Pub Date : 2022-11-09DOI: 10.14238/pi62.5.2022.341-56
Suryadi Limardi, Dini Mutia Hasanah, N. Utami
Background Linear growth retardation in the first two years of life leads to numerous harmful consequences. Lack of diversity in the diet and inadequate amounts of complementary food have been associated with stunted growth in children. Objective To assess the dietary intake and investigate for associations with stunting among children aged 6-23 months. Methods This case-control study compared the dietary intake of children aged 6-23 months with and without stunting in the South and West Wewewa subdistricts of Southwest Sumba, East Nusa Tenggara, Indonesia. Complementary food types, dietary diversity, and nutritional intake were assessed and compared between groups. Nutrient intake sufficiency and stunting were analyzed by logistic regression. Results A total of 200 participants were equally allocated into groups with and without stunting. Only 6% of stunted children received adequate complementary food diversity compared to 14% of non-stunted children (P=0.05). The stunted group had significantly lower consumption of flesh foods (beef, fish, poultry, organ meat, and other kinds of meat) compared to the non-stunted group (7% vs. 16% of subjects, respectively; P<0.05). The median total protein intake was also significantly lower in stunted children compared to non-stunted children [7.72 (IQR 6.46, 11.31) g vs. 10.02 (IQR 6.53, 13.95) g, respectively; P<0.05] although no association was found between protein intake sufficiency and stunting in the multivariate analysis. Only maternal unemployment was positively associated with stunting (OR 2.32; 95%CI 1.26 to 4.26). Conclusion Overall, most subjects did not receive sufficient amounts of nutrients. Although dietary diversity was not found to be significantly different between those with and without stunting, a significantly lower proportion of stunted children consumed flesh food. The stunted group also received significantly lower protein from their diet although no association was found between nutrient intake sufficiency and stunting. Further studies are needed to longitudinally assess the effects of macronutrient and micronutrient intake sufficiency on linear growth in children.
{"title":"Dietary intake and stunting in children aged 6-23 months in rural Sumba, Indonesia","authors":"Suryadi Limardi, Dini Mutia Hasanah, N. Utami","doi":"10.14238/pi62.5.2022.341-56","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.341-56","url":null,"abstract":"Background Linear growth retardation in the first two years of life leads to numerous harmful consequences. Lack of diversity in the diet and inadequate amounts of complementary food have been associated with stunted growth in children. \u0000Objective To assess the dietary intake and investigate for associations with stunting among children aged 6-23 months. \u0000Methods This case-control study compared the dietary intake of children aged 6-23 months with and without stunting in the South and West Wewewa subdistricts of Southwest Sumba, East Nusa Tenggara, Indonesia. Complementary food types, dietary diversity, and nutritional intake were assessed and compared between groups. Nutrient intake sufficiency and stunting were analyzed by logistic regression. \u0000Results A total of 200 participants were equally allocated into groups with and without stunting. Only 6% of stunted children received adequate complementary food diversity compared to 14% of non-stunted children (P=0.05). The stunted group had significantly lower consumption of flesh foods (beef, fish, poultry, organ meat, and other kinds of meat) compared to the non-stunted group (7% vs. 16% of subjects, respectively; P<0.05). The median total protein intake was also significantly lower in stunted children compared to non-stunted children [7.72 (IQR 6.46, 11.31) g vs. 10.02 (IQR 6.53, 13.95) g, respectively; P<0.05] although no association was found between protein intake sufficiency and stunting in the multivariate analysis. Only maternal unemployment was positively associated with stunting (OR 2.32; 95%CI 1.26 to 4.26). \u0000Conclusion Overall, most subjects did not receive sufficient amounts of nutrients. Although dietary diversity was not found to be significantly different between those with and without stunting, a significantly lower proportion of stunted children consumed flesh food. The stunted group also received significantly lower protein from their diet although no association was found between nutrient intake sufficiency and stunting. Further studies are needed to longitudinally assess the effects of macronutrient and micronutrient intake sufficiency on linear growth in children.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"70 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87074654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.14238/pi62.5.2022.318-23
Diska Yulia Trisiana, F. F. Yani, Fitrisia Amelin, Aumas Pabuti
Background Kidney damage in chronic kidney disease (CKD) disrupts the 1?-hydroxylase enzyme, preventing the conversion of vitamin D into the active form of calcitriol. To our knowledge, no previous studies have assessed calcitriol levels in children with CKD. Decreased vitamin D levels may occur at an early stage of the disease, so it is important to evaluate calcitriol levels in children with early stage CKD. Objective To assess calcitriol levels in children with CKD according to disease stage and other characteristics. Methods This cross-sectional study was conducted on 43 pediatric CKD patients at Dr. M Djamil Hospital, Padang, Indonesia. We recorded patient characteristics and performed laboratory tests, including routine hematology, blood urea nitrogen (BUN), creatinine, uric acid, electrolytes, calcium, and calcitriol levels. Based on estimated glomerular filtration rate (GFR), patients were grouped into either early-stage (stages I and II), or advanced-stage (stages III to V) CKD. Univariate and multivariate analyses were conducted to determine the association between calcitriol levels with disease stage and other characteristics. Results The overall mean calcitriol level of our subjects was 108.77 (SD 10.79) pmol/L. Mean levels at each CKD stage from I to V were 164.28 (SD 160.90), 94.14 (SD 50.63), 72.16 (SD 13.18), 62.92 (SD 4.87), and 67.51 (SD 4.87) pmol/L, respectively. Calcitriol levels did not differ significantly by CKD stage (P=0.114) when each stage from I to V was considered separately. There was no significant difference in calcitriol levels by growth characteristics (P=0.944), etiology (P=0.311), or anemic status (P=0.104). However, low calcitriol levels were found in all subjects with advanced stage CKD, compared to 63.6% subjects with early stage CKD (P=0.004). Mean calcitriol levels were significantly lower in CKD stage IV (P=0.049) and stage V (P=0.027) compared to stage I. Conclusions The decrease in calcitriol level occurs at an early stage in CKD. Calcitriol levels are significantly lower in advanced stage than in early stage CKD.
{"title":"Calcitriol levels and the stage of chronic kidney disease in children","authors":"Diska Yulia Trisiana, F. F. Yani, Fitrisia Amelin, Aumas Pabuti","doi":"10.14238/pi62.5.2022.318-23","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.318-23","url":null,"abstract":"Background Kidney damage in chronic kidney disease (CKD) disrupts the 1?-hydroxylase enzyme, preventing the conversion of vitamin D into the active form of calcitriol. To our knowledge, no previous studies have assessed calcitriol levels in children with CKD. Decreased vitamin D levels may occur at an early stage of the disease, so it is important to evaluate calcitriol levels in children with early stage CKD. \u0000Objective To assess calcitriol levels in children with CKD according to disease stage and other characteristics. \u0000Methods This cross-sectional study was conducted on 43 pediatric CKD patients at Dr. M Djamil Hospital, Padang, Indonesia. We recorded patient characteristics and performed laboratory tests, including routine hematology, blood urea nitrogen (BUN), creatinine, uric acid, electrolytes, calcium, and calcitriol levels. Based on estimated glomerular filtration rate (GFR), patients were grouped into either early-stage (stages I and II), or advanced-stage (stages III to V) CKD. Univariate and multivariate analyses were conducted to determine the association between calcitriol levels with disease stage and other characteristics. \u0000Results The overall mean calcitriol level of our subjects was 108.77 (SD 10.79) pmol/L. Mean levels at each CKD stage from I to V were 164.28 (SD 160.90), 94.14 (SD 50.63), 72.16 (SD 13.18), 62.92 (SD 4.87), and 67.51 (SD 4.87) pmol/L, respectively. Calcitriol levels did not differ significantly by CKD stage (P=0.114) when each stage from I to V was considered separately. There was no significant difference in calcitriol levels by growth characteristics (P=0.944), etiology (P=0.311), or anemic status (P=0.104). However, low calcitriol levels were found in all subjects with advanced stage CKD, compared to 63.6% subjects with early stage CKD (P=0.004). Mean calcitriol levels were significantly lower in CKD stage IV (P=0.049) and stage V (P=0.027) compared to stage I. \u0000Conclusions The decrease in calcitriol level occurs at an early stage in CKD. Calcitriol levels are significantly lower in advanced stage than in early stage CKD.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"74 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82073571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.14238/pi62.5.2022.333-40
M. Sitaresmi, H. Seale, A. Heywood, R. Padmawati, Y. Soenarto, C. Macintyre, J. Atthobari
Abstract Background Rotavirus is a leading cause of hospitalized diarrhea cases in Indonesia. Despite the rotavirus vaccine being recommended by the Indonesian Pediatric Society since 2011, it has yet to be been included in the Indonesian national immunization program (NIP) schedule. Objective To explore maternal knowledge of and attitudes towards rotavirus diarrhea, as well as barriers to vaccine acceptance in Yogyakarta, Indonesia. Methods We conducted 26 in-depth interviews in two districts (rural and urban areas) of Yogyakarta Province, Indonesia. Participants included women in their third trimester of pregnancy and mothers of infants younger than 14 weeks. We then proceeded with thematic analysis. Results Participants did not perceive diarrhea as being a priority health problem. Very few had heard of rotavirus diarrhea or were aware of vaccine availability. While participants would accept vaccinating their children against rotavirus, some key barriers impacted vaccine use. As the rotavirus vaccine is not included in the Indonesian NIP, parents perceived it as not essential. Parents were concerned about the safety and benefit of the vaccine due to its perceived newness. Other concerns were cost and halal status. Participants expressed a need for more information on the vaccine's effectiveness and safety, with their primary healthcare providers (HCPs) considered to play the most important role in vaccine acceptance. Conclusions In Yogyakarta, Indonesia, awareness of the seriousness of rotavirus disease and the availability of the rotavirus vaccine is low. Its newness, safety, efficacy, and cost, and doubts about its halal status, were barriers to vaccine acceptance. Information and recommendations from HCPs play an essential role in vaccine acceptance.
{"title":"Maternal knowledge and attitudes towards rotavirus diarrhea and vaccine acceptance in Yogyakarta, Indonesia: a qualitative study","authors":"M. Sitaresmi, H. Seale, A. Heywood, R. Padmawati, Y. Soenarto, C. Macintyre, J. Atthobari","doi":"10.14238/pi62.5.2022.333-40","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.333-40","url":null,"abstract":"Abstract \u0000Background Rotavirus is a leading cause of hospitalized diarrhea cases in Indonesia. Despite the rotavirus vaccine being recommended by the Indonesian Pediatric Society since 2011, it has yet to be been included in the Indonesian national immunization program (NIP) schedule. \u0000Objective To explore maternal knowledge of and attitudes towards rotavirus diarrhea, as well as barriers to vaccine acceptance in Yogyakarta, Indonesia. \u0000Methods We conducted 26 in-depth interviews in two districts (rural and urban areas) of Yogyakarta Province, Indonesia. Participants included women in their third trimester of pregnancy and mothers of infants younger than 14 weeks. We then proceeded with thematic analysis. \u0000Results Participants did not perceive diarrhea as being a priority health problem. Very few had heard of rotavirus diarrhea or were aware of vaccine availability. While participants would accept vaccinating their children against rotavirus, some key barriers impacted vaccine use. As the rotavirus vaccine is not included in the Indonesian NIP, parents perceived it as not essential. Parents were concerned about the safety and benefit of the vaccine due to its perceived newness. Other concerns were cost and halal status. Participants expressed a need for more information on the vaccine's effectiveness and safety, with their primary healthcare providers (HCPs) considered to play the most important role in vaccine acceptance. \u0000Conclusions In Yogyakarta, Indonesia, awareness of the seriousness of rotavirus disease and the availability of the rotavirus vaccine is low. Its newness, safety, efficacy, and cost, and doubts about its halal status, were barriers to vaccine acceptance. Information and recommendations from HCPs play an essential role in vaccine acceptance.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"19 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79430719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.14238/pi62.5.2022.324-32
Nadhea Debrinita Surya, Nicolas Daniel Widjanarko, Theressa Kristiayu Permatasari, Yuliana Yosephine, E. Wijaya
Background The digit span (DS) test is one of the most commonly used neuropsychological tests to assess certain cognitive domains, i.e., short-term verbal memory, working memory, and attention. Subclinical hypothyroidism (SH) may be associated with a risk of cognitive impairment in children and adolescents. Objective To evaluate the association between SH and DS test performance in children. Methods Eligible studies evaluating SH and DS test performance were included in this systematic review and further assessed for risk of bias using the Newcastle Ottawa Scale. We carried out a meta-analysis using the random effects model to determine mean difference with 95% confidence interval (95%CI) for continuous data. This systematic review was conducted according to the Preview Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results Out of 1,511 participants in the five included studies, 129 had SH and 1,382 were euthyroid. The quality of all studies were fair to good. Three studies were extracted for meta-analysis, with results showing a trend toward a poorer DS test performance in the SH group compared to controls, although this difference was statistically insignificant (IV -0.57; 95%CI -1.61 to 0.46; P=0.28). There was no significant heterogeneity among the included studies (I2=0%; P=0.69). Conclusion No significant association was noted between SH and the domains of cognitive function assessed using the DS test. Several intrinsic and extrinsic factors and inability of the DS test to detect subtle impairment may limit its usefulness in children.
{"title":"Subclinical hypothyroidism and digit span test performance in children: a systematic review and meta-analysis","authors":"Nadhea Debrinita Surya, Nicolas Daniel Widjanarko, Theressa Kristiayu Permatasari, Yuliana Yosephine, E. Wijaya","doi":"10.14238/pi62.5.2022.324-32","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.324-32","url":null,"abstract":"Background The digit span (DS) test is one of the most commonly used neuropsychological tests to assess certain cognitive domains, i.e., short-term verbal memory, working memory, and attention. Subclinical hypothyroidism (SH) may be associated with a risk of cognitive impairment in children and adolescents. \u0000Objective To evaluate the association between SH and DS test performance in children. \u0000Methods Eligible studies evaluating SH and DS test performance were included in this systematic review and further assessed for risk of bias using the Newcastle Ottawa Scale. We carried out a meta-analysis using the random effects model to determine mean difference with 95% confidence interval (95%CI) for continuous data. This systematic review was conducted according to the Preview Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. \u0000Results Out of 1,511 participants in the five included studies, 129 had SH and 1,382 were euthyroid. The quality of all studies were fair to good. Three studies were extracted for meta-analysis, with results showing a trend toward a poorer DS test performance in the SH group compared to controls, although this difference was statistically insignificant (IV -0.57; 95%CI -1.61 to 0.46; P=0.28). There was no significant heterogeneity among the included studies (I2=0%; P=0.69). \u0000Conclusion No significant association was noted between SH and the domains of cognitive function assessed using the DS test. Several intrinsic and extrinsic factors and inability of the DS test to detect subtle impairment may limit its usefulness in children.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"36 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75026099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-28DOI: 10.14238/pi62.5.2022.304-10
Arya Adnan Fadilah, E. Haksari, S. Wandita
Background Neonatal sepsis is a global health problem contributing significantly to neonatal morbidity and mortality. It is difficult to clinically distinguish neonates with and without sepsis. Interleukin-6 (IL-6) concentration in neonates has high sensitivity and specificity to predict neonatal sepsis in infants at risk. Objective To determine the utility of umbilical cord blood IL-6 as a predictor of early-onset neonatal sepsis. Methods This prospective cohort study was conducted in neonates born to mothers with sepsis risk factors from December 2020 to January 2021. We measured IL-6 from umbilical cord blood taken after placental expulsion. IL-6 ³16.4 pg/ml was considered to be elevated. Subjects were monitored for signs of clinical sepsis until 72 hours after birth. We also recorded the presence of other maternal and infant risk factors of sepsis and assessed association between IL-6 and other risk factors with the occurrence of sepsis, expressed as relative risk (RR) with 95% confidence interval (95%CI). Results During the study period, 40 neonates were born to mothers with sepsis risk factors; 13 (32.5%) developed clinical sepsis. Significantly more infants with elevated IL-6 developed neonatal sepsis (55.5%) than those with normal IL-6 (13.6%). After multivariate analysis incorporating other significant variables, the risk factors predictive of clinical early-onset neonatal sepsis were IL-6 [RR 5.54 (95%CI 1.68-18.25); P=0.016], prematurity [RR 4.92 (95%CI 1.66-14.59); P=0.014], and initial Apgar score [RR 3.38 (95%CI 1.34-3.38); P=0.046]. Conclusion In neonates with maternal risk factors, an IL-6 level of ³16.4 pg/ml is associated with an increased risk of early-onset neonatal sepsis.
{"title":"Umbilical cord blood interleukin-6 level as a predictor of early-onset neonatal sepsis","authors":"Arya Adnan Fadilah, E. Haksari, S. Wandita","doi":"10.14238/pi62.5.2022.304-10","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.304-10","url":null,"abstract":" \u0000 \u0000Background Neonatal sepsis is a global health problem contributing significantly to neonatal morbidity and mortality. It is difficult to clinically distinguish neonates with and without sepsis. Interleukin-6 (IL-6) concentration in neonates has high sensitivity and specificity to predict neonatal sepsis in infants at risk. \u0000Objective To determine the utility of umbilical cord blood IL-6 as a predictor of early-onset neonatal sepsis. \u0000Methods This prospective cohort study was conducted in neonates born to mothers with sepsis risk factors from December 2020 to January 2021. We measured IL-6 from umbilical cord blood taken after placental expulsion. IL-6 ³16.4 pg/ml was considered to be elevated. Subjects were monitored for signs of clinical sepsis until 72 hours after birth. We also recorded the presence of other maternal and infant risk factors of sepsis and assessed association between IL-6 and other risk factors with the occurrence of sepsis, expressed as relative risk (RR) with 95% confidence interval (95%CI). \u0000Results During the study period, 40 neonates were born to mothers with sepsis risk factors; 13 (32.5%) developed clinical sepsis. Significantly more infants with elevated IL-6 developed neonatal sepsis (55.5%) than those with normal IL-6 (13.6%). After multivariate analysis incorporating other significant variables, the risk factors predictive of clinical early-onset neonatal sepsis were IL-6 [RR 5.54 (95%CI 1.68-18.25); P=0.016], prematurity [RR 4.92 (95%CI 1.66-14.59); P=0.014], and initial Apgar score [RR 3.38 (95%CI 1.34-3.38); P=0.046]. \u0000Conclusion In neonates with maternal risk factors, an IL-6 level of ³16.4 pg/ml is associated with an increased risk of early-onset neonatal sepsis.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84663913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-28DOI: 10.14238/pi62.5.2022.364-6
M. A. Shodikin, D. Agustina
Spontaneous pneumothorax is a rare but fatal complication of miliary tuberculosis. We report a 13-year-old boy presenting with shortness of breath. He was diagnosed with miliary tuberculosis with spontaneous pneumothorax, which showed significant improvement after the insertion of a thoracostomy tube and anti-tuberculosis drug therapy.
{"title":"Spontaneous pneumothorax in a child with miliary tuberculosis: a case report","authors":"M. A. Shodikin, D. Agustina","doi":"10.14238/pi62.5.2022.364-6","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.364-6","url":null,"abstract":"Spontaneous pneumothorax is a rare but fatal complication of miliary tuberculosis. We report a 13-year-old boy presenting with shortness of breath. He was diagnosed with miliary tuberculosis with spontaneous pneumothorax, which showed significant improvement after the insertion of a thoracostomy tube and anti-tuberculosis drug therapy.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"20 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82564878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-28DOI: 10.14238/pi62.5.2022.311-7
L. K. Wahyuni, I. Mangunatmadja, Risma K Kaban, E. Z. Rachmawati, M. Harini, Budiati Laksmitasari, Agatha Geraldyne, Inez Ayuwibowo Sangwidjojo, Dini Prima Utami, Victor Prasetyo Poernomo, Adrian Prasetya Sudjono
Background Non-nutritive sucking (NNS) maturity has been used as one of the markers of oral feeding readiness in infants. Prematurity may hinder the attainment of NNS milestones. Depending on gestational age (GA) at birth, preterm infants may display various degrees of immaturity, potentially affecting the strength, coordination, and efficiency of skills required for NNS. Objective To identify the progression of NNS patterns across gestational age groups of preterm infants in Indonesia by comparing NNS parameters between moderate-to-late preterm and very preterm infants. Methods NNS evaluation was conducted in 120 preterm infants born at 28-34 weeks gestational age in five tertiary hospitals in Jakarta, Indonesia. Three aspects of NNS (suction pressure, number of suctions per burst, and time between bursts) were documented and arranged to present a descriptive overview. A suction pressure measurement device was used to record, identify, and analyze NNS parameters. We hypothesize that maturity, as determined by GA, positively affected the attainment of NNS milestones. Results Moderate-to-late preterm infants (GA 32 to <37 weeks), compared to very preterm infants (GA 28 to <32 weeks), had higher mean NNS pressure (-79.8 vs. -72.7 mmHg, respectively, P=0.041) and shorter mean time between bursts (6.63 vs. 7.36 s, respectively, P=0.030). Mean number of suctions per burst were also significantly different between the two GA groups (8.90 vs. 8.99 sucks/burst, respectively, P=0.048). Conclusion Maturity, as reflected by GA, had a positive effect on the attainment of NNS milestones in preterm infants in Indonesia. Significant differences in the three NNS parameters: number of suctions per burst, time between bursts, and suction pressure were found between moderate-to-late preterm and very preterm infants.
{"title":"Non-nutritive sucking milestones of preterm infants in Indonesia: a descriptive study","authors":"L. K. Wahyuni, I. Mangunatmadja, Risma K Kaban, E. Z. Rachmawati, M. Harini, Budiati Laksmitasari, Agatha Geraldyne, Inez Ayuwibowo Sangwidjojo, Dini Prima Utami, Victor Prasetyo Poernomo, Adrian Prasetya Sudjono","doi":"10.14238/pi62.5.2022.311-7","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.311-7","url":null,"abstract":"Background Non-nutritive sucking (NNS) maturity has been used as one of the markers of oral feeding readiness in infants. Prematurity may hinder the attainment of NNS milestones. Depending on gestational age (GA) at birth, preterm infants may display various degrees of immaturity, potentially affecting the strength, coordination, and efficiency of skills required for NNS. \u0000Objective To identify the progression of NNS patterns across gestational age groups of preterm infants in Indonesia by comparing NNS parameters between moderate-to-late preterm and very preterm infants. \u0000Methods NNS evaluation was conducted in 120 preterm infants born at 28-34 weeks gestational age in five tertiary hospitals in Jakarta, Indonesia. Three aspects of NNS (suction pressure, number of suctions per burst, and time between bursts) were documented and arranged to present a descriptive overview. A suction pressure measurement device was used to record, identify, and analyze NNS parameters. We hypothesize that maturity, as determined by GA, positively affected the attainment of NNS milestones. \u0000Results Moderate-to-late preterm infants (GA 32 to <37 weeks), compared to very preterm infants (GA 28 to <32 weeks), had higher mean NNS pressure (-79.8 vs. -72.7 mmHg, respectively, P=0.041) and shorter mean time between bursts (6.63 vs. 7.36 s, respectively, P=0.030). Mean number of suctions per burst were also significantly different between the two GA groups (8.90 vs. 8.99 sucks/burst, respectively, P=0.048). \u0000Conclusion Maturity, as reflected by GA, had a positive effect on the attainment of NNS milestones in preterm infants in Indonesia. Significant differences in the three NNS parameters: number of suctions per burst, time between bursts, and suction pressure were found between moderate-to-late preterm and very preterm infants.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"18 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73086355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.14238/pi62.5.2022.295-303
N. Kurniati, Z. Munasir, Pramita Gayatri, E. Yunihastuti, B. Bela, A. Alam
Background The World Health Organization (WHO) recommends viral load (VL) monitoring for HIV patients on antiretroviral therapy (ART). However, availability of VL monitoring in low-income countries remains limited. Objective To investigate factors associated with virological failure in HIV-infected children treated without routine VL monitoring. Methods This cohort study was done in children living with HIV (CLHIV) registered at Cipto Mangunkusumo General Hospital from 2004 to 2021. Viral load monitoring was not routinely done. Subjects with at least one VL result after 6 months on ART were included in the study. Virological failure was defined as a VL of >1,000 copies. Subjects’ data were obtained from medical records, laboratory reports, and dispensing pharmacies. Statistical analysis was done following survival analysis with hazard ratio. Results There were 384 children who had at least 1 VL result after ART was initiated. Median age at diagnosis was 30 months. Length of follow-up ranged from 6 to 216 months, with a mean frequency of VL monitoring of 0.7 times/person/year. Most subjects were already in clinical stages 3 and 4 (77.8%); 75% met severe immunodeficiency criteria. Virological failure was found in 45.8% of subjects after a median of 33 months on first-line ART, yielding an incidence of 3.3 per 1,000 person months. Independent associated factors were age at diagnosis of <60 months (HR 1.714; 95%CI 1.13 to 2.6), severe immunodeficiency (HR 1.71; 95%CI 1.15 to 2.54), referral cases (HR 1.70; 95%CI 1.23 to 2.36), and WHO clinical staging 3 (HR 1.987; 95%CI 0.995 to 3.969) and 4 (HR 2.084; 95%CI 1.034 to 4.201). Subjects with virological failure had lower weight-for-age z-scores [median 1.92; interquartile range (IQR) -3.003 to -0.81] and height-for-age z-scores [median -2.05; IQR -2.902 to -1.04] at the time of failure. Conclusions In HIV-infected children treated without routine VL monitoring, age at diagnosis <60 months, severe immunodeficiency, WHO clinical stage 3 and 4, and referral from other centers were associated with virological failure.
{"title":"Virological failure of first-line antiretroviral therapy in children living with HIV in Indonesia and associated factors","authors":"N. Kurniati, Z. Munasir, Pramita Gayatri, E. Yunihastuti, B. Bela, A. Alam","doi":"10.14238/pi62.5.2022.295-303","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.295-303","url":null,"abstract":"Background The World Health Organization (WHO) recommends viral load (VL) monitoring for HIV patients on antiretroviral therapy (ART). However, availability of VL monitoring in low-income countries remains limited. \u0000Objective To investigate factors associated with virological failure in HIV-infected children treated without routine VL monitoring. \u0000Methods This cohort study was done in children living with HIV (CLHIV) registered at Cipto Mangunkusumo General Hospital from 2004 to 2021. Viral load monitoring was not routinely done. Subjects with at least one VL result after 6 months on ART were included in the study. Virological failure was defined as a VL of >1,000 copies. Subjects’ data were obtained from medical records, laboratory reports, and dispensing pharmacies. Statistical analysis was done following survival analysis with hazard ratio. \u0000Results There were 384 children who had at least 1 VL result after ART was initiated. Median age at diagnosis was 30 months. Length of follow-up ranged from 6 to 216 months, with a mean frequency of VL monitoring of 0.7 times/person/year. Most subjects were already in clinical stages 3 and 4 (77.8%); 75% met severe immunodeficiency criteria. Virological failure was found in 45.8% of subjects after a median of 33 months on first-line ART, yielding an incidence of 3.3 per 1,000 person months. Independent associated factors were age at diagnosis of <60 months (HR 1.714; 95%CI 1.13 to 2.6), severe immunodeficiency (HR 1.71; 95%CI 1.15 to 2.54), referral cases (HR 1.70; 95%CI 1.23 to 2.36), and WHO clinical staging 3 (HR 1.987; 95%CI 0.995 to 3.969) and 4 (HR 2.084; 95%CI 1.034 to 4.201). Subjects with virological failure had lower weight-for-age z-scores [median 1.92; interquartile range (IQR) -3.003 to -0.81] and height-for-age z-scores [median -2.05; IQR -2.902 to -1.04] at the time of failure. \u0000Conclusions In HIV-infected children treated without routine VL monitoring, age at diagnosis <60 months, severe immunodeficiency, WHO clinical stage 3 and 4, and referral from other centers were associated with virological failure.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"116 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80143166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.14238/pi62.5.2022.357-63
Mohamad Saekhu, Eka Susanto, S. Handryastuti, Samsul Ashari, Setyowidi Nugroho
Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.
{"title":"Spinal dermal sinus coinciding with an infected giant epidermoid cyst in an infant presenting with constipation: a case report","authors":"Mohamad Saekhu, Eka Susanto, S. Handryastuti, Samsul Ashari, Setyowidi Nugroho","doi":"10.14238/pi62.5.2022.357-63","DOIUrl":"https://doi.org/10.14238/pi62.5.2022.357-63","url":null,"abstract":"Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"3 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83066435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-11DOI: 10.14238/pi62.6.2022.430-4
Yulia Fatma Wardani, I. Laksono, Teti Adriana Lubis
Almost 2 billion people, about a quarter of the world’s population, are infected with soil-transmitted helminths (STH) worldwide. Approximately 270 million preschool children and more than 550 million school-age children live in areas of extensive parasite transmission.1,2 Indonesia is a moderate-to-high-risk area of STH, with an overall mean prevalence of 28.12%. However, the prevalence in Papua is higher.3 A study reported that 50% of school-aged children in Jayapura, Papua, a high-risk area, suffered from STH, with distributions of 48.5% Ascaris lumbricoides, 28.6% Trichuris trichiura, 14.3% hookworm, and 8.6% mixed infection.4
{"title":"Trichuris dysentery syndrome, the neglected tropical disease: a case series","authors":"Yulia Fatma Wardani, I. Laksono, Teti Adriana Lubis","doi":"10.14238/pi62.6.2022.430-4","DOIUrl":"https://doi.org/10.14238/pi62.6.2022.430-4","url":null,"abstract":"Almost 2 billion people, about a quarter of the world’s population, are infected with soil-transmitted helminths (STH) worldwide. Approximately 270 million preschool children and more than 550 million school-age children live in areas of extensive parasite transmission.1,2 Indonesia is a moderate-to-high-risk area of STH, with an overall mean prevalence of 28.12%. However, the prevalence in Papua is higher.3 A study reported that 50% of school-aged children in Jayapura, Papua, a high-risk area, suffered from STH, with distributions of 48.5% Ascaris lumbricoides, 28.6% Trichuris trichiura, 14.3% hookworm, and 8.6% mixed infection.4 ","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"6 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82066326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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