Tinggi Badan Anak Baru Masuk Sekolah Dasar (TBABS) Menurut Endemisitas Gangguan Akibat Kekurangan Yodium (GAKY) di Kabupaten Dairi, Provinsi Sumatera Utara

SITANGGANG, Berlin, Ir. Untung S. Widodo, MPS

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

Latar Belakang : Gangguan Akibat Kekurangan Yodium (GAKY) merupakan masalah kesehatan yang serius karena dampaknya mempengaruhi kelangsungan hidup dan kualitas sumber daya manusia. Efek kekurangan yodium pada anak akan menghambat pertumbuhan fisik dan mental. Anak baru masuk sekolah atau anak yang saat ini duduk di bangku SD kelas 1, adalah anak yang lahirkan dan dibesarkan pada masa krisis ekonomi berlangsung, dikawatirkan jumlah mereka yang stunted/pendek semakin meningkat. Bagaimana pengaruh kekurangan iodium terhadapa TB anak baru sekolah yang tinggal di daerah endemik berat kekurangan yodium seperti Kabupaten Dairi (TGR 33,9%). Tujuan : Mengetahui hubungan tingkat endemisitas GAKY dengan TBABS, dan mempelajari hubungan TBABS dengan status gizi saat bayi dan balita, sosial ekomoni keluarga (pendidikan, pekerjaan, penghasilan), TB orang tua. Metode : Jenis penelitian observasional dengan rancangan cross-sectional. Sampel untuk TBABS anak SD kelas 1 (n=444) dan kelas 4,5,6 sampel untuk palpasi (n=2184), dan untuk EYU (n=247). Lokasi di Kab. Dairi-Prov. Sumatera Utara, pada 4 kecamatan (kec. endemis berat, sedang, ringan dan non endemis). Variabel bebas tingkat endemisitas GAKY, variabel terikat TBABS, variabel luar/pengganggu status gizi saat bayi, dan balita, tinggi badan orang tua, dan sosial ekonomi keluarga (pendidikan, pekerjaan, penghasilan). TB diukur dengan microtoice, TGR dengan palpasi kelnjar gondok, EYU dengan metode Ammonium Persulfate Digestion Methode (APDM) diperiksa di Laboratorium Balai Penelitian GAKY Magelang. Hasil : Dari 2.184 anak di palpasi, 423 orang menderita godok (TGR 19,7%). Dari 247 anak diperiksa urin, prevalensi kadar EYU <20 μg/l 0,4%, median EYU <50 μg/l 4,1%, median EYU <100 μg/l 21,1%, median EYU 100-299 μg/l 65,6%, dan median EYU ≥300 μg/ 8,9%. Ada peningkatan rata-rata EYU dari 139 μg/l menjadi 163,94 μg/l. Dari 444 anak baru sekolah yang diukur TB, ditemukan prevalensi anak stunted/pendek 56,5% di atas prevalensi nasional 36,1%. Rata-rata TBABS laki-laki 109,8 cm, perempuan 109,1 cm, masih di bawah rata-rata TBABS hasil survei nasional. Kesimpulan : Ada hubungan yang bermakna antara endemistas GAKY dengan TBABS (p=0,036). Faktor yang berhubungan dengan TBABS adalah status gizi pada saat bayi, tinggi badan, orang tua, dan penghasilan keluarga.

Background: Iodine Deficiency Disorder (IDD) is a serious health problem because it affects survival and quality of human resources. Iodine deficiency in children can distort physical and mental development. New elementary school children sitting in grade 1 were born and grew up during economic crisis. It is anticipated that the number of stunted is increasing. New elementary school children living in high endemic Iodine deficiency areas such as District of Dairi (TGR 33.9%) may have risks of iodine deficient and becoming stunted. Objective: To identify relationship between IDD endemic level and height of new elementary school children and to study relationship between height of new elementary school children and nutrition status during infancy and childhood, social economic status of the family (education, job, income), height of parents. Methods: The study was observational with cross sectional design. Samples consisted of students of grade 1 (n=444) and grade 4, 5, 6 for palpation (n=2184) and for EYU (n=247). Location of the study was District of Dairi, Province of Sumatera Utara in 4 sub districts (with high, medium, low endemic and non endemic). Independent variable was IDD endemic level, dependent variable was height of new elementary school children. Height was measured using microtoise, TGR using palpation of goiter glands, urine iodine excretion using ammonium persulfate digestion method, at IDD laboratory of BP-GAKY Magelang. Result: Out of 2,184 children with palpation as many as 423 had goiter (TGR 19.7%). Out of 247 children who got urine examination, 0.4% had prevalence of urine iodine excretion median < 20 μg/l; 4,1% urine iodine excretion median < 50 μg/l; 21.1% urine iodine excretion median < 100 μg/l; 65.6% urine iodine excretion median 100 – 299 μg/l; and 8.9% urine iodine excretion median ≥ 300 μg/l. There was average increase of urine iodine excretion from 139 μg/l to 163.94 μg/l. Out of 444 children as much as 56,5% had prevalence of being stunted (national was 36.1%); average height of new elementary school children was 109.8 cm for male and 109.1 cm for female, both were below average height of new elementary school children based on result of national survey (114,9 for male, 109 for female). Conclusion: There was significant relationship between IDD endemic level and height of new elementary school children (p=0.035). There was relationship between nutrition status of infants, height of parents, family income and height of new elementary school children.

Kata Kunci : Gizi Anak,Endemi GAKY,Tinggi Badan