Pengukuran Weight for Height Z-Score (WHZ) dan Mid Upper Arm Circumstance (MUAC) di Berbagai Tempat di Dunia untuk Menentukan Status Gizi Balita dan Risiko Kematian – Sebuah Tinjauan Sistematis

AbstrakGizi buruk atau severe acute malnutrition (SAM) adalah salah satu permasalahan kurang gizi yang menyebabkan kematian balita setiap tahun. Pengukuran status gizi dibutuhkan untuk mengidentifikasi kasus malnutrisi dan sebagai indikator dalam kegiatan monitoring, baik kasus individu maupun dalam penanganan masalah di masyarakat. Pengukuran berat badan per tinggi badan atau weight-for-height Z-scores (WHZ) dan lingkar lengan atau mid-upper arm circumference measure (MUAC) menjadi indikator yang saat ini direkomendasikan World Health Oragnisation (WHO) untuk menentukan status gizi balita. Tetapi, beberapa penelitian menemukan bahwa pengukuran dengan WHZ dan MUAC menimbulkan kontradiksi untuk mendiagnosis SAM. Tujuan kajian ini adalah mengetahui penggunaan indikator WHZ dan MUAC untuk menentukan status gizi balita dan risiko kematiannya berdasarkan beberapa penelitian di seluruh dunia dan mengetahui indikator mana yang lebih disarankan oleh para peneliti tersebut. Metode melalui penelusuran artikel yang bersumber dari Medline, Google, dan PubMed dengan penuntun kata kunci. Hasil diperoleh artikel terseleksi sesuai kriteria inklusi ada 10 artikel yang memberikan informasi yang variatif. Simpulan dari kajian ini adalah beberapa penelitian merekomendasikan penggunaan WHZ atau MUAC sebagai indikator tunggal, tetapi penelitian lain menunjukkan bahwa WHZ dan MUAC sama-sama dapat digunakan mendeteksi status gizi sekaligus risiko kematian pada balita SAM. Pengukuran MUAC dianggap lebih baik untuk mengidentifikasi risiko kematian pada balita gizi buruk.Kata kunci: status gizi, gizi buruk, WHZ ,MUAC AbstractSevere acute malnutrition (SAM) is one of under nutrition problems that cause deaths of many children every year. The nutritional status of a child needs to be evaluated periodically to identify and monitor malnourished children, both at individual and community levels. Measurement of weight for height z-score (WHZ) and mid upper arm circumstance (MUAC) have been recommended by the World Health Oragnisation (WHO) as indicators to determine nutritional status and diagnose malnutrition in children aged between 6–59 months. However, there are contradictive results between WHZ and MUAC in assessing the nutritional status and risk of mortality risk of the children with SAM. We searched articles from Medline, Google, and PubMed. Ten articles were selected: some recommended the use of WHZ or MUAC as the only indicator, but some also stated that WHZ and MUAC can be used together to assess the nutritional status and risk of mortality in children with SAM. MUAC is assumed to identify better the risk of death among malnourished children.Keywords: Nutritional status, SAM, WHZ, MUA

Faktor-faktor yang berhubungan dengan kadar malondialdehyde plasma pada penyandang diabetes mellitus tipe 2

Background: Diabetic is associated with the risk of having lipid peroxidation causing macro and micro vascular diseases. Malondialdehyde (MDA) is a mutagen product of lipid peroxidation.Objective: This research was to identify some factors associated to plasma MDA (P-MDA) level in type 2 diabetes mellitus.Method: Eighty two subjects were randomly recruited. Subjets were members of Persadia, physical training club for diabetic at Mardjoeki Mahdi Hospital in Bogor. Data of fruits, vegetables, and nuts-legumes-seeds consumption were collected by interviewing using semi quantitative food frequency questionnaires. Fasting blood glucose and plasma MDA were assayed using Wills method, based on the reaction of thiobarbituric acid. Other data such as physical training, smoking status, and diseases history were collected by interviewing using structured questionnaires. Nutritional status data was determined as body mass index. All data was analyzed using Odds Ratio (OR) and logistic regression test to identify the dominant factors contributed to P-MDA level.Results: Factors that contribute to P-MDA level is vegetables, nuts-legumes-seeds consumption and physical training. Consuming vegetables less than 300 g/d and nuts-legumes-seeds less than 2.5 servings/d are associated significantly with having high level of P-MDA (≥0.8 nmol/L), respectively OR=5 (95%CI:1.154-22.02) and OR=4.8 (95%CI:1.26-18.57). Not having physical activity routinely is risk for having high level P-MDA (OR=1.3; 95%CI:1.12-1.45). Those factors are associated to P-MDA level independently.Conclusion: Vegetables and nuts-legumes-seeds consumption have a significant contribution to P-MDA level, it is important to know further which type and chemical content in those food that can prevent lipid peroxidation

STATUS GIZI BALITA DI KABUPATEN BOGOR PADA KRISIS EKONOMI

NUTRITIONAL STATUS OF UNDERFIVE YEARS CHILDREN DURING ECONOMIC CRISIS AT BOGOR DISTRICT.Background: The relationships between nutritional status, growth and development of vital organ have been published else where. The increasing of body weight and height can be used as indicators of good nutritional status of ctildren under five of age. The prevalence of severe malnutrition of children under five years lends to increase. Vitamin A deficiency and anemia were also still problems in Indonesia. The periodic information about nutritional status of children less than five years of age is important.Method: The assessment of nutritional status of under five children had been conducted in the area of 10 Puskesmas in Kabupaten Bogor. The selection of these areas based on the survey in 1992. Data collection was carried out twice in April 1999 and November 1999. The assessment included vitamin A status, anthropometry and hemoglobin level.Results: The result shows there was no case of xerophthalmia among the children. However, analysis shows that 7.3% children under five of age have serum vitamin A level below 10 ug/dl in April 1999 and 6.8 in November 1999.The prevalence of severe malnutrition based on weight for age tend to increase 3.1% (in 1992), 3.9% (in April 1999), and 4.4% (in November 1999). The prevalence of underweight significantly increased (p<0.05) from 11.4% to 24%. The prevalence of wasting also shows significantly increased both at 0-23 months and 24-60 months of age from 4.7% to 13.9% and 6.3 to 11.6% respectively. The prevalence of stunting not significantly increased. The prevalence of anemia increased from 41.7% in 1992 to 48.7% in April 1999 and 49.2% in November 1999. However, the increase was not significant statistically.Key Words: underfive years old, nutritional status, vitamin A status, anemia status

Status Gizi Balita Di Kabupaten Bogor Pada Krisis Ekonomi

NUTRITIONAL STATUS OF UNDERFIVE YEARS CHILDREN DURING ECONOMIC CRISIS AT BOGOR DISTRICT.Background: The relationships between nutritional status, growth and development of vital organ have been published else where. The increasing of body weight and height can be used as indicators of good nutritional status of ctildren under five of age. The prevalence of severe malnutrition of children under five years lends to increase. Vitamin A deficiency and anemia were also still problems in Indonesia. The periodic information about nutritional status of children less than five years of age is important.Method: The assessment of nutritional status of under five children had been conducted in the area of 10 Puskesmas in Kabupaten Bogor. The selection of these areas based on the survey in 1992. Data collection was carried out twice in April 1999 and November 1999. The assessment included vitamin A status, anthropometry and hemoglobin level.Results: The result shows there was no case of xerophthalmia among the children. However, analysis shows that 7.3% children under five of age have serum vitamin A level below 10 ug/dl in April 1999 and 6.8 in November 1999.The prevalence of severe malnutrition based on weight for age tend to increase 3.1% (in 1992), 3.9% (in April 1999), and 4.4% (in November 1999). The prevalence of underweight significantly increased (p<0.05) from 11.4% to 24%. The prevalence of wasting also shows significantly increased both at 0-23 months and 24-60 months of age from 4.7% to 13.9% and 6.3 to 11.6% respectively. The prevalence of stunting not significantly increased. The prevalence of anemia increased from 41.7% in 1992 to 48.7% in April 1999 and 49.2% in November 1999. However, the increase was not significant statistically

PRAKTEK PENYAPIHAN DINI SERTA HUBUNGANNYA DENGAN KEADAAN SOSIAL EKONOMI DAN WILAYAH TEMPAT TINGGAL

ABSTRACTThe most dominant factor influences the infant health is breast milk. Mothers who are no longer breastfed infants 0-6 months old are said practice an early weaning patterns. Early weaning patterns in which breastfeeding is replaced with complementary foods tend to lead tomalnourishedchildren.Studying the early weaning practice of infants 0-6 months old in correlation to socioeconomic and geographical conditions. Samples were households with infants 0-6 months old in 33 provinces in Indonesia available in Riskesdas 2013 data, was about 7935 households.Data were obtained from questionnaire of RKD13 Block Jb; Breast milk and complementary foods and RKD13 Block III; Block IV included education, work, economic/quintile, and geography. Household categories were household that were practicing early weaning pattern to their babies 0-6 months old.Thedata analysis showed about 6.7 percent infants already got early weaning practices in 0-6 months old. When it was associated with the number of people in Indonesia in 2015 about 250 million people, then the very young baby already weaned around 1.2 million inhabitants. It was known that there was a correlation between the status of working mothers, education, and the place of residence to early weaning patterns. Early weaning practices of infants was influenced by several factors. Factors of education, occupation, economic status, and residential geography influencedthe early weaning practices. ABSTRAK Faktor yang paling dominan mempengaruhi kesehatan bayi adalah air susu ibu (ASI). Ibu yang tidak lagi memberikan ASI pada bayi usia 0-6 bulan dikatakan sebagai praktek penyapihan dini.Pola penyapihan dini dimana pemberian ASI digantikan dengan makanan pendamping ASI (MP-ASI) cenderung mengakibatkan anak kurang gizi. Mempelajari praktek penyapihan dini bayi usia0-6 bulan serta kaitannya dengan keadaan sosial ekonomi dan geografi. Sampel adalah rumah tangga yang memiliki bayi usia 0-6 bulan di 33 provinsi di Indonesia yang tersedia dalam data Riskesdas 2013, yaitu berjumlah 7935 Rumah tangga. Data diperoleh dari kuesioner RKD13 yaitu Blok Jb; ASI dan MPASI dan RKD13 Blok III; dan Blok IV meliputi variabel pendidikan, pekerjaan, status ekonomi/kuintil, dan keadaan geografi. Kategori Rumah tangga adalah RT yang sudah melakukan penyapihan dini terhadap bayinya yang berusia 0-6 bulan. Berdasarkan hasil analisis data riskesdas 2013 diperoleh informasi sebanyak 6,7 persen bayi telah disapih pada usia 0-6 bulan. Bila dikaitkan dengan jumlah penduduk di Indonesia tahun 2015 yang diperkirakan sekitar 250 juta jiwa, maka bayi berusia 0-6 bulan yang telah disapih berkisar 1,2 juta jiwa. Diketahui bahwa terdapat hubungan antara status ibu bekerja, pendidikan, dan wilayah tempat tinggal terhdap pola penyapihan dini. Praktek penyapihan dini bayi dipengaruhi beberapa faktor.Faktor pendidikan, pekerjaan, status ekonomi, dan geografi tempat tinggal mempengaruhi praktik penyapihan bayi secara dini.ABSTRACTThe most dominant factor influences the infant health is breast milk. Mothers who are no longer breastfed infants 0-6 months old are said practice an early weaning patterns. Early weaning patterns in which breastfeeding is replaced with complementary foods tend to lead tomalnourishedchildren.Studying the early weaning practice of infants 0-6 months old in correlation to socioeconomic and geographical conditions. Samples were households with infants 0-6 months old in 33 provinces in Indonesia available in Riskesdas 2013 data, was about 7935 households.Data were obtained from questionnaire of RKD13 Block Jb; Breast milk and complementary foods and RKD13 Block III; Block IV included education, work, economic/quintile, and geography. Household categories were household that were practicing early weaning pattern to their babies 0-6 months old.Thedata analysis showed about 6.7 percent infants already got early weaning practices in 0-6 months old. When it was associated with the number of people in Indonesia in 2015 about 250 million people, then the very young baby already weaned around 1.2 million inhabitants. It was known that there was a correlation between the status of working mothers, education, and the place of residence to early weaning patterns. Early weaning practices of infants was influenced by several factors. Factors of education, occupation, economic status, and residential geography influencedthe early weaning practices. ABSTRAKFaktor yang paling dominan mempengaruhi kesehatan bayi adalah air susu ibu (ASI). Ibu yang tidak lagi memberikan ASI pada bayi usia 0-6 bulan dikatakan sebagai praktek penyapihan dini.Pola penyapihan dini dimana pemberian ASI digantikan dengan makanan pendamping ASI (MP-ASI) cenderung mengakibatkan anak kurang gizi. Mempelajari praktek penyapihan dini bayi usia0-6 bulan serta kaitannya dengan keadaan sosial ekonomi dan geografi. Sampel adalah rumah tangga yang memiliki bayi usia 0-6 bulan di 33 provinsi di Indonesia yang tersedia dalam data Riskesdas 2013, yaitu berjumlah 7935 Rumah tangga. Data diperoleh dari kuesioner RKD13 yaitu Blok Jb; ASI dan MPASI dan RKD13 Blok III; dan Blok IV meliputi variabel pendidikan, pekerjaan, status ekonomi/kuintil, dan keadaan geografi. Kategori Rumah tangga adalah RT yang sudah melakukan penyapihan dini terhadap bayinya yang berusia 0-6 bulan. Berdasarkan hasil analisis data riskesdas 2013 diperoleh informasi sebanyak 6,7 persen bayi telah disapih pada usia 0-6 bulan. Bila dikaitkan dengan jumlah penduduk di Indonesia tahun 2015 yang diperkirakan sekitar 250 juta jiwa, maka bayi berusia 0-6 bulan yang telah disapih berkisar 1,2 juta jiwa. Diketahui bahwa terdapat hubungan antara status ibu bekerja, pendidikan, dan wilayah tempat tinggal terhdap pola penyapihan dini. Praktek penyapihan dini bayi dipengaruhi beberapa faktor.Faktor pendidikan, pekerjaan, status ekonomi, dan geografi tempat tinggal mempengaruhi praktik penyapihan bayi secara dini

STATUS HOMOCYSTEINE DAN ASAM FOLAT PADA IBU HAMIL MEREKA

HOMOCYSTEINE AND FOLIC ACID STATUS OF ANEMIC PREGNANT WOMEN.Background: Folic acid deficiency among pregnant women in Indonesia is quite prevalent. It is believed to cause the anemia and the risk of infant neutral tube defect. Folic acid plays a certain role in homocysteine convertion into methionine. Serum homocysteine will increase with the decrease folic acid.Objective: To obtain folic acid consumption, homocysteine and folic acid status in pregnant women suffering from anemia using recent method of determination, and relationship of the three variables.Methodology: Pregnant women in the study area were screened by their Hb values under 11 g/dL. Thirty anemic pregnant women consumption was obtained by used 2x24 hours recall method. Folic acid was analysed by Ion Capture Method and homocysteine was analysed by Fluoresence Polarization Immuno assay.Results: Folic acid consumption was 61 ± 50 µg/mL with a range of 3.5 to 15.1 µg/mL. Normal value of serum folic acid was 3.1 to 12.4 µg/mL. Therefore, the value folic acid of pregnant women in this study was still in the range of normal value. Serum homocysteine value in pregnant women was 7.1 ± 1.95 µg/mL with a range of 3.0 to 10.9 µg/mL, while normal value was 5 to 15 µg/dL.Conclusion: homocysteine, folic acid, pregnant women, anemia.

Status Homocysteine Dan Asam Folat Pada Ibu Hamil Mereka

HOMOCYSTEINE AND FOLIC ACID STATUS OF ANEMIC PREGNANT WOMEN.Background: Folic acid deficiency among pregnant women in Indonesia is quite prevalent. It is believed to cause the anemia and the risk of infant neutral tube defect. Folic acid plays a certain role in homocysteine convertion into methionine. Serum homocysteine will increase with the decrease folic acid.Objective: To obtain folic acid consumption, homocysteine and folic acid status in pregnant women suffering from anemia using recent method of determination, and relationship of the three variables.Methodology: Pregnant women in the study area were screened by their Hb values under 11 g/dL. Thirty anemic pregnant women consumption was obtained by used 2x24 hours recall method. Folic acid was analysed by Ion Capture Method and homocysteine was analysed by Fluoresence Polarization Immuno assay.Results: Folic acid consumption was 61 ± 50 µg/mL with a range of 3.5 to 15.1 µg/mL. Normal value of serum folic acid was 3.1 to 12.4 µg/mL. Therefore, the value folic acid of pregnant women in this study was still in the range of normal value. Serum homocysteine value in pregnant women was 7.1 ± 1.95 µg/mL with a range of 3.0 to 10.9 µg/mL, while normal value was 5 to 15 µg/dL.Conclusion: homocysteine, folic acid, pregnant women, anemia