Background Although vaccination programs have succeeded in reducing the incidence of diphtheria, it remains a health problem in Asia, including Indonesia. Objective To investigate the clinical spectrum and outcomes of pediatric diphtheria in Wahidin Sudirohusodo Hospital. Methods This study was a retrospective review of childhood diphtheria medical records from January 2011 to December 2017 in Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Recorded data consisted of age, gender, nutritional and immunization statuses, signs and symptoms, throat swab culture results, complications, and outcomes.    Results Of 28 subjects aged 9 months to 17.10 years, the majority were >5 years (57.1%) and male (60.7%). Subjects’ mean age was 6.15 years and 82.1% of cases were well nourished. Overall, 85.7% had received complete immunizations, while 14.3% were not immunized, having received neither basic nor booster vaccines. The presenting manifestations were fever, pseudomembranes, and sore throat in all subjects, enlarged tonsils (78.57%), dysphagia (67.86%), cough (57.14%), headache (57.14%), hoarseness (67.86%), bull neck (25%), and myocarditis (14.3%). Most subjects had hospital stays of >10 days (67.9%). Mortality was 14.3%, usually in those admitted with a late, deteriorating condition and dying before getting optimal treatment. Poor outcome was significantly associated with the lack of basic or booster immunizations, poor nourishment, bull neck, myocarditis, and hospital stays < 5 days (P<0.05 for all).  Conclusion The clinical spectrum and outcomes of pediatric diphtheria in this study are relatively similar to reports from other hospitals. Mortality was mostly in patients who lack basic or booster immunizations, are poorly nourished, or have bull neck, myocarditis, or hospital stays < 5 days.

Purpose: To analyze risk factors and various nutrients associated with stunting among children aged 6-60 months. Methods: This is a case-control and cross-sectional study between 40 stunting cases and 40 controls. Data on possible risk factors associated with stunting were obtained through direct interviews and using a questionnaire. Examination of vitamin D, zinc, albumin, and ferritin levels was performed on both groups. Data were analyzed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Co., Armonk, NY, USA) to determine risk factors for stunting and to assess the relationship between nutritional levels and stunting. Results: The incidence of stunting was highest in children aged 12-36 months. Children with low weight and very low weight for age comprised of 55% and 22.5%, respectively, of the study participants. The highest mother's educational level was junior high school (40%). History of low birth weight (LBW) was more commonly observed in the stunting group than that in the control group (25.0% and 7.5%, respectively; p=0.034, odds ratio, 0.310 [95% confidence interval, 0.122-0.789]). Approximately 7.5% of cases had premature birth. Exclusive breast feeding was found to be not correlated with stunting. The mean zinc level in the stunting group was 34.17 ng/mL, which was different from that in the control group (50.83 ng/mL) (p=0.023). Blood ferritin, vitamin D, albumin, and calcium levels were not strongly correlated with stunting. Conclusion: LBW is the main risk factor contributing to stunting and is strongly associated with low zinc level.

Joint United Nations Programme in HIV/AIDS (UNAIDS) reported that 1.8 million children under 15 years old had HIV with 150,000 new pediatric cases in 2015, and only 49% had an antiretroviral (ARV) therapy. Mortality in HIV-infected children with severe acute malnutrition was 30.4% in Africa. A 1-year and 8-months-old girl was hospitalized due to diarrhea, vomiting, oral thrush, and recurrent fever before admission. She has been hospitalized for HIV infection one month ago and treated with ARV. Her mother was treated with ARV before. Physical examination showed a severely ill, poorly nourished, stunting, and conscious child with normal vital signs. There was oral thrush. The evidence of nutritional marasmus was old man face, piano sign, wasting, and baggy pants. Laboratory findings revealed anemia, positive antigen and antibody of HIV infection, and low Cluster of Differentiation 4 (CD4). She was treated with ARV, Cotrimoxazole, and management of malnutrition and diarrhea. The prognosis of the patient was poor. A 1-year and 8-months-old girl with HIV infection complicated with severe acute malnutrition, acute diarrhea, oral thrush, and anemia of chronic disease were reported. The diagnosis was based on clinical and laboratory findings. Management focused on the therapy of HIV and accompanying illness. The prognosis was poor.

Background: Dengue hemorrhagic fever (DHF) is still periodically around developing countries including Indonesia. Morbidity and mortality of DHF can be reduced if early diagnosis and appropriate management. Objective: Our study evaluate risk factors of death in pediatric DHF patients hospitalized in Wahidin Sudirohusodo Hospital Makassar. Methods:  we review the medical records of patients aged ≤ 18 years from January 2016 to December 2018 with confirmed DHF  based on WHO criteria and serologically positive anti-dengue Ig M or positive anti-dengue IgM and Ig G. Results: During the study period, 70 patients aged 1-17 years with the complete medical records enrolled in this study.  The DHF severity consisted of 37 cases (52,9%) with shock(DSS) and 33 cases (41,7%) without shock and  mostly of them was  admitted to the hospital on > 3 days of fever (63 cases /90,0%). Boys were predominantly (39/55,7%) found than girls (31/44,3%) and the majority of cases above 5 years (50/71,4%) with well-nourished patients in 46 cases (65,7%).  The hematocrit level ≥ 40 mg/dl, platelets ≤ 40.000/mm3, and leukocyte ≤ 4000 mm3/l were observed in 41 cases (58,6%), 36 cases (51,4%), and  48 cases (68,6%); respectively. Death was observed in four girls (5.7%) (p 0,034/OR 1,148/ 95% CI 1,003 - 1,315) with DSS because of  severe condition on admission. Conclusions: Girl was an  independent risk factor of death among children with DHF.