BackgroundWHO recommended incorporation of Haemophilus influenzae type b (Hib) vaccination into immunization program. Indonesia would adopt Hib as a National Immunization Program in 2013. We aimed at analyzing immunogenicity, safety, and consistency of a new combined DTP-HB-Hib (diphtheria-tetanus-pertussis-Hepatitis B-Haemophilus influenza B) vaccine.MethodsA prospective, randomized, double blind, multicenter, phase III study of Bio Farma DTP-HB-Hib vaccine conducted in Jakarta and Bandung, August 2012 - January 2013.Subjects were divided into three groups with different batch number. Healthy infants 6–11 weeks of age at enrollment were immunized with 3 doses of DTP-HB-Hib vaccine with interval of 4 weeks, after birth dose of hepatitis B vaccine. Blood samples obtained prior to vaccination and 28 days after the third dose. Safety measures recorded until 28 days after each dose.ResultsOf 600 subjects, 575 (96 %) completed study protocol. After 3 doses, 100.0 and 96.0 % had anti-PRP concentration ≥0.15 and ≥1.0 μg/ml. Anti-diphtheria and anti-tetanus concentration ≥0.01 IU/ml detected in 99.7 and 100.0 %; while concentration ≥0.1 IU/ml achieved in 84.0 and 97.4 %. Protective anti-HBs found in 99.3 %. The pertussis vaccine response rate was 84.9 %.None Serious Adverse events (SAEs) considered related to study vaccine or procedure.ConclusionsThe 3-dose of DTP-HB-Hib was immunogenic, well tolerated and suitable for replacement of licensed-equivalent vaccines based on immunologic and safety profiles.Trial registrationNCT01986335 – October 30th 2013.

Background: Febrile seizures frequently occur in children under 5 years old and usually create fear and anxiety among parents. Poor understanding of febrile seizure among parents contributes to mismanagement of seizure. The objective of this study was to identify the knowledge and attitude on febrile seizure among mothers of under five children. Methods: This descriptive community-based survey comprised of 96 mothers with under 5 children who were chosen through randomization. This survey was, conducted in Hegarmanah Village, Jatinangor, West Java, Indonesia in October 2013. Data were collected using a questionnaire and analyzed using frequency analysis. Results: Fifty nine respondents (61%) considered that high fever in their children will result in seizure and 63 mothers (65%) stated that this condition was a life-threatening situation which could lead to brain damage (50%) and paralysis (50%). There were some respondents who would manage seizure by shaking (27%) or holding the child tightly during seizure (22%) and putting spoon into the children mouth (59%). Sixty respondents (62.5%) prevented febrile seizure by giving them coffee. Conclusions: Knowledge and attitude regarding febrile seizure is good, but the knowledge and attitude towards the outcome and what to do during febrile seizures occasion are still poor.

We retrospectively evaluated clinical features and outcomes in children treated for tuberculous meningitis (TBM) at Hasan Sadikin Hospital, Bandung, Indonesia, during 2011–2020. Among 283 patients, 153 (54.1%) were <5 years of age, and 226 (79.9%) had stage II or III TBM. Predictors of in-hospital death (n = 44 [15.5%]) were stage III TBM, hydrocephalus, male sex, low-income parents, seizures at admission, and lack of bacillus Calmette-Guérin vaccination. Predictors of postdischarge death (n = 18 [6.4%]) were hydrocephalus, tuberculoma, and lack of bacillus Calmette-Guérin vaccination. At treatment completion, 91 (32.1%) patients were documented to have survived, of whom 33 (36.3%) had severe neurologic sequelae and 118 (41.7%) had unknown outcomes. Predictors of severe neurologic sequelae were baseline temperature > 38°C, stage III TBM, and baseline motor deficit. Despite treatment, childhood TBM in Indonesia causes substantial neurologic sequelae and death, highlighting the importance of improved early diagnosis, better tuberculosis prevention, and optimized TBM management strategies.

Background: Nearly one-third of febrile seizure patients suffered recurrent febrile seizures. Several risk factors contribute to this recurrence, namely young age, family history of febrile seizures, low body temperature and rapid duration of fever before onset of seizures. Recently, the types of seizure and gender have been stated increasing risk of this recurrence. The objectives of this study was to identify the risk factors of recurrent febrile seizures. Methods: A descriptive study was carried out by retrieving data from inpatient medical records during the period of January 1st, 2009 to December 31st, 2013 at one of the top referral hospitals in West Java, Indonesia. Variables of this study were the first febrile seizure age, gender, type of febrile seizure, a family history of febrile seizure, a family history of epilepsy, body temperature when febrile seizure occurred and duration of fever before onset of seizure. The collected data were tabulated by frequency and percentage and displayed in tables. Results: Out of 154 patients with febrile seizures 58 suffered recurrent febrile seizures. Forty three percent had a first febrile seizure at the age of under12 months, 72% were male, 46% had fever less than 24 hours before the onset of seizure, 65% had complex febrile seizures, 28% had positive family history of febrile seizures, and 5% had positive family history of epilepsy. Conclusions: The risk factors for recurrent febrile seizures are young age, male, rapid duration of fever before onset of seizure and complex febrile seizure.