Background: Although survival rates for retinoblastoma (RB) are over 95% in high-income countries, its high mortality rate in low and middle-income countries remains a great concern. Few studies investigated treatment outcome and factors contributing to RB survival in these latter settings. Aims of this study are to determine treatment outcome of Indonesian children diagnosed with RB and to explore factors predictive of treatment outcome. Methods: This study was a retrospective medical records review combined with an illustrative case report. Children newly diagnosed with RB between January 2011 and December 2016 at a tertiary care referral hospital in Indonesia were included. A home visit was conducted to perform an in-depth interview with a mother of two children affected by RB. Results: Of all 61 children with RB, 39% abandoned treatment, 21% died, 20% had progressive or relapsed disease and 20% event-free survival. Progressive or relapsed disease was more common in older (2 years at diagnosis, 29%) than young (<2 years at diagnosis, 0%) children (P=0.012). Event-free survival estimate at 5 years was higher in young (42%) than older (6%) children (P=0.045). Odds-ratio for event-free survival was 6.9 (95% CI: 1.747 -27.328, P=0.006) for young versus older children. Other clinical and socio-demographic characteristics had no significant correlation with treatment outcome or event-free survival. The case report elucidated conditions and obstacles that Indonesian families face when their children are diagnosed with RB. Conclusion: Survival of children with RB in Indonesia is much lower compared to high-income and many other low and middle-income countries. Abandonment of treatment is the most common cause of treatment failure. Older age at diagnosis is associated with more progressive or relapsed disease and worse survival. Interventions to improve general public and health-care providers' awareness, early detection and treatment adherence are required.

Background: Starting from 2014, the Indonesian government has implemented Universal Health Coverage (UHC) with the aim to make healthcare services accessible and affordable to all Indonesian citizens. A major reason for childhood cancer treatment failure in low-and middle-income countries, particularly among families with low socioeconomic status (SES), is abandonment of expensive cancer treatment. Our study compared childhood cancer treatment outcomes of the overall, low, and high SES population before and after introduction of UHC at a large Indonesian academic hospital.Methods: Medical records of 1040 patients diagnosed with childhood cancer before (2011-2013, n = 506) and after (2014-2016, n = 534) introduction of UHC were abstracted retrospectively. Data on treatment outcome, SES, and health-insurance status at diagnosis were obtained.

Various factors associated with Acute Respiratory Infections (ARI) in toddlers have been widely observed, but there are no studies using data from the Sleman Health and Demographic Surveillance System (HDSS). This study aimed to determine the factors associated with ARI in children under five in Sleman, Yogyakarta, Indonesia. This research was an observational analytic study with a cross-sectional design, using secondary data from the Sleman HDSS. Data of 463 children under five who met the inclusion and exclusion criteria were used in this study. Inclusion criteria were toddlers who have complete observed variable data. The variables observed were the characteristics of children under five, the attributes of the mother, the physical condition of the house, the use of mosquito coils, sanitation facilities, and sources of drinking water. The exclusion criteria were toddlers with pulmonary tuberculosis in the past year. Data analysis used chi-squared tests for bivariate analysis and multivariate logistic regression analysis. The results showed that working mothers had a greater risk of ARI under five children with OR 1.46 (95% CI = 1.01–2.11), and groundwater as a water source was a protective factor against the occurrence of ARI in toddlers with OR 0.46 (95% CI = 0.26–0.81). After a logistic regression analysis was performed, only the drinking water source variable had a statistically significant relationship with the incidence of ARI in children under five with OR = 0.47 (95% CI = 0.268–0.827). Research on the relationship between water quality and the incidence of ARI in children under five is needed to follow up on these findings.

Background Assessing health-related quality of life (HRQOL) and its determinants in children may provide a comprehensive view of child health. The study aimed to assess the HRQOL in Indonesian children and its determinants. Methods We conducted a community-based cross-sectional study in the Sleman District of Yogyakarta Special Province, Indonesia, from August to November 2019. We recruited children aged 2 to 18 years old using the Sleman Health and Demography Surveillance System sample frame. We used the validated Indonesian version of Pediatric Quality of life Inventory™ (Peds QL™) 4.0 Generic core scale, proxy-reports, and self-reports, to assess the HRQOL. Results We recruited 633 proxies and 531 children aged 2–18 years. The mean total score of self-report and proxy-report were 89.9+ 8.5 and 93.3 + 6.4. There was a fair to moderate correlation between self-reports and proxy-reports, with intra-class correlation ranging from 0.34 to 0.47, all p < 0.001. Half of the children (49.4% from proxy-report and 50.1% from self-report) reported having acute illness during the last month. Based on proxy-reports, multivariate regression analysis demonstrated lower HRQOL for children with acute health problems, younger age, history of low birth weight, abnormal delivery, lower fathers’ educational level, and government-paid insurance for low-income families. Conclusion Sociodemographic determinants of a child’s HRQOL, acute health problems, and low birth weight were associated with lower HRQOL in the general pediatric population. In low- and middle-income countries where acute infections and low birth weight are still prevalent, its prevention and appropriate interventions should improve child health.

Introductions Duchenne muscular dystrophy (DMD) is an X-linked recessive progressive muscular disease marked by developmental delays due to mutations in the DMD gene, which encodes dystrophin. Brain comorbidity adds to the burden of limited mobility and significantly impacts patients’ quality of life and their family. The changes of expression of dystrophin isoforms in the brain due to DMD gene mutations are thought to be related to the cognitive and neurobehavior profiles of DMD. Objectives This cross-sectional study aimed to characterize cognitive and neurodevelopmental profiles of patients with DMD and to explore underlying genotype-phenotype associations. Methods Patients with DMD aged 5–18 years from Dr Sardjito Hospital and Universitas Gadjah Mada Academic Hospital from 2017–2022 were included. Multiplex ligation-dependent probe amplification and whole exome sequencing were used to determine mutations in the DMD genes. Cognitive function was measured by intelligence quotient testing using the Wechsler Intelligence Scale for Children and adaptive function tests with Vineland Adaptive Behavior Scales. The Autism Mental Status Exam and Abbreviated Conner’s Rating Scale were used to screen for autism spectrum disorder (ASD) and attention deficit and hyperactivity disorder (ADHD), respectively. Results The mean total IQ score of DMD patients was lower than that of the general population (80.6 ± 22.0 vs 100 ± 15), with intellectual disability observed in 15 boys (29.4%). Of the 51 patients with DMD, the Dp71 group had the lowest cognitive performance with a total IQ score (46 ± 24.8; p = 0.003), while the Dp427 group and Dp140 group’s total IQ scores were 83.0 ± 24.6 and 84.2 ± 17.5 respectively. There were no DMD patients with ASD, while 4 boys (7.8%) had comorbidity with ADHD. Conclusion Boys with DMD are at higher risk of intellectual disability. The risk appears to increase with mutations at the 3’ end of the gene (Dp71 disruption). Moreover, Dp71 disruption might not be associated with ADHD and ASD in patients with DMD.

Latar belakang. Infeksi Cytomegalovirus (CMV) merupakan penyebab tersering infeksi kongenital anak di negara berkembang. Infeksi ini dapat menyebabkan tuli sensorineural (SNHL) dan gangguan perkembangan. Di RSUP dr Sardjito, pasien dengan infeksi CMV aktif bergejala akan menjalani terapi 6 minggu Ganciclovir atau 2 minggu terapi Ganciclovir dilanjutkan 4 minggu terapi Valganciclovir. Namun, luaran terapi tersebut belum diteliti lebih lanjut.Tujuan. Melihat luaran terapi ganciclovir dan atau valganciclovir pada pasien infeksi Cytomegalovirus di Instalasi Kesehatan Anak RSUP Dr Sardjito.Metode. Penelitian ini menggunakan metode kohort retrospektif dari data rekam medis pasien dengan diagnosis infeksi CMV aktif di Instalasi Kesehatan Anak RSUP dr Sardjito periode Januari 2014 sampai dengan April 2018. Variabel luaran (BERA dan Denver II) dibandingkan antara pre dan post terapi ganciclovir. Analisis statistik data dasar menggunakan analsisi deskriptif. Untuk variable luaran menggunakan T test.Hasil. Didapatkan hasil yang signifikan untuk perbaikan fungsi pendengaran pada telinga kanan (p<0,001) dan kiri (p<0,03) dibandingkan dengan yang mengalami perburukan. Sementara untuk perbandingan gangguan perkembangan sebelum dan sesudah terapi ganciclovir tidak berbeda bermakna (p>0,05).Kesimpulan. Pemberian terapi ganciclovir dan valganciclovir dapat memperbaiki fungsi pendengaran (tes BERA), tetapi perbaikan tidak didapatkan pada aspek neurodevelopmental (tes Denver II) dari pasien dengan infeksi CMV.

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Background The coronavirus disease 2019 (COVID-19) pandemic may increase mental health problems due to several pandemic-related stressors. These stressors may arise and become health problems. The study aims to provide evidence of determinants of mental health among adults in Yogyakarta, Indonesia, and examines individual, family, and community factors contributing to adult mental health problems during the COVID-19 pandemic based on gender. Methods A total of 1,328 people (aged 24–59) from Sleman District, Yogyakarta, Indonesia, were involved in this cross-sectional study. We used secondary data from the Sleman HDSS sixth wave’s data collection in 2020. The measurement of mental health was the Self-Reporting Questionnaire (SRQ). The analysis was conducted using chi-square tests and logistic regression. Results This study showed that 21.16% of respondents had a mental health problem. Based on stratified analysis by gender, the highest determinant of mental health in the male population was getting laid off (OR: 10.2; 95% CI: 1.50–70.0), and in the female population, it was having cancer (OR: 9.71; 95% CI: 1.67–56.5). The highest risk factor for the family level was being a woman in the poorest family (OR: 2.74; 95% CI: 1.46–5.11). In addition, at the community level, living in urban areas was protective against mental health problems (OR: 0.59; 95% CI: 0.36–0.97). Conclusions The individual level significantly influences mental health; however, we cannot ignore the contribution of family and community factors to preventing mental health problems in the adult population.