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All Journal Paediatrica Indonesiana Majalah Kedokteran Nusantara The Journal Of Medical School Cermin Dunia Kedokteran
Munar Lubis
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Health Professions Medicine & Pharmacology Public Health

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (355.312 KB) | DOI: 10.14238/pi47.4.2007.161-5

Abstract

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).Parent’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.
Effect of oral glucose administration on pain in neonates undergoing peripheral blood collection Effa Triani; Munar Lubis; Chairoel Yoel
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.544 KB) | DOI: 10.14238/pi47.4.2007.185-8

Abstract

Background Peripheral blood sampling with heel sticks in neonatescould represent minor invasive procedure which generates pain.The oral glucose administration can reduce the pain in neonatesduring this procedure.Objective To compare the pain sense after oral glucoseadministration or placebo during peripheral blood sampling withheel sticks in neonates.Methods A double blind randomized clinical trial study wasconducted from January to March 2004 in three teaching hospitalsin Medan. The population of this study was divided into twogroups (glucose and placebo) and each group consisted of 32neonates. The intervention group got 1 ml of 40% glucose andthe placebo group got 1 ml of sterile water. Blood sample wastaken with sterile hemolet with heel sticks from healthy atermneonates. The pain was measured using NIPS score and measuredin first 30 seconds after heel sticking. The heart and respiratoryrate measurement was done before and during the interventionand we also counted crying time. Data were analyzed with studentt–test.Results The significant mean difference of NIPS score in glucosegroup was 2.22 (SD 0.83) vs 4.72 (SD 0.96) in placebo group(P<0.0001). There was significant mean difference of crying time,i.e. 0.16 (SD 0.37) in glucose group vs 2.05 (SD 0.77) in placebogroup (P<0.0001). There was significant differences of heart ratebefore and during heel sticking in both groups.Conclusion There were some differences of pain sense in neonateswho received 40% glucose compared to those who received sterilewater during peripheral blood sampling.
Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Wisman Dalimunthe; Charles Siregar; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (231.223 KB) | DOI: 10.14238/pi47.5.2007.216-20

Abstract

Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on children’s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.
Effect of iron and zinc supplementation in the treatment of malaria in children Danny Dasraf; Bugis Mardina Lubis; Bidasari Lubis; Nelly Rosdiana; Munar Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (345.527 KB) | DOI: 10.14238/pi47.6.2007.256-60

Abstract

Background Iron and zinc administration for children withmalaria in endemic area were known to decrease parasitemia butdata on their effectiveness when given together to increasereticulocytes as erythropoiesis parameter and hemoglobin isinsufficient.Objective To determine the effect of zinc to increase ironabsorption in the treatment of Plasmodium falciparum malaria inchildren.Methods Children with positive Plasmodium falciparum on theirblood smear (n=86) examination were randomly assigned to dailysupplementation of iron 6 mg per kg body weight per day plusplacebo or iron plus zinc 10 mg per day for 30 days. Venous bloodspecimens were collected at the start and at the end of the study.Results Sixty-nine children completed the supplementations andhad both baseline and follow-up blood specimen study. After 30-day supplementation, the iron plus placebo and iron plus zincgroups showed significant difference on hemoglobin concentration(0.58 and 0.09 g/dl; P<0.05). There was no significant differencein reticulocyte production index and reticulocyte count beforeand after intervention in both groups. There was only significantdifference in red blood cells concentration after supplementationof iron plus placebo and iron plus zinc (4.7 in 4.5 million/μl;P<0.05).Conclusions Iron supplementation with or without zinc showssignificant increase of hemoglobin concentration. It is slightlyhigher in iron plus placebo group.
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

Abstract

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.
Comparison of the efficacy of artesunate-amodiaquine with quinine-clindamycin for treatment of uncomplicated falciparum malaria in children Purnama Fitri; Armila Armila; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.775 KB) | DOI: 10.14238/pi49.2.2009.91-6

Abstract

Background Drug-resistant Plasmodium falciparum malaria is amajor contributor to increasing malaria-related morbidity andmortality. Artesunate-amodiaquine is a potential combinationtherapy that shows improved treatment efficacy. Clindamycin incombination with quinine is also a safe and effective treatmentfor multidrug-resistant P. falciparum malaria.Objectives To compare the efficacy of artesunate-amodiaquine andquinine-clindamycin combination therapies for the treatment ofuncomplicated falciparum malaria.Methods This randomized open label trial in 23 2 children agedbetween one month and 18 years old took place in MandailingNatal, North Sumatra, from August to September 2006. The AAgroup received a 3-day oral course of artesunate (4 mg/kg BWonce a day) plus amodiaquine (10 mg/kg BW once a day). TheQC group received a 3-day course of clindamycin (5 mg of base/kgBW twice a day) plus a 7-day course of quinine (10 mg of salt/kgBW orally for the first four days, then 5 mg of quinine salt/kg BWfor the next three days). We performed thin and thick peripheralblood smears on days 0, 2, 7, and 28.Results A total of 232 eligible children were enrolled but only22 7 completed the study (114 in group AA, 113 in group QC).The cure rates were lOOo/o in both groups by the second day, andthere was no recrudescence in either group. We found more sideeffects in AA group compared with in QC group, i.e., headacheand vomiting.Conclusion Artesunate-amodiaquine and quinine-clindamycincombinations showed similar efficacy for the treatment of uncomplicatedP. falciparum.
Parascreen as an alternative diagnostic tool for falciparum malaria Jenny Ginting; Siska Mayasari; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.220-3

Abstract

Background Malaria is a parasitic disease with high morbidityand mortality. Rapid immunochromatographic are emerging todetect specific antigens of human plasmodia.Objective To determine the sensitivity and specificity ofParascreenfor the detection of Plasmodium falciparum in children.Methods A diagnostic test study was performed in MandailingNatal District, Penyabungan, North Sumatera. Subjects werepublic health center and hospital patients with symptoms of fever,pallor, headache, and diarrhea. Blood specimens were obtained forParascreen testing. Microscopy of Giemsa-stained blood samplesserved as the gold standard.Results One hundred and four subjects were studied. The sensitiv-ity and specificity ofParascreen were 76% and 100%, respectively.Positive and negative predictive values of the test were 100% and49%, respectively. Likelihood ratio was infinite for a positive testand 0.23% for a negative test.Conclusion Parascreen is a useful and highly specific di-agnostic tool for P. falciparum malaria
Comparison of oxygen saturation measured by pulse oximetry and arterial blood gas analysis in neonates Srie Yanda; Munar Lubis; Yoyoh Yusroh
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.441 KB) | DOI: 10.14238/pi43.6.2003.211-5

Abstract

Background Arterial blood gas is usually beneficial to discern thenature of gas exchange disturbances, the effectiveness of com-pensation, and is required for adequate management. AlthoughPaO 2 is the standard measurement of blood oxygenation, oxygensaturation measured by pulse oximetry (SapO 2 ) is now a custom-ary noninvasive assessment of blood oxygenation in newborn in-fants.Objective To compare oxygen saturation measured by pulse oxi-metry (SapO 2 ) and arterial blood gas (SaO 2 ), its correlation withother variables, and to predict arterial partial pressure of oxygen(PaO 2 ) based on SapO 2 values.Methods A cross sectional study was conducted on all neonatesadmitted to Pediatric Intensive Care Unit (PICU) during February2001 to May 2002. Neonates were excluded if they had impairedperipheral perfusion and/or congenital heart defects. Paired t-testwas used to compare SapO 2 with SaO 2 . Correlation between twoquantitative data was performed using Pearson’s correlation. Re-gression analysis was used to predict PaO 2 based on SapO 2 val-ues.Results Thirty neonates were included in this study. The differ-ence between SaO 2 and SapO 2 was significant . There were sig-nificant positive correlations between heart rate /pulse rate andTCO 2 , HCO 3 ; respiratory rate and TCO 2 , HCO 3 , base excess (BE);core temperature and HCO 3 , BE; surface temperature and pH,TCO 2, HCO 3, BE; SapO 2 and pH, PaO 2 ; and significant negativecorrelation between SapO 2 and PaCO 2 ; the correlations were weak.The linear regression equation to predict PaO 2 based on SapO 2values was PaO 2 = -79.828 + 1.912 SapO 2 .Conclusion Pulse oximetry could not be used in place of arterialblood gas analysis available for clinical purpose
The effectiveness of chloroquine compared to Fansidar in treating falciparum malaria Emil Azlin; Ichwan HH Batubara; Wisman Dalimunte; Charles Siregar; Bidasari Lubis; Munar Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (329.919 KB) | DOI: 10.14238/pi44.1.2004.17-20

Abstract

Background The most difficult problem in eradicating malaria isthe resistance of P. falciparum to drugs. Mandailing Natal has thehighest malaria incidence in North Sumatera.Objective This study aimed to investigate the efficacy of chloro-quine and Fansidar in treating falciparum malaria.Methods A randomized double-blind study was done from April toMay 2001. Eighty-three patients with acute uncomplicated P.falciparum malaria infection were randomized into two groups.Group I (35 patients) received chloroquine and group II (48 pa-tients) received Fansidar. Blood examinations were performed onthe 1 st , 2 nd , 7 th , and 28 th days.Results The resistance of P. falciparum to drugs in the chloro-quine group were found in 10 patients with R II and 1 patients withR III, while in the Fansidar group, there were 14 patients with R II.Conclusion The efficacy of chloroquine and Fansidar in treatingfalciparum malaria was not significantly different
Hemolytic anemia in falciparum and vivax malarial patients based on serum bilirubin examination Yoyoh Yusroh; Bidasari Lubis; Syahril Pasaribu; Munar Lubis; Tiangsa Sembiring; Adillida Adillida
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (571.454 KB) | DOI: 10.14238/pi44.3.2004.95-100

Abstract

Objective To examine hemolysis in falciparum and vivax malarialpatients based on serum bilirubin examination.Methods A cross sectional study was conducted on childrenyounger than 15 years of age who visited public health center inthe district of Mandailing Natal with complaints of fever, shivering,pale, jaundice, diarrhea, or headache between April 9 th and April19 th 2001. Variables recorded were age, gender, body weight, bodyheight, symptoms and signs, anti malarial drugs, and laboratorytest results. Thin and thick blood smears were done as diagnostictools of malaria. Thin blood smear was also performed to deter-mine the level of malaria parasites in blood (parasitemia) and toexamine the morphology of red blood cells. Hemolysis was deter-mined by bilirubin examination.Results In P. falciparum malaria, there was a moderate correlation(r=0.68, p<0.0001) between parasitemia and indirect bilirubin con-centration. While in P. vivax malaria, there was only a weak corre-lation (r=0.46, p=0.007) between parasitemia and indirect bilirubinconcentration. It was also found that in falciparum malaria, para-sitemia, total and indirect bilirubin concentrations were significantlyhigher than that in vivax malaria, with p values of 0.009, 0.015 and0.003, respectively.Conclusion Hemolysis in falciparum malaria is more severe thanthat in P. vivax malaria, with marked elevation of indirect bilirubin.The elevation of serum bilirubin correlated with parasitemia
Co-Authors Adillida Adillida Aridamuriany D Lubis Aridamuriany D. Lubis Armila Armila Badai Buana Nasution Bidasari Lubis Bugis Mardina Lubis Chairoel Yoel Chairuddin P Lubis Chairuddin P. Lubis Chairul Yoel Charles Siregar Danny Dasraf Dini Lailani Effa Triani Emil Azlin Emil Salim Erniwaty P Panggabean Gema N. Yanni Gema Nazri Yanni Hanung Adi Nugroho Ichwan HH Batubara Indah Nur Lestari Iskandar Z Lubis Iskandar Z. Lubis Isra Firmansyah Isti Ilmiati Jenny Ginting Kristina Ambarita Lily Irsa Lily Rahmawati Monalisa Elizabeth Nelly Rosdiana Oke Rina Ramayani, Oke Rina Purnama Fitri Putri Amelia Rafita Ramayati Rina A.C. Saragih Rina Amalia C Saragih ROSIHAN ANWAR Rusdidjas dr Rusdidjas Rusdidjas Siska Mayasari Sri Alemina Ginting Sri Sofyani Srie Yanda Syafruddin Haris Syahril Pasaribu Tiangsa Sembiring Wisman Dalimunte Wisman Dalimunthe Yoyoh Yusroh Yunnie Trisnawati