Paediatrica Indonesiana最新文献

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"title":"Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age","authors":"Indah Septiane, F. Kadi, T. Yuniati, Nina Surtiretna, Aris Primadi","doi":"10.14238/pi62.4.2022.267-75","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.267-75","url":null,"abstract":"Background Early onset neonatal sepsis is a potential life-threatening problem for preterm infant. Diagnosing early onset neonatal sepsis is challenging. Difficulties in establishing diagnosis might cause delay definitive treatment. \u0000Objective To analyze for potential associations between early onset neonatal sepsis (EONS) risk and mean platelet volume (MPV) as well as immature platelet fraction (IPF) in neonates of 28-36 weeks gestational age. \u0000Methods A prospective cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Mean platelet volume (MPV) and IPF were evaluated in the first ?6 hours of life and during the 48-72 hours after the first examination. This examination was followed by observation for sepsis development. Double logistic regression analysis was used. \u0000Results Of 115 subjects, 45 preterm infants (39.1%) developed early onset neonatal sepsis. The increase in both mean MPV and mean IPF were significantly different (P<0.05). Double logistic regression analysis revealed that an increase in mean MPV (ORadj=6.14; 95%CI 1.99 to 18.96; P=0.002) and mean IPF (ORadj=6.56; 95%CI 2.64 to 16.34; P<0.001) were significantly associated with increased risk of sepsis. \u0000Conclusion The MPV and IPF increase are associated with greater incidence of EONS in preterm infants.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89450010","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}

{"title":"Iron status and developmental delay among children aged 24–36 months","authors":"Jessica Ferdi, S. Bardosono, B. Medise","doi":"10.14238/pi62.4.2022.257-66","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.257-66","url":null,"abstract":"Background Optimal child development is needed for adequate learning. Children, particularly toddlers, require iron for brain development, and consequently, overall development. \u0000Objective To analyze for an association between iron status and developmental status in children aged 24–36 months. \u0000Methods This explorative cross-sectional study was held in Kampung Melayu, Jakarta. Subjects were recruited using a total population sampling method. Data were collected through interview with parents, anthropometric examinations, and blood tests. Developmental status was determined using the Ages and Stages Questionnaire-3 (ASQ-3) and iron status was based on ferritin, high sensitivity C-reactive protein (hs-CRP), and hemoglobin levels. Data analyses included Chi-square/Fisher’s exact, Mann-Whitney, and logistic regression tests. \u0000Results Of 80 subjects, 17.5% had developmental delay and 41.3% had deficient iron status. There was no significant association between iron status and developmental status in bivariate analysis, but the logistic regression analysis revealed that iron status (OR=6.9; 95%CI 1.328 to 35.633; P=0.022) and nutritional status (OR=11.75; 95%CI 1.551 to 88.979; P=0.017) contributed to developmental delay. \u0000Conclusion Better iron status and nutritional status are associated with better child development of children aged 24–36 months. So efforts are needed to maintain iron status as well as nutritional status.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85305364","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}

{"title":"A comparison of objective and subjective measurements of non-nutritive sucking in preterm infants","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/pi62.4.2022.276-83","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.276-83","url":null,"abstract":"Background Of preterm infants born before 32 weeks of gestation, 40-70% have atypical and immature feeding skills, which could delay initiation of oral feeding. A formal objective measurement of non-nutritive sucking may increase the accuracy of determining the right time to initiate oral feeding, however, most hospital perinatology care units do not own a suction pressure measurement device to objectively measure non-nutritive sucking parameters. \u0000Objective To compare objective and subjective non-nutritive sucking (NNS) based on sucking pressure, number of suctions per burst, and time between bursts. \u0000Methods One hundred twenty preterm infants born at 28-34 weeks’ gestation were evaluated for objective and subjective NNS. Data were collected from August to November 2021 at five hospitals in Jakarta. Objective NNS was measured by a suction pressure measurement device, while subjective NNS was clinically examined. Number of suctions per burst, sucking pressure, and time between bursts were analysed by Spearman’s correlation test. \u0000Results A positive and significant correlation between objective and subjective NNS was found in all parameters (P<0.001). The highest correlation was found in time between bursts (r=0.74; P<0.001), followed by number of suctions per burst (r=0.60; P<0.001), and sucking pressure (r=0.58; P<0.001). \u0000Conclusion The correlation between objective and subjective NNS examination was moderate in preterm infants. Therefore, an objective NNS measurement is still required for optimizing the examination.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86910066","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}

{"title":"Risk factors of early neonatal death in East Nusa Tenggara, Indonesia: a case-control study","authors":"Irene K.L.A. Davidz, K. Kuntoro, H. T. Joewono, I. Irwanto","doi":"10.14238/pi62.4.2022.284-92","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.284-92","url":null,"abstract":"Background The neonatal mortality in East Nusa Tenggara is still high, contributes up to 75% of all neonatal death and more than 70% of early neonatal death which occurred less than 7 days after birth.. \u0000Objective This study aimed to analyze the risk factors of early neonatal death in East Nusa Tenggara. \u0000Methods This case control study was conducted in 18 districts of East Nusa Tenggara, Indonesia. The case was newborn death, while the control was alive newborn during the early neonatal period. The data was obtained from the maternal and neonatal medical record that was kept in provincial health office and each health district office. An interview with mothers was performed if needed. The observed variables were the early neonatal death as a dependent variable and various independent variables. \u0000Results The early neonatal death was associated with maternal age under 20 or over 35 years old (OR=1.8; 95%CI 1.1 to 3.1; P=0.032), the history of stillbirth (OR=27.5; 95%CI 11.6 to 64.5; P=0.000), mother with tuberculosis (OR=15.3; 95%CI 1.7 to 137.3; P=0.015), mother with hyperthyroid (OR=15.5; 95%CI 2.2 to 107; P=0.006), the risk for premature labor (OR= 4.5; 95%CI 2.3 to 8.7; P=0.000), prolonged labor (OR=2.3; 95%CI 1.2 to 4.8; P=0.020), the delivery not in a health facility (OR=18.6; 95%CI= 6.5 to 52.7; P=0.000), low birth weight infants (OR=5.6; 95%CI 3 to 10.3; P=0.000), and asphyxia (OR=25.2; 95%CI 95% 9.9 to 64.5; P=0.000). \u0000Conclusions Increased early neonatal death is associated with maternal age, history of stillbirth, mother with hyperthyroid or tuberculosis, prolonged or risk for premature labor, delivery not in a health facility, low birth weight infants, and asphyxia.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86947073","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}

{"title":"Trainees’ perceptions on learning environment based on the level of training in a pediatric training program in Indonesia","authors":"R. Triasih, Felisia Ang, Weda Kusuma, Gandes Retni Rahayu","doi":"10.14238/pi62.4.2022.249-56","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.249-56","url":null,"abstract":"Background Learning environment in a pediatric specialist training program is complex and may influence trainees’ performance and achievement. We evaluated the trainees’ perception on learning environment and compared it between levels of the training. \u0000Methods We conducted a cross-sectional study to pediatric trainees in Pediatric Specialist Training Program at Universitas Gadjah Mada, Yogyakarta, Indonesia in May 2019. The data was collected online using the Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire, which was translated into Indonesian language and was self-completed by the trainees. \u0000Results All (136) trainees, which consisted of 35 (25.7%) junior, 44 (32.3%) middle, and 57 (42%) senior levels, completed the survey. The mean total score of PHEEM for all trainees was 108.10 (+ 17.03), which was not different between levels of the trainees. The mean scores for the role of autonomy, teaching, and social support were not different between levels of training either. Nevertheless, the junior scored less than the middle and senior trainees for questions on performing inappropriate tasks. \u0000Conclusion The learning environment of the pediatric training program in our setting was perceived good but improvement was required. There was no difference in perception of learning environment based on the level of the training.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74176796","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}

{"title":"Mild and severe diabetic ketoacidosis in children: a report of two cases","authors":"Vini Jamarin, N. S. Marzuki","doi":"10.14238/pi62.4.2022.293-6","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.293-6","url":null,"abstract":"Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus (DM) in children caused by insulin deficiency. This condition is often unidentified or diagnosed late, and treated with inadequate therapy. Diabetic ketoacidosis can lead to several complications, the most fatal being cerebral edema. We present two cases of DKA with different clinical presentation and severity. Early identification and proper management of DKA can help improve outcomes and avoid complications.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76872637","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}

{"title":"Predictors of mortality in immunocompromised children with respiratory infections","authors":"Lea Sutrisna, R. Triasih, I. Laksanawati","doi":"10.14238/pi62.4.2022.237-42","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.237-42","url":null,"abstract":"Background Respiratory infection is a common morbidity and a major cause of mortality in immunocompromised children. Hence, identification of clinical parameters that predict mortality among immunocompromised children with respiratory infections is of importance to provide timely and appropriate intervention. \u0000Objective To determine predictors of mortality in immunocompromised children with respiratory infections. \u0000Methods We conducted a prospective cohort study of immunocompromised children aged 18 years or younger with respiratory tract infections who were admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia. All eligible children were prospectively followed up until hospital discharge. Clinical and laboratory parameters during the first 24 hours of hospitalization were collected. \u0000Results Of 79 eligible children, the overall mortality was 11 subjects (13.9%). Fever, tachycardia, tachypnea, cyanosis, leukopenia, neutropenia, thrombocytopenia, and pleural effusion were predictive factors of mortality in bivariate analysis (P<0.25). A logistic regression model showed that neutropenia (absolute neutrophil count <125/mm3) and tachycardia were the best independent predictors of mortality in immunocompromised children with respiratory infections. The children with tachycardia had 15.8 times higher probability of mortality (95%CI 5.0 to 4.4) and those with neutropenia had 8.24 times higher probability of mortality. Cyanosis and pleural effusion were also independent mortality predictors. \u0000Conclusion The risk of mortality is significantly increased in immunocompromised children with respiratory infection when tachycardia and neutropenia are also present.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81228079","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}