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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 2,114 Documents
 206   207   208   209   210 
Soil-transmitted helminth infection, intestinal permeability, and intestinal inflammation in preschool-age children Aulia, Gina; Djuardi, Yenny; Supali, Taniawati
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.232-8

Abstract

Background Soil-transmitted helminth (STH) infection is a major health problem in low-and middle-income countries (LMIC). The presence and activity of STH can cause changes in the intestinal mucosa, including cell damage that can affect intestinal permeability and stimulate immune responses such as inflammation. Objective To assess the inflammatory and permeability status of the intestinal mucosa in various STH infections in preschool-age children residing in Nangapanda District, Ende Regency, East Nusa Tenggara. Methods In this cross-sectional study, stool samples were obtained from children aged 12-59 months and examined for worm eggs using the Kato Katz method. Concentrations of biomarkers for intestinal permeability and inflammation were measured by enzyme-linked immunosorbent assay (ELISA). We measured fecal alpha-1-antitrypsin (AAT) as an intestinal permeability biomarker and fecal calprotectin (FC) as an intestinal inflammation biomarker and evaluated the association between these biomarkers with STH infection. Results The prevalence of STH infection in 111 evaluated preschool-age children was 17.1%. Ascaris lumbricoides was the predominant species, followed by Trichuris trichiura. Most subjects (64.7%) had AAT levels >0.27 mg/g, while only 35.1% had FC >50 mg/kg. STH infection status was not significantly associated with AAT concentration status, even when analyzed by STH species. A significant association was found only between T. trichiura infection and FC concentration. In this study, which included infected and uninfected groups, children infected with T. trichiura had higher concentrations of FC than those uninfected. Conclusion STH infection was not significantly correlated with fecal biomarkers except between T. trichiura infection status and increased gut inflammatory biomarker. AAT levels were generally elevated in the evaluated preschool-aged population regardless of STH infection, indicating that other factors may have contributed to increased gut permeability.
Risk factors for feeding difficulties in children with cerebral palsy Nur, Fadhilah Tia; Handryastuti, Setyo; Pusponegoro, Hardiono D.
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.156-63

Abstract

Background Cerebral palsy (CP) is caused by brain injury sustained during development. It is a motor and posture disorder. Feeding problems are more likely to appear in children with severe motor impairment, leading to insufficient caloric intake and malnourished. Objective To indentify association between the Gross Motor Function Classification System (GMFCS)  and CP type  as risk factors of  feeding difficulties in children with  CP. Methods This cross-sectional study was conducted between January and September 2015, in a Pediatric Neurology Outpatient Clinic at a tertiary hospital in Surakarta, Indonesia. Nutritional status, feeding difficulties, and the  GMFCS were used to assess children with  CP.  We performed Gross Motor Function Measure-88 to identify the GMFCS. Regulation of the Minister of Health of the Republic of Indonesia No. 2 of 2020 concerning child anthropometric standards was carried out to evaluate and classify nutritional status. Krick CP growth curve was used to compare spastic quadriplegia. Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13.9 kcal/cm body height (BH) ± 10%. Results The majority of CP patients (96.3%) were spastic, with quadriplegic and diplegic cases being the most common. Malnourished impacted 78% of all participants; in addition, 78% of participants reported having feeding difficulties, with roughly one-third having a high GMFCS score. The GMFCS scale on oromotor dysfunction (OMD) and bad postural control (BPC) showed statistically significant, with P values of 0.042 and 0.041, respectively. The GMFCS scale and spastic CP type is also statistically significant with BPC (OR 6.35;95%CI 3.29 to 24.12 and OR 4.32;95%CI 2.53 to 22.35, respectively). Sixty-eight% of children with CP were wasted, with 10% experiencing severely wasted. Conclusion Children with CP who have a higher GMFCS score and spastic CP are more likely to have feeding issues.
Neurological manifestations in patients with multisystem inflammatory syndrome in children (MIS-C) in the post-COVID-19 era Wati, Dyah Kanya; Suparyatha, Ida Bagus Gede; Hartawan, I Nyoman Budi; Manggala, Arya Krisna; Artini, Ni Wayan Noni; Aurelya, Anira Rema
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.239-44

Abstract

Background Multisystem inflammatory syndrome in children (MIS-C) is an emerging condition associated with the COVID-19 pandemic. It occurs in approximately 2-8% cases of COVID-19, sometimes leading to shock, multiorgan failure, and the need for intensive care. Neurological manifestations are uncommon and sometimes overlap with previous comorbidities. Objective To explore the neurological manifestations in critically ill children with MIS-C. Methods This cross-sectional study included children aged <18 years, diagnosed with MIS-C according to World Health Organization (WHO) criteria and admitted to the pediatric intensive care unit (PICU) at a tertiary hospital in Bali, Indonesia. Retrospective data were extracted from electronic medical records covering January 2022 to December 2023. Demographic characteristics, clinical manifestations, treatments, and outcomes were collected and analyzed using SPSS. Patient were grouped based on the presence or absence of neurological symptoms for comparison. Results There were 47 children diagnosed with MIS-C; 78.7% of them were critically ill and treated in our intensive care unit. Thirty-seven subjects were included in the study. The most common symptom was fever (83.8%). Neurological manifestations were found in 12 children (32.4%), most commonly decreased consciousness (58.3%), followed by seizures (25.0%), hemiparesis (8.3%), and behavioral changes (8.3%). When comparing subjects with vs. without neurological symptoms, those with neurological manifestations had higher proportions of invasive mechanical ventilation (58.3% vs. 36.0%, respectively), combined use of intravenous immunoglobulin and methylprednisolone (83.3% vs. 64.0%, respectively), and mortality (58.3% vs. 28.0%, respectively). Conclusion Neurological  manifestations, particularly decreased consciousness, were common in critically ill MIS-C patients. These patients exhibited higher rates of invasive ventilation and mortality, emphasizing the need for early recognition and targeted management.
The effect of the BLUI blanket on the reduction of bilirubin levels in neonatal jaundice: a preliminary clinical study Fadilah, Tubagus Ferdi; Adisasmita, Asri C.; Ascobat, Purwantyastuti; Siswanto, Johanes Edy; Koestoer, Raldi Artono; Susianti, Yanti; Irwan, Hermansyah; Gunarsih, Arum; Heryana, Ade
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.245-52

Abstract

Background Neonatal jaundice is a prevalent condition in newborns, characterized by elevated bilirubin levels. Conventional phototherapy treatments for neonatal jaundice typically require hospital admission, separation from mothers, and may interfere with breastfeeding and bonding. The Blue Light Universitas Indonesia (BLUI) LED phototherapy blanket was developed to address these limitations by providing a portable, home-based alternative that maintains mother-infant contact while delivering effective therapy. Objective To evaluate the efficacy of the Blue Light Universitas Indonesia (BLUI) LED phototherapy blanket in reducing bilirubin levels in infants with physiological jaundice. Methods A preliminary study was conducted from December 2022 to February 2023, involved 14 infants with physiological jaundice at Hermina Hospital Ciputat, Sariasih Hospital Ciputat, and the General Hospital of South Tangerang. The inclusion criteria were infants with physiological jaundice, gestational age ≥35 weeks, and birth weight ≥2,000 grams. The dependent variable was the reduction in total serum bilirubin levels, assessed by spectrophotometry. Paired sample T-test was used to compare bilirubin levels before and 24 hours after intervention with the BLUI Blanket. Results The study included 14 infants, with a mean age of 6.86 days and mean gestational age of 37.71 weeks. The BLUI Blanket demonstrated a mean bilirubin reduction of 3.11 mg/dL after 24 hours of continuous treatment, with a 19.02% decrease. The intervention was well-tolerated, with minimal adverse effects, such as maculopapular skin rash occurring in only one infant. Conclusion The BLUI Blanket is an effective and safe phototherapy device for reducing bilirubin levels in infants with physiological jaundice. This preliminary study supports further research to confirm these findings in larger populations.
Vitamin D3 and seizure frequency in children with epilepsy using polypharmacy Aprilyani, Setya Puspa Dewi; Putranti, Alifiani Hikmah; Sareharto, Tun Paksi; Rahmadi, Farid Agung; Pratiwi, Rina
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.122-8

Abstract

Background Children with epilepsy usually need vitamin D administration, primarily due to the effects of antiepileptic drugs (AEDs). The use of AEDs, particularly polypharmacy, can reduce serum 25(OH)D levels. Vitamin D improves the function of neurotransmitters furthermore boosting the seizure threshold. There has been relatively little study investigating the effects of vitamin D3 treatment on seizure frequency. Objective To compare seizure frequency before and after administering vitamin D3 to the children with epilepsy who used polypharmacy.  Methods Sixteen children with epilepsy and polypharmacy, aged 2-18 years, from the Pediatric Neurology Clinic, Dr. Kariadi Hospital, Semarang, were studied using a quasi-experimental approach with one group pretest-posttest. The vitamin D3 was given orally for two months with different dosages according to age andsubjects’ pretest serum 25(OH)D levels. Children with vitamin D insufficiency or deficiency were giventherapy dosage, and the normal vitamin D status were given supplementation dosage.Seizure frequency, serum 25(OH)D levels, and vitamin D status were assessed before and after treatment. Results Seizure frequency was significantly lower after vitamin D treatment for the entire group compared to pre- administration (P=0.019). For subjects with hypo-vitamin D levels pre-treatment, median seizure frequency was significantly decreased following normalization of vitamin D levels at one month (P=0.016) and two months (P=0.018) of vitamin D treatment. Using mean data, seizure frequency also significantly decreased at one month and at two months post-treatment. Conclusion Vitamin D3 administration is associated with an increase in serum 25(OH)D levels, as well as a decrease in seizure frequency. Vitamin D3 administration can significantly reduce seizure frequency in epilepsy patients undergoing polypharmacy who are vitamin D deficient.
Score for Neonatal Acute Physiological Evaluation with Perinatal Extension (SNAPPE II) as a predictor of mortality from neonatal sepsis Quispe Castañeda, Claudia Vanessa; Becerra-Villanueva, Luis Alonso; Alva-Vargas, Marcela Sofía; Meregildo-Rodríguez, Edinson Dante; Vásquez-Tirado, Gustavo Adolfo
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.103-9

Abstract

Background Sepsis is considered one of the leading causes of neonatal mortality. In the quest to reduce neonatal mortality, it is crucial to identify factors that increase the risk of death in neonates. The use of tools such as assessment scales allows us to identify neonates at higher risk of mortality. The SNAPPE II scale might be a predictive factor for mortality in this age group, could be considered as a tool to be used in all neonatal ICU (NICU). Objective To determine whether SNAPPE II, with a score of ? 40 points, is a good predictor of mortality due to neonatal sepsis. Methods A retrospective cohort study was conducted on 162 term neonates diagnosed with neonatal sepsis at the Víctor Lazarte Echegaray Hospital, within the neonatal intermediate care unit (NIMCU) and NICU, from 2021 to 2023. The SNAPPE II scale was applied to all subjects, and scores were analyzed for potential associations with subject mortality. Results The SNAPPE II score was associated with mortality in neonatal sepsis. Multivariable logistic regression analysis revealed a significant association at cut-off of ? 40 pints between higher score and subject mortality (aOR=1.29; 95%CI 1.13 to 1.56; P<0.001). Additionally, we found that mechanical ventilation was an independent predictor of mortality from neonatal sepsis (aOR=1.48; 95%CI 1.46 to 151.9; P<0.01). Conclusion The SNAPPE II score with a cut-off of 40 points is a good predictor of mortality in neonatal sepsis.
Risk factors for sleep disturbances and low quality of life in adolescents with epilepsy Salendu, Praevilia Margareth; Manurung, Elsa Ameliana
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.117-21

Abstract

Background Epilepsy impacts health-related quality of life and increases sleep disturbances. Duration of medication use, recurrent seizures, number of anti-epileptic drugs (AEDs), abnormal electroencephalography (EEG), and comorbidities are factors that might affect sleep and quality of life in adolescents with epilepsy. Objective To analyze risk factors related to sleep disturbances and quality of life in adolescents with epilepsy. Methods This analytical-observational study was performed in epilepsy outpatients treated between January – June 2024, of adolescent age, and had used AEDs for more than a year. Quality of life was evaluated using the Pediatric Quality of Life InventoryTM (PedsQLTM) – Epilepsy Module, and sleep disturbances were evaluated using the Sleeping Disturbance Scale for Children (SDSC) questionnaire. Fisher’s and Kolmogorov-Smirnov analyses were performed along with logistic regression for multivariate analysis. Results Forty-eight patients participated in this study. Subjects’ mean age was 12.69 (SD 2.4) years and 54.2% of subjects were male. Mean duration of medication use was 2 years with the minimum interval of the last seizure episode occurring 1 week before observation. More than half of the patients (60.4%) had abnormal EEGs. Most patients were treated with monotherapy AED (81.3%). Seventy five percent of patients had low quality of life and 47.9% had sleep disturbances. In multivariate analysis, adolescents with abnormal initial diagnosis EEGs had 19.1 times higher risk of sleep disturbances (95%CI 3.3 to 110.4 P= 0.001) than those with normal EEGs. Among patients with abnormal EEGs, sleep disturbances increase the risk of low quality of life (OR 1.6; 95%CI 0.93 to 2.73; P=0.015) . Conclusion Abnormal EEG was a significant risk factor for sleep disturbances and low quality of life in adolescent epilepsy patients.
Internet addiction and sleep disorder in adolescents in Makassar, Indonesia Pranoto, Amelia; Maddeppungeng, Martira; Renaldi, Rinvil; Ganda, Idham Jaya
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.129-36

Abstract

Background Sleep disorders has been associated with bedtime activity, thus affected poor school performance, mood and behavioral disorders, as well as obesity. The increase of handheld media and internet use puts adolescents at higher risk of internet addiction. Increased screen time tends to increase the risk of sleep disorders. Objective To provide an overview of internet addiction in Makassar teens and its possible association with sleep disorders in adolescents. Methods This cross-sectional study was done in July to August 2021, in private junior high school, involved students aged 13-15 years. There were 196 questionnaires submitted, which was filled by the parents and the students. Data were collected online by Google form using the Kuesioner Diagnostic Adiksi Internet (KDAI) and the Sleep Disturbance Scale for Children (SDSC). Parents assisted and supervised the students while filling the questionnaire, except for the KDAI which was filled only by the student.  Results There were 85 students (43.4%) identified to have internet addiction by KDAI scoring; among them, 73 students (85.90%) had sleep disorders as identified by SDSC. Internet addiction (KDAI score) and sleep disorders (SDSC) were positively and significantly associated (OR 61.4%; 95%CI 95% 25.19 TO 149.86; P<0.000). There was also a strong positive correlation in KDAI score and SDSC score (r = 0.777; P=0.000). Conclusion  Internet addiction has a significant negative impact on sleep and was associated with sleep disorders in adolescents during the pandemic period.  
The Indonesian version of the Early Childhood Screening Assessment (ECSA_INA) to screen for social, emotional and behavioral disorders in children Rosana, Elvira; Anggraini, Alifah; Sitaresmi, Mei Neni
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.137-46

Abstract

Background  The incidence of emotional, social, and behavioral disorders in children is quite high in the world, including in Indonesia. Therefore, earlier screening is necessary for effective treatment. Currently there is no screening tool for emotional, social, and behavioral disorders in children, especially toddlers, that has been validated in Indonesia. The Early Childhood Screening Assessment (ECSA) is a widely used and recommended instrument for children aged 1.5 - 5 years. This research aims to carry out a cross-cultural adaptation of ECSA in Indonesian (ECSA_INA) and assess its internal validity and reliability. Methods The study consisted of 2 phases: transcultural adaptation and internal validity and reliability testing on parents of children aged 1.5-5 years The first phase consists of the forward translation of original instruments into Indonesian, synthesis from experts and backward translation to the original language and then discussion by experts. Furthermore, pre-testing was carried out in 6 parents of children aged 1.5-5 years. We conducted the second phase of the internal validity and reliability test on 70 parents of children aged 1.5 - 5 years. Each respondent filled in ECSA_INA 2 times, with an interval of 14 days. Furthermore, the data were analyzed statistically with the correlation test of Cronbach’s α, Intraclass Correlation Coefficient (ICC) and Pearson correlation. Results The internal consistency was good (Cronbach’s α = 0.831). Test- retest reliability was good with intraclass correlation coefficient (ICC) of 0.867 (p<0.000). Overall internal validity is good. Conclusion The ECSA_INA is a reliable and valid instrument for screening social, emotional and behavior in Indonesian children.  
Risk factors of mortality in children with acquired prothrombin complex deficiency at Dr. Zainoel Abidin General Hospital,Banda Aceh Munawarah, Syifa; Sovira, Nora; Anidar, Anidar; Herdata, Heru Noviat; Edward, Eka Destianti; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.253-9

Abstract

Background  Acquired prothrombin complex deficiency (APCD) is a rare but life-threatening bleeding disorder in children. Intracranial hemorrhage (ICH) is the leading cause of death, with an estimated risk affecting 50–80% of cases. Key risk factors associated with mortality in APCD include onset of disease, presence of ICH, and the initial Glasgow Coma Scale (GCS) score. Routine intramuscular administration of vitamin K at birth has been shown to effectively prevent early and late-onset vitamin K deficiency bleeding. However, in settings where vitamin K prophylaxis is not administered or is delayed, the risk of APCD increases significantly. Despite these concerns, other potentially relevant clinical factors contributing to APCD outcomes remain under-investigated. Objective To identify risk factors associated with APCD mortality in children treated at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods This cross sectional study analyzing children diagnosed with APCD at Dr. Zainoel Abidin General Hospital from October 2022 to October 2024. Data were collected from the medical records of 30 children and analyzed using Chi-square and logistic regression tests. Results This study included 30 subjects, the majority of whom were male and aged 8 days to 6 months. Most of subject were born full term, delivered vaginally, and had birth weight ≥ 2.500 grams. Notably, 25/30 children did not receive vitamin K prophylaxis, 14/18 children were exclusively breastfed without vitamin K prophylaxis, and 25/30 children had good nutritional status. Late-onset APCD was observed in 14 out of 30 cases.  Intracranial vs extracranial hemorrhage was occurred in 21 vs 9 children. Initial GCS scores ≤ 8 at initiation of treatment were noted in 11/30 children. The mortality rate was occurred in 12/30 subjects (40%). Chi-square analysis revealed significant associations between increased mortality and late onset APCD (P=0.030), ICH (P=0.049), and initial GCS score ≤ 8 (P=0.009). Logistic regression analysis revealed initial GCS score was associated with the highest risk of mortality in APCD, with a 16-fold increase in risk (P=0.022; OR 15.9; 95%CI 1.5 to 168.9). Conclusion Intracranial hemorrhage, late-onset APCD, and initial GCS scores ≤ 8 are significantly associated with increased APCD mortality, with initial GCS emerging as the most influential risk factor.

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