Abstrak: Abstrak

Pneumonia merupakan penyebab kematian terbesar pada anak di seluruh dunia. Setiap tahunnya diestimasikan sekitar 18% kematian anak di bawah usia 5 tahun di seluruh dunia disebabkan oleh pneumonia. Faktor risiko pasti yang berkontribusi diantaranya yaitu balita yang tidak mendapatkan ASI eksklusif.

Tujuan studi ini untuk mengetahui hubungan pemberian ASI eksklusif terhadap kejadian pneumonia balita usia 12 -23 bulan setelah dikontrol terhadap confounder. Studi kasus kontrol ini dilakukan di tiga wilayah puskesmas Kota Cimahi berdasarkan angka insidens kasus pneumonia balita yang tertinggi di tahun 2012. Kasus adalah balita usia 12 - 23 bulan yang berkunjung ke sarana puskesmas penelitian periode Januari - Desember 2012 dan didiagnosa sebagai kasus pneumonia. Kontrol merupakan tetangga dari kasus, dengan perbandingan jumlah kasus dan kontrol yaitu 1:1. Besar sampel minimal sebanyak 133 untuk masing - masing kelompok. Analisis multivariat dengan menggunakan regresi logistik. Besar asosiasi balita yang tidak mendapat ASI eksklusif memiliki OR untuk terjadinya pneumonia sebesar 3,58 kali (95% CI: 2,08 - 6,19) dibandingkan yang mendapat ASI eksklusif setelah dikontrol terhadap confounder.

Penelitian ini memperkuat penelitian terdahulu yang membuktikan kekuatan hubungan pemberian ASI eksklusif terhadap kejadian pneumonia pada balita. Berfokus pada daerah dengan angka insiden kasus penumonia yang tinggi, pihak dinas kesehatan dan puskesmas dapat lebih meningkatkan upaya promosi dan fasilitasi ASI eksklusif, menciptakan kawasan tanpa asap rokok di tingkat rumah tangga, pengurangan adanya paparan asap pembakaran di dalam rumah, peningkatan pengetahuan ibu berkaitan faktor risiko pneumonia.

Pneumonia is the biggest cause of death in children worldwide. Each year approximately 18% of estimated deaths of children under five worldwide are caused by pneumonia. Definite risk factors that contribute to them are children under five who are not exclusively breastfed.

The purpose of this study to determine the relationship of exclusive breastfeeding on the incidence of pneumonia children under five age 12 -23 months after controlling for confounders.Case-control study was conducted in three areas of public health centers Cimahi City based incidence rates were highest children under five cases of pneumonia in 2012. Cases were children aged 12-23 months who visited the research public health centers means the period of January to December 2012 and was diagnosed as a case of pneumonia. Control is a neighbor of the case, the ratio of the number of cases and controls is 1:1. Minimum sample size for each of as many as 133 - each group. Multivariate analysis using logistic regression. Major association children under five who are not exclusively breastfed for the occurrence of pneumonia had an OR of 3.58 (95% CI: 2.08 to 6.19) than those who are breastfed exclusively after controlling for confounders.

This study reinforces previous research that proves the strength of association of exclusive breastfeeding on the incidence of pneumonia in infants. Focusing on areas with a number of high incidence of cases of pneumonia, the health department and public health center could further enhance the promotion and facilitation of exclusive breastfeeding, creating a smoke-free area at the household level, reduction in exposure to combustion fumes in the house, increasing maternal knowledge of risk factors associated pneumonia.

Abstrak: Latar Belakang: Pneumonia merupakan penyakit menular pada saluran pernapasan termasuk tiga besar penyakit penyebab mortalitas balita Indonesia pada 2019—2022. Kota Tangerang, bagian Provinsi Banten yang termasuk peringkat tiga nasional penemuan pneumonia balita tahun 2022, melaporkan 5247 kasus pneumonia balita di tahun yang sama berdasarkan Profil Dinas Kesehatan Kota Tangerang. Tujuan: Mengetahui hubungan cakupan rumah sehat, status gizi kurang, BBLR, pemberian ASI eksklusif, dan kepadatan penduduk terhadap pneumonia balita di Kota Tangerang tahun 2022. Metode: Studi ekologi dengan unit analisis 13 kecamatan. Data bulanan dianalisis secara univariat, bivariat (Korelasi Pearson dan Korelasi Spearman), dan multivariat (Regresi Linear Berganda). Hasil: Cakupan rumah sehat berhubungan signifikan dengan kejadian pneumonia balita di 2 kecamatan, yaitu Karang Tengah (p-value = 0,036) dengan korelasi kuat negatif (r = -0,607) dan Batuceper (p-value = 0,013) dengan korelasi kuat positif (ρ = 0,689). Pemberian ASI eksklusif berhubungan signifikan dengan kejadian pneumonia balita di Kecamatan Tangerang (p-value = 0,028) dengan korelasi kuat negatif (r = -0,629). Kepadatan penduduk berhubungan signifikan dengan kejadian pneumonia balita 2 kecamatan, yaitu Karawaci (p-value = 0,045) dengan korelasi kuat positif (r = 0,586) dan Periuk (p-value = 0,015) dengan korelasi kuat positif (ρ = 0,681). Sementara itu, variabel yang tidak berhubungan signifikan (p-value >0,05) dengan kejadian pneumonia balita di seluruh kecamatan adalah status gizi kurang dan BBLR. Pengaruh terbesar kejadian pneumonia balita adalah cakupan rumah sehat di 2 kecamatan (Cipondoh dan Tangerang), status gizi kurang di 7 kecamatan (Ciledug, Karang Tengah, Pinang, Jatiuwung, Cibodas, Periuk, dan Batuceper), BBLR di 3 kecamatan (Larangan, Karawaci, dan Benda), dan kepadatan penduduk di Kecamatan Neglasari. Kesimpulan: Beberapa variabel berhubungan signifikan dan berkorelasi kuat dengan kejadian pneumonia balita, yakni cakupan rumah sehat di Karang Tengah (r = -0,607) dan Batuceper (ρ = 0,689), pemberian ASI eksklusif di Kecamatan Tangerang (r = -0,629), dan kepadatan penduduk di Karawaci (r = 0,586) dan Periuk (ρ = 0,681).

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Background: Pneumonia is an infectious respiratory disease and ranks among the top three causes of under-five mortality in Indonesia from 2019—2022. Tangerang City (part of Banten Province that ranked third nationally in under-five pneumonia cases in 2022) reported 5247 pneumonia cases on Profil Dinas Kesehatan Kota Tangerang’s publication. Objective: To examine the relationship between healthy house coverage, wasting, low birth weight (LBW), exclusive breastfeeding, and population density with under-five pneumonia in Tangerang City in 2022. Methods: An ecological study was conducted, with the unit of analysis consisting of 13 sub-districts. Monthly data were analyzed through univariate, bivariate (Pearson and Spearman Correlation), and  multivariate analyses (Multiple Linear Regression). Results: Healthy house coverage was significantly associated with under-five pneumonia in 2 sub-districts, namely Karang Tengah (p-value = 0,036) with strong and negative correlation (r = -0,607) and Batuceper (p-value = 0,013) with strong and positive correlation (ρ = 0,689). Exclusive breastfeeding was significantly associated with under-five pneumonia in Tangerang sub-district (p-value = 0,028) with strong and negative correlation (r = -0,629). Population density was significantly associated with under-five pneumonia in 2 sub-districts, namely Karawaci (p-value = 0,045) with strong and positive correlation (r = 0,586) and Periuk (p-value = 0,015) with strong and positive correlation (ρ = 0,681). Meanwhile, variables that were not significantly associated were wasting and LBW. The most significant influences on under-five pneumonia were healthy house coverage in 2 sub-districts (Cipondoh and Tangerang), wasting in 7 sub-districts (Ciledug, Karang Tengah, Pinang, Jatiuwung, Cibodas, Periuk, and Batuceper), LBW in 3 sub-districts (Larangan, Karawaci, and Benda), and population density in Neglasari sub-district. Conclusion: Several variables were significantly related and strongly correlated with under-five pneumonia, namely healthy house coverage in Karang Tengah (r = -0,607) and Batuceper (ρ = 0,689), exclusive breastfeeding in Tangerang sub-district (r = -0,629), and population density in Karawaci (r = 0,586) and Periuk (ρ = 0,681).

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