Skripsi

Hubungan antara Infeksi Parasit Usus, Alfa-1 Antitripsin, dan Status Gizi pada Anak Prasekolah di Kecamatan Nangapanda, Nusa Tenggara Timur = Relationships Between Intestinal Parasitic Infection, Alpha-1 Antitrypsin, and Nutritional Status in Preschool-age Children in Nangapanda District, East Nusa Tenggara.

Latar Belakang Infeksi parasit usus merupakan masalah kesehatan utama di Indonesia dan rentan terjadi pada anak. Salah satu dampak infeksi parasit usus adalah malnutrisi. Parasit usus dapat merusak barier dan selanjutnya meningkatkan permeabilitas mukosa usus. Studi ini bertujuan untuk meneliti hubungan antara infeksi parasit usus, permeabilitas usus, dan status gizi pada anak-anak prasekolah di Kecamatan Nangapanda. Metode Sebanyak 108 sampel feses dan data antropometri didapatkan dari anak-anak prasekolah berusia 12 sampai dengan 59 bulan di Kecamatan Nangapanda, Kabupaten Ende, Nusa Tenggara Timur. Sampel feses diperiksa untuk infeksi cacing usus dengan metode mikroskopis dan status gizi ditentukan berdasarkan standar z-score World Health Organization (WHO Anthro) tahun 2006. Sejumlah 68 data konsentrasi AAT didapatkan menggunakan pemeriksaan ELISA feses yang dikonversi ke dalam mg/g feses. Hasil Infeksi parasit usus, terutama infeksi B. hominis, ditemukan pada 27,8% anak. Prevalensi underweight, stunted, dan wasted secara berurutan adalah 20,4%, 21,3%, dan 6,5%. Infeksi T. trichiura tunggal ditemukan berkaitan dengan underweight (p=0,026), sedangkan koinfeksi T. trichiura-A. lumbricoides berkaitan dengan malnutrisi apapun (p=0,018), underweight (p=0,008), dan stunted (p=0,009). Mayoritas dari 98 anak (95,6%) mengalami peningkatan AAT ( ≥ 0,27 mg/g feses) dengan median konsentrasi AAT tertinggi didapatkan pada kelompok noninfeksi. Peningkatan AAT memiliki hubungan negatifdengan infeksi tunggal (p=0,019) dan infeksi parasit apapun (p=0,040), tetapi tidak menunjukkan hubungan berarti dengan status gizi. Kesimpulan Infeksi T. trichiura baik infeksi tunggal maupun koinfeksi dengan A. lumbricoides memiliki hubungan positif dengan malnutrisi. Walaupun infeksi parasit memiliki hubungan negatif dengan konsentrasi AAT, marker permeabilitas usus ini tidak berhubungan dengan status gizi. Studi lebih lanjut perlu dilakukan untuk meneliti faktorfaktor lain yang berperan pada hubungan antara infeksi parasit dan malnutrisi.
Kata Kunci: Alfa-1 antitripsin, anak prasekolah, infeksi parasit usus, malnutrisi


Introduction Intestinal parasitic infections (IPI) are a major health problem in Indonesia, particularly affecting children. One of the impacts of IPI is malnutrition. Intestinal parasites can damage the gut barrier, leading to increased intestinal mucosal permeability. This study aims to investigate the relationship between intestinal parasitic infections, intestinal permeability, and nutritional status among preschool children in Nangapanda District. Method A total of 108 fecal samples and anthropometric data were collected from preschool children aged 12 to 59 months in Nangapanda District, Ende Regency, East Nusa Tenggara. The fecal samples were examined for intestinal helminth infections using a microscopic method, and nutritional status was determined based on the World Health Organization 2006 z-score standards (WHO Anthro). A total of 68 AAT concentration data were obtained using fecal ELISA test, which were then converted into mg/g of feces. Results Intestinal parasitic infections, particularly B. hominis infections, were found in 27.8% of the children. The prevalence of underweight, stunted, and wasted children was 20.4%, 21.3%, and 6.5%, respectively. Single T. trichiura infection was related to underweight (p=0.026), while T. trichiura-A. lumbricoides coinfection was associated with any malnutrition (p=0.018), underweight (p=0.008), and stunting (p=0.009). Majority out of 98 children (95.6%) had elevated AAT levels ( ≥ 0.27 mg/g feces), with the highest median AAT concentration observed in the non-infected group. Elevated AAT levels were significantly associated with single infections (p=0.019) and any parasitic infections (p=0.040), but no significant relationship was found with nutritional status. Conclusion T. trichiura infection, whether as a single infection or as a coinfection with A. lumbricoides, has a positive association with malnutrition. Although parasitic infection is negatively associated with AAT concentration, this marker of intestinal permeability is not related to nutritional status. Further studies are needed to investigate other factors involved in the relationship between parasitic infection and malnutrition.
Keywords: Alpha-1 antitrypsin, intestinal parasitic infections, malnutrition, preschool age children