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Tuberkulosis (TB) adalah penyakit menular yang disebabkan oleh bakteri Mycobacterium tuberculosis, yang dapat menyebar di udara saat penderita TB batuk. Penyakit ini biasanya mempengaruhi organ paru dan dapat juga mengenai organ yang lain. Sampai saat ini TB masih menjadi masalah kesehatan masyarakat di dunia walaupun upaya pengendalian telah diterapkan lama. Anak merupakan salah satu kelompok risiko yang berdampak dalam penularan TB. Dari seluruh penderita TB di dunia, sekitar 11% terjadi pada anak usia <15 tahun. Dari data Riskesdas 2018, prevalensi TB paru pada anak berkisar 0,1-0,3%. Salah satu faktor risiko yang dapat menyebabkan kejadian TB pada anak adalah malnutrisi yang dapat menyebabkan penurunan kekebalan tubuh anak dan memudahkan anak terserang penyakit TB. Penelitian ini bertujuan untuk mengetahui hubungan status gizi dengan kejadian tuberkulosis pada anak usia 0-14 tahun. Desain penelitian adalah cross sectional dilakukan dari Mei-Juli 2023 dengan menggunakan data Riskesdas 2018. Kelompok terpapar adalah anak dengan status gizi kurang sebesar 19.821 responden dan anak dengan status gizi buruk sebesar 7.307 responden. Kelompok tidak terpapar adalah anak dengan status gizi baik sebesar 170.934 responden. Hasil penelitian menunjukkan bahwa proporsi tuberkulosis anak usia 0-14 tahun di Indonesia sebesar 0,19%. Terdapat hubungan yang bermakna antara status gizi dengan kejadian tuberkulosis pada anak usia 0-14 tahun setelah dikontrol dengan variabel umur dan status pekerjaan ibu. Anak dengan status gizi kurang memiliki risiko 1,8 kali lebih tinggi untuk mengalami tuberkulosis dibandingkan dengan anak dengan status gizi baik (nilai p = <0,001; POR = 1,82 (95% CI 1,38-2,40)). Anak dengan status gizi buruk memiliki risiko 2,2 kali lebih tinggi untuk mengalami tuberkulosis dibandingkan dengan anak dengan status gizi baik (nilai p = <0,001; POR = 2,19 (95% CI 1,47-3,25)). Hal ini diharapkan dapat memberikan gambaran pentingnya pemantauan status gizi pada anak dalam peningkatan kekebalan tubuh anak sehingga terhindar dari penularan dan perkembangan penyakit tuberkulosis.
Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis, which can spread through the air when people with TB cough. The disease usually affects the lungs and can also affect other organs. TB is still a public health problem worldwide despite long-standing control efforts. Children are one of the risk groups for TB transmission. Of all TB patients in the world, about 11% occur in children aged <15 years. From the 2018 Riskesdas data, the prevalence of pulmonary TB in children ranged from 0.1-0.3%. One of the risk factors that can cause the incidence of TB in children is malnutrition, which can cause a decrease in children's immunity and make it easier for children to get TB disease. This study aims to determine the relationship between nutritional status and the incidence of tuberculosis in children aged 0-14 years. The research design was cross sectional, conducted from May-July 2023 using the 2018 Riskesdas data. The exposed group was children with a nutritional status of 19,821 respondents and children with a nutritional status of 7,307 respondents. The unexposed group was children with a good nutritional status of 170,934 respondents. The results showed that the proportion of tuberculosis among children aged 0-14 years in Indonesia was 0.19%. There was a significant relationship between nutritional status and the incidence of tuberculosis in children aged 0-14 years after controlling for the variables of age and maternal employment status. Children with undernutrition had a 1.8 times higher risk of developing tuberculosis compared to children with good nutrition (p value = <0.001; POR = 1.82 (95% CI 1.38-2.40)). Children with malnutrition had a 2.2 times higher risk of developing tuberculosis compared to children with good nutrition (p value = <0.001; POR = 2.19 (95% CI 1.47-3.25)). This is expected to illustrate the importance of monitoring children's nutritional status in improving children's immunity so as to avoid the transmission and development of tuberculosis.
Stunting is a malnutrition that is still a public health problem in Indonesia and causes various adverse effects on children's health. Besides caused by a chronic lack of nutrition, stunting can also be caused by recurrent of infectious diseases. Efforts to prevent infectious diseases, such as immunization, will play a role in increasing child growth, especially in developing countries. The purpose of this study was to examine the association between basic immunization status and the incidence of stunting in toddlers in Indonesia. This study used a cross-sectional study design using secondary data from SSGI 2021. The inclusion criteria for this study were that toddlers were aged 12–59 months at the time of data collection, their height was measured, were not experiencing severe or chronic illness, and had complete variable data. A total of 70,267 toddlers met the inclusion criteria, and all were taken as research samples. Data analysis was performed using the Cox regression to obtain a prevalence ratio (PR) with 95% of confidence interval. This study shows that the prevalence of stunting among children aged 12–59 months in Indonesia is 23.1%, and the proportion of children under five who have complete basic immunization status is 74.92%. The results of the multivariate analysis showed that basic immunization status had a statistically significant association with the incidence of stunting. Toddlers with incomplete basic immunization status are at risk 1.19 times higher for stunting compared to toddlers with complete basic immunization status [adjusted PR 1.19 (95% CI 1.15–1.23)]. Toddlers who are not immunized at all have an even higher risk of experiencing stunting, which is 1.27 times higher compared to toddlers with complete basic immunization status [adjusted PR 1.27 (95% CI 1.15–1.39)], after controlling for variables such as the mother's education, economic status, and the child's birth weight. Efforts are needed to complete the child's immunization status on time according to schedule and increase the mother's knowledge regarding the use of health services, the fulfillment of toddler nutrition, and the stimulation of child growth and development.
Indonesia has targeted a reduction in stunting prevalence to 14,2% in 2029. However, this effort still faces major challenges such as the complexity of the double burden of malnutrition and suboptimal feeding practices during the first 1000 days of life. At individual level, a child can experience more than one malnutrition problem at once, which called the double burden of malnutrition. Limited studies have examined the double burden of malnutrition at individual level in Indonesia. Therefore, this study was conducted to identify the association of complementary feeding practices and the double burden of malnutrition among children aged 6-23 months in Indonesia. This was a cross-sectional study using secondary data from the 2022 Indonesia Nutritional Status Survey. The double burden of malnutrition was assessed in forms of coexisting stunting-wasting and stunting-overweight, while complementary feeding practices was measured based on WHO and UNICEF IYCF indicators. A total of 69.884 children were analyzed for stunting-wasting and 72.158 children for stunting-overweight after meeting data completeness and no extreme values. Multiple logistic regression analysis was conducted to estimated asjusted prevalence odds ratio (aPOR). This study found the prevalence of stunting-wasting and stunting-overweight was 2.7% and 0.7%, respectively. Among the children, 50.9% met the minimum dietary diversity (MDD), 83.5% met the minimum meal frequency (MMF), 45.3% met the minimum acceptable diet (MAD), 72.5% consumed eggs and flesh foods (EFF), 24.9% consumed sweet beverages (SwB), and 21.6% had zero consumption of fruits and vegetables (ZVF). SwB and ZVF indicators were significantly associated with both forms of the double burden of malnutrition. Children who did not consume sweet beverages had a 10% lower risk of stunting-wasting (aPOR: 0.90; 95% CI: 0.81–0.996) and a 31% lower risk of stunting-overweight (aPOR: 0.69; 95% CI: 0.57–0.84) compared to children who consume sweet beverages. Meanwhile, children who consumed fruits and vegetables had a 20% lower risk of stunting-wasting (aPOR: 0.80; 95% CI: 0.71–0.90) and a 29% lower risk of stunting-overweight (aPOR: 0.71; 95% CI: 0.57–0.89) than those with zero intake of fruits and vegetables. These findings highlight the importance of improving the diversity and quality of foods provided in government programs, along with strengthening nutrition education and sweet beverages nutrition labeling policies to prevent the double burden of malnutrition among children.
