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Nurhalina; Promotor: Tri Yunis Miko Wahyono; Kopromotor:Bambang Wispriyono, Syahrizal Syarif; Penguji: Besral, Helda, Ririn Arminsih Wulandari, Suwito, Soewarta Kosen
Abstrak:
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Pada tahun 2024, prevalensi stunting di Kabupaten Gunung Mas adalah 14,1%, kekurangan berat badan (14,8%), gizi kurang (9,6%), dan gizi buruk (2,3%). Masalah gizi telah menurun selama lima tahun terakhir, tetapi belum mencapai target Tujuan Pembangunan Berkelanjutan (SDGs). Upaya pencegahan masih berfokus pada intervensi gizi, tetapi belum memasukkan efek paparan merkuri dalam kerangka global. Merkuri diketahui berinteraksi dengan nutrisi dan mengganggu metabolisme tubuh sehingga mempengaruhi asupan zat gizi dan meningkatkan risiko penyakit infeksi. Kedua faktor tersebut merupakan determinan masalah gizi di dunia. Tujuan penelitian ini adalah menilai dampak pajanan merkuri terhadap status gizi Balita. Metode penelitian ini adalah studi observasional dengan pendekatan crosssectional study,yang dilakukan pada 146 balita yang berdomisili di daerah pertambangan emas skala kecil selama satu tahun atau lebih. Pengukuran antropometri dilakukan untuk menilai gizi kurang/buruk, stunting dan underweight. Penelitian ini mengukur konsentrasi merkuri rambut dan merkuri urin sebagai biomarker pajanan merkuri. Asupan merkuri melalui konsumsi ikan dinilai untuk mengetahui sumber pajanan merkuri. Hasil penelitian menunjukkan bahwa sebesar 20,6% responden mengalami gizi kurang/buruk, stunting (34,25%), dan underweight (32,2%). Konsentrasi merkuri rambut 0,008 - 1,122 mg/kg (median 0,163 mg/kg), sedangkan konsentrasi merkuri urin 0,0011 - 0,0317 mg/L (median 0,0023 mg/L). Asupan merkuri melalui konsumsi ikan 0,020 - 0,0609 mg/kg/hari. Asupan merkuri melalui konsumsi ikan berhubungan secara signifikan dengan kadar merkuri rambut. Kelompok dengan asupan ≥ 0,20 mg/kg/hari memiliki konsentrasi merkuri dalam rambut lebih tinggi, 0,165 mg/kg, tetapi konsentrasi merkuri urin lebih rendah,0,001 mg/L. Hasil uji statistik menunjukkan konsentrasi merkuri rambut secara signifikan meningkatkan risiko gizi kurang/buruk sebesar 19,6 kali (95% CI = 1,1– 362,3); risiko stunting 8,4 kali (95% CI = 0,1–1094), dan risiko underweight 15,89 kali (95% CI = 0,0–1562,0). Dengan demikian, disimpulkan bahwa konsentrasi merkuri rambut merupakan faktor yang paling berperan dalam hubungan pajanan merkuri terhadap status gizi Balita. Hasil penelitian ini menjadi informasi awal tentang pajanan merkuri dan dampaknya terhadap status gizi. Oleh karena itu, pemerintah perlu mengeluarkan kebijakan tentang pencegahan pencemaran merkuri di lingkungan, pemantauan rutin pajanan merkuri dan keamanan pangan, serta pengobatan dan perawatan kelompok kasus. Kami merekomendasikan integrasi intervensi gizi dan kesehatan lingkungan dalam kerangka kerja nasional untuk pencegahan dan tatalaksana malnutrisi di Indonesia, khususnya di daerah-daerah dengan pajanan merkuri yang tinggi.
In 2024, the prevalence of stunting in Gunung Mas Regency was 14.1%, underweight 14.8%, wasting 9.6%, and severe wasting 2.3%. During the last years, the nutritional problems have decreased, but these figures have not reached the target of Sustainable Development Goals (SDGs). Prevention efforts still focused on nutritional intervention, but they had not yet included the effects of mercury exposure in the global framework. Mercury was known to interact with nutrition and disrupt the body's metabolism, thus affecting nutrient intake and increasing the risk of infectious disease. Both factors were determinants of nutritional problems in the world. This study aimed to assess the impact of mercury exposure on the toddlers' nutritional status. This study was a cross-sectional observational study; it was conducted on 146 toddlers who had lived in small-scale gold mining areas for one year or more. Anthropometric measurements were conducted to assess wasting, stunting, and underweight. Mercury exposure was assessed based on biomarker measurements by measuring mercury levels in hair and urine. The results showed that 20.6% of respondents were wasting, 34.25% stunted, and 32.2% underweight. Hair mercury concentration was 0.008 - 1.122 mg/kg (median 0.163 mg/kg), while urinary mercury was 0.0011 - 0.0317 mg/L (median 0.0023 mg/L). Mercury intake through fish consumption was 0.020 - 0.0609 mg/kg/day. Mercury intake through fish consumption was significantly associated with hair mercury concentration. The group with intake ≥ 0.20 mg/kg/day had higher hair mercury concentration of 0.165 mg/kg, but lower for urinary mercury concentration of 0.001 mg/L. Statistical analysis showed that hair mercury concentration significantly increased the risk of wasting by 19.6 times (95% CI = 1.1–362.3). The risk of stunting was 8.4 times (95% CI = 0.1–1094), and the risk of underweight was 15.89 times (95% CI = 0.0–1562.0). This study concluded that hair mercury concentration was the most important factor in the relation of mercury exposure and toddler nutritional status. This study result became basic information about mercury exposure and the effect on toddler nutritional status. Therefore, the government should develop a policy on mercury pollution prevention, routine monitoring of mercury exposure, food safety, medication, and treatment of case groups. We recommend integrating nutrition and environmental health interventions into Indonesia’s national framework for preventing and managing malnutrition, especially in areas with high mercury exposure.
D-642
Depok : FKM-UI, 2026
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Jahiroh; Pemb. Nurhayati Prihartono; Penguji: Ratna Djuwita, Rusli
T-3889
Depok : FKM UI, 2013
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Herlina Hutagalung; Pembimbing: Ratna Djuwita; Penguji: Puji Wahyuni, Asih Setiarini
S-7462
Depok : FKM UI, 2012
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Vierto Irrenius Girsang; Pembimbing: Yovsyah; Penguji: Ratna Djuwita, Sulistyo, Fajrinayanti
T-4093
Depok : FKM UI, 2014
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Dwitya Dian Pratiwi; Pembimbing: Helda; Penguji: Yovsyah, Hidayat Nur Gazali Djajuli
Abstrak:
Gizi kurang adalah salah satu penyebab kematian pada balita sekitar 45% dari kasus kematian balita di dunia. Pola asuh merupakan sikap dan perilaku orang tua terhadap anaknya, rencana penjadwalan pemberian makan serta penyajianya kepada anak adalah merupakan salah satu dari pola asuh. Pola asuh orang tua yang kurang merupakan faktor ekternal terjadinya gizi kurang pada balita. Di RSUD Kramat Jati status gizi kurang pada balita memiliki presentase 35%. Studi cross sectional bertujuan untuk melihat hubungan pola asuh orang tua terhadap status gizi kurang pada balita. Pengambilan data dilakukan secara langsung pada bulan April-Juni 2023 pada seluruh balita yang berkunjung ke poliklinik RSUD Kramat Jati dengan jumlah sampel 374 responden. Hasil uji statistik menunjukkan ada hubungan antara pola asuh orang tua dengan status gizi kurang. Pola asuh kurang baik pada balita yang memiliki gizi kurang baik mempunyai resiko 2,031 kali dibandingkan pada balita dengan status gizi normal (PR;2,031; CI 95%:1,338–3,083;nilai-p 0.018). Hasil analisis regresi logistik hubungan pola asuh orang tua dengan status gizi kurang pada balita setelah dikontrol oleh variabel kovariat: usia ibu, pendidikan terakhir ibu, pekerjaan ibu, pekerjaan ayah, pendapatan keluarga, sanitasi lingkungan, jenis kelamin, dan penyakit infeksi pada balita menunjukan balita dengan pola asuh kurang baik mempunyai risiko 2,080 kali mengalami status gizi kurang dibandingkan dengan balita yang mempunyai status gizi normal (PR:2,080;CI 95%:1,359 – 3,182; nilai-p:0,001).
Malnutrition is one of the causes of death in toddlers, around 45% of under-five deaths in the world. Parenting patterns are the attitudes and behavior of parents towards their children, the plan for scheduling feeding and serving it to children is one of the parenting patterns. Poor parenting patterns are an external factor in the occurrence of malnutrition in toddlers. At Kramat Jati Regional Hospital, the percentage of malnutrition among toddlers is 35%. This cross-sectional study aims to see the relationship between parental parenting patterns and malnutrition status in toddlers. Data collection was carried out directly in April-June 2023 on all toddlers who visited the Kramat Jati Regional Hospital polyclinic with a sample size of 374 respondents. The results of statistical tests show that there is a relationship between parenting patterns and malnutrition status. Poor parenting patterns for toddlers who have poor nutrition have a risk of 2.031 times compared to toddlers with normal nutritional status (PR; 2.031; 95% CI: 1.338–3.083; p-value 0.018). The results of the logistic regression analysis of the relationship between parenting patterns and malnutrition status in toddlers after being controlled by covariate variables: mother's age, mother's last education, mother's job, father's job, family income, environmental sanitation, gender, and infectious diseases in toddlers show that those with poor parenting patterns have a 2.080 times risk of experiencing malnutrition compared to toddlers who have normal nutritional status (PR: 2.080; 95% CI: 1.359 – 3.182; p-value: 0.001).
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Malnutrition is one of the causes of death in toddlers, around 45% of under-five deaths in the world. Parenting patterns are the attitudes and behavior of parents towards their children, the plan for scheduling feeding and serving it to children is one of the parenting patterns. Poor parenting patterns are an external factor in the occurrence of malnutrition in toddlers. At Kramat Jati Regional Hospital, the percentage of malnutrition among toddlers is 35%. This cross-sectional study aims to see the relationship between parental parenting patterns and malnutrition status in toddlers. Data collection was carried out directly in April-June 2023 on all toddlers who visited the Kramat Jati Regional Hospital polyclinic with a sample size of 374 respondents. The results of statistical tests show that there is a relationship between parenting patterns and malnutrition status. Poor parenting patterns for toddlers who have poor nutrition have a risk of 2.031 times compared to toddlers with normal nutritional status (PR; 2.031; 95% CI: 1.338–3.083; p-value 0.018). The results of the logistic regression analysis of the relationship between parenting patterns and malnutrition status in toddlers after being controlled by covariate variables: mother's age, mother's last education, mother's job, father's job, family income, environmental sanitation, gender, and infectious diseases in toddlers show that those with poor parenting patterns have a 2.080 times risk of experiencing malnutrition compared to toddlers who have normal nutritional status (PR: 2.080; 95% CI: 1.359 – 3.182; p-value: 0.001).
T-6905
Depok : FKM-UI, 2024
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Winona Margareth Cindy Teresa Aipipidely; Pembimbing: Lhuri Dwianti Rahmartani; Penguji: Renti Mahkota, Sulistyo
Abstrak:
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Latar Belakang: Tuberkulosis (TB) masih menjadi masalah kesehatan global dan Indonesia menempati peringkat kedua dengan beban TB tertinggi di dunia. Balita merupakan kelompok rentan karena sistem imun yang belum matang, sehingga infeksi TB pada balita dapat memengaruhi status gizi. Status gizi balita berperan penting dalam menentukan kesehatan dan kemampuan tubuh melawan infeksi. Balita dengan TB berisiko mengalami penurunan status gizi, sementara gizi buruk dapat memperburuk perjalanan penyakit. Tujuan: Mengetahui gambaran status gizi balita penderita TB di Indonesia. Metode: Penelitian cross-sectional ini menggunakan data 1.030 balita penderita tuberkulosis dari SSGI 2024. Status gizi balita sebagai variabel dependen diukur menggunakan indikator Berat Badan menurut Tinggi Badan/Panjang Badan (BB/TB atau BB/PB). Analisis bivariat deskriptif dilakukan untuk menggambarkan perbedaan distribusi status gizi berdasarkan faktor lingkungan, perilaku, pelayanan kesehatan, dan faktor individu, dengan uji chi-square. Nilai p digunakan untuk menunjukkan signifikansi perbedaan distribusi antar kategori variabel. Hasil: Dari 1.030 balita penderita TB yang dianalisis, 17,4% memiliki status gizi kurang, 75% gizi normal, dan 6,7% gizi lebih. Proporsi gizi kurang secara signifikan lebih tinggi pada balita dengan riwayat berat badan lahir rendah (25,1%) dibandingkan balita tanpa riwayat BBLR (15,3%) (p-value = 0,022), serta pada balita yang tidak mendapatkan ASI eksklusif (21,6%) dibandingkan balita yang mendapatkan ASI eksklusif (10,7%) (p-value = 0,013). Variabel lain, yaitu jenis kelamin, usia, pendidikan orang tua, status imunisasi, pemantauan perkembangan, dan perilaku konsultasi gizi, tidak menunjukkan perbedaan signifikan terhadap status gizi balita. Secara geografis, proporsi gizi kurang tertinggi ditemukan di Papua (29,2%) dan secara signifikan lebih tinggi di wilayah pedesaan dibandingkan wilayah perkotaan (p-value = 0,040). Kesimpulan: Upaya perbaikan perlu diarahkan pada penguatan dukungan ASI, pemantauan dan intervensi khusus bagi bayi BBLR, peningkatan akses gizi dan layanan kesehatan di wilayah pedesaan.
Background: Tuberculosis (TB) remains a major global health problem, and Indonesia ranks second among countries with the highest TB burden worldwide. Children under five are a vulnerable group due to their immature immune systems, making TB infection in this age group more likely to affect nutritional status. Nutritional status plays a critical role in determining health outcomes and the body’s ability to fight infection. Children with TB are at increased risk of experiencing nutritional decline, while poor nutritional status can further worsen the progression of the disease. Objective: To describe the nutritional status of children under five with tuberculosis in Indonesia Methods: This cross-sectional study used data from 1,030 children under five with tuberculosis from SSGI 2024. Nutritional status of the children, as the dependent variable, was measured using the Weight-for-Height/Length (WH/L) indicator. Descriptive bivariate analysis was conducted to illustrate differences in the distribution of nutritional status based on environmental factors, behaviors, healthcare services, and individual factors, using the chi-square test. The p-value was used to indicate the significance of differences in distribution across variable categories. Results: Among the 1,030 children analyzed, 17.4% had undernutrition, 75% had normal nutrition, and 6.7% were overweight. The proportion of undernutrition was significantly higher among children with a history of low birth weight (25.1%) than among those without low birth weight (15.3%) (p-value = 0.022), and among children who did not receive exclusive breastfeeding (21.6%) than among those who received exclusive breastfeeding (10.7%) (p-value = 0.013). Other variables, including sex, age, parental education, immunization status, growth monitoring, and nutrition consultation behavior, did not show significant differences in nutritional status. Geographically, the highest proportion of undernutrition was observed in Papua (29.2%) and was significantly higher in rural areas than in urban areas (p-value = 0,040). Conclusion: Improvement efforts should focus on strengthening support for exclusive breastfeeding, enhancing monitoring and targeted interventions for low-birth-weight infants, and improving access to nutrition and health services in rural areas.
S-12188
Depok : FKM-UI, 2026
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Rifa'I Ali; Promotor: Ratna Djuwita; Kopromotor: Umi Fahmida, Besral; Penguji: Hadi Pratomo, Mondastri Korib Sudaryo, Rini Sekartini, Dodik Briawan, Hera Nurlita
Abstrak:
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Masalah stunting pada anak masih menjadi tantangan serius di Indonesia, termasuk di Kabupaten Pohuwato, Gorontalo. Penelitian ini bertujuan untuk menganalisis pengaruh edukasi Panduan Gizi Seimbang Berbasis Pangan Lokal terhadap perubahan praktik pemberian makan, asupan gizi, status besi, dan status gizi anak baduta. Desain penelitian yang digunakan adalah mixed methods exploratory sequential design, diawali dengan riset formatif kualitatif untuk pengembangan media edukasi, kemudian dilanjutkan dengan kuasi eksperimen dengan pendekatan non-randomized pretest-posttest control group design. Intervensi edukasi dilakukan selama 12 bulan dengan pendekatan komunikasi perubahan perilaku sosial (SBCC) menggunakan modul PGS-PL yang disesuaikan dengan kondisi lokal melalui edukasi intensif, peer educator dan juga demo masak.
Hasil penelitian menunjukkan bahwa edukasi PGS-PL berpengaruh signifikan terhadap peningkatan skor keragaman makanan (DDS) (OR = 1,89; p = 0,048) dan Konsumsi sumber pangan hewani (OR=1,55, p = 0,037), serta peningkatan asupan energi, protein, karbohidrat, lemak, vitamin A, asam folat, zat besi, dan seng (p < 0,05). Namun, tidak ditemukan pengaruh signifikan terhadap kadar serum ferritin dan serum transferrin receptor. Status gizi anak mengalami peningkatan signifikan pada indeks tinggi badan menurut umur (TB/U) sebesar 0,60 z-score (p = 0,007), tetapi tidak signifikan pada indeks berat badan menurut umur (BB/U), dan terdapat penurunan signifikan pada indeks berat badan menurut tinggi badan (BB/TB) (p = 0,034).
Penelitian ini menegaskan bahwa edukasi gizi berbasis pgs-pl dengan pendekatan kombinasi edukasi intensif, peer educator dan demo masak dapat menjadi strategi efektif dalam meningkatkan praktik pemberian makan dan status gizi anak balita di wilayah dengan potensi pangan lokal.
Stunting in children remains a serious public health challenge in Indonesia, including in Pohuwato District, Gorontalo. This study aimed to analyze the effect of nutrition education based on the Local Food-Based Balanced Nutrition Guidelines (PGS-PL) on changes in feeding practices, nutrient intake, besi status, and nutritional status of children aged 6–14 months. The research employed a mixed methods exploratory sequential design, starting with formative qualitative research for the development of educational media, followed by a quasi-experimental study using a non-randomized pretest-posttest control group design. The education intervention was conducted over 12 months using a social and behavior change communication (SBCC) approach, incorporating the PGS-PL module adapted to local conditions through intensive education, peer educators, and cooking demonstrations.
The results showed that PGS-PL education had a significant effect on increasing Dietary Diversity Scores (DDS) (OR = 1.89; p = 0.048) and Egg and/or flesh food (EFF) (OR=1,55, p=0,037), as well as improving the intake of energy, protein, carbohydrates, fat, vitamin A, folic acid, besi, and seng (p < 0.05). However, no significant effect was found on serum ferritin and serum transferrin receptor levels. Children's nutritional status showed a significant improvement in the height-for-age index (HAZ) by 0.60 z-score (p = 0.007), but no significant change was observed in the weight-for-age index (WAZ), and there was a significant decrease in the weight-for-height index (WHZ) (p = 0.034).
This study confirms that nutrition education based on PGS-PL using a combination of intensive education, peer educators, and cooking demonstrations can be an effective strategy for improving feeding practices and the nutritional status of toddlers in areas with local food potential.
D-584
Depok : FKM-UI, 2025
S3 - Disertasi Pusat Informasi Kesehatan Masyarakat
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Dian Kurnia Rabbani; Pembimbing: Ratna Djuwita; Penguji: Mondastri Korin Sudaryo, Eulis Wulantari, Dewi Dwinurwati Wahyuni
T-4760
Depok : FKM-UI, 2016
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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Firda Vanesa Kusumadewi; Pembimbing: Mondastri Korib Sudaryo; Penguji: Yovsyah, Yulius Warta Kusuma
Abstrak:
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Erupsi gunung berapi merupakan salah satu bencana yang sering terjadi di Indonesia, Gunung Semeru adalah salah satu gunung yang cukup aktif erupsi. Erupsi menyebabkan perubahan pada lingkungan, iklim mikro, dan kualitas udara. Penelitian ini bertujuan untuk mengetahui hubungan antara variasi iklim terhadap kejadian ISPA di Kabupaten Malang dan Lumajang yang terdampak erupsi Gunung Semeru pada 4 Desember 2022. Data yang digunakan adalah data observasi iklim dan kualitas udara milik BMKG dan data ISPA milik dinas kesehatan selama Agustus 2022 - Maret 2023. Penelitian ini menggunakan studi ekologi dengan uji korelasi sebagai metode analisisnya. Proporsi ISPA tertinggi berada di Kecamatan Pronojiwo (5,1%), sedangkan untuk jumlah kasus ISPA tertinggi berada di Kecamatan Dampit (3.005). Seluruh variabel dalam penelitian tidak menunjukkan adanya hubungan yang signifikan secara statistik dengan kejadian ISPA (p-value > 0,005). Namun, koefisien korelasi menunjukkan adanya korelasi yang lemah hingga sedang: suhu udara rata-rata (r = 0,155), suhu minimum (r = -0,038), DTR (r = -0,046), suhu maksimum (r = -0,315), curah hujan (r = -0,024), kelembaban relatif (r = -0,188), lama penyinaran matahari (r = 0,186), dan konsentrasi PM2,5 (r = 0,192). Potensi korelasi antara variabel iklim dan kualitas udara dengan kejadian ISPA dapat menjadi pertimbangan untuk penelitian selanjutnya.
Volcanic eruptions are a frequent natural disaster in Indonesia, with Mount Semeru being one of the most active volcanoes. Eruptions induce changes in the environment, microclimate, and air quality. This study aimed to investigate the relationship between climate variations and the incidence of Acute Respiratory Infections (ARI) in Malang and Lumajang Regencies, areas affected by the Mount Semeru eruption on December 4, 2022. Observational data on climate and air quality from the BMKG (Indonesian Agency for Meteorology, Climatology, and Geophysics) and ARI incidence data from local health departments, spanning August 2022 to March 2023, were utilized. This ecological study employed correlation analysis as its methodological approach. The highest proportion of ARI was observed in Pronojiwo District (5.1%), while the highest number of ARI cases was recorded in Dampit District (3,005 cases). All variables in the study did not demonstrate a statistically significant relationship with ARI incidence (p-value > 0.05). However, the correlation coefficients indicated weak to moderate correlations: mean air temperature (r = 0.155), minimum temperature (r = -0.038), Diurnal Temperature Range (DTR) (r = -0.046), maximum temperature (r = -0.315), rainfall (r = -0.024), relative humidity (r = -0.188), duration of sunshine (r = 0.186), and PM2.5 concentration (r = 0.192). The potential correlation between climate and air quality variables and ARI incidence warrants consideration for future research.
Volcanic eruptions are a frequent natural disaster in Indonesia, with Mount Semeru being one of the most active volcanoes. Eruptions induce changes in the environment, microclimate, and air quality. This study aimed to investigate the relationship between climate variations and the incidence of Acute Respiratory Infections (ARI) in Malang and Lumajang Regencies, areas affected by the Mount Semeru eruption on December 4, 2022. Observational data on climate and air quality from the BMKG (Indonesian Agency for Meteorology, Climatology, and Geophysics) and ARI incidence data from local health departments, spanning August 2022 to March 2023, were utilized. This ecological study employed correlation analysis as its methodological approach. The highest proportion of ARI was observed in Pronojiwo District (5.1%), while the highest number of ARI cases was recorded in Dampit District (3,005 cases). All variables in the study did not demonstrate a statistically significant relationship with ARI incidence (p-value > 0.05). However, the correlation coefficients indicated weak to moderate correlations: mean air temperature (r = 0.155), minimum temperature (r = -0.038), Diurnal Temperature Range (DTR) (r = -0.046), maximum temperature (r = -0.315), rainfall (r = -0.024), relative humidity (r = -0.188), duration of sunshine (r = 0.186), and PM2.5 concentration (r = 0.192). The potential correlation between climate and air quality variables and ARI incidence warrants consideration for future research.
S-12021
Depok : FKM UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Syamsu Alam; Pembimbing: Helda; Penguji: Ratna Djuwita, Kusharisupeni, Julitasari, Imam Subekti
T-3216
Depok : FKM-UI, 2010
S2 - Tesis Pusat Informasi Kesehatan Masyarakat
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