Methods An analytical, cross-sectional study was performedin children aged 6 months-5 years with severe pneumonia atSanglah Hospital, Denpasar, Bali from April-November 2010.Laboratory examinations included CRP and serum iron levels.The correlation between CRP and serum iron levels was analyzedby Pearson's correlation.Results From 69 children with severe pneumonia, 23 childrenfulfilled the inclusion criteria. Subjects' median CRP level was9.22 mg/Land median serum iron level was 25.55 ug/dL. Thecoefficient correlation between CRP and serum iron levels was-0.580 (P=0.004). The determination coefficient value was0.316.Conclusion In children with severe pneumonia, CRP levelcorrelates negatively with serum iron levels. [Paediatr lndones.2012;52:38-42).

Supporting factors and barriers in implementing kangaroo mother care in Indonesia Hadi Pratomo; Uut Uhudiyah; Ieda Poernomo Sigit Sidi; Yeni Rustina; Rulina Suradi; Anne-Marie Bergh; Quail Rogers-Bloch; Reginald Gipson
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Kangaroo mother care (KMC) was introduced toIndonesia in the 1990s. Since then, KMC has not been widelyimplemented and has not received national policy support.Objective The objectives of this case study were to implementKMC by an intervention that would ultimately benefit tenhospitals in Java, Indonesia, as well as identify supporting factorsand barriers to KMC implementation.Methods An intervention with four phases was conducted inten hospitals. Two teaching hospitals were supported to serve astraining centers, six hospitals were supported to implement KMCand two other hospitals were supported to strengthen existingKMC practices. The four phases were comprised of a baselineassessment, a five-day training workshop, two supervisory visitsto each hospital, and an end-line assessment.Results A total of 344 low birth weight infants received KMCduring the intervention period. Good progress with regards toimplementation was observed in most hospitals between the firstand second supervisory visits. Supporting factors for KMC were thefollowing: support received from hospital management, positiveattitudes ofhealthcare providers, patients, families and communities,as well as the availability of resources. The most common challengeswere record keeping and data collection, human resources and staffissues, infrastructure and budgets, discharge and follow-up, as wellas family issues. Challenges related to the family were the inabilityof the mother or family to visit the infant frequently to provideKMC, and the affordability of hospital user fees for the infant tostay in the hospital for a sufficient period of rime.Conclusion KM C appeared to be well accepted in most hospitals.For an intervention to have maximum impact, it is importantto integrate services and maintain a complex network ofcommunication systems. [Paediatr lndones. 2012;52:43-50).

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