Hasil Pencarian  ::  Simpan CSV :: Kembali

"ABSTRAKRuang Lingkup dan Cara Penelitian: Akhir-akhir ini banyak dilaporkan tentang kasus diare non spesifik oleh sejawat yang bekerja di klinik. Hal ini mungkin disebabkan oleh adanya infeksi saluran cerna oleh kuman tertentu yang tidak dapat diisolasi dengan prosedur yang lazim dilakukan untuk isolasi dan identifikasi kuman usus patogen aerob. Sejak berkembangnya teknik isolasi dan identifikasi kuman anaerob dan mikroaerofilik yang pesat pada awal tahun 70-an, maka kuman penyebab diare yang dapat diisolasi tidak terbatas pada kuman aerob raja, melainkan juga kuman usus anaerob dan mikroaerofilik. Kuman usus mikroaerofilik (Campylobacter jejuni) yang menimbulkan gangguan pada saluran cerna manusia memberikan gejala klinik yang mirip dengan infeksi kuman usus lainnya. Di berbagai negara C. jejuni merupakan penyebab infeksi saluran cerna pada manusia, dan frekuensinya lebih tinggi dibandingkan dengan frekuensi infeksi oleh Salmonella dan Shigella atau keduanya bersama-sama. Untuk menegakkan diagnosis mikrobiologik infeksi saluran cerna oleh C. jejuni, diperlukan isolasi dan identifikasi dengan cara yang spesifik. Sehubungan dengan permasalahan tersebut di atas, telah dilakukan kerjasama dengan Bagian Anak RSCM/FKUI untuk melakukan pemeriksaan tinja 50 penderita diare akut. Bahan pemeriksaan berupa tinja penderita yang diperoleh dengan rectal toucher. Setiap bahan pemeriksaan dibiak pada agar Campi BAP dalam sui,san mikroaerofilik, pada suhu 42 °C. Teknik isolasi dan identif. ntuk Campylobacter jejuni menurut Skirrow yang telah diuji oleh WHO Scientific Working Group.Hasil dan Resimpulan: Dari 50 anak pria dan wanita yang dirawat di Bagian Anak RSCM 1 FKUI dengan diare akut, berhasil diisolasi 3 (6%) Campylobacter jejuni. Dalam penelitisan ini, peneliti belum berhasil menemukan adanya Campylobacter jejuni dalam bahan pemeriksaan dengan metoda pewarnaan sediaan langsung dari tinja penderita, seperti yang dikemukakan oleh beberapa peneliti di luar negeri.

---

ABSTRACT

Scope and Method of Study: Recently there are so many cases of non specific diarrhea reported from the colleagues who works on clinical wards. This could happen because there are some kind of microorganism that infected the alimentary tract not possible to isolate by the common procedure usually used to isolate the Enterobacteriaceae. Since the development of anaerobic and microaerophylic isolation and identification techniques in 1970, the diarrhea causing microorganisms that can be isolated not only the aerobic but also the anaerobic and microaerophylic enteric microorganisms. The microaerophylic enteric microorganism (Campylobacter jejuni) that infected the alimentary tract has clinical symptom resemble to another enteric microorganisms infections. In several countries Campylobacter jejuni causing alimentary tract infection more frequent than Salmonella and Shigella or both. To diagnose the Campylobacter jejuni causing diarrhea], need a specific microbiological procedure. According to that problem, joint cooperation had been carried out with the Department of Pediatric RSCM/FKUI to examine 50 children who suffered from acute diarrhea. The specimen to examine is the excrement of the sufferer obtained by rectal toucher. Each specimen inoculated on Campi BAP and incubated in microaerophylic atmosphere at 42°C. Skirrow's technique modified by WHO Scientific Working Group had been used to isolate and identify Campylobacter jejuni.

Findings and Conclusions: Campylobacter jejuni had been isolated in 6% out for 50 boys and girls who suffer acute diarrhea being treated in the Department of Pediatric RSCM/FKUI. In this case we could not find Campylobacter jejuni by direct excrement staining method, as reported by others abroad."

"Latar belakang: Diare akut masih merupakan masalah kesehatan yang penting dengan angka morbiditas dan mortalitas yang cukup tinggi. Virus merupakan penyebab tersering diare akut pada anak. Diare akut akibat virus akan menyembuh sendiri dan tidak membutuhkan terapi antibiotik. Namun, data dari Kemenkes Indonesia menyebutkan bahwa 85 pasien dengan diare di Jakarta diobati dengan antibiotik. Sampai saat ini, penelitian prevalens dan manifestasi klinis tentang diare akut akibat virus selain rotavirus masih jarang dilakukan. Penelitian tentang prevalens dan gambaran klinis diare akibat virus rotavirus, adenovirus, norovirus dan astrovirus belum pernah dilakukan di Indonesia.Tujuan: Mengetahui proporsi dan manifestasi klinis diare akut yang disebabkan oleh rotavirus, norovirus, adenovirus, dan astrovirus pada anak.Metode: Studi potong lintang dilakukan di RSCM dan RSUD Budhi Asih Jakarta, sejak Februari hingga September 2017. Penelitian melibatkan 100 orang anak berusia 6-36 bulan yang datang dengan keluhan diare akut. Spesimen tinja diperiksa menggunakan rapid test CerTest untuk mendeteksi adanya rotavirus, adenovirus, norovirus dan astrovirus, kemudian dilakukan pemeriksaan analisis tinja untuk menilai terjadinya intoleransi laktosa.Hasil: Diare akut akibat virus didapatkan pada 36 dari 100 anak, terdiri dari rotavirus 74,3 sebagai penyebab tersering, diikuti adenovirus 17,9 , norovirus 5,1 dan astrovirus 2,6 . Tiga spesimen ditemukan terdapat koinfeksi 2 virus. Diare akut akibat virus lebih sering terjadi pada anak berusia kurang dari 24 bulan 73,2 , dan 55,6 diantaranya mengalami gizi kurang. Laki-laki lebih banyak terinfeksi sebesar 1,5 kali dibandingkan perempuan. Muntah merupakan gejala yang bermakna secara statistik terkait diare akut akibat virus ini 66,7 ; p=0,045 . Manifestasi klinis lainnya yaitu diare lebih dari 10 kali per hari 58,3 , dehidrasi 68,8 , batuk 66,7 , pilek 77,8 , demam 88,6 , dan warna tinja kuning hijau 44,4 . Analisis tinja menunjukkan tidak terdapat hubungan yang bermakna secara statistik antara diare akut akibat virus dengan terjadinya intoleransi laktosa pH.

---

Background Acute diarrhea remains a major cause of morbidity and mortality in Indonesia and worldwide. Virus is the most common cause of acute diarrhea in children. Viral acute diarrhea is usually self limited, and does not require antibiotic therapy. However, data from Ministry of Health Indonesia reported that 85 of patients with diarrhea in Jakarta are treated with antibiotics. Data on the prevalence and clinical manifestations of viral acute diarrhea other than rotavirus are still limited. Research on prevalence and clinical features of viral diarrhea rotavirus, adenovirus, norovirus and astrovirus has not been done in Indonesia.

Objective To know the prevalence of acute diarrhea caused by virus in children and its clinical manifestations.

Methods A cross sectional study was conducted at Cipto Mangunkusumo Hospital and Budhi Asih Hospital from February to September 2017. A total of 100 stool specimens were collected from patients aged 6 36 months with acute diarrhea and tested for rotavirus, adenovirus, norovirus and astrovirus by rapid test and then performed for stool analysis.

Results Of the 100 specimens, 36 36 were found to be positive for virus causing diarrhea. Rotavirus 74.3 was the most frequently detected, followed by adenovirus 17.9 , norovirus 5.1 and astrovirus 2.6 . Three specimens were found positive by two viruses. Viral diarrhea was seen in 73.2 of children aged under 24 months, of whom 55.6 of them were undernourished. Males were affected 1.5 times as much as females. Vomiting was significantly associated with viral acute diarhhea 66.7 p 0.045 . Other clinical manifestations were passage of diarrheic stools more than 10 times a day 58.3 , dehydration 68.8 , cough 66.7 , rhinorhea 77.8 , fever 80.6 , and yellow greenish stools 44.4 . Stool analysis revealed that there was no statistically significant association between viral diarrhea and lactose intolerance pH"

"Diare merupakan masalah global karena menyebabkan tingginya angka kesakitan dan kematian pada bayi dan anak. Diare yang belangsung 7 - 13 hari disebut diare melanjut, dan akan meningkatkan risiko terjadinya diare persisten 6 kali lebih tinggi.Penelitian ini bertujuan untuk mengkaji faktor-faktor risiko terjadinya diare melanjut pada anak < 2 tahun, membuat dan menerapkan sistem skor untuk memprediksi kejadian diare melanjut, dan mengetahui apakah faktor etiologi diare persisten telah ditemukan pada diare melanjut.Suatu penelitian operasional dengan rancangan nested case control, pada anak < 2 tahun dengan diare akut yang dirawat di ruang rawat inap RSUP Fatmawati. Subjek direkrut dengan metode consecutive sampling pada September 2015 - Maret 2016. Subjek dieksklusi bila mendapat pengobatan imunosupresi, menderita HIV, penyakit metabolik, penyakit keganasan, mengalami disentri, mengalami diare saat dirawat di rumah sakit, ada penyakit penyerta, dan subjek pasca mengalami operasi pada organ saluran cerna. Evaluasi luaran penelitian dilakukan sejak subjek masuk perawatan di rumah sakit sampai subjek pulang rawat.Sebanyak 62 subjek untuk tiap kelompok kasus dan kontrol mengikuti penelitian. Seluruh faktor risiko dianalisis secara bivariat dan multivariat regresi logistik. Faktor risiko terjadinya diare melanjut yang didapatkan adalah riwayat penggunaan antibiotik, defisiensi seng, leukosit tinja, peningkatan kadar AAT tinja dan malnutrisi. Model skor prediksi diare melanjut terdiri dari 2 model. Model 2 lebih dapat diterapkan di fasilitas kesehatan primer. Sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, rasio kemungkinan positif, dan rasio kemungkinan negatif dari validasi skoring model 2 berturut-turut adalah 73, 95, 94, 76, 14,6, dan 0,28. Area di bawah kurva ROC pada validasi 0,898. Faktor etiologi diare persisten telah ditemukan pada diare melanjut intoleransi laktosa, malabsorpsi lemak, dan infeksi Clostridium difficile .Sebagai simpulan, faktor risiko terjadinya diare melanjut pada anak < 2 tahun dengan diare akut yang berperan paling bermakna adalah riwayat penggunaan antibiotik, defisiensi seng, leukosit tinja, peningkatan kadar AAT tinja dan malnutrisi. Selain itu, faktor etiologi diare persisten telah ditemukan pada diare melanjut, dan model skor yang dibuat dapat dipertimbangkan digunakan dalam praktek klinik sehari-hari.

---

Diarrhea has been a global problem since it has high morbidity and mortality rate in infants and children. Diarrhea lasting for 7 ndash 13 days is called prolonged diarrhea, and the risk of progressing into persistent diarrhea will be 6 times higher. The aim of this study was to assess the risk factors for prolonged diarrhea in children below 2 years old, to establish and apply a scoring system to predict the occurence of prolonged diarrhea, and to determine whether the etiologic factor of persistent diarrhea have already been found in prolonged diarrhea. An operational study with a nested case control design, in children 2 years old with acute diarrhea hospitalized in the inpatient wards of Fatmawati Hospital. Subjects were recruited using the consecutive sampling method from September 2015 to March 2016. Subjects were excluded when they were receiving immunosupressive treatment, suffering from HIV, metabolic disease, malignancy, dysentery, just had diarrhea during hospitalization, comorbidities, and had underwent digestive surgery. Evaluation of the research outcome was started when the subject admitted to the hospital until the subject being discharged. The number of subjects included was 62 for each case and control group. All risk factors were analyzed using bivariate and multivariate logistic regression. We found that the risk factors for the occurrence of prolonged diarrhea are history of antibiotic use, zinc deficiency, fecal leukocytes, elevated level of stool AAT, and malnutrition. The prolonged diarrhea prediction score model had 2 models. Model 2 is more applicable in primary health care. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of scoring model 2 validation were 73, 95, 94, 76, 14.6, and 0.28 respectively. The area under the ROC curve for validation is 0.898. The etiologic factor of persistent diarrhea have already been found in prolonged diarrhea lactose intolerance, fat malabsorption, Clostridium difficile infection. In conclusion, the most significant risk factors for prolonged diarrhea in children below 2 years old are the history of antibiotic use, zinc deficiency, fecal leukocytes, elevated levels of stool AAT, and malnutrition. In addition, etiologic factors of persistent diarrhea have already been found in prolonged diarrhea and scoring model can be considered be used in daily clinical practice. "

"ABSTRAKPenelitian ini bertujuan untuk mengetahui implementasi clinical pathway pada kasus diare akut dengan proses audit. Jenis penelitian ini adalah kuantitatif dan kualitatif dengan menggunaan konsep operational research dengan metode telaah dokumen, telaah data dan wawancara mendalam. Hasil penelitian didapatkan topik audit adalah implementasi clinical pathway diare akut dengan tujuan menilai kelengkapan pengisian clinical pathway, kepatuhan DPJP, PPJP, Gizi dan Farmasi serta menilai kesesuaian lama hari rawat dengan clinical pathway. Standar penilaian yang digunakan adalah standar nasional yaitu KARS. Hasil pengukuran menunjukkan bahwa kelengkapan pengisian clinical pathway 25 , tidak ditemukan variasi pada pemeriksaan laboratorium, asuhan nutrisi dan asuhan keperawatan, namun pada tata lakasana diare akut masih ditemukan variasi pada obat tambahan sebesar 41 , dan lama hari rawat sudah sesuai yaitu 3,3 hari. Beberapa hal yang perlu rumah sakit lakukan adalah mengembangkan kebijakan terkait clinical pathway, memperbaiki formulir clinical pathway dan sistem sosialisasi, membuat petunjuk teknis clinical pathway, sistem monitoring dan evaluasi, serta menurukan standar lama hari rawat dan diskusi terkait variasi terapi.

---

ABSTRACTThis study aims to determine the implementation of clinical pathway of acute diarrhea with the audit process. This type of research is quantitative and qualitative by using operational research concept with document review method, data analysis and in depth interview. The result of the research shows that the audit topic is the implementation of clinical pathway of acute diarrhea with the aim to assessing completeness of clinical pathway, compliance of primary responsible physician, primary responsible nurse, nutrition and pharmacy and assessing the length of stay with clinical pathway. Assessment standard used is the national standard that is KARS. The result of measurement showed that completeness of filling clinical pathway 25 , no variation on laboratory examination, nutrition and nursing care, but still found variation on additional drug 41 , and length of stay was 3.3 day. Some things that hospital need to do is developed policies related to clinical pathway, improve clinical pathway forms and socialization systems, make clinical pathway technical guidance, monitoring and evaluation systems, and reduce standards length of stay and discussion of variations in therapy."

"Diare merupakan penyebab utama kematian balita usia di bawah 5 tahun di Indonesia. Mikroorganisrne penyebab utama sebagian besar penderita diare akut adalah rotavirus. Diare akut dapat menyebabkan kematian dikarenakan keparahan gejala klinis yang dialami penderita seperti dehidrasi, muntah dan demam. Penelitian ini bertujuan untuk memprediksi gejala klinis terhadap penyebab diare akut rotavirus di Kota Mataram tahun 2009. Metode penelitian yang digunakan adalah kuantitatif dengan disain studi cross sectional. Hasil penelitian menunjukan faktor gejala klinis yang paling dominan dalam memprediksi penyebab diare akut rotavirus adalah dehidrasi, muntah dan demam. Umur merupakan faktor resiko yang rnempengaruhi kejadian diare akut rotavirus. Uji diagnostik gejala klinis diare akut rotavirus terhadap gold standar PCR rotavirus menunjukan bahwa pada balita yang mengalami diare dengan penyebab rotavirus dan berumur 1-5 bulan 81 % dapat diprediksi melalui gejala klinis demam (sensitivitas 81%). Sedangkan untuk balita yang mengalami diare akut dengan penyebab rotavirus dan berumur 6 -11 bulan 83% (sensitivitas 83%) dapat diprediksi melalui gejala klinis muntah. Sedangkan kombinasi gejala klinis balita yang mengalami diare akut dengan penyebab rotavirus dan berumur 6 - 11 bulan 79 % (sensitivitas 79%) dapat dideteksi melalui kombinasi gejala klinis dehidrasi dan muntah. Kesimpulan: gejala klinis dehidrasi, muntah dan demam dapat memprediksi diare akut rotavirus.

---

Diarrhea is a major cause of death of children under 5 years in Indonesia. The main microorganisms that cause acute diarrhea is rotavirus. The death of patients with acute diarrhea is due to the severity of clinical symptoms such as dehydration, vomiting and fever. This aim of this studyis to predict the clinical symptoms related with acute diarrhea which rotavirus as a single causative agent. Population of this study were acute diarrheal patients from Mataram in 2009. The research method used was quantitative with a cross sectional study design.

The results showed that clinical factors which can be used to predict that rotavirus as a causative agent are dehydration, vomiting and fever. Age is a risk factor affecting the incidence of acute rotavirus diarrhea. Diagnostic test of clinical symptoms and the gold standard PCR showed that 81% cases of rotavirus diarrhea on infant aged 1-5 months can be predicted by clinical symptoms of fever. As for the toddler who suffered from acute diarrhea by rotavirus (age 6 -11 months), 83% cases can be predicted by clinical symptoms of vomiting. Moreover, the combination of clinical symptoms (dehydration and vomiting) could detect 79% infants (6-11 months) who had acute rotavirus diarrhea.

Conclusion: The clinical symptoms of dehydration, vomiting and fever can be used to predict acute rotavirus diarrhea."

"Diarrhea poses significant health risks in developing countries like Indonesia, especially among children, contributing to high morbidity and mortality rates according to the 2018 World Health Organization report. The escalating antimicrobial resistance among enteric pathogens in these nations is also a critical concern. The aim of this research is to profile Gram-negative bacteria in pediatric patients with diarrheal conditions and analyze the antibacterial gene resistance of Gram-negative bacteria in these patients. Stool samples were cultured and sent to the FKUI Microbiology Laboratory for DNA isolation. Pathogenic Gram-negative bacteria were identified and sequenced at the Bioinformatics Core Facilities at IMERI-FKUI using Next-Generation Sequencing (NGS). Antibiotic resistance to antibiotics such as cefixime, co-trimoxazole, ciprofloxacin, and carbapenem was determined. Eighteen bacterial samples revealed a diverse landscape of Klebsiella pneumoniae and E. coli strains. Klebsiella pneumoniae predominated (56%), with various Sequence Types (STs) and phylotypes identified. Notably, ST-231 and ST-101 were associated with the K1 phylotype, indicating potential virulence. E. coli (44% of samples) showed a spectrum of pathogenicity, including ExPEC as the most prevalent. Virulence gene analysis highlighted complex pathogenic mechanisms and significant antibiotic resistance, especially in E. coli. K. pneumoniae and E. coli isolates showed high resistance to multiple antibiotics, including fluoroquinolones, fosfomycin, aminoglycosides, and beta-lactams. This research enhances the understanding of gastrointestinal health in children and underscores the urgent need for effective antimicrobial stewardship to combat antimicrobial resistance."

"ABSTRAKLatar belakang: Diare akut merupakan masalah kesehatan yang penting dengan morbiditas dan mortalitas yang cukup tinggi. Perubahan komposisi mikrobiota usus pada diare akut ditandai dengan menurunnya komposisi bakteri yang menguntungkan bagi tubuh, yaitu Bifidobacterium dan Lactobacillus, dan peningkatan bakteri patogen seperti Enterobacter dan Clostridium. Kondisi ini disebut disbiosis. Pemberian probiotik pada kasus diare akut dapat mengatasi disbiosis, mempercepat masa penyembuhan, dan mengurangi komplikasi. Sampai saat ini, belum terdapat penelitian di Indonesia mengenai pemberian probiotik untuk mengatasi disbiosis pada diare akut. Tujuan: Membuktikan bahwa terjadi disbiosis pada diare akut, yang dapat diseimbangkan dengan pemberian probiotik. Metode: Studi uji klinis, kontrol plasebo, dilakukan di RSUD Budhi Asih Jakarta, sejak Januari hingga Maret 2018. Penelitian melibatkan 36 orang anak berusia 6-48 bulan yang datang dengan keluhan diare akut. Spesimen tinja diperiksa menggunakan teknik non culture real time PCR untuk mendeteksi jumlah Lactobacillus, Bifidobacterium, Enterobacter, Clostridium dan all bacteria, kemudian dilakukan pemberian probiotik atau plasebo selama 5 hari, kemudian dilakukan pemeriksaan mikrobiota kembali 2-3 minggu kemudian. Hasil: Jumlah bakteri Lactobacillus lebih tinggi pada kelompok diare akut dibandingkan anak sehat yaitu dalam median jarak interkuartil : 1,52x103 1,22x104 vs 6,87x10 2,41x102 p

---

ABSTRACTBackground Acute diarrhea is an important health problem with high morbidity and mortality. During acute diarrhea, changes in gut microbiota is marked by decreased of beneficial microbes such as Bifidobacterium and Lactobacillus, and increase of pathogenic bacteria such as Enterobacter and Clostridium, which is also known as dysbiosis. Treatment with probiotic may help to repair dysbiosis, quickens healing time, and decrease complications. Currently there is no research to investigate dysbiosis in acute diarrhea in Indonesia.Objective To prove that there is dysbiosis during acute diarrhea, and can be normalize by giving probiotic.Methods Placebo controlled, unblinded clinical trial was performed in RSUD Budhi Asih, Jakarta from January until March 2018. 36 children age 6 48 months with acute diarrhea were enrolled. Fecal specimen was taken and analyzed using non culture real time PCR to detect the presence of Lactobacillus, Bifidobacterium, Enterobacter, Clostridium, and all bacteria. Children were then given probiotic or placebo for 5 days. Second fecal sample was taken 2 3 weeks afterwards.Results Higher amount of Lactobacillus are observed in children with acute diarrhea vs healthy control with a median interquartile range 1,52x103 1,22x104 vs 6,87x10 2,41x102 p"

"Latar Belakang. Cairan rehidrasi oral dan zinc telah menjadi terapi standar dalam tata laksana diare akut pada anak. Probiotik sudah digunakan secara luas pada kasus diare akut pada anak meskipun belum direkomendasikan oleh WHO. Penelitian yang membandingkan penambahan probiotik pada terapi standar masih sangat terbatas.Tujuan. Mengetahui efektivitas pemberian suplementasi probiotik pada terapi standar diare akut. Metode. Penelitian uji klinis acak tersamar ganda dilakukan pada anak usia 6 bulan sampai 36 bulan dengan diare akut tanpa dehidrasi dan dehidrasi ringan sedang, yang dilakukan di kelurahan Kenari, Jakarta Pusat antara bulan Oktober 2011 sampai Februari 2012. Kelompok perlakuan diberikan terapi standar ditambah probiotik Lactobacillus rhamnosus R0011 1.9 x 109 cfu dan Lactobacillus acidophilus R0052 0.1 x 109 cfu, sedangkan kelompok kontrol diberikan terapi standar dan plasebo. Luaran yang dinilai adalah durasi diare dan frekuensi defekasi. Penelitian ini bersifat intention to treat analysis. Hasil. Total 112 subjek masuk dalam penelitian, terdiri dari 56 subjek mendapat terapi standar ditambah probiotik, dan 56 subjek hanya terapi standar. Median lama durasi diare setelah terapi pada kelompok perlakuan yaitu 68,5 jam sedangkan pada kelompok kontrol 61,5 jam (p=0,596). Median frekuensi defekasi pada kelompok perlakuan yaitu 5 kali, sedangkan pada kelompok kontrol 5,5 kali (p=0,795). Simpulan. Pada penelitian ini tidak ditemukan penurunan durasi diare dengan penambahan probiotik pada terapi standar. Meskipun kelompok perlakuan memiliki frekuensi defekasi yang lebih sedikit dibandingkan dengan kelompok kontrol, namun perbedaan tersebut tidak bermakna.

---

Background. Oral rehydration solution and zinc have been used as standard therapy for treating acute diarrhea in children. Probiotics are widely used in treatment of acute diarrhea in children, although it has not been recommended by WHO. Studies comparing supplementation of probiotics to standard therapy are still limited.

Objectives. To know the efficacy of probiotic supplementation to standard therapy in acute diarrhea.

Methods. A randomized double blind clinical trial was performed in children aged 6-36 months with acute diarrhea without dehydration or mild to moderate dehydration in Kenari sub district, central Jakarta, between October 2011 until Februari 2012. Supplemented group was given standard therapy and probiotics Lactobacillus rhamnosus R0011 1.9 x 109 cfu and Lactobacillus acidophilus R0052 0.1 x 109 cfu, while control group was given standard therapy and placebo. The outcomes were duration of diarrhea and frequency of defecation. Stool frequency was recorded daily until resolution of diarrhea. The analysis was based on intention to treat.

Results. A total of 112 subjects were included in the study, consisted of 56 subjects in supplemented group and 56 subjects in control group. Median duration of diarrhea in supplemented group was 68,5 hours while in the control group was 61,5 hours (p=0,596). Median frequency of defecation in supplemented group was 5 times, while in the control group was 5,5 times (p=0,795).

Conclusion. This study did not find shorter duration of diarrhea with supplementation of probiotics to standard therapy. Although supplemented group had lower frequency of defecation compared to control group, the difference was not significant."

"Latar belakang. Diare masih merupakan penyebab morbiditas dan mortalitas yang cukup tinggi pada anak, dan efeknya akan meningkat pada diare melanjut. Eksresi yang meningkat dan malnutrisi menimbulkan defisiensi makro dan mikronutrien, zinc salah satunya. Defisiensi zinc merupakan masalah global terutama di negara berkembang. Tujuan. Penelitian ini bertujuan untuk mengetahui apakah defisiensi zinc sebagai faktor risiko diare akut menjadi diare melanjut. Metode. Penelitian ini merupakan uji potong lintang dan kohort yang dilakukan di RSCM, dan tiga rumah sakit umum daerah pada anak usia > 1 bulan - 60 bulan. Kriteria inklusi meliputi pasien dengan diare akut kurang 7 hari. Kriteria eksklusi meliputi gizi buruk, diare berdarah dan subjek dengan penyakit penyerta dan keganasan. Pengumpulan sampel darah untuk pemeriksaan kadar zinc serum. Hasil. Sembilan puluh sembilan subjek dilakukan analisis. Usia terbanyak adalah 12-36 bulan, dengan lelaki berbanding perempuan 1,3:1. Lebih dari 90% pendidikan ibu adalah rendah dan pendapatan orangtua 90,0% rendah. Prevalens defisiensi zinc adalah 20,2%. Tidak terdapat hubungan antara defisiensi zinc dengan usia, status nutrisi, riwayat diare berulang, pendidikan ibu dan pendapatan orangtua. Insidens diare melanjut sebesar 25,3%. Defisiensi zinc bukan merupakan faktor risiko diare akut menjadi diare melanjut RR 1,82 (IK 95% 0,633-5,260) dengan p 0,261. Riwayat diare berulang merupakan faktor risiko diare akut menjadi diare melanjut RR 3,4 kali (IK95% 1,3-9,5 dengan p 0,013). Simpulan. Defisiensi zinc bukan merupakan faktor risiko diare akut menjadi diare melanjut. Riwayat diare berulang berisiko untuk terjadinya diare akut menjadi diare melanjut.

---

Background. Acute diarrhea is one of the causes of high morbidity and mortality in children, and its morbidity and mortality is increasing in prolonged diarrhea. Prolonged diarrhea might continue to persistent diarrhea and malnutrition due to macro- and micronutrient deficiency, such as zinc. Recently, zinc deficiency has become a global health problem in developing countries, such like Indonesia.

Objectives. This study aimed to identify whether zinc deficiency is one of risk factors of prolonged diarrhea and to evaluate the level of zinc in prolonged diarrhea compare to acute diarrhea.

Method. This study is a cross-sectional and cohort studies, underwent at Cipto Mangunkusumo Hospital and three other general hospitals in West Java. The study was performed in children aged > 1 month – 60 months old. The inclusion criteria were acute diarrhea less than 7 days. The exclusion criteria were severe malnutrition, bloody diarrhea and subjects having concomitant diseases. Blood samples were withdrawn for serum zinc measurement.

Results. There were ninety-nine subjects participated in this study. The majority subjects aged 12-36 months old, with boy:girl ratio = 1.3:1. More than 90% subjects had low educated mothers and came from low income families (90.0%). The prevalence of zinc deficiency in this study was 20.2%. There were no correlation between zinc deficiency and age, nutritional status, recurrent diarrhea, mother's education level, and family income. The incidence of prolonged diarrhea was 25.3%. Zinc deficiency was not a risk factor for prolonged diarrhea [RR 1.82 (95%CI 0.633-5.260), p=0.261]. The history of recurrent diarrhea was a risk factor for prolonged diarrhea [RR 3,4 (95%CI 1.3-9.5, p=0.013)].

Conclusion. In this study, zinc deficiency was not the risk factor for prolonged diarrhea. History of recurrent diarrhea was the risk factor for prolonged diarrhea."