Pemulihan gizi buruk rawat jalan dapat memperbaiki asupan energi dan status gizi pada anak usia di bawah tiga tahun

https://doi.org/10.22146/ijcn.17754

Arnelia Arnelia(1*), Astuti Lamid(2), Rika Rachmawati(3)

(1) Puslitbang Gizi dan Makanan (P3GM), Badan Litbangkes Depkes RI
(2) Puslitbang Gizi dan Makanan (P3GM), Badan Litbangkes Depkes RI
(3) Puslitbang Gizi dan Makanan (P3GM), Badan Litbangkes Depkes RI
(*) Corresponding Author

Abstract


Background: New approaches for the management of severe malnutrition such as outpatient rehabilitation complement the existing WHO inpatient protocols.

Objective: The objectives of this study was to assess the improvement of energy intake as well as the nutritional status of severe malnourished children during comprehensive outpatient rehabilitation.

Method: This study was conducted among severe malnourished children treated as outpatient rehabilitation at Nutrition Clinic at Center of Food and Nutrition Research and Development (CFNRD) in Bogor Indonesia. The design of the study was one group pretest-posttest design and recruitment of sample was taken from health centers in Bogor District. The criteria of sample was severe acute malnutrition based on weight for height Z score (WHZ) < -3 or, having clinical sign and aged under three years old. During a-six-months-comprehensive rehabilitation, the treatment was performed including: treatment of infectious diseases, nutrition and health education, psychosocial stimulation, formula-milk and supplementary feeding. WHO formula-milk was provided as F-75 and F-100 and supplementary feeding was given such as blended food, biscuit.

Results: From a total of 26 severely malnourished children were selected, 24 children included in the analysis, 1 child was died 1 child was dropout. It was found that the average energy intake in baseline was 82 + 15 kcal/kg body weight/day.  After 1 month and 3 months intervention, average energy intake increased signifcantly to 121 + 13 kcal/kgBW/day and to 148 + 21 kcal/kg BW/day, respectively (p<0.000). Nutritional status increased from WHZ score of -3.56 + 0.71 at baseline, became -2.35 + 0.69 and -1.87 + 0.85 after 1 month and 3 months intervention. The proportion of normal child based on weight for height category were 50% after 3 months and 73.9% at the end of out patient rehabilitation. 

Conclusion: The comprehensive outpatient rehabilitation could significantly improve the energy intake and the nutritional status of severe malnourished children under three years of age.


Keywords


severe malnourished; outpatient; energy intake; WHO formula

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References

Caulfield LE, de Onis M, Black RE. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria, and measles. Am J Clin Nutr 2002; 80: 193–8.

UNICEF. Strategy for improved nutrition of children and women in developing countries; 1990. 3. WHO. Management of severe malnutrition : a manual for physicians and other senior health workers. Jeneva: WHO; 1999.

Depkes RI. Studi kesehatan ibu dan anak. Badan Litbangkes Dep Kes RI; 2001.

Depkes RI. Survei kesehatan rumah tangga (SKRT). Badan Litbangkes Dep Kes RI; 2004.

Depkes RI. Laporan hasil riskesdas Indonesia tahun 2007. Badan Litbangkes Depkes RI; 2008.

Depkes RI. Buku bagan tatalaksana anak gizi buruk. buku 1. Direktorat Bina Gizi Masyarakat, Binkesmas, Depkes; 2006.

WHO, UNICEF. WHO child growth standards and the identification of SAM in infants and children; 2009.

Pollitt E, Watkins WE, Husaini MA. Three month nutritional supplementation in Indonesian infants and toddlers benefits memory function 8 y later. Am J Clin Nutr 1997; 66: 1357-63.

Gantham-McGegor SM, Fernald LC, Sethuraman K. Effects of health and nutrition on cognitive and behavioral development in children in the first three years of life. Part 1: Low birthweight, breastfeeding, and protein- energy malnutrition. Food and Nutrition Bulletin 1999; 20(1): 53-75.

Arnelia, Heryudarini H, Muljati S, Sihadi, Raswanti I, Suwarti S. Penambahan mineral mix dapat meningkatkan status gizi pasien gizi buruk di Klinik Gizi P3GM Bogor. Media Gizi dan Keluarga 2005; 29(1):106-12.

Lemenshow S, Hesmer DW, Klar J, Lwanga SK. Adequacy of sample size in health studies. (terjemahan) Pramono D. Yogyakarta: Gadjah Mada University Press; 1997.

Menteri Kesehatan RI. Keputusan Menteri Kesehatan RI no. 220/Menkes/SK/VIII/2002. Klasifikasi status gizi anak bawah lima tahun; 2002.

Suhartono, Budiman D, Castro T. Pertumbuhan dan perkembangan anak gizi buruk masa lalu di Kabupaten Tanggamus Provinsi Lampung. Jurnal Gizi Indonesia 2008; 5(1): 41-8.

Amrahu S, Zemone T. Risk factors for severe acute malnutrition children under the age of five : a case control study. Ethiop.J.Health Dev 2008; 22(1): 21-5.

WHO. Guidelines for the inpatient treatment of severely malnourished children. SEARO Technical Publication 2003; 24.

Depkes RI. Petunjuk teknis tatalaksana anak gizi buruk. buku II. Direktorat Bina Gizi Masyarakat, Binkesmas, Depkes; 2006.

Collins S, Sadler K. Outpatient care for severe malnourished children in emergency relief progammes: a retrospective cohort study. Lancet 2002; 360: 1824-30.

Collins S , Dent N, Binns P, Bahwere P, Sadler K, Hallam A. Management of severe acute malnutrition children. Lancet 2006; 368: 998 – 2000.

Collins S, Sadler K, Dent N, Khara T, Guerrero S, Myatt M, Saboya M, Walsh A. Key issues in the success of community-based management of severe malnutrition. Food and Nutrition Bulletin 2006; 27(3) (supplement).



DOI: https://doi.org/10.22146/ijcn.17754

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