Pengaruh kesehatan lingkungan terhadap kejadian diare dan status gizi anak umur 6 bulan sampai 59 bulan di Kota Pekan Baru Provinsi Riau

SUSANTO, dr. Adi Heru Sutomo, MSc.,D.CommNutr

2003 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar belakang. Masalah kesehatan masyarakat di kota Pekanbaru, seperti lazimnya di Indonesia masih berkisar pada kesehatan lingkungan. Faktor sosial ekonomi seperti pendidikan, pekerjaan, pendapatan dan jumlah anggota keluarga turut mempengaruhi baik atau buruknya kesehatan lingkungan. Keadaan kesehatan lingkungan tercermin dari tinggi atau rendahnya insiden diare. Semakin lama dan sering diare yang diderita balita dapat menyebabkan terjadinya perubahan status gizi. Tujuan. Mengetahui faktor-faktor yang mempengaruhi kesehatan lingkungan, mengetahui pengaruh kesehatan lingkungan terhadap kejadian diare dan status gizi balita. Metode. Penelitian ini merupakan penelitian observasional dengan rancangan Studi Cohort prospektif. Penelitian dilaksanakan di kota Pekanbaru. Sampel penelitian adalah rumahtangga (household) dan subjek penelitian adalah anak umur 6-59 bulan. Pengambilan sampel secara purposif dengan besar sampel 90 balita. Subjek terpapar (exposed) dan tidak terpapar kesehatan lingkungan (non-exposed) diamati selama 3 bulan terhadap kejadian diare dan perubahan status gizi (WHZ). Analisis data dengan Chi Square, regresi logistik dan regresi linier berganda pada tingkat kemaknaan p<0,05. Hasil. Faktor pendapatan keluarga berpengaruh terhadap kesehatan lingkungan (OR=14; CI:4,171-47,074). Kesehatan lingkungan berpengaruh terhadap episode (p=0,002) dan durasi diare (p=0,004). Balita dengan keadaan kesehatan lingkungan tidak baik mempunyai resiko 2,25 kali lebih sering terkena diare dan 2,69 lebih lama menderita diare. Kontribusi kesehatan lingkungan 9,9% terhadap episode dan 10,3% terhadap durasi diare. Episode diare pada kesehatan lingkungan yang tidak baik berpengaruh terhadap status gizi (p=0,040) dan kesehatan lingkungan tidak berpengaruh terhadap perubahan status gizi (p=0,380). Kesimpulan. Faktor pendapatan keluarga berpengaruh terhadap kesehatan lingkungan. Kesehatan lingkungan yang tidak baik berpengaruh terhadap episode dan durasi diare. Episode diare berpengaruh (negatif) terhadap status gizi, sedangkan kesehatan lingkungan tidak berpengaruh terhadap status gizi. Kata kunci: Lingkungan, diare, gizi, balita, cohort

Backgrounds. Public health problems in the city of Pekanbaru, as any other city in Indonesia, are ranged in environmental health. Socio-economical factors like education, job, revenue level, and the amount of family members are affecting environmental health. Environmental health level can be measured by the amount of the diarrhoea incidents. Longer and more often diarrhoea suffered by children can cause declinations in nutritional status. Objectives. To know the factors that affecting the environmental health level, to know the effects of environmental health level to the diarrhoea incidents, and nutritional status of children between 6 to 59 months. Methods. This Observational research was using Cohort prospective design. The research was taken place in the city of Pekanbaru. Samples were households, and the subjects were children between 6 to 59 months. Samples were collected using purposive random sampling with the amounts of the samples were 90 children. The exposed and non-exposed subjects to environmental health were observed for 3 months to diarrhoea incidents and the change of nutritional status using WHZ. Data was analysed using Chi square, logistic regression and double linear regression with level of significance p<0,05. Results. Family revenue level were significantly affecting the environmental health level (OR=14; CI: 4,171-47,074). Environmental health was affecting to the amount of episodes (p=0,002) and durations of diarrhoea (p=0,004). Children with low level of enviromental health level had a risk of 2,25 times more often and 2,69 times longer suffering from diarrhoea. Contributions of environmental health were 9,9% to the episodes and 10,3% to the durations of diarrhoea. The episodes of diarrhoea of low environmental health level were affecting the nutritional status (p=0,040), while environmental health level was not related to the changing of nutritional status (p=0,380). Conclusion. Family revenue are related to the environmental health level. Low level of environmental health was related to the episodes and durations of diarrhoea. Diarrhoea episodes are related to the nutritional status, while environmental health level was not related to the nutritional status. Keywords: Environment, diarrhoea, nutrition, children, cohort

Kata Kunci : Gizi Anak,Diare,Kesehatan Lingkungan