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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 12 Documents
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Search results for , issue "Vol. 65 No. 5 (2025): September 2025" : 12 Documents clear
Elephantiasis and nodular scabies coinfection: a rare case report Armiyanti, Yunita; Shodikin, Muhammad Ali; Tohari, Achmad Ilham
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.438-42

Abstract

Indonesia  is a tropical country and  home to many infectious diseases. Two of them are filariasis and scabies. The coinfection of filarial infection and scabies may cause severe morbidity for the patient, especially children. There has been no reported coinfection or management between these two diseases. An 11-year-old boy was brought to the pediatrics division of Dr. Soebandi Hospital with diffuse enlargement of the left lower extremity and scrotum, along with non-pitting edema, itching, and nodular skin lesions all over the body. It is important to consider holistic approaches to prevent further morbidity and disability.
Quality of life in episodic hypoxic children after emergency department or PICU hospitalization Yuniar, Irene; Julianti, Julianti; Gunardi, Hartono; Dewi, Rismala; Wiguna, Tjhin; Lubis, Munar
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.357-63

Abstract

Background Studies on long–term outcomes of hypoxic children after being hospitalized are limited, even though hypoxia is known to affect their quality of life (QoL). Objective To assess the QoL of children with episodic hypoxia following hospitalization in the emergency department (ED) and Pediatric Intensive Care Unit (PICU). Methods A prospective cohort design study targeting pediatric patients aged 2–7 years with critical illness was conducted at Dr. Cipto Mangunkusumo Hospital. Inclusion criteria are hypoxia patients receiving oxygen therapy, defined from the ratio of partial arterial oxygen pressure and inspired oxygen (PaO2/FiO2). The PedsQLTM questionnaire was used to assess QoL at the time of admission and 3 months after hypoxia event. Patients with cerebral palsy, mental retardation, chromosomal abnormalities, liver transplantation, and length of stay ≤24 hours were excluded. Data distribution in numerical form was analyzed using the Kolmogorov–Smirnov test. Results Forty-six children with a median age of 4 (2–7) years had decreased QoL at 3 months after episodic hypoxia, based on PedsQLTM scores. The physical, emotional, and social domains were significantly decreased (P<0.01) compared to QoL at the time of admission. Prior to admission, 78.3% of children had already experienced impaired QoL. Conclusion Children with episodic hypoxia demonstrated a decline in QoL at 3 months after hypoxia event based on PedsQLTM scores. Specifically, the physical, emotional, and social domains were significantly decreased compared to at the time of admission.  
Antibiotic use in children before and after an e-learning intervention Rosyady, Maulana; Karyanti, Mulya Rahma; Chozie, Novie Amelia
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.373-81

Abstract

Background Antibiotic resistance is a global health threat. E-learning can be used to increase the knowledge of medical staff and the effectiveness of antibiotic use. Objective To evaluate the impact of e-learning intervention for pediatric doctors and residents on antibiotic use in pediatric patients. Methods This single-arm intervention study involved all pediatric doctors and residents from the Department of Child Health, Faculty of Medicine at Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital (FMUI-CMH). Staff and residents underwent e-learning intervention on the topic of antimicrobial stewardship (AMS) via the E-learning Management System Universitas Indonesia (EMAS UI) website, followed by comparison of their pre- and post-intervention knowledge. The appropriate use of antibiotics pre- and post-intervention at October and December 2022, respectively, by was assessed by Gyssen's flowchart. Results A total of 135 (54.4%) antibiotic uses in the pre-intervention period and 170 (72.24%) in the post-intervention period were considered appropriate. A significantly greater proportion of subjects received appropriate antibiotic use after the intervention compared to before (95%CI 0.363 to 0.795; P=0.002). Forty-two out of 56 pediatricians and 119 out of 123 pediatric residents participated in the e-learning program. There was a significant improvement in knowledge levels between the pre- and post-intervention periods among pediatricians, with more passing the post-intervention assessment compared to the pre-intervention assessment (1 vs. 29, respectively; P=0.001). Similarly, a significant increase was observed among pediatric residents (10 vs. 66, respectively; P=0.001). Conclusion There was a significant increase in appropriate antibiotic use in pediatric patients at CMH after pediatric doctors and residents underwent e-learning interventions.
The frequency and distribution of healthcare-associated infections in children Murni, Indah Kartika; Wirawan, Muhammad Taufik; Patmasari, Linda; Laksanawati, Ida Safitri
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.382-9

Abstract

Background Healthcare-associated infections (HAIs) are major contributors to increased morbidity, mortality, and healthcare costs. Ongoing epidemiological surveillance of nosocomial infection is needed to accurately assess their burden and inform prevention strategies. Objective To determine the frequency and distribution of HAIs. Methods A 26-month prospective cohort study (February 2016 to April 2018) was carried out at Dr Sardjito Hospital, a tertiary hospital in Indonesia, where pediatric patients hospitalized in the wards and pediatric ICU were monitored daily. HAIs were defined according to the criteria set by the Centers for Disease Control and Prevention. Results Out of 1,855 patients enrolled in the study period, 314 (16.9%) had HAI with an incidence density rate of 20.1 infections per 1,000 patient-days (416/20,672). The incidence of nosocomial urinary tract infection (UTI) was 4.3% (82/1,855) and the catheter-associated urinary tract infection (CAUTI) incidence density rate was 16.5 CAUTIs/1,000 patient-days (36/2,179). The incidence of nosocomial pneumonia, which includes both hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), was 3.2% (59/1,885), while the specific incidence rate of VAP was 5.1 per 1,000 patient-days (14/1,359). The incidence of nosocomial bloodstream infection was 1.9% (36/1,855) and the central line-associated bloodstream infection (CLABSI) incidence rate was 4.4 CLABSIs/1,000 patient-days (5/1,121). The incidences of surgical site infection, phlebitis, nosocomial upper respiratory infection, and nosocomial gastroenteritis were 0.2% (3/1,855), 0.9% (17/1,855), 2.9% (54/1,855), and 3.4% (63/1,855), respectively. Conclusion One-sixth of children in our hospital developed HAIs, with an incidence rate of 20.1 HAI/1,000 days. The most common HAI was CAUTI, followed by VAP and CLABSI.
Early enteral nutrition administration and time to achieve resting energy expenditure in critically ill children Yulman, Annisa Rahmania; Pudjiadi, Antonius Hocky; Tridjaja, Bambang; Kadim, Muzal; Prawitasari, Titis
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.390-8

Abstract

Background Malnutrition in critically ill children remains a significant concern, as a standardized nutritional support protocol has yet to be developed. Resting energy expenditure (REE) is recommended as a parameter for determining the fulfillment of energy needs in critically ill children, which should ideally be achieved within 72 hours. To achieve these energy needs, enteral nutrition (EN) is believed to have a lower mortality rate and a shorter length of stay compared to parenteral nutrition (PN). Objective  To evaluate the factors associated with delayed EN initiation and late achievement of REE.  Methods Data consisting of age, sex, nutritional status, timing of EN initiation, time required to achieve REE targets, PELOD-2 score, use of ventilators, duration of ventilation, hemodynamic status, use of inotropes and inotropic score, use of sedation, gastrointestinal symptoms, procedures performed during treatment, and technical issues were collected retrospectively from medical records from 2017 – 2018 in the Pediatric Intensive Care Unit (PICU) at Dr. Cipto Mangunkusumo Hospital. The REE was calculated using Schofield formula based on age and sex. These data were used to compare the proportion of the subjects receiving early EN (<48 hours) and delayed EN (>48 hours) and those who achieved REE <72 hours and delayed REE (>72 hours). Multivariate analysis was performed to determine which factors affecting late EN initiation and delayed REE achievement using logistic regression analysis. Results Of 203 subjects, 63.1% received early EN and 67.5% achieved REE at ≤72 hours. Delayed EN was associated with post-abdominal surgery (OR 10.89; 95%CI 4.31 to 27.50; P<0.001), ventilator use (OR 4.60; 95%CI 1.78 to 11.90; P=0.004), inotrope use (OR 4.18; 95%CI 1.56 to 11.17; P=0.002), gastrointestinal symptoms (OR 3.41; 95%CI 1.59 to 7.29; P=0.002), and abnormal nutritional status (OR 2.49; 95%CI 1.09 to 5.72; P=0.031). The REE >72 hours was associated with late EN (OR 20.62; 95%CI 6.48 to 65.65; P<0.001), enteral intolerance after receiving EN (OR 14.77; 95%CI 4.40 to 49.6; P<0.001), and PELOD-2 score ≥7 (OR 3.98; 95%CI 1.01 to 15.66; P=0.048). Conclusion The prevalence of EN and REE within 72 hours in the PICU is quite encouraging. Factors contributing to delayed EN administration include post-abdominal surgery, ventilator use, inotrope use, gastrointestinal symptoms, and abnormal nutritional status.  Delayed EN >48 hours, enteral intolerance after receiving EN, and PELOD-2 score >7 were the factors contributing to delayed REE achievement. However, these delays can be reduced by developing a comprehensive enteral feeding protocol. The factors influencing delayed EN and late REE achievement are an important basis for designing enteral feeding protocols to improve the clinical outcomes of critically ill children in the PICU.
Maternal and neonatal risk factors associated with necrotizing enterocolitis in neonates Quispe Castañeda, Claudia Vanessa; Segura-Fernández, Emma Mariela; Alva-Vargas, Marcela Sofía; Meregildo-Rodríguez, Edinson Dante; Vásquez-Tirado, Gustavo Adolfo
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.410-5

Abstract

Background Necrotizing enterocolitis (NEC) remains a leading cause of morbidity in hospitalized neonates—particularly preterm infants—yet its multifactorial etiology and the relative roles of maternal versus neonatal factors are not fully defined. We assessed whether prematurity, neonatal sepsis, and maternal conditions, including preeclampsia, are independently associated with NEC. Objective To evaluate for associations between maternal and neonatal risk factors and the development of necrotizing enterocolitis (NEC) in hospitalized neonates. Methods This case-control study with a retrospective analytical observational design included 235 neonates hospitalized in the Neonatology Unit of the Víctor Lazarte Echegaray Hospital (HVLE) from 2016 to 2023. Clinical records were randomly selected. Seventy-eight neonates with a confirmed diagnosis of NEC comprised the case group, while 157 neonates without NEC comprised the control group. Various maternal and neonatal factors present in this population were analyzed for potential associations with NEC.The influence of potential confounding variables was also considered. Data collection was carried out through a review of neonatal medical records. Results Multivariate analysis identified three factors significantly associated with NEC. Prematurity (P< 0.05) emerged as the main neonatal risk factor, followed by neonatal sepsis (P<0.05). Among maternal factors, preeclampsia showed a significant association with NEC (P<0.05). These variables were considered independent risk factors for NEC. On the other hand, no statistically significant association was found between NEC and other maternal conditions analyzed in this study, such as maternal obesity, sepsis, gestational diabetes, or chronic hypertension (P>0.05). Conclusion Prematurity and neonatal sepsis are neonatal factors significantly associated with a higher risk of NEC. Likewise, preeclampsia emerged as a significant maternal risk factor associated with NEC.
Impact of Brain Gym® on health outcomes of toddlers born with low birth weight: a randomized trial Setiawan, Cahyo; Kartini, Apoina; Winarni, Sri; Darundiati, Yusniar Hanani
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.399-409

Abstract

Background Low birth weight (LBW) children are at risk of developmental delay, including impaired motor skills, cognitive function, and stress regulation. Brain Gym® activities have been shown to improve motor coordination, attention span, and fine motor skills in preschool and primary school-aged children. Evidence for the use of Brain Gym® is limited for infants and toddlers with medical vulnerabilities such as low birth weight (LBW), who are at increased risk of developmental delay and heightened stress sensitivity. Objective To evaluate the impact of Brain Gym® exercises on cognitive function, motor skills (fine and gross motor), and cortisol levels in children aged 12–23 months with a history of LBW compared to a control group. Methods  A randomized controlled trial (RCT) was conducted in Sragen, Indonesia, involving 80 low birth weight (LBW) children aged 12 to 23 months. Participants were randomly allocated into two groups: an experimental group receiving Brain Gym® intervention and a control group.The experimental group received Brain Gym® exercises combined with routine baby massage, while the control group received only baby massage. Cognitive and motor development were assessed using the Denver Developmental Screening Test (DDST), while stress biomarkers were measured through salivary cortisol levels using enzyme-linked immunosorbent assay (ELISA). Assessments were conducted at baseline (pre-intervention) and after the 8-week intervention period. The evaluators who administered the DDST and laboratory staff analyzing cortisol were blinded to group allocation. Results The primary outcomes of this study were motor skills, cortisol levels, and cognitive function. At baseline, there were no significant differences between the Brain Gym® group and the control group in fine motor, gross motor, or cognitive function scores, as assessed by the DDST. After the intervention, between-group comparisons revealed no statistically significant differences in gross motor, fine motor, cortisol, or cognitive function outcomes. Within-group analysis showed that gross motor scores in the Brain Gym® group significantly increased after the intervention (P = 0.038), while fine motor scores demonstrated a non-significant trend toward improvement (P = 0.110). Cortisol levels in the Brain Gym® group significantly decreased (P = 0.009), whereas the control group exhibited no significant changes in gross motor (P = 0.548), fine motor, or cortisol levels (P = 0.118). Cognitive function scores remained statistically unchanged in both groups. Conclusion Our findings suggest that Brain Gym® exercises can improve gross motor function and reduce stress in LBW children. These findings highlight the potential of early interventions in enhancing development, but should be interpreted cautiously due to the modest sample size and short intervention period. Future studies should focus on the long-term effects and the mechanisms underlying these improvements.
Hemodynamically significant patent ductus arteriosus and tissue oxygenation in preterm infants Amaliah, Lissaberti; Indrayady, Indrayady; Ramadanti, Afifa; Nova, Ria; Akbari, Atika
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.364-72

Abstract

Background  One of the most common side effects of preterm birth is hemodynamically significant patent ductus arteriosus (hsPDA), with a prevalence of approximately 70% among preterm infants. The clinical consequences of hsPDA are impaired tissue perfusion and oxygenation to organs. Near-infrared spectroscopy (NIRS), a validated non-invasive method for determining regional oxygen saturation (rSO2), can identify early changes in organ perfusion and oxygenation.  Cerebral and renal tissues as these vital organs are highly susceptible to systemic hypoperfusion caused by hsPDA, which can lead to serious complications such as brain injury and renal insufficiency.  We used (NIRS to clarify the impact of hsPDA on regional oxygenation in the brains and kidneys of preterm infants. Objective To compare oxygenation of cerebral and renal regional tissues in preterm infants with and without hsPDA Methods A cross-sectional study was conducted at Mohammad Hoesin Hospital. Forty preterm infants (gestational age <37 weeks), born between November 2023 and September 2024, who were diagnosed with PDA and had a chronological age >24 hours and <7 days, were enrolled. Infants with multiple congenital anomalies, ductal-dependent cyanotic congenital heart disease, early-onset sepsis, or without parental consent were excluded. Cerebral and renal oxygenation were assessed using NIRS monitoring. Statistical analysis was performed with unpaired T-test. Results Based on echocardiographic criteria, 22 of the 40 infants had hsPDA, while 18 had non-hsPDA. The mean cerebral rSO2 values in the hsPDA and non-hsPDA groups were 79.5 (SD 12.1)% and 80.9 (SD 4.3)%, respectively. The mean renal rSO2 values were 70.4 (SD 17.8)% and 77.8 (SD 6.4)%, respectively. The mean cerebral fractional tissue oxygen extraction (FTOE) values of the hspda and non-hsPDA groups were 0.2 (0.1 to 0.21). The mean renal FTOE values were 0.3 (SD 0.19) and 0.2 (SD 0.07), respectively. There were no significant differences between the two groups in renal and cerebral rSO2 and FTOE. Conclusion Preterm infants’ cerebral and renal tissue oxygenation is  were not significantly different in those with and without hsPDA.  
Early detection of meconium peritonitis in term neonate: a case report Marsubrin, Putri Maharani Tristanita; Iskandar, Stephen Diah; Wulandari, Haryanti Fauzia; Bermanshah, Evita Kariani; Rahayatri, Tri Hening; Roeslani, Rosalina Dewi
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.443-6

Abstract

Meconium peritonitis (MP) is a very rare, sterile peritonitis that results from fetal gut perforation in utero. Late diagnosis and treatment may cause severe morbidity and mortality related to sepsis. Here we report a term, appropriate for gestational age (AGA) neonate with meconium peritonitis. A one-day-old baby was brought to our hospital with lethargy and progressive abdominal distention for the last 12 hours and hypovolemic shock on admission. The diagnosis of meconium peritonitis was established based on physical examination, supported by abdominal X-ray and ultrasound. A sigmoid colon perforation was found during emergency surgery and a sigmoid colostomy was done. The infant was discharged on the 20th post-operative day with good enteral feeding tolerance.
Target height prediction in Indonesian children: a population-based and clinically relevant model Moelyo, Annang Giri; Ferdian, Hanum
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.416-21

Abstract

Background The traditional calculation of target height (TH) overlooks two important factors: the assortative mating correlation, which reflects the tendency for people of similar height to partner, and the parental–offspring correlation, which measures the strength of the relationship between parents’ and children’s heights. A more accurate model is needed for the Indonesian population.   Objective To develop a target height (TH) prediction model for Indonesian children and to compare its performance with traditional formulas. Methods This retrospective study used nationally representative data from the Indonesia Family Life Survey (IFLS). Adult height data from the IFLS-5 (2014) for 2,506 subjects and the corresponding parental height data from the IFLS-3 (2000) were analyzed. We used a new model, namely estimated target height (eTH), which combined the Hermanussen–Cole and van Dommelen methods, to estimate each participant’s TH. This new model was compared to traditional models which used Tanner (TTH) and modified Tanner (mTH) formulas.   Results The new eTH model yielded the following formulas: TH (boys) = 0.36 × father’s height + 0.43 × mother’s height + 42.77; and TH (girls) = 0.30 × father’s height + 0.36 × mother’s height + 50.47. Correlations with the observed adult height were highest for the new model (r = 0.528 for boys; r = 0.534 for girls), compared to traditional models. Conclusion This study provides a locally validated model for TH estimation in Indonesian children that demonstrates improved clinical applicability over traditional formulas.

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