Nilai Diagnostik Indeks Wayne dan Indeks Newcastle untuk Penapisan Kasus Hipertiroid

NILAI DIAGNOSTIK INDEKS WAYNE DAN INDEKS NEWCASTLE UNTUK PENAPISAN KASUS HIPERTIROI

Faktor Ibu Yang Berhubungan Dengan Kemampuan Kognitif Anak PRA Sekolah Di Daerah Endemik Defisiensi Yodium

Background: Maternal conditions were important determinants for children development. Therefore, mothers impacted by IDD condition also became risk factor for children developmental delays. Objective: Analyze the associations between maternal social status, maternal nutritional status including maternal goiter status, maternal IQ, and quality of care, with pre-school children cognitive abilities in IDD endemic areas. Method: This study explores the data screening of parenting and iodized salt intervention studies of pre-school children in IDD endemic areas. The study was conducted in Pituruh, Purworejo district. A total pair of 82 mothers and 4-5 years aged children became subjects of this research. Data were analyzed with path analysis. Result: The percentage of child cognitive ability problems found were high (59.5%) and 17.1% mothers had goitre enlargement. Multivariate analysis with Path showed that home quality of care (r=0.41) and maternal verbal responsiveness (r=0.24) associated directly and rather strongly with preschool child cognitive ability. Maternal education and IQ both significantly correlated with home environmental quality of care. Since both variable having colinearity, just one variable chosen as determinant of care. Maternal IQ associated indirectly with child cognitive ability through home environmental quality of care (r=0.38) and maternal verbal responsiveness (r=0.31). Maternal goiter associated with child cognitive development indirectly through its association with maternal IQ (r= 0.23). Conclusion: The cognitive abilities of preschool children in endemic areas GAKI affected directly by the home environmental quality of care and maternal verbal responsiveness. Indirectly, maternal quality of care is affected by maternal IQ and maternal education. Maternal goiter status affected children cognitive abilities through its influence on maternal IQ, maternal education, and quality of care

Nilai Diagnostik Indikator Fisik Dibandingkan Baku Emas Untuk Menegakkan Diagnosis Terduga Kretin Pada Batita

Iodine severe deficiency is a major cause of impairment due to iodine deficiency disorders. Cretinism is a consequence of iodine deficiency in the womb with clinical signs that stand out among others is mental retardation. In Indonesia, there were many cases of endemic goiter and cretinism. Diagnosis of cretinism can be established more accurately by laboratory tests, but it is expensive and less practical when conducted the field. Currently there are available tools for early detection for hypothiroid in neonates (NHI, Quebec) less expensive and easier to implement however it can not be used for older children. The instrument need to be developed for older children that was easy, deap and can provide a reliable diagnostic result. This diagnostic test research studied the diagnostic value of physical indicators for the diagnosis of suspected cretinism in infants and toddlers. The research was conducted in Magelang, Wonosobo, Wonogiri and Ponorogo Districts, for 10 months. Subject were infants and children under three years old. The information generated in the form of cretinism suspected early detection instrument (DDSK) for infant and toddler at the community level. The proportion of subjects with high TSH and low FT4 (hypothyroid) were 4.6% and 98.8%. The proportion of subjects experiencing developmental disorder were 36.4% (Denver test); impaired function of hearing were 2.7% and impaired motor function were 5.5%. The result of diagnosis using DDSK form, subjects detected cretinism suspected of 11.9%, and the diagnostic gold standard (the combined test results of Denver, Bayley, clinical examination and laboratory) of 11.3%. There is a significant relationship (p< 0.001) between the presence of positive test results with cretinism suspected; grades Se= 47.1%, Sp= 92.5%. Compare with gold standard, physical indicators of diagnostic test (DDSK) could diagnosed suspected cretinism among children under three years. Revising components and scoring in the indicators of cretinism suspected early detection instrument (DDSK) for infant and toddler were necessary

Perubahan Kadar Iodium Urin, Tsh, Dan T4 Bebas Pada Wus Setelah Pemberian Garam Dosis 30-35 PPM Kio3

Background. In several countries, iodine deficiency has been turned into iodineexcess. These iodine excess due to poor monitoring of iodine concentration onsalt, which cause high and uneven iodine rations. The objective of the study wasto determine if intervention of 30-35 ppm iodized salt improves UIE, TSH and fT4level in childbearing age women. Methods. This is a quasi-experimental study byproviding 30-35 ppm KIO3 iodized salt for 6 months on childbearing age women inIDD mild endemic area (n=71). The control group were only measured by iodine saltconsumption of each monthly used (n=76). The study conducted in in Bener villagePurworejo. Urinary iodine concentration (UIC), TSH and fT4 were measured atbaseline and endline. TSH and fT4 level were measured using ELISA method. UIEwas analysed using APDM method. Result. Subject characterisitcs of each groupare not much different. Iodine concentration median (range) of treatment group andcontrol group were 149 (20-400) μg/ L and 160 (28 – 698) μg/ L, respectively. MeanTSH level which were normal before intervention (3.03 ± 1.19 μIU/ ml vs 2.52 ±1.29 μIU/ ml), improved significantly after intervention compared to the control group(2.03 ± 1.28 μIU/ ml vs 2.71 ± 1.66 μIU/ ml). Mean free T4 level which were normalbefore intervention (1.29 ± 0.29 ng/ dl vs 1.32 ± 0.24 ng/ dl), decreased significantlyafter intervention compared to the control group (1.04 ± 0.24 ng/ dl vs 1.18 ± 0.43ng/ dl). Conclusion. 30 – 35 ppm iodized salt Intervention for 6 months was able toprovide iodine requirement, improve level of TSH and maintain level of fT4 in normallevel

Bentuk Dan Penggunaan Garam Beryodium Pada Tingkat Rumahtangga

Background: In the market, salt is available in the form of powder (table salt), granule (raw salt) or bricked (pressed salt). Salt has been used as vehicle for iodine fortification since end of 1970s. This iodised salt is set as the long term strategy to control iodine deficiency. lodised salt is also available in those three forms. lodised salt survey at household level was conducted in 2007 as part of the Basic Health Research (BHR), Ministry of Health. Objectives: To study the form and use of iodized salt at household level. Methods: Data from the lodised salt survey 2007 was used for analysis. Salt sample was taken from households in 30 selected districts/cities through out the country. The 30 districts/cities was randomly selected that based on result of lodised salt survey 2005. Iodine content in salt was determined using titration method. The form of salt used by household was also observed. Results: As much as 20.8% of salt used by household were in the bricked form, 35.8% in the granule form and 43.4% in the powder form. In urban areas, 33.3% of household consume granule form, 18.9% consume bricked form and 47.8% consume powder form. Meanwhile, in rural areas, 37.1% of household consume granule form, 21.9% consume bricked form and 41.0% consume powder form. The mean value of iodine content was the lowest (15.9 ppm) in granule form, followed by bricked form (18.0 ppm) and the highest was powder form (28.3 ppm). Using titration method, 7.8% of salt samples contained less than 5.0 ppm of iodine, and only 24.5% salt contained above 30 ppm. As high as 14.2% salt samples contained between 5.0-9.9 ppm iodine, 27.8% contained between 10.0-19.9 ppm iodine and 25.7% contained between 20.0-29.9 ppm iodine. There were only 0.2% salt that contained no iodine and 1.1% salt contained over 80 ppm iodine. Conclusions: The percentage of household that used salt in the form of powder was higher than those used granule and bricked forms. Iodine content in salt in the form of powder was the highest than those salt in the form of bricked and granule

BENTUK DAN PENGGUNAAN GARAM BERYODIUM PADA TINGKAT RUMAHTANGGA

Background: In the market, salt is available in the form of powder (table salt), granule (raw salt) or bricked (pressed salt). Salt has been used as vehicle for iodine fortification since end of 1970s. This iodised salt is set as the long term strategy to control iodine deficiency. lodised salt is also available in those three forms. lodised salt survey at household level was conducted in 2007 as part of the Basic Health Research (BHR), Ministry of Health. Objectives: To study the form and use of iodized salt at household level. Methods: Data from the lodised salt survey 2007 was used for analysis. Salt sample was taken from households in 30 selected districts/cities through out the country. The 30 districts/cities was randomly selected that based on result of lodised salt survey 2005. Iodine content in salt was determined using titration method. The form of salt used by household was also observed. Results: As much as 20.8% of salt used by household were in the bricked form, 35.8% in the granule form and 43.4% in the powder form. In urban areas, 33.3% of household consume granule form, 18.9% consume bricked form and 47.8% consume powder form. Meanwhile, in rural areas, 37.1% of household consume granule form, 21.9% consume bricked form and 41.0% consume powder form. The mean value of iodine content was the lowest (15.9 ppm) in granule form, followed by bricked form (18.0 ppm) and the highest was powder form (28.3 ppm). Using titration method, 7.8% of salt samples contained less than 5.0 ppm of iodine, and only 24.5% salt contained above 30 ppm. As high as 14.2% salt samples contained between 5.0-9.9 ppm iodine, 27.8% contained between 10.0-19.9 ppm iodine and 25.7% contained between 20.0-29.9 ppm iodine. There were only 0.2% salt that contained no iodine and 1.1% salt contained over 80 ppm iodine. Conclusions: The percentage of household that used salt in the form of powder was higher than those used granule and bricked forms. Iodine content in salt in the form of powder was the highest than those salt in the form of bricked and granule.   Keywords: form, use, iodised salt, househol

FAKTOR RISIKO STUNTING DI DAERAH ENDEMIK GAKI KABUPATEN TIMOR TENGAH UTARA

Latar Belakang. Stunting merupakan salah satu masalah gizi  serius di beberapa negara di dunia, khususnya negara-negara berkembang termasuk Indonesia. Faktor risiko stunting antara lain tinggi badan ibu, penyakit infeksi dan Berat Bayi Lahir Rendah (BBLR) serta faktor lain seperti konsumsi goitrogenik, kadar iodium garam, dan kadar iodium urin. Iodium merupakan mikronutrien penting untuk pertumbuhan dan perkembangan normal. Prevalensi stunting yang tinggi dan status iodium yang tidak diketahui menjadi perhatian penting untuk mengetahui faktor risiko stunting di daerah endemik GAKI. Tujuan. Penelitian ini bertujuan mengetahui faktor risiko stunting di daerah endemik GAKI. Metode. Penelitian ini merupakan penelitian observasional analitik dengan desain penelitian case control. Sampel penelitian adalah siswa sekolah dasar berusia 10-12 tahun  sebanyak 106 orang. Analisis hasil penelitian secara bivariat menggunakan chi square, dan analisis multivariat menggunakan regresi logistik. Hasil. Rata-rata tinggi badan menurut umur (TB/U) anak stunting dan tidak stunting adalah 138,8 cm. Sedangkan rata-rata tinggi badan ibu adalah 148,3 cm yang artinya lebih tinggi dari cut off 145 cm sebagai standar seorang ibu dikatakan pendek/stunting. Analisis bivariat tinggi badan ibu (OR:3,69, CI:1,32-10,32) dan riwayat penyakit infeksi (OR:11.02, CI:2.38-50,90) merupakan faktor risiko stunting (p<0,05). BBLR bukan merupakan faktor risiko stunting. Hasil analisis multivariate menunjukkan tinggi badan ibu dan riwayat penyakit infeksi merupakan faktor risiko yang dapat memprediksi kejadian stunting sebesar 15 persen, sedangkan 85 persen disebabkan oleh faktor lain yang tidak diamati dalam penelitian ini. Kesimpulan. Peluang ditemukan anak stunting dari ibu yang pendek (<145 cm) dan riwayat penyakit infeksi (ISPA dan diare) saat balita lebih tinggi dibandingkan dari ibu yang memiliki tinggi badan normal (>145 cm) dan tanpa paparan penyakit ISPA dan diare saat balita di daerah endemik GAKI

Pengaruh Iodium Terhadap Perubahan Fungsi Tiroid Dan Status Iodium

Iodine is an essential element that enables the thyroid gland to produce thyroid hormones. The source of iodine in the body comes from food, iodized salt and iodine capsules. Iodized salt and iodine capsules had been used by the government in Iodine Deficiency Disorders (IDD) elimination program. However, iodine capsules prophylaxis program in the IDD endemic areas had caused symptoms of hyperthyroidism, subsequently the program was discontinued since 2009. The aim of this research to determine the effect of iodine supplementation on thyroid function and iodine status. This was quasi-experimental design, conducted in Pituruh Purworejo District. Sample of this study consisted of 85 women of childbearing age, divided into three intervention groups. Each group obtained iodized salt for one month, then continued with the provision of iodized salt and 200 mg iodine capsules in group I, iodized salt and 400 mg iodine capsules in group II, and iodized salt and shredded tuna fish 2 times a week in group III for 3 months. Thyroid status was measured by levels of TSH, FT4 analyzed with ELISA. Iodine status measured by UIE levels analyzed with spectrophotometer. Data was analyzed using General Linear Model Repeated Measure (GLM RM). After 3 months, in all three treatment groups the TSH changes were statistically significant. In FT4 hormone levels, after administration of the intervention occurred “Wolff-Chaikoff” mechanism. There were significant increase on Iodine status (UIE) (p< 0.05) in all three treatment groups. There is a change in iodine status and thyroid function after administration of three forms of iodine intervention

HUBUNGAN STATUS IODIUM DENGAN FUNGSI TIROID DI KOTA YOGYAKARTA, KABUPATEN PURWOREJO, DAN KOTA BUKITTINGGI

Latar Belakang. Iodium merupakan bahan esensial yang dibutuhkan tubuh untuk membentuk hormon tiroid. Kecukupan iodium dapat dilihat dari status iodium yaitu kadar iodium urine (UIE) dan kadar tiroglobulin. Status iodium sangat memengaruhi regulasi hormon tiroid dimana kadar TSH dan FT4 sangat berperan dalam mekanisme fungsi tiroid. Defisiensi iodium merupakan permasalahan yang laten sehingga sewaktu-waktu dapat muncul kembali. Tujuan. Penelitian ini bertujuan untuk melihat hubungan status iodium dengan indikator fungsi tiroid di daerah dengan riwayat kecukupan iodium yang berbeda–beda. Metode. Penelitian ini merupakan penelitian cross-sectional pada wanita usia subur (WUS) umur 15 sampai 45 tahun di Kota Yogyakarta, Kabupaten Purworejo, dan di Kota Bukittinggi. Besar sampel setiap daerah sebanyak 120 WUS, sehingga total sampel adalah 360 WUS. Variabel yang diukur adalah IMT, TSH, FT4, UIE, dan tiroglobulin. Pengukuran kadar TSH dan FT4 serta tiroglobulin menggunakan metode ELISA sedangkan pengukuran kadar UIE dengan metode spektrofotometri. Hasil. Fungsi tiroid dilihat dari kadar TSH dan FT4 mayoritas normal pada ketiga daerah tersebut. Status iodium dilihat dari kadar median UIE di Kota Yogyakarta dan Kabupaten Purworejo lebih dari normal, sedangkan di Kota Bukittinggi median UIE < 90 persen atau defisiensi iodium ringan dengan proporsi iodium <50 µg/L lebih dari 20 persen. Terdapat hubungan yang signifikan antara TSH dengan UIE dan tiroglobulin di Kabupaten Purworejo. Kesimpulan. Defisiensi iodium masih menjadi masalah kesehatan masyarakat di Kota Bukittinggi. Terdapat hubungan yang bermakna antara status iodium dengan fungsi tiroid di Kabupaten Purworejo