Kontribusi infeksi malaria, infeksi kecacingan terhadap anemia ibu hamil di Kabupaten Banggai

WIJIANTO, Prof.dr. Hamam Hadi, MS.,Sc.D

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Gizi dan Kesehatan)

Latar belakang : Anemia yang merupakan salah satu masalah gizi pada ibu hamil, di Kabupaten Banggai prevalensinya mencapai 64,7%. Hasil beberapa penelitian menunjukkan adanya hubungan antara infeksi malaria, infeksi kecacingan dengan anemia, namun besarnya kontribusi dari kedua variabel tersebut belum banyak dibuktikan. Perlu dilakukan suatu penelitian tentang besarnya kontribusi dari infeksi malaria, infeksi kecacingan terhadap anemia ibu hamil. Tujuan Penelitian : Mengkaji hubungan dan mengukur besarnya kontribusi dari infeksi malaria, infeksi kecacingan, terhadap anemia pada ibu hamil. Metode: Penelitan ini merupakan studi observasional dengan rancangan “cross sectional study”, dilakukan di Kabupaten Banggai dengan jumlah responden 298 ibu hamil. Pengukuran kadar Haemoglobin (Hb) dengan ”HemoCue”, infeksi malaria dengan metode “Giemsa”, infeksi kecacingan dengan ”kato katz”. Statistik kai-kuadrat untuk analisis bivariat, regresi logistic dan analisis nilai Atributable Risk untuk analisis multivariat. Hasil: Prevelensi anemia ibu hamil telah mengalami penurunan dari 64,7% menjadi 36,6%. Terdapat 39,6% pernah menderita klinis malaria dan 5,4% yang masih terinfeksi positif. Terdapat 88,9% ibu hamil yang ternfeksi kecacingan. Variabel dominan yang berhubungan dengan status anemia adalah infeksi kecacingan, risiko KEK dan usia kehamilan. Ibu hamil yang terinfeksi kecacingan berisiko 5 kali (95% CI : 1,592-16,809) menderita anemia dibanding dengan yang tidak terinfeksi kecacingan. Ibu hamil yang berisiko KEK berpeluang menderita anemia 3,4 kali (95% CI: 1,867 - 6,288) dibanding dengan yang tidak berisiko KEK. Hasil analisis nilai Atributable Risk (AR) infeksi kecacingan dapat memberikan kontribusi sebesar 78,1%, sedangkan risiko KEK memberikan kontribusi sebesar 33,7% terhadap kejadian anemia pada ibu hamil. Karena prevalensinya yang rendah, infeksi malaria belum memberikan kontribusi yang berarti terhadap kejadian anemia ibu hamil. Kesimpulan: Telah terjadi penurunan prevalensi anemia menjadi 36,6%. Infeksi kecacingan dan risiko KEK mempunyai kontribusi yang besar terhadap kejadian anemia pada ibu hamil, karena prevalensinya yang rendah infeksi malaria belum memberikan kontribusi yang bermakna.

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, and 88,9% 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. Worm infection 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.

Kata Kunci : Anemia Ibu Hamil,Infeksi Malaria dan Kecacingan, malaria, worm, anemia, and pregnant women