Kontribusi penyakit malaria terhadap prevalensi anemia ibu hamil di daerah endemis, Kabupaten Jayapura, Provinsi Papua

SUSANTI, Gutit Enny, dr. Hamam Hadi, MS.,ScD

2001 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar BelakanP: Berdasarkan Survey kesehatan rumah tangga tahun 1995 Prevalensi anemia ibu hamil di Provinsi Irian Jaya masih relatip tinggi yaitu 48 %. Tingginya prevalensi tersebut kemungkinan disebabkan oleh rendahnya konsumsi protein, zat besi, vitamin C, serta adanya infeksi parasit malaria dan cacing mengingat Irian jaya merupakan daerah endemis malaria. Yang menjadi masalah adalah berapa besar kontribusi infeksi parasit tersebut terhadap anemia (kadar Hb) ibu hamil. Tujuan Penelitian: Untuk mengetahui kontribusi konsumsi zat gizi (protein, zat besi, vitamin C) dan infeksi parasit (malaria dan cacing) terhadap prevalensi ibu hamil, Rancangan Penelitian: Penelitian ini merupakan penelitian survey dengan rancangan Cross Secsionul. Populasi penelitian ini adalah semua ibu hamil yang tinggal didaerah penelitian. Data yang dicari meiiputi; 1 ) data sekunder yaitu, jumlah penduduk, tingkat pendidikan, pendapatan, cakupan pelayanan kesehatan ibu hamil, 2) data primer yaitu Umur, tingkat pendidikan, pekerjaan, pendapatan keluarga, jumlah anggota keluarga, umur kehamilan, konsumsi zat gizi, kepatuhan minum tablet Fe, infeksi malaria dan cacing, serta kadar Hb. Analisa data dikakukan secara deskriptif dan analitik dengan uji regresi multivariate dan logistik bevariate menggunakan program SPSS. Hasil Penelitian: Prevalensi anemia ibu hamil 85,2 %, terbesar pada usia kehamilan 14 - 28 minggu, dengan intensitas ringan 15 %, sedang 67 %, dan berat 3 %. fiu hamil yang minum tablet Fe < 90 % 68,l % anemia. Prevalensi malaria 55 %, dengan jenis malaria tertiana 29 YO,tr opika 24 %, dan mix 2 %. dari 100 orang yang terinfeksi 78,5 % anemia. Prevalensi Infestasi cacing A. lumbricoides 75,8 %, T.trichiura 72 %, dan cacing kait 443 %, Infestasi cacing tidak hanya tunggal tapi juga mix (campuran) dua dan tiga jenis cacing sekaligus. Hasil arralisa regresi multivariate diketahui bahwa konsumsi protein, zat besi, kepatuhan minum tablet Fe, infeksi malaria dan infestasi A. lumbricoides mempunyai hubungan yang bermakna dengan anemia ibu hamil (protein P 0,003, zat besi P < 0,001, kepatuhan minum tablet besi P < 0,001, malaria P < 0,001, dan cacing A. lumbricoides P < 0,001), sedang konsumsi vitamin C, infestasi cacing T. trichiura, cacing kait, dan campuran antara dua dan tiga jenis cacing tidak bermakna. Konsumsi protein, zat besi, vitamin C, dan kepatuhan minum tablet Fe mempunyai hubungan positip sedang infeksi malaria dan cacing mempunyai hubungan negatip. Subyek yang mengkonsumsi protein < 6497 % RDA mempunyai resiko anemia 44,7 kali lebih besar dari yapg > 64,97 % RDA, zat besi < 44,33 % RDA mempunyai resiko 71,9 kali dari yang > 44,33 %, vitamin C < 90 % RDA mempunyai resiko 1,065 kali dari yang yang > 90 %, infeksi malaria 1,9 kali dari yang tidak terinfeksi sedang infestasi cacing faktor resikonya tidak berbeda antara yang terinfeksi dan tidak. Kesimpulan: Semakin rendah konsumsi protein, zat besi, vitamin C, serta kepatuhan minum tablet Fe semakin tinggi resiko anemia, dan semakin tinggi intensitas infeksi malaria dan cacing semakin tinggi resiko anemia

Background: Based on the household health survey in 1995, the anemia prevalence of pregnant mother in Irian Jaya was still relatively high, i.e. 48 %. This high prevalence was probably caused by low consumption of protein, iron, vitamin C, malaria infection and worm as Irian Jaya was still a malaria endemic area. The problem was that the size of parasit infection contrinution toward anemia (Hb level) among pregnant mothers. Objectives: To frnd out the contribution of nutritious consumption (protin, iron, vitamin C) and parasit infection (malaria nad worm) on the prevalence among pregnant mothers. Methods of study: This study was a survey study using cross-sectional approach. The population were pregnant mothers living int the area. The data to find out included ])secondary data, i.e. number of inhabitants, level of education, income health services for pragnant mothers, 2) primary data, i.e., age, level of education, job family income, number of family members, age of pragnancy, malaria and worm infection, Hb level. The data analysis was done descriptively and analystically using multivariate nad logistic bevariate regression tests using SPSS. Results: The prevalece of pregnant mothers was 85,2 %, the highest was at the age of 14-28 week pergnancy, with 15 % low intensity, 67 % medium, and 3 % high intensity. Pregnant mothers who had t Fe tablet was less than Malaria tertiana was 29 %, tropica 24 YO and mix 2 %. Among 100 pregnant mothers, 78,5 % were infected with anemia 78,5 %. T. trichiura 72 % and hook worm 44,5 % worm infection was not only single but also mix of two or three kinds. The result of mulfivariate regression analysis showed that the consumption of protein, Fe, Fe tablet compliace, malaria infection and A.lumbricoides I nvestation had significant relationship with anemia among pregnant mothers (protein P 0,003, Fe P < 0,OO 1, Fe tablet consumption P < 0,001, malaria infection P < 0,001 and A lumbricoides investation P < 0,001): and menwhile the consumption of vitamin 6, T.trichiura investation, hookworm, and mix two to three worm was not significant. The consumption of protein, Fe, vitamin C, and Fe tablet compliance had positive relationship, while malaria and worm infation had negative relationship. The subyects consumption protein < 64,97 % RDA had risk up to 44,7 % times bigpr than those with > 64,97 % RDA; Fe < 44,33 % had risk 71,9 times bigger than those with > 44,33 %; vitamin C < 90 % RDA had risk > 1,065 times bigger than those with > 90 YO; malaria infection 1,9 times bigger than those who were not different between those infected and those who were not infected. Conclusion: The lower consumption of protein, Fe, vitamin C, and compliance for Fe , the higher anemia risk. And the higher ontensity of malaria and worm infection, the higher anemia risk.

Kata Kunci : Gizi Wanita Hamil,Daerah Endemis Malaria,Prevalensi Anemia, Malaria-anemia-pregnancy