Malnutrition 2011

7/24/2019 Malnutrition 2011

1/95

Malnutrition in Children

mtsdarmawan


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Background


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02/18/16 dr. Darmawan, S! "

#i$i %&utrition'

( )roses enggunaanmakanan secaranormal


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02/18/16 dr. Darmawan, S! *

+eadaan #i$i

( +eseimanganantarakonsumsi, en-eraan emakaian.


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Learning Obyektif

( Mamu menelaskan engertian malnutrisisecara umum dan kondisi malnutrisi dindonesia

( Mamu menelaskan engertian, ciri enanganan kekurangan gi$i

( Mamu menelaskan engertian, ciri danenanganan keleihan gi$i

( Mamu menelaskan engertian malnutrisimikronutriendan entingn-aenanggulangan malnutrisi mikronutrien


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Background

terentingmoriditas mortalitas304kematian sedunia5

3*4 kematian di negara erkemang d2001

( )M 7 1stdigamarkan d 120s 79:eran-ak di de;eloing countries

S!.


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Background

(:wo


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Background

( Marasmus7 intake rotein calories,

9 !datasi star;ation %kelaaran'

( +washiorkor79 ntake kalori


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Background

(:wo


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+washiorkor

( BB :B aku( dema anasarkamen-amarkan BB

( Massa otot mengecil.

(+ulit tiis, lemek erercak merah( amut erwarna irang, kasardan kaku,serta mudah dicaut

( !nak aatis, cengengdan rewel


11/95

Marasmus

( !nak kurus kering.( Sering rewel, cengeng, enakut.

( +ulit keriut waah st orang tua.

( )erut uncit, ramut merah arang( !nak cengeng dan rewel

( Marasmik ~ Kwashiorkor7 gaungankeduan-a


12/95

)rinsi enanganan kurang

gi$i( !suan makanan dg an-ak rotein,tinggi kalori, cuku cairan, ;itamin danmineral.

( Makanan dalam entuk mudah dicernadisera.

( Bertaha.

( )en-akit lain-g men-ertai ditangani.

( )emantauan en-uluhankeluarga


13/95

Mengaa enting diatasi

( +arena tidak akan caai tum angsemurna.

erkemangan otak uga uruk

generasi yg EOonF 7 tidak rodukti< dan tidakmamu hadai tantangan


14/95

re=uenc-

>S!( 147 malnutrisi kronik.

( ncidence 104,ahkan d kelomokristi

( 104di oedalaman 7 secondar- toinade=uate nutrition

( Hositali$ed children 7

9 1/* acute )M %istilah lama'

9 2I 4 chronic )M.


15/95

re=uenc-

nternationalJHK 7

( 2013 7 re;alence to 1I.64

( Low weight


16/95

re=uenc-

( Sekarang, 304anak di!siaselatan 7)M, 6.3 ?re;alence dio Barat.

( SuASaharan !


17/95

DeNnition

JHK 7( OCellular imalanceetween 7

9 sul- energi nutrisi keutuhan tuuh


18/95

DeNnition

(:uuh tidakmendaatkan kecukuan9 ;itamins, minerals other nutrients

maintain aringan sehat ndernourished or o;ernourished


19/95

Malnutrisi Akut

Malnutrisi !kutBerat

Malnutrisi !kutModerat

Rawat inap Rawat jalan

+lasiNkasi :raditional


20/95

)eredaan Malnutrisi !kut +ronis

( tiologiereda( ndikatordiagnostik ereda

9 Malnutrisi kronis 7

(stunting %:B/>'(>nderweight stunting %BB/>'


21/95


( tiologiereda( ndikatordiagnostik

ereda

9 Malnutrisi !kut 7(wasting %kurus' LL! atau

BB/:B'

HIV


22/95


( )eredaan endekatan terai9:ie rogram

(Malnutrisi kronis 9 re;enti< 7 sulemennutrisi

(Malnutrisi !kut 9 terai 7 diet terai komlet

9 Durasi rogram

(Malnutrisi kronis A ertahun

(Malnutrisi !kut 9 1A2 ulan


23/95

Malnutrisi akut

( okus ada underweight %BB/>'

9 Lancet 7 tidak menggunakan

( JHK masih gunakan


24/95

Malnutrisi akut

( MC% ntegrated Management Child ll M:BS

tidak memakai indikator antroometrik

9 Han-a erdasar tanda klinis

9 Malnutrisi akut tidak sensiti< dan nonAseciNc


25/95

Tenis malnutrisi

a. Malnutrisi mikronutrien, terenting 7kekurangan ;it !, -odium e

. +ekurangan gi$i

c. +eleihan gi$i %o;erweight oesitas'


26/95

>ndernutrition

( +ekuranganintake nutrien esensial orenggunaan or ekskresi erleihan.

( Bisa erua 7

9 Malnutrisi Sekunder9 Malnutri Mikronutrien

9 Malnutrisi )rotein nergi %)M'

(Most imortant


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Malnutrisi Sekunder

( Diet normal

( Makanan :D!+

dicerna atai diasorsi9 Diarea

9 )arasit

Tapeworm


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>ndernutrition

( Ba-i, anak kecil, elasan tahun, wanitahamil or uteki 7 erlu additionalnutrients.

( &utrient loss7 accelerated- diarrhea,keringat erleih, erdarahan masi


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Malnutrisi Sekunder


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>ndernutrition

( Chronic malnutrition 79 14in the >S!;sto 304Southeast !sia.

( @ 2/"malnourished 7 !sia

( @ 1/*7 in !


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>ndernutrition

( )M 7 en-ea kematian di negerkemang

( !kiat intakekalori inade=uate 7 roteins,;itamins minerals.

( >ndernourished child mjd )M ila 79 +eceatan ertumuhan , in


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K;ernutrition

( n >S!, akiat dietar- imalances.( esults


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K;ernutrition

( isk 7 - eing 204o;erweight,consuming a diet high in


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K;ernutrition

( +urang gi$i pengaruhis-stem the senses o< sight,taste, and smell.

an?iet-, eruahan mood s-chiatrics-mtoms

( Dimulai dg eru le;elnutrient darah

aringan perub levelen$-me, anormalitasaringan, mal


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K;er weight Kesitas

( BB/:B or BM 834ile7 o;erweight 34ile 7oese.

( Masukanenergi keutuhan

( Berhu dg oesitas ortu inactivity(eramAam memaca, :U'

re;alensi d anak dewasa.

( )re;ensi LBH M>D!H terai.( dukasi health- eating


36/95

K;er weight Kesitas

( BB :B anak seusia.( Hidung mulut relati< kecil, dagu

erentuk ganda, erut uncit

( Sering malas ergaul karenamalu

risiko en-akit erat saatdewasa

9 kardio;askuler 7 stroke,hiertensi,

9 metaolik 7 DM


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)rinsi :atalaksana

( !tasi


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Malnutrisi Mikornutrien

( !suan nutrien st ;it !, e -odium tidak cuku.

( Secara Nsik sering tak terdeteksitai memengaruhi kesehatan leihdari 2 mil-ar orang di seluruh dunia.

Seelum terai 2 tahun setelah :? kalsium


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Seelum terai 2 tahun setelah :? kalsium


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DeNsiensi Uitamin !

( )en-ea utama 7 konsumsi

( Sumer 7

V daun singkong, a-am, tomat, kangkung

V daun ea-a, daun katukV ea-a, wortel, telur, ikan, hati


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!kiat DeNsiensi Uitamin !

imunitasmudah in


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Bercak Bitot


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Werosis


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Werosis


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)re;ensi

( +onsumsi harian79 Sa-uran hiau uah erwarna,

sa-ur ditumis or dimasak dg

santan, agar ;it ! larut( +asul ;it ! dosis tinggidierikan

tia 6 ulan %eruari !gustus',

uga dierikan ada iu melahirkan


47/95

DeNsiensi e

!kiat 7(:ersering 7 anemia de< esi

%!dee'.

risiko rematur, BBL

risiko kematian iu hamil

kemamuan kera Nsik %leto-' kemamuan elaar


48/95

!nemia DeNsiensi Besi !DeBe

( Men-erang 2 uta org,

( 04 di negara erkemang9 "4 anak ra sekolah, 324 umil

( Berkurang dengan 7

9 !kti;itas Nsik mental

( Meningkat karena 79 Mortalitas a-i lahir

9 Cacing, Malaria, HU

( Beras tinggi esi daatmenolong


49/95

)ellagra deNsiensi B"

%&iacin'


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DeNsiensi Xodium

( )en-ea 7

Makanan air kurang mengandung-odium.

(:idak gunakan garam -odium dlmmakanan, khususn-a kelg -g tinggal didaerah gondok endemik.


51/95

!kiat #!+X

( Y rendah( #gn erkemangan Nsik 7 :B terhamat,

ggn sara< motorik gerakan laman,

ggn endengaran tuli.( DeNsiensi tingkat kretinisme.

( Dewasa 7 emesaran kelear gondok

( Janita usia suur sering 7 inD


52/95

Hiotiroidisme kongenital


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2. DeNciensi Xodium

( DeNsiensi Xodium9 Men-erang I*0 uta org di

seluruh dunia

9 )en-ea tunggal kerusakanotakada a-i -g dapatdicegah

9 #oiter

9 Lahir mati

9 Miscarriages

9 etardasi Mental( Sumer teraik -odium alami

9 Sea weed / rumput aut

9 Sea food

Goiter

(pembesaran tiroid)


54/95

)re;ensi

( Selalu gunakan garam -odium di :.( >ntuk endemik anak 1A3 tahun

dieri kasul -odium selama 1 tahun


55/95

DeNsiensi Mikronutrien Lain

( Zinc9 etardasi ertumuhan

9 Maturasi seksual terlamat

9 Lesi kulit mata

9 *84 enduduk dunia erisikoerisiko deNsiensi $inc

( +alsium

9 Ksteoorosis7 kerauhantulang

( UitaminD

9 ickets7 mal


56/95

Kther DeNciencies

( Uitamin C9 Seakan Scur;-7 rolem in

kam engungsian

( &iacin9 Seakan )ellagra7 dermatitis,

diarea, dementia

9 !kiat diet tinggi mai$ena%rendah tr-tohan'

(:hiamin9 seakan erieri

9 !kiat diet tinggi eras EkilatF

( olate9 De


57/95

Cheilosis de< ;it B2


58/95

!kiat Malnutrisi

Defisiensi engurangi !

survivalVitamin A

PEM

LBW productivity

Ironintelligence

Iodine


59/95

Mortalitas Balita !kiat >nderweight

( Deaths

Over 375,000

child deaths

Year


60/95

Causes and S-mtoms


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Causes

>S! 7( )rimar- reasons 7 kemiskinan kurang

makan.

( 104 saa7

( )M occurs in

9 304 asien edah

9 in *84 asien rawat ina


62/95

Causes

risk chronic diseases, eseciall- dintestinal tract, kidne-s, and li;er 7

( Cancer, !DS, intestinal arasites, andother gastric disorders ma- lose weight

raidl- rentanundernourishment karenatak daat asorsi;itamins, calories iron.


63/95

Causes

( +etergantungan drug or alcohol

kemamuan asorsi nutrients rusak

( ating disorders 7

anore?iaor ulimia7 restrict


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S-mtoms

( +etidaksengaaan losing 10 ounds7sign o< malnutrition.

( Skinn-or loated %kemung/engkak'79 ale, thick, dr-, and ruises easil-.

( ashesand changes in igmentation(Tointsache ones 7 so


65/95

Kther s-mtoms include

( !nemia, diarrhea, disorientation( night lindness, irritailit-, an?iet-,

attention deNcits, goiter, loss o< re[e?esand lack o< muscular coordination

( muscle twitches, amenorrhea

( scaling and cracking o< the lis andmouth.

( Malnourished children ma- e short


66/95

Causes

( ood allergies.di\cult to otain


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Clinical

Hi t


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Histor-

( Clinical signs and s-mtoms o< )Minclude7

9 )oor weightgain

9Slowing o< linear growth9 Beha;ioralchanges 9

(irritailit-, aath-, socialresonsi;eness, an?iet-, and

attention deNcits

Hi t


69/95

Histor-

(Clinical signs and s-mtoms o


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Histor-( :he most commonand clinicall- signiNcant

deNciencies 79 ron A atigue, anemia, cogniti;e


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)h-sical o< )M

sucutaneoustissue 7 most a]ected 7legs, arms, uttocks


72/95

)h-sical o< )M

(!dominalNndings9 !dominal distension secondar- to oor

adominal musculature

9 Heatomegal- secondar- to


73/95

Causes

( Most common cause 7 inade=uate


74/95

Causes

(nstead, diseases and, in articular, chronicillnesses la- an imortant role in theetiolog- o< malnutrition.

( Children with chronic illness 7 risk


75/95

Causes

( Chronic illnesses that commonl-are associated with nutritionaldeNciencies include the


76/95

Causes

( SigniNcant risk 79 )rematurit-

9 De;elomental dela-

9 n utero to?in e?osure %ie,


77/95

#i$i uruk

( Bentuk terarah kurang gi$i menahun( ndonesia kehilangan 220 uta Y oin

( Damak lain 7^ rodukti;itas 20A"04

( !nak endek

( #gn tumuh kemang otak Yrendah

#i$i uruk


78/95

#i$i uruk

(:umuh kemang otak 80 4saat dlmkandungan s/d 2A3 tahun.

( JHK 7 3*4 kematiana-i alitadidasari gi$i anak -ang elek.

( +) erat 7 risiko kematian 334.( 6,I uta alita / 2I."4ndonesia kurang

gi$i akiat !S M)!S

( 1,3 uta gi$i uruk.( +) ringan ada anak ulan A 2 tahun,

#i$i uruk


79/95

#i$i uruk

1. Daat dicegah2. Bukan han-a karena kemiskinan,

tai ola asuh_ tidak

tercaain-a gi$i memadai%masalah keluarga'.

". isiko meninggal gi$i uruk 1" ?

+LB #i$i


80/95

+LB #i$i

(Ditemukann-a alita 7 BB/> di awahstandar atau

(:andaAtanda marasmusatau kwasiorkor

Diagnosis


81/95

Diagnosis

K;erall 79 aearance, eha;ior, od-A


82/95

Diagnosis

( Blood urine 7 measure ;itamins minerals le;els waste roducts.


83/95

:reatment


84/95

:reatment

( &ormali$ingnutritional status starts with anutritional assessment. :his rocess enales7

9 a nutritionist or dietician conNrm themalnutrition

9 assess the e]ects o< the disorder

9


85/95

:reatment

(:ue


86/95

:reatment

:ue ndergoing chemothera- or radiation :?( Seriousl- urned( )ersistent diarrhea or ;omiting( Jhose # tract is aral-$ed.

i;


87/95

)rognosis

( 104od- weight lost 7 withoutsidee]ects,

( *04 7 almost alwa-s


88/95

)rognosis

( Some )M childrens reco;ercomletel-

( Kthers 7 rolems throughout li


89/95

)re;ention

( !S e?clusi;e

( !ll !mericans 2 - 7

9 Consume lent- o<


90/95

)re;ention

( Screening


91/95

ood ntolerance !llerg-

( !lergi7 reaksi imunologisterhada makanan

( ntoleransi7 nonAimmunologis

( +linis 79 sistem resirasi, #, dermatologis

or geala sistemik

(:es challenge

ood !llerg- S-mtoms


92/95

ood !llerg- S-mtoms

( # 7 n-eri adomen,kemung, diare, malasorsi,nausea, muntah, konstiasi

( esirator-7 asma,

atuk kronik erulang %B+B',

hidung untu atau meler,whee$ing


93/95

ood !llerg- S-mtoms

( Dermatologis 7

eksema, atoi, urtikaria,

angioedema, gatal, rash

( Sistemic 7 anaNlaksis, n-erikeala, eruahan keiasaan/

eha;ioral

ood !llerg- S-mtoms

Hidu is )ilihan


94/95

Hidu is )ilihan

terima


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terima

kasih

Documents

Malnutrition 2011