Hubungan Asap Rokok terhadap Derajat Keparahan Pneumonia Anak Usia di Bawah 5 Tahun

Maria Stefani, Andy Setiawan

Sari


Latar belakang. Pneumonia merupakan penyebab utama kematian pada anak usia di bawah 5 tahun di dunia. Di Indonesia, prevalensi pneumonia pada anak di bawah usia 5 tahun mencapai 18,5 per mil. Paparan asap rokok merupakan salah satu faktor risiko pneumonia.
Tujuan. Membuktikan hubungan paparan asap rokok terhadap pneumonia berat pada anak usia di bawah 5 tahun.
Metode. Penelitian ini merupakan studi kasus kontrol di Rumah Sakit Atma Jaya. Kelompok kasus didefinisikan sebagai anak usia di bawah 5 tahun dengan pneumonia berat, sedangkan kontrol merupakan anak dengan pneumonia sesuai klasifikasi WHO. Wawancara dilakukan terhadap orangtua responden untuk mendapatkan data paparan asap rokok. Analisis data menggunakan metode chi-square dan regresi logistik dengan tingkat signifikansi sebesar 0,05.
Hasil. Penelitian ini melibatkan 67 responden, terdiri dari 34 kasus dan 33 kontrol. Analisis bivariat menunjukkan hubungan signifikan antara paparan asap rokok dengan pneumonia berat. Keberadaan perokok (p=0,000), jumlah perokok di rumah (p=0,000), perilaku orangtua merokok di dalam rumah (p=0,001) dan kepadatan rumah (p=0,012) merupakan faktor risiko yang signifikan terhadap kejadian pneumonia berat pada anak usia di bawah 5 tahun.
Kesimpulan. Paparan asap rokok dan kepadatan rumah merupakan faktor risiko pneumonia berat untuk anak usia di bawah 5 tahun.


Kata Kunci


pneumonia; paparan asap rokok; anak; derajat keparahan

Teks Lengkap:

PDF

Referensi


Liu L, Oza S, Hogan D, dkk. Global, regional, and national causes of child mortality in 2000-13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 2015;385:430-40.

World Health Organization. Priority medicines for Europe and the world update report. Geneva: World Health Organization; 2013.

Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI. Riset Kesehatan Dasar. Indonesia: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2013.

Kasper DL, Fauci AS, Hauser SL, dkk. Harrison’s principles of internal medicine. Edisi ke-19. New York: McGraw Hill; 2015. h. 803-9.

Kliegman R, Stanton B, St. Geme JW, Schor NF, Behrman RE. Nelson textbook of pediatrics. Edisi ke-20. Philadelphia, PA: Elsevier; 2016. h. 2088-93.

Ramezani M, Aemmi SZ, Moghadam ZE. Factors affecting the rate of pediatric pneumonia in developing countries: a review and literature study. Int J Pediatr 2015;3:1173-81.

World Health Organization. Tobacco: fact sheets. Geneva: World Health Organization; Jul 2019. Diunduh pada 20 Agustus 2019. Didapat dari: https://www.who.int/news-room/fact-sheets/detail/tobacco.

World Health Organization. WHO report on the global tobacco epidemic: country profile Indonesia. Geneva: World Health Organization; 2017.

Feldman C, Anderson R. Cigarette smoking and mechanisms of susceptibility to infections of the respiratory tract and other organ systems. J Infect 2013;67:169-84.

Drehmer JE, Walters BH, Nabi-Burza, Winickoff JP. Guidance for the clinical management of thirdhand smoke exposure in child health-care setting. J Clin Outcomes Manag 2017;24:551-9.

World Health Organization. Revised WHO classification and treatment of pneumonia in children at health facilities. Geneva: World Health Organization; 2014.

Fleiss Jl, Levin F, Paik MC. Statistical Methods for Rates and Proportions. Edisi ke-3. New York: John Wiley & Sons, Inc; 2003.

World Health Organization. WHO Child Growth Standards. Geneva: World Health Organization; 2006.

Ikatan Dokter Anak Indonesia. Jadwal Imunisasi IDAI 2017. Indonesia: Ikatan Dokter Anak Indonesia; Apr 2017. Diunduh pada 20 Jul 2018. Didapat dari: http://www.idai.or.id/artikel/klinik/imunisasi/jadwal-imunisasi-2017.

Fonseca Lima EJ, Mello MJ, Albuquerque MF, Lopes MI, Serra GH, Lima DE. Risk factors for community-acquired pneumonia in children under five years of age in the post-pneumococcal conjugate vaccine era in Brazil: a case control study. BMC Pediatr 2016;16:157.

Pemerintah Indonesia. Undang-Undang No. 20 Tahun 2003 tentang Sistem Pendidikan Nasional. Lembaran Negara RI Tahun 2003 No. 78. Jakarta: Sekretariat Negara; 2003.

Couluris M, Schnapf BM, Casey A, Xu P, Gross-King M, Krischer J. How to measure secondhand smoke exposure in a pediatric clinic setting. Arch Pediatr Adolesc Med 2011;165:670-1

Neumann T, Rasmussen M, Heitmann BL, Tonnesen H. Gold standard program for heavy smokers in a real-life setting. Int J Environ Res Public Health 2013;10:4186-99.

Ahn A, Edwards KM, Grijalva CG, dkk. Secondhand smoke exposure and illness severity among children hospitalized with pneumonia. J Pediatr 2015;167:869-74.

Matt GE, Quintana PJ, Hovell MF, dkk. Households contaminated by environmental tobacco smoke: sources of infant exposures. Tob Control 2004;13:29-37.

PrayGod G, Mukerebe C, Magawa R, Jeremiah K, Torok ME. Indoor air pollution and delayed measles vaccination increase the risk of severe pneumonia in children: results from a case-control study in Mwanza, Tanzania. PLoS One 2016;11:e0160804.

Jroundi I, Mahraoui C, Benmessaoud R, dkk. Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco. Int J Infect Dis 2014;28:164-70.

Ngocho JS, de Jonge MI, Minja L, dkk. Modifiable risk factors for community-acquired pneumonia in children under 5 years of age in resource-poor settings: a case–control study. Trop Med Int Health 2019;24:484-92.

Principi N, Esposito S. Prevention of community-acquired pneumonia with available pneumococcal vaccines. Int J Mol Sci 2017;18:30.

Dunne EM, Satzke C, Ratu FT, dkk. Effect of ten-valent pneumococcal conjugate vaccine introduction of pneumococcal carriage in Fiji: results from four annual cross-sectional carriage surveys. Lacet Glob Health 2018;6:1375-85.

Hoang VT, Dao TL, Minodier P, dkk. Risk factors for severe pneumonia according to WHO 2005 criteria definition among children <5 years of age in Thai Binh, Vietnam: a case-control study. J Epidemiol Glob Health 2019;9:274-80.

Gupta N, Bhadrala N. Risk factors for acute severe pneumonia in under five children. Int J Contemp Pediatr 2019;6:949-54.

Kisworini P, Setyati A, Sutaryo. Mortality predictors of pneumonia in children. Paeditr Indones 2010;50:150-3.

Onwunaka C, Nwimo IO, Ilo CI, Okafor JO. Maternal compliance practices during childhood pneumonia in Imo State, Nigeria. J Health, Med Nurs 2015;15:72-7.

Mahabee-Gittens EM. Missed opportunities to intervene with caregivers of young children highly exposed to secondhand tobacco smoke. Prev Med 2014;69:304-5.

Kim S, Apelberg BJ, Avila-Tang E, dkk. Utility and cutoff value of hair nicotine as a biomarker of long-term tobacco smoke exposure, compared to salivary cotinine. Int J Environ Res Public Health 2014;11:8368-82.

Mahabee-Gittens EM, Merianos AL, Gordon JS, dkk. Electronic Health Record Classification of Tobacco Smoke Exposure and Cotinine Levels in Hospitalized Pediatric Patients. Hosp Pediatr 2019;9:659-64.




DOI: http://dx.doi.org/10.14238/sp23.4.2021.235-41

Refbacks

  • Saat ini tidak ada refbacks.


##submission.copyrightStatement##

##submission.license.cc.by-nc-sa4.footer##

Informasi Editorial:
Badan Penerbit Ikatan Dokter Anak Indonesia
Jl. Salemba I No 5, Jakarta 10430, Indonesia
Phone/Fax: +62-21-3912577
Email: editorial [at] saripediatri.org

Lisensi Creative Commons
Sari Pediatri diterbitkan oleh Badan Penerbit Ikatan Dokter Anak Indonesia
Ciptaan disebarluaskan di bawah Lisensi Creative Commons Atribusi-NonKomersial-BerbagiSerupa 4.0 Internasional.