Background: Neonatal MortalityRate (NMR) reflects the quality of health services provided by the government. It is very important to disclose the health system capability of each country in managing mother and child health programs because it is an essential health policy that should be prioritized. The health system capability of a country will determine the welfare and social guarantee because most of NMR causes are preventable. Several components such as maternal factors, neonatal and health services were determined as predictors of NMR. The objective of this study is to compare neonatal mortality trends among eight South East Asia Countries (SEAC) from 2000 to 2017. Method: A cross-sectional design was used to analyze the data regarding the causes of neonatal death between 2000 and 2017. Data were taken from World Health Organization Maternal Child Epidemiology Estimation (WHO MCEE) database.The collected data were live birth; neonatal mortality rate; and the big five of neonatal mortality etiologies in the eight SEAC. Data were then analyzed descriptively with line chart to describe the trend of NMR. Result: This study found that Indonesia had the highest neonatal mortality rate, yet the trend decreased gradually from 102.700 in 2000 to 60.986 in 2017, followed by Philippines, Vietnam, Myanmar, Cambodia, Thailand, Laos, and Malaysia respectively. On the other hand, the trend of live birth was the lowest in Indonesia and the highest in Philippines . According to the data regarding the leading cause of NMR, preterm birth was the major cause of neonatal mortality followed by birth asphyxia and congenital defects. Conclusion: Indonesia has the highest mortality rate, yet the etiology such as as premature birth, asphyxia, and congenital disorder is similar to the other eight countries.

Persistent organic pollutants can accumulate inside the human body, including in mothers’ milk, which may affect infant development. This cross-sectional study aimed to examine selected persistent organic pollutants in the milk of 100 mothers in Sendai city, Miyagi Prefecture, Japan. We used gas-chromatography-electron capture negative chemical ionization-mass spectrometry to check for octachlorostyrene, dechlorane (Dec) plus, Dec 602, Dec 603, and Dec 604. Octachlorostyrene was detected in 86 samples at more than the method detection limit (84 pg g-lipid⁻¹) but no dechloranes were above the method detection limit (1 ng mL⁻¹ for dechlorane plus, Dec 602, and Dec 603; 20 ng mL⁻¹ for Dec 604). The mean octachlorostyrene concentration was 461 pg g-lipid⁻¹, the median was 337 pg g-lipid⁻¹, and the standard deviation 450 pg g-lipid⁻¹. No baseline characteristics were associated with octachlorostyrene level except for mother’s occupation (stay-at-home mother, 353 ± 327 pg g-lipid⁻¹; others, 531 ± 509 pg g-lipid⁻¹). Octachlorostyrene was also significantly negatively correlated with lipid content (r = −0.35, p = 0.0004). However, the maximum intake of octachlorostyrene among infants in this study (3.5 ng/kg/day) was under the acceptable daily intake (30 ng/kg/day, derived from 12−month study in rats), and is therefore unlikely to pose a health risk.

Children mortality rates describe the health services’ quality as indicators of each countries’ welfare, particularly in Indonesia. Several factors were determined as the main contributors of mortality, such as neonatal factors, maternal, environment and health services. The important of this research is to give recommendation to the government of Indonesia to propose some policies in handling of the increasing children mortality and modifying underlying disease as contributor mortality among children in Indonesia. The design of this study is cross sectional. The data was taken from World Health Organization Maternal Child Epidemiology Estimation from 2000 to 2017. There were three main categories : neonatal mortality rate (NND), post neonatal mortality rate (PND) and under five mortality rate (UFIVE). The leading causes of mortality were searched according to those categories and followed by descriptive analysis by line graphs. According to the data that had been found, there was declining on NND (102.700 to 60.986), PND (138.553 to 63.471), UFIVE (241.253 to 124.457). The children mortality tend to decline at the range of 17 years, meanwhile the highest mortality among the three of groups are : premature birth in neonates, ARI in post neonates and premature birth in under five children. In conclusion, the trend of three parameters of children mortality declined within 17 years. On several cases, there were outbreak of injury on 2004 and fluctuation of measles incident among infant and under five children. Premature birth and ARI have the highest prevalence among children in Indonesia.

Background: Fine particulate matter (PM2.5) is an environmental factor contributing to the death rate. However, few studies have demonstrated the association between PM2.5 and the under-five mortality rate. Objective: To determine the correlation between PM2.5 and under-five children mortality in Indonesia. Methods: A secondary data analysis of the WHO Global Health Observatory on Environmental Pollution and Children Mortality during 2012-2016 was conducted. The environmental pollution was measured by PM2.5 levels (μg/m3) in rural, urban, and both areas. Mortality data were categorized by specific causes—meningitis/encephalitis, acute lower respiratory infection, diarrhoeal diseases, tetanus, prematurity, birth asphyxia, and congenital anomalies. Data were analyzed using Mann-Whitney and Spearman correlations. Results: The PM2.5 total concentration in urban areas was greater than in rural areas for four years (18.4±1.19 vs. 15.4±1.1, p = 0.016). Prematurity, acute lower respiratory infection, and birth asphyxia were the leading causes of under-five mortality. The PM2.5concentration in urban and rural areas was significantly associated with an acute lower respiratory infection, tetanus, prematurity, birth asphyxia, and congenital anomalies (p <0.05). Additionally, the PM2.5 concentration was negatively correlated with tetanus, prematurity, birth asphyxia, and congenital anomalies (p <0.001; r = -0.8, -0.8, -0.82, -0.83, respectively). Conclusion: PM2.5 air pollution was correlated with tetanus, prematurity, birth asphyxia, and congenital anomalies from 2012-2016 in Indonesia. Further action is needed to handle the sources of air pollution contamination to preventing under-five mortality in the community.

Unexplained acute kidney injury (AKI) in children owing to diethylene glycol (DEG) contamination during drug production has gained attention in recent years. This qualitative study investigated the effects of DEG exposure on the incidence of unknown AKI in children. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines was proposed to search for studies using predefined search terms in the PubMed, EBSCO, and Web of Science databases without publication date restrictions. The inclusion criteria are observational study, case study, case report, and case series design; and having provided accurate data for DEG poisoning and AKI diagnosis in children. All authors performed the study screening, data extraction, and data synthesis processes. Consensus was reached by mutual agreement. The data synthesis was conducted according to the DEG and unexplained AKI in children by examining the statistical data using Microsoft Excel 2017 and storing the data using the cloud service of Universitas Islam Indonesia. Of the 115 included studies, 21 met the inclusion criteria, including 2 case-control studies, 1 cross-sectional study, 4 case studies, and 14 case reports. DEG-contaminated paracetamol caused unexplained AKI in children. Other drugs including cough expectorants, antihistamines, and sedatives were administered. Chemicals other than DEG, such as propylene glycol and ethylene glycol, also induce AKI owing to overprescription and unintentional exposure. A recent epidemic of unexplained AKI showed contaminated paracetamol as the poisoning agent regardless of formula.

As an endocrine disruptor chemical, pesticide exposure may affect the regulation of growth hormones such as insulin-like growth factor-1 (IGF-1). A few current studies to date have noted that long-term pesticide exposure disrupted IGF-1, a potential risk of stunting in children. This study aims to evaluate studies to date of the effect of pesticide exposure on stunting incidence. This systematic review and meta-analysis adhered to the PRISMA (Pre-ferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. The PubMed and EBSCO databases were searched for relevant articles without publication restrictions. This review aimed to include reviews, randomized controlled trials (RCT), and cohort, case-control, and cross-sectional studies, which provide actual exposure types of pesticides with stunting measurement by height-age z score. A screening, extraction, and synthesis were conducted, leading to a consensus for reaching mutual agreement. The analysis was performed using Microsoft Excel 2017 for the screening and extraction, Revman version 5.4 software for the meta-analysis, and OpenMEE software for the meta-regression. Of the 13 studies subjected to the qualitative analysis, 6 were eligible for inclusion in the meta-analysis: 2 reviews, 2 RCTs, 2 cohorts, 2 case-control, and 5 cross-sectional studies. Exposure to organophosphate and pyrethroid pesticides was not associated with stunting (P=0.78; odds ratio [OR], 1.11; 95% confidence interval [CI], 0.65–1.88). Heterogeneity existed for 79% of the meta-analysis (P≤0.000; z=-5.37; 95% CI, -0.034 to -0.016), and the meta-regression identified age as the causative covariate. Pesticide exposure, regardless of type, is not associated with stunting in children.