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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 2,118 Documents
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Parents’ perceptions and expectations of COVID-19 vaccination for children in Banda Aceh Teuku Ade Prasetia; Bakhtiar Bakhtiar; Heru Noviat Herdata; Nora Sovira; Anidar Anidar; Eka Yunita Amna; Syafruddin Haris
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.256-66

Abstract

Background Parents usually make the decisions on COVID-19 vaccinations for their children under the age of 18. Objective To explore parents' perceptions and expectations of COVID-19 vaccination for children in Banda Aceh. Methods This study used a qualitative design with a phenomenological approach. Data were collected through in-depth interviews of 36 parents in Banda Aceh. The data were analyzed qualitatively through thematic analysis. Results Three themes were studied: (1) perceptions of parents willing to have their children vaccinated against COVID-19, (2) perceptions of parents who refused or delayed their children’s vaccination against COVID-19, and (3) parents' expectations regarding COVID-19 vaccination in children. Benefits of the vaccine and government policy were among the reasons that parents were willing to have their children vaccinated. Vaccine safety concerns, lack of information, strong immunity, healthy lifestyle, and religious beliefs were the main reasons for parental refusal or delay in vaccinating their children. Reduced cases of COVID-19 and the end of the pandemic, not being infected, developing immunity, and no adverse events following immunization, face-to-face learning in schools, as well as increased education and socialization from the government, society that was critical and selective in receiving information were the expectation of parents regarding COVID-19 vaccination in children. Conclusion The perception of vaccine benefits and government policy influence parents to have their children vaccinated, while perception of vaccine safety concerns, lack of information, strong immunity, healthy lifestyle, and religious beliefs influence parents to refuse or delay their children being vaccinated. Parents' expectations regarding COVID-19 illness, their children’s response to the vaccine and education, as well as the government’s and society’s roles during the pandemic are qualitatively elucidated.
The effectiveness of Lactobacillus reuteri on serum bilirubin levels in neonatal hyperbilirubinemia with phototherapy Deska Andina Rezki; Isra Firmansyah; Dora Darussalam; Sulaiman Yusuf; Nora Sovira; Bakhtiar Bakhtiar
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.219-25

Abstract

Background Hyperbilirubinemia occurs in 60% of full term and 80% of premature infants. Phototherapy is the main treatment, but it has side effects, sometimes requires hospitalization, and causes the baby to be separated from the mother. Underdeveloped gut microflora and increased enterohepatic circulation in newborns contribute to increased serum bilirubin levels in early life. Objective To assess the efficacy of adding probiotic L. reuteri on phototherapy in full-term neonates with hyperbilirubinemia. Methods In this double-blind, randomized clinical trial, full term infants with hyperbilirubinemia at Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia, were randomly assigned to either an intervention or control group. All subjects received phototherapy. The intervention group was also given five drops of L. reuteri once a day orally before phototherapy started, while the control group received a placebo. Bilirubin levels after 24-hour phototherapy were evaluated in both groups. Results A total of 42 term neonates met the inclusion criteria. The intervention group had a significantly greater decrease in total serum bilirubin (TSB) level (6,517 mg/dL) than did the control group (4,434 mg/dL) (P<0.001), as well in indirect bilirubin levels in the intervention group had decrease 6.40 mg/dL while in the control group 4.43 mg/dL after 24 hours of phototherapy (P<0.001). Conclusion In full-term neonates with hyperbilirubinemia who underwent 24-hour phototherapy, adding probiotic L. reuteri leads to a significantly greater reduction in total and indirect bilirubin levels compared to the control group.
Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography Sayma Rahman Munmun; Mohammad Rukunuzzaman; Mohammad Wahiduzzaman Mazumder; Archana Shrestha Yadav; Luthfun Nahar; Mohammad Benzamin; Abu Sayed Mohammad Bazlul Karim
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.274-81

Abstract

Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard, is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease. Objective To observe the role of transient elastography in the assessment of the progression of liver damage in children with chronic hepatitis B. Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings. Results The mean age was 11.46 (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively. Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like serum ALT, AST as well as virological parameters. Conclusion Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis. A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis.
Does protein intake correlate with tubular function in very preterm neonates? Henny Adriani Puspitasari; Partini Pudjiastuti Trihono; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.245-55

Abstract

Background High protein intake in very preterm neonates (VPN) is important for growth. However, preterm kidneys have fewer functional nephrons and many of the ones present may be immature. Studies have shown that high protein intake induces nephron hypertrophy, proteinuria, and glomerular sclerosis, which lead to tubular injury. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker that is released during proximal tubular cell injury. The uNGAL to creatinine (uNGAL/Cr) ratio is commonly performed for normalization. Objective To assess for a possible association between protein intake and uNGAL/Cr ratio in VPN. Methods A prospective cohort study was conducted in two NICUs in Jakarta. Subjects’ urine specimens were collected at 0-48 hours, 72 hours, and 21 days after birth to determine uNGAL/Cr ratio as a biomarker of tubular injury. Protein was administered according to study sites NICU guidelines. Protein intake was recorded daily from 14-21 days of age for formula and measured twice with a human milk analyzer for breast milk. ELISA was used to measure uNGAL concentration. Low protein intake was defined as <3g/kg/day and high protein intake was defined as ?3g/kg/day. Maternal and perinatal variables were recorded from medical records. Results Fifty-nine VPN were recruited, of whom 39 completed the study. Median uNGAL/Cr ratio ranged from 0.32-104.11 ng/mg. The uNGAL/Cr ratio was not correlated with protein intake but was inversely correlated with gestational age and birth weight [r = -0.320, P=0.019 for the 72-hr (T2) urinary collection]. Higher uNGAL/Cr levels were associated with maternal infection [14.4 (range 4.4-104.1) vs 7.2 (range 0.5–32.4) ng/mg, P=0.004 at the 0-48-hr (T1)], maternal anemia [6.9 (range 1.2–66.6) vs 1.7 (range 0.3–89.2) ng/mg, P=0.001 at the 21-day (T3)] and nephrotoxic medication [15.9 (range 1.3–63.8) vs 1.0 (range 0.4–8.6) ng/mg, P=0.026 at the 72-hr]. Conclusion Protein intake according to current nutritional guidelines does not correlate with tubular injury in VPN, as measured by uNGAL/Cr ratio. Maternal infection, maternal anemia, lower birth weight, and nephrotoxic medication, were associated with higher uNGAL/Cr levels in VPN.
The effects of large-scale social restriction during the covid-19 pandemic on glycemic control and occurrence of complications in children with type-1 diabetes mellitus Sahara Effendy; Setya Wandita; Madarina Julia
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.298-303

Abstract

Background The global pandemic of severe acute respiratory syndrome caused by the coronavirus-2 (SARS-CoV-2) infection has resulted in a national large-scale social restriction (LSSR) to limit the spread of the virus. Objective To determine the impacts of LSSR on glycemic controls and the occurrence of complications in type-1 diabetes mellitus (T1DM) children. Methods A retrospective longitudinal study was carried out in Dr. Sardjito Hospital, Yogyakarta. Subjects were 0-18 years old T1DM patients diagnosed before the LSSR with at least six months of disease. Data on demographics, T1DM status, HbA1c level, and complications pre-LSSR, and during LSSR were taken from medical records. Paired T-tests were used to assess the difference in HbA1c level between the two-time points Results: We included information on 21 children based on the inclusion and exclusion criteria. Their median (range) age was 13.9 (1.42-17.3) years, with a median (range) diabetes duration of 2.6 (0.0-10.92) years. Glycemic control improved in 76% of the children. The mean HbA1c before and during LSSR was 10.9 (SD 2.7) and. 9.7 (SD 2.3), respectively; P<0.05. The glycemic control was not associated with sex, age, duration of diabetes, travel time to the clinic, or a total daily insulin dose. There was also no significant difference in the occurrence of complications. Conclusion Despite limitations during LSSR, glycemic control improved in most patients with T1DM. This might be related to improved health awareness during the pandemic, more regular meals, and better parental control.
A province-wide childhood malignancy profiles in Indonesia (2010-2019): Yogyakarta Pediatric Cancer Registry Supriyadi, Eddy; Purwanto, Ignatius; Armytasari, Inggar; Ritter, Julie; Widjajanto, Pudjo Hagung; Veerman, Anjo JP
Paediatrica Indonesiana Vol. 63 No. 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.226-37

Abstract

Background The global burden of childhood cancer is poorly quantified, but it is estimated that 80% of all children with cancer live in low- and middle-income countries with cure rates of childhood cancer far lower than in high-income nations. Objective To describe the Yogyakarta Region pediatric cancer profile from 2010-2019 and compare it to that of a 2000-2009 study in the same setting. Methods This retrospective study of childhood cancer was conducted in patients aged £18 years and diagnosed in Dr. Sardjito General Hospital from 2010 to 2019. Pediatric cancer patient data were collected from hospital hardcopy and electronic medical records. An estimated annual average incidence rate of childhood cancer was calculated and the number of patients by their regions of origin were visualized. The number of childhood malignancies recorded is also compared by the number found in 2000-2009 study. Results There were 1,839 new cases registered in Yogyakarta Pediatric Cancer Registry during the study period. The mean age at diagnosis was 6.3 years and male-to-female ratio was 1.4: 1.0. Fifty-six% of cancers were diagnosed in the 0-5-years age group. The most common diagnosis category was leukemia, which accounted for 60% of all childhood malignancies. The three most common diagnoses were acute lymphoblastic leukemia (44%), acute myeloid leukemia (12%), and retinoblastoma (7%). The annual average incidence rates of leukemia and solid tumors were 26.8 and 17.5 per million, respectively. The number of patients registered in 2000-2009 study was 1,124 case. Therefore, there was an increase of 63.6% in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. Conclusion There is an increase in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. The number of patients referred to our hospital increased, indicating a more inclusive registry, better referral system, and better access to health care facility.
Prophylactic efficacy of 400 vs. 200 mg/kg /day calcium gluconate to prevent neonatal hypocalcemia Apsera, Liza; Sianturi, Pertin; Nafianti, Selvi
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.346-52

Abstract

Background Serum calcium is at its lowest level within 24–48 hours after birth, rendering the neonate vulnerable to hypocalcemia. In our center, despite prophylactic administration of 200 mg/kg/day calcium gluconate, the prevalence of neonatal hypocalcemia remains high. Aim To determine the prophylactic efficacy of 400 vs. 200 mg/kg/day calcium gluconate in preventing neonatal hypocalcemia. Methods A randomized clinical trial with a pre- and post-test experimental design was done on neonates who fasted or received only minimal enteral feeding. Subjects were randomized to receive either 400 mg/kg/day (intervention group) or 200 mg/kg/day (control group) of intravenous calcium gluconate. We compared serum ionized calcium levels on the first day of admission before calcium gluconate administration and on the third day of hospitalization between the intervention and control groups. Results The median ionized calcium levels in the intervention vs. control group before calcium gluconate administration was 1.16 (range 0.4-2.4) mmol/L vs. 1.15 (range 0.6-4.5) mmol/L , respectively (P=0.561). After three days of calcium gluconate administration, the median ionized calcium level was 1.19 (range 0.7-1.45) mmol/L vs. 1.19 (range 0.68-4.6) mmol/L in the intervention vs. control group, respectively (P=0.828). The difference in pre- vs. post-administration ionized calcium levels was significant within the intervention group (P=0.032), but not within the control group (P=0.128). Conclusion Prophylactic intravenous calcium gluconate at 400 mg/kg/day was not more effective in preventing neonatal hypocalcemia than 200 mg/kg/day.
Cumulative cyclophosphamide dose and serum anti-Mullerian hormone levels in adolescent cancer survivors in Indonesia Mulatsih, Sri; Ayuandari, Sarrah; Rahmawati, Naafi Rizqi; Oktasari, Rizki; Dewanto, Agung
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.376-82

Abstract

Background As both the prevalence and survival rates of cancer in children and adolescents has risen, longer-term effects of cancer treatment must be investigated. High-risk gonadotoxic chemotherapeutic agents such as cyclophosphamide may affect the ovarian reserve and impact female adolescent fertility. Anti-Mullerian hormone is a reliable marker to assess ovarian reserve. Objective To assess for a possible correlation between the cumulative dose of cyclophosphamide and serum anti-Mullerian hormone (AMH) levels among adolescent cancer patients. Methods This cross-sectional study included 12-18-year-old adolescent female cancer patients who had experienced menarche and received cyclophosphamide therapy. We recorded the patients’ full history, including menstrual history, computed the cumulative dose of cyclophosphamide received, and measured serum AMH levels. The correlation test was performed to evaluate for a possible correlation between the cumulative dose of cyclophosphamide and ovarian reserve as represented by AMH levels. Results Out of 12 female adolescent cancer patients, three complained of disturbances in their menstrual cycles. Low levels of AMH (<1.5 ng/mL) were noted in five patients. Median cumulative cyclophosphamide dose was 1,000 mg/m2 (range 1,000 to 5,250 mg/m2). Cumulative cyclophosphamide dose was negatively correlated with serum AMH levels, but this correlation was not statistically significant (r=-0.316, P=0.318). Conclusion This study has not been able to show a correlation between cumulative cyclophosphamide dose and serum AMH level. Regular evaluation of fertility and involvement of fertility team is recommended in adolescents receiving high-risk gonadotoxic chemotherapeutic agents.
Maternal barriers to stimulating early childhood development on Tidore Island Kusila, Gilbert Renardi
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.361-9

Abstract

Background The first 5 years of life provide a foundation for neuroplastic development, which establishes the capacity to accomplish complicated tasks in later life. However, this period is vulnerable to multiple stressors and adversities that prevent children from achieving age-related developmental milestones. Mothers as primary caregivers may find it challenging to engage her child in stimulating activities. Objectives To understand maternal barriers to stimulating early childhood development and potential interventions that can be developed. Methods This explorative, qualitative study was conducted in 13 different service coverage areas of the Soasio Community Health Center (Puskesmas), Tidore Islands, North Maluku, Indonesia. A total of 30 mothers participated in structured interview sessions. The analysis was conducted inductively, by generating some key issues from the interview. Results Eight maternal barriers to engaging in child stimulation activities were found: (1) family members, (2) gender-related interaction, (3) partial understanding of child health-related information, (4) prioritizing one developmental achievement over others, (5) timidity in decision making, (6) delaying stimulation due to overreliance on the role of school, (7) responsive feeding, and (8) media. Maternal motivation, societal awareness of child development, and support of maternal and family mental health are needed to improve maternal engagement in child stimulation. Conclusions Family, community, and life experiences may become maternal barriers to stimulating childhood development. Providing better social support, information access, and woman empowerment in decision-making will help mothers to be more engaged in child development stimulation activities.
Development, validity, and reliability of a questionnaire on mothers’ knowledge in complementary feeding practices (PI-MPASI) in Indonesia Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.335-45

Abstract

Background A number of complementary educational feeding modules have been circulating in the community, but mothers have yet to use them optimally. There is an urgent need for an effective educational method on appropriate complementary feeding and an instrument to measure maternal knowledge in proper complementary feeding practices. Objective To develop and assess the validity and reliability of a questionnaire on complementary feeding practices. Methods We conducted a qualitative study to develop a questionnaire followed by a cross-sectional study to test the validity and the reliability of the PI-MPASI questionnaire. The research team designed the PI-MPASI questionnaire through a literature review with a team of experts, based on the evidence-based feeding practice recommendations for infants and toddlers in Indonesia as compiled by the Indonesian Pediatric Society (IPS) in 2015. Content validation was carried out through expert review, whilst the construct validity and the reliability were tested on 110 mothers who met the inclusion criteria. Results In the content validity assessment, an average congruent percentage of 90% was obtained for the sub-themes of time, nutritional adequacy, safety, and feeding responsiveness as the four essential points that mothers should know regarding proper complementary feeding practices. Most of the item scores showed moderate to high correlations with the total score, with reliability test showcasing a good internal consistency (Cronbach's alpha = 0.715). Conclusion This study showed that our questionnaire on mothers’ knowledge in complementary feeding practices (PI-MPASI) is a valid and reliable instrument to assess maternal knowledge on correct complementary feeding practices in Indonesia.

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