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Factors related to missed opportunities for immunization at urban and suburban primary health centers in Medan Oke Rina Ramayani; Ridwan M. Daulay; Sri Sofyani; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background Missed opportunites for immunization is one of theimportant causes of low immunization coverage that should beprevented.Objective To investigate missed opportunities for immunizationand related factors at urban and suburban primary health centersin Medan.Methods A cross sectional study was conducted between January-March 2004. Primary health centers in Medan were divided intourban (20 primary health centers) and suburban (19 primaryhealth centers) groups. The sample size was 109 children whovisited primary health centers for immunization. Study was doneby a questionnaire taken after infants received immunization (exitinterview).Results The proportion of missed opportunities in urban andsuburban area was 22.3% (95% CI 16.9%;27.7%) and 29.9% (95%CI 24.0%;35.2%) (P=0.191), respectively. Factors such as age ofstarting immunization, number of children more than 4, and lowparental attitude about immunization (P=0.001) were related tomissed opportunities for immunization.Conclusions There is no difference between proportion of missedopportunities at primary health centers in urban and suburbanarea. Related factors to missed opportunities for immunizationare age of starting immunization older than 3 months, number ofchildren more than 4, and low parental attitude aboutimmunization.

Parental knowledge, attitude and practice on malaria in Mandailing Natal district Syafruddin Haris; Sri Sofyani; Bidasari Lubis; Munar Lubis; Syahril Pasaribu; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Malaria is still considered to be an important healthproblem in Indonesia. Malaria has been found in islands withdifferent degree of endemicity. Behavior of the community isone of the factors affecting the incidence of malaria in MandailingNatal district.Objective To know the parental knowledge, attitude, and practiceamong parents whose children suffered from malaria or not.Methods A cross sectional study was conducted in six primaryschools and one health centre in October 2004. Subjects wereparents whose children were malaria positive and malaria negativebased on laboratory examination. Sample size was 85 parents foreach group. Selected respondents were interviewed usingstructured questionnaire. Degree of knowledge, attitude, andpractice on malaria were established using scoring system withinthree categories: good, less, and poor. Data were collected andpresented using chi-square and P<0.05 was considered as a levelof significant.Results The mean age of 85 parents whose children were positivemalaria, was 38.47 years (SD 6.67) and the mean age of thosewhose children were negative malaria was 40.41 years (SD 8.05).Parentâ€™s education level was 62.9% primary school and 90% oftheir children were school-aged. There were significant differenceson parental knowledge, attitude and practice in each group(P<0.05). There was also a significant correlation betweenoccupation and knowledge, but not between parental educationlevel and parental age. Parental knowledge and attitude on theincidence of malaria in Mandailing Natal district were good,though their practice were poor.Conclusion There are significant differences on parentalknowledge, attitude and practice, between parents whose childrenwere positive and negative for malaria.

Short-term impact of acute uncomplicated malaria on the cognitive performance of school children living in an endemic area Masyitah Masyitah; Lily Rahmawati; Sri Sofyani; Munar Lubis; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi49.2.2009.82-6

Background In Indonesia, malaria remains a public healthproblem. In North Sumatra between 2000 and 2004, an estimated50,670 clinical cases occurred every year, leading to the deathsof 9-10 people per year.Objectives To determine the short-term impact of acute uncompli-cated malaria on the cognitive performance of school children.Methods A prospective study was conducted on students at fourelementary schools in Madina, North Sumatra, Indonesia, fromAugust 15 to September 3, 2006. Subjects were classified intomalaria and non-malaria groups based on microscopically confirmedblood smears; they were selected by means of random sampling.Cognitive performance was measured with two examination paperson mathematics and Indonesian language before and two weeksafter artesunate and amodiaquin treatment for three days in themalaria group. Independent or paired t-tests were used to analyzedifferences in mean scores of cognitive performance.Results From 925 children examined, 384 suffered from malaria.One-hundred and thirty three children were recruited from themalaria group and 132 children were recruited from the non-malaria group. There was no difference in the distribution ofgeneral characteristics of the subjects. There was a significantdifference in cognitive performance between the malaria andnon-malaria groups (P<0.0001) before and after treatments. Inthe malaria group, there was a significant difference in cognitiveperformance before (mean 38.9; SD 15.19) and after treatment(mean 72.9; SD 10.41) with P<O.OOOl.Conclusion Acute uncomplicated malaria significantly affectsthe cognitive performance of school children living in a malaria-endemic area.

Behavior of elementary schoolchildren with iron deficiency anemia after iron therapy Rina A.C. Saragih; T. Mirda Zulaicha; Sri Sofyani; Bidasari Lubis; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Some studies had been performed to determine theassociation between iron status and children's behavior yet it isstill controversial.Objective To investigate whether iron therapy has an effect onthe behavior of children with iron deficiency anemia (IDA).Method A randomized placebo-controlled clinical trial wasconducted in Labuhan Batu on November 2006-April2007. IDAwas defined as Hb < 12 g/dl, MCHC< 31%, ROW index > 220and Mentzer index> 13. Elementary school children (6-12 yearsold) with IDA were randomly assigned to the treatment groupwith a daily therapy of 6 mg iron/kg/day or placebo group for three months. The subjects' behavior was evaluated with child behavior check list (CBCL) before and six months after intervention.Results After six months, 110 subjects completed the therapy.Scores of CBCL in iron group after intervention were internalizing42.64 (SO 9.95), externalizing 37.13 (SO 9.04) & total score 38.24 (SO 10.20). There was significant decreased on externalizing and total problems score in the treatment group after intervention (P< 0.05). However, there was no significant difference on scores between groups.Conclusion Iron therapy had significantly decrease CBCL scoreon externalizing and total problems in the treatment group,however there was no significant difference on scores if comparedwith placebo group.

Influence of educative game instrument on children's motor development in child day care Lucie Permana Sari; Sri Sofyani; Bistok Saing; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Child day care center is an institution functioning tohelp families to fulfil their child's need by providing stimulation witheducative game instrument (EGI) while they work outside home.Objectives To evaluate motor development of children at child daycare center with EGI stimulation compared with that of childrenwithout stimulation.Methods An experimental study using pretest-posttest control groupdesign was cartied out on children aged 2 to 5 years old, at Islamic CenterDay Care Center (without EGI) and Tanah-Besi Day Care Center inTebing Tinggi (with EGI for six months). Inclusion criteria: healthy,well-nourished children aged 2 to 5 years with informed consent, nodevelopmental delay (confirmed by Denver-II developmental screeningtest). Exclusion criteria: pre term birth children. Forty subjects wereselected by means of simple random sampling. Research data weretaken with Cronbach's motor skills scale. Subjects consisted of 3 to 4years old children, mostly four years old.Results Motor skills scores (mean; SD) of the Islamic CenterDay Care Center group and Tanah-Besi Day Care Center groupbefore stimulation were 104.9; 10.37 and 104.7; 5.47 (P=0.923),respectively, and after stimulation 105.2; 9.56 and 135.3; 7.67 (P<0.001), respectively. Motor skills scores (mean; SD) of Tanah-BesiDay Care Center group before and after stimulation were 104.7; 5.4 7and 135.3; 7.67 (P< 0.001) respectively. Motor skill dimensions score(mean; SD) ofTanah-Besi Day Care Center group before and afterstimulation: speed 28.9; 1.75 and 38.8; 2.79, stability 22.3; 1.02 and30.6; 1.57, accuracy 20.3; 1.15 and 26.7; 1.63, strength 33.3; 1.55and 39.1; 1.68, respectively with P< 0.001.Conclusions There is a significant difference in motor skillsscores and motor skill dimensions of children who receive EGIstimulation compared to those who do not.

Evaluation of Neurological Deficit in Hospital Discharged Encephalitis Lubuk P. Saing; Robert MJ. Simanjutak; Manihar D. Marbun; Iskandar Z. Lubis; Bistok Saing
Paediatrica Indonesiana Vol 36 No 5-6 (1996): May - June 1996
Publisher : Indonesian Pediatric Society

A study was done on 30 encephalistis patients treated and discharged from Dr. Pimgadi Hospital Medan in the year 1990-1991, The study was conducted cross sec- tionally. The aim of the study was to find out the type and percentage of neurological deficits, including factors associated with the sequelae. Eight patients (27%) developed neurological deficit, only (3%) patient developed neurological deficits after being disÂcharged until the period of evaluation. The neurological deficits encountered mostly were epilepsy, paraparesis, and right hemiparesis, each of which in 2 cases (7%), and monoÂparesis of the right limb and aphasia, each in 1 case (3%). The was no significant assoÂciation of neurological deficit with prognostic factor.

Missed Opportunities for Immunization at The Out-Patient Clinic: Prevalence and Related Factors Hafiz Abubakar; Ali Antoni; Johnwan Usman; Iskandar Z. Lubis; RA. Aggraini Erma
Paediatrica Indonesiana Vol 36 No 7-8 (1996): July - August 1996
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi36.7-8.1996.146-54

From November 1992 through Januaiy 1993 a cross sectional study was conducted to determine the prevalence and related factors of missed opportunities for immunization (MOI). The study involved 280 babies aged less than 12 months. InterÂview was performed by using a questionnaire as the babies left the clinic after seeing the clinic personnel (exit interview). The primary source of information was the accomÂpanying person and their immunization card. There were 149 (53%) male and 131 (47%) female babies. A total of 208 babies (74.3%) stated to have immunization card, although only 19 (9.1Â°/.) look it at the time of the study. Out of 234 babies (83.5%) with partial immunization status, 9 had contraindication to immunization. Among 225 ba- es without contraindication, only 88 babies were suggested to have immunization. MOI was found in 137 (48.8%) babies (95% confidence interval: 43%; 55%). Concerning the kind of vaccine, OFV was the most often missed. Of 88 babies (31.4%) suggested for immunization, 43 agreed and had been given various vaccines including simultaneus immunization at the Well-Child Clinic. Screening for immunization not consistently practiced, missed interpretation to contraindication was detected. Among babies sugÂgested for immunization, significant relationships were found between the number of children in the family (p<0.05), father's (p<0.05) and mother's education (p<0.001) and acceptance to immunization.

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