Terapi dan Suplementasi Besi pada Anak

Gunadi, Dedy; Lubis, Bidasari; Rosdiana, Nelly

doi:10.14238/sp11.3.2009.207-11

Cited by 7 publications

(10 citation statements)

References 14 publications

(19 reference statements)

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“…Tabel 3 memperlihatkan perbandingan antara cut-off point Indeks Mentzer yang digunakan secara universal (13) dengan cut-off point lain (10,7 dan 14,3) untuk mencari sensitivitas dan spesifisitas terbaik. Tabel 3 memperlihatkan IM memiliki rerata sensitivitas 62,9%, spesifisitas 28,6% dengan NDP (positive predictive value) dan NDN (negative predictive value) 9) 26,32% (13,4-43,1) Spesifisitas 28,,6% (3,7-71) 28,6% (3,9) 28,57% (3,7-70,9) NDP (positive predictive valuei) 86,1% (79,1-91) 82,1% (72,9-88,7) 66,7% (49,6-80,3) NDN (negative predictive value) 22,2% (6,9-52,4) 11,8% (3,7-31,5) 6,7% (2,1-18,9) RKP(positive likelihood ratio) 1,1 (0,7-1,9) 0,9 (0,5-1,5) 0,4 (0,2-0,8) RKN (negative likelihood ratio) 0,6 (0,2;2,3) 1,4 (0,4-4,8) 2,4 (0, 5)…”

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“…Hal ini dapat terjadi akibat asupan zat besi yang kurang, absorpsi zat besi yang rendah atau pertumbuhan yang cepat. 4,5 Anemia defisiensi besi dapat memengaruhi pertumbuhan dan perkembangan anak seumur hidup karena menyebabkan gangguan kognitif, perilaku, dan pertumbuhan pada anak. 5,6 Kadar Hb yang rendah tidak hanya ditemukan pada ADB, tetapi juga penyakit-penyakit lain, seperti keracunan timbal, thalassemia, anemia sideroblastik, dan anemia akibat inflamasi.…”

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“…4,5 Anemia defisiensi besi dapat memengaruhi pertumbuhan dan perkembangan anak seumur hidup karena menyebabkan gangguan kognitif, perilaku, dan pertumbuhan pada anak. 5,6 Kadar Hb yang rendah tidak hanya ditemukan pada ADB, tetapi juga penyakit-penyakit lain, seperti keracunan timbal, thalassemia, anemia sideroblastik, dan anemia akibat inflamasi. Indonesia sebagai bagian dari negara sabuk Thalassemia memiliki prevalens thalassemia yang cukup tinggi, yaitu sekitar 2-11% sehingga sangat penting untuk membedakan ADB dari thalassemia akibat adanya perbedaan tata laksana dan prognosis.…”

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Indeks Mentzer sebagai Alat Diagnostik Anemia Defisiensi Besi di Sarana Kesehatan dengan Fasilitas Terbatas: Perbandingan Berbagai Nilai Cut Off

Sari

Aliza

Soedjatmiko

2019

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Latar belakang. Anemia defisiensi besi (ADB) adalah penyebab tersering anemia pada anak kurang dari 5 tahun dan dapat menyebabkan gangguan kognitif, perilaku, dan pertumbuhan yang menetap sehingga diagnosis harus ditegakkan sedini mungkin. Diagnosis ADB ditegakkan dengan pemeriksaan laboratorium yang mahal dan tidak tersedia merata di Indonesia. Untuk itu, penggunaan Indeks Mentzer (IM) merupakan salah satu alat penegakan diagnosis yang mudah. Tujuan. Mengetahui validitas IM untuk mendiagnosis ADB di daerah dengan fasilitas terbatas, dan mengetahui apakah cut-off point baru diperlukan untuk populasi di Indonesia. Metode. Penelitian ini merupakan uji diagnostik dengan metode potong lintang. Subjek adalah anak sehat berusia 12-59 bulan yang pucat. Penapisan dilakukan di 27 Posyandu dan 27 PAUD di Kecamatan Jatinegara. Subjek yang memenuhi kriteria inklusi menjalani pemeriksaan darah perifer lengkap, kemudian subjek dengan anemia mikrositik hipokrom diperiksa profil besi dan C-reactive protein (CRP). Validitas dinilai dengan membandingkan IM dengan hasil profil besi. Penentuan cut-off point spesifik untuk populasi di Indonesia dilakukan dengan membandingkan sensitivitas, spesifisitas, nilai duga positif (NDP) dan negatif (NDN), rasio kemungkinan positif (RKP), dan rasio kemungkinan negatif (RKN) antara beberapa cut-off points.Hasil. Penelitian ini mendapatkan 340 subjek dengan klinis pucat, 100 subjek setuju untuk melakukan pemeriksaan laboratorium, dan sisa 45 subjek dengan anemia mikrositik hipokrom. Penelitian ini memberikan sensitivitas 60,5%, spesifisitas 28,6%, NDP 82,1%, NDN 11,8%, RKP 0,9, dan RKP 1,4. Titik potong baru yang disarankan adalah 10,7 dengan sensitivitas 81,6% dan NDP 86,1%.Kesimpulan. Nilai diagnostik IM rendah dengan NDP yang baik untuk diagnosis ADB. Titik potong 10,7 dapat juga digunakan sebagai uji tapis ADB di fasilitas terbatas.

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Indeks Mentzer sebagai Alat Diagnostik Anemia Defisiensi Besi di Sarana Kesehatan dengan Fasilitas Terbatas: Perbandingan Berbagai Nilai Cut Off

Sari

Aliza

Soedjatmiko

2019

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“…Iron deficiency anemia (IDA) is associated with changes in neurotransmitter receptors and the signal delivery process of the nervous system. 2,3 Primary prevention of iron deficiency can be achieved by eating a varied diet or a diet containing enough iron. Secondary prevention includes screening programs and early treatment of iron deficiency.…”

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Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children

Rungngu

Wahani

Mantik

2016

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Background The prevalence of iron deficiency anemia (IDA) remains high in Indonesian children. When anemia is detected in a patient, the physician's task is to identify the cause, address it, provide iron therapy, and prevent recurrence. However, prevention is best done by early detection. The reticulocyte hemoglobin equivalent (Ret-He) is a direct measurement of iron level in reticulocytes recently produced in the bone marrow. The Ret-He measurement may be an early indicator of iron deficiency, as it is sensitive at the initial stage of the condition. Objective To assess for a relationship between Ret-He and IDA as well as to evaluate the usefulness of Ret-He for diagnosing IDA in children. Methods This analytic, observational study with cross-sectional approach included 50 children aged 6-12 years and was performed from November 2013 to March 2014. The subjects were divided into IDA or non-IDA groups, based on ferritin levels. A correlation analysis using logistic regression was performed and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and odds ratio (OR) were calculated. Results were considered to be statistically significant for P values <0.05. Results A low Ret-He level was significantly associated with IDA in children (P=0.005). The Ret-He cut-off point of 27.8 pg/L had sensitivity of 43.8%, specificity 85.3%, PPV 58.3%, and NPV 76.3%, with OR 4.5 (95%CI 1.1 to 17.7). Conclusion We find a significant positive relationship between Haemoglobin (Hb) and Ret-He in children, A low level of Ret-He is associated with greater risk of IDA in children. The Ret-He has a high specificity. As such, Ret-He may be useful as a screening tool for early detection of IDA in children. [Paediatr Indones. 2016;56:90-4.].

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“…4 Iron deficiency anemia is, therefore, a major public health problem with a prevalence of more than 40% in Indonesia. 5 Anemic children experience inhibited growth and intellectual development, and are more susceptible to disease due to immune deficiency. If the anemia goes untreated, it will impact the development of intelligence.…”

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Reticulocyte hemoglobin content as a predictor of iron deficiency anemia

Suari¹,

Ariawati²,

Adiputra³

2015

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Background Iron deficiency anemia (IDA) is the most common form of anemia in developing countries, such as Indonesia. Iron deficiency anemia in children is a serious problem because it affects their growth and development. Early detection of IDA and subsequent treatment in childhood may prevent future health problems.Objective To assess the use of reticulocyte hemoglobin content (CHr) to detect IDA in children aged 6-60 months. MethodsWe performed a cross-sectional study to measure the sensitivity and specificity of CHr compared to serum ferritin which is considered to be the gold standard for IDA diagnosis. The study was conducted from September 2011 to March 2013 in children aged 6-60 months who visited the Pediatric Outpatient Clinic, Sanglah Hospital, and Puskesmas II in West Denpasar. Data analysis was performed by 2x2 table. The results were assessed by area under the curve (AUC) and receiver operating characteristic (ROC). ResultsOf 121 children underwent blood testing during the study period, 69 children were excluded because they did not have hypochromic microcytic anemia, leaving 52 subjects eligible for the study. The prevalence of IDA in this study was 31%. Reticulocyte hemoglobin content (CHr) ≤ 23.1 pg had 88% (95%CI 71 to 100%) sensitivity and 25% (95%CI 11 to 39%) specificity. ConclusionReticulocyte hemoglobin content < 23.1 pg may be a good predictor of IDA. [Paediatr Indones. 2015;55:171-5.].

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Terapi dan Suplementasi Besi pada Anak

Cited by 7 publications

References 14 publications

Indeks Mentzer sebagai Alat Diagnostik Anemia Defisiensi Besi di Sarana Kesehatan dengan Fasilitas Terbatas: Perbandingan Berbagai Nilai Cut Off

Indeks Mentzer sebagai Alat Diagnostik Anemia Defisiensi Besi di Sarana Kesehatan dengan Fasilitas Terbatas: Perbandingan Berbagai Nilai Cut Off

Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children

Reticulocyte hemoglobin content as a predictor of iron deficiency anemia

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