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BACKGROUND: Iron plays an essential role in the process of neurotransmitter synthesis and neuron myelination. Iron deficiency impacts low cognitive performance, even involved in long-term effects even though iron deficiency has been overcome. Given the impact caused by iron deficiency, it is necessary to monitor the status of iron in the body. Diagnostic tests carried out so far use blood specimens taken with invasive method. This creates fear for the child because of the pain it causes. AIM: This study aims to obtain a non-invasive alternative diagnostic test in detecting iron deficiency in children using saliva as an examination specimen. METHODS: The design of this study was case control, with a sample of elementary school children aged 9–12 years and for women who had not experienced menstruation. The sample consisted of 40 people who were taken randomly and grouped into iron deficiency and normal. Determine the group of iron deficiency and normal was based on the results of an examination of serum iron levels. Next, saliva samples were taken to determine saliva iron levels. The characteristics of the sample data were obtained through a questionnaire, while the measurement of serum iron levels was carried out by the spectrophotometric method, and the measurement of saliva iron levels was carried out by the ELISA method. Data were analyzed using Spearman’s test. RESULTS: Based on serum iron measurements, it was found that the mean serum iron levels in children with iron deficiency were lower than normal children (38.153 ± 8.99 q/dL vs. 79.198 ± 14.2219 q/dL), on the contrary, on examination of iron levels, it was found that in children with iron deficiency, saliva iron levels were higher than in normal children (5.745 ± 3.04 q/dL vs. 2,576 ± 1.43 q/dL). The correlation test results showed a significant negative correlation between serum iron levels and moderate iron levels (p = 0.000, r = –0.518). CONCLUSION: Saliva iron levels can be used as an alternative non-invasive diagnostic test to assess children’s iron status.

Latar belakang: Zinc merupakan salah satu mikronutrien penting yang dibutuhkan oleh tubuh. Rendahnya zinc dalam tubuh akan menghambat efek metabolit hormon pertumbuhan atau GH, sehingga sintesis dan sekresi Insulin Like Growth Factor 1 (IGF-1) berkurang dan berdampak terhadap reterdasi pertumbuhan.  Penelitian ini bertujuan untuk menganalisis hubungan antara kadar zinc serum dan kadar IGF-1 serum pada anak Sekolah Dasar di Kecamatan Tuah Negeri Kabupaten Musi Rawas. Metode: Desain penelitian ini adalah cross sectional, dengan sampel anak Sekolah Dasar usia 7-13 tahun. Sampel berjumlah 79 orang yang diambil secara  random. Dilakukan pengukuran status gizi berdasarkan TB/U dan  pengambilan darah untuk  pengukuran kadar Zn dan IGF-1 serum. Adapun data karakteristik sampel diperoleh melalui kuesioner, sedangkan pengukuran kadar Zn dan IGF-1 serum dilakukan dengan metode ELISA. Selanjutnya data dianalisis menggunakan uji chi-square. Hasil: berdasarkan pengukuran status gizi didapatkan   19 (24%) anak mengalami stunting dan 60 (76%) anak memiliki status gizi normal. Pada anak stunting 89.5% mempunyai kadar Zn yang rendah dan 78.9% mempunyai kadar IGF-1 yang rendah. Hasil analisis bivariat didapatkan p=0.017 dan PR=5.667 untuk hubungan antara status gizi dan kadar Zn serum; p=0.000 dan PR=8.983 untuk hubungan antara kadar Zn serum dengan kadar IGF-1 serum. terdapat hubungan yang bermakna antara status gizi dengan kadar Zn serum dan kadar Zn serum dengan IGF-1 serum. Kesimpulan:  Anak yang mengalami stunting beresiko 5.667 kali mempunyai kadar Zn yang rendah dan anak dengan kadar Zn serum  yang rendah beresiko 8.983 kali mempunyai kadar IGF-1 serum yang rendah juga. Zn dan IGF-1 diperlukan dalam proses pertumbuhan anak. Perlunya edukasi kesehatan tentang pentingnya asupan zinc pada orang tua, agar kebutuhan Zn pada anak dapat terpenuhi.

BACKGROUND: Iron deficiency is the leading cause of iron deficiency anemia and is a health problem for children in developing countries. School-age children are susceptible to iron deficiency because children’s growth and development require iron. Although iron is needed for children’s growth and development, iron also plays a role in cognitive function. Many factors cause iron deficiency in children. AIM: This study aims to determine the most dominant factor causing iron deficiency in elementary school children. METHODS: The design of this study was case-control, with a sample of elementary school children aged 9–12 years in the Tuah Negeri Subdistrict. After examining the serum iron, children were grouped into two groups, namely, iron deficiency and normal. Each group consists of 85 children, and the total sample is 170 children. Measurement of serum iron levels was done by spectrophotometric method, while data on children’s characteristics were obtained through questionnaires. In addition, nutritional status measurements were also carried out to determine whether the child was stunted, measurements based on TB/U, and Z-score was calculated using Anthro 1.02 software. Finally, the data were analyzed by univariate, bivariate, and multivariate using Statistical Package for the Social Sciences version 22. RESULTS: Based on the child characteristics data, 60% of children aged >10–12 years, 54.1% were female, and 23.5% of children were stunted. Data on the characteristics of parents obtained 67.6% of mothers and 74.1% of fathers with low education; 84.1% of mothers and 55.3% of fathers work as farmers, and 54.7% have low economic status. Bivariate results showed that two characteristic variables, namely, economic status (p = 0.003) and nutritional status (p < 0.001), were significantly related to the incidence of iron deficiency in children. The results of multivariate analysis showed that children with low economic status were at risk of 2.361 times (p = 0.011) of having an iron deficiency while stunting children were at risk of 6.785 times (p < 0.001) of having iron deficiency. CONCLUSION: Stunting is the dominant factor associated with iron deficiency in elementary school children in Tuah Negeri Sub-district.

BACKGROUND: Children in rural areas are susceptible to zinc deficiency. Zinc deficiency in children can affect cognitive function in children. Zinc plays a role in cellular function and critical brain growth processes, including cell replication, DNA and RNA synthesis, and the release of neurotransmitters. AIM: This study aimed to analyze the condition of zinc deficiency and its relationship with the level of intelligence in children in rural areas. METHODS: The study design was cross-sectional, with a sample of 44 elementary school children aged 9–12 years taken randomly. Blood was drawn to measure serum Zn-levels, and serum Zn-levels were measured using Colorimetric Assay Kit (E-BC-K137). Zinc intake data were obtained from the food recall form, which was carried out 3 × 24 h. The level of intelligence is measured by the Culture Fair Intelligence Test method. The sample characteristics data obtained through a questionnaire. Furthermore, the data were analyzed using the Chi-square test. RESULTS: About 84.2% of children with insufficient zinc intake had low serum Zn-levels. There was a significant relationship between zinc intake and serum zinc levels (p = 0.026; PR = 4.293). Children with low serum zinc levels of 96.5% have intelligence levels below average. There was a significant relationship between serum zinc levels and intelligence level as well (p = 0.001; PR = 24,500). CONCLUSION: Zinc deficiency in children is characterized by low serum Zn-levels. Low serum Zn-level is caused by low zinc intake, thus children with low serum Zn-levels are at risk of having intelligence level below average. Therefore, health education about the importance of zinc intake in children should be given to parents, so that the incidence of zinc deficiency in children can be reduced.

Background: The partnership between Puskesmas (Community Health Center) and school to improve the health of school-age children known as the Trias school health unit. In Seluma only 7.69% of schools have a room for health school program. This study aims to explore the partnership between Puskesmas’ and schools in malaria prevention to school-age children in Seluma. Method: This study used qualitative research with phenomenological approach. It was conducted in April 2019. The main informants consisted of 5 teachers, from 5 elementary schools and 2 UKS staff Puskesmas from Puskesmas Puguk and Puskesmas Talang Tinggi, who have worked over than three years. The data collected by indepth interview, FGDs and observation. Results: The role of the UKS Puskesmas staffs was not optimal in carrying out the triad UKS activities. They only carry out routine UKS activities. Partnership between Puskesmas and schools has not been implemented optimally. It is still very limited action to cooperate the routine triad implementation from the Puskesmas and schools. A review needs to be done to assess the performance of the UKS, especially through healthy school competition activities.

BACKGROUND: Tuberculosis is an infectious disease and global concern today. AIM: This study aims to map the incidence of pulmonary tuberculosis risk factors in Kabanjahe District, Karo Regency. METHOD: This research is an ecological study with a case-control study design. This research was conducted in Kabanjahe District in January - October 2020. All people who checked and declared to have tuberculosis based on clinical symptoms to be the population in this study. The sample size was calculated with a minimum sample size of 58 for the case group and 58 for the control group with a ratio of 1:1. The distribution pattern of pulmonary tuberculosis and environmental risk factors with the incidence of tuberculosis was carried out using a Geographic Information System (GIS) to determine the distribution of cases. Spatial analysis used average nearest neighbor, overlay and buffer followed with logistic regression as multivariate statistical analysis. RESULT:  The distribution pattern of pulmonary tuberculosis in Kabanjahe District tends to group (clusters). GeoDa software found the relationship between population density and tuberculosis incidence in Kabanjahe District with p values 0.04. There is a relationship between income, ventilation, floor conditions, humidity, and lighting with the incidence of tuberculosis. Humidity is the most dominant variable associated with the incidence of tuberculosis.   CONCLUSION: The incidence of tuberculosis cases in Kabanjahe District is dominantly influenced by the humidity factor of the house which is increasingly at risk due to poor ventilation, unstable room temperature, and bad circulation.

Background: Incidence of diarrhea increased by poor environmental conditions factors. The several factors of environmental health are housing, disposal waste, clean water supply, and sewerage. This study's purpose was to determine the determinants of environmental sanitation related to the incidence of diarrhea in infants at the work area of Pusat Kesehatan Masyarakat (Puskesmas) Singa, Karo District. Method: This research was quantitative research as a case study of diarrhea among infants in Puskesmas Singa. The subjects were housewives who had infants and suffered from diarrhea in the last six months of the study, with 225 total population and 63 people selected by simple random sampling. The data analyzed used logistic regression to found the influence of environmental sanitation on diarrhea. Results: The results found there were six variables analyzed, there were three variables that influenced the incidence of diarrhea, the variable ownership of feces disposal facilities was the most dominant factor with Exp B 18.267 (p-value 0.003; 95% CI: 2.750-121.334), and the quality of clean water are variables that influence the incidence of diarrhea with Exp B 5.763 (p-value 0.026; 95% CI: 1.234-26.904), food and drink sanitation are variables that influence the incidence of diarrhea with Exp B 12.451 (p-value 0.004; 95% CI: 2.190 - 70.773). Conclusion: It concludes that diarrhea among infants has a dominant relationship of water sanitation, disposal sanitation, and food sanitation as determinants. It needs to improve basic sanitation to decrease the count of diarrhea.