Pengaruh Suplementasi Seng Terhadap Kejadian Pneumonia pada Penyakit Jantung Bawaan Pirau Kiri ke Kanan
Sari
Latar belakang. Anak dengan penyakit jantung bawaan (PJB) pirau kiri ke kanan lebih mudah menderita
pneumonia. Seng merupakan trace element yang berperan dalam sistem imunitas tubuh.
Tujuan. Membuktikan pengaruh suplementasi seng dalam mencegah kejadian pneumonia pada anak PJB
pirau kiri ke kanan.
Metode. Dilakukan double blind randomized controlled trial pada anak PJB pirau kiri ke kanan usia 12–60
bulan di Poliklinik Kardiologi Anak RS dr Kariadi. Subjek penelitian dibagi 2 kelompok yang mendapat
suplementasi seng 20 mg/hari dan plasebo, pemberian selama 2 minggu, selanjutnya dipantau selama 3
bulan. Data kejadian pneumonia dikumpulkan melalui wawancara saat kontrol atau melalui telepon setiap
2 minggu selama 3 bulan. Pemeriksaan antropometri dan laboratorium dilakukan sebelum dan sesudah
suplementasi. Analisis statistik dilakukan dengan uji chi-square dan Mann-Whitney.
Hasil. Subjek 40 anak dengan PJB pirau kiri ke kanan didapatkan kejadian pneumonia pada kelompok seng
(5%) lebih rendah dibanding plasebo (30%), perbedaan ini tidak berbeda bermakna. Episode pneumonia
lebih rendah pada kelompok seng 1 kali dibandingkan plasebo 1-2 kali selama 3 bulan pengamatan, tidak
berbeda bermakna. Terdapat peningkatan kadar seng secara bermakna pada kelompok perlakuan dari median
57,55 menjadi 72,42 mcg/dL dibandingkan plasebo 42,40 menjadi 52,85 mcg/dL (p=0,002). Terdapat
perbedaan bermakna selisih peningkatan kadar seng pada kelompok seng 20 mcg/dL dibanding plasebo
7,25 mcg/dL (p=0,004). Didapatkan manfaat suplementasi seng terhadap pencegahan pneumonia dengan
relative risk reduction (RRR) 83%.
Kesimpulan. Suplementasi seng menurunkan kejadian pneumonia pada anak PJB pirau kiri ke kanan.
Kata Kunci
Teks Lengkap:
PDFReferensi
Priyatno A. Deteksi dini penyakit jantung bawaan
kritis pada neonatus. Dalam: Riswanto S, Susanto R,
penyunting. Pendekatan klinis jantung, paru, infeksi dan
hematologi. Salatiga;2007.h.25-30.
Soeroso S, Sastrosoebroto H. Penyakit jantung bawaan
non sianotik. Buku ajar kardiologi anak. Dalam:
Sastroasmoro S, Madiyono B, penyunting. Jakarta: Balai
Penerbit;1994.h.191-233.
Bedard E, Shore DF, Gatzoulis MA. Adult congenital
heart disease overview. Brit Med Bull 2008;85:151-80.
Wilar R, Wantania JM. Beberapa faktor yang berhubungan
dengan episode infeksi saluran pernafasan akut pada
anak dengan penyakit jantung bawaan. Sari Pediatri
;8:154-8.
Healy F, Hanna BD, Zinman R. Pulmonary complications
of congenital heart disease. Paediatr Res Rev
;30:1-6.
Afandi NS. Infeksi saluran pernafasan akut pada anak
dengan penyakit jantung bawaan. Dalam:Putra ST,
Roebiono PS, Rahayuningsih SE, Wulandari DA,
penyunting. Towards competence-based practice in
pediatric cardiology. Bandung: Indonesian Society of
Pediatric Cardiology;2007.h.71-7.
Dardenne M. Seng and immune fuction. Eur J Cli Nutr
;56:20-3.
Cunningham-Rundles S. Seng and immune function.
IZA 2005:1-4.
Dijkhuizen M, Wieringa F. Vitamin A, iron and Seng
deficiency in Indonesia. J Nutr Pediatr 2001;34:102-7
Sastroasmoro S. Telaah kritis makalah kedokteran.
Dalam: Sastroasmoro S, Ismael S, penyunting. Dasardasar
metodologi penelitian klinis. Edisi ke-4. Jakarta:
Sagung Seto;2011.h.469-79
Agustian L, Sembiring T, Ariani A. Peran zinkum terhadap
pertumbuhan anak. Sari Pediatri 2009;11:244-9.
Sjarif DR, Anggriawan AL, Putra ST, Djer MM.
Anthropeometric profiles of children with congenital
heart disease. Med J Indones 2011;20:40-5.
Tokel K, Azak E, Ayabakan C, Varan B, Aslamaci S,
Mercan S. Somatic growth after corrective surgery for
congenital heart disease. Turk J Pediatr 2010;52:58-67.
Schrimshaw NS, SanGiovanni JP. Synergism of nutrition,
infection and immunity: an overview. Am J Clin Nutr
;66:464-77.
Fontaine O. Effect of seng supplementation on
clinical course of acute diarrhoea. J Health Popul Nutr
;19:339-46.
Hotz C, Brown KH. Assessment of the risk of seng
deficiency in populations and options for its control.
Food Nutr Bull 2004;25:S99-200.
Aggarwal R, Sentz J, Miller MA. Role of seng
administration in prevention of childhood diarrhea and
respiratory illnesses: a meta-analysis. AAP 2007;119:
-30.
WHO. Essential concepts concerning diarrhoea.
Guidelines for policy makers and programme managers:
The treatment of diarroea. Geneva: Switzerland.
WHO;2006.
Roth D, Richard S, Black R. Seng supplementation for the
prevention of acute lower respiratory infection in children
in developing countries: meta-analysis and meta-regression
of randomized trials. IJE 2010;39:795-808.
Bhatnagar S, Natchu U. Seng in child healt and disease.
Indian J Pediatr 2004;71:991-5.
Bhandari N, Bahl R, Teneja S, Strand T, Molbak K,
Ulvik R. Effect of routine Seng supplementation
on pneumonia in children aged 6 manths to 3 years:
randomized controlled trial in urban slum. BMJ
;324.
Bhutta ZA, Black RE, Brown KH, Gardner JM, Gore
S, Hidayat A. Prevention of diarrhea and pneumonia
by Seng supplementation in children in developing
countries: Pooled analysis of randomized controlled
trials. J Pediatr 1999;135:689-97.
Sazawal S, Black R, Jalla S, Mazundar S, Sinha A, Bhan
M. Seng supplementation reduces the incidensce of
acute lower respiratory infection in infants and preschool
children: a double-blind, controlled trial. Pediatrics
;102:1-5.
Lassi Z, Haider B, Bhutta Z. Seng supplementation
for the prevention of pneumonia in children aged 2
months to 59 months. Cochrane Database Syst Rev
;12:193-9.
Chandyo RK, Shrestha PS, Valentiner-Branth P, Mathisen
M, Basnet S, Ulak M. Two weeka of Seng administration
to Nepalese children with pneumonia does not reduce the
incidence of pneumonia or diarrhea during the next six
months. J Nutr 2010;140:1677-82.
Sampaio D, de-Mattos A, Ribeiro T, de-Leite M, Cole
C, Costa-Ribeiro H. Seng and other micronutrients
supplementations through the use of sprinkles: impact
on the occurence of diarrhea and respiratory infections
in institutionalized children. J Ped 2013;89:286-93.
Yau KI, Fang LJ, Wu MH. Lung mechanics in infants
with left-to-right shunt congenital heart disease. Pediatric
Pulmonology 1996:42-7.
Owayed A, Campbell D, Wang E. Underlying causes of
recurrent pneumonia in children. Arch Pediatr Adolesc
Med 2000;154:190-5.
Geskey J, Cyran S. Managing the morbidity associated
with respiratory viral infections in children with
congenital heart disease. Int J Paedtr 2012;20:1-8.
Prasad A, Fitzgerald J, Bao B, Beck F, Chandrasekar
H. Duration of symptoms and plasma cytokine levels
in patients with the common cold treated with Seng
acetate. Ann Intern Med 2000;133:245-52.
Vakili R, Vahedian M, Khodael G, Mahmoudi M. Effects
of seng supplementation in occurrence and duration
of common cold in school aged children during cold
season: a double-blind placebo-controlled trial. Iran J
Pediatr 2009;19:376-80.
Suara R, Crowe J. Effect of Seng salts on respiratory
syncytial virus replication. ASM J 2004;48:783-90.
Ngom P, Howie S, Ota M, Prentice A. The potential
role and possible immunological mechanisms of zinc
adjuntive therapy for severe pneumonia in children.
Open Immunol J 2011;4:1-10.
DOI: http://dx.doi.org/10.14238/sp16.4.2014.221-8
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