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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 2,127 Documents

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Association between passive smoking and Mycobacterium tuberculosis infection in children with household TB contact Novaily Zuliartha; Ridwan M. Daulay; Melda Deliana; Wisman Dalimunthe; Rini Savitri Daulay
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Background Tuberculosis (TB) and cigarette consumption are relatively high in Indonesia. Passive smoking may increase the risk of infection and disease in adults and children exposed to TB. An association between passive smoking and Mycobacterium tuberculosis infection in children has not been well documented. Objective To assess for an association between passive smoking and M. tuberculosis infection in children who had household contact with a TB patient. Methods This cross-sectional study was conducted in February and March 2011. Children aged 5 to 18 years who had household contact with a TB patient underwent tuberculin testing for M. tuberculosis infection. Subjects were divided into two groups: those exposed to passive smoke and those not exposed to passive smoke. Chi-square test was used to assess for an association between passive smoking and M. tuberculosis infection. Results There were 140 children enrolled in this study, with 70 exposed to passive smoke and 70 not exposed to passive smoke. Prevalence of M. tuberculosis infection was significantly higher in the passive smoking group than in those not exposed to passive smoke [81.4% and 52.9%, respectively, (P= 0.0001)]. In the passive smoking group there were significant associations between nutritional state, paternal and maternal education, and M. tuberculosis infection. But no associations were found between M. tuberculosis infection and familial income or BCG vaccination. Conclusion Among children who had household contact with a TB patient, they who exposed to passive smoke are more likely to have M. tuberculosis infection compared to they who not exposed to passive smoke.

Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum Diana Bancin; Elisabeth S. Herini; Pungky Ardani Kusuma; Neti Nurani
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Congenital obstructive posterior urethral membranes (COPUM) is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This congenital anomaly of urinary tract potentially causes hydroureteronephrosis that is often associated with recurrent urinary tract infections and, ultimately, one of the most common causes of end-stage renal disease in children.1,2 Congenital hypertrophy of the verumontanum as part of COPUM is very rare. Only a few reports have been written on congenital hypertrophy of the vermontanum causing congenital obstructive uropathy.3-6

Family socioeconomic status and weight velocity in children aged 6-24 months Tiara Eka; Julius Anzar; Mutiara Budi Azhar
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Background Socioeconomic status is one of the external factors that influences weight velocity.Objective To assess for a correlation between family socioeconomic status and weight velocity.Method This cross-sectional study was performed from October to December 2014. Subjects were patients at community health centers in Palembang, and included by a consecutive sampling technique. Data were collected by interviewing mothers using questionaires. We measured the childrenâ€™s weight and compared it to the previous weight measurement on the Child Health Card (Kartu Menuju Sehat/KMS). Risk of failure to thrive was determined by plotting increments onto the 2009 WHO Growth Velocity Standards Chart. Data were analyzed by Fisherâ€™s exact and Chi-square tests.Results The 97 respondents consisted of 74 children (76%) with good weight velocity and 23 children (24%) with risk of failure to thrive. Using indicators of socioeconomic status, we found a significant correlation between the level of family welfare and weight velocity. (PR=48.000; 95%CI 2.3 to 997.1; P=0.016). However, level of maternal education (P=0.788) and the number of children in the family (P=0.550) had no significant correlation to weight velocity. Caregivers of children (P= 0.560) and duration of exclusive breastfeeding (P=0.390) were not confounding variables for weight velocity in this study.Conclusion High to moderate level of family welfare is significantly correlated to good weight velocity. However, weight velocity has no significant correlation to either the level of maternal education or the number of children in the family. Caregivers of children and duration of exclusive breastfeeding are not confounding variables for this study.

Natural resistance-associated macrophage protein 1 gene polymorphisms in thalassemia patients with tuberculosis infection Mohammad Ghozali; Sari Puspa Dewi; Reni Ghrahani; Ani Melani Maskoen; Lelani Reniarti; Edhyana Sahiratmadja; Tri Hanggono Achmad
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

that needs regular blood transfusions leading to accumulation of iron in the cells. This iron overload level in macrophage might cause intracellular bacteria, particularly Mycobacterium tuberculosis (MTB) to multiply. Polymorphisms in natural resistance-associated macrophage protein 1 (NRAMP1), a metal transporter across the phagosome membrane, play important role in regulating iron, which is also needed by MTB. Increased iron in thalassemia patients may have an increased potential risk for TB.Objective To compare natural resistance-associated macrophage protein 1 (NRAMP1) gene polymorphisms (INT4, D543N, and 3â€™UTR) in thalassemia patients with and without tuberculosis (TB) infection.Methods A cross-sectional measurement of NRAMP1 genetic polymorphisms was performed in pediatric thalassemia patients with TB (n=40) and without TB (n=50). Iron status including serum iron, total iron-binding capacity (TIBC), and ferritin, was compared between the two groups. The NRAMP1 genetic polymorphisms were analysed using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). Allelic and genotypic distributions of each polymorphism were assessed for possible associations with TB infection.Results Mean serum iron and TIBC in thalassemia patients with TB were higher compared to thalassemia patients without TB (mean serum: 166.26 vs. 134.92 Î¼mol/L, respectively; P=0.026) and (mean TIBC: 236.78 vs. 195.84 Î¼mol/L, respectively; P=0.029). In thalassemia patients with TB, we observed significantly higher frequency of the C allele in INT4 (10% vs. 2%, respectively; OR=5.44; 95%CI 1.1 to 26.4; P=0.02) and the TGTG deletion allele (78.8% vs. 51%, respectively; OR=3.56; 95%CI 1.83 to 6.9; P=0.0002) in 3â€™UTR polymorphisms than in thalassemia patients without TB. There were no significantÂ differences in distributions of the A allele between TB and non-TB groups (16.3% vs. 15%, respectively; P=0.84) or the GA genotype (32.5% vs. 30%, respectively; P=0.79) in D543N.Conclusion The NRAMP1 polymorphisms are known to be associated with major gene susceptibility to TB, and in our thalassemia patients this association is even more pronounced.

Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children Susanti Lisupindan Palimbong Rungngu; Audrey Wahani; Max F.J. Mantik
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Background The prevalence of iron deficiency anemia (IDA) remains high in Indonesian children. When anemia is detected in a patient, the physicianâ€™s task is to identify the cause, address it, provide iron therapy, and prevent recurrence. However, prevention is best done by early detection. The reticulocyte hemoglobin equivalent (Ret-He) is a direct measurement of iron level in reticulocytes recently produced in the bone marrow. The Ret-He measurement may be an early indicator of iron deficiency, as it is sensitive at the initial stage of the condition.Objective To assess for a relationship between Ret-He and IDA as well as to evaluate the usefulness of Ret-He for diagnosing IDA in children.Methods This analytic, observational study with cross-sectional approach included 50 children aged 6-12 years and was performed from November 2013 to March 2014. The subjects were divided into IDA or non-IDA groups, based on ferritin levels. A correlation analysis using logistic regression was performed and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and odds ratio (OR) were calculated. Results were considered to be statistically significant for P values <0.05.Results A low Ret-He level was significantly associated with IDA in children (P=0.005). The Ret-He cut-off point of 27.8 pg/L had sensitivity of 43.8%, specificity 85.3%, PPV 58.3%, and NPV 76.3%, with OR 4.5 (95%CI 1.1 to 17.7).Conclusion We find a significant positive relationship between Haemoglobin (Hb) and Ret-He in children, A low level of Ret-He is associated with greater risk of IDA in children. The Ret-He has a high specificity. As such, Ret-He may be useful as a screening tool for early detection of IDA in children.

The role of glucomannan fiber in childhood functional constipation Indiana Aulia; Supriatmo Supriatmo; Emil Azlin; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

its most common type is functional constipation. The dietary fiber may be useful in childhood functional constipation management, but unfortunately the role of fiber in functional constipation is still less developed.Objective To determine the role of glucomannan in treatment of childhood functional constipation.Methods A crossover randomized controlled trial (RCT) was done from May until July 2012 in a boarding school in Medan, North Sumatera. The subjects were children with functional constipation aged 7 to 12 years. Subjects were randomised into two group receiving glucomannan fiber as polysaccharide gel (group A) and maltodextrin as placebo (group B) with each dose of 100 mg/kg/day (maximum of 5 g/day) diluted in 50 ml water/500 mg for 4 weeks, then after a wash out period we did the crossover of the two groups. Frequency and consistency of stools were recorded into diary sheet for 4 and 8 weeks of treatment. Functional constipation has been diagnosed based on Rome III criteria. Data was analyzed using independent T-test and Chi-square test.Results A total of 36 subjects were eligible with each group consisting of 18 subjects and mean of weight of 25 kg. We found significant difference in stool frequency, treated on glucomannan with P= 0.002 before and P = 0.0001 after the wash out period. For stool consistency, we found difference while treated on glucomannan 9/18 (P= 0.034) in 4 weeks before and 11/18 (P = 0.008) in 4 weeks after the wash out period.Conclusion Glucomannan has significant effect to improve functional constipation especially in 4 weeks treatment.

A comparison of neutrophil gelatinase-associated lipocalin and immature to total neutrophil ratio for diagnosing early-onset neonatal sepsis Rocky Wilar; Dasril Daud; Suryani Asâ€™ad; Dwi Bahagia Febriani; Mina Mina
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Background Neonatal sepsis is a clinical syndrome caused by the invasion of microorganisms into the bloodstream. Early diagnosis of early-onset neonatal sepsis (EONS) is difficult. Laboratory tests with high sensitivity and specificity are needed in order to make early diagnoses in newborns.Objective To compare the sensitivity and specificity of neutrophil gelatinase-associated lipocalin (NGAL) and immature to total (IT) neutrophil ratio for the diagnosis of early-onset neonatal sepsis.Methods This observational study with cross-sectional design was conducted in the Neonatology Division, Prof. R. D. Kandou General Hospital from November 2012 to April 2014. Consecutive sampling was applied. There were 103 newborns with suspected EONS who fulfilled the inclusion criteria. Complete blood counts, blood cultures, as well as NGAL and IT ratio measurements were performed.Results NGAL was not significantly more sensitive than IT ratio [80.4% vs. 67.3%, respectively; (P=0.058)]. However, NGAL had lower specificity than IT ratio (27.7% vs. 50.0%, respectively; P=0.016). The positive predictive values (57.0% vs. 64.9%, respectively; P=0.176), and negative predictive values (54.2% vs. 52.6%, respectively; P=0.451) were similar in both diagnostic tests.Conclusion Immature to total neutrophil (IT) ratio has higher specificity compared to NGAL for early diagnosis of EONS. However, the difference in sensitivity between the two test is not statistically significant.

Selenium and functional constipation in children Marlina Tanjung; Supriatmo Supriatmo; Melda Deliana; Ade Rachmat Yudiyanto; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.Objective To determine the effect of selenium on functional constipation in children.Methods We conducted a single-blind, randomized clinical trial from November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in Medan, North Sumatra. Subjects were children aged 12 to 17 years with functional constipation, diagnosed according to the ROME III criteria. Patients were randomly allocated into either the selenium group (n=57) or the placebo group (n=57). Subjects were clinically evaluated for frequency of defecation, stool consistency, severity of abdominal pain, and side effects during the 2 weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day 21).Results A total of 114 subjects were eligible to participate. The average frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation in the placebo group, a statistically significant difference (P=0.0001). There was no significant difference in frequency of defecation on the 7th day of treatment. But after day 7, there were significant differences between the groups at days 14 and 21. Normal stool consistency was found in 45 subjects (78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the selenium group, significantly more than those in the placebo group (P<0.05). In placebo group, normal stool consistency was found in 27 subject (47.4%) with (P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001). On day 14, the selenium group had significantly more subjects without pain than the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively (P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found no side effects of selenium treatment in our subjects.Conclusion Selenium is effective in improving clinically functional constipation, in terms of increased frequency of defecation, normalization of stool consistency, and less severe abdominal pain.

Prevalence and clinical characteristics of rotavirus diarrhea in Mataram, Lombok, Indonesia Wayan Sulaksmana Sandhi Parwata; Wayan Sukardi; Abdul Wahab; Yati Soenarto
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

diarrhea and dehydration among children aged <5 years in developed and developing countries, including Indonesia. There have been few studies on the prevalence of rotavirus diarrhea in Mataram.Objective To determine the prevalence and characteristics of rotavirus diarrhea in children under five years of age with acute diarrhea in Mataram.Methods A cross sectional study using the WHO Generic Protocol for Rotavirus Surveillance was conducted in the Nusa Tenggara Barat (NTB) General Hospital, Mataram, as part of a multicenter study by the Indonesian Rotavirus Surveillance Network (IRSN) for children under five years of age. Subjects were diagnosed with rotavirus diarrhea based on stool sample examinations, using RT-PCR for genotyping. They were admitted to the Pediatrics Ward of the NTB Provincial General Hospital from January to December 2010.Results Of 329 children admitted with acute diarrhea, 210 (63.8%) had rotavirus positive stool specimens. For the year 2010, the highest incidence of rotavirus infection was in the month of January (86.4%). Rotavirus infections were found in children less than 2 years of age (65.4%), with the highest prevalence in the age group of 6 to 23 months (68.5%). In addition to clinical symptoms of watery diarrhea, there was a significantly greater percentage of vomiting in rotaviral vs. non-rotaviral diarrhea (67.7% vs. 32.3%, respectively; P<0.05). The majority of G and P genotypes found were G1 (86%), G2 (12%), P[8] (66%), P[4] (12.8%), and P[6] (8%).Conclusion Rotavirus infections are the most common cause of acute diarrhea in children aged <2 years in Mataram, Indonesia.

Risk factors for the failure to achieve normal albumin serum levels after albumin transfusion in neonates Nadya Arafuri; Pudjo Hagung Widjajanto; Ekawaty L. Haksari
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Albumin transfusion for the treatment of neonatal hypoalbuminemia may reduce morbidity. In conditions with disrupted endothelial integrity (e.g., sepsis and critical illness), the administered albumin may leak into the interstitial space, hence, serum albumin levels may fall below expected levels after transfusion. To date, few studies have been done to evaluate the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Objectives To determine the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Methods We performed a case-control study in the Neonatal Ward of Dr. Sardjito Hospital from 2007 to 2012. Normal albumin level was defined as above 3 g/dL. The case group included neonates with post-transfusion albumin levels <3 g/dL and the control group included those with post-transfusion albumin â‰¥3 g/dL. Subjects received intravenous transfusions of 25% or 20% albumin according to the clinical standard of the Neonatal Ward of Dr. Sardjito Hospital. Neonates with very low birth weight, severe birth trauma, burn injuries, severe bleeding, or incomplete medical records were excluded. The data were analyzed with logistic regression test.Results From January 2007 to December 2012, 124 neonates were enrolled in the study. Multivariate analysis showed that low albumin levels before transfusion (OR 12.27; 95%CI 2.17 to 69.30), presence of critical illness (OR 4.01; 95%CI 1.49 to 10.79), diagnosis of sepsis (OR 3.56; 95%CI 1.36 to 9.32), and the >24-hour interval between albumin examination and transfusion (OR 0.06; 95%CI 0.01 to 0.37) were significant risk factors affecting the failure to achieve normal albumin levels.Conclusions Failure to achieve normal albumin levels after transfusion in neonates was significantly associated with low albumin level prior to transfusion, critical illness, sepsis, and >24-hour interval between transfusion and post-transfusion albumin examination.[Paediatr Indones. 2016;56:129-33.].

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