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Abstract

Kejadian stunting merupakan masalah kesehatan anak di Indonesia yang berdampak pada anemia, perkembangan dan sistem imunitas. Pada balita anemia, peningkatan morbiditas dan gangguan perkembangan dapat menyebabkan gangguan pada struktur dan fungsi tubuh dalam kemampuan anak menuju kematangan yang bersifat tetap dan berpengaruh pada kesehatan di masa mendatang. Penelitian ini bertujuan untuk mengetahui hubungan stunting dengan kadar hemoglobin, morbiditas dan perkembangan batita. Penelitian ini menggunakan desain penelitian cross-sectional dan dilakukan pada bulan Juli 2019 di wilayah kerja Puskesmas Kebondalem di Kabupaten Pemalang dengan sampel batita usia 6-26 bulan. Variabel penelitian yang dinilai adalah kadar hemoglobin (Hb), morbiditas, perkembangan yang diukur melalui kemampuan gerak kasar, gerak halus, bicara, bahasa dan sosialisasi, dan kemandirian, dan stunting pada batita, serta karakteristik ibu. Pengumpulan data dilakukan dengan pengukuran antropometri, pemeriksaan Hb, dan wawancara. Analisis multivariat menggunakan uji regresi logistik. Pada penelitian ini, diantara total 142 batita, 45,1% mengalami stunting. Pada penelitian ini ditemukan bahwa anak yang mengalami stunting mengalami risiko anemia dan mobiditas, masing-masing sebesar 125 (POR=125,21; 95% CI=16,17-969,26) dan 2,5 kali (POR=2,46 95% CI=1,12-5,04) lebih tinggi dibanding dengan anak yang tidak stunting. Tidak ditemukan hubungan antara stunting dengan perkembangan anak (POR=0,22; 95% CI=0,02 2,23). Pada penelitian ini, ditemukan adanya hubungan anak stunting dengan anemia dan morbiditas. Keberhasilan program pengendalian stunting dapat berintegrasi dengan program pencegahan dan pengendalian penyakit.

References

  1. UNICEF Indonesia. Nutrition/ : Tackling the “double burden” of malnutrition in Indonesia [Internet]. UNICEF. [cited 2022 Dec 23]. Available from: https://www.unicef.org/indonesia/ nutrition
  2. Global Nutrition Report. Indonesia/ : The burden of malnutrition at glance [Internet]. 2023. Available from: https:/ /globalnutritionreport.org/resources/nutrition-profiles/ asia/south-eastern-asia/indonesia/
  3. UNICEF East Asia and Pacific Region. Southeast Asia Regional Report on Maternal Nutrition and Complementary Feeding [Internet]. Bangkok; 2021. Available from: https:// www.unicef.org/eap/media/9466/file/Maternal Nutrition and Complementary Feeding Regional Report.pdf
  4. Hondru G, Wieringa FT, Poirot E, Berger J, Som S V., Theary C, et al. The interaction between morbidity and nutritional status among children under five years old in cambodia: A longitudinal study. Nutrients. 2019;11(7):1–12.
  5. Wright CM, MacPherson J, Bland R, Ashorn P, Zaman S, Ho FK. Wasting and Stunting in Infants and Young Children as Risk Factors for Subsequent Stunting or Mortality: Longitudinal Analysis of Data from Malawi, South Africa, and Pakistan. J Nutr. 2021;151(7):2022–8.
  6. Badan Penelitian dan Pengembangan Kesehatan. Hasil Utama RISKESDAS 2018 [Internet]. Jakarta; 2018. Available from: https://kesmas.kemkes.go.id/assets/upload/ dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf
  7. Tim Nasional Percepatan Penanggulangan Kemiskinan (TNP2K). 100 Kabupaten/Kota Prioritas untuk Intervensi Anak Kerdil (Stunting). Jakarta: Sekretaris Wakil Presiden Republik Indonesia; 2017.
  8. Kuziga F, Adoke Y, Wanyenze RK. Prevalence and factors associated with anaemia among children aged 6 to 59 months in Namutumba district, Uganda: A cross- sectional study. BMC Pediatr. 2017;17(1):1–9.
  9. Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, Fawzi WW, et al. Associations of Suboptimal Growth with All-Cause and Cause-Specific Mortality in Children under Five Years: A Pooled Analysis of Ten Prospective Studies. PLoS One. 2013;8(5).
  10. Diana D, Susanti Y, ... Overview of Family Characteristics of Stunting Toddlers. Proc … [Internet]. 2020;1(1):139–52. Available from: http://jurnal.globalhealthsciencegroup.com/ index.php/PICNHS/article/view/347
  11. Budiastutik I, Nugraheni A. Determinants of Stunting in Indonesia: A Review Article. Int J Heal Res. 2018;1(1):2620 5580.
  12. Gaston RT, Habyarimana F, Ramroop S. Joint modelling of anaemia and stunting in children less than five years of age in Lesotho: a cross-sectional case study. BMC Public Health [Internet]. 2022;22(1):1–11. Available from: https://doi.org/ 10.1186/s12889-022-12690-3
  13. Handryastuti S, Pusponegoro HD, Nurdadi S, Chandra A, Pramita FA, Soebadi A, et al. Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature. J Nutr Metab. 2022;2022.
  14. Ernawati F, Syauqy A, Arifin AY, Soekatri MYE, Sandjaja S. Micronutrient deficiencies and stunting were associated with socioeconomic status in indonesian children aged 6–59 months. Nutrients. 2021;13(6).
  15. Shinsugi C, Mizumoto A. Associations of nutritional status with full immunization coverage and safe hygiene practices among thai children aged 12–59 months. Nutrients. 2022;14(1).
  16. Jonker FAM, te Poel E, Bates I, Boele van Hensbroek M. Anaemia, iron deficiency and susceptibility to infection in children in sub-Saharan Africa, guideline dilemmas. Br J Haematol. 2017;177(6):878–83.
  17. Soekatri MYE, Sandjaja S, Syauqy A. Stunting was associated with reported morbidity, parental education and socioeconomic status in 0.5–12-year-old Indonesian children. Int J Environ Res Public Health. 2020;17(17):1–9.
  18. Wicaksono RA, Arto KS, Mutiara E, Deliana M, Lubis M, Batubara JRL. Risk factors of stunting in indonesian children aged 1 to 60 months. Paediatr Indones Indones. 2021;61(1):12–9.
  19. Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018;14(4):1–10.
  20. Turner J, Parsi M, Badireddy M. Anemia [Internet]. StatPearls [Internet]. Available from: https:// www.ncbi.nlm.nih.gov/books/NBK499994/?report=classic
  21. Smith C, Teng F, Branch E, Chu S, Joseph KS. Maternal and Perinatal Morbidity and Mortality Associated with Anemia in Pregnancy. Obstet Gynecol. 2019;134(6):1234–44.
  22. Mohammed SH, Larijani B, Esmaillzadeh A. Concurrent anemia and stunting in young children: Prevalence, dietary and non-dietary associated factors. Nutr J. 2019;18(1):1 10.
  23. Adhikari RP, Shrestha ML, Acharya A, Upadhaya N. Determinants of stunting among children aged 0-59 months in Nepal: Findings from Nepal Demographic and health Survey, 2006, 2011, and 2016. Vol. 5, BMC Nutrition. 2019.
  24. Gosdin L, Martorell R, Bartolini RM, Mehta R, Srikantiah S, Young MF. The co-occurrence of anaemia and stunting in young children. Vol. 14, Maternal and Child Nutrition. 2018.
  25. Tesema GA, Worku MG, Tessema ZT, Teshale AB, Alem AZ, Yeshaw Y, et al. Prevalence and determinants of severity levels of anemia among children aged 6-59 months in sub-Saharan Africa: A multilevel ordinal logistic regression analysis. PLoS One [Internet]. 2021;16(4 April):1–21. Available from: http:/ /dx.doi.org/10.1371/journal.pone.0249978
  26. Endris BS, Dinant GJ, Gebreyesus SH, Spigt M. Risk factors of anemia among preschool children in Ethiopia: a Bayesian geo-statistical model. BMC Nutr. 2022;8(1):1–11.
  27. Utami RA, Setiawan A, Fitriyani P. Identifying causal risk factors for stunting in children under five years of age in South Jakarta, Indonesia. Enferm Clin. 2019;29:606–11.
  28. Vonaesch P, Tondeur L, Breurec S, Bata P, Nguyen LBL, Frank T, et al. Factors associated with stunting in healthy children aged 5 years and less living in Bangui (RCA). PLoS One. 2017;12(8).
  29. Woldehanna T, Behrman JR, Araya MW. The effect of early childhood stunting on children’s cognitive achievements: Evidence from young lives Ethiopia. Ethiop J Heal Dev. 2017;31(2):75–84.
  30. Ekholuenetale M, Barrow A, Ekholuenetale CE, Tudeme G. Impact of stunting on early childhood cognitive development in Benin: evidence from Demographic and Health Survey. Egypt Pediatr Assoc Gaz. 2020;68(31).
  31. Roberts M, Tolar-Peterson T, Reynolds A, Wall C, Reeder N, Rico Mendez G. The Effects of Nutritional Interventions on the Cognitive Development of Preschool-Age Children: A Systematic Review. Nutrients. 2022;14(3):1–15.
  32. Alam MA, Richard SA, Fahim SM, Mahfuz M, Nahar B, Das S, et al. Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study (PLoS One (2020) 15:1 (e0227839) DOI: 10.1371/journal.pone.0227839). PLoS One. 2020;15(2):1 16.
  33. Pemerintah Kabupaten Pemalang. Rencana Aksi Daerah Percepatan Pencegahan dan Penanggulangan Stunting di Kabupaten Pemalang. Peraturan Bupati Pemalang No. 84 Tahun 2019, 84 Tahun 2019 Indonesia; 2019.
  34. Wemakor A, Garti H, Azongo T, Garti H, Atosona A. Young maternal age is a risk factor for child undernutrition in Tamale Metropolis, Ghana. BMC Res Notes [Internet]. 2018;11(1):1 5. Available from: https://doi.org/10.1186/s13104-018 3980-7
  35. Rahman MS, Mushfiquee M, Masud MS, Howlader T. Association between malnutrition and anemia in under-five children and women of reproductive age: Evidence from Bangladesh demographic and Health Survey 2011. PLoS One. 2019;14(7):1–18.
  36. Senior AM, Nakagawa S, Raubenheimer D, Simpson SJ. Global associations between macronutrient supply and age specific mortality. Proc Natl Acad Sci U S A. 2020;117(48):30824–35.
  37. Debnath SC, Haque E, Hasan DMM, Samin S, Rauf MA, Rabby MF. Undernutrition and Morbidity Profile of Exclusively Breastfeeding Children: A Cross sectional Study. Int J Prev Med [Internet]. 2018;9(55):1–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6036768/ pdf/IJPVM-9-55.pdf
  38. Bailey RL, West KP, Black RE. The epidemiology of global micronutrient deficiencies. Ann Nutr Metab. 2015;66(suppl 2):22–33.
  39. Leidman E, Tromble E, Yermina A, Johnston R, Isokpunwu C, Adeniran A, et al. Acute Malnutrition Among Children, Mortality, and Humanitarian Interventions in Conflict Affected Regions — Nigeria, October 2016–March 2017. MMWR Morb Mortal Wkly Rep. 2017;66(48):1332–5.
  40. Oh TK, Song KH, Song IA. History of anemia and long-term mortality due to infection: a cohort study with 12 years follow-up in South Korea. Vol. 21, BMC Infectious Diseases. 2021.
  41. Nugraheni A, Utami A, Margawati A, Wahyudi F, Julianti HP, Pramono D. Modeling Impact of stunting on Morbidity, Development, Hemoglobin Levels as Evidence Based Intervention of Community in Toddlers stunting in Pemalang District. In: International Conference on Translational Medicine and Health Sciences 2019. Semarang: Faculty of Medicine, Diponegoro University; 2019. p. 56.
  42. Scott SP, Chen-Edinboro LP, Caulfield LE, Murray-Kolb LE. The impact of anemia on child mortality: An updated review. Nutrients. 2014;6(12):5915–32.
  43. Fajariyah RN, Hidajah AC. Correlation Between Immunization Status and Mother’S Height, and Stunting in Children 2–5 Years in Indonesia. J Berk Epidemiol. 2020;8(1):89.
  44. Chisti MJ, Kawser CA, Rahman ASMMH, Shahid ASMS Bin, Afroze F, Shahunja KM, et al. Prevalence and outcome of anemia among children hospitalized for pneumonia and their risk of mortality in a developing country. Sci Rep [Internet]. 2022;12(1):1–7. Available from: https://doi.org/10.1038/ s41598-022-14818-2
  45. Yustisia Riana Anmaru Y, Laksono B. The Influencing Factor Analysis of Stunting Incidence in Children Aged 24-59 Months At Kedung Jati Village. Public Heal Perspect J [Internet]. 2019;4(2):2019–116. Available from: http:// journal.unnes.ac.id/sju/index.php/phpj
  46. Wahyuni W, Wakhidah LN, Fatmawati S, Widayati RS. The Relation of Stunting with Immunization Status and the History of Low Birth Weight in the Work Area of Public Health Center at Gilingan. Proc 1st Paris Van Java Int Semin Heal Econ Soc Sci Humanit (PVJ-ISHESSH 2020). 2021;535:468–71.
  47. Alshwaiyat N, Ahmad A, Wan Hassan WMR, Al jamal H. Association between obesity and iron deficiency (Review). Exp Ther Med. 2021;22(5):1–7.
  48. Kim JY, Shin S, Han K, Lee KC, Kim JH, Choi YS, et al. Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and Nutrition Examination Surveys. Eur J Clin Nutr. 2014;68(2):253–8.
  49. Nshimyiryo A, Hedt-Gauthier B, Mutaganzwa C, Kirk CM, Beck K, Ndayisaba A, et al. Risk factors for stunting among children under five years: A cross-sectional population-based study in Rwanda using the 2015 Demographic and Health Survey. BMC Public Health. 2019;19(1):1–10

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