ABSTRACT
The highest tuberculosis (TB) mortality and morbidity occured in developing countries, including Indonesia. In terms of nutrition, WHO expects TB research conducted nationwide to provide scientific evidence that all important tuberculosis patients are assessed nutritional status and given nutritional counseling in all health facilities. There also need an operational standard in the treatment of malnutrition due to TB. The aims of this study were to identify nutrient intake and blood micronutrient level in TB patients before and after 2 months of therapy with nutritional counseling. The pre-experimental pretest posttest 1 group study was conducted in 10 Puskesmas in Bogor District in 68 pulmonary tuberculosis patients aged 15-55 years. Primary data were collected through interviews, anthropometric measurements and laboratory checks. Results of BTA examination showed that most patients were TB patients with BTA 1 + 49.1% and 35.8% with BTA 3 +, the rest of BTA 2+ and scanty. There were significant differences in macro and micronutrient intake before and after intensive phase therapy accompanied by nutritional counseling (p <0.05). The levels of retinol, selenium, vitamin D and vitamin E in the blood also showed significant differences before and after intensive phase therapy (p <0.05). The macro and micronutrient intake after intensive phase therapy was higher than before. Most of patients experienced an increase in dietary intake in almost all food group, as well as micronutrient levels (retinol, selenium, vitamin D and vitamin E) in the blood increased after intensive phase therapy with nutrition counseling.
Keyword: nutrition intake, pulmonary tuberculosis, nutrition counseling
ABSTRAK
Angka kesakitan dan kematian TB tertinggi ada di negara berkembang, termasuk di Indonesia. Dari segi nutrisi, WHO mengharapkan penelitian TB yang dilakukan di seluruh negara dapat memberikan bukti ilmiah bahwa semua pasien TB penting dinilai status gizinya dan diberikan konseling gizi di semua sarana kesehatan dan perlunya ditetapkan standar operasional dalam penanganan malnutrisi akibat TB. Penelitian ini bertujuan untuk mengidentifikasi asupan gizi dan kadar mikronutrien pasien TB sebelum dan sesudah terapi 2 bulan dengan konseling gizi. Desain penelitian pra-eksperimental pretest posttest 1 kelompok dilakukan di 10 Puskesmas di Kabupaten Bogor pada 68 pasien TB paru, berusia antara 15-55 tahun. Data primer dikumpulkan melalui wawancara, pengukuran antropometri dan pemeriksaan laboratorium. Hasil pemeriksaan BTA menunjukkan bahwa pasien terbanyak adalah pasien TB dengan BTA 1 + sebesar 49,1 % dan 35,8 % dengan BTA 3 + sisanya BTA 2+ dan scanty. Terdapat perbedaan bermakna pada asupan makro dan mikronutrien sebelum dan setelah terapi fase intensif yang disertai konseling gizi (p<0.05). Kadar retinol, selenium, vitamin D dan vitamin E dalam darah juga menunjukkan perbedaan bermakna sebelum dan sesudah terapi fase intensif (p<0.05). Rerata asupan makro dan mikronutrien sesudah terapi fase intensif lebih tinggi dibandingkan sebelum terapi. Sebagian besar pasien mengalami peningkatan pola konsumsi makan pada hampir semua golongan bahan makanan, begitu juga dengan kadar mikronutrien (retinol, selenium, vitamin D dan vitamin E) dalam darah mengalami peningkatan sesudah terapi fase intensif yang telah disertai konseling gizi.
Kata kunci: asupan gizi, tuberkulosis paru, konseling gizi
The system of matrix metalloproteinases and their role in patients with pulmonary tuberculosis
