Infant morbidity and mortality rates remain high in Indonesia, with acute respiratory illnesses (ARI) and diarrhea the leading two health problems in children under 5 years. We aimed to describe the nutritional status, feeding practice and case management of ARI and diarrhea of infants from two regions of Indonesia during the first 6 months of life.
This study was an observational study conducted in parallel to an immunogenicity and efficacy trial of an oral rotavirus vaccine (RV3-BB) in the Klaten and Yogyakarta regions, Indonesia. Mothers were interviewed at 3 time points: within the first 6 days of their infant’s life, and at 8–10 and 22–24 weeks of age. Questions asked included pregnancy history, infant nutritional status, feeding status and health of infants within up to 2 weeks prior to the assessment.
Between February 2013 and January 2014, 233 mother-infant pairs were recruited. 60% (136/223) of infants were exclusively breastfed (EBF) until 6 months of age with the strongest support for EBF reported by mothers themselves 70% (101/223) and 25% (36/223) from their partners. At 6 months, 6% (14/223) of infants were underweight and severely underweight; 4% (8/ 223) wasted and severely wasted; and 12% (28/223) were stunted and severely stunted. Non-recommended medication use was high, with 54% (21/39) of infants with reported cough within 2 weeks of an assessment receiving cough medication, 70% (27 /39) an antihistamine, 26% (10/39) a mucolytic and 15% (6 /39) an oral bronchodilator. At age 22–24 week, infants with reported diarrhea within 2 weeks of an assessment had low use of oral rehydration solutions (ORS) (3/21;14%) and zinc therapy (2/ 21;10%).
In this unique observational study, breastfeeding rates of 60% at 6 months were below the Indonesian national target of >75%. Adherence to WHO guidelines for management of ARI and diarrhea was poor, with high use of non-recommended cough medications and oral bronchodilators in the first 6 months of life and low use of ORS and zinc therapy. Ongoing education of primary health care workers and parents regarding management of common illness is needed in Indonesia.
Statistics Indonesia MoHRI. The National Population and family planning board,. Indonesia demographic and health survey 2012. Jakarta: Statistics Indonesia, Ministry of Health Republic Indonesia, The National Population and Family Planning Board; 2012.
Department of Maternal Newborn Child and Adolescent Health (MCA/WHO). Neonatal and child health profile : Indonesia 2013. Available from: http://apps.who.int/iris/bitstream/10665/170250/1/9789240694439_eng.pdf. Accessed 20 Oct 2016.
Black RE, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–87.
Ministry of Health Republic Indonesia. Indonesia health profile 2013. Jakarta: Ministry of Health Republic Indonesia; 2013.
Badan Penelitian Dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar : Riskesdas 2013: Kemenkes RI; 2013.
Hernani S. Agustina T, Sariasih T. Report on situational analysis of acute respiratory infections in children in Indonesia. Jakarta: University of Indonesia; 2009.
Sonego M, Pellegrin M, Becker G, Lazzerini M. Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle- income countries: a systematic review and meta-analysis of observational studies. PLoS One. 2015:1–17.
IDAI. Jadwal imunisasi 2017 2017 [updated 18 April 2017]. Available from: http://www.idai.or.id/artikel/klinik/imunisasi/jadwal-imunisasi-2017. Accessed 28 Apr 2017.
WHO. Unicef. Ending preventable child deaths from pneumonia and Diarrhoea by 2025 : the integrated global action plan for pneumonia and Diarrhoea (GAPPD). France: WHO; 2013.
Mitra AK, Rabbani F. The importance of breastfeeding in minimizing mortality and morbidity from diarrhoeal diseases: the Bangladesh perspective. J Diarrhoeal Dis Res. 1995;13(1):1–7. PubMed
Chirico G, Marzollo R, Corrinovis S, Fonte C, Gasparoni A. Antiinfective properties of human milk. J Nutr. 2008;138:1801S–6S. PubMed
Rowe AK, et al. Deming MS. Management of Childhood Illness at health facilities in Benin: problems and their causes. Am J Public Health. 2001;91(10):1625–35.
Boonstra E, et al. Adherence to management guidelines in acute respiratory infections and diarrhoea in children under 5 years old in primary health care in Botswana. Int J Qual Health Care. 2005;17(3):221–7.
Mary E, Rimsza SN. Unexpected infant deaths associated with use of cough and cold medications. Pediatrics. 2008;5:e318–22.
Richard C, Dart IMP, Randall Bond G, Winston DC, Manoguerra AS, Palmer RB, Kauffman RE, Banner W, Green JL, Rumack BH. Pediatric fatalities associated with over the counter (nonprescription) cough and cold medications. Ann Emerg Med. 2009;53(April 2009):8.
WHO. Pocket book of hospital care for children: guidelines for the Management of Common Childhood Illnesses with limited resources. 2nd ed. Malta: WHO; 2013.
IDAI. Pedoman Pelayanan Medis. IDAI: Jakarta; 2011.
Badan Pusat Statistik. Population density of Jawa Tengah by regency/City 2013 2017 . Available from: https://klatenkab.bps.go.id/subject/153/geografi.html#subjekViewTab3. cited 4 May 2017.
Badan Pusat Statistik. Luas Wilayah, Banyaknya Penduduk dan Kepadatan Penduduk per Km2 menurut Kecamatan di Kabupaten Sleman, 2015 2017 . Available from: https://slemankab.bps.go.id/statictable/2016/10/12/7/banyaknya-penduduk-menurut-jenis-kelamin-dan-sex-rasio-per-kecamatan-di-kabupaten-sleman-2015.html. Accessed 4 May 2017.
Badan Pusat Statistik. Produk Domestik Regional Bruto Per Kapita Atas Dasar Harga Berlaku Menurut Provinsi, 2010–2015 2016. Available from: https://www.bps.go.id/linkTableDinamis/view/id/957. Accessed 25 April 2017.
Indonesian Ministry of National Development Planning (BAPPENAS). Penduduk Miskin dan Indeks Kemiskinan [cited 2017]. Available from: https://data.go.id/dataset/penduduk-miskin-dan-indeks-kemiskinan.
Badan Pusat Statistik. Jumlah Penduduk Miskin, Persentase Penduduk Miskin dan Garis Kemiskinan, 1970–2015 2017 [updated 6 March 2017]. Available from: https://bps.go.id/subject/23/kemiskinan-dan-ketimpangan.html#subjekViewTab3. Accessed 23 May 2017.
Ministry of Health Republic Indonesia. Basic health survey 2013. Jakarta: Ministry of Health Republic Indonesia; 2013.
Kementrian Kesehatan Republik Indonesia. Menuju Masyarakat Sehat yang Mandiri dan Berkeadilan. Kinerjad Dua Tahun kementrian Kesehatan Republik Indonesia. 2009–2011. Jakarta: Kementrian Kesehatan Republik Indonesia; 2011.
(SUN) S. Progress reported through in-country self-assessment exercise. Indonesia: Scalingupnutrition (SUN) organisation; 2015.
IDAI. Diagnosis, Tata Laksana dan Pencegahan Obesitas pada Anak dan Remaja. UKK Nutrisi dan Penyakit Metabolik, editor. IDAI: Jakarta; 2014.
Indonesia Maternal and Child Health Data 2014 . Available from: http://www.countdown2015mnch.org/country-profiles/indonesia. [Accessed 12 Sep 2016].
Ananta Y, Gandaputra E, Waiman E, Partiwi I, Marzuki N, Yohmi E, et al. Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia. Paediatrica Indonesiana. 2016;56(1):24–31. CrossRef
Ministry of Health Republic Indonesia. InfoDATIN Situasi dan Analisis ASI Ekslusif. Jakarta Selatan: Ministry of Health Republic Indonesia; 2014.
Poole S, Gephart S. State of the science for practice to promote breastfeeding success among young mothers. Newborn Infant Nurs Rev. 2014;14:112–8. CrossRef
AAP. FAQs : Breastfeeding initiatives. Available from: http://pediatrics.aappublications.org/content/pediatrics/115/2/496.full.pdf. Accessed 28 April 2017.
Chang AB, Laundau L, Asperen P, Glasgow N, Robertson C, Marchant J, et al. Cough in children: definition and clinical evaluation. Position statement of the Thoracic Society of Australia and new Zealand. Med J Aust. 2006;184:398–403. PubMed
Vernacchio L, Kelly J, Kaufman D, Mitchell A. Cough and cold medication use by US children 1999-2006: results from the Sloan survey. Pediatrics. 2008;122:323–9. CrossRef
Rimza M, Newberry S. Unexpected infant deaths associated with use of cough and cold medications. Pediatrics. 2008;122:e318–22. CrossRef
Gupta P, Aggarwal A, Gupta P, Sharma K. Oral Salbutamol for symptomatic relief in mild Bronchiolitis: a double blind randomised placebo controlled trial. Indian Pediatr. 2008;45:547–53. PubMed
Say B, Degirmencioglu H, Gozde Kanmaz Kutman H, Uras N, Dilmen U. Supraventricular tachycardia after nebulized salbutamol therapy in a neonate: case report. Arch Argent Pediatr. 2015;113(2):e98–100. PubMed
- Nutritional status, exclusive breastfeeding and management of acute respiratory illness and diarrhea in the first 6 months of life in infants from two regions of Indonesia
K. J. Lee
J. E. Bines
C. D. Satria
C. D. Kirkwood
M. H. Danchin
- BioMed Central
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