Gaki, anemia, kecerdasan, dan prestasi belajar anak remaja

LATIFAH, Leny, Prof. dr. Hamam Hadi, MS, Sc.D

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Meskipun defisiensi multi mikronutrien seringkali muncul dalam konteks kemiskinan, masih sedikit yang diketahui tentang dampak defisiensi multi mikronutrien terhadap perkembangan kognitif. Berbagai penelitian menunjukkan bahwa anemia mempengaruhi tingkat keparahan dan menurunkan efektivitas intervensi GAKI, sehingga diasumsikan interaksi anemia dan GAKI memperberat risiko hambatan kecerdasan dan prestasi. Tujuan: Mengetahui hubungan status anemia dan GAKI dengan tingkat kecerdasan serta prestasi belajar anak remaja di daerah endemik GAKI. Metode: Penelitian ini merupakan penelitian observasional dengan rancangan crossectional. Responden penelitian adalah 120 siswa kelas 1 SMP di daerah endemik GAKI di kabupaten Temanggung. Status GAKI ditentukan dengan palpasi, kecukupan konsumsi yodium dengan indikator EYU (ekskresi yodium urine), dan anemia ditentukan dengan kadar Hb. Kecerdasan diukur dengan CFIT (Culture Fair Intelligence Test), prestasi belajar diukur dengan tes matematika dan Bahasa Indonesia terstandar. Hasil : Sebanyak 36 subyek (30%) terdeteksi mengalami GAKI, dan 25 subyek (20.8%) dinyatakan anemia. Risiko perempuan mengalami GAKI adalah 3.95 kali (OR: 3.95; 95%CI; 1.56 - 10.01), dan risiko perempuan mengalami anemia adalah 1.55 kali daripada laki-laki, tetapi secara statistik tidak signifikan (OR: 1.55; 95%CI; 0.61-3.93). Subyek dengan anemia memiliki resiko 1.8 kali untuk menderita GAKI, tetapi secara statistik tidak signifikan (OR: 1.80; 95%CI; 0.70-4.43). Tidak ada perbedaan prestasi belajar antara subyek GAKI dan non GAKI (p>0.05), maupun subyek dengan anemia dan non anemia (p>0.05). Subyek dengan GAKI memiliki tingkat kecerdasan lebih rendah daripada subyek non GAKI (p<0.05). Hasil analisis regresi menunjukkan bahwa status EYU, pendidikan ayah, dan kecerdasan subyek berpengaruh signifikan terhadap prestasi matematika (p<0.05). Kesimpulan : Status anemia tidak terbukti berhubungan dengan GAKI. Tidak ada hubungan status pembesaran goiter serta anemia terhadap penurunan prestasi belajar. Dampak GAKI pada perkembangan kognitif tampaknya masih terlihat sampai masa anak remaja. Status GAKI berdasar pembesaran goiter berhubungan dengan menurunnya tingkat kecerdasan, sedangkan kecukupan konsumsi yodium berhubungan dengan penurunan prestasi matematika.

Backround: Although multi micronutrient deficiencies often occur in the context of poverty, little is known about the impact of multi micronutrient deficiencies on cognitive development. Recent evidences suggest that anemia have adverse effect on thyroid metabolism, and reduce the effectiveness of intervention towards IDD (Iodine Deficiency Disorders). It is assumed that interaction between anemia and IDD heightened the risk of cognitive developmental delayed. Objective: To determine the potential associations between anemia and IDD with intelligence and school achievement among early adolescent. Design: This was a crossectional study, included 120 randomly selected first grade of two junior high schools in the endemic areas of IDD in Temanggung, Central Java. IDD status was determined by palpation, iodine intake was estimated by measuring urinary iodine excretion (UIE), and anemia status was determined by measuring Haemoglobin level in blood sample. Intelligence was estimated with CFIT (Culture Fair Intelligence Test) and school achievements data taken from standardized tests of math and Indonesian language. Result: Among the samples, 36 of them (30%) had IDD, and 25 samples (20.8%) were anemics. Girls had 3.95 times chance to had IDD (OR: 3.95; 95%CI; 1.56 - 10.01), and 1.55 times chance to had anemia than boys, but statistically not significant (OR: 1.55; 95%CI; 0.61-3.93). Samples with anemia were 1.8 times at risk to had IDD, but statistically not significant (OR: 1.80; 95%CI; 0.70-4.43). There were no difference in school achievements between samples with IDD and non IDD (p>0.05), and also between anemics and non anemics samples (p>0.05). Samples with IDD had lower level of intelligent compared to those without IDD (p<0.05). Linear regression analysis showed that UIE status, father education, and intelligence significantly related to math achievement. Conclusion : Anemia was not related to IDD. There were no relation between IDD and anemia with school achievement. Adverse impact of IDD towards cognitive development continuously shown in the early adolescent. IDD status based on goitre enlargement related to the decreasing level of intelligent, while UIE status related to the decreasing level of math achievement.

Kata Kunci : GAKI, anemia, kecerdasan, prestasi belajar, matematika, bahasa, IDD, anemia, intelligent, school achievement, math, language