PENGARUH SUPLEMENTASI BESI (Fe) DAN SENG (Zn) TERHADAP PERUBAHAN UKURAN ANTROPOMETRI DAN KADAR ALBUMIN ANAK KURANG ENERGI PROTEIN (KEP) USIA 6 — 24 BULAN THE INFLUENCE OF IRON AND ZINC SUPPLEMENTATION TO THE ANTHROPOMETRICAL MEASUREMENT AND SERUM ALBUMIN LEVEL AMONG PROTEIN ENERGY MALNUTRITION (PEM) CHILDREN AGE BETWEEN 6 - 24 MONTHS

Abstract

Background : Zinc deficiency is related to anorexia, low dietary intake, decreasing serum albumin level, and growth retardation of children. Growth retardation can be used as one of clinical characteristics of zinc deficiency among children suffering the Protein Energy Malnutrition (PEM). Therefore, the supplementary food program with high protein will be effective if it was supplied with zinc. Objective : This research is to examine the influence of the iron and zinc supplementary to the anthropometrical measurement and serum albumin level among the PEM children . Research Design : The research design is a Non Equivalent Control Group Design. The total of seventy six (76) children suffering the Protein Energy Malnutrition (PEM) who are participating in the Provision of Food Supplementary - Social Safety Net for Health Program are divided into two groups. The treatment group received syrup with 20 mg iron and 20 mg zinc supplementary every week for 12 weeks. The control group received no treatment. Result : There is a significant difference of the Weight/Age index between the treatment group and the control group (p = 0.000) likewise after adjusment for covariates (p = 0,000). Weight/Lenght index between two groups is significantly different (p = 0.000) and so after being tested with the covariates (p = 0.007). There is no significant difference on Lenght/Age index between the two groups (p = 0.069) likewise after adjusment for covariates (p = 0.666). Serum albumin level of the treatment group has significant difference from that of the control group (p = 0.001), and so after adjusment for covariates (p = 0.012). Conclusion : This result suggested that iron and zinc supplementary among PEM children is able to increase the Weight/Age index, Weight/Lenght index, and the serum albumin level, but no significant changes in the Length/Age index. Latar Belakang defisiensi seng berhubungan dengan menurunnya nafsu makan, asupan makanan, menurunnya konsentrasi albumin, serta kelambatan pertumbuhan. Kelambatan pertumbuhan dapat menjadi salah satu tanda klinis dad defisiensi seng pada anak KEP. Oleh sebab itu program pemberian makanan tambahan tinggi protein akan lebih efektif bila diberi tambahan seng. Tujuan Penelitian : untuk mengetahui pengaruh suplementasi besi dan seng terhadap perubahan ukuran antropometri dan kadar albumin anak KEP usia 6 — 24 bulan. Rancangan Penelitian : kuasi eksperimen dengan rancangan Non Equivalent Control Group Design. Sebanyak 76 anak penderita KEP peserta Program Pemberian Makanan Tambahan Jaring Perlindungan Sosial-Bidang Kesehatan (PMT JPS-BK) dibagi menjadi 2 kelompok. Kelompok perlakuan diberi suplemen dalam bentuk sirup yang mengandung 20 mg besi dan 20 mg seng setiap minggu selama 3 bulan, sedangkan kelompok pembanding tanpa perlakuan. Hasil Penelitian : Indeks BB/U kelompok perlakuan berbeda bermakna dengan indeks BB/U kelompok pembanding (p = 0,000) demikian juga setelah diuji dengan memasukkan variabel perancu (p = 0,000). Indeks BB/PB kelompok perlakuan berbeda bermakna dengan indeks BB/PB kelompok pembanding (p = 0,000) begitu pula setelah diuji bersama-sama dengan variabel perancu (p = 0,007). Tidak ada perbedaan indeks PB/U antara kelompok perlakuan dengan kelompok pembanding (p = 0,069) begitu pula setelah dikoreksi dengan variabel perancu (p = 0,666). Kadar albumin kelompok perlakuan berbeda bermakna dengan kadar albumin kelompok pembanding (p = 0,001) demikian juga setelah dikoreksi dengan variabel perancu ternyata suplementasi besi dan seng dapat meningkatkan kadar albumin anak KEP (p = 0,012). Simpulan : suplementasi besi dan seng pada anak KEP dapat meningkatkan indeks BB/U, BB/PB dan kadar albumin, tetapi tidak dapat meningkatkan indeks PB/U.