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Fitri Amaliah

Potret anak stunting di Desa Pangkalan Kecamatan Teluk Naga Kabupaten Tangerang tahun 2017 = Portrait of stunting children in Pangkalan Village Teluk Naga Subdistrict Tangerang Regency, 2017

"Stunting terjadi dimulai didalam Rahim dan berlanjut setidaknya selama 2 tahun pertama kehidupannya, menentukan potensi individu untuk kehidupan kedepan dalam hal risiko morbiditas dan mortalitas, prestasi sekolah, produktivitas kerja, kekuatan fisik, dan risiko penyakit kronis. Tujuan dari penelitian ini untuk Mengetahui Potret Anak Stunting di Desa Pangkalan, Kecamatan Teluk Naga, Kabupaten Tangerang Tahun 2017. Penelitian Kualitatif dengan Rapid Assessment Procedures (RAP), dilakukan kepada informan yang memiliki anak stunting usia < 23 bulan dan 24-59 bulan pada bulan Juni 2017. Penggalian informasi melalui Diskusi Kelompok Tearah, Wawancara mendalam serta observasi. Hasil penelitian menunjukkan, sebagian besar informan memiliki tinggi badan < 150 cm, usia antara 20-25 tahun dan jarak antar kehamilan > 3th, tinggal di wilayah yang sanitasinya kurang baik karena sebagian besar masih BAB di kali dan sampah keluarga yang dibakar disekitar rumah. Anggota keluarga lain selain ibu ikut terlibat dalam pengasuhan anak. Sebagian besar informan tidak melakukan IMD dan ASI Eksklusif. Pola asuh makan informan terhadap anaknya tergolong kurang baik karena anak sering diberikan makanan jajanan, saat anak sakit, makanan yang diberikan lebih sedikit, dan anak makan sambil jalan-jalan, untuk keanekaragaman makanan juga masih kurang dimana sayuran sebagian besar hanya diberikan kuahnya saja sementara buah jarang diberikan. Kemudahan akses terhadap pelayanan kesehatan tidak dimanfaatkan dengan baik terlihat sebagian besar informan hanya mengimunisasi anaknya 2-3 kali dan pengetahuan tentang gizi seimbang masih kurang, dan masih mengikuti budaya untuk memantang beberapa makanan selama hamil.

Stunting takes place inside the uterus and continues for at least the first 2 years of life, determining the individual's potential for future life in terms of risk of morbidity and mortality, school performance, work productivity, physical strength, and chronic disease risk. The purpose of this research is to know the Portrait of Stunting Children in Pangkalan Village, Teluk Naga Subdistrict, Tangerang Regency Year 2017. Qualitative Research with Rapid Assessment Procedures (RAP), conducted to informants who have child stunting age <23 months and 24-59 months month June 2017. Excavation of information through
Focus Group Discussion, In-depth interview and observation. The results showed, most informants have a height <150 cm, age at the time od pregnancy between 20-25 years and distance between pregnancy> 3th, living in a poorly sanitary area because most are still defecate in the river and family trash burned around the house Family members other than mothers get involved in parenting. Most
informants do not do IMD and Exclusive Breast Milk. Feeding patterns of informants to their children are not good enough because children are often given food snacks, when children are sick, the food is given less, and children eat while walking, for the diversity of food is also still lacking where most vegetables are only given sauce only while the fruit Rarely given. Ease of access to health services is not well utilized seen most informants only immunize their children 2-3
times and knowledge about balanced nutrition is still lacking, and still follow the culture to challenge some food during pregnancy."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2017

S69751

UI - Skripsi Membership Universitas Indonesia Library

Elisa Basir

Hubungan antara nitrogen dioksida dan sulfur dioksida dalam rumah dengan gangguan saluran pernapasan pada anak balita di Kecamatan Teluk Naga Kabupaten Tangerang tahun 2006 = Association between nitrogen dioxide and sulfur dioxide inside house with respiratory tract symptomps in children in Kecamatan Teluk Naga Tangerang in 2006

"Penyakit ISPA di Kecamatan Teluk Naga masih merupakan penyakit dengan kasus tertinggi dari 10 penyakit utama. Cakupan rumah sehat di Kecamatan Teluk Naga masih terbilang rendah yaitu hanya sebesar 32,97%. Nitrogen dioksida dan sulfur dioksida merupakan polutan gas yang dapat berasal dari bahan bakar memasak, seperti kayu bakar, batubara, minyak tanah dan bahkan gas.

Penelitian ini bertujuan untuk mengetahui hubungan antara nitrogen dioksida (NO2) dan sulfur dioksida (SO2) dalam rumah sebagai salah satu zat pencemar yang bersumber dari aktivitas dalam rumah dalam kaitannya dengan kejadian gangguan saiuran pernapasan anak balita. Selain NO2 dan SO2, diteliti pula mengenai lingkungan fisik rumah, karakteristik balita dan sumber pencemar dan aktivitas rumah tangga. Lingkungan fisik rumah yang diteliti meliputi dari ventilasi rumah dan kamar, jenis lantai, jenis dinding, kepadatan rumah dan kamar, letak dapur, ventilasi dapur, kelembaban dan suhu. Karakteristik balita yang diteliti meliputi jenis kelamin, status gizi, status imunisasi lengkap, status imunisasi campak, dan pemberian ASI exclusive. Sumber pencemar dan aktivitas rumah tangga yang diteliti meliputi perokok dalam rumah, penggunaan bahan bakar untuk memasak, penggunaan obat nyamuk dan kebiasaan anak ikut ibu memasak.

Dengan menggunakan jenis rancangan cross sectional, pengambilan sampel menggunakan cara cluster, digunakan 120 anak balita yang diteliti.

Terdapat 13,6% balita yang mengalami batuk pilek disertai kesulitan bemapas dan 42,2% balita yang mengalami batuk pilek selama 2 minggu terakhir. Sebanyak 53% balita tinggal dalam rumah dengan kadar NO2 tinggi dan sebanyak 50% balita tinggal dalam rumah dengan kadar SO2 tinggi. Dengan menggunakan analisa bivariat menggunakan uji chi square (X2) tidak diperoleh hubungan yang bermakna pada 502 dengan gangguan saluran pemapasan pada balita. Pada NO2 walaupun diperoleh hubungan yang bermakna secara statistic, tetapi dikarenakan bersifat protektif (OR

Terdapat hubungan yang signifikan antara jenis bahan bakar memasak, letak dapur, suhu, status imunisasi lengkap dan status imunisasi campak dengan kejadian batuk pilek disertai kesulitan bernapas pada balita. Terdapat hubungan yang signifikan antara jenis bahan bakar memasak dan suhu dengan kejadian batuk pilek pada balita.

Disimpulkan tidak terdapat hubungan yang signifikan antara NO2 dan SO2 dengan gangguan saluran pernapasan pada balita. Disarankan agar sektor terkait memberikan himbauan dan bantuan untuk pergantian bahan bakar memasak dari kayu bakar menjadi paling tidak minyak tanah ataupun gas dan agar bidan desa setempat memberikan informasi akan pentingnya imunisasi bagi kesehatan balita.

Acute Respiratory Infections in Kecamatan Teluk Naga still reached the highest cases in 10 main diseases in Kecamatan Teluk Naga. The coverage of healthy house in Kecamatan Teluk Naga still in low percentage, which was only 32.97% in 2004. Nitrogen dioxide and sulfur dioxide are gas pollutants which can come out from energy used such as woods, coal, kerosene and even gas.
The objective of this research was to know the association between nitrogen dioxide and sulfur dioxide inside house as pollutants which can come out from household activities and the occurrence of respiratory tract symptoms in children. Another variables that had been observed were physical house environment, pollutants source and household activities and also children characteristics. Physical house environment consists of ventilations around the house and children bedrooms, floor type, walls type, house density, bedroom density, kitchen location, kitchen ventilation, humidity and temperature. Pollutants source and household activities consists of smoker inside house, energy used, repellant, and mother's habit to take their child to the kitchen while cooking.
Children characteristic consists of gender, nourish status, complete immunization status, measles status, and exclusive breast feeding.
This research conducted cross sectional design by using cluster with the number of sample was 120.
There were 13.6% children who had cough, runny nose and difficulty of breathe and 42.2% children who had cough and runny nose. 53% children lived in the house with high concentration of NO2 and 50% children lived in the house with high concentration of SO2. By using chi square (X2) analysis, there were no association between S02 and respiratory tract symptoms in children. There was association between NO2 and respiratory tract symptoms in children with odd ratio < 1, but since the association was protective, we considered it as no association."

Depok: Universitas Indonesia, 2006

T19993

UI - Tesis Membership Universitas Indonesia Library

Arie Sunandar

Kualitas air tanah di dataran rendah Teluk Naga Kabupaten Tangerang

"Penelitian ini bertujuan untuk mengetahui persebaran wilayah kualitas airtanah dangkal dengan parameter DHL dan Salinitas. Dan bagaimana variasinya berdasarkan curah hujan, geologi, jarak dari sungai dan jarak dari laut. Pengukuran kualitas airtanah dangkal dilakukan pada bulan Januari dan April tahun 2009. Hasil penelitian menunjukan persebaran wilayah kualitas airtanah di Kecamatan Teluknaga dapat diklasifikasikan sebagai air tawar, agak payau, payau, asin, dan sangat asin, dengan didominasi oleh kualitas airtanah payau. Kualitas airtanah tawar pada saat tidak ada hujan sebarannya hanya terdapat pada tanggul pantai (Qbr) bagian selatan, sedangkan pada saat hujan sebaran kualitas airtanah tawar cenderung meluas di bagian tengah sampai sebagian selatan Kecamatan Teluknaga pada geologi aluvium. Faktor curah hujan mempengaruhi tinggi-rendahnya kualitas airtanah di Kecamatan Teluknaga. Sebaran kualitas airtanah secara keseluruhan tidak dipengaruhi oleh faktor jarak dari sungai dan laut, namun hanya pada geologi aluvium (Qa), sebaran kualitas airtanahnya dipengaruhi oleh faktor jarak dari sungai dan laut.

This study aims to know the distribution of shallow groundwater quality by DHL parameter and salinity. And how its variation based on rainfall, geology, distance from the river and the distance from the sea. The measurement of shallow groundwater quality is conducted in year month of January and April 2009. Results of research shows the quality distribution of groundwater in Teluknaga District can be classified as fresh water, slightly brackish, brackish, salty, and very salty, dominated by brackish groundwater. Quality of fresh groundwater, while not raining, its distribution only found in south coastal embankment (Qbr), but while raining, the distribution of fresh groundwater quality tended to be widespread in the middle part to the southern part of Teluknaga District in alluvium geology. Rainfall factors affected high and low groundwater quality in Teluknaga District. The distribution of overall groundwater quality is not influenced by distance factor between river and sea, but only on alluvium geology (QA), its distribution groundwater quality is influenced by distance factor from river to the sea."

Depok: Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Indonesia, 2009

S34102

UI - Skripsi Open Universitas Indonesia Library

Muhlisa

Health belief ibu hamil terahdap pemanfaatan pelayanan kesehatan di Desa Muara Kecamatan Teluk Naga Kabupaten Tangerang tahun 2006

"Di dunia ini setiap menit seorang perempuan meninggal karena komplikasi yang terkait dengan keharnilan dan persalinannya. Menurut hasil herbagai survci, Angka Kematian Ibu (AKI) di Indonesia saat ini berkisar antam 300 dan 400 kcmatian ibu per 100.000 kelahiran hidup, sedangkan AKI di negara maju hanya sekitar I0 per l00.000 kelahiran hidup. AKI yang tinggi di Indonesia menunjukkan masih buruknya tingkat kesehatan ibu dan bayi baru lahir (WHO,2005). Pada waktu kesehatan didekatkan ke masyarakat, belum tentu masyarakat memanfhatkannya kanena berbagai alasan, termasuk ketidak-tahuan, dan hambatan ekonomis.

Kemiskinan dan rendahnya status sosial ekonomi perempuan mempunyai andil. Terbatasnya kesempatan memperoleh informasi dan pengetahuan baru, hambatan membuat keputusan, terbatasnya akses memperoleh pendidikan memadai, dan kelangkaan pelayanan kesehatan yang peka terhadap kebutuhan perempuan juga berperan terhadap situasi ini (Sak Motherhood: A Matter of Human Rights and Social Justice, 1998). Mengingat pentingnya kesehatan ibu hamil dan hubungannya dengan penggunaan pelayanan kesehatan yang masih di bawah standar maka perlu untuk melakukan kajian mengenai health belief ibu hamil itu sendiri terhadap pelayanan kesehatan.

Penelitian ini menggunakan pendekatan kualitatif untuk mendapat gambaran lebih jelas dan mendalam tentang health beltéf Ibu hamil dalam mcmiiih pelayanan kesehatan. Infomaan dalam penelitian ini adalah ibu dengan bayi (usia di bawah l tahun), yang memanfaatkan pclayanan kcsehatan, di Deea Muara Kecamatan Teluk Naga Kabupaten Tangerang.

Hasil yang didapatkan dari penelitian antara lain, ibu hamil memandang kehamilannya adalah sesuatu yang biasa saja dan sudah merupakan kodrat setiap perempuan, bersifat alamiah dan harus bisa mcnjalaninya dengan baik. Penilaian terhadap tcnaga keschatan juga membuat seseorang a.l

Ibu hamil yang mempersepsikan kehamilannya sebagai kondisi yang biasa saja dan tidak mempunyai risiko akan masalah yang dapat terjadi pada saat hamil, dan mempertimbangkan manfaat dan hambatan, dimana lebih besar manfaatnya akan melakukan pemeriksaan secara rutin dan mcndapat informasi yang cukup dan sesuai kcbutuhan dari orang yang mempunyai pengaruh, begitu juga sebaliknya."

Depok: Fakultas Psikologi Universitas Indonesia, 2006

T34174

UI - Tesis Membership Universitas Indonesia Library

Soplanit, Maria V.

Perkawinan tradisional peranakan Cina di Teluk Naga Tangerang

"Keberadaan etnik Cina di Indonesia adalah suatu kenyataan sosial yang telah berlangsung sejak berabad-abad yang lalu. Aspek budaya kelompok masyarakat ini selalu menarik untuk diteliti dan dibahas. Salah satu diantaranya adalah perkawinan tradisional. Skripsi ini membahas pelaksanaan perkawinan tra-di sional di kalangan etnik Cina di daerah Tangerang. Untuk kepentingan penyusunannya telah dialkukan penelitian terhadap etnik Cina di beberapa desa di Kecamatan Teluknaga Tangerang. Perkawinan tradisional yang dideskripsikan adalah perkawinan tradisional golongan peranakan, yang rrerupakan kelompok mayoritas dari etnik Cina di daerah tersebut. Sebelum membahasnya, terlebih dahulu diberikan gambaran singkat mengenai beberapa aspek kehidupan etnik Cina, khususnya golongan peranakan di sana."

Fakultas Ilmu Pengetahuan dan Budaya Universitas Indonesia, 1987

S13044

UI - Skripsi Membership Universitas Indonesia Library

Widya Anggraeni

Particulate matter (PM10) dan faktor lingkungan rumah yang mempengaruhi kejadian infeksi saluran pernapasan akut (ISPA) balita di Kecamatan Teluk Naga Kabupaten Tangerang tahun 2006 = Particulate matter (PM10) and house environment factors influencing incidence of acute respiratory infections among children under five of age in Teluknaga sub district, Tangerang district 2006

"Infeksi Saluran Pernapasan Akut (ISPA) pada balita di wilayah Kecamatan Teluk Naga Kabupaten Tangerang menempati posisi pertama dari sepuluh besar penyaldt berdasarkan Laporan Tahunan Puskemas. Hal ini berhubungan dengan kondisi fisik rumah, kualitas udara dalam rumah antara lain PM10, dan karakteristik balita penelitian ini bertujuan untuk mengetahui kadar PM10 dan faktor lingkungan rumah yang mempengaruhi kejadian ISPA pada balita.

Rancangan penelitian ini adalah kasus kontrol dengan populasi balita di wilayah Kecamatan Teluk Naga Kabupaten Tangerang yang menjadi sampel adalah balita yang terpilih dengan sampel acak secara sistimatika dari Laporan Bulanan (LB1) Puskesmas dengan sampel 195 balita, terdiri Bari kasus 65 dan kontrol 130 dimana sampel kasus adalah balita ISPA sedangkan sampel kontrol adalah tetangga kasus yang tidak menderita ISPA dan berjenis kelamin sama. Data yang dikumpulkan dengan pengukuran adalah kadar PM10, kelembaban, suhu dan pencahayaan sedangkan data variabel lainnya dengan observasi dan wawancara mengg unakan kuesioner. Data dianalisis secara univariat, bivariat dan multivariat.

Hasil analisis chi square terdapat empat variabel yang berbeda bermakna pada balita yang tinggal di rumah memenuhi syarat dan tidak memenuhi syarat yaitu kadar PM10 kelembaban, pencahayaan dan suhu pada tingkat kemaknaan 5% dengan kejadian ISPA balita, yaitu PMIQ dengan nilai p = 0,000 (5,21:2,7 - 10,04), kelembaban dengan nilai p = 0,001 (3,02: 1,57 - 5,81), pencahayaan dengan nilai p = 0,000 (15,06: 6,77 - 33,49), dan suhu dengan nilai p = 0,000 (36,49:10,85 -122,71).

Variabel ventilasi, jenis lantai, kepadatan hunian, bahan bakar, asap rokok, that nyamuk bakar, status gizi dan imunisasi tidak bermakna secara statistik karena mempunyai nilai p > 0,05.

Hasil analisis regresi logistik secara stafistik tidak ditemukan adanya interaksi antara variabel yang diteliti, tetapi suhu rumah ditemukan sebagai faktor pengganggu antara PM10 dengan kejadian ISPA.

Dari penelitian ini sangat penting disarankan untuk mengurangi sumber pencemaran kualitas udara dalam rumah terutama bagi Dinas Kesehatan Kabupaten agar secara rutin memantau secara kondusif kondisi dan standar kualitas udara dalam ruang dan saran bust Puskesmas agar mengaktilkan klinik sanitasi untuk memberikan penyuluhan dan pendidikan tentang hubungan kondisi lingkungan rumah dengan ISPA."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2006

T19081

UI - Tesis Membership Universitas Indonesia Library

Yustina Anie Indriastuti

Effect of iron and zinc supplementation on iron, zinc and morbidity status of anemic adolescent school girls (10-12 years) in Tangerang District

"Anemia is the main micronutrient deficiency problem among adolescent school girls in Indonesia. Anemia due to iron deficiency often coexists with zine deficiency. Iron and zinc have anlagonistic interaction. Therefore, it was appropriate ratio of iron-zinc supplementation. Objective The study was aimed to investigate the different ratios of iron-zinc supplementation Fe: Zn = 2: 1 and Fe: Zn = 4: 1 on improving the iron and zinc status and eventually reduction of the morbidity of anemic adolescent school girls compared to iron supplementation alone. Methodology randomized, double blind community trial was conducted among anemic adolescent school girls (10-12 years old). Selection of subjects was conduted in two steps. Firstly, 238 girls (out of 1358 girls), with hemoglobin concentration level < 115 g/L using Hemocue were recruited and given antihelminthic drug (500 mg mebendazole as a single dose). Secondly, those who had hemoglobin concentration < 120 g/L using Cell Dyn from venous blood one week after deworming (n+133) were enrolled into the study. The 133 subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks with: Group 1 (n=45): iron (60 mg/day), Group 2 (n=45): iron and zinc (30 mg and 15 mg/day) or group 3 (n=43): iron and zinc (60 mg and 15 mg/day).Supplement intake was supervised at base line, weight and height were measured and the available iron and zinc intake from diet was estimated using a model modified from WHO/FAO and Murphy, based on the data 24-hour Food Recall and Food Frequency Questionnare. Iron (hemoglobin/Hb, serum ferritin/SF, serum transferrin receptor/TfR, zinc protoporphyrin/ZPP, Mean Corpuscular Volume/MCV, Red-cell Distribution Width/RDW, body iron/BI) and zinc (serum zinc/SZ) status and supplementation. Morbidity status of diarrhea and Acule Respiratory Infection (ARI) were recorded weekly. The phagocytes cell and Cell-Mediated Immunity were measured only for 50% of the subjects. Results and Discussion By the end of the supplementation, most indicators of iron status were increased significantly in all subjects both they took iron supplementation with or without zinc, and the proportion of iron deficiency anemia reduced. Iron supplementation alone or iron-zinc improved zinc status. The proportion of zinc deficiency was sinificantly reduced only among subjects who took iron-zinc supplementation with the ratio of Fe: Zn =2: 1. which was significantly lower compared to the other two groups at the end of supplementation. In iron/zinc 2 : 1 group, no subject had iron deficiency anemia and zinc deficiency after 12 weeks of supplementation, which suggested that iron-zinc supplementation with the ration of Fe: Zn = 2 : 1 had reduced both iron deficiency anemia and zinc deficiency. In this study, iron deficiency among anemic school girls was due to insufficiency of iron in red blood cell, and iron or iron-zinc supplementation for 12 weeks had less benefit to increase iron status. The possibility; of hemoglobinopathies such as thalassemia trait affecting adolescent girls in this study should be considered as several studies indicated that the prevalence of tlinlassemia trait among the same population in Indonesia is high. Iron deficiency also occurred at the storage level, which increased and reached the normal value with iron or iron-zinc supplementation. At the end of supplementation, the mean value of most indicators of iron status in all groups did not reach the normal value (such as Hb < 120 g/L, ZPP > 40 umol/mol heme, MCV <2 80 fL, RDW > l4%), perhaps the 12-weeks of iron supplementation was not long enough to fulfill iron for the 120 erythrocyte life cycle. lt seems, that the competition between iron and zinc occurred both at the storage level and the erythrocyte formation, and iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction as the improvement of both iron and zinc status was higher compared to the other groups. Most anemic adolescent school girls in this study had low available iron and zinc intake from the diet, with low intake of enhancers and high intake of inhibitors, which is not enough to promote either iron or zinc absorption from the supplements. The reduction of the proportion ol' subjects suffering from ARI was the highest among subjects who took either iron alone (3l.1% to 6.7%) compared to those who took iron- zinc supplement with ratio 2: 1 (1 7.3% to l1.l%) or iron-zinc supplement with ratio 4: 1(16.3 % to l4%), indicating that iron alone reduced morbidity status in tenn of Acute Respiratory Infection (ARI). However, adding zinc to iron supplements with ratio 2: 1 scents to improve the specific immune response of anemic adolescent school girls, as shown that the ratio of CD-4/CD-S was slightly increased among subjects who took iron- zinc supplement with the ratio of Fe: Zn= 2: 1 Conclusions and Recommendations lt was concluded, that both iron deficiency anemia (22%) and zinc deficiency (15.8%) were problems in the study area. Iron deficiency and hemoglobinopathies such as that assemia trait might be the causes of anemia among adolescent school girls. A daily 30 mg iron and 15 mg zinc supplementation among anemic adolescent schools girls for 12 weeks improved iron and zinc status and reduced iron deficiency anemia and zinc deficiency. Iron supplementation alone increased iron status, while adding zinc to iron supplementation protected the adverse effect of iron on decreasing zinc status. The competition between iron and zinc might occur in the role of both nutrients for erythrocytes formation as well-as at storage level, and supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction on improving bot.h iron and zinc status. As most of the anemic adolescent school girls had inadequate iron and zinc intake from the diet, the deficiencies of other micronutrients such as; vitamin A, folic acid and vitamin B12 should also be considered as the causes of anemia. Combined iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 was appropriate on reducing the risk of anemic adolescent school girls suffering from Acute Respiratory Infection, however the mechanism of both iron and zinc on enhancing immune system could not clearly be shown from the results of this study. It is recommended to establish an iron-zinc supplementation program with ratio of 2: 1 through the existing channel of school health program to alleviate iron de iciency anemia and zinc deficiency 'among adolescent girls. Research cum action prioritized is to explain the contribution of bioavailability iron and zinc intake from the diet including increase the enhancers and minimize the inhibitors to the absorption of iron-zinc supplementation with ratio of Fe: Zn = 2: 1. The possibility of hemoglobinopathies such as thalassemia trait, as the cause of anemia needs further investigations."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2005

D757

UI - Disertasi Membership Universitas Indonesia Library

Yustina Anie Indriastuti

Effect of iron and zinc supplementation on iron, zinc and morbidity status of anemic adolescent school girls (10-12 years) in Tangerang District

Objective

The study was aimed to investigate the different ratios of iron-zinc supplementation Fe: Zn = 2: 1 and Fe: Zn = 4: 1 on improving the iron and zinc status and eventually reduction of the morbidity of anemic adolescent school girls compared to iron supplementation alone.

Methodology

A randomized, double blind community trial was conducted among anemic adolescent school girls (10-12 years old). Selection of subjects was conduted in two steps. Firstly, 238 girls (out of 1358 girls), with hemoglobin concentration level < 115 g/L using Hemocue were recruited and given antihelminthic drug (500 mg mebendazole as a single dose). Secondly, those who had hemoglobin concentration < 120 g/L using Cell Dyn from venous blood one week after deworming (n+133) were enrolled into the study.

The 133 subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks with: Group 1 (n=45): iron (60 mg/day), Group 2 (n=45): iron and zinc (30 mg and 15 mg/day) or group 3 (n=43): iron and zinc (60 mg and 15 mg/day).Supplement intake was supervised at base line, weight and height were measured and the available iron and zinc intake from diet was estimated using a model modified from WHO/FAO and Murphy, based on the data 24-hour Food Recall and Food Frequency Questionnare. Iron (hemoglobin/Hb, serum ferritin/SF, serum transferrin receptor/TfR, zinc protoporphyrin/ZPP, Mean Corpuscular Volume/MCV, Red-cell Distribution Width/RDW, body iron/BI) and zinc (serum zinc/SZ) status and supplementation. Morbidity status of diarrhea and Acule Respiratory Infection (ARI) were recorded weekly. The phagocytes cell and Cell-Mediated Immunity were measured only for 50% of the subjects.

Results and Discussion

By the end of the supplementation, most indicators of iron status were increased significantly in all subjects both they took iron supplementation with or without zinc, and the proportion of iron deficiency anemia reduced. Iron supplementation alone or iron-zinc improved zinc status. The proportion of zinc deficiency was sinificantly reduced only among subjects who took iron-zinc supplementation with the ratio of Fe: Zn =2: 1. which was significantly lower compared to the other two groups at the end of supplementation. In iron/zinc 2 : 1 group, no subject had iron deficiency anemia and zinc deficiency after 12 weeks of supplementation, which suggested that iron-zinc supplementation with the ration of Fe: Zn = 2 : 1 had reduced both iron deficiency anemia and zinc deficiency.

In this study, iron deficiency among anemic school girls was due to insufficiency of iron in red blood cell, and iron or iron-zinc supplementation for 12 weeks had less benefit to increase iron status. The possibility; of hemoglobinopathies such as thalassemia trait affecting adolescent girls in this study should be considered as several studies indicated that the prevalence of tlinlassemia trait among the same population in Indonesia is high.

Iron deficiency also occurred at the storage level, which increased and reached the normal value with iron or iron-zinc supplementation. At the end of supplementation, the mean value of most indicators of iron status in all groups did not reach the normal value (such as Hb < 120 g/L, ZPP > 40 umol/mol heme, MCV <2 80 fL, RDW > l4%), perhaps the 12-weeks of iron supplementation was not long enough to fulfill iron for the 120 erythrocyte life cycle.

lt seems, that the competition between iron and zinc occurred both at the storage level and the erythrocyte formation, and iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction as the improvement of both iron and zinc status was higher compared to the other groups. Most anemic adolescent school girls in this study had low available iron and zinc intake from the diet, with low intake of enhancers and high intake of inhibitors, which is not enough to promote either iron or zinc absorption from the supplements.

The reduction of the proportion ol' subjects suffering from ARI was the highest among subjects who took either iron alone (3l.1% to 6.7%) compared to those who took iron- zinc supplement with ratio 2: 1 (1 7.3% to l1.l%) or iron-zinc supplement with ratio 4: 1(16.3 % to l4%), indicating that iron alone reduced morbidity status in tenn of Acute Respiratory Infection (ARI). However, adding zinc to iron supplements with ratio 2: 1 scents to improve the specific immune response of anemic adolescent school girls, as shown that the ratio of CD-4/CD-S was slightly increased among subjects who took iron-zinc supplement with the ratio of Fe: Zn= 2: 1.

Conclusions and Recommendations

lt was concluded, that both iron deficiency anemia (22%) and zinc deficiency (15.8%) were problems in the study area. Iron deficiency and hemoglobinopathies such as that assemia trait might be the causes of anemia among adolescent school girls. A daily 30 mg iron and 15 mg zinc supplementation among anemic adolescent schools girls for 12 weeks improved iron and zinc status and reduced iron deficiency anemia and zinc deficiency. Iron supplementation alone increased iron status, while adding zinc to iron supplementation protected the adverse effect of iron on decreasing zinc status.

The competition between iron and zinc might occur in the role of both nutrients for erythrocytes formation as well-as at storage level, and supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction on improving bot.h iron and zinc status. As most of the anemic adolescent school girls had inadequate iron and zinc intake from the diet, the deficiencies of other micronutrients such as; vitamin A, folic acid and vitamin B12 should also be considered as the causes of anemia.

Combined iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 was appropriate on reducing the risk of anemic adolescent school girls suffering from Acute Respiratory Infection, however the mechanism of both iron and zinc on enhancing immune system could not clearly be shown from the results of this study.

It is recommended to establish an iron-zinc supplementation program with ratio of 2: 1 through the existing channel of school health program to alleviate iron de iciency anemia and zinc deficiency 'among adolescent girls. Research cum action prioritized is to explain the contribution of bioavailability iron and zinc intake from the diet including increase the enhancers and minimize the inhibitors to the absorption of iron-zinc supplementation with ratio of Fe: Zn = 2: 1. The possibility of hemoglobinopathies such as thalassemia trait, as the cause of anemia needs further investigations."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2005

D714

UI - Disertasi Membership Universitas Indonesia Library

Prihandoko S.

Simbol Religius dan Perwujudannya dalam Masyarakat : Studi Kasus Upacara Ngalabuh pada Masyarakat Nelayan Pantai Teluk Naga, Tangerang

"Studi mengenai kegiatan ritual keagamaan dalam masyarakat, merupakan suatu hal yang penting untuk dapat memahami kebudayaan masyarakat tersebut. Upacara Ngalabuh yang dilakukan oleh masyarakat nelayan pantai Teluk Naga, dapat digunakan sebagai cara untuk mempalajari simbol-simbol religius sekaligus merupakan wujud kebudayaan masyarakat pemiliknya. Bagi masyarakat pantai Teluk Naga, upacara Ngalabuh merupakan suatu upaya penting untuk menyelamatkan diri mereka serta akan menolong manusia terhadap rasa aman dari kekuatan yang tidak .mereka diketahui. Pada sisi lain, kepercayaan yang dimiliki bersama serta kegiatan ritual yang mereka laksanakan bersama pula, mendorong ke arah solidaritas sosial yang terjadi di antara masyarakat tersebut."

Depok: Fakultas Ilmu Sosial dan Ilmu Politik Universitas Indonesia, 1998

LP-pdf

UI - Laporan Penelitian Universitas Indonesia Library

Rio Alfian Pradana

Gambaran Karakteristik Orang Tua dan Balita Kurang Gizi di Wilayah Kerja Puskesmas Kosambi Tangerang = The Characteristics of Parents and Children under five suffer from malnutrition in Puskesmas Kosambi Tangerang Work Area

"Kurang gizi dipengaruhi beberapa faktor, diantaranya, karakteristik orang tua dan balita. Penelitian bertujuan untuk mengetahui gambaran karakteristik orang tua dan balita kurang gizi di wilayah kerja Puskesmas Kosambi Tangerang. Penelitian menggunakan desain deskriptif sederhana. Responden penelitian berjumlah 84 orang dengan teknik consecutive sampling. Hasil penelitian menemukan karakteristik orang tua balita kurang gizi adalah usia, tingkat pendidikan yang rendah, pekerjaan dengan penghasilan yang rendah, dan pola asuh pemberian makan yang kurang baik. Karakteristik balita kurang gizi mayoritas berjenis kelamin perempuan dan berusia rata-rata 29,85 bulan. Pendidikan kesehatan mengenai pencegahan kurang gizi pada balita diperlukan untuk menurunkan angka kurang gizi pada balita.

Parents and child characteristics are some of the many factors, affecting poor nutrition in children under five. This study aims to describe the characteristics of parents and children under five suffer from malnutrition in Puskesmas Kosambi, Tangerang work area. This study used descriptive design with consecutive sampling method. This study gathered 84 samples. Study results showed the characteristics of the parents of children with poor nutrition are age, low educational level, occupation with low income, and poor feeding pattern by parents. Most of the children suffer from malnutrition are female and at the age of 29,85 months. Health education regarding prevention of poor nutrition in children is necessary to decrease the prevalence of children with poor nutrition."

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2013

S47207

UI - Skripsi Membership Universitas Indonesia Library

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