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INDONESIA
Paediatrica Indonesiana
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.
Arjuna Subject : -
Articles 9 Documents
 1 
Search results for , issue "Vol 61 No 1 (2021): January 2021" : 9 Documents clear
Postpartum lactation counseling and exclusive breastfeeding: analysis of the 2017 Indonesian Demographic and Health Survey Warantika Rikma Yuniarini; Elisabeth Siti Herini; Abdul Wahab
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.25-33

Abstract

Background The percentage of exclusive breastfeeding in Indonesia on 2018 dropped from 39.8% in infants aged 0 monthsto 15.3% in infants aged 5 months. According to the 2018 Indonesian Basic Health Research Survey (Riskesdas), an average of 37.3% of infants were exclusively breastfed until the age of 6 months. This rate is far from the target of 80% by Ministry of Health of Indonesia. Objective To assess for an association between postpartum counseling and the practice of exclusive breastfeeding in Indonesia. Methods This retrospective cohort study used data from the 2017 Indonesian Demographic and Health Survey (IDHS). The sample comprised 258 infants aged 6 months. Postpartum counseling and other variables were analyzed for possible associations with exclusive breastfeeding by Chi-square test; risk ratios (RR) with 95% confidence intervals (CI) were calculated. Logistic regression test was used to analyze for adjusted odds ratios. Results In 6 months period, the percentage of subjects who received postpartum counseling was 59.7% and who exclusively breastfed was 18.8%. There was no significant association between postpartum lactation counseling and exclusive breastfeeding. However, there were significant associations between exclusive breastfeeding and not using currently as well as maternal residence in rural areas. Conclusion Postpartum counseling on breastfeeding lacks a significant association with exclusive breastfeeding practice at 6 months of age. Therefore, the Ministry of Healthshould reevaluate the implementation of its counseling services.
Pediatric SOFA score for detecting sepsis in children Muhammad Aulia; Silvia Triratna; Yulia Iriani; Achirul Bakri; Indra Saputra
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.1-7

Abstract

Background The pediatric logistic organ dysfunction-2 (PELOD-2) score is recommended by the Indonesian Pediatric Society Emergency and Intensive Care Working Group as an indicator of life-threatening organ dysfunction for sepsis in children. However, The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) recommended the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) score in determining life-threatening organ dysfunction, which has not been adjusted for pediatric patients. Objective To assess the accuracy of the pediatric SOFA score in diagnosing sepsis in children admitted to the pediatric intensive care unit (PICU) at Mohammad Hoesin Hospital, Palembang, South Sumatera. Methods The study was conducted in children with organ dysfunction caused by infection admitted in PICU, from April to December 2019. Subjects were included by consecutive sampling, according to the following inclusion criteria: all patients aged 1 month to 18 years who met organ dysfunction and two SIRS criteria, with infection according to the 2005 PSCC criteria. Laboratory tests performed included complete blood count (CBC), blood gas analysis, measurement of C-reactive protein (CRP), liver and kidney function tests. In all patients, pSOFA and PELOD-2 scores were calculated within 24 hours of admission. We compared the accuracy of pSOFA score to PELOD-2 score >= 11. Results Of 108 subjects, there were 59 males and 49 females, with median age 11 (range 1-193) months. We compared the accuracy of pSOFA score to PELOD-2 score >= 11 and obtained a sensitivity of 93.3% and a specificity of 79.5%, for pSOFA cut-off score ? 8. Pediatric SOFA score cutoff >= 8 was determined by receiver operating curve (ROC). The area under the curve (AUC) for pediatric SOFA score was 93.9% (95%CI 89.7 to 98.0%). Conclusion Pediatric SOFA score >= 8 is the optimal cut-off for predicting life-threatening organ dysfunction in pediatric sepsis. Multicenter revalidation is needed to find the most optimal cut-off point for general use in Indonesia.
New PELOD-2 cut-off score for predicting death in children with sepsis Ni Made Rini Suari; Abdul Latief; Antonius H. Pudjiadi
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.39-45

Abstract

Background According to the most recent Sepsis-3 Consensus, the definition of sepsis is life-threatening organ dysfunction caused by dysregulated immune system against infection. Currently, one of the most commonly used prognostic scoring system is pediatric logistic organ damage-2 (PELOD-2) score. Objective To determine and validate the pediatric logistic organ dysfunction-2 (PELOD-2) cut-off score to predict mortality in pediatric sepsis patients. Methods A prospective cohort study was conducted in the intensive care units of Cipto Mangunkusumo Hospital, Jakarta. We assessed subjects with PELOD-2 and calculated the predicted death rate (PDR) using SFAR software. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate calibration and the area under the curve (AUC) of the receiver operating characteristic curve (ROC) to estimate discrimination. Results Of 2,735 children admitted to the emergency department, 52 met the inclusion criteria. Patients had various types of organ dysfunction: 53.8% respiratory, 28.8% neurological, 15.4% cardiovascular, 1.9% hematological. The mortality rate in this study was 38.5%. Mean PELOD-2 score was higher in patients who died than in those who survived [13.9 (SD 4.564) vs. 7.59 (SD 3.025), respectively, P=0.000]. The discrimination of PELOD-2 score with the lactate component had an AUC of 85.5% (95%CI 74.5 to 96.5), while PELOD-2 without lactate had an AUC of 85.4% (95%CI 74.5 to 96.3%). We propose a new PELOD-2 cut-off score to predict organ dysfunction and death of 10, with 75% sensitivity, 72% specificity, 62.5% PPV, and 82% NPV. PELOD-2 score > 10 had a moderate, statistically significant correlation to mortality (r=0.599; P<0.001). Conclusion A PELOD-2 score > 10 is valid for predicting life-threatening organ dysfunction in pediatric patients with sepsis.
Maternal visual perception of children’s nutritional status and feeding style Ikromi Dalimunthe; Tiangsa Sembiring; Rita Evalina
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.34-8

Abstract

Background Mothers’ visual perception is an important determinant for their children’s nutritional status. Visual perception of their children’s nutritional status is believed to drive mothers to modify or apply certain feeding styles, which influence the probability of either optimal growth or malnutrition. Objective To determine if maternal visual perception of children’s nutritional status influences maternal feeding style. Methods The study was conducted in 3 kindergartens in Medan, North Sumatera, involving children aged 4-5 years and their mothers. Mothers filled three-part questionnaires, consisting of basic information, a series of body image sketches by a graphic artist to assess maternal visual perception, and the Parental Feeding Style Questionnaire (PFSQ) to assess maternal feeding style. Children’s body heights and weights were measured to assess their nutritional status. Results A total of 102 subjects were eligible for this study. Surprisingly, more than half of the mothers involved in our study misinterpreted their children nutritional status. Thus, there was no significant relationship between maternal visual perception, nor maternal misperception, and maternal feeding style. In fact, mothers tended to encourage their children to eat when they considered their children to have normal nutritional status. Conclusion Mothers’ visual perception does not influence feeding practice.
Risk factors of stunting in Indonesian children aged 1 to 60 months Rizki Aryo Wicaksono; Karina Sugih Arto; Erna Mutiara; Melda Deliana; Munar Lubis; Jose Rizal Latief Batubara
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.12-9

Abstract

Background The Indonesian province of Aceh has a high prevalence of stunting. Identifying risk factors for stunting may help prevention efforts. The Growth Diagrams of Indonesian Children are a specific tool to diagnose stunting in Indonesian pediatric populations. Objective To determine the risk factors of stunting in children aged 1-60 months using the Growth Diagrams of Indonesian Children. Methods This observational, analytic study with case-control design was conducted in the Lawe Alas District, Southeast Aceh, Indonesia to compare prior risk factors exposure between stunted children (cases) and non-stunted children (controls) from January-April 2018. Subjects were children aged 1-60 months and recruited by consecutive sampling. Results The subjects comprised 97 cases and 97 controls, totaling 194 subjects, internal risk factors of stunting were short birth length (OR 2.87; 95%CI 1.24 to 6.61; P=0.011), inadequate calorie intake (OR 2.37; 95%CI 1.32 to 4.27; P=0.004), non-exclusive breastfeeding (OR 3.64; 95%CI 2.01 to 6.61; P<0.001), chronic diarrhea (OR 6.56; 95%CI 3.33 to 13.01; P<0.001) and upper respiratory tract infections (OR 3.47; 95%CI 1.89 to 6.35; P<0.001). External risk factors of stunting were unimproved sanitation (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), unimproved water sources (OR 2.71; 95%CI 1.50 to 4.88; P=0.001), low family income (OR 2.49; 95%CI 1.38 to 4.49; P=0.002), low paternal educational level (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), low maternal educational level (OR 2.64; 95%CI 1.38 to 5.04; P=0.003), and living in households with >4 family members (OR 1.23; 95%CI 0.69 to 2.17; P=0.469). Regression analysis showed that the dominant risk factor of stunting was chronic diarrhea (OR 5.41; 95%CI 2.20 to 13.29; P<0.001). Conclusion The history of chronic diarrhea and non-exclusive breastfeeding are the main risk factors of childhood stunting.
Psychosocial impact of the COVID-19 pandemic on doctors’ children: are we heading towards a mental health pandemic? Riffat Omer; Humayun Iqbal Khan; Muhammad Khalid Masood; Najaf Masood; Fatima Tahira
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.46-52

Abstract

Background The coronavirus pandemic (COVID-19) may affect the behavior of children. Non infected children of doctors seem to be susceptible to psychosocial health disorders. Objective To assess the psychosocial impact of the COVID-19 pandemic on children of doctors. Methods This questionnaire-based survey filled up by doctors was done with the Pediatric Symptom Check List-17 (PSC-17) to assess the psychosocial impact of the COVID-19 pandemic on doctors’ children aged 10-15 years with no clinical evidence of being infected with coronavirus and possible contributing factors to mental distress/psychosocial health disorders. A PSC -17 Score of >=15 was considered as a significant indicator of suspected psychosocial impact. Results Children’s mean age was 12.5 (SD 1.9) years, and 53.8% of them were male. Of 357 questionnaire responses, 36.1% had a significant PSC-17 score (>15) and a small, but significant inverse correlation was observed with age (r=-0.147; P=0.005). More screen time than usual was perceived by doctors to be the most common potential contributing factor (63%) to their children’s psychosocial impact. Conclusion The COVID-19 pandemic is likely to leave lasting effects on children’s mental health. Parents should closely monitor children for any changes in psychosocial behavior, so that timely intervention can be considered. Psychosocial screening of children is needed and should be conducted at schools.
Phototherapy and serum calcium levels in full term neonates with hyperbilirubinemia Carissa Lidia; I Made Kardana; Gusti Ayu Putu Nilawati; Ida Bagus Subanada; I Gusti Agung Ngurah Sugitha Adnyana; Ayu Setyorini Mestika Mayangsari
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.8-11

Abstract

Background Hyperbilirubinemia is one of the most common problems in newborns. Severe hyperbilirubinemia, known as kernicterus, can suppress O2 consumption and oxidative phosphorylation, as well as damage brain cells, resulting in neuronal dysfunction and encephalopathy. Phototherapy is a common therapy for neonatal hyperbilirubinemia, but may rarely lead to the adverse effect of hypocalcemia. Objective To investigate serum calcium levels in full term neonates with hyperbilirubinemia, before and after phototherapy. Methods This cohort study compared total serum calcium level before and after phototherapy in full term neonates with hyperbilirubinemia. Subjects were full term neonates aged 2-14 days with high total serum bilirubin levels, according to the Bhutani curve, and were treated with phototherapy at Sanglah Hospital, Denpasar, Bali, Indonesia. Paired T-test was used to compare serum calcium levels before and after phototherapy. Results There were 35 subjects in this study. Paired T-test revealed that subjects’ serum calcium significantly decreased after phototherapy [before: 9.47 mg/dL vs. after: 9.23 mg/dL; mean difference 0.24; (95%CI 0.03 to 0.46; P=0.025)]. None of our subjects had hypocalcemia after phototherapy. Conclusion Full term neonates with hyperbilirubinemia have reduced serum calcium levels after phototherapy.
Case report of a COVID-19 family cluster originating from a boarding school Citra Cesilia; Silvia Sudarmaji; Djatnika Setiabudi; Heda Melinda Nataprawira
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.53-60

Abstract

Since it was first identified in Wuhan City, Hubei Province, China in December 2019, SARS-CoV-2 has spread to 195 countries and infected more than 8 million people globally. Indonesia, an archipelago consisting of thousands of islands and 34 provinces, has the largest number of confirmed cases and mortality in Southeast Asia. A total of 464 districts/cities in Indonesia have been affected by COVID-19, of which 189 districts/cities are considered to be local transmission areas. Riau Province, located in Sumatra Island, consists of 12 districts/cities with a population of more than 6.8 million. This province has the 1st largest number of COVID-19 cases on Sumatra Island. Currently, more than 3000 childrens have been infected with case fatality rate <0.3% and recovery rate >90%. In May 2020, the public health office of Riau reported that just 34 children were confirmed to have COVID-19, with symptoms varying from asymptomatic to moderate with only a few family clusters identified. During the pandemic, contact tracing is the main approach to detect and isolate sources of infection in order to reduce viral transmission. This method has also been used to control transmission of other respiratory diseases such as tuberculosis (TB), MERS, and SARS. We report here on a familial cluster of COVID-19 in the Meranti Island Regency, which is located 145 km from the city of Pekanbaru (Riau Province). The island can only be reached in four hours by speed boat.
Preterm human milk composition and dietary intake of breastfeeding mothers in the Indonesian population Putri Maharani Tristanita Marsubrin; Rinawati Rohsiswatmo; Damayanti R. Sjarif
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.20-4

Abstract

Background Human milk consumption is a protective factor against infection. However, the high variability of human milk composition makes it difficult for clinicians and researchers to assess the adequacy of nutritional intake. Objective To identify the nutritional profiles and composition of premature human milk and dietary intake of breastfeeding mother. Methods Human milk specimens were collected from mothers who gave birth to very premature and/or very low birth weight infants. Infants had been admitted to the Neonatology Unit of Dr. Cipto Mangunkusumo Hospital, Jakarta. The milk specimens were analyzed with a mid-infrared milk analyzerTM (MIRIS) for four weeks, and maternal dietary macronutrient intake was determined with food record questionnaires on food consumption frequency and food recall. Results Significant changes in nutritional composition of human milk were observed, with the fat concentration and calories increasing with time, and protein concentration decreasing with time. There were no significant differences observed in carbohydrate concentration of milk over the four weeks (P=0.447). Maternal intake of protein, carbohydrates, fat and calories was lower than the recommended values for breastfeeding women. Conclusion The macronutrient (protein and fat) and energy contents of human milk change weekly. Dietary intake of breastfeeding women are lower than recommended values.

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