Pengaruh Iodinsasi Air mInum Dalam kendi Terhadap Kadar Iodium Urin dan Kecerdasan Anak Usia 25-59 bulan (di kecamatan Ngargoyoso, Karanganyar, Jawa Tengah)

ABSTRAK

YuliaLanti Retno Dewi. T630209001.2012. Pengaruh Iodinsasi Air mInum Dalam kendi Terhadap Kadar Iodium Urin dan Kecerdasan Anak Usia 25-59 bulan (di kecamatan Ngargoyoso, Karanganyar, Jawa Tengah). Disertasi. Program Pascasarjana Universitas Sebelas Maret Surakarta. Pembimbing: Prof. Dr. Ambar Mudigdo, dr, SpPA (K) (Promotor), Prof. Drs. Suranto, MSc, PhD (Ko-Promotor), Prof. Bhisma Murti, dr, MPH, MSc, PhD (Ko-Promotor).

Anak prasekolah usia 25-59 bulan yang tinggal di daerah endemik kekurangan iodium termasuk golongan rentan terhadap gangguan akibat kekurangan iodium. Kecamatan Ngargoyoso termasuk daerah endemik berat kekurangan iodium. Selama ini belum ada penelitian suplementasi iodium pada kelompok usia tersebut.
Penelitian ini bertujuan menguji hipotesis bahwa suplementasi iodium melalui air minum yang ditempatkan dalam kendi dapat meningkatkan kadar iodium urin dan kecerdasan anak prasekolah usia 25-59 bulan.
Sebuah randomized, placebo controlled trial telah dilakukan di kecamatan Ngargoyoso.Penelitian dilakukan pada bulan Juli-November 2011. Enam puluh tujuh anak usia 25-59 bulan dari 4 desa yang memenuhi kriteria (1) kadar iodium urin <100µg/L, (2) sudah tidak mendapat ASI, (3) setuju ikut dalam keseluruhan penelitian ; dan tidak menderita retardasi mental, gizi buruk, cacat bawaan atau keluarganya menderita gondok, diikut sertakan dalam penelitian ini. Mereka secara acak dibagi menjadi dua kelompok, yaitu kelompok iodium (n =33) dan kelompok plasebo (n = 34). Kelompok iodium mendapat 100 µg KIO3 (2 tetes=0.1 ml) setiap hari, dan kelompok plasebo mendapat 2 tetes (0.1 ml) air suling di dalam air kendi selama 12 minggu. Data awal dan 12 minggu pasca perlakuan yang meliputi kadar iodium dalam urin, intelligence quotient, status gizi, asupan gizi, sosial ekonomi, dan pola asuh anak dikumpulkan, dianalisis dan dibandingkan.
Hasil penelitian menunjukkan bahwa 100 µg KIO3 per hari meningkatkan kadar iodium dalam urin dari 62.45 (±26.21) µg/L menjadi 244.55 (±120.19) µg/L dan meningkatkan IQ dari 101.48 (±11.03) poin menjadi 110.27 (±9.40) poin. Faktor perancu terhadap perkembangan otak yang meliputi status gizi, asupan energi, protein, zat besi, sosial ekonomi keluarga dan pola asuh anak pada kedua kelompok tidak menunjukkan perbedaan bermakna. Dapat disimpulkan bahwa perbaikan fungsi kognitif dalam penelitian ini semata-mata akibat penambahan iodium
Ringkasnya, penelitian ini menunjukkan bahwa KIO3 dapat digunakan secara efektif untuk suplementasi air minum. Kendi dapat diterima, murah dan terbeli. Suplementasi ini meningkatkan IQ sebesar 8.8 poin.

Kata kunci: iodisasi air minum, kendi, kadar iodium urin, kecerdasan, prasekolah.

ABSTRACT

Yulia Lanti Retno Dewi. T630209001. 2012. Effect of water iodization presented in kendi on the urinary iodine excretion and intelligence of preschool children aged 25-59 months in Ngargoyoso sub-district, Karanganyar Central Java. Dissertation. Postgraduate School of Sebelas Maret University, Surakarta. Supervisor: Professor Ambar Mudigdo, MD, PhD; Co-Supervisor I: Professor Suranto, MSc, PhD; Co-Supervisor II: Professor Bhisma Murti, MD, MPH, MSc, PhD.

Preschool children aged 25-59 months living in endemic area are vulnerable to iodine deficiency disorders. Ngargoyoso sub-district is one of IDD pockets in Indonesia and classified as severe endemic. To date there is no iodine supplementation trials in this group.
A randomized, placebo, controlled trial was carried out in Ngargoyoso sub-district to test the hypotheses that iodine supplementation would increase urinary iodine excretion and intelligence scores of preschool children aged 25-59 months. The study was conducted between July and November 2011. Sixty seven preschool children aged 25-59 months were recruited from 4 villages using inclusion criteria: (1) Urinary iodine excretion < 100µg/L, (2) Not breastfed anymore, (3) Agreed to participate in the whole study. Children with mental retardation, severe malnutrition, congenital malformations, or their siblings suffered from goiter were excluded from the study. The children were then randomly allocated into two groups: iodine group (n = 33) and placebo group (n = 34). Iodine group received 100 µg KIO3 (two drops = 0.1 ml) daily, while placebo group received two drops (0.1 ml) distillated water into their drinking water in a kendi, for twelve weeks. Baseline and post-treatment data on urinary iodine excretion, intelligence quotient, nutritional status, nutrient intakes, social economy, and care practices were collected for comparison between groups.
The results showed that 100 µg KIO3 daily significantly increased urinary iodine excretion from 62.45(±26.21)µg/L to 244.55(±120.19)µg/L and improved intelligence quotient from 101.48 (±11.03) points to 110.27 (±9.40) points. There are some confounding factors for brain development namely: stunting, iron deficiency, protein-energy intakes, socioeconomic factors and care practices, those were equals between groups. It can be concluded that the improvement of cognitive function in this study was solely due to iodine supplementation.
In summary, the study shows that KIO3 can be used effectively to supplement iodine into drinking water. Kendi is acceptable, affordable, and cost-effective. The supplementation increases intelligence quotients by 8.8 points.

Keywords: drinking water iodization, kendi, urinary iodine excretion, intelligence, preschool children.