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The first 24 hour bilirubin level as a predictor of hyperbilirubinemia in healthy term newborns. Rina Triasih, Rina Triasih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 03 (2002)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (187.743 KB)

Background: The practice of early discharge in healthy term newborns results in difficulty for recognition, follow-up and early treatment of hyperbilirubinemia, the most common cause of readmission in term newborns.Objectives: The aim of the study was to determine the ability of first 24 hours total and unbound bilirubin levels in predicting hyperbilirubinemia in healthy term newborns in the first week of life. Methods: The first 24 hours and 5th day of total and unbound bilirubin were measured in 84 healthy term newborns. The total bilirubin level was measured spectrophotometrically whereas unbound bilirubin level was determined by peroxidase-oxidation method. Hyperbilirubinemia was defined as serum total bilirubin of a 12.9 mg/dL or serum unbound bilirubin of a 0.5 mg/dL after 24 hours of life.Results: A correlation between first 24 hours and 5th day of total bilirubin was found (r= 0.53) with a regression equation: Y (total bilirubin day 5) = 4.69 + 1.15 X (total bilirubin first 24 hours). In unbound bilirubin (r= 0.31), the regression equation was Y (unbound bilirubin day 5) = 0.13 + 0.95 X (unbound bilirubin first 24 hours). The relative risk of newborns whose first 24 hours total bilirubin of a 4.5 mg/dL and becoming hyperbilirubinemia was 12 (95% CI = 2.9 - 48.4), and newborns whose unbound bilirubin of a 0.09 mg/dL was 9.5 (95% CI = 1.2-77.4).Conclusions: Total bilirubin level a 4.5 mg/dL in the first 24 hours can predict the occurance of hyperbilirubinemia in the first week of life inthe term newborns.Key word: fullterm newborn, hyperbilirubinemia, prediction, total bilirubin, unbound bilirubin

EVALUASI KEPATUHAN PETUGAS DALAM TATALAKSANA PNEUMONIA DI KABUPATEN TOLITOLI Rahman, Abd; Hakimi, Mohammad; Triasih, Rina
JURNAL KESEHATAN REPRODUKSI Vol 2, No 3 (2015)
Publisher : Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan UGM

EVALUASI KEPATUHAN PETUGAS DALAM TATALAKSANA PNEUMONIA DI KABUPATEN TOLITOLIAbd Rahman1, Mohammad Hakimi2, Rina Triasih3ABSTRACTBackground: The infant mortality rate in Central Sulawesi Province is 52 per 1000 live births, which isthe fifth highest in Indonesia. The high rate of morbidity and mortality of acute respiratory infection andpneumonia in children under five in Tolitoli District in past year related to the implented efforts triandsARI eradication program. This is indeed related to how officers comply with pneumonia managementcorrectly.Objective: To evaluate officersâ€™ compliance in implementing pneumonia manager Tolitoli Distric.Method: This was an observational study with cross-sectional study design, using quantitative approach,Data were collected through observation and interview using standardized questionnaire by tramednurses. Officer who handled pneumonia program in Tolitoli District and those in Publich Health Centreswere recruited as subjects.Result and Discussion: One hundred and nineteen subjects were recruited to this study. The percentaseof officers who complied with pneumonia management was 69%. The result of multivariate analysis thatwas training increased officersâ€™ compliance in pneumonia management which was adjusted to education,knowledge and length of work had a significant relationship (PR: 1.79; 95% CI: 1,38 â€“ 2,33) and theincreased value R2 of 6.3%, it mean.Conclusion: Trained officers were more compliant than untrained officers with the prevalence risk of1.79 times. Education, knowledge, and length of working service were related to officersâ€™ compliance inpneumonia management.Keywords: training, officersâ€™ compliance in pneumonia managementABSTRAKLatar belakang: Angka kematian bayi di Propinsi Sulawesi Tengah sebesar 52 per 1000 kelahiran hidupdan menempati urutan kelima tertinggi di Indonesia. Tingginya angka kesakitan dan angka kematian balitaakibat pneumonia di Kabupaten Tolitoli dalam beberapa tahun terakhir tidak terlepas dari seberapa jauhupaya program pemberantasan penyakit ISPA telah dilaksanakan. Hal ini sangat terkait dengan bagaimanakepatuhan petugas dalam melakukan tata laksana pneumonia secara tepat.Tujuan: Diketahuinya kepatuhan petugas dalam melakukan tatalaksana pneumonia di Kabupaten Tolitoli.Metode: Penelitian ini merupakan jenis penelitian observasional dengan rancangan cross sectional denganmenggunakan pendekatan kuantitatif. Data dikumpulkan melalui observasi dan wawancara dengan subyekpenelitian dengan menggunakan lembar observasi dan kuesioner.Hasil dan Pembahasan: Sebanyak 119 subyek diikutkan dalam penelitian ini. Rata-rata petugas yang patuhterhadap tata laksana pneumonia sebesar 69%. Hasil analisis multivariat menunjukkan bahwa variabelpelatihan dan kepatuhan petugas dalam tatalaksana pneumonia dengan mengikutsertakan variabel pendidikan, pengetahuan dan masa kerja untuk dianalisis secara bersama mempunyai hubungan yangsignifikan ((RP;1,79, IK 95%; 1,38 â€“ 2,33) dan peningkatan nilai R2 sebesar 6,3%Kesimpulan: Petugas yang telah dilatih lebih patuh dibanding petugas yang belum dilatih dengan risikoprevalensi 1,53 kali. Faktor pendidikan, pengetahuan dan masa kerja berhubungan secara bermaknadengan kepatuhan petugas dalam tataksana pneumonia.Kata kunci: pelatihan, Kepatuhan petugas tatalaksana pneumonia1 Tolitoli Faculty of Medicine and Health Science2 Maternal and Child Health-Reproductive Health Graduate Program, FK-UGM3 Pediatric Department, Dr. Sardjito General Hospital, Yogyakarta

Knowledge and Implementation of Integrated Management of Childhood Illness at East Kalimantan Zulaikha, Fatma; Triasih, Rina; Purwanta, Purwanta
KEMAS: Jurnal Kesehatan Masyarakat Vol 14, No 2 (2018)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v14i2.13707

Pneumonia is the most common cause of morbidity and mortality among young children worldwide. Integrated Management of Childhood Illness (IMCI) is a procedural form in the care of childhood illness which aims to minimize morbidity and mortality rate in children, including pneumonia. This was a cross-sectional study at Samarinda and Kutai Kartanegara community health center from July to October 2015. The health workersÃ¢â‚¬â„¢ knowledge was assessed through questionnaire. The quality of IMCI implementation was evaluated through direct observation in primary health care. A total of 46 health workers were involved in this study. Observation of IMCI implementation quality was conducted in 104 children. The majority of respondents (73.9) had sufficient knowledge; however, in terms of direct implementation on the field, most of the respondents (87%) were included in incompetent category. It can be concluded that level of knowledge was related to implementation of cough IMCI in community health center, but the correlation was weak.

The first 24 hour bilirubin level as a predictor of hyperbilirubinemia in healthy term newborns. Rina Triasih Rina Triasih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 34, No 03 (2002)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (187.743 KB)

Background: The practice of early discharge in healthy term newborns results in difficulty for recognition, follow-up and early treatment of hyperbilirubinemia, the most common cause of readmission in term newborns.Objectives: The aim of the study was to determine the ability of first 24 hours total and unbound bilirubin levels in predicting hyperbilirubinemia in healthy term newborns in the first week of life. Methods: The first 24 hours and 5th day of total and unbound bilirubin were measured in 84 healthy term newborns. The total bilirubin level was measured spectrophotometrically whereas unbound bilirubin level was determined by peroxidase-oxidation method. Hyperbilirubinemia was defined as serum total bilirubin of a 12.9 mg/dL or serum unbound bilirubin of a 0.5 mg/dL after 24 hours of life.Results: A correlation between first 24 hours and 5th day of total bilirubin was found (r= 0.53) with a regression equation: Y (total bilirubin day 5) = 4.69 + 1.15 X (total bilirubin first 24 hours). In unbound bilirubin (r= 0.31), the regression equation was Y (unbound bilirubin day 5) = 0.13 + 0.95 X (unbound bilirubin first 24 hours). The relative risk of newborns whose first 24 hours total bilirubin of a 4.5 mg/dL and becoming hyperbilirubinemia was 12 (95% CI = 2.9 - 48.4), and newborns whose unbound bilirubin of a 0.09 mg/dL was 9.5 (95% CI = 1.2-77.4).Conclusions: Total bilirubin level a 4.5 mg/dL in the first 24 hours can predict the occurance of hyperbilirubinemia in the first week of life inthe term newborns.Key word: fullterm newborn, hyperbilirubinemia, prediction, total bilirubin, unbound bilirubin

Child tuberculosis in Respira Lung Hospital, Yogyakarta: demographic and clinical profiles Stefani Candra Firmanti; Rina Triasih
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018): SUPPLEMENT
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Tuberculosis (TB) remains a significant source of morbidity and mortality among children in endemic settings. Demografic and clinical profiles of children with TB in Yogyakarta have not been well documented. A total of 80 children with TB were diagnosed with TB during the study period. There were 41 (51.2%) females and 39 (48.8%) males. The case findings of child TB cases has been increasing from 20 cases in 2014, 28 cases in 2015, and 32 cases in 2016. The majority of the children (89.3%) aged less than 5 years. The most common symptoms were cough 50 (62.5%), followed by weight loss 45 (56.3%), and fever 28 (35%). Contact with a TB case was identified in 46 (57.5%) children. Mantoux test was done in 76 (95%) children with positive result documented in 61(76.3%) children. Chest X-ray was done in 54 (67.5%) children, of which 52 (65%) chest X- rays showed suggestive of TB. Confirmed diagnosis (bacteriology) was only documented in one child (1.25%).

Interferon-g-Inducible Protein 10 for Diagnosis of Tuberculosis in Children Stefani Candra Firmanti; Rina Triasih; Tri Wibawa; Sofia Mubarika Haryana
The Indonesian Biomedical Journal Vol 12, No 1 (2020)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v12i1.973

BACKGROUND: The diagnosis of tuberculosis (TB) in children is challenging by the absence of a practical gold standard. Interferon (IFN)-ginducible protein 10 (IP-10) is a chemokine that may serve as the leading candidate marker in child TB diagnosis. The aim of this study is to assess the diagnostic value of IP-10 in the diagnosis of TB in children.METHODS: We recruited eligible symptomatic and asymptomatic children aged <15 years actively by contact investigation and passively from inpatient and outpatient clinics in two hospitals, in Yogyakarta, Indonesia. We conducted clinical examination and chest X-ray in all eligible children. Sputum smear and the rapid molecular TB test were performed in children with TB symptoms. All participants underwent blood sampling for IFN-g Release Assay and IP-10 test.RESULTS: A total of 79 children were recruited to this study. Twelve children were with TB disease, 16 with latent TB infection (LTBI), 40 were TB-exposed only and 11 were non-TB. Children with evidence of TB infection either with TB disease or LTBI had higher levels of antigen-stimulated IP-10 compared to non-infected children, both TB exposed only and non-TB (p=0.000). A cut-off 408.74 pg/mL for antigen-stimulated IP-10 showed high diagnostic accuracy for diagnosis of TB infection (AUC: 0.97, 95% CI: 0.92-1.00, sensitivity: 92.3%, and specificity: 91.9%). However, the stimulated levels of IP-10 between children with TB disease and LTBI were not significantly different (p=0.268).CONCLUSION: IP-10 performed well to diagnose TB infection in children. However, it cannot be used to differentiate TB infection from TB disease.KEYWORDS: IFN-g, IP-10, latent TB, active TB, children

Hubungan antara Riwayat Kejang pada Keluarga dengan Tipe Kejang Demam dan Usia Saat Kejang Demam Pertama Atut Vebriasa; Elisabeth S. Herini; Rina Triasih
Sari Pediatri Vol 15, No 3 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Salah satu faktor risiko kejang demam adalah riwayat kejang pada keluarga, dihubungkan dengan tipe kejang demam pertama dan usia saat terjadi kejang demam pertama. Beberapa penelitian menunjukkan riwayat kejang meningkatkan risiko kejang demam kompleks sebagai tipe kejang demam pertama dan berhubungan dengan usia kejang demam pertama yang lebih dini.Tujuan. Mengetahui hubungan riwayat kejang pada keluarga dengan tipe kejang demam pertama dan usia saat kejang demam pertama.Metode. Penelitian dilaksanakan di Bagian Ilmu Kesehatan Anak RSUP Dr. Sardjito,Yogyakarta sejak Januari 2009-Juli 2010. Pengambilan sampel dilakukan secara konsekutif dan dikelompokkan berdasarkan ada tidaknya riwayat kejang pada keluarga, tipe kejang demam pertama, dan usia saat terjadi kejang demam pertama.Hasil. Seratus lima puluh anak usia 6 bulanâ€“5 tahun yang memenuhi kriteria inklusi dan eksklusi diikutsertakan dalam penelitian. Terdapat 91 (60,6%) anak yang mempunyai riwayat kejang pada keluarga dan kejang demam pertama terjadi pada usia yang lebih dini pada kelompok ini (median usia 13,0 vs 17,0 bulan; IK95%: 0,00-0,03; p=0,01). Anak dengan riwayat kejang lebih banyak mengalami kejang demam sederhana dibandingkan kejang demam kompleks (61,4% vs 59,2%), meskipun perbedaannya tidak bermakna (IK95%: 0,78-1,37; p=0,80)Kesimpulan. Anak dengan riwayat kejang pada keluarga cenderung mengalami kejang demam pertama pada usia yang lebih dini. Riwayat kejang pada keluarga tidak meningkatkan risiko terjadi kejang demam kompleks sebagai tipe kejang demam pertama.

Faktor Risiko Kejadian Sakit Tuberkulosis pada Anak yang Kontak Serumah dengan Penderita Tuberkulosis Dewasa Nevita Nevita; Retno Sutomo; Rina Triasih
Sari Pediatri Vol 16, No 1 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp16.1.2014.5-10

Latar belakang. Anak yang tinggal serumah dengan penderita TB paru dewasa berisiko tinggi untuk terinfeksi dan sakit TB. Pelacakan terhadap anak kontak serumah (contact screening) berpotensi menurunkan morbiditas dan mortalitas TB pada anak. Namun demikian, kegiatan itu belum rutin dilakukan di negara-negara endemis karena keterbatasaan tenaga dan fasilitas.Tujuan. Mengetahui faktor risiko sakit TB pada anak yang tinggal serumah dengan penderita TB paru dewasaMetode. Penelitian kasus kontrol pada anak usia â‰¤15 tahun yang tinggal serumah dengan penderita TB paru dewasa yang diobati di 18 Puskesmas, 2 balai pengobatan paru, dan 3 rumah Sakit di Kotamadya Yogyakarta antara bulan agustus 2010 dan Juni 2012. Kami melakukan anamnesis, pemeriksaan fisik, uji tuberkulin, dan foto Rontgen dada pada semua anak yang memenuhi kriteria inklusi dan eksklusi untuk menentukan ada tidaknya sakit TB. Dikatakan sakit TB apabila terdapat paling sedikit satu gejala TB dan foto Rontgen dada yang sugestif TB atau ditemukannya gejala dan tanda extrapulmonary TB.Hasil. Terdapat 126 anak, 21 sebagai kasus dan 105 sebagai kontrol. Karakteristik anak (usia balita (OR 1,94 95% CI (0,76â€“4,93), telah mendapatkan vaksinasi BCG (OR 1,09 95% CI (0,12â€“8,83)) karakteristik kasus indeks (derajat BTA sputum positif (OR 2,72 95% CI (0,76 -9,78), orang tua sebagai kasus indeks (OR 1,05 95% CI (0,42â€“2,67)) dan karakteristik lingkungan (polusi asap rokok dalam rumah (OR 1,07 95% CI (0,38â€“2,99) dan jumlah anggota keluarga >6 (OR1,85 95% CI (0,70â€“4,88) tidak berhubungan dengan risiko terjadinya sakit TB pada anak kontak serumah.Kesimpulan. Risiko kejadian sakit TB pada anak tersebut tidak berhubungan dengan karakteristik anak, kasus indeks, dan lingkungan yang diteliti.

Berat Badan Lahir Rendah sebagai Faktor Risiko Stunted pada Anak Usia Sekolah Aulia Fakhrina; Neti Nurani; Rina Triasih
Sari Pediatri Vol 22, No 1 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.1.2020.18-23

Latar belakang. Stunted pada usia sekolah menyebabkan kemampuan kognitif rendah, fungsi fisik tidak optimal, dan produktivitas masa depan yang rendah.Tujuan. Mengidentifikasi apakah berat badan lahir rendah (BBLR) merupakan faktor risiko stunted pada anak usia sekolah. Metode. Kami melakukan penelitian kasus-kontrol dari bulan Mei â€“ Desember 2016 yang melibatkan siswa sekolah dasar berusia 6-7 tahun yang dipilih secara cluster random sampling di lima kabupaten di Daerah Istimewa Yogyakarta. Stunted didefinisikan sebagai nilai Z score untuk tinggi badan menurut usia <-2 standar deviasi berdasarkan kriteria WHO 2005. Data klinis dan demografi diperoleh menggunakan kuesioner yang diisi oleh orang tua. Hasil. Kejadian stunted adalah 11,8%. Riwayat BBLR (adjusted Odd Ratio (aOR) 3,38; IK 95% 2,03 -5,63), jenis kelamin laki-laki (aOR 1,62; IK 95% 1,160-2,27), usia kehamilan kurang bulan (aOR 4,23; IK 95% 2,18-8,24), pola pemberian MPASI dini (aOR 1,65; IK 95% 1,11-2,45) dan tinggal di daerah pedesaan (aOR 1,68; IK 95% 1,01-2,62) merupakan faktor risiko terjadinya stunted pada usia sekolah. Stunted pada usia sekolah tidak berhubungan dengan pemberian ASI eksklusif dan tingkat pendidikan orang tua.Kesimpulan. Anak-anak yang lahir dengan BBLR berisiko mengalami stunted pada masa sekolah.

Skor Prediksi Kematian Pneumonia pada Anak Usia di Bawah Lima Tahun Ambarsari Latumahina; Rina Triasih; Kristia Hermawan
Sari Pediatri Vol 18, No 3 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp18.3.2016.214-9

Latar belakang. Pneumonia merupakan penyebab utama kematian pada anak usia di bawah lima tahun di negara berkembang.Â Pengembangan sistem skor yang sederhana untuk memprediksi kematian pada pneumonia dapat meningkatkan kualitas pelayananÂ dan menurunkan angka kematian anak akibat pneumonia.Tujuan. Menyusun skor prediksi kematian pada anak dengan pneumonia.Metode. Penelitian kohort retrospektif pada anak (umur 2 bulan sampai 5 tahun) yang dirawat di RSUP Dr. Sardjito dengan pneumoniaÂ sejak Januari 2009 sampai Desember 2014. Anak dengan rekam medis tidak lengkap atau dengan infeksi HIV dieksklusi. DigunakanÂ metode Spiegelhalter Knill-Jones untuk penyusunan skor kematian. Prediktor kematian dengan likelihood ratio (LHR) â‰¤0,5 atau â‰¥2Â dimasukkan dalam sistem skor. Cut off point dari skor total ditentukan dengan kurva receiver operating characteristic (ROC).Hasil. Di antara 225 anak yang memenuhi kriteria, 42 (18,7%) meninggal. Prediktor kematian yang memenuhi kriteria LHR adalahÂ usia <6 bulan (LHR 2,05), takikardia (LHR 2,11), saturasi oksigen (SpO2) <92% (LHR 2,54), anemia (LHR 0,38) dan leukositosisÂ (LHR 2,04). Skor prediksi kematian terdiri atas usia (skor=5 bila usia <6 bulan dan 0 bila >6 bulan); frekuensi nadi skor=6 bilaÂ takikardia dan -8 bila normal); saturasi oksigen (skor=3 bila SpO2 <92% dan 0 bila SpO2 >92%); hemoglobin (skor=4 bila anemiaÂ dan -6 bila normal), leukosit (skor=3 bila leukosit dan 0 bila normal). Total skor >3 Mempunyai sensitivitas dan spesifitas terbaik,Â yaitu 85,7% dan 72,1%.Kesimpulan. Skor prediksi kematian pneumonia >3 dapat digunakan untuk memprediksi kematian pada anak dengan pneumonia.

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