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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 9 Documents

Search results for , issue "Vol 57 No 6 (2017): November 2017" : 9 Documents clear

Mantoux tests of children in household contact with adult acid fast bacilli-positive or -negative pulmonary tuberculosis Wardah Wardah; Ridwan Muktar Daulay; Emil Azlin; Wisman Dalimunthe; Rini Savitri Daulay
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Tuberculosis (TB) is the leading cause of mortality and morbidity in developing countries. In children, the major source of TB transmission is adults with pulmonary TB who have acid fast bacilli (AFB)-positive sputum. However, tuberculosis infection can also occur in children in household contact with adults who have AFB-negative pulmonary TB. Objective To compare Mantoux test results and induration diameters in children with adult pulmonary TB household contact who were either positive or negative for AFB, and to assess for possible associations between Mantoux test results with age, family income, and house ventilation in both groups. Methods A cross-sectional study was conducted from January to March 2014. Mantoux test was performed in children aged 3 months to 18 years who had household contact with either AFB-positive or -negative adult pulmonary TB patients. Results A total of 106 children were enrolled in the study. All subjects had household contact with adult pulmonary TB patients who were either AFB-positive (54 children) or AFB-negative (52 children). Mean Mantoux test induration diameters were significantly different between groups (10.9 (SD 6.55) mm vs. 6.2 (SD 5.91) mm, respectively; P=0.001). In addition, there was significantly higher risk of positive Mantoux test in children in contact with adult AFB-positive TB patients than in the AFB-negative group (OR 5.66; 95%CI 2.36-13.59; P=0.0001). However, there were no significant differences in positive Mantoux test results in each of the AFB-positive and -negative groups, with regards to age, family income, or house ventilation. Conclusion Mean Mantoux test induration diameter in children who had household contact with AFB-positive adults is significantly larger than that of the AFB-negative group. Positive Mantoux test results in children are associated with AFB-positive adult TB in the household. There is no association between positive Mantoux test results and age, family income, or house ventilation in both groups. Â

Quality of life in children with congenital heart disease after cardiac surgery Sindy Atmadja; Tina Christina Tobing; Rita Evalina; Sri Sofyani; Muhammad Ali
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Major achievements in congenital heart disease (CHD) treatment over the past 20 years have altered the course and prognosis of CHD. Improvement of quality of life (QoL) is now a major goal of CHD treatment. Objective To assess the QoL in children after cardiac surgery for CHD. Methods A cross-sectional study was performed in children aged 2 to 18 years. The case group had 20 children with a history of corrective heart surgery in the 12 months prior to the study. The control group had 20 healthy children, age-matchedÂ to the case group. The QoL of both groups was assessed by Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales. The same post-operative children were also assessed with the PedsQL Cardiac Module. Data were analyzed using T-test with P < 0.05 as the level of significance. Results This study recruited 40 subjects: 20 post-operative and 20 healthy children. PedsQL Generic Core Scales assessment showed significant differences between groups in the physical function parameter of QoL (P<0.05) in children aged 13-18 years, but there were no significant differences in the social, emotional, and school function parameters. In children aged 2-12 years, there were no significant differences in physical, social, emotional, or school parameters. The PedsQL Cardiac Module assessment revealed that 35% of post-operative children was at risk for physical appearance problems, 80% was at risk for anxiety problems, 40% was at risk for cognitive problems, and 80% was at risk for communication problems. Conclusion Thirteen to 18-year-old children with non complex CHD have poorer physical function than healthy children. Post operative children are at risk for physical appearance, anxiety, cognitive, and communication problems.

Side effect of deferiprone as iron chelator in patient with thalassemia Mikhael Yosia; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background There are currently three available iron chelators: deferoxamine (DFO), deferasirox (DFX) and deferiprone (DFP). In Dr. Cipto Mangunkusumo Hospital and Indonesia, in general, the accessibility of DFP for thalassemia patients has been adequate. Even though its efficacy in removing iron has been proven by countless studies, questions relating to its safety and possible side effects continue to be raised. Objective To assess common side effects of DFP usage by an intensive literature search and compare them to that in a pediatric thalassemia patient, in order to determine if the child's symptoms in the were potentially caused by DFP. Methods A literature search using MeSH terms was done in PubMed. Full copies of articles that fulfil the inclusion criteria, based on their title, abstract, and subject descriptors, were critically appraised using The Joanna Brigs Institute (JBI) critical appraisal tools. Results A total of 10 research articles from 1998-2013 were deemed applicable to this study including: 2 case reports, 5 prospective cohort studies, 2 retrospective cohort studies, and 1 randomized control trial with a grand total of 1,026 samples. Conclusion Side effects of DFP include: neutropenia, agranulocytosis, increased ALT, gastrointestinal problems, arthralgia or arthropathy, increased appetite or weight, thrombocytopenia, urine discoloration, as well as auditory and visual disturbances. Our case report patient's symptoms of gum bleeding and haemorrhagic mass are not related to her DFP consumption.

Risk factors of soil-transmitted helminth infection among elementary school students Kadek Adit Wiryadana; I Wayan Ardyan Sudharta Putra; Putu Diah Saraswati Rahayu; Made Martha Pradnyana; Made Lady Adelaida; I Made Sudarmaja
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Helminth infection remains a health problem, especially in school-aged children. Mass eradication programs with a single dose of anti-helminthic drugs were employed by the local government in some endemic areas in Bali. However, the effectiveness of the programs has not been well evaluated. Objective To investigate prevalence and possible risk factors of helminth infection, including nutritional status, in elementary school students from endemic areas who participated in mass eradication programs. Methods This cross-sectional study involved 126 students from Elementary School No. 3 Gegelang, Karangasem, Bali, a location that had recently undergone a mass eradication program. Diagnoses were based on direct smear examination of fecal specimens. Information on suspected risk factors and nutritional status were collected by questionnaire and anthropometric measurement, respectively. Statistical analyses included Chi-square and odds ratio, using SPSS v21 software. Results The prevalence of helminth infection was 31.7% with etiologies of Trichuris trichuria (75%), Ascaris lumbricoides (17.5%), or both infections (7.5%). Habits of not using footwear [OR=4.88; 95%CI 1.15 to 20.65], not keeping nails trimmed [OR=3.33; 95%CI 1.07 to 10.37], and absence of a proper toilet [OR=4.31; 95%CI 1.93 to 9.64] were found to be significant risk factors for helminth infection. However, we found no significant association between helminth infection and nutritional status, although a considerable number of students had less than normal reference values, in terms of weight, height, and BMI for age. Conclusion The prevalence of helminth infection continues to be high, with personal hygiene and sanitation as significant risk factors. History of mass eradication programs did not confer an effective protection against helminth infection.

Relationship between age at menarche and exposure to sexual content in audio-visual media and other factors in Islamic junior high school girls Tity Wulandari; Melda Deliana; Sri Sofyani; Siska Mayasari Lubis
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background In recent decades, girls have experienced menarche at earlier ages, which may have negative effects on health. Exposure to audio-visual media and other factors may influence the age at menarche, although past studies have produced inconsistent results. Objective To assess for relationships between the age at menarche and audio-visual media exposure, socio-economic status, nutritional status, physical activity, and psychosocial dysfunction in adolescent girls. Methods This cross-sectional study was conducted from August to October 2015 in students from two integrated Islamic junior high schools in Medan, North Sumatera. There were 216 students who met the inclusion criteria: aged 10-16 years and experienced menarche. They were asked to fill out questionnaires that had been previously validated, regarding their history of exposure to audio-visual media, physical activity, and psychosocial dysfunction. The data were analyzed by Chi-square and Fisherâ€™s exact tests in order to assess for relationships between audio-visual media exposure and other potential factors with the age at menarche. Results Of 261 female students at the two schools, 216 had undergone menarche, with a mean age at menarche of 11.6 (SD 1.13) years. There was no significant relationship between age at menarche and audio-visual media exposure (P=0.68). Also, there were no significant relationships between factors such as socio-economic and psychosocial status with age at menarche (P=0.64 and P=0.28, respectively). However, there were significant relationships between earlier age at menarche and overweight/obese nutritional status (P=0.02) as well as low physical activity (P=0.01). Multivariate logistic regression analysis showed that low physical activity had the strongest influence on early menarche (RP=2.40; 95%CI 0.92 to 6.24). Conclusion Age at menarche is not significantly associated with sexual content of audio-visual media exposure. However, there were significant relationships between earlier age at menarche and obese/overweight nutritional status as well as low physical activity.

The relationship between infant iron status and risk of neurological impairment Buntat Buntat; Nurhayati Masloman; Johnny Rompis
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Iron deficiency (ID) is a commonly found nutritional disorder and a persistent problem, especially in Indonesia. Iron deficiency during the critical period in childhood brain development is estimated to cause irreversible damage that hinders infant development. Objective To determine the relationship between infant iron status and neurological development. Methods We conducted a cross-sectional study at the Growth and Development Outpatient Clinic, Prof. Dr. R. D. Kandou Hospital, Manado, from March to May 2015. By consecutive sampling, we obtained 44 healthy infants aged 7 to 10 months who fulfilled the inclusion criteria. Infants with a history of perinatal complications, such as head trauma, hypoglycemia, respiratory distress syndrome, infection, or malaria were excluded Subjects' serum hemoglobin and ferritin were examined for iron status. Infants' risk of neurological impairment was assessed by the Bayley Infant Neurodevelopmental Screener (BINS). Results were analyzed by descriptive analysis for the characteristics and Spearman's rank correlation coefficient analysis for the relationship between iron status and neurological development. Results From 14 infants with ID, 8 infants had a high risk of developmental impairment. Of the 30 non-ID subjects, 4 infants had a high risk of developmental impairment. Of the 30 non-ID infants, 16 infants had a low risk of impaired development, while 2 infants with ID had low risk of developmental impairment. Spearman's rho revealed that infant iron deficiency was significantly associated with high risk of neurological impairment. (r=-0.547; P<0.0001). Conclusion Lower serum ferritin levels (iron deficiency) is significantly associated with greater risk of impaired neurological development in infants aged 7-10 months.

Comparison of inflammation and oxidative stress levels by the severity of obesity in prepubertal children Ni Luh Putu Surya Candra Eka Pertiwi; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Children with severe obesity are more likely to develop diabetes and cardiovascular diseases at a younger age. Inflammation and oxidative stress associated with childhood obesity may be important in the development of insulin resistance and atherosclerosis. Objective To compare levels of high-sensitivity C-reactive protein (hsCRP) and malondialdehyde (MDA) by the severity of obesity in prepubertal children aged 6 to 10 years. Methods We conducted a cross-sectional study at the Pediatric Nutrition and Metabolic Syndrome Clinic, Sanglah Hospital, Bali, from August to December 2015. Subjects were categorized into three body mass index (BMI) groups, according to the 2000 Centers for Disease Control and Prevention growth chart: overweight (85th-94.9th percentile), obese (95th-98.9th percentile), or severely obese (â‰¥ 99th percentile). Plasma MDA and serum hsCRP were analyzed in blood specimens obtained at enrollment. Data were analyzed by Kruskal-Wallis test, followed by Mann-Whitney U test for post-hoc comparison between groups. Results Subjects were 20 overweight children, 29 obese children, and 28 severely obese children. Levels of MDA were significantly higher in the severely obese [median 0.25 (IQR 0.1) Î¼mol/L] than in obese subjects [median 0.19 (IQR 0.1) Î¼mol/L; P=0.001], and than in overweight subjects [median 0.16 (IQR 0.1) Î¼mol/L; P<0.0001]. Also, the severely obese children had significantly higher hsCRP levels compared to obese [median 3.2 (IQR 2.0) mg/L vs. 1.3 (1.6) mg/L, respectively; P<0.0001] and compared to overweight children [median 0.7 (IQR 0.6) mg/L; P<0.0001]. Â Â Â Conclusion Prepubertal children at the â‰¥ 99th percentile for BMI (severely obese) are more likely to have significantly higher hsCRP and MDA compared to those in the obese and overweight groups. Â

Initial clinical and laboratory profiles to predict pediatric dengue infection severity Natharina Yolanda; Harris Alfan
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background. In dengue infection, it is difficult to differentiate mild and severe dengue prior to its critical phase. Ability to identify risk factors for severe dengue form patients' initial presentation would help decrease the need of hospitalization, increase physicians' awareness, and improve outcome. Objective. To predict pediatric dengue infection severity based on initial patient characteristics, routine clinical and laboratory profiles. Methods. This was a cross-sectional study based on medical records of children with dengue infection in Atma Jaya Hospital, Jakarta. Inclusion criteria were children aged 1 - 18 years old with proven dengue infection, hospitalized in Atma Jaya Hospital during January - December 2016. Clinical profiles and laboratory parameters at the time of patient presentation were extracted and analyzed in relationship with dengue severity. Result. Data collected was 110 patients with mean age 9.5 years old. Initial clinical profiles that significantly related to severe dengue were: age <=5 years old (OR = 0.113, p = 0.001), hepatomegaly (OR = 2.643, p = 0.035), pleural effusion (OR = 9.545, p = 0.000), platelet <=125,000/uL (OR = 0.201, p = 0.025), hyponatremia (OR = 10.139, p = 0.000) and AST >135 u/L (OR = 5.112, p = 0.014). Gender, duration of fever, additional symptoms, spontaneous bleeding, blood pressure, pulse pressure, hematocrit, leucocyte, random blood glucose, calcium, and ALT were not related significantly to dengue severity. Conclusion. Physician should be cautious in pediatric dengue patients presented in age younger than 5 years old, with hepatomegaly and/or pleural effusion, platelet below 125,000/uL, hyponatremia, and AST more than three times upper normal limit. These patients have higher risk of severe dengue than patients without those findings.

Maternal attitude and child interest in various play activities before and after mother-child play sessions Soedjatmiko Soedjatmiko; Hartono Gunardi; Rini Sekartini; Bernie Endyarni Medise; Ikhsan Johnson; Yulianti Wibowo; Ray Wagiu Basrowi
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Play stimulates children's growth and development. When mothers and their children play, a positive attitude from the mother and adequate interest from the child is required. Little is known about the play activities that effectively stimulate such positive maternal attitude and child interest. Objective To assess for associations between various play activities with maternal attitude and child interest before and after mother-child play sessions. Methods Pre-post intervention questionnaires were distributed to mothers before and after playing with their children. Children were aged 1-5 years, from two play sites (in Surabaya and Makassar), and included using purposive sampling. Eight types of toys/play activities were provided. The allocated time for answering the 17-question survey was 15 minutes. Average scores before and after the mother-child play sessions were analyzed using paired T-test. Results We collected 264 valid questionnaires, 235 in Surabaya and 29 in Makassar. Improvement of maternal attitude after the mother-child play session was found in 132 mothers [mean diff. 0.07 (SD 0.42); 95%CI -0.117 to -0.015; P=0.011]. Play activities with significant improvements in maternal attitude were jigsaw puzzle [mean diff. 0.09 (SD 0.66); 95% CI 0.007 to 0.167;P= 0.033), Lego blocks (mean diff.-0.10 (SD 0.69); 95%CI -0.186 to -0.018; P=0.017), mini-gardening (mean diff. -0.15 (SD 0.75); 95%CI -0.238 to -0.057; P=0.002), sandbox [mean diff.-0.24 (SD 0.83); 95%CI -0.339 to â€“ 0.138; P < 0.001], fishing [mean diff. -0.17 (SD 0.68); 95%CI -0.253 to -0.088; P < 0.001], and animal figurines [mean diff. -0.21 (SD 0.75); 95%CI -0.3 to -0.117;P <0.001]. Improvement of child interest was found in 161 children [mean diff. 0.20 (SD 0.52); 95%CI -0.264 to -0.116; P<0.001]. Play activities with significant improvements in child interest were jigsaw puzzle, Lego blocks, origami, mini-gardening, fishing, and animal figurines. Conclusion Some mother-child play activities, but not all, significantly improve both maternal attitude and child interest toward play.

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