Status Gizi Anak Balita Di Daerah Malaria

STATUS GIZI ANAK BALITA DI DAERAH MALARI

Status Vitamin A Anak 12-59 Bulan dan Cakupan Kapsul Vitamin A di Indonesia

Masalah kurang vitamin A (KVA) masih merupakan masalah gizi di Indonesia. Program untuk mengatasi KVA dilakukan dengan program suplementasi kapsul vitamin A untuk anak 6-59 bulan dua kali setahun (Februari dan Agustus). Tetapi cakupan program tersebut belum optimal dan bervariasi antar daerah dan sebagian Balita masih terkena KVA. Studi ini bagian dari SEANUTS yang bertujuan untuk mengetahui cakupan kapsul vitamin A, faktor-faktor yang mempengaruhi status serum retinol anak Indonesia umur 12-59 bulan. Studi dilakukan di 48 kabupaten yang mencakup 3595 Balita. Cakupan kapsul dan faktor-faktor dikumpulkan oleh enumerator dengan kuesioner terstruktur. Serum retinol dianalisis dengan metode HPLC dari 504 sub-sampel Balita. Cakupan kapsul vitamin A sebesar 83,0 persen. Faktor yang berperan Balita tidak menerima kapsul vitamin A adalah status ekonomi rendah (OR 1,75 95% CI 1,35-2,27), tidak pernah ke posyandu (OR 7,90 95% CI 6,20-10,06), ke posyandu hanya 1-3 kali dalam 6 bulan terakhir (OR 2,62 95%CI 2,00-3,49), dan pendidikan ibu SMP ke bawah (OR 1,41 95% CI 1,11-1,78). Serum retinol Balita yang tidak menerima kapsul lebih rendah (p=0,039) dibanding yang menerima kapsul (1,37+0,47 dibanding 1,51+0,53 µmol/L). Kadar serum retinol tertinggi pada 2 bulan sesudah distribusi kapsul (2,10+0,36 sampai 2,18+0,61 µmol/L) dan kemudian terus menurun sampai sebelum bulan distribusi kapsul 6 bulan berikutnya (1,21+0,45 sampai 1,28+0,40 µmol/L). Hal ini berarti kenaikan serum retinol antara 0,82-0,97 µmol/L dengan suplementasi kapsul vitamin A. Program kapsul vitamin A masih tetap diperlukan karena kapsul meningkatkan status vitamin A yang masih belum optimal

Asupan Zat Besi, Vitamin a Dan Zink Anak Indonesia Umur 6-23 Bulan

Anak di bawah dua tahun paling rentan terhadap kekurangan gizi. Oleh karena itu, seribu hari kehidupan pertama merupakan periode kritis anak untuk mendapatkan kesehatan dan status gizi yang baik. Penelitian ini bertujuan untuk mengukur asupan zat besi, vitamin A dan zink dari makanan anak yang berkontribusi terhadap masalah kurang gizi mikro. Desain penelitian ini potong-lintang dengan sampel 1,177 anak umur 6-23 bulan di 48 kabupaten di Indonesia. Asupan makanan diukur menggunakan metoda recall 24 jam asupan makan, oleh enumerator terlatih. Asupan zat gizi dihitung berdasarkan Daftar Komposisi Bahan Makanan Indonesia. Variabel lainnya seperti karakteristik rumah tangga, ASI dan praktik pemberian makanan pendamping ASI, pelayanan kesehatan, angka kesakitan, antropometri dan hemoglobin. Hasil penelitian menunjukkan rerata asupan vitamin A, zat besi dan zink adalah 298+9 µg, 4,6+0,2 mg, and 3,3+0,1 mg. Bila dibandingkan dengan Angka Kecukupan Gizi yang Dianjurkan (AKG) vitamin A, zat besi, dan zink adalah 74,6+1,8%, 60,3+2,7%, dan 41,0+1,1%. Prevalensi anemia sebesar 56,4 persen. Analisis ANCOVA menggambarkan bahwa asupan berhubungan secara nyata dengan tempat tinggal (desa/kota), status sosial ekonomi, umur, morbiditas (kesakitan), nafsu makan, pemberian ASI dan konsumsi susu dan hasil olahnya. Walaupun demikian, analisis dengan regresi logistik ganda menggambarkan bahwa asupan rendah vitamin A dibawah AKG berhubungan dengan umur anak yang lebih muda, status sosial ekonomi rendah, penyapihan dan nafsu makan yang rendah. Asupan zat besi rendah berhubungan dengan umur, tempat tinggal, status sosiaI ekonomi rendah, sedangkan asupan zink berhubungan dengan status sosial ekonomi rendah dan penyapihan. Anak dengan konsumsi zat besi kurang dari AKG berhubungan dengan prevalensi anemia

Pola Pertumbuhan Bayi Di Daerah Endemik Malaria: Kasus Di Desa Robek, Flores

Telah diteliti pola pertumbuhan bayi di daerah endemik malaria yaitu di Desa Robek, Kecamatan Rao, Kabupaten Flores, Nusa Tenggara Timur. Penelitian dilakukan dengan menimbang berat badan bayi sekali sebulan sejak dilahirkan sampai berumur 12 bulan. Hasil penelitian menunjukkan bahwa meskipun rata-rata berat badan lahir bayi-bayi di daerah itu lebih rendah dari pada baku Harvard; sampai umur 4 bulan ternyata laju pertumbuhan berat badan mereka sama seperti bayi sehat di daerah lain di Indonesia. Tetapi sesudah umur ini, laju pertambahan berat badan mereka cenderung mengarah ke pola pertumbuhan tidak sebagaimana layaknya untuk bayi-bayi sehat menurut baku Harvard. Pertambahan berat badan bayi yang mengidap penyakit malaria lebih rendah daripada yang tidak mengidap penyakit tersebut

Serum Retinol Dan Status Gizi Ibu Menyusui Menentukan Kadar Vitamin a Dalam Asi

Latar Belakang: Status vitamin A ibu menyusui dan bayinya telah dibuktikan mempunyai hubungan yang erat. Bayi dari ibu yang menderita kurang vitamin A mempunyai risiko yang tinggi menderita KVA. Asumsinya hubungan tersebut dimediasi oleh kadar vitamin A dalam ASI sebagai sumber vitamin A utama. Tujuan: Tulisan ini bertujuan untuk mengetahui hubungan antara status vitamin A ibu menyusui dan kadar vitamin A dalam ASI. Metode: Studi dilakukan pada 440 ibu menyusui yang bayinya umur 6-12 bulan di Kabupaten Tasikmalaya dan Ciamis. Serum vitamin A dalam darah dan kadar vitamin A dalam ASI dikumpulkan dan dianalisis dengan metode HPLC. Kovariat antropometri, morbiditas, karakteristik ibu dan bayi yang berperan dalam serum vitamin A dan vitamin A ASI dikumpulkan. Analisis uji-t, ANOVA dan ANCOVA dilakukan untuk menguji peran status vitamin A ibu terhadap vitamin A ASI. Hasil: Hasil studi menunjukkan KVA ibu menyusui berpengaruh secara signifikan terhadap rendahnya kadar vitamin A dalam ASI setelah dikontrol oleh kovariat status gizi ibu menyusui. Rerata vitamin A dalam ASI pada ibu yang KVA dan non KVA 47,0 μg/dL dan 88,2 μg/dL. Kesimpulan: Setelah dikontrol oleh kovariat status gizi ibu menyusui, kurang vitamin A pada ibu menyusui berpengaruh secara signifikan terhadap rendahnya kadar vitamin A dalam ASI

Cakupan Suplementasi Kapsul Vitamin a Pada Ibu Masa Nifas Dan Faktor-faktor Yang Memengaruhi Di Indonesia Analisis Data Riskesdas 2010

Background: Vitamin A supplementation program for postparum mothers has been implemented in lndonesia since 1996. The objective is to improve vitamin A status of postpartum mother and newborn through improvement of vitamin A status in breastmilk. However, Riskesdas 2010, across-sectional nationwide health study, reveals that the coverage is lower than in children underfives. In order to improve the coverage, there is a need to analyze factors associated with high or low coverage. The objective of this paper is to assess vitamin A coverage for postpartum mothers and factors of household, mother, access to health services that favour or limit the coverage. Methods: Riskesdas 2010 collected information on whether 19,000 samples mother 10-59 years having living children underfives received vitamin A capsules during postpartum period of the last child. A multivariate logistic regression was used to measure odd ratio. Vitamin A supplementation coverage among mother (in pospartum period) was 56.1%, varies 35-70% among provinces, higher in urban (61.4%) than in rural areas (50.8%). Gdd ratios of mothers who didn\u27t receive capsule are significantlyassociated with not having neonatal care (AGR = 2,334, 95% CI 2,156-2,530), not receiving iron tablet during pregnancy (AGR = 2,076,95% CI 1,874-2,298), ANC 3 times or less (AGR = 1.252,95% CI 1,095-1,431), without ANC (AGR = 1,355, 95% CI 1,217-1,510), not receiving TT immunization (AGR = 1,245, 95% CI 1, 156-1,341). The coverage is also significantly associated with not attending Posyandu, low education, did not know Polindes with AGR slightly above 1, but not associated with age and marital status. Results: The analysis shows that factors significantly associated with the coverage are mostly assessibility of health care of mothers during pregnancy and delivery High coverage of vitamin A supplementation should be improved by increasing access of women during pregnancy and delivery in community and health education on importance of vitamin A supplementation

The Impact of Vitamin a Fortified Vegetable Oil on Vitamin a Status of Children Under Five Years of Age: a Cohort-like Study

Introduction: Sub-clinical vitamin A deficiency (VAD) and anemia remain major nutritional problem in Indonesia. Although the government has implemented distribution of vitamin A capsules (VAC), there are one third of children missed VAC distribtion. The prevalence of anemia is also still high. Objectives: Part of this study was conducted to measure the effectiveness of vitamin A fortification in unbranded cooking oil among 6-59-month-old children of poor families in 2 districts in Indonesia prior mandatory vitamin A fortification in cooking oil. Materials and Methods: Total number of samples were 126 children. Venous blood was drawn by trained phlebotomist. Serum retinol and hemoglobin were measured by HPLC and hemoque respectively at baseline just before cooking oil fortification and 12 months after at endline. Trained enumerators collected data of morbidity and measurement of vitamin A content in cooking oil from the households, food stalls and markets was done periodically during the study. There was not any intervention from the study team on distribution and purchase of fortified cooking oil by the families, because cooking oil was distributed and sold through exsisting market mechanism. Enumerators collected socio-demographic variables. They also collected 24-hr dietary recall and food frequency questionnaires to measure nutrient intakes at base- and endline. Results: Serum retinol significantly increased by 5.07, 6.82, 6.01 µg/dL in 6-11, 12-23, and 24-59 month-old children respectively. Hemoglobin increased by 0.13 (p>0.05) , 0.56 (p<0.05), 0.81 g/dL (p<0.05) in 6-11, 12-35, 36-59 month-old children respectively. Conclusions: Vitamin A fortification in cooking oil significantly improved serum retinol in underfive children in all age groups and hemoglobin only in older age group

Aktivitas Ibu dalam Organisasi dan Paparan terhadap Media Massa dalam Penyimpangan Positif Status Gizi Anak Balita

Malnutrition causes growth and mental retardation, and also contributes to child mortality. One of the causal factors which leads to protein energy malnutrition are social factors. This study looked for social factors which are associated to mother's participation in organizations and mother's exposure to mass media in regards to positive deviance of children's nutritional status. Design of this study was case control. The case samples were children with good nutritional status, while for control children with malnutrition were used. Matching was conducted according to sex, age, and socio economic status of the family. Nutritional status was determined by Z-Score weight for age. The study was conveyed in Gunung Kidul and Sukabumi district with total a number of samples of 450 children under five years old. The respondents were the mothers of participating children. The study showed a significant correlation of nutritional status of underfive children with mother's participation in organizations (p < 0.05). There was also a significant difference of media exposure between mother's exposure of newspaper, magazine, and television to nutritional status of children under five (p < 0.05). The study revealed that mother's participation including their role in the organization, exposure of mothers to newspaper, magazine, and television could improve nutritional status of children under five

Konsumsi Minyak Goreng dan Vitamin A pada Beberapa Kelompok Umur di Dua Kabupaten

Indonesia plans to implement mandatory vitamin A fortification of cooking oil. A pilot study of voluntary vitamin A fortification in unbranded cooking oil showed that vitamin A status improved significantly a year afterfortification for five age groups except for children 12-23 months of age. The objective of the study was to measure cooking oil consumption and dietary consumption of vitamin A in children, women of reproductive age(WRA), and lactating mothers. The study was a cross-sectional study in Tasikmalaya and Ciamis, Indonesia, covering 1.594 samples randomly selected of poor households. Cooking oil was collected at household byrecall of usual cooking oil purchase and individual sample by 2x24h recall of food consumption. The results showed that households prefer bought unbranded cooking oil sold in plastic pouch at foodstall (warung) nearbyhome (96.2%), purchased oil every 1-3 days (60.6%), each purchace contained < 250 mL oil (73.9%). The average (mean+SE) cooking oil consumption at household was 27.5+1.0 mL/capita/day. Cooking oilconsumption at individual level on the average was 22.3+0.5 mL/capita/day lower compared to household consumption of oil, varied significantly of 2.4+0.4, 13.3+0.8, 23.0+1.0, 30.5+1.3, 33.5+1.2, 33.1+1.3 mL/day in 6-11, 12-23, 24-59 month old, 6-9 year old, WRA, and lactating mothers respectively. Cooking oil consumptionwas lower in children 6-11 and 12-23 months old which contributed to non-significant improvement of serum vitamin A level particularly in children 12-23 months old but not other groups since they consumed higher intake of cooking oil or still brestfed for children 6-11 month old

Cakupan Penimbangan Anak Balita Di Indonesia

Background: Monthly weighing session in Posyandu is an important activity for growth monitoring and promotion escpecially for children below five years old. By knowing weight every month, growth trajectory can be assessed and nutrition intervention and education can be applied. However, there has been a tendency of decreasing coverage of Posyandu in Indonesia during recent years. Objectives: To determine the coverage of children below five years old attending Posyandu or other weghing post. Methods: Data used for the analysis was from Susenas Modul (VSEN.2004.MPK). Samples were children aged 0 – 59 months weighted in Posyandu or other weighing post one month prior to data collection. Analysis of weighing coverage was based on some variables including province, urban rural area, age of children, frequency of visit to health facilities, and household expenditur. Results: Out of a total 21,932 children included in the analysis, 50.4% attended Posyandu or other weighing session, 47.9% not attended, and 2.1% did not know. The figure was lower than the target of 80% coverage set by MOH. The coverage varied among provinces, the lowest was found in North Sumatra (29.6%) and the highest in DI Yogjakarta (77.3%). The coverage was higher in urban areas (56.9%) than that in rural areas (45.3%). There was a trend of decreasing coverage by increasing age of children. The coverage of weighing participation of babies aged less than 6 months old was 68.2% and continued to decrease especially after the age of 24 months old to only 33.0% among children aged 48 months old or older. Poor families was more likely to have lower coverage (47.4%) than families of high socio economic status (60.1%). Conclusion: High coverage of children under five years old attending weighing session in Posyandu was found in certain province (DI Yogjakarta), urban areas, younger children, better health care behavior, and high socio economic status. [Penel Gizi Makan 2005,28(2): 56-65