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Globally, dozens of COVID-19 vaccines are licensed under emergency or conditional authorization, but especially in low and middle-income countries, their availability varies. Indonesia decided to become independent and produce its own vaccines locally. This study investigated the safety and immunogenicity of a SARS-CoV-2 recombinant protein subunit vaccine adjuvanted with Alum + CpG 1018. This study involved 360 adults aged 18 years and above. It compared two vaccine dosages, a-12.5 µg and a 25-µg dose of receptor binding domain protein, to a placebo (1:1:1). A total of 40.6% of participants in this study experienced at least one adverse event (AE), with most being mild. There was no statistically significant difference in AEs between the groups. The microneutralization test showed the highest neutralizing antibody titer (IU/mL) in the 25 µg dose vaccine group at day 28 after the second dose (3,300 95%CI 2,215-4,914), although it was not statistically different from the 12.5 µg dose group (3,157 95%CI 2,135-4,669). Similarly, IgG antibody concentrations in the 25 µg dose vaccine group at day 28 were the highest compared to the 12.5 µg dose and placebo. According to protocol, only the formulation with the better antibody profile and comparable reactogenicity was further evaluated at months three and six. Thus, follow-up was only performed for the 25 µg dose vaccine, demonstrating antibody persistence at month six and had a favorable safety profile. These results position this SARS-CoV-2 recombinant protein subunit vaccine adjuvanted with Alum + CpG 1018 as a promising candidate to fight against COVID-19.

Self-efficacy is the conviction that one can perform the tasks required to accomplish specific goals. Teachers' self-efficacy is crucial in the physical education environment to promote active engagement in achieving the objectives of the Great Design of National Sport (DBON). This study aims to examine physical education teachers' self-efficacy and how it affects their participation in DBON implementation. The research method used was a descriptive survey with a quantitative approach. The research sample consisted of 40 physical education teachers in Cilacap district at the elementary school level selected by random sampling. Data were collected through questionnaires measuring the level of self-efficacy and teachers' participation in DBON programs. Data were analyzed using descriptive and inferential statistical techniques. This study revealed that the average self-efficacy of sports teachers in contributing to achieving the goals of the National Sports Grand Design (DBON) related to increasing sports culture in the community was 90.78%. In addition, the average self-efficacy of sports teachers in terms of capacity, synergy, and productivity of national achievement sports is 88.12%. The average self-efficacy of sports teachers related to improving the sports-based economy is 87.08%. These results indicate that the level of self-efficacy of physical education teachers is in the moderate to high category. There is a significant positive correlation between teachers' self-efficacy and their level of participation in DBON activities, where teachers with high self-efficacy are more likely to be actively involved in sports development programs in schools and communities. The conclusion of this study is that increasing physical education teachers' self-efficacy can significantly contribute to the successful implementation of the National Sport Grand Design. Recommendations include training and workshops to improve teachers' self-efficacy as well as support from the school and government to facilitate teachers' active participation in DBON programs. Keywords: Self-efficacy, Physical Education, Teachers, National Sport Grand Design

Abstract Background Typhoid fever is commonly found until today, especially in developing countries. It has fatal complications and measures must be taken to reduce the incidence of typhoid. Vaccinations are a key factor in prevention. This is a phase II randomized observer-blind clinical trial on a novel Vi-DT conjugate vaccine on 200 subjects 12 to 40 years of age. Methods Subjects were screened for eligibility after which a blood sample was taken and one dose of vaccine was administered. Investigational vaccine used was Vi-DT and control was Vi-PS. Twenty-eight days after vaccination, subjects visited for providing blood sample to assess immunogenicity and were asked about local and systemic adverse reactions that occurred in the first 28 days. Results Subjects had minor adverse reactions. Pain was the most common local reaction. Muscle pain was the most common systemic reaction. There were no serious adverse events up to 28 days post vaccination. Seroconversion rates were 100% in the Vi-DT group and 95.96% in the Vi-PS group. Post vaccination GMTs were increased in both groups but it was significantly higher in the Vi-DT group (p

Background. The inefficiency of the forehand stroke technique often stems from suboptimal execution of an athlete’s biomechanical movements. For a forehand stroke to be effective, each biomechanical component – the ankles, knees, hips, shoulders, and elbows – must function in an optimal manner. Disconnection of any of these elements can lead to ineffective technique. High speed, influenced by the racket speed at the point of impact, is a key indicator of a perfect forehand stroke. However, the challenge lies in the fact that an athlete’s movement and ball impact cannot be accurately observed with the naked eye, necessitating specialized tools for analysis. Study purpose. The study aims to develop software that assists in predicting ball speed outcomes based on an athlete’s biomechanical movement during a forehand stroke execution. Materials and methods. The research method employed R&D. Data collection techniques consisted of video recordings of athletes’ forehand strokes, which were later analyzed using software that examines movement angles of 10 national athletes. Results. The results indicated the average angles of elbows = 106.23, shoulders = 153.62, hips = 165.33, knees = 167.63, ankles = 164.54; and ball speed = 199.41 cm/s. Conclusions. The conclusion drawn is that to execute an effective forehand stroke with good ball speed, a moment of inertia must occur at the point of impact. The athletes should bend their elbow slightly, thereby reducing rotational resistance and increasing the speed of the racket head. The ankles, hips, and shoulders must move in synchronization within a continuous coordination chain, thereby allowing the athlete to fully leverage kinetic chain. The flexion movement of the elbow during the forward swing step is more effective than the extension movement where the elbow is slightly bent, resulting in a perfect shot.

The aim of this research to identify and analyze organizational resources consisting of man, money, material, methods, machine, networking and information systems in PELTI Semarang. This research is a qualitative research using ethnographic methods. Data collection techniques with observation, interviews and documentation. The results of this study 1) man for planning are not going well because there is no selection process, while organizing, actuating and supervising are going well. 2) money in this organization for planning, organizing and supervising is going well, while the actuating is not good because there are needs that do not have a budget. 3) material for planning, organizing and actuating is not going well because this organization does not yet have a tennis court while supervision is going well. 4) methods in this organization for planning, organizing, actuating and supervising goes well. 5) machine for this organization from planning, organizing, actuating and supervising activities are going well. 6) networking for this organization for planning, organizing, actuating and supervising is running well. 7) the information system for planning, organizing and supervising is running well, while the actuating is not going well.

Satuan Tugas Imunisasi Ikatan Dokter Anak Indonesia (IDAI) secara berkala mengevaluasi jadwal imunisasi untuk menyesuaikan dengan vaksin baru, program imunisasi Kemenkes, WHO position paper dan sumber-sumber lain. Di dalam jadwal imunisasi rekomendasi IDAI tahun 2023 ini ada beberapa tambahan antara lain vaksin dengue baru, dan keterangan tambahan beberapa vaksin lain. Untuk memudahkan dalam melaksanakannya dilampirkan juga tabel jadwal imunisasi tahun 2023. Untuk memahami dasar pertimbangan jadwal imunisasi dan perubahannya perlu mempelajari uraian di dalam artikel ini dan keterangan di bawah tabel tersebut untuk diterapkan ke dalam layanan imunisasi.

Latar belakang. Kasus pertama pasien COVID-19 di Indonesia dilaporkan pada bulan Maret 2020. Pemerintah memberlakukan Pembatasan Sosial Berskala Besar termasuk penutupan sekolah tatap muka serta mengeluarkan protokol kesehatan untuk diterapkan oleh masyarakat. Pandemi menyebabkan perubahan besar dalam tatanan kehidupan, kebiasaan dan pola hidup remaja. Tujuan. Penelitian ini ingin melihat pengetahuan dan kepatuhan remaja terhadap implementasi protokol kesehatan pada tahun ke dua pandemi COVID-19. Metode. Penelitian ini menggunakan metode potong lintang menggunakan kuesioner yang diisi secara daring dan dilakukan pada tahun ke dua pandemi COVID-19 dari bulan April hingga Juli 2021. Subjek merupakan remaja usia 10-18 tahun di DKI Jakarta. Pemilihan sekolah dilakukan secara cluster sampling. Hasil. Sebanyak 406 responden dari 20 sekolah mengikuti penelitian. Hanya sekitar 5,42% responden yang menjawab dengan benar cara transmisi SARS-CoV-2 dan hanya 43,84% responden yang menjawab dengan tepat 6 langkah cuci tangan. Sebanyak 45,81% responden memiliki nilai total pengetahuan yang baik (nilai >7). Terdapat tren yang menunjukkan persentase remaja yang mendapatkan skor pengetahuan di atas tujuh lebih banyak pada kelompok remaja dengan nilai kepatuhan yang lebih tinggi. Kesimpulan. Pada tahun ke dua pandemi COVID-19 masih banyak remaja yang kurang pengetahuannya mengenai COVID-19 dan belum menerapkan protokol kesehatan dengan baik.

The objectives of this study: (1) How to find out the training motivation of PPLP boxing athletes during the Covid-19 pandemic in Palu City; (2) How to maintain the intrinsic motivation of PPLP boxing athletes during training during the COVID-19 pandemic in Palu City; (3) How to maintain the extrinsic motivation of PPLP boxing athletes during training during the COVID-19 pandemic in Palu City; (4) What obstacles do PPLP boxing athletes face during training during the COVID-19 pandemic in Palu City. The research uses qualitative methods with the design of phenomenological studies. The data source is information from PPLP athletes from Central Sulawesi Province, coaches, provincial dispora and parents of PPLP boxing athletes. The data obtained are analyzed qualitatively with the following steps: (1) data collection; (2)data reduction; (3) presentation of data. The results showed that the training conditions of pplp boxing athletes during the Covid-19 pandemic in Palu city felt the influence of the Covid-19 pandemic from the beginning of appearing in Central Sulawesi in 2020. The obstacle to training pplp boxing athletes during the Covid-19 pandemic in Palu city is that during this pandemic, the government issued a very unprofitable policy for PPLP boxing athletes. The training strategies for boxing athletes during the covid-19 pandemic in the city of Palu can still train during the pandemic; they are restricting training grounds. Online media is a solution for PPLP Central Sulawesi boxing athletes; by using online media, they can carry out training through the program provided by the trainer and not carry out training in crowded places.

Background: COVID-19 is one of the most devastating pandemics of the 21st century. Vaccination is one of the most effective prevention methods in combating COVID-19, and one type of vaccine being developed was the protein subunit recombinant vaccine. We evaluated the efficacy of the CoV2-IB 0322 vaccine in Depok, Indonesia. Methods: This study aimed to assess the humoral and cellular immune response of the CoV2-IB 0322 vaccine compared to an active control vaccine (COVOVAX™ Vaccine). A total of 120 subjects were enrolled and randomized into two groups, with 60 subjects in each group. Participants received either two doses of the CoV2-IB 0322 vaccine or two doses of the control vaccine with a 28-day interval between doses. Safety assessments were conducted through onsite monitoring and participant-reported adverse events. Immunogenicity was evaluated by measuring IgG anti-RBD SARS-CoV-2 and IgG-neutralizing antibodies. Cellular immunity was assessed by specific T-cell responses. Whole blood samples were collected at baseline, 14 days, 6 months, and 12 months after the second dose for cellular immunity evaluation. Results: Both vaccines showed high seropositive rates, with neutralizing antibody and IgG titers peaking 14 days after the second dose and declining by 12 months. The seroconversion rate of anti-S IgG was 100% in both groups, but the rate of neutralizing antibody seroconversion was lower in the CoV2-IB 0322 vaccine group at 14 days after the second dose (p = 0.004). The CoV2-IB 0322 vaccine showed higher IgG GMT levels 6 and 12 months after the second dose (p < 0.001 and p = 0.01). T-cell responses, evaluated by IFN-γ, IL-2, and IL-4 production by CD4+ and CD8+ T-cells, showed similar results without significant differences between both groups, except for %IL-2/CD4+ cells 6 months after the second dose (p = 0.038). Conclusion: Both vaccines showed comparable B- and T-cell immunological response that diminish over time.

Ikatan Dokter Anak Indonesia secara periodik mengkaji rekomendasi jadwal imunisasi untuk menyesuaikan dengan berbagai perkembangan yang terkait dengan jadwal imunisasi di Indonesia. Jadwal imunisasi 2020 ini bertujuan agar dapat digunakan oleh anggota IDAI dalam memenuhi keinginan masyarakat mendapatkan vaksin yang lebih lengkap. Perubahan pada rekomendasi tahun 2020 adalah pada imunisasi Hepatitis B, IPV, BCG, DTP, Hib, Campak /MR/MMR, JE, Varicella, Hepatitis A dan Dengue. Jadwal imunisasi lain tidak ada perubahan. Untuk memudahkan dalam melaksanakannya dilampirkan juga tabel jadwal imunisasi tahun 2020. Untuk memahami dasar pertimbangan jadwal imunisasi dan perubahannya perlu mempelajari uraian di dalam artikel ini dan keterangan dibawah tabel tersebut untuk diterapkan ke dalam layanan imunisasi.

Abstract Background Typhoid fever caused by Salmonella enteric serovar Typhi (S. Typhi) is a common cause of morbidity in the world. In 2017, 14.3 million cases of Typhoid and paratyphoid fever occurred globally. School age children between 3 to 19 years old are the most affected. Poor sanitation and multi drug resistance have increased the need for vaccines to reduce the global burden of disease. Based on previous trials, typhoid conjugate vaccines have longer- lasting protection, higher efficacy, require fewer doses and are suitable from infancy that allows them to be incorporated into the routine immunization program. Our previous phase I trial proved that a novel Vi-DT typhoid conjugate vaccine is safe and immunogenic in subjects 2–5 and 18–40 years. Our phase II trial consisted of subjects 6 months to 40 years. Our previously published paper on subjects 6 to

Introduction: World Health Organization estimates the annual global incidence of typhoid fever at 11-21 million cases and approximately 128 000 to 161 000 deaths. The currently used Vi-polysaccharides (Vi-PS) vaccines have been proven to be safe and efficacious in children 2 years and above. However, poor immunogenicity of Vi-PS was observed in children below 2 years of age. This Phase II study is the continuation of the previously published Phase I study that aims to evaluate the safety and immunogenicity of a novel Vi-DT Typhoid Conjugate Vaccine (Bio Farma) in subjects 6 to

Latar belakang. Anemia defisiensi besi (ADB) adalah penyebab tersering anemia pada anak kurang dari 5 tahun dan dapat menyebabkan gangguan kognitif, perilaku, dan pertumbuhan yang menetap sehingga diagnosis harus ditegakkan sedini mungkin. Diagnosis ADB ditegakkan dengan pemeriksaan laboratorium yang mahal dan tidak tersedia merata di Indonesia. Untuk itu, penggunaan Indeks Mentzer (IM) merupakan salah satu alat penegakan diagnosis yang mudah. Tujuan. Mengetahui validitas IM untuk mendiagnosis ADB di daerah dengan fasilitas terbatas, dan mengetahui apakah cut-off point baru diperlukan untuk populasi di Indonesia. Metode. Penelitian ini merupakan uji diagnostik dengan metode potong lintang. Subjek adalah anak sehat berusia 12-59 bulan yang pucat. Penapisan dilakukan di 27 Posyandu dan 27 PAUD di Kecamatan Jatinegara. Subjek yang memenuhi kriteria inklusi menjalani pemeriksaan darah perifer lengkap, kemudian subjek dengan anemia mikrositik hipokrom diperiksa profil besi dan C-reactive protein (CRP). Validitas dinilai dengan membandingkan IM dengan hasil profil besi. Penentuan cut-off point spesifik untuk populasi di Indonesia dilakukan dengan membandingkan sensitivitas, spesifisitas, nilai duga positif (NDP) dan negatif (NDN), rasio kemungkinan positif (RKP), dan rasio kemungkinan negatif (RKN) antara beberapa cut-off points. Hasil. Penelitian ini mendapatkan 340 subjek dengan klinis pucat, 100 subjek setuju untuk melakukan pemeriksaan laboratorium, dan sisa 45 subjek dengan anemia mikrositik hipokrom. Penelitian ini memberikan sensitivitas 60,5%, spesifisitas 28,6%, NDP 82,1%, NDN 11,8%, RKP 0,9, dan RKP 1,4. Titik potong baru yang disarankan adalah 10,7 dengan sensitivitas 81,6% dan NDP 86,1%. Kesimpulan. Nilai diagnostik IM rendah dengan NDP yang baik untuk diagnosis ADB. Titik potong 10,7 dapat juga digunakan sebagai uji tapis ADB di fasilitas terbatas.

Background Growth and developmental delays are common among children under the age of five years (under-five children), especially in slum areas. Early detection and intervention may give better prognoses. Objective To detect growth and developmental delays and related risk factors among under-five children living in an inner-city slum area of the Indonesian capital. Methods This cross-sectional study was conducted from October to November 2018 in Tanah Tinggi, Johar Baru District, an inner-city slum area in Central Jakarta. Subjects were healthy children aged 3–60 months. Socioeconomic profile was obtained through questionnaires, anthropometric data through measurements, and developmental status through the Kuesioner Pra Skrining Perkembangan (KPSP) instrument. Development was considered to be delayed for KPSP scores

Latar belakang. Hemofilia merupakan salah satu penyakit kronik yang dapat memengaruhi kualitas hidup. Tujuan. Mengetahui prevalensi, gangguan kualitas hidup, kesesuaian kualitas hidup berdasarkan laporan anak dan laporan orangtua serta pengaruh faktor medis terhadap kualitas hidup anak hemofilia di RSCM. Metode. Penelitian potong lintang pada pasien hemofilia usia 5-18 tahun di Poliklinik Hematologi Departemen Ilmu Kesehatan Anak RSCM selama September-Desember 2016. Pengisian kuesioner PedsQLTM 4.0 dilakukan dengan wawancara. Faktor risiko dianalisis secara multivariat. Hasil. Gangguan kualitas hidup menurut laporan anak 52,9% (rerata 64,37±11,75) dan menurut orangtua 60,8% (rerata 64,37±13,87) dari total 102 anak hemofilia. Dimensi yang paling terganggu adalah dimensi fisik menurut kelompok 5-7 tahun, sedangkan menurut kelompok 8-18 tahun adalah dimensi fisik dan sekolah. Terdapat ketidaksesuaian antara laporan kualitas hidup anak dan orangtua pada kelompok usia 5-7 tahun. Kekakuan sendi merupakan faktor risiko terjadinya gangguan kualitas hidup menurut laporan anak (p=0,005, RP 4,335, IK 95% 1,550-12,126) dan orangtua (p=0,04, RP 2,902, IK 95% 1,052-8,007). Kesimpulan. Terdapat 52,9% (laporan anak) dan 60,8% (laporan orangtua) anak hemofilia yang kualitas hidupnya terganggu. Kekakuan sendi merupakan faktor yang paling memengaruhi kualitas hidup. Untuk menilai kualitas hidup anak usia 5-7 tahun diperlukan laporan anak dan orangtuanya, sedangkan anak usia 8-18 tahun cukup laporan anak atau orangtua saja.

Latar belakang. Kualitas tumbuh kembang balita ditentukan oleh nutrisi, kasih sayang, stimulasi, dan perlindungan terhadap penyakit. Ibu sebagai pengasuh utama anak berperan penting mengoptimalkan pertumbuhan dan perkembangan anak, sehingga harus memiliki sikap yang baik tentang pemantauan tumbuh kembang saat kunjungan ke tenaga kesehatan. Peningkatan pengetahuan Ibu dapat dilakukan dengan edukasi dan pelatihan. Tujuan. Menganalisis efektivitas seminar pada perubahan sikap ibu dalam pemberian dukungan nutrisi dan stimulasi selama pemantauan tumbuh kembang. Metode. Penelitian desain potong lintang dengan kuesioner pre dan post intervensi dilakukan pada ibu dengan balita. Perubahan sikap ibu dievaluasi dalam pemantauan tumbuh kembang anaknya. Intervensi berupa seminar mengenai kesehatan anak yang diadakan di 6 kota besar di Indonesia dengan purposive sampling peserta yang mengisi lengkap kuesioner. Analisis data digunakan metode paired T-test dalam software IBM SPSS statistics versi 22. Hasil. Terdapat 617 ibu yang mengisi lengkap kuesioner yang diberikan dalam seminar. Terjadi peningkatan yang bermakna (beda mean -0,15±0,26;95%CI -0,17sampai-0,13; p

Abstract Background The new combination of DTwP-HB-Hib vaccines has been developed in Indonesia following World Health Organization (WHO) recommendation and integrated into national immunization program. The aims of the study were to measure 1) antibody persistence 12–18 months after a primary series, 2) immune response and safety after a booster dose of DTwP-HB-Hib. Methods This was a multi-center, open-labeled, prospective, interventional study. Subjects who had received complete primary dose of DTwP-HB-Hib vaccine from the previous phase III trial were recruited in this trial. Subjects were given one dose of DTwP-HB-Hib (Pentabio®) booster at age 18–24 months old. Diphtheria, tetanus, pertussis, hepatitis B, Hemophilus influenza type B antibodies were measured before and after booster to determine antibody persistence and immune response. Vaccine adverse events were assessed immediately and monitored until 28 days after the booster recorded with parent’s diary cards. Results There were 396 subjects who completed the study. Increased proportion of seroprotected subjects from pre-booster to post-booster were noted in all vaccine antigens: 74.5 to 99.7% for diphtheria; 100 to 100% for tetanus; 40.4 to 95.5% for pertussis; 90.2 to 99.5% for hepatitis B; and 97.7 to 100% for Hib. Common systemic adverse events (AEs) were irritability (23.7–25%) and fever (39.9–45.2%). Local AEs such as redness, swelling, and induration were significantly less common in the thigh group (7.7, 11.3, and 7.1%) than in the deltoid group (28.9, 30.7, and 25%) (P

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 – 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

Basic immunization coverage in Indonesia in 2013 was still low (59.2%) (IBHS, 2013). Physicians’ attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner’s (GP) and pediatrician’s attitude towards immunization and its coverage in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians). Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians) while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices. Key words: Attitude, general practitioners, immunization practice, private setting, pediatricians Gambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek Swasta Riset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%). Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap dokter dan cakupan imunisasi di praktik swasta. Penelitian potong lintang dilakukan dengan menyebarkan kuesioner tentang sikap dan praktik imunisasi kepada responden, yaitu 29 dokter umum (DU) dan 65 dokter spesialis anak (DA) pada bulan November 2014. Mayoritas responden berpendapat bahwa vaksin program pengembangan imunisasi harus diberikan. Vaksin hepatitis B dosis I mayoritas diberikan dalam 12 jam setelah lahir (90% oleh DU dan 74% oleh DA). Vaksin polio oral mayoritas diberikan sebelum pulang perawatan (65% oleh DU dan 81% oleh DA), Vaksin DTwP-HB-Hib diberikan oleh 27% DU dan 21% DA kepada ≥75% pasien. Penggunaan vaksin pneumokokus, rotavirus, hepatitis A, tifoid dan influenza pada >75% pasien adalah kurang dari 25%, kecuali vaksin influenza, yaitu 31% digunakan oleh DA. Pemberian vaksin MMR pada >75% pasien dilakukan oleh 16% DU dan 29% DA. Penelitian imunisasi pada praktik swasta ini mungkin merupakan laporan yang pertama dipublikasi di Indonesia. Penelitian lebih lanjut diperlukan untuk mengetahui hambatan imunisasi di praktik swasta. Kata kunci: Cakupan imunisasi, dokter, imunisasi, praktik, spesialis

Latar belakang. Demam, pengurangan waktu tidur, nyeri, dan reaksi lokal adalah beberapa kejadian ikutan pasca imunisasi. Untuk mencegah hal tersebut, profilaksis parasetamol pasca imunisasi diberikan oleh tenaga medis maupun orang tua. Peraturam Menteri Kesehatan Republik Indonesia dan Pedoman Imunisasi IDAI belum menetapkan secara tegas boleh atau tidaknya pemberian profilaksis parasetamol pasca imunisasi. Tujuan. Mengetahui efektivitas pemberian profilaksis parasetamol oral untuk mencegah kejadian ikutan pasca imunisasi kombinasi DTwP-Hep B-Hib. Metode. Uji klinis tersamar acak ganda (double blind randomized control trialI) dengan pemberian parasetamol dan plasebo pada pasien pasca imunisasi kombinasi DTwP-Hep B-Hib di Puskesmas Kecamatan Kramat Jati dan Kelurahan Batu Ampar selama September 2015 sampai Oktober 2015. Satu hari pasca imunisasi, kelompok perlakuan diberikan parasetamol (40-50 mg/kgBB/hari) yang terbagi empat dosis, sedangkan kelompok kontrol mendapatkan plasebo. Selama empat hari pasca imunisasi dilakukan pengukuran suhu aksila, lama tidur, dan reaksi inflamasi lokal. Hasil. Subjek terdiri atas 100 bayi yang mendapatkan imunisasi kombinasi DTwP-Hep B-Hib ketiga. Karakteristik dasar meliputi usia, jenis kelamin, dan status gizi tidak berbeda di kedua kelompok. Subjek penelitian mendapatkan profilaksis parasetamol (50 subjek) dan profilaksis plasebo (50 subjek). Seluruh subjek penelitian tidak demam, tidak mengalami gangguan tidur, dan tidak ditemukan reaksi lokal. Pemberian parasetamol 24 jam pasca imunisasi DTwP-Hep B-Hib menunjukkan penurunan suhu 0,1OC - 0,2OC yang bermakna secara statistik (p0,05) pada lama tidur. Kesimpulan. Pemberian parasetamol profilaksis pasca imunisasi DTwP-Hep B-Hib selama satu hari dapat menurunkan suhu tubuh pada 24 jam pasca imunisasi.

Ikatan Dokter Anak Indonesia melalui Satuan Tugas Imunisasi mengeluarkan rekomendasi Imunisasi IDAI tahun 2017 untuk menggantikan jadwal imunisasi sebelumnya. Jadwal imunisasi 2017 ini bertujuan menyeragamkan jadwal imunisasi rekomendasi IDAI dengan jadwal imunisasi Kementerian Kesehatan RI khususnya untuk imunisasi rutin. Jadwal imunisasi 2017 juga dibuat berdasarkan ketersediaan kombinasi vaksin DTP dengan hepatitis B seperti DTPw-HB-Hib, DTPa-HB-Hib-IPV, dan dalam situasi keterbatasan atau kelangkaan vaksin tertentu seperti vaksin DTPa atau DTPw tanpa kombinasi dengan vaksin lainnya. Hal baru yang terdapat pada jadwal 2017 antara lain: vaksin hepatitis B monovalen tidak perlu diberikan pada usia 1 bulan apabila anak akan mendapat vaksin DTP-Hib kombinasi dengan hepatitis B; bayi paling sedikit harus mendapat satu dosis vaksin IPV (inactivated polio vaccine) bersamaan (simultan) dengan OPV-3 saat pemberian DTP-3; vaksin DTPw direkomendasikan untuk diberikan pada usia 2,3 dan 4 bulan. Hal baru yang lain adalah untuk vaksin influenza dapat diberikan vaksin inaktif trivalen atau quadrivalen, vaksin MMR dapat diberikan pada usia 12 bulan apabila anak belum mendapat vaksin campak pada usia 9 bulan. Vaksin HPV apabila diberikan pada remaja usia 10-13 tahun, pemberian cukup 2 dosis dengan interval 6-12 bulan; respons antibodi setara dengan 3 dosis. Vaksin Japanese Encephalitis direkomendasikan untuk diberikan mulai usia 12 bulan pada daerah endemis atau pada turis yang akan bepergian ke daerah endemis. Vaksin dengue direkomendasikan untuk diberikan pada anak usia 9-16 tahun dengan jadwal 0, 6, dan 12 bulan. Dengan pemberian imunisasi sesuai rekomendasi, diharapkan anak-anak Indonesia terlindungi dari penyakit infeksi yang dapat dicegah dengan imunisasi.

Background Core body temperature measurement is not commonly done in pediatric populations because it is invasive and difficult to perform. Therefore, axillary and tympanic membrane temperature measurements are preferable, but their accuracy is still debatable. Objective To compare the accuracy of axillary and tympanic temperatures to rectal temperature in children with fever, and to measure the cut-off point for fever based on each temperature measurement method. Methods A diagnostic study was conducted among feverish children aged 6 months to 5 years who were consecutively selected from the Pediatric Outpatient Clinic, Pediatric Emergency Unit, and the inpatient ward in the Department of Child Health, Cipto Mangunkusumo Hospital (CMH), from December 2014 to January 2015. Subjects underwent three measurements within a two minute span, namely, the axillary, tympanic membrane, and rectal temperature measurements. The values obtained from the examination were analyzed with appropriate statistical tests. Results The cut-off for fever on axilla was 37.4oC and on tympanic membrane was 37.4oC, with sensitivity 96% (95%CI 0.88 to 0.98) and 93% (95%CI 0.84 to 0.97), respectively; specificity 50% (95%CI 0.47 to 0.84) and 50% (95%CI 0.31 to 0.69), respectively; positive predictive value/PPV 90% (95%CI 0.81 to 0.95) and 85% (95%CI 0.75 to 0.91), respectively; and negative predictive value/NPV 83% (95%CI 0.61 to 0.94) and 69% (95%CI 0.44 to 0.86), respectively. The optimal cut-off of tympanic membrane and axilla temperature was 37.8oC (AUC 0.903 and 0.903, respectively). Conclusion Axillary temperature measurement is as good as tympanic membrane temperature measurement and can be used in daily clinical practice or at home. By increasing the optimum fever cut-off point for axillary and tympanic membrane temperature to 37.8oC, we find sensitivity 81% and 88%, specificity 86% and 73%, PPV 95% and 91%, and NPV 95% and 91%, respectively.

Deteksi dini gangguan tumbuh kembang balita dapat dilakukan melalui anamnesis, pemeriksaan fisis rutin, skrining perkembangan dan pemeriksaan lanjutan. Keluhan orangtua mengenai penyimpangan perkembangan anaknya perlu ditindaklanjuti karena sebagian terbukti benar. Penting pula menanyakan faktor-faktor risiko di lingkungan mikro (ibu), mini (lingkungan keluarga dan tempat tinggal), meso (lingkungan tetangga, polusi, budaya, pelayanan kesehatan dan pendidikan) dan makro (kebijakan program) yang dapat mengganggu tumbuh kembang balita atau dapat dioptimalkan untuk mengatasi gangguan tersebut. Pemeriksaan fisis rutin meliputi pengukuran tinggi dan berat badan, bentuk dan ukuran lingkar kepala, kelainan organ-organ lain dan pemeriksaan neurologis dasar. Skrining perkembangan dapat menggunakan kuesioner atau melakukan pengamatan langsung pada balita. Kuesioner Pra Skrining Perkembangan (KPSP) berisi 10 pertanyaan untuk setiap kelompok umur, yang ditanyakan kepada orangtua oleh paramedis atau dokter. Buku Pedoman Perkembangan Anak di Keluarga (Depkes RI) menilai 4 keterampilan balita untuk setiap kelompok umur, yang dapat dilakukan oleh paramedis atau kader kesehatan. Pediatric Symptom Checklist (PSC) berisi 35 perilaku anak yang dapat ditanyakan oleh paramedis atau dokter kepada orangtua. Kuesioner Skrining Perilaku Anak Prasekolah menyerupai PSC tetapi hanya berisi 30 pertanyaan. Skrining Perkembangan Denver II mempunyai kepekaan yang cukup baik untuk deteksi gangguan gerak kasar, gerak halus, berbahasa dan personal sosial. Selain itu secara tidak langsung dapat mendeteksi gangguan penglihatan, koordinasi matatangan, pendengaran, pemahaman, komunikasi verbal - non verbal, pemecahan masalah dan kemandirian, namun kurang peka untuk gangguan emosional. Checklist for Autism in Toddlers (CHAT) adalah salah satu alat skrining untuk deteksi dini gangguan spektrum autistik (austistic spectrum disorder) anak umur 18 bulan sampai 3 tahun. Pemeriksaan lanjutan yang komprehensif sebaiknya melibatkan berbagai profesi dan disiplin keilmuan untuk memastikan jenis, derajat dan penyebab gangguan, serta merencanakan tindak lanjut yang komprehensif dan terintegrasi agar anak dapat tumbuh kembang optimal.

Demam tifoid masih merupakan masalah kesehatan masyarakat. Upaya pencegahan meliputi perbaikan sanitasi lingkungan, higiene perorangan, persiapan makanan yang baik dan pemberian vaksin. Baik vaksin tifoid peroral maupun parenteral dapat mencegah gejala klinis demam tifoid. Kejadian ikutan pasca imunisasi (KIPI) vaksin antigen Vi polisakarida kapsuler pada anak Indonesia belum banyak dilaporkan. Penelitian ini bertujuan untuk mengetahui KIPI vaksin antigen Vi polisakarida kapsuler pada anak Indonesia. Metode. Penelitian deskriptif potong-lintang dilakukan pada anak Indonesia sehat umur 2-5 tahun yang mengunjungi Klinik Tumbuh Kembang Utan Kayu pada Juli 2000 atau Klinik Dokter Keluarga Kiara pada Agustus 2000. Digunakan vaksin antigen Vi polisakarida kapsuler (typhim-Vi) dalam kemasan 10 ml. Penyuntikan 0,5 ml vaksin dilakukan oleh dokter Peserta Pendidikan Spesialis Anak pada paha bagian anterolateral dengan menggunakan semprit steril sekali pakai. KIPI dimonitor dengan menggunakan formulir KIPI Departemen Kesehatan. Hasil. Dari 198 anak yang divaksinasi, KIPI yang berhasil dipantau 174 (87,9%) anak. Gejala klinis KIPI yang ditemukan adalah nyeri pada tempat suntikan (44,8%), demam > 38,5∞ C (14,4%), indurasi (9,2%), dan muntah (0,6%). Kesimpulan. KIPI vaksin antigen Vi polisakarida kapsuler penelitian ini cukup komparabel dengan penelitian lain dalam hal demam. Bengkak dan indurasi lebih tinggi dibanding penelitian lain. Hal yang mungkin berperan adalah vial multidosis yang rentan terhadap timbulnya kontaminasi.

Pekerja anak jalanan sama sekali bukan merupakan pemandangan asing di Ibukota Jakarta. Mereka merupakan komunitas anak yang cukup besar dengan berbagai masalah kompleks yang belum dapat diatasi hingga kini. Masa kanak-kanak yang seharusnya diisi dengan belajar dan bermain agar proses tumbuh kembang berlangsung optimal, justru dihadapkan pada berbagai risiko yang dapat membahayakan kesehatan dan tumbuh kembang mereka. Bekerja tidak selalu berdampak negatif, namun cukup banyak bahaya yang harus mereka hadapi. Berkurangnya partisipasi mereka dalam pendidikan karena harus bekerja, risiko mengalami kecelakaan lalu lintas, adanya polusi udara, jam kerja yang panjang, paparan terhadap perilaku sosial yang tidak baik, hingga paparan terhadap perlakuan salah, baik secara fisik, seksual, maupun emosional; merupakan potensi nampak negatif Survai atau penelitian yang ada sejauh ini telah memberikan gambaran umum mengenai status kesehatan mereka berdasarkan keluhan kesehatan yang dialami dalam 30 hari terakhir dan status gizi. Namun belum ada data mengenai korelasi antara status kesehatan mereka dengan faktor risiko yang mereka hadapi sebagai pekerja anak jalanan. Gangguan perkembangan kognitif merupakan aspek yang banyak dibahas, penelitian di Afrika mendapatkan rendahnya kemampuan membaca dan matematika pada pekerja anak.

Latar Belakang. Dua puluh satu persen penduduk Indonesia adalah remaja. Hanya 11,6% lulusan SMU yang melanjutkan ke perguruan tinggi, yang tidak melanjutkan antara lain memasuki jenjang perkawinan, padahal perkawinan pada usia muda sangat mengundang risiko yang tidak bisa diabaikan. Mereka yang memasuki jenjang perkawinan, umumnya mempunyai kesiapan fisik dan pengetahuan yang belum memadai, sehingga perlu disiapkan. Seorang ibu yang mempunyai pengetahuan yang baik akan menghasilkan tumbuh-kembang balita yang baik pula, khususnya dalam tiga tahun pertama usia anak. Tujuan Pustaka. Penelitian ini bertujuan untuk melihat kesiapan fisik, dan pengetahuan remaja perempuan terhadap tumbuh kembang balita. Metoda. Penelitian merupakan studi analitik potong lintang pada remaja perempuan siswi SMU di 7 sekolah di Jakarta Timur, yang dilaksanakan Januari 2006 sampai Maret 2006. Setelah mendapat persetujuan penelitian maka dilakukan pemeriksaan fisis dan pengambilan sampel darah untuk pemeriksaan hemoglobin. Selanjutnya responden mengisi kuesioner untuk mengetahui pengetahuan mereka tentang tumbuh kembang balita. Hasil. Dari 300 responden diperoleh rerata umur 17,2 tahun, suku Jawa 40,2 % dan umumnya tinggal dengan orang tua (75,7%). Responden yang anemia sebanyak 25,36%, gizi kurang 18,5%, gizi baik 74,4%, gizi lebih 4,7%, dan obesitas 2,3%. Sumber informasi yang berhubungan dengan masalah tumbuh kembang balita hanya 13,6% berasal dari sumber formal yaitu orang tua, guru dan tenaga kesehatan. Remaja yang berpengetahuan tinggi didapatkan sebanyak 19%, pengetahuan sedang 33%, dan pengetahuan rendah 48%. Remaja yang tidak siap menjadi calon ibu secara fisik didapatkan pada 42,3%. Kesiapan pengetahuan didapatkan pada 63,7% remaja, sedangkan kesiapan fisik dan pengetahuan yang memadai didapatkan pada 31,3%. Tidak ada hubungan antara kesiapan responden untuk menjadi calon ibu dengan demografi keluarga dan sumber informasi. Kesimpulan. Lebih dari separuh remaja (57,7%) telah mempunyai kesiapan fisik untuk menjadi calon ibu. Kesiapan pengetahuan remaja terhadap materi tumbuh kembang balita sebesar 63,7 %. Tingkat kesiapan fisik dan pengetahuan remaja menjadi calon ibu sebesar 31,3%. Tidak ada hubungan antara karakteristik keluarga dan sumber informasi dengan kesiapan remaja perempuan SMU di Jakarta Timur untuk menjadi calon ibu.

Bayi risiko tinggi ialah bayi yang secara klinis belum menunjukkan hambatan perkembangan tetapi berpotensi untuk mengalami gangguan perkembangan akibat faktor risiko biomedik, lingkungan psikososial atau sosial ekonomi. Faktor risiko tersebut secara langsung atau tidak langsung dapat mengganggu perkembangan otak, sehingga mengganggu perkembangan gerak, komunikasi, kognitif, emosi-sosial dan perilaku. Plastisitas otak adalah kemampuan susunan saraf untuk menyesuaikan diri berupa perubahan anatomi, kemampuan neurokimiawi atau perubahan metabolik. Stimulasi dini adalah rangsangan auditori, visual, taktil dan kinestetik yang diberikan sejak perkembangan otak dini, dengan harapan dapat merangsang kuantitas dan kualitas sinaps sel-sel otak, untuk mengoptimalkan fungsi otak. Stimulasi dini harus memperhatikan tahapan maturasi otak, waktu, jenis stimulasi, cara melakukan stimulasi, intensitas, perbedaan individual, keterpaduan dan dukungan program lain yang berkelanjutan. Peran dokter dan perawat di ruang bayi baru lahir, serta orangtua sangat penting, oleh karena itu mereka perlu dibekali pengetahuan dan ketrampilan mengenai stimulasi dini

Menghadapi masalah kesehatan anak dunia, Indonesia tidak dapat berdiam diri namun harus turut berpartisipasi aktif. Pakar WHO menegaskan bahwa dalam upaya pencegahan penyakit infeksi, dua hal yang harus menjadi perhatian utama ialah penyediaan air bersih dan imunisasi. Munculnya resistensi antibiotik pada beberapa mikroorganisme, keadaan imunokompromais, peningkatan kesehatan anak dengan risiko tinggi, telah memicu para ahli memalingkan arah untuk mencapai upaya pencegahan yang paripurna. Dalam satu dasa warsa terakhir, imunisasi telah mengalami perkembangan yang sangat pesat seiring dengan kemajuan teknik rekayasa genetika dan biomolekuler. Masuknya vaksin baru sebagai hasil teknologi modern yaitu vaksin influenza trivalen (TIV) dan vaksin pneumokokus (PCV7) memerlukan panduan penggunaannya yang dituangkan dalam Rekomendasi Satgas Imunisasi IDAI.

Infeksi virus hepatitis A (VHA) ditularkan melalui transmisi fekal-oral, dan merupakan masalah di banyak negara, termasuk Indonesia. Bila terjadi pada anak usia sekolah akan mempengaruhi proses belajar dan membutuhkan pengeluaran biaya untuk perawatan. Tujuan penelitian ini untuk menentukan attact rate, penyebab, serta gejala penyakit pada Kejadian Luar Biasa (KLB) hepatitis akut di SMPN-259 Jakarta Timur. Penelitian ini bersifat prospektif observasional. Pada hasil penelitian didapatkan jumlah murid seluruhnya 1420 orang (usia 12-16 tahun), 1157 orang mengisi kuesioner yang dibagikan. Dari kuesioner didapatkan attack rate penyakit adalah 38,5 % terdiri dari kelas I 165/ 442 (37,3 %), kelas II 94/338 (27,8 %), kelas III 187/377 (49,6 %). Murid yang memerlukan perawatan di rumah sakit 19/1157 (4,3 %). Tidak didapatkan murid yang meninggal (crude fatality rate = 0). Pengambilan sampel dilakukan secara random pada kelompok murid yang sakit dengan hasil sebagai berikut: IgM anti HAV positif 38/45 (84,4 %) pada murid sakit yang tidak dirawat inap, dan 14/16 (87,5 %) pada murid sakit yang dirawat inap. Gejala klinis pada subyek dengan IgM anti HAV (+) meliputi urin gelap 67 %, lemah 57,7 %, demam 50 %, muntah 48 %, anoreksia 48 %, nyeri perut 46 %, kuning 36,5 %, diare 25 %, dan mialgia 19,2 %. Terdapat 51,6% subyek dengan IgG antiHAV positif pada kelompok subyek yang tidak sakit. Kesimpulan attack rate KLB hepatitis akut di SMPN-259 Jakarta adalah 38,5 % semua anak sembuh 0%. Penyebab KLB hepatitis akut terbukti adalah VHA

Sindrom Down (SD) adalah kelainan genetik yang paling sering ditemukan dan berhubungan dengan retardasi mental. Kelainan yang terjadi disebabkan oleh adanya kelebihan materi genetik kromosom 21. Karakteristik fisis anak dengan SD cukup jelas sehingga para tenaga kesehatan yang mengadakan kontak awal dengan neonatus, termasuk dokter ahli kebidanan dan kandungan, perawat kamar bersalin, dan dokter umum, dapat mengenali kelainan ini dengan relatif mudah. Anak dengan SD memiliki berbagai masalah kesehatan dan tumbuh kembang yang tak jarang cukup kompleks, maka skrining pra dan pasca natal, intervensi dini, dan pemantauan tumbuh kembang yang terus-menerus perlu dilakukan agar anak dengan SD dapat memiliki kualitas hidup yang lebih baik. Tata laksana medis, dukungan keluarga, pendidikan, dan pelatihan khusus dapat meningkatkan kemampuan anak dengan SD secara bermakna dan menjembatani transisi menuju kedewasaan.

Latar belakang. Enam bulan pertama kehidupan merupakan kesempatan emas untuk melakukan deteksi dini gangguan tumbuh kembang. Bayi risiko tinggi (risti) merupakan kelompok yang rentan terhadap keterlambatan perkembangan. Contoh instrumen penilaian perkembangan yang terbaru adalah Bayley scales of infant and toddler developmentEdisi III (Bayley III). Tujuan.Mengetahui gambaran keterlambatan perkembangan bayi risiko tinggi dan rendah pada usia 3 dan 6 bulan. Metode. Penelitian kohort prospektif dilakukan terhadap bayi risti yang mendapat perawatan di Unit Neonatologi Rumah Sakit Cipto Mangunkusumo (RSCM) dan bayi risiko rendah di empat Posyandu serta Poliklinik Tumbuh Kembang RSCM selama periode Mei – Desember 2010. Penilaian perkembangan dilakukan dengan instrumen Bayley III pada usia koreksi 3 dan 6 bulan. Hasil. Proporsi laki-laki lebih banyak pada kedua kelompok. Proporsi gagal tumbuh pada kelompok risti lebih banyak dan meningkat pada usia 6 bulan (20,6% vs 3,6%). Median nilai komposit pada area area kognitif dan motorik lebih rendah untuk bayi risti (p

Latar belakang. Diabetes melitus tipe-1 (DM tipe-1) merupakan penyakit kronis yang dapat mempengaruhi emosi dan perilaku anak dan remaja. Pasien mengalami tekanan yang berhubungan dengan bagaimana mengontrol metabolik dan tumbuh kembang yang sedang berlangsung. Tujuan. Mengetahui gangguan perilaku pasien DM tipe-1 dan faktor-faktor yang berhubungan dengan gangguan perilaku. Metode. Penelitian dilakukan secara potong lintang pada bulan Agustus 2006 di poliklinik Endokrinologi Departemen IKA FKUI RSCM. Subjek penelitian adalah pasien DM tipe-1 umur 4-18 tahun yang diambil secara purposive sampling. Sumber data diperoleh dari orangtua/ wali responden dengan wawancara terpimpin, menggunakan Pediatric Symptom Check List-17 (PSC-17) dan Kuesioner Masalah Mental Emosional (KMME). Hasil. Prevalensi gangguan perilaku pasien DM tipe-1 dijumpai kemungkinan gangguan psikososial 45,8%, paling banyak adalah gangguan internalisasi (33,3%). Kemungkinan gangguan mental emosional 41,7%. Lama sakit lebih dari 5 tahun dan pernah mengalami komplikasi memiliki risiko lebih besar mengalami gangguan mental emosional. Kesimpulan. Kemungkinan gangguan perilaku pada diabetes tipe-1 45,8%. Skrining gangguan perilaku pada pasien DM tipe-1 perlu dilakukan secara rutin di pusat pelayanan kesehatan sehingga dapat segera dievaluasi lebih lanjut.

Latar belakang. Prevalensi bullying pada anak SD di Indonesia belum diketahui. Tujuan. Mengetahui gambaran dan prevalensi bullying, pemahaman pelajar mengenai istilah bullying, hubungan antara status bullying dengan masalah emosi, dan perilaku serta prestasi akademis. Metode. Penelitian potong lintang dengan subyek pelajar SD kelas V usia 9-11 tahun di SDN Cikini 02 Pagi dan SDS Tunas Bangsa pada bulan Oktober 2011. Bullying dinilai menggunakan Olweus Bully/Victim Questionnaire yang dimodifikasi, sedangkan masalah emosi dan perilaku dideteksi menggunakan self-report Strengths and Difficulties Questionnaire (SDQ). Prestasi akademis dinilai berdasarkan nilai rapor tengah semester. Hasil. Penelitian dilakukan pada 76 subyek dan didapatkan prevalensi bullying 89,5%. Tidak terdapat perbedaan jenis kelamin pada subyek yang terlibat dalam bullying. Sebagian besar subyek yang terlibat bullying berusia >9 tahun. Subyek dengan status sosio-ekonomi rendah cenderung menjadi korban, sedangkan subyek dengan status sosio-ekonomi menengah dan tinggi cenderung menjadi korban sekaligus pelaku. Tipe bullying tersering adalah fisik. Pelaku bullying terbanyak adalah teman sebaya. Bullying paling sering terjadi di ruang kelas pada waktu istirahat sekolah. Dampak bullying jangka pendek tersering yang dialami korban adalah perasaan sedih. Sebagian besar korban melaporkan bullying yang dialaminya kepada orang lain. Hanya 22% subyek yang mengetahui istilah bullying dengan tepat. Tidak didapatkan hubungan antara status bullying dengan masalah emosi dan perilaku maupun prestasi akademis. Kesimpulan. Prevalensi bullying pada murid kelas V SDN Cikini 02 Pagi dan SDS Tunas Bangsa 89,5%. Pemahaman tentang istilah bullying pada anak SD di Jakarta Pusat rendah. Tidak didapatkan hubungan antara status bullying dengan masalah emosi dan perilaku maupun prestasi akademis.

Terapi sensori integrasi, sebagai bentuk terapi okupasi, mulai populer diberikan untuk tata laksana anak dengan berbagai gangguan perkembangan, belajar, maupun perilaku. Namun dasar teori, bentuk gangguan pemrosesan sensori, dan efektivitas terapi umumnya belum diketahui secara luas di kalangan dokter spesialis anak. Bukti sahih tentang manfaat terapi sensori integrasi untuk tata laksana anak dengan gangguan spesifik memungkinkan aplikasi dan pemberian edukasi pada keluarga pasien secara lebih optimal.

Latar belakang. Kemampuan berbahasa merupakan indikator seluruh perkembang Tujuan Penelitian. Mendapatkan gambaran umum pada anak dengan keterlambatan bicara/bahasa dengan menggunakan ELM scale 2. Metode. Penelitian deskriptif potong lintang dilakukan pada 49 anak berusia 1-36 bulan dengan keterlambatan bicara di Poliklinik Tumbuh Kembang RSUP Cipto Mangunkusumo (RSCM) dan RSIA Hermina Bekasi, pada bulan September sampai Desember 2006. Hasil. Persentase anak dengan gangguan bicara ekspresif 22 (44,9%). Berdasarkan nilai persentil skor, terbanyak 30 (61,2%) mempunyai nilai basal pada auditori ekspresif < 2, dan 19 (38,8%) yang mempunyai nilai persentil skor 2-98. Walaupun nilai ini berada pada rentang skor 2-98, anak yang mempunyai persentil skor 2,5,10 tetap didapatkan fail menurut umur pada rentang 75-90%( non critical item) penilaian ELM scale 2. Hal ini masih lebih baik dibanding jika anak mempunyai nilai skor standar

Latar belakang. Pasien HIV anak berisiko tinggi mengalami gangguan neurokognitif akibat keterlibatan sistem saraf pusat (SSP). Pemberian antiretrovirus (ARV menurunkan viral load di SSP sehingga mencegah penurunan fungsi kognitif. Tujuan. Memberikan gambaran fungsi kognitif pasien HIV anak dalam terapi ARV. Metode. Studi potong lintang dilakukan terhadap pasien HIV anak berusia 5-15 tahun. Penilaian kognitif dilakukan dengan instrumen Wechsler intelligence scale for children IV (WISC IV) dilanjutkan dengan pemeriksaan elektroensefalografi untuk membuktikan kerusakan akibat keterlibatan SSP pada infeksi HIV. Hasil. Sembilan puluh pasien HIV anak (median usia 9 tahun) telah memperoleh ARV selama 1-124 bulan dengan median 69 bulan. Hasil rerata verbal, performance, dan full-scale IQ (FSIQ) berturut-turut adalah 88,66 (SB 15,69), 85,30 (SB 15,35), dan 85,73 (SB 15,61). Dua puluh tiga (25,6%) subjek memiliki verbal IQ abnormal, 34 (37,8%) performance scale abnormal, dan 32 (35,6%) FSIQ abnormal. Hasil EEG abnormal didapatkan pada 22 subjek (22,4%) dan tidak memiliki hubungan dengan stadium klinis, usia dan lama pemberian ARV, serta viral load. Stadium HIV menunjukkan hubungan bermakna dengan komponen verbal scale IQ dan FSIQ (p=0,042 dan p=0,044). Hasil IQ tidak memiliki hubungan dengan usia pemberian ARV, lama pemberian ARV, dan viral load. Kesimpulan. Pasien HIV anak yang telah mendapat terapi ARV selama 1-124 bulan memiliki rerata IQ abnormal pada verbal, performance, dan FSIQ meskipun jika dinyatakan dalam bentuk kategori, lebih dari 50% subjek memiliki IQ normal pada ketiga skala WISC.

Latar belakang. Epilepsi merupakan penyakit kronik yang dapat mempengaruhi kualitas hidup anak di masa depan. Saat ini penelitian untuk menilai kualitas hidup anak epilepsi masih terbatas. Tujuan. Melakukan penilaian faktor-faktor klinis, demografi, psikososial dan obat anti epilepsi (OAE) yang mempengaruhi kualitas hidup anak epilepsi dengan menggunakan instrumen Quality of life in childhood epilepsy questionnaire-parent form (QOLCE). Metode. Penelitian dilaksanakan di Poliklinik Neurologi Departemen Ilmu Kesehatan Anak FKUI-RSCM dalam kurun waktu Desember 2007 sampai April 2008. Terkumpul 68 orang responden yang memenuhi kriteria inklusi dengan melakukan wawancara secara langsung oleh peneliti. Hasil. Jumlah serangan kejang dalam 6 bulan terakhir (faktor klinis), usia anak dan jumlah anak dalam keluarga (faktor demografi), kecemasan orang tua (faktor psikososial) mempengaruhi kualitas hidup anak epilepsi. Jumlah obat anti epilepsi (OAE) berkorelasi dengan komponen restriksi fisik pada fungsi fisik yaitu semakin sedikit jumlah OAE semakin tidak dibatasi aktivitas fisiknya. Kesimpulan. Kualitas hidup anak epilepsi dipengaruhi oleh jumlah serangan kejang dalam 6 bulan terakhir, usia anak, jumlah anak dalam keluarga, kecemasan orang tua, dan jumlah OAE. Pengenalan dini terhadap gangguan kualitas hidup pada anak epilepsi dapat memperbaiki kualitas hidup di masa depan.

Latar belakang. Purpura Henoch-Schönlein (PHS) merupakan sindrom klinis yang disebabkan vaskulitis akut sistemik yang paling sering pada anak. Manifestasi klinis melibatkan berbagai organ, seperti kulit, sendi, gastrointestinal, dan ginjal dengan rekurensi terjadi pada hampir 50% kasus. Tujuan. Mengetahui manifestasi klinis, laboratorium, serta rekurensi PHS anak di Indonesia. Metode. Penelitian deskriptif retrospektif dari rekam medis pasien anak berusia 0-18 tahun dengan diagnosis PHS selama periode 1 Januari 2009 hingga 31 Desember 2012 di Rumah Sakit Cipto Mangunkusumo, Jakarta. Hasil. Terdapat 71 kasus PHS, rentang usia 2 sampai 16 tahun dan tersering pada kelompok 6-8 tahun. Proporsi anak perempuan lebih tinggi dibanding laki-laki (rasio 1,2:1). Semua pasien mengalami purpura palpabel, manifestasi tersering adalah gangguan gastointestinal (79%), artritis atau artralgia (68%), dan keterlibatan ginjal (41%). Riwayat infeksi yang mendahului gejala PHS didapatkan 56% kasus. Peningkatan laju endap darah (88%) dan trombositosis (60%) merupakan kelainan laboratorium yang paling sering ditemukan, diikuti hematuria (41%), leukositosis (32%), dan anemia (31%). Penurunan fungsi ginjal ditemukan 6/42 kasus. Perbaikan gejala klinis terlihat dalam waktu kurang dari 4 minggu untuk manifestasi kulit, gastrointestinal, dan persendian. Sebanyak 18/24 subjek dengan hematuria mengalami perbaikan dalam waktu 6 bulan. Penurunan fungsi ginjal menetap tidak ditemukan. Rekurensi didapatkan 5/57 subjek yang memiliki data pemantauan. Kesimpulan. Manifestasi klinis tersering pada PHS adalah purpura palpabel, gangguan gastrointestinal, artritis atau artralgia, dan keterlibatan ginjal. Pemeriksaan darah perifer lengkap dan urinalisis sebaiknya dilakukan pada semua pasien PHS untuk mendukung diagnosis dan menilai keterlibatan ginjal. Pemantauan minimal dilakukan selama 6 bulan untuk menilai keterlibatan ginjal yang mungkin timbul terlambat serta rekurensi.

Background Behavior and emotional problems in a mentally re- tarded child can inhibit the educational process of the child. Objectives The aims of this study were to find out the prevalence of behavior and emotional problems in children with mental retar- dation as reported by parents and to assess associated risk fac- tors consisting of mother’s psychopathology, marital discord, male sex, child’s age, socioeconomic status, and family size. Methods This cross sectional study was carried out on 63 chil- dren with mental retardation in a school for retarded children, SLB C Asih Budi I, from January until March 2003. Parents were inter- viewed at school and home using special questionnaires, the Child Behavior Checklist (CBCL) and Symptom Checklist-90 (SCL-90). Results The prevalence of behavior and emotional problems in this study was 52%. The majority of behavior and emotional prob- lems were anxious/depressed (18%) and withdrawn (16%). Male sex and age group of 12-18 year-old were not risk factors of be- havior and emotional problems (OR=0.49, p=0.190 and OR=1.14, p=0.94, respectively) while socioeconomic status, family size, and mother’s psychopathology were risk factors (OR= 4.08, p=0.008; OR=4.17, p=0.014; OR=9.28, p=0.018; respectively). There was a correlation between behavior and emotional problems of chil- dren and marital discord. Conclusion The prevalence of behavior and emotional problems was 52% in which the majority was internalizing disorder. Risk fac- tors for behavior and emotional problems were mother’s psycho- pathology, four or more children in the family, low socioeconomic status, and marital discord

Background Working mothers with toddlers are often confused with the difficulties of caregiver substitutes. This leads to the con- cern about neglecting their toddlers. Day care centers are expected to respond by substituting the absent mothers, in order for the children’s needs of growth and development to become optimal. Objective To examine the profile of day care centers in correla- tion with growth and development of toddlers, and to understand the characteristics of facilities for growth and development in tod- dlers at day care centers. Method This cross-sectional study was conducted at the day care centers (DCC) of the Department of Social Affairs of the Republic of Indonesia Harapan Ibu (HI) in Salemba, Central Jakarta and Teratai in Bekasi from February 1-August 1, 2004. Results There were 106 children enrolled in this study; 47 chil- dren in DCC HI and 59 in DCC Teratai, male:female ratio was 1:1, mostly at age 3.1-5 years. Growth status was measured accord- ing to body weight/age, body height/age, height circumference/ age and found good, normal, and proper growth status in 85 chil- dren (80.2%), 48 children (45.3%), 102 children (96.2%), respec- tively. We found good nutritional status in 44 children (41.5%) and normal developmental status (Denver II) in 81 children (76.4%). Ratio of caregivers to child was 1:10. All children had complete immunization. No trauma or upper respiratory tract infection was recorded as frequent morbidity. Parents’ reasons for relying their children in DCCs were to enable their children to socialize (50 children/47.2%), and to allow them to become independent (49 children/46.2%). Conclusion DCCs can serve as a safe alternative caregiving sub- stitute based on good growth and development, good nutritional status, also good characteristics facilities

IntroductionThere is a high global incidence of typhoid fever, with an annual mortality rate of 200,000 deaths. Typhoid fever also affects younger children, particularly in resource-limited settings in endemic countries. Typhoid vaccination is an important prevention tool against typhoid fever. However, the available polysaccharide typhoid vaccines are not recommended for children under 2 years of age. A new typhoid conjugate Vi-diphtheria toxoid (Vi-DT) vaccine has been developed for infant immunization. We aimed to define the safety and immunogenicity of the Vi-DT vaccine among adults and children in Indonesia.MethodsAn observational, blinded, comparative, randomized, phase I safety study in two age de-escalating cohorts was conducted in East Jakarta, Indonesia, from April 2017 to February 2018. We enrolled 100 healthy subjects in 2 age groups: adults and children (18-40 and 2-5 years old). These groups were randomized into study groups (Vi-DT vaccine), and comparator groups (Vi-polysaccharide (Vi-PS) vaccine and another additional vaccine) which was administered in 4 weeks apart. Subjects were followed up to six months.ResultOne hundred healthy adults and children subjects completed the study. The Vi-DT and Vi-PS vaccines showed no difference in terms of intensity of any immediate local and systemic events within 30 minutes post-vaccination. Overall, pain was the most common local reaction, and muscle pain was the most common systemic reaction in the first 72 hours. No serious adverse events were deemed related to vaccine administration. The first and second doses of the Vi-DT vaccine induced seroconversion and higher geometric mean titers (GMT) in all subjects compared to that of baseline. However, in terms of GMT, the second dose of Vi-DT did not induce a booster response.ConclusionThe Vi-DT vaccine is safe and immunogenic in adults and children older than two years. A single dose of the vaccine is able to produce seroconversion and high GMT in all individuals.

[This corrects the article DOI: 10.1371/journal.pntd.0005621.].

While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and socialization skills in children with ASD. Methods: This was a cross-sectional study including 40 ASD children aged from 18 months to 6 years and 40 age-matched typically developing controls. Gross motor and socialization skills were scored using the Vineland Adaptive Behavior Scales, 2nd edition (Vineland-II). Results: Below average gross motor function was found in eight of 40 (20%) ASD children. The mean gross motor v-scale score in the ASD group was 15.1 [standard deviation (SD) 3.12], significantly lower than in the control group [18.7, SD 2.09, p = 0.0001; 95% confidence intervals (CI) from −4.725 to −2.525]. The differences were most prominent in ball throwing and catching, using stairs, jumping, and bicycling. The ASD children with gross motor impairments had a mean socialization domain score of 66.6 (SD 6.50) compared to 85.7 (SD 10.90) in those without gross motor impairments (p = 0.0001, 95% CI from −25.327 to −12.736). Conclusion: Children with ASD had lower gross motor skills compared to typically developing children. Gross motor impairments were found in 20% of the ASD children, and these children also had lower socialization skills than those without gross motor impairments.

BACKGROUND:Indonesia reports the second highest dengue disease burden in the world; these data are from passive surveillance reports and are likely to be significant underestimates. Age-stratified seroprevalence data are relatively unbiased indicators of past exposure and allow understanding of transmission dynamics. METHODOLOGY/PRINCIPAL FINDINGS:To better understand dengue infection history and associated risk factors in Indonesia, a representative population-based cross-sectional dengue seroprevalence study was conducted in 1-18-year-old urban children. From October to November 2014, 3,210 children were enrolled from 30 geographically dispersed clusters. Serum samples were tested for anti-dengue IgG antibodies by indirect ELISA. A questionnaire investigated associations between dengue serologic status and household socio-demographic and behavioural factors. Overall, 3,194 samples were tested, giving an adjusted national seroprevalence in this urban population of 69.4% [95% CI: 64.4-74.3] (33.8% [95% CI: 26.4-41.2] in the 1-4-year-olds, 65.4% [95% CI: 69.1-71.7] in the 5-9-year-olds, 83.1% [95% CI: 77.1-89.0] in the 10-14-year-olds, and 89.0% [95% CI: 83.9-94.1] in the 15-18-year-olds). The median age of seroconversion estimated through a linear model was 4.8 years. Using a catalytic model and considering a constant force of infection we estimated 13.1% of children experience a primary infection per year. Through a hierarchical logistic multivariate model, the subject's age group (1-4 vs 5-9 OR = 4.25; 1-4 vs. 10-14 OR = 12.60; and 1-4 vs 15-18 OR = 21.87; p

Moral crisis in society, among others, characterized by: a loss of honesty, loss of sense of responsibility, not able to think ahead, lack of discipline, cooperation crisis, the crisis of justice, and crisis care The establishment of the most appropriate character held at the school for three reasons: Firstly the majority of students recognize physical education in schools. Both school age is a period that is effective to instill values. The third physical education in schools still emphasizes achievement. Primary school age children are children aged 6 to 12 years. At this time the so-called child age child. At this time is the most appropriate time to teach skills and educate the child's character. Physical education and sport merrupakan sections and education in general. The purpose of education is to achieve educational goals through learning physical education and sport. Physical education and sport teaches the following values: Respect, Friendship, Sportif, Creative, ooperation, fair play, hard work, responsibility, and Never give up, Implementation of physical education as a means of forming the character are: 1) Modeling 2). Creating an environment characterized by 3). Habituation 4). Instill discipline 5) develop ethical guidelines and 6). Encourage students to show good behavior. Physical education teachers should give emphasis on what should and what should not be done students to study physical education and sport can be used as a means of forming character.

Background Excessive screen media exposures have many negative impacts on children, including academic performance. Studies on the impacts of screen media on academic performance have been limited, especially in Indonesia. Objective To assess screen media use and academic performance of7th graders in a junior high school, and to evaluate other factors potentially affecting student academic performance. Methods This was a cross-sectional study using surveys, questionnaires, and 12-day logbooks, conducted from May to July 2012. Students were 129 students in the 7,h grade of Junior High Sch ool 115 in Jakarta and selected by consecutive sampling. Chi square test and multivariate analyses with logistic regression calculations were used for statistical analysis. Results The prevalences of students using screen media for > 2 hours per day were 39.5% on weekdays and 64.3% on weekends. The prevalence of students using screen media that was not appropriate for their age was 69% on weekdays and 63.6% on weekends. Screen media content on weekdays and weekends had no impact on academic performance (OR 0.56; 95%CI 0.26 to 1.20; P=0.136 and OR 0.97; 95%CI 0.47 to 1.00; P=0.934, respectively) . In addition, the duration of screen media use on weekdays and weekends had no association with academic performance (OR 0.60; 95%CI 0.30 to 1.23; P=0.161 and OR 0.90; 95%CI 0.44 to 1.86; P=0.782, respectively). Factors significantly associated with students' above average academic performance were female gender (OR 3 .26; 95%CI 1.38 to 7.74; P=0.007), superior intelligence quotient (IQ) compared to average IQ (OR 4.63; 95%CI 1.66 to 12.9; P=0.003), highly superior IQ compared to average IQ (OR 5.45; 95%CI 1.51 to 19.64; P=0.009), as well as achievement motivation and existence of learning strategy, including intermediate vs. low motivation (OR 4.09; 95%CI 1.14 to 14.7 ; P=0.031), and high vs . low motivation (OR61.1; 95%CI 7.42 to 502.95; P

Introduction Despite the considerable number of children with Do\Vll syndrome in Indonesia, there is little data available on the success of intervention programs. This study was performed to define factors affecting the intelligence of young children with Do\Vll syndrome. Objective To determine factors associated Mth lower intelligence in children with Down syndrome, including growth parameters and participation in intervention programs. Methods This cross􀁃sectional study was undertaken from December 2010 to March 2011. Subjects were 60 children with Down syndrome aged 2􀁃6 years who were enrolled in an intervention program at both the Medical Rehabilitation Department, Cipto Mangunkusumo Hospital, and the Growth and Development Clinic, Harapan Kita Women's and Children's Hospital. Parents' data was obtained through self history􀁃taking and perusal of medical records. Subjects' anthropometric data (body weight, body height, and head circumference) was obtained through measurements using calibrated instruments. A psychologist administered IQ tests on the subjects. Results of the anthropometric and IQ tests were given to parents one week following the examinations. Results From the 111 children with Down syndrome registered in the intervention programs, 60 children (36 boys and 24 girls) met the inclusion criteria. The mean age of subjects was 4 years 6 months. Most subjects were well􀁃 nourished. Fifty􀁃five subjects had microcephaly. Eighty􀁃two percent of subjects participated in the program regularly and 70% of subjects had started in the program at less than 1 year of age. Subjects' mean IQ was 52.8. Analysis showed that girls, subjects who were overweight and obese, subjects with microcephaly, those with irregular attendance in the program, and those living under the poverty line were at highest risk for severe mental retardation. Conclusion Factors associated v.ith the intelligence in children with Down syndrome were female gender, overweight/obesity, severe microcephaly, below􀁃poverty line economic status, and irregular participation in the program. [Paediatr Indones. 2012;52:194-9].

Background Baby massage is one of the touch stimulation that could be applied as soon as possible after birth. Giving massage regularly will affect the behavior of newborn. Objectives To explore the effects of ten-day massage on infant's behavior. Methods A randomized control trial was done from December 200S to March 2009. Full-term newborm were randomly assigned into massage group or control group. Babies in massage group were given massage by their mothers and supervised by midwives. All babies were evaluated twice, i.e., on day 1 and day 11, using Brazelton Scale (Neonatal Behavior Assessment Scale). The behavior was compared between the two groups. Results A total of 72 full-term newborn infants appropriate for gestational age were included in this study. Infants in the massage group sbowed significant difference in adaptive behavior compared to control group. Those adaptive behavior consisted of habituation (WMD 1.08 CI 95% 0.67 to 1.49, P

Background Obesity can result in emotional and behavior problems in school-age children. Child Behavior Checklist (CBCL) is a standard instrument for evaluating behavior problems, however it is considered not practical. The 17-item Pediatric Symptom Checklist (PSC-17) is a more simple instrument but its diagnostic value has never been evaluated in obese children. Objectives To evaluate the diagnostic value of PSC-17 compared to CBCL as the gold standard. Methods This cross-sectional study was done in May - June 2009. Children aged 6-12 years with obesity were included. Parents filled the CBCL and PSC-17 questionnaires. Sensitivity, specificity, predictive values, and likelihood ratios were calculated for PSC-17. Results Most subjects aged 6-9 years (83%). Boys out numbered girls. Emotional and behavior problems detected by CBCL and PSC-17 were identified in 28% and 22% subjects, respectively. The most common problem was internalization (withdrawal, somatic complaints, anxiety/depression). The PSC-17 had sensitivity and specificity of 69.2% and 95.6% respectively. Positive and negative predictive values were 85.7% and 89%, whereas positive and negative likelihood ratios were 15.7 and 0.32. Conclusions The prevalence of emotional and behavior problems detected using CBCL and PSC-17 in obese children was 28% and 22%, respectively. The PSC-17 has moderate sensitivity to screen emotional and behavior problem in obese children.[Paediatr Indones. 2010;50:42-8].