Amerta Nutrition

Back Matter Vol. 8 No. 1SP, 2024

Amerta Nutrition — 2024-08-30

Factors of Child Growth Failure Based on the Composite Index of Anthropometric Failure in West Sulawesi Province

Hasna Izdihar Latifah — 2024-08-30

Background: The composite index of anthropometric failure (CIAF) provides a comprehensive measure of growth failure through various child anthropometric indicators. In regions with a high prevalence of stunting, several factors may contribute to the occurrence of growth failure in children under five years.

Objectives: This study aims to analyze the factors influencing the incidence of child growth failure based on the CIAF in a province with high stunting prevalence in Indonesia.

Methods: The cross-sectional study used the 2022 Indonesian Nutrition Status Survey (SSGI) data. The sample comprised children aged 0-23 months from West Sulawesi Province, totaling 1,573 children. The number of samples analyzed was 1,327 children, excluding incomplete data and outliers that were values outside a certain range and treated as missing values based on the World Health Organization (WHO). Multivariate analysis was conducted using logistic regression with a complex sample facility.

Results: This study found that 24.9% of children experienced growth failure based on the CIAF. Factors associated with the incidence of growth failure based on the CIAF were older age between 12-23 months (OR=4.5; CI=2.36-8.43; p=0.000), birth weight less than 2,500 g (OR=6.85; CI=3.85-12.21; p=0.000), boys (OR=1.56; CI=1.13-2.15; p=0.000), incomplete immunization status (OR=1.8; CI=1.31-2.77; p=0.001), and poor economic status in quintile 1 (OR=2.1; CI=1.08-3.99; p=0.028).

Conclusions: The risk factors for child growth failure based on the CIAF included older age, male sex, low birth weight, incomplete immunization status, and low economic status.

Tiered Training Model to Improve the Skills of Posyandu Cadres in Measuring Child Anthropometry in Demak Regency, Indonesia

Suyatno Suyatno — 2024-08-30

Background: Posyandu cadres still lack the skills to measure anthropometry. Not all cadres received regular training.

Objectives: This study aims to develop a training model to improve the skills of Posyandu cadres in conducting anthropometric measurements.

Methods: This study used a research and development approach with two main stages. The first stage was the development of the training model. The second stage was field testing of the new training model, using a pretest-posttest control group design. The training model in the form of Training of trainers (ToT) was tested to 49 cadres in the treatment and control groups with expert resource persons, followed by grassroots training with 142 cadres in the treatment group and 146 cadres in the control group with resource persons from the ToT participants. The intervention lasted three months. The effect of applying the training model on changes in the ability of cadres in anthropometric measurements was analyzed using the General Linear Model with a significant p-value <0.05.

Results: The developed anthropometry training model is tiered training, including ToT followed by grassroots training. Through the implementation of this training model, the number of trained cadre participants increased threefold. The results of the tiered anthropometry training model trial proved to improve knowledge, attitude, practice, self-efficacy, as well as the precision and accuracy of measuring the length, height, and weight of children by Posyandu cadres (p<0.05).

Conclusions: The implementation of a tiered anthropometry training model can increase cadre participants and improve the capacity of cadres in measuring child anthropometry.

Effect of Booklet Education and Cadre Assistance on Iron Tablets Consumption among Anemic Pregnant Women in East Jakarta

Adhila Fayasari — 2024-08-30

Background: Anemia during pregnancy significantly increases maternal risk and poor pregnancy outcomes by 1.71-fold. Enhancing pregnant women's knowledge and adherence to health guidelines requires a comprehensive approach.

Objectives: This study analyzed the effects of booklet education and cadre assistance on adherence to iron tablet consumption among anemic pregnant women in East Jakarta.

Methods: This quasi-experimental study was conducted in 2019 on anemic pregnant women in Makasar Public Health Center, Jakarta. This study comprised three groups: iron-folic acid supplementation only (IF), iron-folic acid supplementation with booklet education (IFB), and iron-folic acid supplementation with booklet education and cadre assistance (IFBA), serving as control, intervention I, and intervention II, respectively. The interventions lasted for three months. Adherence to iron supplementation and knowledge, attitude, and behavior (KAB) regarding anemia were measured. The data were analyzed using ANOVA/Kruskall-Wallis test, Wilcoxon test, and Mc-Nemar test with a significance level of 0.05.

Results: There was no difference in the increase of knowledge and behavior regarding anemia among the three groups (p < 0.05) although the behavior score in the IFBA group was significantly higher than in the other two groups. In addition, there was no difference in the percentage of adherence to iron tablet consumption before and after the intervention in the IF, IFB, and IFBA groups (p > 0.05). However, the IFBA group showed an increase of about 41% in adherence.

Conclusions: There was no difference in the increase of knowledge and attitude regarding anemia among the three groups, except for behavior. However, the IFBA group showed a significant increase in knowledge, attitude, and behavior after the intervention.

Determinants for Low Birth Weight in Mothers Giving Birth during the Covid-19 Pandemic

Lia Kurniasari — 2024-08-30

Background: Low birth weight (LBW) remains a significant global health issue, leading to higher rates of infant and child morbidity and mortality. In 2022, Indonesia had a 12.58% rate, while in Kutai Kartanegara Regency, East Kalimantan, the rate was higher at 16.30%. The Covid-19 pandemic, which severely impacted East Kalimantan also influenced LBW rates.

Objectives: Analyzed the determinants of LBW incidence during the Covid-19 pandemic in Kutai Kartanegara.

Methods: This population of 1265 mothers delivered in four public health centers with the highest cases of BBLR. This study used a case control design for 240 mothers, including 120 mothers who gave birth to babies with low birth weight and 120 mothers who gave birth to babies with LBW. Data were obtained from e-cohort data according to specific inclusion and exclusion criteria. Data collection occurred from August until October 2022 through interviews with structured questionnaires and maternal child handbooks. Data analysis was performed with logistic regression.

Results: Determinant factors LBW were maternal nutritional risk (upper arm circumference <23.5 cm) (OR=2.800, 95% CI=1.237-6.340), history of anemia (OR=3.156, 95% CI=1.716-5.804), history of Covid-19 (OR=4.357, 95% CI=2.355-8.063), living with a smoker (OR=2.505, 95% CI=1.716-2.804), and not having health insurance (OR=2.744, 95% CI=1.435-5.247).

Conclusions: Internal factors such as age, under arm circumference, anemia, Covid-19, birth spacing, and parity and external factors (such as living with smokers, not having insurance) were interconnected in contributing to the risk of LBW, the pandemic further influenced these determinant factors.

The Risk Factors for Anemia in Women at Third Trimester of Pregnancy in the Primary Health Center of Tanjung Sekayam: A Case-Control Study

Iskandar Arfan — 2024-08-30

Background: The presence of anemia in pregnant women significantly affects the health of both mothers and their fetuses. Around 37% of pregnant women worldwide experience anemia. In the Community Health Center of Tanjung Sekayam, the prevalence of anemia in women at the third trimester of their pregnancy was notably high, at 50.4%.

Objectives: This study aims to identify the risk factors for anemia in women at third trimester of pregnancy in the working area of the Community Health Center of Tanjung Sekayam Subdistrict, Sanggau Regency.

Methods: This study was an observational research with a case-control design. The study population consisted of 153 women at third trimester of pregnancy, receiving antenatal care in the Community Health Center of Tanjung Sekayam. The samples included 62 respondents, selected through a simple random sampling, comprising of 31 cases and 31 controls. Data were collected using questionnaires and analyzed with the Chi-Square test to assess the factors associated with the occurrence of anemia.

Results: There was a relation among maternal age (p=0.000; OR=22.9), interpregnancy interval (p=0.024; OR=6.9), parity (p=0.011; OR=2.2), nutritional status (chronic energy deficiency) (p=0.000; OR=11.3), compliance (p=0.021; OR=3.9), and knowledge (p=0.001; OR=8.2) and the prevalence of anemia in the third trimester. However, the family support did not show any significant relation.

Conclusions: Maternal age, pregnancy interval, parity, nutritional status, compliance with iron tablet intake, and knowledge are related to the prevalence of anemia in third trimester of pregnancy. Family support did not show any significant relation with the incidence of anemia, possibly due to the limitations in measuring the family support itself and other factors, such as discomfort in consuming iron tablets and forgetfulness. More structured interventions and intensive education on the importance of iron and nutrition during the pregnancy are needed to reduce the risk of anemia.

The Maternal, Dietary Diversity, and Immunization Completeness Factors as the Determinants of Two-Year-Old Toddler Stunting in Kalinyamatan District Jepara Regency

Akmaliya Hayuningsih — 2024-08-30

Background: Stunting affects the quality of a country's human resources so it is important to prevent and overcome it. Stunting cases in Kalinyamatan Jepara District have increased from 12.4% in 2021 to 18.9% in 2022 and to 19.05% in 2023.

Objectives: This research analyzed the stunting risk factors of two-year-old toddlers in Kalinyamatan district, Jepara Regency.

Methods: This case-control study involved 77 stunting children and 77 normal children. The researchers selected the subjects at the integrated health care service with the highest number of visitors of two-year-old toddlers from 12 villages in Kalinyamatan district, Jepara regency, based on the inclusion and exclusion criteria. The research lasted from March to April 2024. The researchers collected the primary data with a questionnaire and the dietary diversity with a food recall questionnaire for 2x24 hours. Secondary data was collected from the mother-child health book (KIA).

Results: The results showed no differences in terms of ages and sex types from both stunting and normal children. The multivariate analysis with logistic regression test found a correlation between the anemia history during pregnancy (OR:2.75; 95% CI:1.31 – 5.78; p:0.007), career woman status (OR: 2.81; 95% CI: 1.24-6.37; p:0.014), low birth weight (OR: 3.98; 95% CI: 1.54-10.27; p:0.004), low dietary diversity (OR: 3.71; 95% CI: 1.63-8.44; p:0.002), and incomplete immunization (OR: 4.02; 95% CI: 1.66-9.74; p:0.002) with the stunting prevalence.

Conclusions: Maternal (the anemia history during the pregnancy, career woman status, and low birth weight), lack of dietary diversity, and incomplete immunization become the simultaneous determinants of stunting risk factors for two-year-old toddlers in Kalinyamatan district, Jepara Regency.

Association between Fat Intake, Dietary Fiber Intake, Physical Activity with Triglyceride Levels among Type 2 Diabetes Mellitus Patients at Grogol Health Center, Sukoharjo

Anisa Nur Safitri — 2024-08-30

Background: Hyperlipidemia is closely associated with dietary intake and physical activity. Excessive dietary fat intake, inadequate dietary fiber, and low physical activity will increase the risk of obesity and lipid profile disorder among type 2 diabetics.

Objectives: This study aimed to identify the association between fat intake, dietary fiber intake, and physical activity with triglyceride levels among type 2 diabetics.

Methods: A cross-sectional study was conducted using Sequential Random Sampling on 31 patients with type 2 diabetes with dyslipidemia from Grogol Community Health Center, Sukoharjo, in March 2023. The 3x24-hour food recall nonconsecutive days was used to collect data on fat and fiber intake, the International Physical Activity Questionnaire-Short Form (IPAQ-SF) was employed to obtain physical activity data, and the patient's medical record for the last month was utilized to obtain fasting blood sugar and triglyceride levels. The statistical test was carried out using the Spearman Rank correlation test.

Results: Around 54.8% of subjects had excessive fat intake (60.90 g/day); 96.8% of subjects had severe deficit fiber intake (9.74 g/day); 51.6% of subjects had low physical activity (894.74 METs/minute/week). A statistically significant association exists between fat intake and level of triglyceride (p=0.005; r=0.493), but there was no significant association between dietary fiber intake and triglyceride levels (p=0.897; r=0.024), and there was no significant association between physical activity and level of triglyceride (p=0.394; r=-0.159).

Conclusions: There is a significant association between fat intake and the level of triglyceride. As such, it is necessary to decrease intakes of saturated fat and trans fatty acids; replacing them with unsaturated fatty acids could be beneficial in lowering triglyceride levels.

The Stunting Determinants in Toddlers from Landak Regency, West Kalimantan: A Cross-Sectional Study

Elly Trisnawati — 2024-08-30

Background: Stunting is a nutrition problem that can slow down the growth. With prevalence at 32.5%, Landak Regency in West Kalimantan has been designated as a stunting hotspot. The lack of a maximum penalty for the stunting case in Landak Regency is not based on factors causing the stunting itself, because there is no identifiable factor causing the stunting in certain area due to narrow roads and sharp curves.

Objectives: The objective of this study was to identify causes and distribution of the stunting case in Landak Regency.

Methods: A total of 330 households in Meranti, Sebangki, and Senakin were included in this cross-sectional study because they were at a risk of the stunting. Toddlers, mothers, health care, and environmental factors were among the found variables. The researchers employed a basic random sampling strategy for the sampling and used the secondary health center data to find out whether or not toddlers were stunted. Researchers in this study collected data on the independent variables by observing and interviewing participants. Using the chi-square test, the data was analyzed.

Results: The results showed that determinants of the stunting in Landak Regency were the history of early breastfeeding initiation (p-value=0.032), exclusive breastfeeding (p-value=0.042), frequency of exclusive breastfeeding (p-value=0.040), the continued breastfeeding (p-value=0.024), complementary feeding (p-value=0.042), immunization history (p-value=0.007), infectious disease history (p-value=0.000), maternal height (p-value=0.046), delivery assistance (p-value=0.000), access to health services (p-value=0.004), the role of health workers (p-value=0.002), and family latrine ownership (p-value=0.000).

Conclusions: Several factors were found to be associated with incidence of the stunting among toddlers in Landak Regency.

The Relation of Infectious Diseases, Water Access, Hygiene Practice, and Sanitation with the Stunting: A Case-Control Study in Sambas Regency

Indah Budiastutik — 2024-08-30

Background: The main nutritional problem concerned by the Indonesian government is the stunting. This condition is affected by various aspects, mainly caused by infectious diseases, clean and unharmonious living behavior, the availability of drinking water, and environmental sanitation.

Objectives: The purpose of this study is to determine the relation of infectious diseases, water access, hygiene practices, and sanitation towards the stunting incidence factors in Sambas Regency.

Methods: This research used Ex Post Facto with a case-control design. The study population was residents of Sambas Regency with a total of 535,725 people, a total sample of 241 children aged 0-59 months comprising of 89 respondents as cases and the rest 159 respondents as controls, using inclusion and exclusion criteria both from the control group and from the case group. Data analysis used the chi-square test.

Results: The results showed a relation of infectious diseases (p-value=0.000), drinking water sources (p-value=0.000), clean and healthy living behavior (p-value=0.000), and environmental conditions (p-value=0.000) with the stunting incidences.

Conclusions: The study concludes that there is a significant relation of infectious disease variables, the drinking water sources, hygiene practices, and environmental conditions with the stunting. It requires control and completion of the stunting cases through environmental sanitation improvement, namely the provision of access to clean water, healthy and clean living behaviors, and good cooperation between the government and the community, in educating people through counseling and socialization of the stunting prevention and management.

The Effects of Warm Compress and Coconut Water Administration on the Primary Dysmenorrhea in Teenage Girls of the Al Ikhlash Putri Modern Boarding School, Kuningan Regency

Oya Siti Rukoyah — 2024-08-30

Background: The menstruating teenage girls show a high primary dysmenorrhea incidence which is very discomforting, in form of abdominal cramps or pain spread to the back, headache, nausea and vomiting, as well as diarrhea, so they have to take a rest in a certain period of time and stop carrying out their activities and works.

Objectives: This research aims to identify the effects of warm compress and coconut water administration towards the primary dysmenorrhea in teenage girls of Al-Ikhlash Putri Modern Boarding School, Kuningan Regency.

Methods: This research was the pre-experimental research with one group pretest-posttest design. Total 83 teenage girls from classes 1 to 3 in Senior High School at the age of 14-18 years were selected as population. Instrument used was the Standard Operating Procedure (SOP) and the checklist sheet (observation and interview). Data processing was carried out using the SPSS program. The purposive sampling was applied in taking the sample, so 26 teenagers, relevant to the inclusion and exclusion criteria, were obtained. Data collected were primary data. Univariate and bivariate analyses were utilized with the paired t-test in testing effects and chi-square test in testing correlation of every variable.

Results: There was a difference test with p-value 0.000, while the significant effect was found in menstrual pain before and after warm compress and coconut water administration in teenage girls.

Conclusions: Warm compress and regularly consuming coconut water can minimize the menstrual pain in teenage girls.

Association between Six Key Messages Behaviour and Incidence of Stunting in Under-Two-Year-Old Children in Central Java Province

Martha Irene Kartasurya — 2024-08-30

Background: The stunting prevalence in Central Java Province remains high. Six key messages, i.e. iron tablet supplementation, healthy latrines, exclusive breastfeeding, Integrated Health Care Post (Posyandu) visit, hand washing, and Antenatal Care visit are the efforts to reduce the prevalence of stunting.

Objectives: This study aimed to analyse the relationship between the behaviour of the six key messages and the stunting prevalence in four districts of Central Java Province.

Methods: This cross-sectional study was conducted in Brebes Regency, Tegal Regency, Banyumas Regency, and Semarang City with 424 mothers who have under two-year-old children randomly selected as sample. Data were collected by interview using a structured questionnaire with the results grouped into attitude and practices categories. The body’s weight and length were measured by a digital scale and infantometer. Data were analysed using the chi-square test.

Results: The findings indicated that 21.5% of children under two had stunting. Besides, behaviour regarding six key messages were mostly good. There was no association between mothers' iron tablet consumption behaviour and the nutritional status of under-two children. There was an association between maternal attitudes about exclusive breastfeeding and knowledge about hand washing with length for age index (p=0.004). There was also an association between antenatal care and Posyandu visits practice with weight for age index (p=0.004 and 0.018). There was a relationship between attitude regarding the use of latrines and the weight for length index (p=0.001).

Conclusions: Only the key messages of exclusive breastfeeding attitude, antenatal care visit practice, Posyandu visit practice, and hand washing attitude were associated with the nutritional status of under-two children.

Analysis of Factors of the Use of Food Additives in the Elementary School

Rezania Asyfiradayati — 2024-08-30

Background: Merchants sell a variety of food for schoolchildren. In an attempt to make the food they offer more enticing and long-lasting, dealers frequently add food additives, sometimes prohibited food additives which is against the law. Predisposing conditions affect the addition of additives to snacks.

Objectives: The study aimed to determine the factors that influence the addition of food ingredients not allowed by snack vendors in snacks sold around elementary schools

Methods: This study used a survey approach with a cross-sectional design. The 99 traders that made up the study's sample were chosen randomly. The use of food additives was the dependent variable and the independent variables were gender, education, knowledge, age, and length of selling. Test kits were used in laboratories to analyze snack samples sold by traders in order to identify food additives (formalin, borax, Rhodamine B, and Yellow Methanol). Multivariate, bivariate, and univariate analysis were used in the research process. The multiple logistic regression with 95% Confident Interval and chi-square statistical tests were employed in this investigation.

Results: The number of snacks checked by test-kit with the result was 21.2% of snacks containing prohibited food additives with a good level of knowledge on the sword as much as 52.5%. The results of the chi-square test statistics for knowledge (p=0.001), age (p=0.010), length of sale (p=0.022) was related to the use of prohibited food additives. The results of multivariate analysis showed that knowledge was the most influential factor in the use of food additives.

Conclusions: Traders' knowledge about the use of food additives was the main factor, besides that relate factors were age and length of selling.

Stunting Prevention through Exclusive Breastfeeding in Indonesia: A Meta-Analysis Approach

Demsa Simbolon — 2024-08-30

Background: The direct cause of stunting in toddlers is nutritional intake, one of which is because babies do not receive exclusive breastfeeding for up to 6 months.

Objectives: The purpose of this study is to measure the effect of exclusive breastfeeding on stunting prevention through a meta-analysis approach.

Methods: This study uses a meta-analysis approach by searching for research articles from various databases such as Google Scholar, PubMed, and Science Direct. The keywords used are by the Medical Subject Heading (MeSH), namely "exclusive breastfeeding", "stunting", "infant", "exclusive breastfeeding", "linear growth disorder", and "stunted toddlers". The criteria for the article are publications from 2013 to 2021, can be downloaded in full text, using a cross-sectional and case-control study design, and effect size data is available in the form of Odds Ratio (OR). The process of submitting articles is presented in a PRISMA diagram. Data analysis using the Review Manager 5.4.1 application with a random effect analysis model. Presentation results in the form of forest plots and funnel plots.

Discussions: 26 research articles are worthy of analysis, consisting of 9 from international journals and 17 from national journals. The Heterogeneity test results showed a p-value of 0.00001 and an I² value of 85%. The results of the analysis with a random effect model were obtained from the forest plot which showed a pooled Odds Ratio of 2.90 (95% CI: 2.07-4.08), meaning that babies who did not receive exclusive breastfeeding had a 2.9 times higher risk of stunting compared to babies who received exclusive breastfeeding. These findings show a significant influence of non-exclusive breastfeeding on the incidence of stunting (p-value 0.0001 < 0.05).

Conclusions: Exclusive breastfeeding can effectively prevent stunting.

Front Matter Vol. 8 No. 1SP, 2024

Amerta Nutrition — 2024-08-30