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"[ABSTRAKLatar Belakang: Diare akut adalah masalah umum di negara berkembang sepertiIndonesia; penyakit ini banyak ditemukan dalam praktek sehari-hari dengan angkamorbiditas dan mortalitas yang cukup tinggi. Pada beberapa Rumah Sakit diJakarta ditemukan bahwa pasien diare akut dewasa mengalami defisiensi kadarseng sebesar 69.3%.Pemberian seng sudah terbukti bermanfaat untuk pengobatan diare akut padaanak.Tujuan: Mengetahui dampak suplementasi seng sebagai terapi alternatif /adjuvant untuk pengobatan diare akut pada pasien dewasa, denganmembandingkan lama berlangsung dan berat-ringan gejala pada kelompok pasienyang diberikan dan yang tidak diberikan suplementasi seng.Metode: Double blind randomized controlled trial dilakukan pada penelitian iniuntuk mengetahui efek suplementasi seng terhadap durasi dan gejalagastrointestinal pada pasien diare akut rawat inap di RS Pusat Pertamina di Jakartaselama periode Januari-Desember 2013. Analisis data dilakukan denganmenggunakan uji chi-square (x2) untuk perbandingan durasi diare dan uji generallinear model (GLM) untuk menilai tren perubahan gejala penyerta diare.Hasil: Analisis data dari 84 pasien yang dikelola: 30 pasien pria [seng 19,plasebo 11] dan 54 pasien wanita [seng 23, plasebo 31] ~ (p 0.111)memperlihatkan pemberian suplementasi seng bermakna mengurangi durasi diareakut (p 0.027) dan bermakna mengurangi gejala mual (p 0.032). Selain itu adatren perbaikan pada sebagian gejala penyerta diare akut, seperti sakit perut,frekuensi b.a.b., konsistensi feses, gejala muntah, kembung, dan gangguanaktivitas sehari-hari.Simpulan: Pemberian suplementasi seng bermakna membuat durasi diare akutlebih singkat dan bermakna mengurangi gejala mual, serta perbaikan padasebagian gejala gastrointestinal.

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ABSTRACTBackground: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea.;Background: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea., Background: Acute diarrhea is a common problem in developing countries suchas Indonesia; which is found in everyday practice with quite high morbidity andmortality rate. It was revealed in adult acute diarrhea patients in several hospitalsin Jakarta the levels of zinc deficiency was 69.3%. Zinc has been proven to bebeneficial in the treatment of acute diarrhea in pediatric patients.Objective: To discover the effectiveness of zinc supplementation as an adjuvanttherapy in acute diarrhea for adult patients by comparing the duration and theseverity of signs and symptoms of acute diarrhea between the zinc and placebogroup.Methods: A double blind randomized controlled trial is done to find out aboutthe effect of zinc supplementation to the duration, signs and symptoms on acutediarrheal in hospitalized adults patients in Pertamina Central Hospital in Jakartafrom January-December 2013. The data is analyzed using chi-square test (x2) forcomparing the duration of diarrhea and general linear model (GLM) to assesstrend changes accompanying symptoms of diarrhea.Results: Analysis of the data from 84 patients: 30 males [19 zinc, 11 placebo]and 54 females [23 zinc, 31 placebo] ~ (p 0.111) obtained zinc supplementationsignificantly reduced the duration of acute diarrhea (p 0.027) and significantlyreduce the symptoms of nausea (p 0.032). In addition there is trend ofimprovement in some acute diarrhea associated symptoms, such as abdominalpain, frequency of diarrhea, stool consistency, vomiting, bloating, and disruptionof daily activities.Conclusion: Zinc supplementation significantly reduce the duration of diarrhea,significantly reduce the symptoms of nausea; besides, improving some symptomsaccompanying acute diarrhea.]"

"Latar Belakang. Cairan rehidrasi oral dan zinc telah menjadi terapi standar dalam tata laksana diare akut pada anak. Probiotik sudah digunakan secara luas pada kasus diare akut pada anak meskipun belum direkomendasikan oleh WHO. Penelitian yang membandingkan penambahan probiotik pada terapi standar masih sangat terbatas.Tujuan. Mengetahui efektivitas pemberian suplementasi probiotik pada terapi standar diare akut. Metode. Penelitian uji klinis acak tersamar ganda dilakukan pada anak usia 6 bulan sampai 36 bulan dengan diare akut tanpa dehidrasi dan dehidrasi ringan sedang, yang dilakukan di kelurahan Kenari, Jakarta Pusat antara bulan Oktober 2011 sampai Februari 2012. Kelompok perlakuan diberikan terapi standar ditambah probiotik Lactobacillus rhamnosus R0011 1.9 x 109 cfu dan Lactobacillus acidophilus R0052 0.1 x 109 cfu, sedangkan kelompok kontrol diberikan terapi standar dan plasebo. Luaran yang dinilai adalah durasi diare dan frekuensi defekasi. Penelitian ini bersifat intention to treat analysis. Hasil. Total 112 subjek masuk dalam penelitian, terdiri dari 56 subjek mendapat terapi standar ditambah probiotik, dan 56 subjek hanya terapi standar. Median lama durasi diare setelah terapi pada kelompok perlakuan yaitu 68,5 jam sedangkan pada kelompok kontrol 61,5 jam (p=0,596). Median frekuensi defekasi pada kelompok perlakuan yaitu 5 kali, sedangkan pada kelompok kontrol 5,5 kali (p=0,795). Simpulan. Pada penelitian ini tidak ditemukan penurunan durasi diare dengan penambahan probiotik pada terapi standar. Meskipun kelompok perlakuan memiliki frekuensi defekasi yang lebih sedikit dibandingkan dengan kelompok kontrol, namun perbedaan tersebut tidak bermakna.

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Background. Oral rehydration solution and zinc have been used as standard therapy for treating acute diarrhea in children. Probiotics are widely used in treatment of acute diarrhea in children, although it has not been recommended by WHO. Studies comparing supplementation of probiotics to standard therapy are still limited.

Objectives. To know the efficacy of probiotic supplementation to standard therapy in acute diarrhea.

Methods. A randomized double blind clinical trial was performed in children aged 6-36 months with acute diarrhea without dehydration or mild to moderate dehydration in Kenari sub district, central Jakarta, between October 2011 until Februari 2012. Supplemented group was given standard therapy and probiotics Lactobacillus rhamnosus R0011 1.9 x 109 cfu and Lactobacillus acidophilus R0052 0.1 x 109 cfu, while control group was given standard therapy and placebo. The outcomes were duration of diarrhea and frequency of defecation. Stool frequency was recorded daily until resolution of diarrhea. The analysis was based on intention to treat.

Results. A total of 112 subjects were included in the study, consisted of 56 subjects in supplemented group and 56 subjects in control group. Median duration of diarrhea in supplemented group was 68,5 hours while in the control group was 61,5 hours (p=0,596). Median frequency of defecation in supplemented group was 5 times, while in the control group was 5,5 times (p=0,795).

Conclusion. This study did not find shorter duration of diarrhea with supplementation of probiotics to standard therapy. Although supplemented group had lower frequency of defecation compared to control group, the difference was not significant."

"ABSTRACTDiarrheal diseases among children are still the problems of concern globally despite of much progress in primary health care, hygiene-sanitation and living condition. According to WHO estimation, in 1997 there were 4 billions episodes of diarrhea in the world that contributed up to nearly 2.5 millions deaths. The diarrheas were the leadingcauses of morbidity and the sixth causes of mortality of human in the world. In recent decades, with the discovery and utilization of Oral rehydration solution (ORS) as well as other Oral rehydration therapies (0RTs) and the promotion of appropriate feeding and caring practice at the community levels, the mortality due to diarrhea is reduced. However, diarrhea is still contributing up to 19% to child mortality in the developing world.Results from 276 surveys conducted in sixty countries between 1981 and 1986 indicated that children under five in developing countries suffered 3.5 diarrheal episodes each year. Incidence of diarrhea is higher in certain communities especially the rural poor. High diarrheal prevalence and mortality among young children lead to serious consequences in health and socio-economy fiom household to the world levels."

"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.ObjectiveThe 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.MethodologyA 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 DiscussionBy 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 Recommendationslt 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."

"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."

"ABSTRAKLatar Belakang: Tuberkulosis (TB) di Indonesia masih menempati urutan ke-3 di dunia.Anak dengan tuberkulosis umumnya mengalami defisiensi zinc dan vitamin A. Defisiensizinc dapat menyebabkan gangguan sistem kekebalan tubuh dan mengganggu sintesisretinol binding protein sehingga dapat menghambat proses penyembuhan TB.Penambahan zinc dan vitamin A dapat membantu meningkatkan respon kekebalan tubuhpada penderita TB.Tujuan: Membuktikan pengaruh suplementasi zinc dan vitamin A dalam meningkatkanstatus gizi dan perbaikan gejala klinis pada anak usia 5-10 tahun dengan tuberkulosisparu.Disain: Penelitian adalah kuasi eksperimen dengan pre post design dengan kontrol.Sebanyak 84 anak yang telah diseleksi dan terdiagnosis TB Paru yang berada di empatwilayah Puskesmas Kecamatan di Jakarta Pusat diambil menjadi subyek penelitian.Kelompok perlakuan dibagi secara acak menjadi dua kelompok yakni kelompok I yangmendapatkan Obat anti Tuberkulosis Standar DOTS dan suplemen (berisi 20 mg zincelemental dan vitamin A asetat 1500 IU) dan kelompok II yang hanya mendapatkan OATsaja. Obat dan suplemen diminum setiap hari selama pengobatan TB. Responkesembuhan dapat diukur dari membaiknya gejala klinis dan status gizi dibandingkanpada saat awal sebelum pengobatan. Analisis untuk melihat perbedaan dua kelompokmenggunakan uji T-Test. Gejala klinis diukur dengan chi-square.Hasil: 84 Subyek terdiri atas kelompok intervensi (n=38) dan kelompok kontrol (n=46).Pada fase inisial (bulan ke dua) perubahan nilai zinc, retinol dan IMT-U pada kelompokintervensi lebih tinggi dibandingkan dengan kontrol, grup I dengan nilai p=0,087;p=0,002; p=0,449 berturut-turut. Perubahan kadar albumin dan hemoglobin kelompokkontrol lebih tinggi dibanding kelompok intervensi denan nilai p=0,000; p=0,142. Padabulan ke enam terjadi kenaikan pada retinol, hemoglobin, IMT-U, kelompok intervensilebih tinggi dari kelompok kontrol dengan p=0,879; p=0,142; p= 0,216. Perubahan kadaralbumin lebih tinggi pada kelompok kontrol p=0,005. Kadar zinc mengalami penurunanpada kedua kelompok p=0,153. Perbaikan gejala klinis lebih cepat terjadi pada kelompokintervensi dan bermakna secara klinis namun tidak bermakna secara statisik.Simpulan: Pemberian suplemen disarankan pada anak TB yang mendapat OAT hinggabulan ke dua, karena dapat meningkatkan status gizi dan perbaikan gejala klinis.

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ABSTRACTBackground: Indonesia is the 3rd in the world on Tuberculosis (TB). Most children withtuberculosis commonly have zinc and vitamin A deficiency. Zinc deficiency causedimmune system disorders and disturb the synthesis of retinol binding protein, it inhibitedthe healing process of TB. Supplementation of zinc and vitamin A helped to improve theimmune response in TB patients.Objective: To prove the effect of zinc and vitamin A supplementation in improving theclinical symptoms and nutritional status in children 5-10 years of tuberculosis.Design: This study was quasi experimental, was conducted in a pre post design. A totalof 84 children who were selected and diagnosed with pulmonary TB in the four districtsof the Public Health Center in Central Jakarta were invited as research subjects. Subjectswere divided into two groups. Group I received the standard DOTS ATT and supplement(containing 20 mg zinc element, as a zinc sulfate and acetate vitamin A 1500 IU), whilegroup II only received ATT. These drugs and supplements are taken daily during TBtreatment. The recovery response can be measured by observing the improvement inclinical symptoms and nutritional status compared to the time before treatment. Theanalysis used to see the differences between the two groups is the T-Test. Clinicalsymptoms are measured by chi-square.Results: There are 84 subjects taken in the intervention group (n = 38) and the controlgroup (n = 46). In intensive phase, delta of zinc, retinol, BMI/A on intervention groupwas higher than control ( p=0,087; =0,002; =0,449, respectively). Delta albumin and Hbwere higher ol control than intervention (p=0,000; =0,142). On the 6th mo, delta ofretinol, Hb increased higher than control (p=0,879; =0,142; =0,216, respectively). Butzinc level decreased on both groups (p=0,153). Clinical symptoms provide good resultsand are clinically meaningful but not significant.Conclusion: Supplementation was valueable with ATT treatment up to two months dueto it could improve nutritional status and clinical symptoms.

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