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Abstrak :
Female adolescents are vulnerable to iron deficiency anemia (IDA) and if it persists into their reproductive years has serious implications not only for the health of their offsprings but for their own as well. An iron supplementation is warranted in order to provide sufficient iron stores prior to pregnancy and to effect desirable birth outcomes. A communication component of the supplementation is regarded as essential for improving compliance. Therefore, an experimental community trial involving adolescent female students in two public high schools in Metro Manila was conducted between October-December 1997. The objective of the study was to asses the effect of communication on compliance to weekly iron supplementation. The students were assigned to three groups: iron plus communication (FeC group, n = 82), iron (Fe group, n = 89), and control group (n=78). The FeC and Fe groups received iron tablets containing 60 mg. Elemental iron and 250 mcg. Folic acid while the control group received placebo tablets from Physical Education Health and Music (PEHM) teachers once a week of eight subsequent weeks. Teachers assigned to the FeC group were trained communication. Comparison were made between the three groups on compliance as communication. Comparisons were made between the three groups on compliace as measured by attendance to tablet distribution and actual ingestion through stool test, record on index card and interview. Additionally, levels and prevalence of anemia were measured before and after intervention and a pre and post test about knowledge on IDA and possible causes and treatments were included. Data about side-effects, reaction from students, parents and teachers about the supplementation-communication activities and suggestions for futher improvements in conductiong such future undertaking were obtained from focus group discussions (FGDs). Comparisons of actual tablet ingestion between the three groups showed significantly higher compliance in the FeC group (P<0.001) than in the other two group as measured by record on index card and interview desoite more side effects felt. Changes from pre to post-test knowledge scores o iron were significantly greater for the FeC group (p<0.001) than in the Fe and control groups. However, hemoglobin levels improved significantly in the Fe group (p<0.05) but not in the FeC group and remained the same in the control group. Reactions obtained through focus group discussions from parent (as reported by students), teachers and the participants found the program beneficial and feasible for implementation on a larger scale. Compliance enhancing strategies and motivational approaches for adolescent female students must consider the potential influence of family, fiends and teachers as revealed by the Venn diagram in planning iron supplementation programs with communication for this target group.

Abstrak :
Defisiensi besi merupakan defisiensi nutrisi terbanyak di seluruh dunia, dengan prevalensi tertinggi pada kelompok perempuan usia reproduksi. Di Indonesia prevalensi anemia defisiensi besi pada ibu hamil 50,5%. Penting dilakukan penapisan dini sebelum terjadi anemia defisiensi besi, untuk mencegah komplikasi sistemik yang permanen, pada ibu maupun janin. Saat ini telah dikembangkan parameter ekuivalen hemoglobin retikulosit (RET-He) yang mendeteksi kadar hemoglobin dalam retikulosit. Usia retikulosit di sirkulasi hanya 24-48 jam, maka RET-He lebih menggambarkan keadaan sebenarnya dari status besi pada sumsum tulang. Saat besi di sumsum tulang menurun, RET-He akan mengalami penurunan. Pemeriksaan RET-He dilakukan pada alat hitung sel darah otomatis dan tidak memerlukan tabung darah tambahan karena dilaporkan sebagai bagian dari hitung retikulosit. Penelitian ini bertujuan untuk mendapatkan rentang nilai RET-He pada perempuan usia reproduksi, melakukan penapisan defisiensi besi pada perempuan hamil trimester I dan II menggunakan RET-He dan membandingkannya hemoglobin, feritin, dan saturasi transferin. Juga untuk mendapatkan titik potong RET-He dengan sensitivitas dan spesifisitas yang optimal pada perempuan hamil trimester I dan II. Didapatkan rentang nilai RET-He pada perempuan usia reproduksi 30,69-36,17 pg. Didapatkan 100 perempuan hamil trimester I dan II yang terdiri dari 3 kelompok berdasarkan feritin dan saturasi transferin yaitu 67 (67%) subyek tanpa defisiensi besi, 17 (17%) subyek dengan defisiensi besi tahap I, dan 16 (16%) subyek dengan defisiensi besi tahap II. Rerata ± SD kadar hemoglobin, RET-He, dan saturasi transferin adalah 12,35 ± 1,02 g/dL, 33,60 ± 1,88 pg, dan 28,63 ± 1,07%. Median(min-maks) feritin adalah 40,10 (6,24 ± 191,30) ng/mL. Dari kurva ROC untuk menentukan titik potong nilai RET-He yang memberikan sensitivitas dan spesifisitas terbaik dibandingkan dengan feritin sebagai baku emas, didapatkan RET-He dengan titik potong 33,65 pg pada sensitivitas 67% dan spesifisitas 64,18% dan area under the curve (AUC) 66,4%, serta didapatkan PPV 47,8%, NPV 79,6%, LR positif 1,86 dan LR negatif 0,52. Ditemukan perbedaan bermakna kadar RET-He antara kelompok tanpa defisiensi besi dan kelompok defisiensi besi tahap II dan antara kelompok defisiensi besi tahap I dan tahap II. Tidak terdapat perbedaan bermakna antara kelompok tanpa defisiensi besi dan kelompok defisiensi besi tahap I. ...... Iron deficiency is the most common nutrient deficiency in the world, on developing and industrial countries. Population with highest risk of iron deficiencies is women in reproductive ages. In Indonesia the prevalence of iron deficiency anemia in pregnant women is 50,5%. Iron deficiency anemia in pregnancy can affect to both mother and fetus. In order to prevent permanent systemic complications, it is important to do early detection before iron deficiency anemia developed. On early phase of iron deficiency before anemia developed, we need an additional test of ferritin, serum iron and saturation index aside from complete blood count. Nowadays people developed a parameter named reticulocyte hemoglobin equivalent (RET-He) which detect the hemoglobin in a young erythrocyte. Reticulocyte will be on circulation for only 24-48 hours, so the RET-He will give more appropriate condition of bone marrow iron. In condition where the bone marrow iron is depleted, the RET-He shows a decrease. This parameter can be tested together with CBC, so that it will not need additional blood sample. This research aim to attain RET-He reference range on reproductive age women, to screen iron deficiency on first and second trimester pregnant women with RET-He and compare it to other parameters that available now : hemoglobin, ferritin, transferrin saturation, and to develope RET-He cut-off with optimal sensitivity and specificity. RET-He’s reference range on reproductive women is 30,69-36,17 pg. We attained 100 I and II trimester pregnant women which can be divided into 3 groups based on ferritin and transferrin saturation : 67 women (67%) without iron deficiency, 17 women (17%) with iron deficiency stage I, and 16 women (16%) with iron deficiency stage II. Hemoglobin’s, RET-He’s and transferrin saturation’s mean ± SD are 12,35 ± 1,02 g/dL, 33,60 ± 1,88 pg, and 28,63 ± 1,07%. Ferritin’s median(min-max) are 40,10(6,24-191,30) ng/mL. Using ROC curve we found RET-He at 33,65 pg as an optimal cut-off point to differentiate iron deficiency with 67% sensitivity, 64,18% specificity, and 66,4% area under the curve (AUC). From crosstabs table of RET-He with ferritin as gold standard and 33,65 pg as cut-off point we attained 47,8% PPV, 79,6% NPV, positive LR 1,86 and negative LR 0,52. We found significant differences of RET-He between non-iron deficiency and iron deficiency stage II groups and between iron deficieny stage I and iron deficiency stage II groups. There was no difference between non-iron deficiency and iron deficiency stage I groups.

Abstrak :
A study to investigate the effect of iron supplementation program among underfive children in North Central 'Timor, East Nusa Tenggara, Indonesia was conducted. The study was comprised into two parts: a cross-sectional study to investigate the impact of the ongoing government of Indonesia iron supplementation program and a intervention trial aiming to investigate the effect of daily compared to weekly iron supplementation. Hemoglobin, weight, height and compliance assessment were performed. The cross-sectional study involved 127 underfive children from four health centers. The average of age, weight and height of the recruited subjects was 36.6 months, 10.4 kg and 84.5 cm respectively. The result of this study showed that the prevalence of anemia among 127 underfive children where iron supplementation program has been implemented was still high, (81.5%), although 75.6% of the subjects claimed to take all the iron syrup. The intervention study recruited 160 preschool children and were divided into two groups: for 10 week one group received a daily supplement of 30 mg Fe, while the other group received 30 mg Fe per week A complete data set was obtained from 75 children in the group supplemented daily and 73 children in the group supplemented weekly. Th average age, weight and height of the subjects for daily group were 43.7 months, 12.1 kg and 91.0 cm respectively while 41.8 months, 11.7 kg and 90.3 cm for the weekly group. The result of this study showed a significant hemoglobin increase in both groups (p<0.001) which reduced the prevalence of anemia from 42.3 to 7 % in daily group and from 55.9% to 27.9% in weekly group. Although the weekly group had higher compliance (100%) compared to daily group (42.1%), it is concluded that daily group resulted in a better effect in reducing anemia prevalence among the preschool children.

Abstrak :
This two month iron supplementation was a community trial study conducted in Sambelia village in Sambelia subdistrict, East Lombok district, West Nusa Tenggara province during October-December 1996. The main objective of the study was to investigate religious leader or toga as distribution channel of iron tablets for women in child-bearing age. There were 187 women involved in this study, 94 received the tablets through religious leaders (Toga group) and 93 from cadre (Cadre group). Both groups of women received 8 tablets of 60 mg elemental iron (combined with 250 pg folic acid, 2500 IU vitamin A and 60 mg vitamin C) to be taken once weekly for two months. Coverage was defined as percentage of women in child-bearing age who received the tablets. The women's compliance was assessed by interview and stool test. Other methods of assessment included anthropometry measurements (weight, height, MUAC) and biochemical test (hemoglobin test with cyanmethemoglobin method). In addition, Focus Group Discussion on some women and personal interview with the distribution channels (toga and cadre) using Semi Structured Interview were also conducted. The women were comparable in socioeconomic condition and hemoglobin status. The distribution through toga and cadre could cover respectively 87.1% and 86.2% of the women. Compliance was better among women in toga group who in average took 6.8 tablets compared to 5.9 among women in cadre group (p < 0.10). There was however no difference in improvement of hemoglobin (after controlling for some confounders) nor in decrease of anemia prevalence between the two groups after 2 months period The Hb increased by 0.14 g/dL and 0.30 g/dL and anemia prevalence decreased by 13.9 % and 16.2 % respectively in toga group and cadre group. In the cadre group, predictors of non full compliers were social factors (ie. age, family income, education level) and frequency of contact with the cadre, whereas in the toga group, only side effects were predictive of non-full compliers. Combining both groups, 31% of non full compliers were identified by social factors (ie. age less than 20 and living in permanent house) and provider-user dynamics (iefrequency of contact with the distribution channels). Results suggest that toga was a potential channel of iron tablet for women in child-bearing age. With different nature of toga and cadre, their cooperation has potential for better achievement of iron supplementation program.

Abstrak :
The effect of weekly iron supplementation and deworming on the hemoglobin level was studied among 289 children aged 2 to 5 years in a randomized double-masked placebo controlled community trial. Subjects were allocated into 3 groups which respectively received iron supplements and deworming, iron supplements only and placebos. Iron supplementation for 8 weeks using 30 mg elemental iron as ferrous sulphate syrup once per week, led to a significant reduction in the prevalence of anemia from 37.2%. to 16.2%. Using unsupervised distribution by mothers, hemoglobin concentration increased significantly in both groups which received iron (p<0.001) and also in the placebo group (p<0.05), but the changes in both treatment groups were significantly higher than the placebo group (p<0.001). No significant difference in hemoglobin changes was found between those who received additional deworming and those who received iron supplement only. Positive iron in stool were confirmed in 68.2% of the children who were reported received iron supplements (n=66). It is concluded that weekly iron supplementation is effective to reduce the prevalence of anemia among preschoolers.

Abstrak :
ABSTRAK
Di Indonesia prevalensi anemia defisiensi besi masih cukup tinggi terutama pada wanita hamil, wanita dewasa, anak usia sekolah dan pra sekolah. Penelitian pada anak dari golongan ekonomi rendah, yang berusia 6 bulan - 6 tahun dengan status gizi baik, menunjukkan prevalensi anemia defisiensi besi 37,9 - 73,0 %.

Pada anak yang lahir cukup bulan dengan cadangan besi yang cukup, defisiensi besi dapat berkembang mulai usia 6 bulan. Hal ini disebabkan karena meningkatnya kebutuhan besi akibat pertumbuhan yang cepat, yang tidak diimbangi dengana konsumsi yang adekuat. Terbatasnya zat besi yang didapat: dari makanan pada anak-anak yang berusia 4 bulan sampai 12 bulan menyebabkan terjadinya defisiensi besi. Jumlah zat besi yang diabsorpsi tergantung dari ketersediaan hayati (bioavailabilitas) zat besi yang dimakan. Besi heme lebih mudah diabsorpsi dari pada besi non heme.

Gejala defisiensi besi pada fase paling awal ditandai dengan penurunan cadangan besi secara berangsur-angsur. Faktor diet diduga memainkan peranan yang penting untuk meningkatkan cadangan besi.

Di Indonesia anak-anak yang berusia 1 tahun mulai diberi makanan biasa selain ASI dan susu formula. Pada golongan ekonomi rendah, makanan terdiri dari serelia dan kacang-kacangan yang mempunyai koefisien absorpsi besi yang rendah.

Ibu-ibu di daerah perkotaan karena kesibukan bekerja, lebih cenderung memberikan anaknya susu formula yang juga mempunyai koefisien absorpsi besi yang rendah.

Pada percobaan binatang (anjing) terjadi penurunan enzim sitokrom oksidase dan laktase mukosa uses pada keadaan defisiensi besi. Penurunan ini menyebabkan terjadinya fenomena malabsorpsi sekunder. Enzim laktase berfungsi untuk menghidrolisis laktosa menjadi glukosa dan galaktosa sebelum diabsorpsi. Laktosa (gala susu) hanya terdapat di dalam susu. Aktivitas enzim laktase tinggi pada waktu lahir dan periode neonatal pada seluruh mamalia. Aktivitas akan menurun sesudah periode disapih, umumnya kurang dari 1/10 puncak aktivitas, kecuali pada manusia kadar tertinggi bertahan sampai usia 5 tahun (Eropa) Sesudah periode ini aktivitas laktase dapat berlanjut terus atau mungkin menurun. Pada bangsa Afrika dan Asia laktase menurun pada usia 3 - 6 tahun (7,8).

Abstrak :
Anemia gizi merupakan masalah gizi yang besar dan Iuas diderita oleh penduduk Indonesia. Anemia gizi biasanya disebabkan jumlah zat besi yang dikonsumsi tidak sesuai dengan jumlah yang dibutuhkan. Di samping itu berbagai faktor juga dapat mempengaruhi terjadinya anemia gizi yaitu, kurangnya konsumsi zat gizi antara lain protein, besi, vitamin C, energi, infeksi, menstruasi, sanitasi Iingkungan, status gizi, pengetahuan dan sosial ekonomi. Konsekuensi yang timbul akibat terjadinya anemia gizi adalah menurunnya aktifitas, produktivitas rendah, terhambatnya perkembangan mental dan kecerdasan (penurunan prestasi belajar), menurunnya kekebalan terhadap penyakit infeksi dan meningkatnya kesakitan. Prevalensi anemia gizi remaja putri berdasarkan beberapa hasil penelitian ternyata cukup tinggi. Hasil SKRT tahun 1995 sebesar 57,1% bahkan studi terhadap siswi SMU Padang tahun 1995 diketahui prevalensi anemia sebesar 80%. Prevalensi ini tergolong dalam masalah kesehatan masyarakat berat, sementara upaya penanggulangan anemia belum mengarah kepada sasaran remaja/mahasiswi ini. Tujuan penelitian ini untuk memperoleh gambaran prevalensi anemia dan faktor-faktor yang berhubungan serta faktor yang paling berhubungan dengan status anemia mahasiswi Akademi Kebidanan (Akbid) di Banda Aceh tahun 2002. Desain penelitian menggunakan crossectional. Populasi adalah seluruh mahasiswi Akbid di Banda Aceh sebanyak 836 orang dan yang menjadi sampel sebanyak 198 orang. Penelitian dilakukan pada 3 Akbid yaitu Akbid Depkes Banda Aceh, Akbid Mona dan Akbid Muhammadiyah pads tingkat I, II dan III dari bulan Juli - Agustus 2002. Penetapan besar sampel berdasarkan alokasi sama rata yaitu 66 orang tiap akademi dan 22 orang pada tiap tingkat. Pengambilan sampel pada masing-masing tingkat dengan sistematic random sampling. Data dikumpulkan dengan beberapa cara yaitu status anemia dengan pemeriksaan kadar Hemoglobin (Hb) menggunakan metoda cyanmethemoglobin, wawancara untuk kebiasaan minum teh, frekuensi haid, lama haid, pengetahuan tentang anemia, tingkat pendidikan ibu dan status tempat tinggal, food recall 2x24 jam untuk konsumsi zat gizi, pengukuran tinggi badan dan berat badan untuk Indeks Masa Tubuh (IMT) dan pengukuran LILA. Variabel dependen penelitian ini adalah status anemia mahasiswi sedangkan variabel independen meliputi konsumsi zat gizi (energi, protein, besi dan vitamin C), status gizi (IMT dan LILA), kebiasaan minum teh, pola haid (frekuensi haid dan lama haid), pengetahuan tentang anemia, tingkat pendidikan ibu dan status tempat tinggal. Analisa data meliputi : univariat dengan distribusi frekuensi (semua variabel), mean, median, standart deviasi, minimum dan maksimum (variabel yang memiliki data numerik), analisis bivariat dengan chi square dan analisis multivariat dengan regresi logistik ganda. Hasil penelitian diketahui prevalensi anemia sebesar 88,9% (anemia ringan 57,1%, anemia sedang 29,8% dan 2% anemia berat). Pada analisis bivariat diperoleh variabel yang bermakna secara statistik (p<0.05) dengan status anemia adalah konsumsi besi, konsumsi vitamin C, kebiasaan minum teh, tingkat pendidikan ibu dan status tempat tinggal dan dalam analisis multivariat variabel yang berhubungan adalah konsumsi besi, konsumsi vitamin C, kebiasaan minum teh dan status ternpat tinggal, selanjutnya variabel yang berhubungan paling dominan dengan status anemia adalah konsumsi zat besi (OR = 6,565). Berdasarkan hasil penelitian yang diperoleh, disarankan agar penanggulangan anemia gizi mahasiswi/remaja putri; sudah harus diprioritaskan. Memasyarakatkan Gerakan membuat taman gizi dengan menanam pohon buah-buahan dan sayur-sayuran sumber vitamin C dan zat besi. Penyuluhan kepada mahasisiwi/remaja putri dan ibu-ibu serta memotivasi mahasiswi untuk mengkonsumsi tablet tambah darah harga murah secara mandiri. Pemeriksaan kadar Hb pada mahasiswi secara berkala yang dimulai sejak mahasiswa baru dan pengobatan bagi penderita anemia terutama anemia berat dan sedang serta memasukkan bahasan anemia pada mata ajaran tertentu. Penyuluhan kepada para pengelola makanan asrama tentang pentingnya variasi makanan terutama makanan sumber vitamin C dan zat besi yang murah dan mudah diperoleh disekitarnya serta cara pengoaahan makanan yang baik. Pada penelitian selanjutnya agar menggunakan desain yang lebih baik, variabel yang berbeda dan sampel pada kelompok rawan anemia lainnya.

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Nutritional anemia is a wide and huge nutrition problem suffered by many Indonesian people. Nutritional anemia usually caused by inadequate amount of iron consumption. Besides, other factors could influence the occurrence of nutritional anemia including inadequate nutrient consumption such as protein, vitamin C, energy, infections, menstruation, poor environmental sanitation, poor nutritional status, lack of knowledge, and poor socioeconomic conditions. As consequences, there is a decrease in activity, low productivity, occurrence of mental retardation, and Iow intelligence, decrease in immunity, and increase in morbidity. According to several studies, prevalence of anemia among teenage girls was high. SKRT result in 1995 showed prevalence of 57.1%. One study among high school girl student in Padang in 1995 showed prevalence as high as 80%. The problem could be categorized as severe public health problem, while the current existing intervention on anemia was not targeted to this segment of population. The aim of this study is to obtain a description on anemia prevalence and its related factors as well as the most associated factors on anemia status among female students of Midwife Academies in Banda Aceh in the year of 2002. The design of the study was cross sectional. Population was all female students in Midwife Academies in Banda Aceh (836 students), with 198 subjects as sample. There were 3 academies, that is, Midwife Academy of Depkes Banda Aceh, Mona Midwife Academy, and Muhammadiyah Midwife Academy including students of all grades in the period of July-August 2002. Sampling was equally distributed among three academies, resulted in 66 students for each academy and 22 students for each grade. Sample in each level was obtained through systematic random sampling. Data was collected using several methods including cyanmethemoglobin to examine Hb level as to determine anemia status, face-to-face interview to know the habit of drinking tea, frequency of menstruation, duration of menstruation, knowledge, mother's educational background and living condition status, 2 X 24 hours recall to predict nutrient consumption, weight and height measurements to calculate body mass index (BMI) and mid upper arm circumference (MUAC) measurement. Dependent variable in this study was anemia status while the independent variables included nutrient consumption (energy, protein, iron, and vitamin C), nutritional status (BMI and MUAC), habit of drinking tea, menstruation pattern (frequency and duration), knowledge, mother's education level and living conditions status. Data analyses included univariate with frequency distribution (for all variables), mean, median, standard deviation, minimum and maximum (for numeric variables), bivariate using chi square, and multivariate analysis using multiple logistic regression. The result showed that prevalence of anemia was 89.4% (mild anemia 47.5%, moderate anemia 40.4%, and severe anemia 1.5%). Bivariate analysis showed that variables that statistically significantly (p

Abstrak :
Tujuan : Mengetahui efektivitas terapi besi intra vena sebagai terapi anemia defisiensi besi dalam kehamilan. Tempat : Bagian Kebidanan dan Kandungan Universitas Indonesia, RSUPN Cipto Mangunkusumo dan RS Budi Kemuliaan Jakarta. Rancangan penelitian : Uji klinis cara random tanpa pendekatan tersamar. Metode : Penelitian dilakukan selama kurun waktu November 2004 hingga Maret 2006 terhadap 21 pasien dengan usia gestasi 14 - 36 minggu yang didiagnosis sebagai anemia defisiensi besi. Dilakukan randomisasi secara blok sehingga terdapat dua kelompok, yaitu kelompok pertama yang mendapat terapi besi oral sulfas ferosus 3 x 300 mg selama 30 hari dan kelompok kedua mendapat terapi besi intra vena iron sucrose. Penilaian hasil pengobatan dilakukan satu bulan setelah terapi dimulai dengan pemeriksaan Hb, Retikulosit dan Feritin, Dilakukan Pula penilaian efek samping dan kepatuhan pasien. Data dikumpulkan, ditabulasi dan dilakukan analisa statistik dengan uji t tidak berpasangan dan uji Mann Withney. Hasil : Peningkatan nilai Hb yang didapatkan pada kelompok pasien yang mendapat terapi iron sucrose adalah 1.6 gr/dl ± 0.92 gr/dl, dengan nilai maksimum peningkatan Hb yang dicapai adalah 3.8 gr/dl. Sedangkan peningkatan nilai Hb pada kelompok yang mendapat terapi oral adalah 1 gr/dl ± 0.85 gr/dl dengan nilai maksimum peningkatan Hb 2.2 gr/dl. Perbandingan kedua kelompok ini secara statistik tidak didapatkan perbedaan yang bermakna. Perbedaan yang bermakna secara statistik ( p = 0.041 ) didapatkan pads perbandingan nilai feritin akhir, di mana nilai feritin akhir pada kelompok oral adalah 29.71 ug/L ±18.37 ug/L, sedangkan nilai Feritin pada kelompok iron sucrose sebesar 68.21 ug/L ± 55.69 ug/L. Tidak didapatkan efek samping yang serius pada saat pemberian iron sucrose. Kesimpulan : Iron sucrose merupakan terapi alternatif untuk anemia defisiensi besi dalam kehamilan yang dapat mengembalikan simpanan besi tubuh dengan cepat tanpa efek samping yang serius.

Abstrak :
ABSTRAK
Ibu hamil adalah salah satu kelompok yang paling rawan dalam berbagai aspek, salah satunya terhadap pangan dan gizi. Diperkirakan sebesar 20% kematian ibu berkaitan dengan rendahnya kadar hemoglobin (anemia gizi) selama kehamilan. Teh memiliki potensi sebagai penyebab anemia karena disinyalir mampu mengabsorbsi mineral sebagai bentuk zat besi yang dikaitkan dengan peranan tanin dalam akndungan teh. Penelitian ini bertujuan untuk mengetahui pengaruh kadar tanin pada teh celup terhadap anemia gizi besi pada ibu hamil. Penelitian dilakukan dengan design Cross Sectional analytic. Responden terdiri dari 94 ibu hamil dengan usia kandungan > 16 minggu. Data dianalisis dengan menggunakan analisa Cox Regression.Hasil analisa bivariat diperoleh bahwa prevalens ibu yang memiliki kadar tanin tinggi perharinya 2.77 kali lebih tinggi (95% CI 0.89 – 8.6) untuk menderita anemia gizi besi dibandingkan ibu yang memiliki kadar tanin lebih rendah. Pada tahap analisa multivariat, didapatkan hasil bahwa prevalens ibu hamil dengan kadar tanin yang tinggi 2,84 kali lebih tinggi (95% CI 0.9 – 9.06) untuk menderita anemia gizi besi setelah dikontrol variabel pola konsumsi protein hewani dengan bioavaiabilitas rendah dan usia ibu. Meskipun hubungan kadar tanin pada teh celup secara statistik tidak significan tetapi kadar tanin, asupan protein hewani dengan bioavaiabilitas rendah dan usia ibu dapat memprediksi nilai kadar serum ferritin ibu hamil.

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ABSTRACT
Pregnant women is one of the critical group in lot os aspect, one of it is food and nutrition. abaut 20% of mother mortality have correlation with less level of haemoglobin (nutrition anemia) during pregnancy. tea has potential causing anemia, because it has possibility be able to absorbs mineral as a form of iron which correlation to the contain of tannin in tea.

this study puposes is to observe the effects of tannin in tea bags to iron nutritional anemia on pregnant women. the design of this study is Cross Sectional analysis. Respondents are 94 pregnant women with gestation > 16 weeks. data analyze by Cox Regression by bivariate analysis pregnant women with high tannin level in each day have prevalence 2.77 more high (95% CI 0.89 - 8.6) to be iron dificency comapre to pregnant women who has lower tannin level. in multivariate analysis step, pregnant women with high tannin level have prevalence 2.45 more high (95% CI 0.9 - 9.06) to be iron deficiency after control by heme consumtion and age of pregnant women variable.

Although the correlation of tannin in tea bags statiscally not significant, but tannin level, heme consumption with low bioavaiability and age of pregnant women be able to predict the value of ferritin level in pregnant women.

Abstrak :
Anemia merupakan akibat sekunder dari Gagal Ginjal Terminal (GGT) yang terjadi pada 80-95% pasien, seiring dengan penurunan laju filtrasi glomerulus pada pasien hemodialisis. Tujuan penelitian untuk mengidentifikasi faktor-faktor yang berhubungan dengan anemia pada pasien hemodialisis rutin. Penelitian ini menggunakan desain cross sectional dengan jumlah sampel 116 orang. Hasil penelitian menunjukkan penyakit inflamasi merupakan faktor yang paling berhubungan dengan anemia ( p = 0,05; OR = 2,7), kedua adekuasi hemodialisis (p = 0,04; OR = 2,3) dan ketiga status nutrisi (p = 0,04; OR = 0,31). Pelaksanaan asuhan keperawatan yang komprehensif dan peran perawat dalam memastikan adekuasi hemodialisis tercapai untuk setiap pasien dengan frekuensi dialisis 3x/minggu selama 4 - 5 jam/sesi hemodialisis merupakan kunci keberhasilan manajemen anemia sebagai salah satu indikator kualitas pelayanan ruang hemodialisis.

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Anemia is a secondary effect of Chronic Renal Failure (CRF), which occurs in 80-95% of patients, in line with the decline of glomerular filtration rate. The purpose of this research was to identify the factors associated with anemia in hemodialysis patient. This study used cross-sectional design with a sample of 116 people. Results showed inflammatory disease was the most influential factor on the incidence of anemia (p = 0.05, OR = 2.7), then the adequacy of hemodialysis (p = 0.04; OR = 2.3) and third nutritional status (p = 0.04; OR = 0.31). Implementation of comprehensive nursing care and the role of nurses ensure adequacy of hemodialysis is achived for each patient with the frequency of hemodialysis performed 3 times a week for 4-5 hour per session of hemodialysis is the key indicator of adequacy of treatment of anemia as a service quality hemodialysis.