ASUPAN VITAMIN D DAN TINGKAT KEPARAHAN DEMAM BERDARAH DENGUE PADA ANAK USIA 1-14 TAHUN DI YOGYAKARTA

Nur Siyam, Prof. dr. Siswanto Agus Wilopo, SU, M.Sc, Sc.D.

2014 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Demam berdarah dengue (DBD) menimbulkan shock dan kematian. Tahun 2012 awal, 62,44% penderita DBD Kota Yogyakarta anak usia 1-12 tahun, sebagian besar mengalami DBD parah. Asupan vitamin D rendah diasumsikan sebagai penyebab DBD parah. Asumsi ini perlu dibuktikan. Tujuan: Menganalisis pengaruh asupan Vitamin D dan keparahan DBD pada anak usia 1-14 tahun. Metode Penelitian: Jenis penelitian observasional analitik dengan rancangan hospitalbased case control study. Penelitian di bangsal rawat inap anak dan instalasi catatan medik RS Jogja dan RSUP Dr. Sardjito tahun 2013. Kelompok kasus adalah anak usia 1- 14 tahun dengan DBD grade III & IV, kontrolnya adalah DBD grade I & II berdasarkan diagnosis dokter dan pemeriksaan laboratorium. Pengambilan sampel dengan consecutive sampling. Data asupan vitamin D diambil dengan food frequency questionnaire (FFQ). Variabel luarnya adalah IMT, Umur, status penyakit kronis dan intensitas terpapar matahari pagi. Penentuan nilai cut-off point sensitifitas dan spesifisitas keparahan DBD berdasarkan asupan vitamin D dan IMT dengan ROC curve. Analisis data dengan analisis univariabel, bivariabel (t-test) dan mutivariabel (regresi logistik). Hasil Penelitian: Jumlah subjek penelitian 120 (60 kasus dan 60 kontrol) tanpa matching. Nilai titik potong asupan vitamin D berdasarkan ROC Curve adalah 2,7 μg/hari. Hasil t test menunjukkan penderita DBD parah mempunyai rata-rata asupan vitamin D 1,10 kali lebih sedikit dibandingkan pada DBD tidak parah. Uji regresi logistik menunjukkan asupan vitamin D <2,7 μg/day bersama IMT ??18,75 kg/m2, penyakit kronis, dan intensitas terpapar matahari pagi <15 menit/hari berpengaruh pada DBD parah (OR=0,47; 95% CI: 0,32-0,71). Simpulan: Anak dengan DBD parah ditemukan lebih banyak pada mereka yang mempunyai asupan vitamin D sedikit, IMT ??18,75 kg/m2, berpenyakit kronis, dan intensitas terpapar matahari pagi <15 menit/hari dibandingkan pada anak DBD tidak parah.

Background: DHF can lead to shock and death. In early 2012, 62,44% of DHF in Yogyakarta on child age 1-12 years, the majority have DHF severity. Lower of vitamin D intake assumed cause of DHF severity. This assumption need to be proved. Objective: To analyse the effect of the vitamin D intake and DHF severity in children 1- 14 year. Methods: This study is an observational analytic with hospital-based case control study design. The research conducted in inpatient wards children and medical record installation in Jogja Hospital and RSUP Dr. Sardjito on year of 2013. The case group was children 1-14 years who were diagnosed with DHF grade III & IV, the control group was DHF grade I & II based on medical diagnosis and laboratorium checking. Sampling technique with consecutive sampling. Data intake of vitamin D was obtained by FFQ. External variables were age, IMT, status of chronic disease, and tensity of morning sun exposure. Determination of the cut-off point value of sensitifity and spesifisity DHF severity based on vitamin D intake and IMT with ROC curve. Data analysis with univariable, bivariable (t-test), and multivariable (logistic regretion). Results: The number of subject was 120 (60 cases and 60 controls) without matching. Vitamin D intake cut-off point based on ROC Curve was 2,7 μg/day. The results of the t test showed severe DHF patients had mean of vitamin D intake of 1.10 times less than in non-severe dengue. Logistic regresi test showed that vitamin D intake <2,7 μg/day, BMI ??18,75 kg/m2, chronic disease and intensity of morning sun exposure <15 min/day were increased risk of DHF severity (OR=0,47; 95% CI: 0,32-0,71). Conclusion: Children with severe dengue was found more to have a little vitamin D intake, BMI ?? 18.75 kg/m2, chronically ill, and the intensity of the morning sun exposure <15 min / day compared to children with non-severe dengue.

Kata Kunci : DBD, Anak, Asupan Vitamin D, Tingkat Keparahan