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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.

Arjuna Subject : -

Articles 2,127 Documents

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Effect of community-based food supplementation on improving growth of underweight children under five years of age in West Nusa Tenggara Aman Bhakti Pulungan; Dini A. Mirasanti
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background The prevalence of underweight children in West Nusa Tenggara is as high as 30%. This region had the third largest number of stunted children in the country. The local government has attempted to tackle this problem by providing supplementary food to underweight children.Objective To assess the success of the community-based food supplementation program onimproving childrenâ€™s growth in West Nusa Tenggara.Methods We conducted a prospective cohort study for 10 months in Paruga District Primary Health Care Unit, Bima, West Nusa Tenggara, in year 2012. Children were given supplementary food according to the Ministry of Healthâ€™s guidelines, consisting of formula milk, high calorie biscuits, and a 60-day supply of eggs, estimated to be sufficient to normalize their weights, for their age and sex. Â A childâ€™s weight and height were measured every 3 months and the results plotted on WHO growth charts for weight-for-age, height-for-age, and weight-for-height (nutritional status). Z-score <-3 SD was classified as severely underweight, severely stunted, or severely wasted, respectively; Z-score between -2 and -3 SD was classified as underweight, stunted, or wasted, respectively; and Zâ€“score >-2 SD was classified as normal for all three categories.Results Twenty-five children under five years of age participated in this study. Subjectsâ€™ median age was 29 months. None of the subjects had normal weight-for-age Z-score at the beginning of the study. Eighty-four percent (21/25) of the subjects were severely underweight. Only 8% (2/25) of the subjects had normal height-for-age Z-score and 88% (22/25) of them were severely stunted. However, 80% (20/25) of subjects had normal nutritional status (weight-for-height). Changes in weight-for-age Z-score varied throughout the study. The highest median score was in the tenth month of follow up (-3.82). The highest median height-for-age score and weight-for-height score were also in the last month of follow up. At the end of the study, only one subject had normal weight-for-age score (4%) and none of the subjects had normal height-for-age scores. Â Conclusion The 10-month supplementary food program for under-five children in the Paruga District is not successful in improving body weight and height.

The relationship between infant iron status and risk of neurological impairment Buntat Buntat; Nurhayati Masloman; Johnny Rompis
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Iron deficiency (ID) is a commonly found nutritional disorder and a persistent problem, especially in Indonesia. Iron deficiency during the critical period in childhood brain development is estimated to cause irreversible damage that hinders infant development. Objective To determine the relationship between infant iron status and neurological development. Methods We conducted a cross-sectional study at the Growth and Development Outpatient Clinic, Prof. Dr. R. D. Kandou Hospital, Manado, from March to May 2015. By consecutive sampling, we obtained 44 healthy infants aged 7 to 10 months who fulfilled the inclusion criteria. Infants with a history of perinatal complications, such as head trauma, hypoglycemia, respiratory distress syndrome, infection, or malaria were excluded Subjects' serum hemoglobin and ferritin were examined for iron status. Infants' risk of neurological impairment was assessed by the Bayley Infant Neurodevelopmental Screener (BINS). Results were analyzed by descriptive analysis for the characteristics and Spearman's rank correlation coefficient analysis for the relationship between iron status and neurological development. Results From 14 infants with ID, 8 infants had a high risk of developmental impairment. Of the 30 non-ID subjects, 4 infants had a high risk of developmental impairment. Of the 30 non-ID infants, 16 infants had a low risk of impaired development, while 2 infants with ID had low risk of developmental impairment. Spearman's rho revealed that infant iron deficiency was significantly associated with high risk of neurological impairment. (r=-0.547; P<0.0001). Conclusion Lower serum ferritin levels (iron deficiency) is significantly associated with greater risk of impaired neurological development in infants aged 7-10 months.

Comparison of inflammation and oxidative stress levels by the severity of obesity in prepubertal children Ni Luh Putu Surya Candra Eka Pertiwi; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Children with severe obesity are more likely to develop diabetes and cardiovascular diseases at a younger age. Inflammation and oxidative stress associated with childhood obesity may be important in the development of insulin resistance and atherosclerosis. Objective To compare levels of high-sensitivity C-reactive protein (hsCRP) and malondialdehyde (MDA) by the severity of obesity in prepubertal children aged 6 to 10 years. Methods We conducted a cross-sectional study at the Pediatric Nutrition and Metabolic Syndrome Clinic, Sanglah Hospital, Bali, from August to December 2015. Subjects were categorized into three body mass index (BMI) groups, according to the 2000 Centers for Disease Control and Prevention growth chart: overweight (85th-94.9th percentile), obese (95th-98.9th percentile), or severely obese (â‰¥ 99th percentile). Plasma MDA and serum hsCRP were analyzed in blood specimens obtained at enrollment. Data were analyzed by Kruskal-Wallis test, followed by Mann-Whitney U test for post-hoc comparison between groups. Results Subjects were 20 overweight children, 29 obese children, and 28 severely obese children. Levels of MDA were significantly higher in the severely obese [median 0.25 (IQR 0.1) Î¼mol/L] than in obese subjects [median 0.19 (IQR 0.1) Î¼mol/L; P=0.001], and than in overweight subjects [median 0.16 (IQR 0.1) Î¼mol/L; P<0.0001]. Also, the severely obese children had significantly higher hsCRP levels compared to obese [median 3.2 (IQR 2.0) mg/L vs. 1.3 (1.6) mg/L, respectively; P<0.0001] and compared to overweight children [median 0.7 (IQR 0.6) mg/L; P<0.0001]. Â Â Â Conclusion Prepubertal children at the â‰¥ 99th percentile for BMI (severely obese) are more likely to have significantly higher hsCRP and MDA compared to those in the obese and overweight groups. Â

Initial clinical and laboratory profiles to predict pediatric dengue infection severity Natharina Yolanda; Harris Alfan
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background. In dengue infection, it is difficult to differentiate mild and severe dengue prior to its critical phase. Ability to identify risk factors for severe dengue form patients' initial presentation would help decrease the need of hospitalization, increase physicians' awareness, and improve outcome. Objective. To predict pediatric dengue infection severity based on initial patient characteristics, routine clinical and laboratory profiles. Methods. This was a cross-sectional study based on medical records of children with dengue infection in Atma Jaya Hospital, Jakarta. Inclusion criteria were children aged 1 - 18 years old with proven dengue infection, hospitalized in Atma Jaya Hospital during January - December 2016. Clinical profiles and laboratory parameters at the time of patient presentation were extracted and analyzed in relationship with dengue severity. Result. Data collected was 110 patients with mean age 9.5 years old. Initial clinical profiles that significantly related to severe dengue were: age <=5 years old (OR = 0.113, p = 0.001), hepatomegaly (OR = 2.643, p = 0.035), pleural effusion (OR = 9.545, p = 0.000), platelet <=125,000/uL (OR = 0.201, p = 0.025), hyponatremia (OR = 10.139, p = 0.000) and AST >135 u/L (OR = 5.112, p = 0.014). Gender, duration of fever, additional symptoms, spontaneous bleeding, blood pressure, pulse pressure, hematocrit, leucocyte, random blood glucose, calcium, and ALT were not related significantly to dengue severity. Conclusion. Physician should be cautious in pediatric dengue patients presented in age younger than 5 years old, with hepatomegaly and/or pleural effusion, platelet below 125,000/uL, hyponatremia, and AST more than three times upper normal limit. These patients have higher risk of severe dengue than patients without those findings.

Maternal attitude and child interest in various play activities before and after mother-child play sessions Soedjatmiko Soedjatmiko; Hartono Gunardi; Rini Sekartini; Bernie Endyarni Medise; Ikhsan Johnson; Yulianti Wibowo; Ray Wagiu Basrowi
Paediatrica Indonesiana Vol 57 No 6 (2017): November 2017
Publisher : Indonesian Pediatric Society

Background Play stimulates children's growth and development. When mothers and their children play, a positive attitude from the mother and adequate interest from the child is required. Little is known about the play activities that effectively stimulate such positive maternal attitude and child interest. Objective To assess for associations between various play activities with maternal attitude and child interest before and after mother-child play sessions. Methods Pre-post intervention questionnaires were distributed to mothers before and after playing with their children. Children were aged 1-5 years, from two play sites (in Surabaya and Makassar), and included using purposive sampling. Eight types of toys/play activities were provided. The allocated time for answering the 17-question survey was 15 minutes. Average scores before and after the mother-child play sessions were analyzed using paired T-test. Results We collected 264 valid questionnaires, 235 in Surabaya and 29 in Makassar. Improvement of maternal attitude after the mother-child play session was found in 132 mothers [mean diff. 0.07 (SD 0.42); 95%CI -0.117 to -0.015; P=0.011]. Play activities with significant improvements in maternal attitude were jigsaw puzzle [mean diff. 0.09 (SD 0.66); 95% CI 0.007 to 0.167;P= 0.033), Lego blocks (mean diff.-0.10 (SD 0.69); 95%CI -0.186 to -0.018; P=0.017), mini-gardening (mean diff. -0.15 (SD 0.75); 95%CI -0.238 to -0.057; P=0.002), sandbox [mean diff.-0.24 (SD 0.83); 95%CI -0.339 to â€“ 0.138; P < 0.001], fishing [mean diff. -0.17 (SD 0.68); 95%CI -0.253 to -0.088; P < 0.001], and animal figurines [mean diff. -0.21 (SD 0.75); 95%CI -0.3 to -0.117;P <0.001]. Improvement of child interest was found in 161 children [mean diff. 0.20 (SD 0.52); 95%CI -0.264 to -0.116; P<0.001]. Play activities with significant improvements in child interest were jigsaw puzzle, Lego blocks, origami, mini-gardening, fishing, and animal figurines. Conclusion Some mother-child play activities, but not all, significantly improve both maternal attitude and child interest toward play.

West syndrome and mosaic trisomy 13: A case report Hechmi Ben Hamouda; Habib Soua; Mohamed Dogui; Hassine Hamza; Mohamed Tahar Sfar
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Trisomy 13, or Patau syndrome, is a rare chromosomal disorder characterized by a triad of cleft lip and palate, postaxial polydactyly, and microphthalmia, with an incidence ranging between 1/5,000 and 1/20,000 births.1 Most patients (80%) with Patau syndrome have complete trisomy 13. Mosaic trisomy 13 is very rare; it occurs in only 5% of all patients with the trisomy 13 phenotype.2 Trisomy 13 is a clinically severe entity, and 90 to 95% of patients born with this syndrome do not survive beyond one year of life. However, patients with mosaic trisomy 13 usually have longer survival and less severe phenotype compared to patients with complete trisomy 13. Malformations mainly affect midline development, with a high frequency of central nervous system involvement. The presence of central nervous system malformations is important as a predictive factor of survival.1,3 It is well known that the incidence of epilepsy is higher in children with Patau syndrome than in the general population, and West syndrome or infantile spasms have been rarely reported in these children.1,4,5 Prior to our report, there has been no case report of West syndrome associated with mosaic trisomy 13. The association of West syndrome with trisomy 13 is considered a symptomatic West syndrome because of preexisting psychomotor development delay and the poor prognosis in most of these children.6 We report here the first case of West syndrome in a girl with mosaic trisomy 13 and discuss the clinical characteristics and prognosis of this association.

Habitual snoring and primary enuresis in children Muhammad Adib Mahara; Oke Rina Ramayani; Elmeida Effendy; Munar Lubis; Rosmayanti Siregar; Beatrix Siregar; Rafita Ramayanti
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Background Obstructive sleep-disordered breathing is assumed to be associated with primary enuresis in children. Prolonged enuresis may cause developmental and emotional disorders, as well as poor school performance. Objective To determine the relationship between habitual snoring and primary enuresis in children. Methods A cross-sectional study was conducted in Muara Batang Gadis District, North Sumatera in April 2016. Subjects were children aged 5-14 years. The Sleep Disturbance Scale for Children (SDSC) questionnaire was used to measure the symptoms of sleep disordered breathing; the International Association Child and Adolescent Psychiatry and Allied Professions (IACAPAP) questionnaire was used to assess for the presence of primary enuresis. The questionnaires were answered by the childrenâ€™s parents. Data were analyzed using Chi-square and logistic regression tests. A P value of <0.05 was considered to be statistically significant. Results The mean age of 110 participants was 9.23 (SD 2.16) years. Twenty-seven (24.5%) subjects snored more than three nights per week (habitual snorers) and 18 (16.4%) subjects had primary enuresis. There was a significantly higher percentage of habitual snorers with enuresis than that of snorers without enuresis (55.5% vs. 18.4%, respectively) (P<0.05). Conclusion There is a significant relationship between habitual snoring and primary enuresis.

Sleep disturbance scale for children as a diagnostic tool for sleep disorders in adolescents Herwanto Herwanto; Hesti Lestari; Sarah M. Warouw; Praevilia M. Salendu
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Background. Sleep is an essential needs for every children. Sleep may cause a large effect on mental health, emotional, physical and immune system. If sleeping time is not sufficient, then sleep disturbance may occur. Objective assessment of the sleeping quality can be done by using Polysomnography and Actigraphy, while for assessing the subjectivity of sleeping quality and quantity can be used questionnaires or interviews. Sleep Disturbance Scale for Children or SDSC is a multidimensional sleeping assessment questionnaire. Objective. To determine the quality of sleeping in adolescents using SDSC. Methods. We conducted a diagnostic test study using cross sectional method, during March to April 2015 at the elementary schools in manado. The inclusion criteria were healthy adolescent aged 10 to 12 years, the parents were willing to sign the informed consent and answer the questionnaire, agreed to attach the wristactigraph. All datas were analyzed using chi square test and table 2 x 2 to showed sensitivity, specificity, positive predicitive value and negative predictive value. Results. Of 60 adolescents, 31 were female and 29 were male with the mean age 11.39 years. The results showed the sensitivity of SDSC was 80.6%, the specificity was 37.9%, the positive predictive value was 58.1% and negative predictive value was 64.7%. Conclusions. Sleep Disturbance Scale for Children is a good screening tool for early detection of sleep disorders in a adolescent.

Thrombospondin-1 and blood pressure in 7-8-year-old children born low birth weight and small for gestational age Marlyn Malonda; Adrian Umboh; Stefanus Gunawan
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Thrombospondin-1 (TSP-1) is associated with endothelial damage, glomerular impairment, and hypertension. Low birth weight (LBW) and small for gestational age (SGA) children have higher risk of morbidity and mortality.Objective To assess for a possible association between TSP-1 level and blood pressure in children who were born low birth weight and small for gestational age.Methods We conducted a cross-sectional study from March to May 2015. Inclusion criteria were children who were born LBW and SGA in 2007-2008 at Prof. Dr. R. D. Kandou General Hospital, resided in Manado, North Sulawesi, had complete medical records, and whose parents consented to their participation. Exclusion criteria were children who were in puberty, obese, had renal disease, taking medications that affect blood pressure, or who were admitted to the hospital in the 2 weeks prior to enrollment.Â Data were analyzed using regression and simple correlation tests to assess for associations between TSP-1 and birth weight, as well as TSP-1 and blood pressure.Results Subjectsâ€™ mean TSP-1 level was 257.95 ng/dL. There was a strong negative correlation between TSP-1 and birth weight (r=-0.784; P<0.0001). In addition, there were strong positive correlations between TSP-1 level and systolic blood pressure (r=0.718; P<0.0001) as well as TSP-1 and diastolic blood pressure (r=0.670; P<0.0001).Conclusion Higher TSP-1 is associated with higher systolic and diastolic blood pressure in 7-8-year-old children who were LBW and SGA at birth. Also, TSP-1 and birth weight have a strong negative correlation.

Association between oxygen saturation and critical congenital heart disease in newborns Lidia Halim; Muhammad Ali; Tiangsa Sembiring
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Background Critical congenital heart disease (CCHD) is relatively common, with a prevalence of 6-8 in every 1,000 live births. This congenital anomaly is a newborn condition that would be ideally suited for a screening program, if simple and reliable methods were available. Pulse oximetry (PO) has been proposed as a screening method to detect CCHD. Objective To assess for a possible association between decreased oxygen saturation and CCHD in newborns. Methods We conducted a cross-sectional study from March 2014 to February 2015 in several hospitals in North Sumatra. Healthy, full term and post-term newborns aged 2 to 72 hours underwent pulse oximetry measurements on the right hand and one of the lower extremities. If oxygen saturation (SpO2) was â‰¤ 95%, the measurement was repeated 2 more times. Subjects also underwent echocardiography. Results A total of 386 newborns underwent SpO2 measurements: 377 newborns had SpO2 > 95% and 9 newborns had SpO2 â‰¤ 95%. Of the infants with SpO2 > 95%, 297 were excluded because their parents refused echocardiography examination. Thus, 80 newborns with SpO2 > 95% and 9 newborns with SpO2 â‰¤ 95% underwent echocardiography. Echocardiography revealed that 5 of 9 newborns with SpO2 â‰¤ 95% suffered from Tetralogy of Fallot (ToF) (3 subjects) and transposition of the great arteries (TGA) (2 subjects). One infant with SpO2 > 95% had ventricular septal defect (VSD), as detected by echocardiography. Oxygen saturation â‰¤ 95% had significant association with CCHD (P<0.001). Conclusion Decreased oxygen saturation has a significant association with critical congenital heart disease in newborns.

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