Scientific Journal of Pediatrics

Effectiveness of Storytelling Versus Lecture Methods on Oral Health Knowledge in Children Aged 7–8 Years: A Quasi-Experimental Study

2026-04-29T07:41:34+00:00

Introduction: Dental caries remains the most prevalent chronic disease in children worldwide, disproportionately affecting school-age populations in low- and middle-income countries. This quasi-experimental study evaluated the effectiveness of storytelling versus traditional lecture methods in improving oral health knowledge among children aged 7–8 years (mean age 7.4 ± 0.5 years) in Padang, Indonesia.

Methods: A total of 110 children were enrolled and assigned to storytelling (n=55) and lecture (n=55) groups, with 108 children (54 per group) completing the study. Pre-test and post-test knowledge assessments were conducted using a validated 15-item questionnaire (Content Validity Index = 0.87, Cronbach’s α = 0.73).

Results: The storytelling group demonstrated a significant mean score increase of +1.28 points (95% CI: 0.97–1.59, p < 0.001, Cohen’s d = 1.12), while the lecture group showed a non-significant gain of +0.35 points (95% CI: -0.13 to 0.83, p = 0.152, Cohen’s d = 0.22). Post-intervention, 83.3% of the storytelling group achieved “good” knowledge levels compared to 51.9% in the lecture group (OR = 4.66, 95% CI: 1.88–11.54, p < 0.001; NNT = 3.2). Children with lower baseline knowledge benefited most from storytelling (r = 0.51, p < 0.010). Children perceived storytelling as more enjoyable (92.6% vs 51.9%), easier to understand (88.9% vs 59.3%), and more motivating for oral hygiene practice (81.5% vs 50.0%).

Conclusion: Storytelling was significantly more effective than lectures in enhancing oral health knowledge, particularly among children with limited baseline understanding, supporting its implementation as a school-based oral health promotion strategy.

Prostaglandin E1 Dose and Duration as Determinants of Adverse Outcomes in Neonates with Duct-Dependent Congenital Heart Disease: A Systematic Review and Meta-Analysis

2026-05-15T02:36:09+00:00

Introduction: Prostaglandin E1 (PGE1) infusion remains the cornerstone of medical stabilisation in neonates with duct-dependent critical congenital heart disease (DD-CCHD), yet contemporary guidance on optimal dose and duration is not informed by quantitative synthesis of recent evidence.

Methods: A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 and MOOSE statements. PubMed/MEDLINE, ScienceDirect, OpenAlex and Europe PMC were searched (1^st January 2014 – 30^th April 2026) for original observational studies reporting PGE1 dose and/or duration with at least one adverse outcome in neonates (≤28 days) with DD-CCHD. The Newcastle–Ottawa Scale (NOS) and GRADE were applied. The primary outcome was the pooled prevalence of any PGE1-related adverse event using the Freeman–Tukey arcsine transformation under a DerSimonian–Laird random-effects model with the Hartung–Knapp–Sidik–Jonkman variance adjustment. The secondary, hypothesis-generating outcome was the pooled standardised mean difference (Hedges g) between higher- and lower-dose strata via the Chinn conversion. Heterogeneity, leave-one-out sensitivity, prespecified subgroup analyses, meta-regression and Egger regression were performed.

Results: Ten observational studies enrolling 1,060 neonates were included. The pooled prevalence of any PGE1-related adverse event was 0.617 (95% confidence interval [CI] 0.509–0.724; I² = 87.6%). The secondary pooled Hedges g was 0.085 (95% CI −1.93 to 2.10), reflecting directional heterogeneity. Apnoea ranged from 9% to 52%, with a clear dose-related signal in two studies (relative risk approximately 1.97, p = 0.037; relative risk approximately 0.44, p = 0.015). Egger's intercept was 0.58 (p = 0.81), indicating no asymmetry. Meta-regression on median initial dose suggested dose-related apnoea risk.

Conclusion: In neonates with DD-CCHD, approximately 62% experienced at least one PGE1-related adverse event. Initiation at 0.005–0.010 µg/kg/min should be regarded as the contemporary clinical default, with structured surveillance for apnoea and fever within 48 hours, gastrointestinal intolerance after 7–10 days and skeletal toxicity after 28 days.

Family Support Domains and Quality of Social Interaction in School-Aged Children with Autism Spectrum Disorder: A Cross-Sectional Study in Palembang, Indonesia

2026-06-08T03:44:29+00:00

Introduction: Autism spectrum disorder (ASD) affects approximately one in 100 children worldwide, and family support is a modifiable determinant of pediatric social functioning, yet the contribution of distinct family-support domains to social-interaction quality remains poorly characterized in Indonesian children. We quantified the association between five Friedman-framework family-support domains (emotional, informational, reward, instrumental, social/network) and social-interaction quality.

Methods: In a cross-sectional analytical study at Sekolah Luar Biasa Negeri Pembina Palembang during November–December 2024, 36 of 40 eligible caregivers of children with ASD aged 7–12 years (mean 9.9 years, 91.7% male) completed Friedman's family-support inventory and the Indonesian Autism Social Skills Profile (ASSP). Spearman correlations with Fisher-z-derived confidence intervals, multivariable logistic regression, receiver-operating-characteristic (ROC) discriminative-performance analysis, and pre-specified subgroup analyses were performed.

Results: Social interaction was moderate in 58.3%, low in 25.0%, and high in 16.7%. Network/social support showed the strongest correlation with ASSP score (ρ = 0.654, 95% CI 0.413–0.808, p < 0.001), and in multivariable regression remained the only independent predictor of non-low quality (adjusted OR 6.42, 95% CI 1.48–27.83, p = 0.013; Nagelkerke R² = 0.547). The composite family-support score discriminated low from non-low quality with AUC = 0.832 (95% CI 0.701–0.963; Youden cut-off ≈ 85, sensitivity 0.78, specificity 0.81).

Conclusion: Network/social support is the predominant family-support component shaping social-interaction quality in Indonesian children with ASD, supporting pediatric primary-care screening focused on caregiver social connectedness.

Diagnostic Accuracy of the LittlEARS Auditory Questionnaire Against Auditory Steady-State Response for Detecting Hearing Loss in Infants Aged 6–24 Months

2026-06-10T03:54:54+00:00

Introduction: Hearing loss is among the most common congenital conditions in childhood, yet most affected infants in Indonesia are identified late because objective audiometry is centralized and preverbal infants show few overt signs. This study aimed to determine the diagnostic accuracy of the parent-completed LittlEARS Auditory Questionnaire against the auditory steady-state response (ASSR) for detecting hearing loss in infants aged 6–24 months.

Methods: In this single-center, cross-sectional diagnostic-accuracy study, 28 children aged 6–24 months (median 9.0 months; 71.4% male) attending a tertiary otorhinolaryngology clinic were enrolled by consecutive sampling. Parents independently completed the Indonesian LittlEARS, and each child underwent ASSR as the reference standard (hearing loss >25 dB HL across 0.5–4 kHz). Diagnostic indices were computed with Wilson 95% confidence intervals (CI); agreement, likelihood ratios, receiver-operating-characteristic analysis, and Firth penalized logistic regression were performed.

Results: ASSR confirmed hearing loss in 19 children (67.9%), of whom 18 had bilateral loss. Referenced to ASSR, LittlEARS yielded a sensitivity of 89.47% (95% CI 68.6–97.1), specificity 77.78% (95% CI 45.3–93.7), positive predictive value 89.47%, negative predictive value 77.78%, and accuracy 85.71% (95% CI 68.5–94.3). Agreement was substantial (Cohen kappa 0.673), the positive likelihood ratio 4.03 and negative likelihood ratio 0.14, and the area under the curve 0.836 (95% CI 0.688–0.985). A suspected-hearing-loss result independently predicted ASSR-confirmed loss (adjusted odds ratio 13.98, 95% CI 1.68–116.25; p=0.015; Nagelkerke R²=0.469).

Conclusion: The LittlEARS questionnaire is an accurate, low-cost screening adjunct for early childhood hearing loss but, given moderate specificity, a positive screen should be confirmed by objective audiometry.

Maternal and Perinatal Determinants of Neonatal Sepsis in Asia: An Exploratory Meta-Analysis

2026-06-10T07:58:07+00:00

Introduction: Neonatal sepsis is a leading cause of newborn death in Asia, but the pooled evidence on its maternal and perinatal determinants is dominated by African cohorts. This study synthesised Asian observational evidence on these determinants.

Methods: PubMed/MEDLINE was searched for case-control, cohort, and cross-sectional studies reporting odds ratios for maternal or perinatal determinants of clinically or culture-diagnosed neonatal sepsis in Asian populations. Ten studies from six countries were included. Because the outcome was dichotomous, effects were pooled as odds ratios using a DerSimonian-Laird random-effects model; risk of bias was appraised with ROBINS-I.

Results: Premature rupture of membranes (odds ratio 2.47, 95% CI 1.63-3.73; I-squared 0%) and maternal urinary tract infection (odds ratio 4.33, 95% CI 2.38-7.86; I-squared 5%) were significantly and consistently associated with neonatal sepsis. Maternal or intrapartum fever (odds ratio 1.98, 95% CI 0.75-5.24) and caesarean delivery (odds ratio 1.44, 95% CI 0.74-2.83) were not significant and were heterogeneous. The direction of every pooled effect matched an independent Ethiopian meta-analysis.

Conclusion: In Asian settings, premature rupture of membranes and maternal urinary tract infection were the most credible and consistent maternal determinants of neonatal sepsis, supporting antenatal screening and timely intrapartum management.