Tesis

Efektivitas Pemberian Makanan Tambahan Protein Hewani Terhadap Pertumbuhan Linear: Studi Komunitas = Effectiveness of Animal Protein Supplementary Feeding on Linear Growth in Under-Five Children: a Community Study.

Latar Belakang : Tingginya prevalensi stunting di Indonesia dipengaruhi oleh kebutuhan gizi yang meningkat disertai kuantitas dan kualitas MPASI yang terbatas. Pemberian protein hewani yang mengandung asam amino esensial lengkap dan berjumlah cukup diharapkan mendukung pertumbuhan linear adekuat. Penelitian mengenai efektivitas PMT protein hewani terhadap pertumbuhan linear pada setting komunitas belum pernah dilakukan di Indonesia. Metode : Penelitian ini merupakan non-randomised controlled trial di Kelurahan Warakas Jakarta Utara pada bulan Agustus-November 2022 dengan subjek antara berusia 6-59 bulan mendapat intervensi PMT protein hewani (telur dan/atau susu) selama 4 bulan serta edukasi, dibandingkan dengan mendapatkan edukasi saja. Analisis dilakukan dengan membandingkan insidens stunting, delta WAZ dan LAZ, weight increment, dan length increment antara kedua kelompok. Hasil : Analisis dilakukan terhadap 56 subjek kelompok intervensi dan 67 subjek kelompok kontrol. Insidensi stunting baru di akhir penelitian ditemukan sebanyak 11,9% pada kelompok kontrol dibandingkan kelompok intervensi 0% memiliki hasil berbeda bermakna (p=0,021, OR IK 95% 1,13). Median delta WAZ kelompok intervensi (0,13 SD) berbeda bermakna (p=0,01) dibandingkan dengan kelompok kontrol (-0,09 SD). Analisis kelompok intervensi delta WAZ menunjukkan perbedaan yang signifikan (p=0,01) dibandingkan dengan kelompok kontrol, namun hasil delta LAZ secara statistik tidak berbeda bermakna tetapi secara klinis intervensi ini bermanfaat. Persentase subjek mencapai weight increment dan length increment adekuat lebih besar pada kelompok intervensi dan berbeda bermakna dibandingkan kelompok kontrol. Kesimpulan : Pemberian edukasi dan PMT protein hewani mampu mencegah terjadinya stunting dengan mendukung tercapainya weight increment dan length increment adekuat dan memberikan efek bermakna terhadap perubahan WAZ.
Kata Kunci: Makanan tambahan, protein hewani, stunting, pertumbuhan linear



Background : The high prevalence of stunting in Indonesia is influenced by increasing nutritional needs and the limited quantity and quality of complementary food. Supplementary feeding of animal proteins containing complete and sufficient amounts of essential amino acids is expected to support adequate linear growth. Research on the effectiveness of animal protein supplementation on linear growth in community settings has never been conducted in Indonesia. Methods : This study is a non-randomized controlled trial in Warakas, North Jakarta, from August-November 2022. Subjects between 6-59 months in intervention group received supplementary feeding of animal proteins (egg and/or milk) for four months and education, meanwhile the control group received education only. Analysis was conducted by comparing the incidence of stunting, delta WAZ and LAZ, weight increment, and length increment. Result : Analysis was conducted on 56 subjects of the intervention group and 67 subjects of the control group. The incidence of stunting at the end of the study (11.9%) was found in the control group compared to the intervention group (0%) has significant results (p=0.021, OR CI 95% 1.13). Analysis of the delta WAZ intervention group showed a significant difference (p=0.01) compared to the control group, however, the delta LAZ result was not statistically different but clinically the intervention was beneficial. The average of endline LAZ subjects at risk of stunting in the intervention group (-0.24 SD) differed significantly (p=0.001) compared to the control group (-0.93 SD). The percentage of subjects achieving adequate weight increment and length increment was greater in the intervention group and showed a significant difference from the control group. Conclusion : The intervention of education and animal protein supplementation can prevent occurrence of stunting by promoting adequate weight increment and length increment and also has a meaningful effect on changes of WAZ.
Keywords: Supplementary feeding, animal protein, stuting, linear growth