Artikel

KONTRIBUSI INFEKSI MALARIA, INFEKSI KECACINGAN
TERHADAP ANEMIA IBU HAMIL DI KABUPATEN BANGGAI
SULAWESI TENGAH


ABSTRACT

Background: Anemia is a nutritional problem among pregnant women in Banggai Regency with the prevalence of 64.7%. Several studies have indicated a relationship between malaria and worm infections and anemia,
but the extent of the contribution of these two variables has not yet been proven. A study to determine the extent of their contribution is needed.

Research Objectives: To find out the relationship and to measure the extent of contribution of malaria infection and worm infection on anemia incidence among pregnant women. Method: This research was an observational study using a cross sectional study design and it was carried out in Banggai Regency among 298 pregnant women. Hemoglobin content was measured with “HemoCue”,malaria infection with “Giemsa”, and worm infection with “kato katz. Chi-
Square statistic was used as bivariate analysis, whereas logistic regression and Atributable Risk value analysis were used as multivariate analysis
Results: There was a decline in the prevalence of anemia from 64.7% to 36.6 %. 5,4% of the respondent were positively infected by malaria, and88,9% of them infected by worm. The dominant variables related with the
anemia status were worm infection, chronic energy deficiency and age of pregnancy. Pregnant women who were infected by worm, were at risk of anemia 5 times higher (95% Cl: 1.592-16.809) than those who were not infected. Pregnant woman who had the risk of chronic energy deficiency,were found to be at risk of suffering from nutritional anemia 3.4 times higher (95% Cl: 1.867-6.288) than those who had not. Results of analysis indicated that Attributable Risk value of worm infection contributed 78.1%, and the risk of chronic energy deficiency contributed 33.7% on the
incidence of anemia among pregnant women . Due to its low prevalence stated earlier, malaria infection had not contributed significantly to the incidence of anemia among pregnant women.

Conclusion: There was a decline in the prevalence of anemia. Worminfection and the risk of chronic energy deficiency contributed significantly to the incidence of anemia. Due to its low prevalence, malaria infection
had not been contributed significantly to the incidence of anemia among the pregnant women.

Key words: malaria, worm, anemia, and pregnant women.

Gangguan Perkembangan Mental dan Kecerdasan


Pada penderita KEP dapat berpengaruh terhadap perkembangan mental dan kecerdasan anak. Stuart dalam penelitiannya menyebutkan bahwa kekurangan zat gizi berupa vitamin, mineral dan zat gizi lainnya mempengaruhi metabolisme di otak sehingga mengganggu pembentukan DNA di susunan saraf. Hal itu berakibat terganggunya pertumbuhan sel-sel otak baru atau mielinasi sel otak terutama usia di bawah 3 tahun, sehingga sangat berpengaruh terhadap perkembangan mental dan kecerdasan anak. Walter tahun 2003 melakukan penelitian terhadap 825 anak dengan malnutrisi berat ternyata mempunyai kemampuan intelektual lebih rendah dibandingkan anak yang mempunyai gizi baik.

Sel otak terbentuk sejak trimester pertama kehamilan, dan berkembang pesat sejak dalam rahim ibu. Perkembangan ini berlanjut saat setelah lahir hingga usia 2 ? 3 tahun, periode tercepat usia 6 bulan pertama. Setelah usia tersebut praktis tidak ada pertumbuhan lagi, kecuali pembentukan sel neuron baru untuk mengganti sel otak yang rusak. Dengan demikian diferensiasi dan pertumbuhan otak berlangsung hanya sampai usia 3 tahun.

Kekurangan gizi pada masa kehamilan akan menghambat multiplikasi sel janin, sehingga jumlah sel neuron di otak dapat berkurang secara permanen. Sedangkan kekurang gizi pada usia anak sejak lahir hingga 3 tahun akan sangat berpengaruh terhadap pertumbuhan dan perkembangan sel glia dan proses mielinisasi otak. Sehingga kekurangan gizi saat usia kehamilan dan usia anak sangat berpengaruh terhadap kualitas otaknya.

Gizi kurang pada usia di bawah 2 tahun akan menyebabkan sel otak berkurang 15-20%, sehingga anak yang demikian kelak kemudian hari akan menjadi manusia dengan kualitas otak sekitar 80-85%. Anak yang demikian tentunya bila harus bersaing dengan anak lain yang berkualitas otak 100% akan menemui banyak hambatan. Dr Widodo Judarwanto SpA (Picky Eater Clinic (Klinik Khusus Kesulitan Makan) Children Family Clinic Jakarta