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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 2,118 Documents

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Correlation between parasitemia and spleen size in patients with P. falciparum infection Dini Lailani; Munar Lubis; Bidasari Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Background Spleen is an important organ in immunity to malariainfection which is always affected in malaria patients. Enlargementof the spleen is one of the main clinical symptoms of malaria. Levelof parasitemia is related to the risk of complications.Objective To describe the correlation between parasitemia andspleen size in patients with P.falciparum infection.Methods One hundred and four patients including children andadults with fever, pale, jaundice, diarrhea, and headache who vis-ited public health centers in 5 villages in Mandailing Natal, NorthSumatera were enrolled in this study. The diagnosis of malariawas based on blood smears stained by Giemsa method, while thespleen size was measured using Hackett method. Correlation be-tween parasitemia and spleen size was tested by Spearman rankcorrelation.Results Splenomegaly was found in 37 of 104 patients (35.6 %)with the size of H1 in 10.6 %, H2 in 15.4 %, H3 in 9.6 %. The meanparasite count between patients with and without splenomegalywas different, and the difference was significant between patientswith spleen size of H0 and H3. The higher the parasitemia, thebigger the spleen size was (r=0.291; p=0.03).Conclusion There was a correlation between parasitemia andspleen size in falciparum malarial infection

Factors associated with the transmission of soil-transmitted helminthiasis among schoolchildren Isra Firmansyah; Sri Alemina Ginting; Munar Lubis; Iskandar Z Lubis; Syahril Pasaribu; Chairuddin P Lubis
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background Soil-transmitted helminthiasis (STH) is an importantpublic health problem in Indonesia.Objective To find out factors influencing the transmission of STHin two different communities in North Sumatera, Indonesia.Methods A cross sectional study was done on 96 primary schoolchildren in Suka village (located on a mountain area) and 96 pri-mary school children in Pantai Cermin village (a coastal area). Sub-jects were recruited by simple random sampling. Kato Katz andcentrifuge floatation methods were used for stool and soil exami-nations, respectively. Data were collected by interviewing parentsof children using a questionnaire and were analyzed using chiâ€“square test by SPSS program version 11.0.Results There was no difference in the prevalence of STH in bothvillages (p>0.05). Parentsâ€™ knowledge and economic status hadsignificant relationships with the prevalence of STH in Suka vil-lage (p<0.05), but not in Pantai Cermin (p>0.05). In both villages,parentsâ€™ education did not have a significant relation with STH,while there were significant relations between STH and hygiene,environment, or soil contamination by worm eggs (p<0.05).Conclusion There were significant relationships between hygiene,environment, or soil contamination and the prevalence of STH inthe two villages.

The effect of vitamin A supplementation on morbidity due to Plasmodium falciparum Adillida Adillida; Yoyoh Yusroh; Munar Lubis; Bidasari Lubis; Tiangsa Sembiring; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Objective To investigate the effect of vitamin A supplementationon malaria morbidity.Methods The study was a randomized double-blind placebo-con-trolled trial, conducted in Panyabungan, Mandailing Natal, NorthSumatera from April 2001 to April 2002. Children aged 6-60 monthssuffering from falciparum malaria were randomly assigned to highdose vitamin A or placebo every 4 months for a year. All childrenwere treated in accordance with health center policy. Malaria mor-bidity was assessed from health center visit due to fever, diarrhea,cough, or abdominal pain. Parents gave reports if their child re-ceived malaria treatment from other health centers.Results The number of febrile episodes (probable malaria illness)was lower in the treatment group than that of control, but not sig-nificant. The parasitemia was not different between both groups.There was a significant difference in spleen enlargement betweenthe treatment group and control (p=0.04). There was no differencein health center visit between the two groups.Conclusion The findings suggest that vitamin A supplementationhas only effect on spleen enlargement in malaria.

Bowel habits of exclusively breastfed 0-4 month-old babies Edi S Tehuteru; Agus Firmansyah; Bambang Madiyono
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background Exclusively breastfed newborns have frequent bowelmovements and sometimes watery stool, which parents or doctorsmight think as diarrhea.Objective The aim of this study was to observe the bowel habitsof exclusively breastfed infants.Methods A longitudinal study was done on 100 babies born be-tween November and December 2002 in Cinta Kasih MaternityHospital. The inclusion criteria were fullterm baby, exclusivelybreastfed for 4 months, and informed consent from parents. Ba-bies with problems in organ or nerve that influenced the gastrointes-tinal tract were excluded. Stool frequency, consistency, and colorwere observed.Results The mean stool frequency per day were 3 times in the 1 stweek (95%CI 2.6;3.4), 2 times in the 2 nd week (95%CI 1.7;2.3),1.8 times in the 3 rd week (95%CI 1.5;2.1), and 1.5 times in the 4 thweek (95%CI 1.3;1.7). In the second and third month, it was 1.4times a day and the fourth month, 1.2 times a day. The consis-tency of meconium was soft in the first four days. After that, 18% ofbabies had watery stool, which increased to 30% on day 15-113.In the last week of the fourth month, all babies had soft stool. Meco-nium was black and lasted for 1-3 days. On the fourth day, thestool became yellow. On day 5-14, 6% of babies had green stool,which increased to 12% on day 15-120.Conclusion The first week of the first month was the week whenthe stool frequency was highest compared to the weeks or monthsafter. The consistency of meconium was soft. After it disappeared,most babies had soft stool. Eighteen up to 30% percent of babieshad watery stool. Regarding the color, meconium was black andstayed for 1-3 days. After that, most babies had yellow stool and 6-12% had green stool

Profile of children with increased intracranial pressure on mannitol treatment Sander D Teddy; Abdul Latief; Bambang Madiyono
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background Early recognition of increased intracranial pressure(IIP) and well-monitored management are determining indicatorsfor treatment outcome. As far as we know, data of children with IIPon mannitol treatment has not been available.Objective To elicit the profile of IIP patients who received mannitolat the Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a cross-sectional study. Data were obtainedfrom medical records of patients with increased intracranial pres-sure who received mannitol at the Department of Child Health,Cipto Mangunkusumo Hospital, Jakarta between July 2001 to Oc-tober 2003Results Fifty-four IIP patients with mannitol treatment were included.Forty-two (78%) were under-five years old. Thirty-six subjects (67%)were boys; 30 (56%) were undernourished. Central nervous systeminfections (meningitis and encephalitis) were the most frequent causesof IIP. Most of the head CT scan revealed cerebral edema, hydroceph-alus, and cerebral hemorrhage. Fifty subjects (93%) had decline of con-sciousness; most of them were somnolent. Improvement in conscious-ness was identified in 31 subjects, in which 21 subjects reached fullconsciousness. Vomiting, which was found in 25 subjects (46%), sub-sided after mannitol administration. Behavioral changes were found in49 subjects (91%); 32 subjects still had persistent behavioral changesafter mannitol administration. Large and protruding fontanel was foundin 7/22 subjects, cerebral nerve paralysis in 23 subjects (43%) andpapillary edema in 6 of 34 subjects who underwent funduscopy. Duringthe treatment with mannitol, fever was found in 5 subjects, vomiting in 2subjects, skin edema and tachycardia each in 1 subject. Metabolic aci-dosis was found in 6/13 subjects, hyponatremia and hypokalemia in 16and 13 out of 30 subjects respectively. Death occurred in 9 subjects(17%).Conclusion In IIP patients, the administration of mannitol has atendency to improve consciousness, vomiting, and behavioral orpersonality changes. The high incidence rate of electrolyte imbal-ances and metabolic acidosis during the treatment indicated theneed of periodic monitoring to detect early disorders.

Adverse events following immunization (AEFI) reports of extended program immunization (EPI) in Indonesia during 1998-2002 Nastiti Kaswandani; Sri Rezeki Hadinegoro; Rulina Suradi
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

Background The incidence of adverse events following immuni-zation (AEFI) increased in correlation with the number of vaccinedoses. Meanwhile AEFI reports should be managed properly tomaintain the compliance and immunization coverage.Objectives The aims of this study were to investigate the inci-dence and profile of AEFI, its onset, severity, classification, andoutcome.Methods This study was a passive surveillance of AEFI reportsreceived by the National Committee on AEFI, Ministry of Health ofIndonesia, during 1998 to 2002.Results Two hundreds and four AEFI cases were reported; 4 casesas zero reports, 182 cases as individual reports, and 18 clusterreports. The AEFI incidence was 0.44 per 1 million doses of vac-cines. Vaccine reaction rate was 1 per 2.3 million vaccine doses.The most common vaccines reported as the causes of AEFI wereDTP, Polio, and TT. Among 182 reported cases, local or mild AEFIreactions were observed in 45, moderate in 49, and severe in 88.Based on WHO field classification, this study reported that 84 casesbelonged to coincidence, 72 to vaccine reactions, 13 to program-matic errors, 7 to injection reactions, and 6 to unclassified reac-tions. Forty-seven patients died, 12 had some sequelae, and 123completely recovered. Meanwhile, among the death cases, 70%occurred coincidently, 17% due to vaccine reactions, and 6 wereunclassified.Conclusions The incidence of AEFI in the extended program im-munization (EPI) in Indonesia during the period of 1998-2002 were182 cases, thus vaccine reaction rate was 1 per 2.3 million vac-cine doses. The most common vaccine which caused AEFI wasDTP. Most AEFI with severe symptoms happened in 4-24 hoursafter immunization.

Rett syndrome in childhood: the clinical characteristics E S Herini; Irawan Mangunatmadja; Purboyo Solek; Hardiono D Pusponegoro
Paediatrica Indonesiana Vol 44 No 4 (2004): July 2004
Publisher : Indonesian Pediatric Society

The prevalence rate of RS in various coun-tries is from 1:10,000 to 1:23,000 female livebirths. RS is most often misdiagnosed as autism,cerebral palsy, or non-specific developmental de-lay. While many health professionals may not befamiliar with RS, it is a relatively frequent cause ofneurological dysfunction in females. There are nobiological markers for this disease, the diagno-sis is established by history taking and clinical find-ings. We reported two patients, both girls, with RS.

Hepatitis B serologic patterns in children of HBV carriers or infected mothers Julfina Bisanto; Imral Chair; Dyah Istikowati
Paediatrica Indonesiana Vol 44 No 5 (2004): September 2004
Publisher : Indonesian Pediatric Society

Background Vertical transmission is usually the cause of increas-ing carrier rates for hepatitis B infection, especially in highly en-demic areas.Objective To determine the serologic patterns of hepatitis B inchildren of HBV carrier/infected mothers.Methods This was a cross sectional study on children of HBVcarrier/infected mothers. Subjects were recruited consecutively andexamined at the Department of Child Health, Cipto MangunkusumoHospital during Januaryâ€“July 2003. Children were included if theywere generally healthy and their parents gave permission. Chil-dren with chronic illness, previous blood transfusions, or drug abusewere excluded.Results Fifty-nine children of 32 HBV carrier/infected mothers wererecruited. HBsAg was positive in 8 children, anti-HBs in 37, andanti-HBc in 4 children. Seventy-three percent of children had beenvaccinated against HBV but only 81% had positive anti-HBs. Ofeighteen children who received hepatitis B vaccine and HBIg atbirth, none was infected. Six out of 25 children who received onlyhepatitis B vaccine were infected.Conclusion HBsAg, anti-HBs, and anti-HBc were positive in 14%,36%, and 7% of children of HBV carrier/infected mothers, respec-tively

Prevalence and associated factors of airway hyper- responsiveness in children with recurrent chronic cough I Gusti Agung Ngurah Sugitha Adnyana; Putu Suwendra; Hendra Santoso
Paediatrica Indonesiana Vol 44 No 5 (2004): September 2004
Publisher : Indonesian Pediatric Society

Background Airway hyper-responsiveness (AH) is a common char-acteristic of asthma. Patient who has recurrent chronic cough withAH is commonly referred as â€œcough variant asthmaâ€. Histamineprovocation test should be performed to determine whether a pa-tient has â€œcough variant asthmaâ€ or recurrent viral bronchitis.Objective To determine AH prevalence in children with recurrentchronic cough and factors associated with it.Methods A cross sectional study was conducted on 6-12 year-oldchildren with recurrent chronic cough at the Pediatrics OutpatientClinic, Sanglah Hospital Denpasar from September 2002 until June2003Results Twenty one out of 64 (33%) subjects suffering from recur-rent chronic cough without wheezing had AH. Associated factorssignificantly associated with AH were age, allergic rhinitis, pater-nal and maternal history of atopy, passive smoking, use of mos-quito-coil, positive skin prick test, and eosinophilia. Spearman cor-relation analysis between associated factors and AH showed thatpositive skin prick test and passive smoking were moderately cor-related with AH (r=0.56, p<0.0001; r=0.57, p<0.0001, respectively),whereas multivariate regression logistic analysis on associatedfactors found true associated factors, such as positive skin pricktest (p=0.01; OR=14.82), history of atopy in father (p=0.02;OR=22.75), and passive smoking (p=0.03; OR=11.97).Conclusions The prevalence of airway hyper-responsiveness inchildren with recurrent chronic cough without history of wheezingwas 33%. Independent associated factors of AH in recurrent chroniccough children are positive skin prick test, history of atopy in fa-ther, and passive smoking

Factors associated with oral Candida colonization in neonates at intensive care unit I Putu Wijana; Hendra Santoso; I Made Swastika
Paediatrica Indonesiana Vol 44 No 5 (2004): September 2004
Publisher : Indonesian Pediatric Society

Background Oral candidiasis still has high prevalence andfrequently causes problems in the neonatal period.Objective To evaluate some factors associated with the occurrenceof oral Candida colonization in neonates.Methods A cross sectional study was performed at the IntensiveCare Unit, Neonatology Division, Department of Child Health,Medical School, Udayana University/Sanglah Hospital Denpasar,from November 2002 to April 2003. Eighty neonates were enrolled.Oral mucous swabs were obtained and examined for Candidacolonization using potassium hydroxide (KOH). Data were analyzedby prevalence ratio and logistic regression; a p value of <0.05 wasconsidered significant.Results The prevalence of oral Candida colonization was 55%(44/80). The colonization was significantly associated with age of>1 week, male sex, gestational age of <37 weeks, Apgar score of<7, birth weight of <1500 grams, oral mucous pH of <7, systemicantibiotic use, and steroid use by mother. Breastfeeding was aprotective factor. Correlation between variables using Spearmantest revealed correlation coefficient of <0.5. By logistic regres-sion, birth weight of <1500 grams (p=0.04) and systemic antibi-otic use (p=0.01) were significant associated factors of oralCandida colonization, while breastfeeding was a significant pro-tective factor (p=0.03).Conclusion Birth weight of <1500 grams and systemic antibioticuse were significant associated factors of oral Candida colonizationand breastfeeding was a significant protective factor of oral Candidacolonization in neonates

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