RHEUMATIC HEART DISEASE , ESPECIALL

RHEUMATIC HEART DISEASE , ESPECIALLY THE SEVERE ONE IS a serious problem, both for the patient, family and society as well. Unfortunately the disease frequently affects school-age children and productive, active adolescents resulting in negative impacts on growth and development. 1 Rheumatic heart disease is the leading acquired cardiac disease frequently encountered in childhood and adolescence in many developing countries. Although it can be prevented, the disease still causes high morbidity and mortality. 2 The prevalence of rheumatic heart disease in Indonesia is sufficiently high, ie, 0.3-0.8 per 1000 school-age children aged 5-15 years, 3,4 with the mor- Factors affecting school performance in children with rheumatic heart disease Reference to educational achievement, absent of school and dropouts Arief Hermanu S, Sudigdo Sastroasmoro, Bambang Madiyono, Ismet N. Oesman Department of Child Health, Medical School University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta ABSTRACT The aim of this study was to determine the association between school performance and age, sex, duration of illness, educational achievement prior to illness, socioeconomic status of family, parent's educational level, number of children in the family and severity of the disease of patients with rheumatic heart disease (RHD). Subjects were patients with RHD treated at the Division of Cardiology, Department of Child Health, Cipto Mangunkusumo Hospital Jakarta. The parameters of school performance were educational achievement, absent of school and dropout. All data were processed by using Epi- Info program to find out bivariate analysis and Statistic Program for Social Sciences (SPSS) for multivariate analysis. We obtained 80 patients with RHD; most of them were of mild severity (64 of 80%) and the remainder 16 (20%) with severe disease. There were 44 (55%) males and 36 (45%) females. Most parents (42 or 53%) had junior high school educational level, most of them, 23 (29%) had elementary school education, and 3 (4%) illiterate. Bivariate and multivariate analyses showed that severity of disease and parental educational level were associated withschool performance of patients with RHD, but age, sex, duration of disease, premorbid educational achievement, socio-economic level of the family and number of children in family were not. [Paediatr Indones 2001; 41:299-304] Keywords : rheumatic heart disease, school performance, prognosis, parental education tality rate of at least 10 times higher compared to that in developed contries. 5,6 This disease is associ- ated with poor nutritional and lower socio-economic status and uneven distribution of health care. 3,4 Be- sides, rheumatic heart disease will also affect daily activities, educational achievement and absent of school that even may cause dropouts. This reflects how rheumatic heart disease can influence school- ing performance. 7 To the best of our knowledge there is no study concerning schooling performance in stu- dents contracting rheumatic heart disease, both in Indonesia and abroad. Among various factors known or suggested as influencing schooling performance in students with RHD are age, sex, family socio-eco- nomic status, parental educational level, number of children the family, duration of illness, educational achievement prior to disease, and severity of the dis- Correspondence : Arief Hermanu S, MD, Department of Child Health, Medical School University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Tel [phone], Fax. [phone].
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Paediatrica Indonesiana Vol. 41 No. 11-12, November-December 2001 300 ease. We aimed to determine factors associated with schooling performance of children with RHD treated in our hospital during the last 9 years. Methods We reviewed patients with RHD visited the outpatient clinic of Cardiology Division, Department of Child Health, Dr. Cipto Mangunkusumo Hospital from 1990 to 1998. Data were obtained from medical records and questionnaire. We collected data for age, sex, socioeconomic status of family, parental educational level, number of children in family, duration of illness, educational achievement prior to illness and severity of the disease. Those data were considered or suggested as risk factors or independent variables, while the dependent variable was school performance possessing 3 parameters, namely educational achievement, absent of school, and dropouts. The inclusion criteria included (1) patients with rheumatic heart disease visited the outpatient clinic of Division of Cardiology, Department of Child Health between January 1, 1990 and December 31, 1998; (2) age 6-15 years, (3) patients had never transferred to other school during educational period; and (4) the medical record was completed with clear address ac- companied by findings on history taking, physical ex- amination, electrocardiographic, chest-x ray, and echocardiography. We excluded patients who died during first quarter before after diagnosis of RHD was established. Results Characteristics of the subjects During the study period 80 patients with RHD visited the Division of Cardiology, Department of Child Health, Cipto Mangunkusumo Hospital. Most of patients were in mild disease 64 (80%) and the other 16 (20%) with severe disease, 3 cases of 16 subjects with severe disease died less than six months after the diagnosis of RHD was established. The subjects comprised of 44 males (55%) and females 36 (45%); most of them (55%) belonged 12-15 year age group (Table 1). According to duration of illness, the most preva- lent length of disease of more than 2 years was found in 44 (55%) of cases and 36 (45%) of cases with du- ration of disease of

Hasil (Bahasa Indonesia) 1:

RHEUMATIC HEART DISEASE , ESPECIALLY THE SEVERE ONE IS a serious problem, both for the patient, family and society as well. Unfortunately the disease frequently affects school-age children and productive, active adolescents resulting in negative impacts on growth and development. 1 Rheumatic heart disease is the leading acquired cardiac disease frequently encountered in childhood and adolescence in many developing countries. Although it can be prevented, the disease still causes high morbidity and mortality. 2 The prevalence of rheumatic heart disease in Indonesia is sufficiently high, ie, 0.3-0.8 per 1000 school-age children aged 5-15 years, 3,4 with the mor- Factors affecting school performance in children with rheumatic heart disease Reference to educational achievement, absent of school and dropouts Arief Hermanu S, Sudigdo Sastroasmoro, Bambang Madiyono, Ismet N. Oesman Department of Child Health, Medical School University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta ABSTRACT The aim of this study was to determine the association between school performance and age, sex, duration of illness, educational achievement prior to illness, socioeconomic status of family, parent's educational level, number of children in the family and severity of the disease of patients with rheumatic heart disease (RHD). Subjects were patients with RHD treated at the Division of Cardiology, Department of Child Health, Cipto Mangunkusumo Hospital Jakarta. The parameters of school performance were educational achievement, absent of school and dropout. All data were processed by using Epi- Info program to find out bivariate analysis and Statistic Program for Social Sciences (SPSS) for multivariate analysis. We obtained 80 patients with RHD; most of them were of mild severity (64 of 80%) and the remainder 16 (20%) with severe disease. There were 44 (55%) males and 36 (45%) females. Most parents (42 or 53%) had junior high school educational level, most of them, 23 (29%) had elementary school education, and 3 (4%) illiterate. Bivariate and multivariate analyses showed that severity of disease and parental educational level were associated withschool performance of patients with RHD, but age, sex, duration of disease, premorbid educational achievement, socio-economic level of the family and number of children in family were not. [Paediatr Indones 2001; 41:299-304] Keywords : rheumatic heart disease, school performance, prognosis, parental education tality rate of at least 10 times higher compared to that in developed contries. 5,6 This disease is associ- ated with poor nutritional and lower socio-economic status and uneven distribution of health care. 3,4 Be- sides, rheumatic heart disease will also affect daily activities, educational achievement and absent of school that even may cause dropouts. This reflects how rheumatic heart disease can influence school- ing performance. 7 To the best of our knowledge there is no study concerning schooling performance in stu- dents contracting rheumatic heart disease, both in Indonesia and abroad. Among various factors known or suggested as influencing schooling performance in students with RHD are age, sex, family socio-eco- nomic status, parental educational level, number of children the family, duration of illness, educational achievement prior to disease, and severity of the dis- Correspondence : Arief Hermanu S, MD, Department of Child Health, Medical School University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Tel [phone], Fax. [phone].Page 2Paediatrica Indonesiana Vol. 41 No. 11-12, November-December 2001 300 ease. We aimed to determine factors associated with schooling performance of children with RHD treated in our hospital during the last 9 years. Methods We reviewed patients with RHD visited the outpatient clinic of Cardiology Division, Department of Child Health, Dr. Cipto Mangunkusumo Hospital from 1990 to 1998. Data were obtained from medical records and questionnaire. We collected data for age, sex, socioeconomic status of family, parental educational level, number of children in family, duration of illness, educational achievement prior to illness and severity of the disease. Those data were considered or suggested as risk factors or independent variables, while the dependent variable was school performance possessing 3 parameters, namely educational achievement, absent of school, and dropouts. The inclusion criteria included (1) patients with rheumatic heart disease visited the outpatient clinic of Division of Cardiology, Department of Child Health between January 1, 1990 and December 31, 1998; (2) age 6-15 years, (3) patients had never transferred to other school during educational period; and (4) the medical record was completed with clear address ac- companied by findings on history taking, physical ex- amination, electrocardiographic, chest-x ray, and echocardiography. We excluded patients who died during first quarter before after diagnosis of RHD was established. Results Characteristics of the subjects During the study period 80 patients with RHD visited the Division of Cardiology, Department of Child Health, Cipto Mangunkusumo Hospital. Most of patients were in mild disease 64 (80%) and the other 16 (20%) with severe disease, 3 cases of 16 subjects with severe disease died less than six months after the diagnosis of RHD was established. The subjects comprised of 44 males (55%) and females 36 (45%); most of them (55%) belonged 12-15 year age group (Table 1). According to duration of illness, the most preva- lent length of disease of more than 2 years was found in 44 (55%) of cases and 36 (45%) of cases with du- ration of disease of <2 years (Table 1). The same table shows distribution of educational achievement prior to illness that good achievement was encoun- tered in 78 (97%) of patients, whereas poor achieve- ment in 2 (3%) of patients. On the basis of socio-economic level and the severity of disease (Table 2),

Hasil (Bahasa Indonesia) 2:

Rematik PENYAKIT JANTUNG, TERUTAMA BERAT ONE IS masalah serius, baik bagi pasien, keluarga dan masyarakat juga. Sayangnya penyakit yang sering menyerang anak-anak usia sekolah dan produktif, remaja yang aktif mengakibatkan dampak negatif pada pertumbuhan dan perkembangan. 1 rematik penyakit jantung adalah penyakit jantung terkemuka diperoleh sering ditemui pada anak-anak dan remaja di banyak negara berkembang. Meskipun dapat dicegah, penyakit masih menyebabkan morbiditas dan mortalitas yang tinggi. 2 Prevalensi penyakit jantung rematik di Indonesia cukup tinggi, yaitu, 0,3-0,8 per 1.000 anak usia sekolah usia 5-15 tahun, 3,4 dengan Faktor matian mempengaruhi kinerja sekolah pada anak-anak dengan Referensi penyakit jantung rematik untuk pendidikan prestasi, absen dari sekolah dan putus sekolah Arief Hermanu S, Sudigdo Sastroasmoro, Bambang Madiyono, Ismet N. Oesman Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Cipto Mangunkusumo, Jakarta ABSTRAK Tujuan penelitian ini adalah untuk mengetahui hubungan antara sekolah kinerja dan usia, jenis kelamin, durasi penyakit, prestasi pendidikan sebelum sakit, status sosial ekonomi keluarga, tingkat pendidikan orang tua, jumlah anak dalam keluarga dan tingkat keparahan penyakit pasien dengan penyakit jantung rematik (RHD). Subyek penelitian adalah pasien dengan RHD dirawat di Divisi Kardiologi, Departemen Kesehatan Anak, Rumah Sakit Cipto Mangunkusumo Jakarta. Parameter kinerja sekolah yang prestasi pendidikan, absen dari sekolah dan putus sekolah. Semua data diolah dengan menggunakan program Info epi- untuk mengetahui analisis bivariat dan Program Statistik untuk Ilmu Sosial (SPSS) untuk analisis multivariat. Kami memperoleh 80 pasien dengan RHD; sebagian besar dari mereka keparahan ringan (64 dari 80%) dan sisanya 16 (20%) dengan penyakit yang parah. Ada 44 (55%) laki-laki dan 36 (45%) perempuan. Sebagian besar orang tua (42 atau 53%) memiliki tingkat pendidikan SMP, sebagian besar dari mereka, 23 (29%) memiliki pendidikan dasar sekolah, dan 3 (4%) yang buta huruf. Bivariat dan analisis multivariat menunjukkan bahwa keparahan penyakit dan tingkat pendidikan orangtua dikaitkan kinerja withschool pasien dengan RHD, tapi usia, jenis kelamin, durasi penyakit, prestasi pendidikan premorbid, tingkat sosial ekonomi keluarga dan jumlah anak dalam keluarga tidak . [Paediatr Indones 2001; 41: 299-304] Keywords: penyakit rematik jantung, kinerja sekolah, prognosis, tingkat kema- pendidikan orang tua dari setidaknya 10 kali lebih tinggi dibandingkan dengan yang di contries maju. 5,6 Penyakit ini dikaitkan dengan diciptakan dengan status sosial-ekonomi miskin gizi dan rendah dan distribusi yang tidak merata dari perawatan kesehatan. 3,4 pihak Be-, penyakit jantung rematik juga akan mempengaruhi kegiatan sehari-hari, prestasi pendidikan dan absen dari sekolah yang bahkan dapat menyebabkan putus. Hal ini mencerminkan bagaimana penyakit jantung rematik dapat mempengaruhi kinerja ing sekolah-. 7 Untuk yang terbaik dari pengetahuan kita tidak ada studi tentang kinerja sekolah di siswa tertular penyakit jantung rematik, baik di Indonesia maupun di luar negeri. Di antara berbagai faktor yang diketahui atau diduga sebagai mempengaruhi kinerja sekolah pada siswa dengan RHD adalah usia, jenis kelamin, status sosial keluarga sosio-eko, tingkat pendidikan orang tua, jumlah anak keluarga, durasi penyakit, prestasi pendidikan sebelum penyakit, dan tingkat keparahan Correspondence dis: Arief Hermanu S, MD, Departemen Kesehatan Anak, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Cipto Mangunkusumo, Jakarta, Tel [phone], Fax. [phone].
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Paediatrica Indonesiana Vol. 41 No 11-12, November-Desember 2001 300 mudah. Kami bertujuan untuk menentukan faktor yang terkait dengan sekolah kinerja anak-anak dengan RHD dirawat di rumah sakit kami selama 9 tahun terakhir. Metode Kami meninjau pasien dengan RHD mengunjungi klinik rawat jalan Kardiologi Divisi, Departemen Kesehatan Anak, Rumah Sakit Dr. Cipto Mangunkusumo dari tahun 1990 sampai 1998. Data diperoleh dari catatan medis dan kuesioner. Kami mengumpulkan data usia, jenis kelamin, status sosial ekonomi keluarga, tingkat pendidikan orang tua, jumlah anak dalam keluarga, durasi penyakit, prestasi pendidikan sebelum penyakit dan keparahan penyakit. Data tersebut dianggap atau diduga sebagai faktor risiko atau variabel independen, sedangkan variabel dependen adalah kinerja sekolah yang memiliki 3 parameter, yaitu prestasi pendidikan, tidak ada sekolah, dan putus sekolah. Kriteria inklusi termasuk (1) pasien dengan penyakit jantung rematik mengunjungi klinik rawat jalan dari Divisi Kardiologi, Departemen Kesehatan Anak antara 1 Januari 1990 dan 31 Desember 1998; (2) usia 6-15 tahun, (3) pasien tidak pernah dipindahkan ke sekolah lain selama periode pendidikan; dan (4) catatan medis selesai dengan alamat yang jelas ac- ditemani oleh temuan pada anamnesis, aminasi mantan fisik, elektrokardiografi, dada x ray, dan ekokardiografi. Kami dikecualikan pasien yang meninggal selama kuartal pertama sebelum setelah diagnosis RHD didirikan. Hasil Karakteristik subjek Selama masa penelitian 80 pasien dengan RHD mengunjungi Divisi Kardiologi, Departemen Kesehatan Anak, Rumah Sakit Cipto Mangunkusumo. Sebagian besar pasien adalah penyakit ringan 64 (80%) dan yang lainnya 16 (20%) dengan penyakit yang parah, 3 kasus dari 16 subyek dengan penyakit parah meninggal kurang dari enam bulan setelah diagnosis RHD didirikan. Subyek terdiri dari 44 laki-laki (55%) dan perempuan 36 (45%); kebanyakan dari mereka (55%) milik kelompok usia 12-15 tahun (Tabel 1). Menurut durasi penyakit, yang paling prevalence dipinjamkan panjang penyakit lebih dari 2 tahun ditemukan di 44 (55%) kasus dan 36 (45%) dari kasus dengan ransum du- penyakit dari <2 tahun (Tabel 1 ). Meja yang sama menunjukkan distribusi prestasi pendidikan sebelum penyakit yang berprestasi baik adalah tered encoun- di 78 (97%) dari pasien, sedangkan prestasi miskin di 2 (3%) dari pasien. Atas dasar tingkat sosial ekonomi dan tingkat keparahan penyakit (Tabel 2),