Introduction: Mental health problems, such as anxiety, depression, and ineffective family coping, in children with lupus nephritis (LN) can increase the severity and affect the management of the disease, thus affecting the quality of life (QoL) of patients. Objective: Analyzing the association between levels of depression, anxiety, coping, disease activity on the QoL of pediatric patients with LN. Patients and Methods: There were 62 pediatric LN participants (16 participants in the induction phase and 46 participants in the maintenance phase). Participants were measured for anxiety, depression, coping, disease activity (systemic lupus erythematosus disease activity index/SLEDAI), and QoL. The measurement results were compared between induction and maintenance groups. Analysis of the association between anxiety, depression, coping, and disease activity with the QoL of children with LN used a multiple logistic regression test with p < 0.05. Results:: The measurement results obtained anxiety (induction = 69.06± 3.92 and maintenance = 45.24± 10.33; p < 0.001), depression (induction = 69.88± 3.34 and maintenance = 42.20± 9.12; p < 0.001), coping (induction = 99.88± 12.93 and maintenance = 115.67± 7.34; p < 0.001), SLEDAI (induction = 15.81± 12.58 and maintenance = 0.43± 1.26; p < 0.001), and QoL (induction = 49.92± 12.44 and maintenance = 88.15± 8.06; p < 0.001).. Anxiety level in the induction group (p = 0.043) and maintenance group (p < 0.001; p = 0.032; p = 0.008; p = 0.009). Depression level in the induction group (p = 0.031) and maintenance group (p = 0.024; p = 0.042; p = 0.003). SLEDAI score in the maintenance group (p = 0.003; p = 0.003). Coping in induction group (p = 0.016; p = 0.016) and maintenance group (p = 0.005). Conclusion: Mental health disorders reduce the QoL of LN children, and the level of QoL in induction phase is lower than maintenance phase.

Background: Treatment of children with HIV infection has increased rapidly by increasing the life span of HIV patients from baby to adult. Improving the quality-of-life (QoL) in children living with HIV is a priority of HIV management in children and caregivers of children living with HIV have important roles. Caregiver stigma, caregiver burden, and caregiver coping affect caregivers in treating children living with HIV. Objective: Analyzing the association of caregiver stigma, caregiver burden, and caregiver coping on QoL of Indonesian children living with HIV. Methods: Participants in this study were caregivers of Indonesian children living with HIV. Participants were measured for caregiver stigma, caregiver burden, caregiver coping, and QoL of Indonesian children living with HIV. The instrument used in measuring caregiver stigma was people living with HIV/AIDS and caregiver questionnaire, caregiver burden used Zarit Burden questionnaire, caregiver coping used F-COPES questionnaire, and QoL used PedsQL for children aged 2– 18 years old. Measurement data were analyzed using logistic regression and independent t tests with P< 0.05. Results: Indonesian children living with HIV in this study had an average age of 7.7± 3.68 years and average participant age of 40.2± 11.26 years. All participants stated that Indonesian children living with HIV tend to keep their health status confidential. Most QoL of Indonesian children living with HIV was good (71.7%), caregiver stigma value was 21.7± 2.06, and caregiver burden level was moderate, of 50.9%. However, there was no significant association between caregiver stigma (β=0.064; P=0.548) and burden level (β=0.058; P=0.593) on QoL. On the other hand, caregiver coping value was 77.2± 7.30, and there was a significant association of caregiver coping on QoL (β=− 0.196; P=0.049). Conclusion: There is an association of caregiver coping on QoL of Indonesian children living with HIV, in which the higher the caregiver coping, the lower the QoL. Meanwhile, there is no significant association of caregiver stigma and burden on QoL of Indonesian children living with HIV.

Setiabudiawan B, et al. Pediatr Gastroenterol Hepatol Nutr. 2021 May;24(3):316-324. https://doi.org/10.5223/pghn.2021.24.3.316

Atopic dermatitis (AD) is a common health problem found in children. Understanding of the determinants of AD-related factors includes gender, family history, childbirth history, and exclusive breastfeeding. Analyzing gender, family history, childbirth history, and exclusive breastfeeding on recurrence of AD symptoms in children. This study employed a cross-sectional design with a purposive sampling method. The procedure for collecting data in this study included data on participant recurrence, gender, family history of atopy disease, childbirth history, and exclusive breastfeeding. The analysis used Chi-square and eta correlation test with p < 0.05. The results showed that 56.0% of male participants experienced recurrent atopic dermatitis symptoms and 56.7% of female participants did not experience recurrence (OR = 1.664; p = 0.349). It was reported that 61.3% of participants did not experience recurrent atopic symptoms with a family history of 1 atopic person and 71.4% of participants experienced recurrence with 2 atopic families (F = 2114; p = 0.349). Most participants who were delivered through cesarean delivery did not experience recurrent atopic dermatitis symptoms as much as 56.0%, while participants who had a history of spontaneous delivery mostly experienced recurrent atopic dermatitis symptoms as much as 52.9% (OR = 1.500; p = 0.467). There was a significant association between participants who received exclusive breastfeeding and recurrent atopic dermatitis symptoms (OR = 4.444; p = 0.032). Recurrent of AD is influenced by exclusive breastfeeding and not influenced by gender, family history of atopy disease, and history of childbirth.

Background: Food allergy in children affects nutritional status that limits their daily activities to prevent eating various foods to avoid allergic reactions. Objective: Analyzing the relationship between nutritional status and daily activities in children with food allergies. Methods: This study used a cross-sectional design that was carried out on children diagnosed with food allergies who underwent outpatient management of food allergies. The data were collected from January to May 2021 that included participant characteristics, nutritional status, and daily activities. Data analysis used Chi-Square and spearman rho test with p < 0.05. Results: There was a significant relationship between age and FAIS (CI 1.83–4.24; p = 0.025). In addition, there was no significant relationship between the affected organs and FAIS (OR = 0.174; p = 0.052). Meanwhile, the relationship between nutritional status and FAIS was significant (OR = 0.161; p = 0.007). There was no significant relationship between parental education and FAIS (OR = 0.817; p = 0.776) as well as sex of the child and FAIS (OR = 0.982; p = 0.977). Conclusion: Daily activities of children with food allergies are influenced by the nutritional status of children and children's age in choosing food.

Chronic rhinosinusitis allergy (CRA) is a disease that is commonly found in children and is mostly caused by allergy to house dust mites (HDM). The use of HDM immunotherapy can be considered in children with allergies. Analyzing the impact of mite immunotherapy on disease burden in Indonesian children with CRA. A randomized control trial study was conducted to participants in 2 groups, namely the immunotherapy group (n = 25) and the non-immunotherapy group (n = 25). Participants were given HDM immunotherapy for 14 weeks, which was given once per week. Participants during therapy were evaluated for rhinosinusitis symptoms and measured their immunity status (specific IgE), sleep quality (SDSC), quality of life (SN5), and family coping (F-COPES) pre-post therapy. Statistical analysis used in this study included paired t-test, Wilcoxon test, independent t-test, or Mann Whitney test with p < 0.05. The value of specific IgE in the immunotherapy group was 4.12 ± 7.75 kU/l (pre-test) and 1.52 ± 2.42 kU/l (post-test; p < 0.001), while in the non-immunotherapy group was 1.47 ± 3.28 kU/l (pre-test) and 1.18 ± 2.81 kU/l (post-test; p = 0.317). The SDSC value in the immunotherapy group was 42.16 ± 2.75 (pre-test) and 30.32 ± 3.22 (post-test; p < 0.001), while in the non-immunotherapy group was 41.92 ± 2.75 (pre-test) and 41.84 ± 2.87 (post-test; p = 0.987). The F-COPES value in the immunotherapy group was 101.56 ± 5.78 (pre-test) and 105.20 ± 4.31 (post-test; p = 0.015), while in the non-immunotherapy group was 100.36 ± 9.63 (pre-test) and 99.96 ± 9.98 (post-test; p = 0.224). The SN-5 value in the immunotherapy group was 30.04 ± 2.78 (pre-test) and 11.00 ± 2.33 (post-test; p < 0.001), while in the non-immunotherapy group was 30.04 ± 2.78 (pre-test) and 30.04 ± 2.78 (post-test; p = 0.767). There was a significant comparison between the immunotherapy group and the non-immunotherapy group on the specific IgE (p = 0.013), SDSC (p < 0.001), and SN-5 (p < 0.001) values. Meanwhile, there was no significant difference in the F-COPES value (p = 0.129). The administration of HDM immunotherapy can improve the participant's immunity, quality of life, and sleep disorder.