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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 :
ABSTRACT
Diarrheal 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 leading causes 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.

Abstrak :
Proporsi BBLR hasil Riskesdas 2018 adalah 6,3% dengan jumlah kasus terbanyak di Provinsi Jawa Barat. Kekurangan zat besi pada ibu hamil dapat menyebabkan pertumbuhan janin terhambat, kelahiran prematur atau BBLR. Program pemberian tablet tambah darah pada ibu hamil diberikan untuk memenuhi kebutuhan zat besi pada ibu hamil. Penelitian ini bertujuan untuk melihat hubungan antara kepatuhan konsumsi suplemen besi selama kehamilan dengan BBLR setelah mengendalikan seluruh variabel confounding. Metode yang digunakan pada penelitian ini adalah kasus kontrol dengan rasio 1:3. Sampel penelitian berasal dari data sekunder Riset Kesehatan Dasar tahun 2018 khusus Provinsi Jawa Barat. Jumlah kasus untuk penelitian ini adalah 180 sampel dan kontrol 540 sampel. Variabel kovariat dalam penelitian ini adalah usia bersalin, tingkat pendidikan, status bekerja, wilayah tempat tinggal, riwayat hipertensi, adanya komplikasi, status merokok, status merokok pasif dan usia gestasi saat melahirkan. Hubungan variabel dinilai dengan analisis bivariat dan multivariat. Hasil penelitian menunjukkan tidak terdapat hubungan bermakna (p>0,05) dengan peluang risiko 1,268 kali lebih besar pada ibu yang tidak patuh mengkonsumsi TTD untuk melahirkan bayi BBLR (OR= 1,268 95%CI 0,87-1,847) setelah dikontrol variabel kovariat. ......Based on Riskesdas 2018, the proportion of LBW in Indonesia is 6.3% with the highest number of cases in West Java Province. Iron deficiency in pregnant women can cause restricted fetal growth, prematur birth or LBW. This study aims to look at the relationship between compliance with iron supplement consumption during pregnancy with LBW after controlling for all confounding variables. The method used in this study is case control with a ratio of 1: 3. The research sample is derived from secondary data used from the 2018 Basic Health Research in West Java Province. The number of cases for this study were 180 samples and 540 controls. The covariate variables in this study were maternal age during pregnancy, education level, work status, area of residence, history of hypertension, complications, smoking status, passive smoking status and gestational age at delivery. The relationship of variables was assessed by bivariate and multivariate analysis. The results showed no significant relationship (p> 0.05) with a 1.268 times greater chance of risk for mothers who consumed less iron supplements than 90 tablets to deliver LBW babies (OR = 1.268 95% CI 0.87-1.847) after covariate controlled variable.

Abstrak :
This randomized double-blind placebo-controlled trial aimed to compare the efficacy of daily iron supplementation and multi-micronutrient supplementation both daily and weekly basis on increasing iron status among 284 apparently healthy Indonesian infants aged 6-12 mo. Infants were randomly assigned to receive either daily 1 RDA multi micronutrient supplement (n = 72), weekly 2 RDA multi micronutrient supplement (n = 70), daily ferrous sulphate 10 mg (n = 72), or placebo (n = 70) for wk. Blood hemoglobin, plasma ferritin, plasma zinc, and plasma C-reactive protein concentrations were measured prior to intervention and after 23 wk of supplementation. At baseline, 58.1% of subjects were anemic, 28.2% were iron deficient, and 11.2% were zinc deficient. After 23 wk of supplementation, both daily 1 RDA multi micronutrient and iron supplemented groups had significantly increased blood hemoglobin and plasma ferritin concentration, furthermore reducing the percentage of anemia and iron deficiency. However, the changes of hemoglobin were not significantly different among the treatment groups. Changes of hemoglobin were significantly higher in daily 1 RDA multi micronutrient group than in placebo group when initial blood hemoglobin was low. The change of plasma ferritin concentration in both daily 1 RDA multi micronutrient and iron groups was significantly higher than in other groups. Hemoglobin and ferritin concentrations of weekly 2 RDA multi micronutrient group were not significantly increase, but there were significantly increased in the subjects with low concentration of blood hemoglobin or plasma ferritin. Proportion of infants with zinc deficiency was increased significantly in iron group Daily I RDA multi micronutrient and daily iron supplementation are efficacious in improving the concentration of blood hemoglobin and plasma ferritin and reducing the percentage of infants with anemia and iron deficiency of Indonesian infants aged 6-12 months in a rural community. However, there was an increasing proportion of infants with zinc deficiency in daily iron supplementation. The efficacy of daily 1 RDA multi micronutrient supplementation was higher among the children with blood hemoglobin < 110 g/L Efficacy of weekly 2 RDA multi micronutrient supplementation on the concentration of blood hemoglobin and plasma ferritin of all subjects was not found, but it affected in children with low concentration of blood hemoglobin or plasma ferritin.

Abstrak :
Diarrheal disease remains an important public health problem in developing countries (Black, 1993) and is enormously associated with one-fourth of all deaths in children less than 5 years in developing countries (Richards et. at, 1993). Despite a remarkable declining in mortality rate, the morbidity rate of acute diarrhea of under five children is still fairly high (Murray, 1992). Alarcon et. al. (1991) reported that each year, diarrheal disease causes approximately more than 1 billion episodes of illness. Therefore, the reported attack rates range from 1 to 12 episodes per child per year with a global average of 3 episodes per child (Richards et. al, 1993) and nearly 5 millions deaths worldwide in children less than 5 years (Shamir, 1998). In Indonesia, the incidence of diarrhea is accounted for up to 200-400 per 1000 population per year; 60-80% of them are under five, mostly infants (Lubis, 1992). Rotavirus is the most common cause of acute diarrheal disease in infants. It is the most commonly identified enter pathogens for infants who admitted to hospital in the USA and many other countries (Saavedra et. al., 1994) included Indonesia, (Soenarto, 1997). In USA accounts for up to 50% of the cases of children hospitalized with diarrhea and dehydration (Cohen, 1991) and is responsible for approximately 1 million cases of severe infantile diarrhea and up to 150 deaths annually (Guarino et.al.,1994). In Indonesia accounts for up to 16% of childhood diarrhea in urban area of North Jakarta and 19-40% of chldhood diarrhea age 0-36 months in Bandung, West Java (Yuwono, 1993).

The incidence of diarrheal disease is higher and the severity of the illness is greater in infants than in older children and adults. Several major factors become predisposed to an increased frequency of diarrheal diseases in infants are increased fecal-oral contamination and infants have a relatively unchallenged immune system that has not previously been exposed to many pathogens and has not acquired protective antibodies. Immune system tolerance of life to some polysaccharide antigens in the first year may diminish the infant's ability to defend against intestinal infections (Cohen, 1991). Non-breastfed infants are at greater age of experiencing diarrhea than those who are partially breast-fed, however infants who are partially breast-fed are at greater risk than those who are exclusively breast-fed (Lubis, 1992). The global diarrheal disease control programs have concentrated almost exclusively on the prevention and treatment of dehydration by promoting appropriate fluid and electrolyte therapy, such as increased of oral rehydration solution-ORS (Alarcon, et. al, 1991). ORS has been considered by World Health Organization as the cornerstone of global efforts to reduce mortality from acute diarrhea (Richards et. al, 1993; Behrens, 1993). Until recently, however, more attention has been directed to the nutritional complications of diarrhea (Alarcon, et. al, 1991).

Abstrak :
Anemia defisiensi zat besi pada ibu hamil dapat diatasi melalui program pemberian Tablet Tambah Darah (TTD). Berdasarkan data Riskesdas tahun 2018, ibu hamil yang mengonsumsi TTD sesuai rekomendasi (90+ tablet) hanya sebesar 38,1%. Beberapa penelitian menyebutkan bahwa faktor-faktor yang memengaruhi ibu hamil tidak patuh mengonsumsi TTD adalah ibu hamil memulai kunjungan ANC pada trimester kedua dan ketiga, melakukan kunjungan ANC kurang dari empat kali, dan mendapatkan pelayanan ANC tidak sesuai standar (<10T). Ketiga faktor tersebut merupakan ukuran dari kualitas kunjungan ANC. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kunjungan antenatal care terhadap kepatuhan konsumsi TTD ibu hamil di Indonesia tahun 2017. Desain penelitian ini adalah cross sectional menggunakan data SDKI 2017. Sampel penelitian ini adalah Wanita Usia Subur (WUS) 15-49 tahun yang memenuhi kriteria inklusi sebesar 12.230. Analisis data menggunakan complex sample. Hasil analisis multivariat menunjukan terdapat hubungan antara kualitas kunjungan antenatal care terhadap kepatuhan konsumsi TTD ibu hamil di Indonesia setelah dikontrol status ekonomi, tempat tinggal, dan tenaga pemeriksa hamil. Ibu hamil yang memiliki kualitas kunjungan ANC baik dan cukup memiliki kepatuhan mengonsumsi lebih tinggi dibandingkan ibu hamil yang memiliki kualitas kunjungan ANC kurang dengan nilai OR sebesar 4,3 (95% CI: 3,46-5,37) dan 2,7 (95% CI: 2,27-3,25). ......Iron deficiency anemia among pregnant women can be corrected with iron supplementation programs. According to Riskesdas data in 2018, pregnant women who took iron tablets with the recommendation (90+ tablets) were only 38.1%. Several studies state that factors that influence pregnant women not to comply with taking iron tablets are pregnant women starting ANC visits in the second and third trimesters, visiting ANC less than four times, and getting ANC services that are not up to standard. The third factor is a measure of the quality of ANC visits. This study aims to determine the relationship between the quality of antenatal visits and adherence to iron supplements consumption of pregnant women in Indonesia in 2017. The design of this study was cross-sectional using the 2017 IDHS data. The sample of this study was women of childbearing age 15-49 years who met the inclusion criteria of 12,230. Data analysis used complex sample. The results of the multivariate analysis showed the relationship between the quality of antenatal visits and adherence to iron supplements consumption of pregnant women in Indonesia after controlling for economic status, place of residence, and pregnant examiners. Pregnant women who had high and sufficient quality ANC visits had higher adherence to consumption than pregnant women who had less quality ANC visits with OR values of 4.3 (95% CI: 3.46-5.37) and 2.7 (95% CI: 2.27-3.25).

Abstrak :
Sekitar 15-20% pasien poliklinik dan unit gawat darurat datang dengan masalah sawar kulit seperti pemfigus, toxic epidermal necrolysis (TEN), dan eritroderma. Masalah nutrisi terjadi pada penyakit sawar kulit melalui beberapa hal, yaitu kondisi hipermetabolisme sedang sampai berat, masalah pemenuhan nutrisi, kehilangan protein dari lesi kulit, dan efek samping metabolik akibat terapi steroid dosis tinggi jangka panjang. Empat pasien serial kasus dengan diagnosis pemfigus, TEN, dan eritroderma dengan masing-masing kondisi penyerta seperti gangguan hati, obesitas, DM tipe lain dan sepsis. Terapi medik gizi diberikan berdasarkan kondisi klinis, toleransi asupan, dan hasil laboratorium pasien. Target pemberian nutrisi dihitung menggunakan Harris Benedict dengan tambahan faktor stress 1,3-1,5. Diberikan nutrisi dengan komposisi seimbang, terdiri atas protein 1,32 g/kg BB ideal/hari, lemak 2530%, dan karbohidrat 4565%. Mikronutrien yang diberikan berupa vitamin B kompleks 3x1, asam folat 1x1 mg, vitamin A 12.000 IU, vitamin C 500-1000 mg, dan seng 2x20 mg. dari monitoring dan evaluasi dilaporkan bahwa pemberian mikronutrien pada penyakit sawar kulit dapat meningkatkan penyembuhan luka dan menurunkan risiko metabolik. Dari empat pasien serial kasus ini, didapatkan satu kasus mortalitas yaitu pada pasien dengan penyulit sepsis. Ketiga pasien kasus lainnya mengalami perbaikan kondisi klinis, penyembuhan luka baik, tidak ada infeksi dan komplikasi selama perawatan, kontrol glikemik baik, perbaikan kapasitas fungsional, dan lama rawat pasien lebih singkat. Ketiga pasien dipulangkan untuk rawat jalan. Terapi medik gizi yang optimal dapat memerbaiki luaran klinis serta menurunkan angka morbiditas dan mortalitas pasien pemfigus, TEN, eritroderma tanpa penyulit metabolik ......One in five to six patients at the polyclinic and emergency department present with skin barrier problems such as pemphigus, toxic epidermal necrolysis (TEN), and erythroderma. Nutritional problems occur in skin barrier disease through several things, namely moderate to severe hypermetabolic conditions, problems with nutritional compliance, loss of protein from skin lesions, and metabolic side effects due to long-term high dose steroid therapy. Three case series patients with pemphigus, TEN with hepatic complications, and erythroderma with obese nutritional status I and one case of pemphigus complicating sepsis and other types of DM. Nutritional medical therapy is given based on the clinical condition, intake tolerance, and laboratory results of the patient. The target of nutrition intake is calculated using Harris Benedict with a stress factor of 1.3-1.5, with a balanced composition, consisting of protein 1.3-2 g / kg ideal body weight / day, 25-30% fat, and 45-65% carbihydrates. The micronutrients were given in the form of 3x1 vitamin B complex, 1x1 mg folic acid, 12,000 IU vitamin A, 500-1000 mg vitamin C, and 2x20 mg zinc. Administration of micronutrients in skin barrier disease can improve wound healing and reduce metabolic risk. In four case series patients, there was one case mortality in a patient with complicated sepsis. The others had improved clinical conditions, good wound healing, no infection and complications during treatment, good glycemic control, improved functional capacity, and shorter patient length of stay. The three patients were discharged for outpatient care. Optimal nutritional medical therapy can improve clinical outcomes and reduce morbidity and mortality in patients with pemphigus, TEN, erythroderma without metabolic complications

Abstrak :
An adequate calcium calcium is an important aspect in maternal and fetal psyciology during pregency. ....

Abstrak :
Defisiensi seng (Zn) mempunyai peran yang besar pada proses tumbuh-kembang. Hal ini terutama akan berdampak pada anak-anak kekurangan gizi. Zn penting dalam kekebalan tubuh baik yang bersifat lokal maupun sistemik. Tujuan penelitian ini adalah untuk menilai dampak suplementasi Zn pada sitokin TNF-a dan diare pada balita dengan malnutrisi berat dari keluarga berpendapatan rendah. Desain penelitian adalah jenis controlled randomized double blind pre-test post-test pada kelompok anak berusia 12-59 bulan. Anak-anak diberi makanan biasa dan dibagi menjadi 2, kelompok kontrol (n+60) dan kelompok intervensi yang diberikan makanan mengandung 15mg/ml Zn. Kadar Zn diukur menggunakan atomic absorption spectrophotometer (AAS), sedangkan TNF-a menggunakan ELISA. Data masukan makanan dikumpulkan melalui cara wawancara makanan dalam 24-jam. Hasil penelitian menunjukkan adanya peningkatan kadar Zn serum yang bermakna dan penurunan kadar TNF-a serta penurunan lama dan frekuensi diare setelah intervensi. Kadar Zn meningkat 87,0% pada kelompok intervensi, sedangkan pada kelompok kontrol peningkatan hanya sebesar 19,6%. Selain itu, terdapat penurunan bermakna baik pada kadar TNF-a serum maupun feses setelah intervensi (p<0.05). Beratnya gejala maupun lamanya diare berkurang secara bermakna pada kelompok intervensi (p<0.001). Dari hasil penelitian ini dapat disimpulkan bahwa pemberian suplemen Zn dapat mengurangi lama dan beratnya diare melalui peningkatan kekebalan tubuh, terutama imunitas lokal yang menggunakan TNF- a sebagai biomarker. (Med J Indones 2003; 12: 247-51)

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Zinc deficiency has a great impact on growth and development, especially in malnourished children. Zinc is important in both local and systemic immunity. The aim of this study was to assess the impact of zinc supplementation on the cytokine, tumor necrosis factor a (TNF-a), and diarrhea in severely undernourished under-five children of low-income families. A randomized double blind pre-test post-test controlled design was selected. A group of 12-59 month-old children were given local food, and treated as control group (n=60), and another group (n=60) were given local food with 15 mg/5 ml zinc as intervention group. Zinc concentration was measured by atomic absorption spectrophotometer (AAS), and TNF-a concentration was determined by ELISA. Data on nutrient intakes were collected using 24-hour food recall method. The result of the study showed that after zinc intervention, zinc serum increased significantly, and TNF-a concentration decreased along with reduction of the duration and frequency of diarrhea. Zinc concentration increased 87.0% in the intervention group, while in the control group the increase was only 19.6%. There was a significant reduction of both serum and fecal TNF-a concentration after intervention (p<0.05). Severity and duration of diarrhea were reduced significantly in the intervention group compared to the control group (p<0.001). It was concluded that zinc intervention reduced the duration and severity of diarrhea through improvement of immunity, especially local immunity with TNF-a as biomarker. (Med J Indones 2003; 12: 247-51)