Objective: The Indonesia Basic Health Research 2018 indicates that Indonesian children are still among the shortest in the world. When referred to World Health Organization Child Growth Standards (WHOCGS), the prevalence of stunting reaches up to 43% in several Indonesian districts. Indonesian National Growth Reference Charts (INGRC) were established in order to better distinguish between healthy short children and children with growth disorders. We analyzed height and weight measurements of healthy Indonesian children using INGRC and WHOCGS. Methods: 6972 boys and 5800 girls (n=12,772), aged 0-59 months old, from Bandung District were measured. Z-scores of length/height and body mass index were calculated based on INGRC and WHOCGS. Results: Under 5-year-old Indonesian children raised in Bandung are short and slim. Mean height z-scores of boys is -2.03 [standard deviation (SD) 1.31], mean height z-scores of girls is -2.03 (SD 1.31) when referred to WHOCGS indicating that over 50% of these children are stunted. Bandung children are heterogeneous, with substantial subpopulations of tall children. Depending on the growth reference used, between 9% and 15% of them are wasted. Wasted children are on average half a SD taller than their peers. Conclusion: WHOCGS seriously overestimates the true prevalence of undernutrition in Indonesian children. The present investigation fails to support evidence of undernutrition at a prevalence similar to the over 50% prevalence of stunting (WHOCGS) versus 13.3% (INGRC). We suggest refraining from using WHOCGS, and instead applying INGRC that closely mirror height and weight increments in Bandung children. INGRC appear superior for practical and clinical purposes, such as detecting growth and developmental disorders.
The most fundamental characteristics of a child are growth and development. Under normal circumstances growth follows a pattern that can be predicted. As a pediatrician we have to distinguish between normal and abnormal growth and recognize a normal variation from a pathological condition. Thorough height measurements performed every 6 months and plotted on the reference growth curve is the simplest and low-cost tool to detect an abnormal growth. Simple guideline is proposed to manage a child with short stature.
Latar belakang. Hipotiroid kongenital (HK) adalah kondisi kekurangan hormon tiroid, tiroksin, dan tri-iodotironina sejak lahir yang dapat menyebabkan gangguan organogenesis sistem saraf pusat serta metabolisme tubuh. Penderita HK yang tidak diterapi dapat berlanjut menjadi individu dengan gangguan perkembangan. Data di Indonesia dari Ikatan Dokter Anak Indonesia (IDAI) sejak tahun 2000-2013, angka kejadian HK pada bayi baru lahir sebanyak 1:2736. Tujuan. Mengetahui hubungan awitan pengobatan dengan gangguan perkembangan pada anak dengan HK.Metode. Penelitian observasional analitik dengan pendekatan potong lintang yang dilakukan periode bulan Agustus–November 2018. Subjek HK datang kontrol ke klinik rawat jalan endokrin dan tumbuh kembang RS. Hasan Sadikin, berusia <36 bulan dan mendapat terapi levotiroksin, dilakukan penilaian perkembangan dengan pemeriksaan Denver dan CAT/ CLAMS (cognitive adaptive test/ clinical linguistic auditory milestone scale). Analisis data menggunakan uji chi-kuadrat dan Mann Whitney (p<0,05). Hasil. Terdapat 92 kasus HK, 12 dieksklusi, subjek terdiri dari 38 laki-laki dan 42 perempuan dengan rerata usia diagnosis 3,0 bulan (0,5–22,0 bulan). Didapatkan adanya hubungan usia saat diagnosis dan awitan pengobatan dengan gangguan perkembangan (p<0,001). Usia saat diagnosis dan awitan pengobatan >3 bulan lebih banyak mengalami gangguan perkembangannya.Kesimpulan. Pasien HK yang terlambat didiagnosis dan diberikan terapi akan mengalami gangguan perkembangan yang lebih banyak.
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