Observational studies have linked low vitamin D (VD) levels to increased asthma attacks in children. Subsequent meta-analyses of adults and children revealed that VD treatment might benefit asthmatic patients by reducing the incidence of exacerbations. Therefore, this review aims to analyze the effects of VD supplementation in reducing asthma exacerbations in children. Published reports from PubMed, Cochrane, and Google Scholar were systematically searched until April 2023. The study protocol was registered in the PROSPERO database CRD42023411796. Randomized controlled trial studies were included in this review. Meta-analysis was performed using Cochrane RevMan 5.1 and presented with 95% confidence intervals (CIs). Ten relevant studies enrolled 1243 asthmatic children (631 children receiving vitamin D3 supplementation, 612 children receiving placebo) were included in this review. Our pooled analysis found that VD supplementation had a significant effect on lowering the total number of asthma exacerbations (RR 0.62; 95% CI: 0.44, 0.87; p = 0.01). Subgroup analysis revealed that a daily dose of VD given based on standard daily dose recommendation had a significant improvement on asthma exacerbations [(RR 0.41; 95% CI: 0,18, 0,92; p = 0.03). Vitamin D supplementation can lower the occurrence of exacerbations in children with asthma, along with the improvement of FEV1.

Highlight: Pediatric tuberculosis patients profile using the medical records was determined.The most pediatric tuberculosis patients under five years have pulmonary tuberculosis.Pediatric tuberculosis patients received BCG immunization had a contact with adult tuberculosis patients histories. The prevalence of tuberculosis (TB) in Indonesia is 391 per 100,000 population with the number of deaths around 110,000 cases in 2016. This study is descriptive research that aims to determine the profile of pediatric TB patients using the medical records at Taman public health center the period 2016-2019 with a total sampling technique. The sample in this study were 31 pediatric patients aged 0-14 years with a history of TB. Pediatric TB patients aged >5 years (58.1%) and who aged ≤5 years (41.9%). Pediatric TB patients had pulmonary tuberculosis (83.9%) and those who had extrapulmonary tuberculosis (16.1%). Pediatric TB patients aged ≤5 years had good nutritional status (32%) and who had poor nutritional status (27.2%). Meanwhile, pediatric TB patients aged >5 years had poor nutritional status (22.7%) and who had good nutritional status (18.1%). Pediatric TB patients who had a history of contact with adult TB patients (86.7%) and who did not have a history of contact with adult TB patients (13.3%). Pediatric TB patients who had received BCG immunization (86.2%) and who had not received BCG immunization (13.8%). This study concludes that most pediatric TB patients are >5 years old, almost all pediatric TB patients have pulmonary tuberculosis. Pediatric TB patients aged ≤5 years are more likely to have good nutrition. Meanwhile, there were more pediatric TB patients aged >5 years who had poor nutritional status. Almost all pediatric TB patients had a history of contact with adult TB patients and had received BCG immunization.

Purpose: Community-acquired pneumonia (CAP) remains one of the leading causes of morbidity and mortality among children, particularly those under the age of five. This study aimed to compare white blood cell (WBC) count and neutrophil-lymphocyte ratio (NLR) between children with complicated and uncomplicated pneumonia hospitalized at Dr. Soetomo Hospital Surabaya. Research methodology: This retrospective study evaluated 49 children hospitalized with CAP from January to October 2021. Pneumonia was diagnosed based on symptoms (fever, cough, dyspnea) and physical findings (tachypnea, chest indrawing, rales). The comparison of WBC count and NLR of children with and without pneumonia complications was made using the Mann-Whitney U test. Results: Of the 49 patients, 28 (57.1%) were male and 40 (81.6%) were under five years old. The median hospital stay was 7 (Interquartile Range [IQR] 4.5 – 9) days. Nine patients (18.4%) had complications, including pneumothorax (33%) and sepsis (22%). Patients with complications had higher median WBC counts (19.5 [IQR 7.2 – 25.1] vs. 12.7 [IQR 10.7 – 15.7] x103/mm3, p=0.224). Similarly, the median NLR was found higher in the complicated pneumonia group (2.9 [IQR 1.5 – 10.8]) than uncomplicated group (1.7 [IQR 0.9 – 4.4], p=0.178). Limitations: The few sample size and retrospective nature of the study limits the generalizability of the findings. Future studies with larger sample sizes and the inclusion of additional biomarkers are warranted to confirm our findings. Contribution: These trends suggest potential utility of WBC count and NLR as biomarkers for pneumonia severity, warranting further research with larger cohorts.

Background Since children are more likely than adults to become infected with Mycobacterium tuberculosis or suffer from tuberculosis (TB), it is important to identify the risk factors of TB in children with adult household TB contacts. Objective To identify the risk factors of TB in children with adult household TB contacts. Methods This cross-sectional study was conducted at the Pediatric Respirology Inpatient Ward and Outpatient Clinic at Dr. Soetomo Hospital, Surabaya, Indonesia, using medical records of hospitalized patients from 2010 to 2018. Patients were children below 18 years of age who had a history of adult TB household contact(s). We analyzed age at TB diagnosis, nutritional status, BCG vaccination status, and HIV status as possible risk factors of TB. Results A total of 367 children with adult household TB contacts were included in our study. Age of <5 years (OR 8.38; 95%CI 3.78 to 18.21; P<0.001), severe malnutrition (OR 8.88; 95%CI 1.19 to 66.27, P<0.05), absence of BCG scar (OR 2.96; 95%CI 1.32 to 6.62, P<0.05), and positive HIV status (OR 6.72; 95%CI 1.72-38.49, P<0.05) were risk factors for contracting active TB. Conclusion Age of <5 years, severe malnutrition, absence of BCG scar, and positive HIV status are significant risk factors for active TB in children with adult household TB contacts.  

Introduction: Hospital-Acquired Pneumonia (HAP) is a nosocomial pneumonia that brings negative impacts, such as prolonged hospital stay and increased cost. Previous studies often discussed about the risk factors of HAP mortality in adult patients rather than in children. This study aimed to analyze the risk factors of mortality in children with HAP. Methods: This was a retrospective observational analytic study using cross sectional method with total sampling. A total of 73 children were enrolled in this study, consisted of inpatients at Pediatric Inpatient Room Dr. Soetomo General Hospital Surabaya who met the inclusion and exclusion criteria. Independent variables were gender, age, onset of HAP, length of stay (LOS), comorbidities, birth weight, type of breastfeeding, the use of mechanical ventilation (MV), and response to therapy. Dependent variable was mortality. The data were collected from medical records, which later were analyzed by bivariate and multivariate analysis. Results: The mortality of children with HAP was 23.3%. Bivariate analysis showed that age (p = 0.009), the use of MV (p = 0.029), and response to therapy (p = 0.036) were proven to affect mortality in children with HAP in Dr. Soetomo General Hospital Surabaya. In addition, the use of MV was the significant risk factor (p = 0.023) given by the multivariate analysis. Gender, onset of HAP, LOS, comorbidities, and type of breastfeeding were not proven to be the risk factors for mortality.Conclusion:Mortality in children with HAP in Dr. Soetomo General Hospital Surabaya was significantly affected by children’s age, the use of MV, and response to therapy. This information might be used as early signs and treatment strategies for children with HAP which lead to the decrease of hospital mortality.

Introduction: Pneumonia is an infectious disease attacking lower respiratory tract. It has one of the highest number of world’s mortality and morbidity in children. Many risk factors are suspected as the reasons why the disease still occur a lot. One of the major risk factors is birth weight which makes their immune system immature and easier to get various complications and infections. The aim of this study is to analyze birth weight as risk factor of pneumonia in children under 5 years old. Methods: This was an analytical study with case control design. This study was held in Primary Health Care of Tambakrejo, from August to December 2017. The sample size was 22 respondents for each case and control group. Technique of sampling was total sampling. Secondary data were collected by medical records at the health center and Kartu Menuju Sehat (KMS). Data were entered into Microsoft Excel then statistically analyzed using IBM SPSS 22. The data were analyzed by Fisher’s Exact Test.Results: During August to December 2017, there were 22 respondents which were diagnosed with pneumonia in Tambakrejo Primary Health Center. Two of them (4.55%) had low birth weight and the rests had normal birth weight (95.45%). The analyze result stated that there is no significant correlation between pneumonia incidence and birth weight. Conclusion: Birth weight is one of pneumonia risk factors without significant impact.