Meita Dhamayanti

Pola Pemberian ASI dan Diare pada Anak Usia 6–24 Bulan

Diare merupakan salah satu penyebab utama kematian anak secara global. Air susu ibu (ASI) diketahui dapat mencegah diare pada anak sehingga World Health Organization merekomendasikan pemberian ASI eksklusif untuk seluruh bayi. Namun, cakupan ASI eksklusif di Indonesia masih rendah sehingga risiko diare pada anak masih tinggi. Penelitian ini bertujuan menilai hubungan pola pemberian ASI dan diare pada anak usia 6–24 bulan. Penelitian observasional dengan studi potong lintang ini dilakukan tanggal 20 Januari–31 Januari 2017. pada 160 ibu dengan anak usia 6–24 bulan yang mendapat ASI yang datang ke posyandu di Puskesmas Talang Ubi, Kabupaten Penukal Abab Lematang Ilir. yang buka selama penelitian dilakukan, lahir tunggal, aterm, berat badan lahir ≥2.500 gram, gizi baik, tidak menderita kelainan kongenital. Data dikumpulkan menggunakan kuesioner untuk mengetahui pola pemberian ASI dan MP ASI serta prevalensi, periode, dan lama diare dalam tiga bulan terakhir. Data dianalisis dengan uji kai-kuadrat, Fisher eksak, Mann-Whitney U, Kruskal-Wallis, ANOVA, serta uji normalitas Kolmogorov Smirnov. Penelitian ini mendapatkan hubungan waktu inisiasi pemberian ASI, ASI eksklusif, lama pemberian ASI, serta frekuensi dan lamanya menyusui dengan prevalensi dan lama diare ( p 0,05). Dapat disimpulkan bahwa pola pemberian ASI dapat menurunkan prevalensi dan mempersingkat lama diare pada anak usia 6–24 bulan. [ MKB. 2017;49(3):165–71] Kata kunci: ASI, ASI eksklusif, diare, MP ASI Breastfeeding Pattern and Diarrhea in Children Aged 6–24 Months Diarrhea is one of the leading causes of global childhood mortality. Breast milk was known to have a protective role against childhood diarrhea that the World Health Organization (WHO) recommendeds exclusive breastfeeding for all infants. However, the coverage of exclusive breastfeeding in Indonesia is still small, leading to a higher risk of childhood diarrhea. The aim of this study was to assess the correlation between breastfeeding pattern, complementary feeding, prevalence, frequency, and diarrhea duration in children aged 6–24 months. This observational cross-sectional study was conducted in the period of 20 January–31 January 2017 on 160 mothers who brestfed their child who was, at the time of the study, 6–24 months old. These were children who visited the Posyandu (Integrated Health Post) of Talang Ubi Public Health Center (Puskesmas Talang Ubi), Penukal Abab Lematang Ilir district at the time of the study, singleton, full term, birth weight ≥2,500 grams, well-nourished, and did not have any congenital abnormalities. Data were obtained through questionnaires that collected information on breastfeeding pattern, complementary feeding, and the prevalence, frequency, and diarrhea duration in the last three months . Data were statistically analyzed using chi-square, Fisher’s exact, Mann-Whitney U, Kruskal-Wallis, and ANOVA tests as well as Kolmogorov Smirnov normality test. This study found the correlation between breastfeeding initiation, exclusive breastfeeding, breastfeeding duration, frequency and duration of lactation, with the prevalence and diarrhea duration (p 0,05). Therefore, this study concludes that the pattern of breastfeeding reduces the prevalence of diarrhea and shortens diarrhea duration in children aged 6–24 months. [ MKB. 2017;49(3):165–71] Key words: Breastfeeding, complementary feeding, diarrhea, exclusive breastfeeding

Different Result of Cognitive Impairment Screening in Adolescent Aged 10-12 Years with Normal and Short Stature in Pangandaran District

In Indonesia, the prevalence of short stature in adolescents aged 13-15 years and 16-18 years are respectively 35,1% and 31,4%. The growth of adolescentsis related in line to the development with the cognitive function. To find out the difference result of cognitive impairment screening in adolescents aged 10-12 years with normal and short stature. This was a cross-sectional analytic study conducted during December 2016 – March 2017 in Pangandaran District, West Java. Body height of the subjects were measured and they answered questions in Mini–Mental State Examination (MMSE) to assess the cognitive function. Data analysis to determine the different results of cognitive impairment screening in adolescent with normal and short stature use statistical Wilcoxon rank sum test. A total of 144 subjects met the inclusion criteria, comprising 45 subjects with short stature and 99 subjects normal. Median (min; max) MMSE scores for adolescent with short stature and normal were 24 (14; 30) and 27 (9; 30). There were significant differences in the median of MMSE scores between adolescents with normal and short stature (median difference = -2.00, CI 95% (-3.00;-0.00), p = 0.013). There were significantly different results of this study in cognitive impairment screening in adolescents aged 10–12 years between normal and short stature. The result of cognitive impairment screening in short statured adolescents aged 10-12 yearswas lower compared to those of normal stature adolescents.

Wabah Difteri di Kecamatan Cikalong Wetan, Kabupaten Cianjur, Jawa Barat, Indonesia

Latar belakang. Sejak tahun 1986 tidak ditemukan lagi kasus difteri yang dirawat di Rumah Sakit Hasan Sadikin Bandung Jawa Barat. Namun, wabah difteri selalu terjadi di beberapa kabupaten di Jawa Barat seperti yang dilaporkan sejak tahun 1993 sampai tahun 2010. Kementerian Kesehatan juga melaporkan peningkatan kasus difteri di beberapa provinsi di Indonesia tahun 2010. Suatu penelitian saat wabah di Kecamatan Cikalong Wetan Kabupaten Cianjur tahun 2001 sebagai gambaran kejadian wabah di salah satu kabupaten di Jawa Barat. Tujuan. Menggambarkan kejadian wabah difteri, mengetahui tingkat kekebalan dengan mengukur kadar antibodi difteri dan untuk menemukan kemungkinan adanya kuman C. difteriaeberedar di masyarakat di daerah wabah. Metode. Data kejadian penyakit dan kematian diperoleh dari Puskesmas Cikalong Wetan RS Cianjur dan Dinas Kesehatan Kabupaten Cianjur. Data kadar antibodi diperoleh dengan mengukur kadar anti bodi terhadap difteri pada 698 subyek, yang dibagi menurut kelompok usia. Titer antibodi diukur dengan menggunakan teknik ELISA ganda. Hasil. Selama wabah terdapat 25 kasus yang dilaporkan dari Puskesmas Cikalong Wetan dengan angka kematian/crude fatality rate(CFR) 28%. Diduga kuat bahwa kasus pertama berasal dari kecamatan yang berdekatan dengan Kecamatan Cikalong Wetan. Beberapa bulan sebelumnya dijumpai kasus rawat inap 21 pasien, 55% di antaranya balita, dengan angka kematian 35% terutama disebabkan oleh miokarditis. Walaupun cakupan imunisasi difteri pertusis tetanus (DPT) tinggi pada anak kurang dari 1 tahun di Kecamatan Cikalong Wetan, hanya 19,3% anak usia 1 tahun memiliki tingkat kekebalan protektif yang memadai. Titer antibodi terus berkurang sesuai dengan meningkatnya usia anak, bahkan tidak ada subjek yang memiliki kadar protektif yang memadai pada kelompok usia 5 – 6 tahun. Enam dari 324 biakan apus tenggorokan pada masyarakat tumbuh strain toxigenic C. difteriae gravis. Kesimpulan. Wabah yang terjadi di Kecamatan Cikalong Wetan Kabupaten Cianjur disebabkan oleh karena rendahnya kadar antibodi terhadap toxigenic C.difteriaepada masyarakat.

The Difference of Lipid Profile among Adolescent Smokers and Non-Smokers at Urban Area in Developing Country

Objective Analyze the differences in TC, LDL, and HDL levels between smokers and non-smokers adolescent. Study Design This analytical cross-sectional study was performed during February to April 2016 in several senior high schools in Bandung. Subjects were adolescent, aged 15‒18 years, who were divided into two groups: smokers and non-smokers using questionnaire. There were 206 boys included in this study, 162 met the inclusion criteria and 44 were excluded. Simple random sampling was performed to obtain 50 smokers and 50 non-smokers for our study. All data were analyzed for mean serum lipid profiles using chi square (x2) and MANOVA test with a p value <0.05 considered significant. Results The x2 analysis showed association between abnormal serum TC, LDL, and HDL levels with smoking status respectively (p=0.006, p=0.025, and p=0.006). MANOVA test results showed significant differences between smokers and non-smokers group in terms of mean±SD TC level (161.7±32.2 and 150.6±19.5), LDL (107.6±29.2 and 92.6±92.6), HDL (38,76±6.39 and 42.8±7.08)) with p value <0,05.Conclusion This study shows that serum TC, LDL, and HDL levels in smokers are statistically different compared to those in non- smokers adolescent.