Kontribusi infeksi malaria, kecacingan dan asupan gizi terhadap anemia ibu hamil di Kabupaten Sorong, Provinsi Papua Barat

MATTO, Mustika Ahmad, Prof. dr. Hamam Hadi, MS.,Sc.D

2010 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Anemia defisiensi zat besi pada ibu hamil masih menjadi masalah utama gizi di Indonesia, meskipun terjadi penurunan prevalensi setiap tahunnya namun menurut WHO masalah ini termasuk masalah serius, sebab prevalensinya diatas 40%, Prevalensi anemia di Kabupaten Sorong tahun 2002 sebesar 61,4. Banyak faktor yang dapat menyebabkan anemia misalnya asupan gizi esensial yang kurang dan penyakit infeksi. Di Indonesia penyebab anemia selain infeksi malaria dan kecacingan, adalah anemia karena kekurangan zat besi. dilaporkan anemia mikrositik hipokrom pada ibu hamil sebesar 59% dan 10,3% makrositik dan menderita jenis lainya 30,8%. Tujuan : Mengetahui berapa besar kontribusi infeksi malaria dan kecacingan terhadap anemia ibu hamil dan mengkaji perbedaan kadar hemoglobin ibu hamil yang terinfeksi malaria, kecacingan, asupan zat besi yang kurang dengan ibu hamil yang tidak menderita infeksi malaria, kecacingan dan asupan zat besi yang baik di Kabupaten Sorong. Metode : Penelitian observasional dengan rancangan Cross-Sectional, di lakukan Kabupaten Sorong pada bulan januari s/d April 2010, jumlah responden 208 ibu hamil,. Variabel independen adalah Infeksi malaria, kecacingan dan asupan besi yang kurang, variabel dependen adalah kadar hemoglobin ibu hamil. Pengukuran kadar Hb dengan Photo screen, malaria dengan giemsa, dan kecacingan dengan katokatz. Statistik kaikuadrat dan t-test untuk analisis bivariat. Regresi linier dan analisis nilai Atribut Risk untuk analisis multivariat. Hasil : Prevalensi Anemia Ibu hamil di Kabupaten Sorong 58,65%, Besarnya kontribusi infeksi malaria 64% dan Infeksi kecacingan 42% pada kejadian Anemia ibu hamil. Berdasarkan hasil analisis bivariat dengan khai-kuadart bahwa ibu hamil yang menderita infeksi malaria berpeluang untuk menderita anemia sebesar 4,2 kali di bandingkan dengan ibu hamil yang tidak terinfeksi malaria, Variabel dominan yang berpengaruh terhadap penurunan kadar hemoglobin yaitu paritas ≥4 ibu hamil dengan nilai perbedaan kadar Hb 1,41 g/dl, Pendidikan ibu perbedaan kadar Hb 1,77 g/dl. Kesimpulan : Prevalensi Anemia di kabupaten Sorong masih tinggi yaitu 58,65 %. Banyak di derita Ibu hamil, pada usia kehamilan trimester III (60,38%) . Besarnya kontribusi infeksi malaria adalah 64% dan Infeksi kecacingan sebesar 42% terhadap kejadian anemia ibu hamil. Ibu Hamil yang menderita kekurangan zat besi sebanyak 100%, Terdapat perbedaan rata-rata kadar hemoglobin ibu hamil pada infeksi malaria, dan infeksi kecacingan .

Background: Fe deficiency anemia in pregnant mothers is a major nutrition problem in Indonesia. Despite decreased prevalence over years according to WHO the problem is serious because its prevalence is above 40%. The prevalence of anemia at District of Sorong in 2002 was 61.4%, higher that the national figure. Many factors can cause anemia such inadequate essential nutrient intake and infectious disease. In Indonesia, causes of anemia are not only malaria infection and intestinal worm but also Fe deficiency. It is reported that in pregnant mothers hypochrom microcytic anemia is as much as 59% and macrocytic 10.3%. Objective: To identify contribution of malaria and intestinal worm infection to anemic pregnant mothers and study difference in hemoglobin level in pregnant mothers with malaria and intestinal worm infection and inadequate Fe intake and those that did not suffer from malaria and intestinal worm infection and had normal Fe intake at District of Sorong. Method: The study was observational with cross sectional design carried out at District of Sorong from January to April 2010 involving 208 pregnant mothers as respondent. The independent variables were malaria, intestinal worm infection and inadequate Fe intake; the dependent variable was hemoglobin (Hb) level of pregnant mothers. Assessment of Hb level used photoscreen, malaria with giemsa and intestinal worm with Katokatz. Bivariate analysis used chi square and t-test and multivariate analysis used linear regression and risk attribute value. Result: The prevalence of anemia in pregnant mothers at District of Sorong was 58.65%. Contribution of malaria infection was 64% and intestinal worm infection was 42%. The result of bivariate analysis with chixvi square showed that pregnant mothers suffering from malaria infection had the probability of being anemic 4.2 times greater than those not infected. Variables dominantly influenced decrease of Hb level was parity ≥4 pregnant mothers with score of Hb level difference 1.41 g/dl and education of mothers with score of difference 1.77 g/dl. Conclusion: The prevalence of anemia at District of Sorong was still relatively high (58.65%). Contribution of malaria infection was 64% and intestinal worm infection was 42%. There was no difference of average Hb level in pregnant mothers with malaria and intestinal worm infection and low Fe intake.

Kata Kunci : Kontribusi infeksi malaria,Kecacingan,Asupan zat besi,Anemia ibu hamil