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Abstract Objective: The South East Asian Nutrition Survey II Indonesia aimed to provide up-to-date data on dietary intake, nutritional and biochemical status of children aged 0·5–12 years in Indonesia 2019–2020. Design: Multistage cluster sampling, stratified by geographical location. Setting: Out of forty-six targeted districts in Indonesia, the study only covered twenty-one districts/cities in Java and Sumatera islands, Indonesia due to COVID-19 pandemic. Participants: A total of 2475 children aged 0·5–12 years were included. Result: The growth (weight-for-age, height-for-age, weight-for-height and BMI-for-age) of Indonesian pre-school- and school-aged children was below the WHO standards. The prevalence of stunting in Java and Sumatera islands was 20·6 and 33·4 % in urban and rural areas, respectively. Stunting was higher in the 1·0–3·9-year age group, boys and rural areas. Overall, 9–12 percent of all children were overweight -obese, with 23·7 % of urban 7–12-year-olds having the highest prevalence. Anaemia was 22·8 % in < 5-year-old and highest in < 1-year-old children. Fe, Zn, vitamins A and D insufficiency was observed in 20·3 %, 11·9 %, 1·9 % and 27·1 % of the children. Dietary intakes of energy, fibre, Ca, Fe, Zn, vitamins A, B1, C and vitamin D below the Indonesian RDA were prevalent and observed in more than half of the children. Conclusion: High stunting, increasing trends of overweight/ obesity, anaemia, serum vitamin D insufficiency, inadequate energy and micronutrient intake in children highlighted the triple burden of malnutrition in Java and Sumatera, Indonesia’s most populous regions in 2019–2020, shortly before COVID-19 pandemic era.

Language development begins at the beginning of human life, but the stages are diverse. This study aimed at describing an 8 year old child speech delay and identifying the causes of the delay and its relation to language performance at school. A case study design encountered that AA could not speak clearly especially, and a hearer did not understand what she said except her mom. For almost one semester, the researchers tried to observe AA's speech pattern and found some speech error-unclear saying words containing H and Z, and X at the beginning and the end of the word. Often the researchers found her emotional when she was not able to perceive and deliver her feelings through words. Parents’ roles and background in the interview transcripts have also been one reason why AA got worse in speaking. However, the language subject result in the AA report book was not poor. The teacher had an alternative language learning to motivate The child to perform her best. Parent support is needed more as AA is under teacher supervision to learn in a higher class.

The phenomenon of teaching English and Indonesian language, especially in North Sulawesi, as a second language overlaps, where some argue that teaching Indonesian language should come first so that children will not forget Indonesian language or, in other words, children will master their national language. In this study, the method used is a descriptive method with a qualitative approach. The sample used as respondents by the researcher is parents in North Sulawesi who have children who can speak English and Indonesian, in addition, to their mother tongue (Manado language/Regional language), and the respondents consisted of 10 parents. The researcher used questionnaires to gather parents' perceptions of whether the children should be taught English or Indonesian Language first. However, some people think teaching English is very important because mastering English as an international language is necessary. English is suitable for children as their second language, but teaching Indonesian language as the national language is also very important. Therefore teaching between these two languages must be balanced so that it does not only English that can be mastered by children or not only Indonesian language.

Humor has been characterized as an index of children's language development and cognitive performance. While research on this area has been abound cross linguistically, specific inquiry on children's humor development in the Indonesian context remains scant. Occupying this lacuna, this research sought to examine kinds of humor acquired by the children in early childhood by invoking McGhee's humor developmental stages. Embracing a descriptive qualitative method, the study involved eleven Indonesian-speaking children in Yogyakarta aged around 1 to 5 years old, where the data were assembled primarily through direct naturalistic observations. The children's spontaneous humor production was recorded as they were interacting with their peers and/or their parents in their homes and neighborhoods. The findings revealed that the children could perceive and produce nonverbal and verbal humor, confirming existing literature. As they grow, certain patterns of humor also emerge, indicative of their cognitive and social development. More research is necessary to better understand how children of different linguistic and cultural backgrounds understand, respond to or initiate a humorous situation. [ABSTRACT FROM AUTHOR]

Background: Drug allergy in children is a rare case that needs special attention. Identifying the factors that affect the severity of drug allergy is important for the improvement of drug allergy management in Indonesian children. Objective: to analyze the factors that influence drug allergy severity in Indonesian children. Methods: This study used a retrospective design and consecutive sampling in 2014-2018. The data collected included sex, types of allergy-causing drugs, previous allergy history, parental allergy history, and clinical manifestations. The data were analyzed by using a logistic regression test where the statistical test results were significant if p <0.05. Results: The average age of the participants was 93.00 ± 50.54 months with a median value of 84 (12 - 204) months. Drug allergy severity in children is influenced by several things, such as the type of drug (β = 5.76; 95% CI 1.29 - 25.70; p = 0.022), sex (β = 1.27; 95% CI 0.30 - 5.36; p = 0.743), previous allergy history (β = 2.44; 95% CI 0.10 - 58.67; p = 0.583), and a drug allergy history on parents (β = 0.65; 95% CI 0.06 - 6.75; p = 0.719). Conclusion: There is a significant relationship between drug allergy severity and the type of drug whereas sex, previous allergy history, and a history of allergy on parents do not find a significant connection. [ABSTRACT FROM AUTHOR]

Background Acute glomerulonephritis (AGN) is a form of glom- erulonephritis characterized by sudden and explosive onset of glom- erular injury symptom. It usually occurs after recent infection by group A beta-hemolytic streptococcus. AGN among Indonesian children seems to be less frequently reported than that among other countries. Objective To determine the current profile of AGN among Indo- nesian children hospitalized in eleven teaching centers. Methods This was a descriptive, cross-sectional study, based on a review of the standard medical records of 509 children with AGN hospitalized in 11 teaching centers in Indonesia over a five-year period (1997-2002). Data extracted from the medical records con- sisted of history of illness, clinical and laboratory findings, and chest X-rays. Results Age of the patients at the onset of AGN ranged from 2.5 to 15 years, with peak age of 8.5 years. The majority (76.4%) was above 6 years old with male predominance (58.3%). About 68.9% and 82% of the patients came from low socioeconomic and low edu- cational status families. Antecedent upper respiratory infections were observed in 45.8% cases and pyoderma in 31.6%. The disease seemed to be more commonly elicited by streptococcal infection than by other infections, as proved by an elevated anti-streptolisin O (ASO) titer (66.6%) and decreased C 3 concentrations (60.4%). The frequent clinical features included periorbital edema (76.3%), hypertension (61.8%), and gross hematuria (53.6%). The most preva- lent laboratory findings were microhematuria (99.3%), proteinuria (98.5%), raised erythrocyte sedimentation rate (85.3%). The initial chest X-rays showed pleural effusion (81.6%) and cardiomegaly (80.2%), whereas echocardiogram documented pericardial effusion (81.6%). Acute pulmonary edema (11.5%), hypertensive encepha- lopathy (9.2%), and acute renal failure (10.5%) were frequent com- plications noted in our study. Conclusion Despite no adequate data on throat or skin cul- tures, AGN among Indonesian children seems mostly to be poststreptococcal AGN as proved by the elevated ASO titer and decrease in serum C 3 concentration

Inflammatory bowel disease (IBD) is a term used to describe two disorders associated with gastrointestinal inflammation: Crohn’s disease (CD) and ulcerative colitis (UC). The incidence of IBD is higher in developed countries, while there is unpublished data of pediatric IBD in Indonesia. Clinical manifestations of IBD vary, consist of gastrointestinal (such as diarrhea and abdominal pain) and extraintestinal manifestations. Definite diagnosis of IBD is based on endoscopy and histopathology. The management includes pharmacotherapy, nutrition, surgery, and psychotherapy. This disorder has a high recurrence rate, where CD’s recurrence rate is higher than UC.1,2

Background and Objectives: Indonesia is currently facing double burden malnutrition in children. As overweight and obesity are due to a disturbed energy balance, this study aimed to assess the association of total energy intake and physical activity with the prevalence of overweight among Indonesian children.Methods and Study Design: The data used for this analysis were from 1143 children, 6-12 years old, that participated in the South East Asian Nutrition Survey (SEANUTS). Physical activity (PA) was measured using pedometers for 2 consecutive days and was categorized low, moderate and high. Child nutritional status was categorized based on body mass index for age z-scores (BAZ) into normal weight (-2 SD ≤BAZ≤1 SD) or overweight (BAZ >1 SD). Energy intake was calculated from a one day 24 hour recall and compared to the Indonesian recommended dietary allowance (RDA) for energy.Results: Children with low PA had higher risk (ODDs 3.4, 95% CI: 2.0, 6.0) of being overweight compared to children who had high PA. Children with moderate PA and energy take >100% RDA had higher risk (ODDs 4.2, 95% CI 1.9, 9.3) of being overweight than children with high PA and energy intakes ≤100% RDA.Conclusions: Low physical activity independently or moderate physical activity and high energy intake are risk factors for Indonesian children to get overweight. Program intervention such as increasing physical activity at school and home is needed to reduce overweight among children. [ABSTRACT FROM AUTHOR]

Background The Child Behavior Checklist ( CBCL) has been widely utilized to estimate emotional and behavioral problems in children in the USA and Europe. Although the Indonesian version of the CBCL/6-18 was proven to have good validity and internal consistency in children with typical development ( TD) in Indonesia, it has not been utilized for children with autism spectrum disorder ( ASD). The purpose of this study was therefore to investigate the usefulness of CBCL/6-18 for detecting emotional and behavioral problems in Indonesian ASD children. Methods One hundred and eight mothers of children with ASD and with TD were enrolled in this study. The diagnosis of ASD in Indonesia was made by expert child neurologists based on DSM- IV- TR. Mothers of children aged 6-18 years completed the Indonesian version of the CBCL. Results The scores of total problems, internalizing, and externalizing were significantly higher in the ASD group than the TD group. Children with ASD scored significantly higher in seven of the eight CBCL subscales (except somatic complaints) compared with TD children. Conclusions The CBCL/6-18 Indonesian version could be considered as a useful tool for detecting emotional and behavioral problems in children with ASD in Indonesia in Muslim populations. [ABSTRACT FROM AUTHOR]

Micronutrient deficiencies and stunting are known as a significant problem in most developing countries, including Indonesia. The objective of this study was to analyze the association between micronutrient deficiencies and stunting with socioeconomic status (SES) among Indonesian children aged 6–59 months. This cross-sectional study was part of the South East Asian Nutrition Surveys (SEANUTS). A total of 1008 Indonesian children were included in the study. Anemia, iron deficiency, vitamin A deficiency, vitamin D deficiency, and stunting were identified in this study. Structured questionnaires were used to measure SES. Differences between micronutrient parameters and anthropometric indicators with the SES groups were tested using one-way ANOVA with post-hoc test after adjusted for age, area resident (rural and urban), and sex. The highest prevalence of anemia, stunting, and severe stunting were found to be most significant in the lowest SES group at 45.6%, 29.3%, and 54.5%, respectively. Children from the lowest SES group had significantly lower means of Hb, ferritin, retinol, and HAZ. Severely stunted children had a significantly lower mean of Hb concentration compared to stunted and normal height children. Micronutrient deficiencies, except vitamin D, and stunting, were associated with low SES among Indonesian children aged 6–59 months. [ABSTRACT FROM AUTHOR]

Stunting is highly prevalent in Indonesian children. The objective of this study was to identify the associations of stunting with morbidity, parental education and socioeconomic status (SES) in Indonesian children. The study population was part of the South East Asian Nutrition Surveys (SEANUTS). A total of 2236 Indonesian children aged 0.5 to 12 years, who had participated in the SEANUTS, were included in this study. Stunting was defined as height for age Z-score (HAZ) ≤ -2 using WHO criteria and severe stunting as HAZ ≤ -3. Information on morbidity, parental education and family SES were collected by structured questionnaires. ANOVA was used for evaluating differences across groups, with or without correction for confounders. The results showed that the overall prevalence of stunting was 31.4%. HAZ in stunted children was associated with disease incidence, including frequency, parental education and family income. There were no significant differences in HAZ values in stunted children with one or more bouts of infectious, digestive tract or respiratory tract illnesses compared to stunted children with no reported illness. The prevalence of stunting in Indonesian children was high and was strongly associated with child morbidity, parental education and SES.

The purpose of this study was to analyze effect of linear growth and psychosocial aspects of caregiving on cognitive development of toddlers. Methods: Longitudinal studies were carried out from pregnancy to three years old children in Bogor. The collected data included body height, nutritional status based on height by age index, morbidity, aspects of caregiving, and cognitive development of three years old children. Linear growth data is obtained from anthropometric measurements of height at birth, age six months, and twelve months measured using a length measuring instrument body with a precision level of 0.10 cm. Caregiving of psychosocial aspect divided by some characteristics, such as learning stimulation, language stimulation, academic stimulation, modelling, warmth and acceptance, caregiving variation, punishment & acceptance and physical environment. Cognitive development measurement was divided into two categories, namely delay and appropriate to age. Multiple logistic regression was applied to analyze the effects. Toddlers who were born stunted and continued to be stunted until they were three years old had lower cognitive development than stunted newborns that were able to achieve normal height at three years old. In addition, children who experience caregiving with poor psychosocial aspects had lower cognitive development than those with good caregiving. This study highlighted the importance efforts to improve nutritional status of children as well as providing good care for them.

Indonesia is currently facing the double burden of malnutrition. While undernutrition is still a major public health problem, the prevalence of overnutrition is increasing. The objective of the South East Asian Nutrition Survey (SEANUTS) was to provide up-to-date data on nutritional status, food consumption and biochemical parameters related to nutrition for children aged 0·5–12 years. The SEANUTS study in Indonesia was conducted in a nationwide representative sample of 7·211 children using multistage cluster sampling based on probability proportional to size, stratified for geographical location, in forty-eight out of 440 districts/cities. The results show that the growth (weight for age, height for age, weight for height and BMI for age) of Indonesian pre-school- and school-aged children is below the WHO standards. The older the children, the more the deviation from the WHO standard curves. Underweight was more prevalent in rural areas (28·9 v. 19·2 %) and overweight/obesity was observed to be more widespread in urban areas (5·6 v. 3·2 %). The prevalence varied with age groups and sexes. The overall prevalence of stunting was 25·2 and 39·2 % in urban and rural areas, respectively. The prevalence of anaemia was nearly 55 % in children aged 0·5–1·9 years and ranged from 10·6 to 15·5 % in children aged 2–12 years. Fe deficiency was observed in 4·1–8·8 % of the children. The percentage of children with dietary intakes of energy, protein, and vitamins A and C below the Indonesian RDA was high and differed across urban and rural areas and age groups. [ABSTRACT FROM AUTHOR]