Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Golongan usia anak merupakan golongan usia yang paling ringan terdampak infeksi COVID-19. Salah satu kemungkinan penyebab keadaan tersebut adalah perlindungan dari efek nonspesifik vaksinasi rutin yang diterima anak sebelumnya. Vaksinasi rutin yang diterima anak dapat memodulasi sistem imun anak terhadap infeksi lain di luar target imunisasi yang dituju melalui mekanisme imunitas heterolog. Bukti-bukti penelitian terdahulu menimbulkan hipotesis antigen vaksin DTP berpotensi menimbulkan imunitas heterolog dengan SARS-CoV-2. Hal ini berdasarkan kemiripan epitop antara antigen SARS-CoV-2 dengan antigen pada vaksin DTP. Belum diketahui bagaimana pengaruh vaksinasi DT booster terhadap respons imun (antibodi S-RBD SARS-CoV-2 dan IFN-ɤ-sel T spesifik SARS-CoV-2) pascavaksinasi COVID-19 inaktif pada anak usia 6–7 tahun. Penelitian ini bertujuan mengetahui pengaruh pemberian vaksinasi DT booster pada anak yang mendapat vaksinasi COVID-19 inaktif terhadap respons imun humoral dan selular anak. Studi potong lintang dilakukan dengan didahului tahapan pengambilan data pada orang tua subjek penelitian di wilayah Senen, Jakarta Pusat. Pengambilan data menggunakan kuesioner yang disebarkan secara luring kepada orang tua melalui guru sekolah anaknya. Dari kuesioner didapatkan data status vaksinasi anak, yang dibedakan dalam 4 kelompok yaitu COVID+/DT+, COVID+/DT–, COVID–/DT+ dan COVID–/DT–, dan diukur antibodi S-RBD, IFN-ɤ-sel T spesifik SARS-CoV-2 dan IgG antidifteri. Hasil penelitian menunjukkan 113 dari 154 subjek penelitian (73,4%) telah memiliki status relative immune terhadap difteri, dengan hasil IgG antidifteri > 0,1 IU/mL. Terdapat imunitas heterolog vaksinasi DT booster terhadap COVID-19 dengan adanya perbedaan bermakna kadar antibodi S-RBD SARS-CoV-2 antara anak yang sudah mendapat vaksin DT booster dibanding yang belum (1182 U/mL vs. 612,5 U/mL, p = 0,026), dan perbedaan bermakna IFN-ɤ-sel T spesifik SARS-CoV-2 pada anak COVID+/DT+ dibanding COVID+/DT– (560,87 mIU/mL vs. 318,03 mIU/mL, p = 0,03). Tidak didapatkan korelasi antara IgG antidifteri dan S-RBD SARS-CoV-2. Selain hasil penelitian data laboratorium, didapatkan pula data keinginan orang tua untuk vaksinasi COVID-19 bagi anaknya adalah sebesar 69,7%. Disimpulkan vaksin DT booster dapat berperan menguatkan respons imun spesifik SARS-CoV-2 pada anak yang menerima vaksin COVID-19 inaktif. ......Corona Virus Disease 2019 (COVID-19) in children tends to be mild. A possible cause is existing protection from the routine vaccination previously received by children. Routine vaccinations can modulate the child's immune system against other pathogen, presumably through a mechanism of heterologous immunity. Previous research had suggested that the Diphtheria-Tetanus-Pertussis (DTP) vaccine antigen has potential to incite heterologous immunity towards SARS-CoV-2, due to similarities between SARS-CoV-2 epitopes and various epitopes found within the DTP vaccine. It was not known whether the Diphtheria-Tetanus (DT) vaccination could modulate the SARS-CoV-2-specific immune response among children aged 6–7 years who received inactivated COVID-19 vaccine. This study thus aimed to assess the impact of DT booster immunization in SARS-CoV-2-specific humoral and cellular immune responses among children who received two doses of CoronaVac. A cross-sectional study was performed on children aged 6–7 years old in the Senen area, Central Jakarta. This study was started with data collection from parents of eligible subjects using questionnaire that was distributed to parents via their children’ school teachers. Based on the collected demographic data and the child's vaccination status, eligible subjects were further screened. The participating subjects were subsequently classified into 4 groups, i.e., COVID+/DT+, COVID+/DT-, COVID-/DT+ and COVID-/DT-. Blood collections were performed to determine anti-diphtheria toxoid antibodies, anti-S-RBD antibodies and SARS-CoV-2-specific T cell-produced IFN-ɤ. The results showed that 113 of 154 subjects (73.4%) had relative immune-status against diphtheria as the result of the anti–diphtheria toxoid antibodies was > 0.1 IU/mL. There was a heterologous immunity of DT booster and COVID-19 vaccine, as there was significant difference in anti-S-RBD antibody titers between the group with DT booster compared to non-DT booster (1182 U/mL vs. 612.5 U/mL, p = 0.026), and a significant difference in IFN-ɤ concentration between the group of COVID+/DT+ and COVID+/DT- (560.87 mIU/mL vs. 318.03 mIU/mL, p = 0.03). No correlation was found between anti-diphtheria and anti-S-RBD antibodies. In addition, our data indicated that parental intention to vaccinate their children against COVID-19 in the Senen area was 69.7%. In conclusion, our results suggested that DT booster vaccine might able to enhance SARS-CoV-2-specific immune responses among children who received inactivated COVID-19 vaccine.

Abstrak :
Latar belakang dan tujuan: Area kumuh identik dengan permasalahan gizi pada anak. Salah satunya adalah masih terdapatnya anak pendek di daerah tersebut. Perawakan pendek dapat disebabkan oleh berbagai faktor, diantaranya dikarenakan oleh dysbiosis. Penelitian ini bertujuan untuk menganalisis komposisi mikrobiota pada anak pendek dan tidak pendek di daerah kumuh di Jakarta serta faktor-faktor yang mempengaruhinya. Metode: Penelitian ini menggunakan desain comparative cross sectional study yang dilakukan di RW 9 dan 11, Kelurahan Kebon Bawang, Jakarta Utara. Subjek dalam penelitian ini adalah 21 anak pendek (HAZ £ -2SD) dan 21 anak tidak pendek (-1SD £ HAZ £ 3SD) usia 2-5 tahun. Data yang dikumpulkan meliputi karakteristik subjek dan keluarga, riwayat cara lahir, riwayat asi eksklusif, riwayat sakit serta higiene dan sanitasi. Selain itu juga dilakukan pengumpulan asupan zat gizi melalui Semi Quantitative Food Frequency Questionnaire (SQFFQ). Analisis mikrobiota dilakukan dengan mengekstraksi DNA dari feses subjek kemudilan dilakukan sekuensing 16S rRNA menggunakan Next Generation Sequencing (NGS). Analisis bioinformatika dilakukan untuk membandingkan komposisi mikrobiota pada kedua kelompok. Uji Manova dan korelasi Spearman dilakukan untuk menganalisis kaitan antara faktor-faktor dan asupan zat gizi dengan komposisi mikrobiota. Hasil: Berdasarkan asupan zat gizi, pada kelompok anak pendek, asupan energi, zat gizi makro (karbohidrat, protein, dan lemak) dan zat gizi mikro (Zn dan Fe) lebih rendah dibandingkan anak yang tidak pendek. Pada kelompok anak pendek terdapat kecenderungan jumlah anak yang dilahirkan secara Caesar lebih banyak, yang memiliki riwayat sakit lebih banyak, konsumsi air minum air isi ulang lebih banyak dan yang tidak mencuci tangan sebelum makan lebih banyak dibandingkan kelompok anak tidak pendek. Dilihat dari komposisi mikrobiota, terdapat perbedaan komposisi mikrobiota pada kedua kelompok, baik pada tingkat genus maupun spesies. Pada kelompok pendek terdapat kelimpahan yang lebih tinggi pada genus Mitsuokella and Alloprevotella serta spesies Providencia alcalifaciens. Sedangkan pada kelompok tidak pendek terdapat kelimpahan lebih tinggi pada genus Blautia, Lachnospiraceae, Bilophila, Monoglobus dan spesies Akkermansia municiphila, Odoribacter splanchnicus and Bacteroides clarus. Perbedaan komposisi mikrobiota ini dipengaruhi oleh riwayat cara kelahiran, riwayat ASI eksklusif, sumber air minum, sumber air untuk aktivitas lain, kebiasaan mencuci tangan sebelum makan serta asupan energi, makronutrient dan mikronutrient. Kesimpulan: Secara umum kelimpahan mikrobiota yang bersifat patogen pada anak pendek lebih tinggi dibandingkan kelompok tidak pendek. Hal ini dipengaruhi oleh asupan zat gizi serta faktor-faktor lainnya. Faktor-faktor yang berpengaruh ini dapat diterapkan oleh anak pendek di daerah kumuh sebagai upaya perbaikan status gizi. ......Background and objective: Slum areas are identic with nutritional problems in children including stunted children. Incidence of stunted can be caused by various factors, one of which is dysbiosis. This study aims to analyze the microbiota composition of stunted and non-stunted children in Jakarta slum areas and related contributing factors. Method: This study used a comparative cross-sectional study design which was conducted in RW 9 and 11, Kebon Bawang Village, North Jakarta. The subjects in this study were 21 stunted children (HAZ£-2SD) and 21 non-stunted children (-1SD£HAZ£3SD) ages 2-5 years. The data collected included subject and family characteristics, mode delivery history, exclusive breastfeeding history, history of illness and hygiene and sanitation. In addition, nutrient intake was also collected through the Semi Quantitative Food Frequency Questionnaire (SQFFQ). Microbiota analysis was performed by extracting DNA from the subject's feces and then 16S rRNA sequencing using Next Generation Sequencing (NGS). Bioinformatics analysis was performed to compare the composition of the microbiota in the two groups. Manova test and Spearman correlation were performed to analyze the association between factors and nutrient intake with gut microbiota composition. Results: Based on nutrient intake, in the stunted children, energy intake, macronutrients (carbohydrates, protein, and fat) and micronutrients (Zn and Fe) were lower than non-stunted children. In the stunted group there was a tendency for the number of children born by Caesarean section to be higher, to have a higher history of illness, to consume more refillable drinking water and not to wash their hands before eating than non-stunted group. There were differences in the composition of the microbiota in the two groups, both at the genus and species levels. In the stunted group there were higher abundance in the genera Mitsuokella and Alloprevotella and the species Providencia alcalifaciens. Whereas in the stunted group there was a higher abundance in the genera Blautia, Lachnospiraceae, Bilophila, Monoglobus and the species Akkermansia municiphila, Odoribacter splanchnicus and Bacteroides clarus. Conclusion: In general, the abundance of pathogenic microbiota in stunted children was higher than in the non-stunted children. This is influenced by nutrient intake and other factors. These influencing factors can be applied by stunted children in slum areas as an effort to improve nutritional status.

Abstrak :
Human Milk Oligosaccharides (HMO), adalah kelompok senyawa ketiga terbanyak dalam ASI dan berhubungan dengan pertumbuhan bayi. Studi prospektif longitudinal dilakukan pada 120 pasangan ibu-bayi berusia 0 – 4 bulan dari RS Kemang Medical Care, Puskesmas Cilandak, Mampang, Pasar Minggu dan Tebet di Jakarta Selatan antara Agustus 2021 – Mei 2022. Analisis gen dilakukan dengan Next Generation Sequencing (NGS) dan Sanger. Profil HMO (2'FL, LNFP I, LNT, LNnT, 3'SL dan 6'SL) diperiksa pada usia 0, 2, 4 bulan. Weight for age zscore (WAZ), weight for length z-score (WLZ), dan weight velocity diperiksa setiap bulan. Penelitian ini menggunakan uji korelasi Pearson dan Spearman, uji Anova untuk pengukuran berulang, Friedman tes, regresi logistik dan model linier umum untuk pengukuran berulang dengan nilai p <0,05 dianggap signifikan secara statistik. Sekretor positif dalam penelitian ini sebanyak 58,3% dan 41,7% sebagai Sekretor lemah. Prevalensi Lewis positif sebesar 85% dan 15% adalah Lewis negatif, sama dengan prevalensi Group 1 (Se+Le+) dan Grup 3 (Se+Le-). Kkonsentrasi 2’FL pada kelompok Se+Leberkorelasi negatif dengan WAZ dan berkorelasi positif dengan LNFP I (r0,478) usia dua bulan (r-0,294). 2’FL pada ibu Sekretor positif berkorelasi negatif dengan WAZ bulan kedua (r-0,294). 2’FL, LNFP I dan LNT memiliki hubungan positif dengan indikator pertumbuhan berat badan. ......Human Milk Oligosaccharides (HMOs) are the third most abundant group of compounds in human milk. HMOs can modulate the immune system of the intestinal mucosa, modulate infection and allergy, and link to growth in early infancy. A prospective longitudinal study was conducted among 120 mother-infant pairs aged 0 – 4 months from Kemang Medical Care Women and Children Hospital, Public Health Center in Cilandak, Mampang, Pasar Minggu, and Tebet in South Jakarta between Agustus 2021 – May 2022. The gene analysis for the Secretor and Lewis status of the mother were performed by usung Targeted Next Generation Sequencing (NGS) and Sanger at baseline. The HMOs profiles (2'FL, LNFP I, LNT, LNnT, 3'SL, and 6'SL), breast milk calories, and fat were examined at 0, 2, and 4 months. Weight growth indicators, namely weight for age z-score, weight for length z-score (WAZ, WLZ, and weight velocity), infection episode, and mother's body mass index (BMI) were examined every month. Data were analyzed using Pearson or Spearman correlation test (correlation coefficient), general linear model for repeated measures ANOVA test and Friedman test (mean difference between and within groups, respectively) and logistic regression unadjusted OR (association between dependent and independent variables), with a p-value <0.05 considered statistically significant. The positive and weak Secretor mothers were 58.3% and 41.7%, respectively. The proportion of Lewis positive and Se+LE+ groups was 85%, while 15% were in Lewis negative and Se+Legroup. At baseline, 2'FL concentration among Se+Le- mothers were negatively correlated with WAZ and LNFP I (r0.478) concentration was positively correlated with infants' WLZ. The 2'FL concentration among Secretor mothers was negatively correlated with infants' WAZ in the second month (r-0.294). Mothers with high 2'FL levels increased the standard deviation of infants' WLZ in the fourth month. Infants' weight velocities were higher among high LNT and 3'SL levels in the second month; and in high 2'FL and LNFP I mothers in the fourth month. HMOs profile (2’FL LNT, LNFP I and 3’SL) of the lactating mothers have a positive relationship with weight growth indicator and innovative intervention to improve HMOs concentration among mothers should be consider as one of the ways to improve infants growth.

Abstrak :
Asam amino menjadi zat gizi baru yang diduga berhubungan dengan pertumbuhan linier ketika banyak penelitian menemukan bahwa asupan protein cukup dan intervensi zat gizi mikro menunjukkan hasil yang tidak memuaskan. Kondisi stunting terjadi bersamaan dengan wasting karena kemungkinan berbagi jalur yang sama. Oleh karena itu, studi mengenai stunting dapat memiliki hasil yang berlebihan ketika wasting tidak dijadikan pengecualian. Studi potong lintang komparatif 2 fase ini bertujuan untuk membandingkan asupan asam amino dan konsentrasinya dalam darah antara anak stunted non-wasted (SNW) dan non-stunted non-wasted (NSNW) yang berusia 12-23 bulan dan menggunakan hasil dari fase 1 untuk mengembangkan rekomendasi pemberian makan dan makanan campuran (MC) dengan menggunakan makanan yang tersedia secara lokal yang kurang dimanfaatkan. Stunting didefinisikan sebagai panjang badan menurut umur (PB/U) dalam Z skor <-2 SD sedangkan untuk non-stunting dengan PB/U ≥-1 SD. Kedua kelompok memiliki Z skor berat badan menurut panjang badan yang normal (BB/PB antara -2 SD hingga +1SD). Pemrograman linier digunakan untuk pengembangan rekomendasi pemberian rekomendasi pemberian makan (Optifood) dan CG (Nutrisurvey2004). Sebanyak 151 data dianalisis. Tidak ada perbedaan signifikan pada asam amino dan asupan gizi makro mikro kecuali proporsi protein yang berisiko kekurangan lebih tinggi pada kelompok SNW. Arginin merupakan satu-satunya konsentrasi darah yang berbeda antar kelompok. Histidin menjadi sebuah masalah gizi mutlak pada kelompok SNW dan NSNW, sedangkan riboflavin dan zink rendah dalam kelompok stunting tetapi cukup pada kelompok normal. Selain itu, zat gizi makro dan mikro lainya kurang dalam kedua kelompok kecuali protein dan vitamin A. Zat gizi yang kurang adalah Ca, Vit C, Thiamin, Riboflavin, Niasin, B6, Folat, B12, Besi, Zink, dan Histidin. Rekomendasi yang diusulkan dapat memenuhi Vit C, Riboflavin, Besi, dan Zink tetapi tidak dapat mencukupi Ca, Thiamin, Niasin, B6, Folat, B12, dan Histidin. Dengan memasukkan kacang tunggak, buncis batik, ikan wader, dan susu sapi dalam pengembangan CG, zat gizi yang sebelumnya kurang dapat tercukupi. ......Amino acids be the emerging nutrients that hypothesized to be associated with linear growth when many studies found that protein intake is considerably adequate and micronutrient intervention showed an unsatisfactory result. Stunting condition concurrently occurred with wasting as they may share similar pathways. Therefore, studies on stunting may have an exaggerated results when wasting was not an exclusion. This 2 phases comparative cross sectional study aimed to compare amino acid intake and its concentration in blood between stunted non-wasted (SNW) and non-stunted non-wasted (NSNW) children aged 12-23 months and using the results of phase 1 to develop a complementary feeding recommendation (CFR) and food multi-mix (FMM) by incorporating underutilized locally available foods. Stunted was defined as length for age z-score (LAZ) <-2 SD whereas for non-stunted with LAZ ≥-1 SD. Both groups have normal weight for length z-score (WLZ between -2 SD to +1SD). Linear programming was used for CFR (Optifood) and FMM development (Nutrisurvey 2004). A total of 151 data was analyzed. No significant different on the amino acid and macro micronutrients intake except the proportion protein at risk of inadequacy was significantly higher among SNW group. Arginine was the only blood concentration that significantly different between the groups. Histidine was an absolute problem nutrient in SNW and NSNW group, whereas riboflavin and zinc were inadequate among stunted group but adequate among normal group. In addition, other macro and micronutrients were inadequate in both groups except for protein and vitamin A. The inadequate nutrients were Ca, Vit C, Thiamin, Riboflavin, Niacin, B6, Folate, B12, Iron, Zinc and histidine. With the proposed recommendations, it can fulfil Vit C, Riboflavin, Iron and Zinc. But it cannot fulfil Ca, Thiamin, Niacin, B6, folate, B12 and histidine. With the incorporation of the selected underutilized cowpea, buncis batik, wader fish and cows’ milk in the FMM development, the nutrients that are challenging in CFR development, can be fulfilled.