STATUS IODIUM PENDUDUK Di DAERAH PANTAI DA NON PANTAI Studi di Kabupaten Jepara dan Pati
Tahun 1999 Volume 34 Nomor 3
Oleh : Siti Fatimah Muis, M.Sulchan, Hertanto WS, Cahya Purnami
Salah satu dan masalah gizi utama di Indonesia adalah kekurangan/defisiensi iodium Defisiensi iodium pada berbagai derajat akan mengganggu pertumbuhan dan perkembangan janin, bayi , dan anak serta berdampak terhadap ibu hamil dan menyusui (Bumil – busui) Survei gondok pada tahun 1980-1982 menunjukkan bahwa 21 dan’ 31 kabupaten di Jateng mempunyai’ prevalensi’ gondok yang tinggi (30%-80% Melalui program pemberantasan GAKI (gangguan akibat kekurangan iodium) . semua daerah menunjukkan penurunan nyata dalam prevalensi gondok. Namun, pemetaan ulang GAK1 di tahun 1996 menunjukkan bahwa prevalensi gondok di Pati masih tinggi, sedangkan Jepara dinyatakan sebagai daerah endemik GAKI berdasar parameter UEI (urinary excreted iodine), yang angkanya terendah diantara 35 kabupaten/kodya se-Jateng.
Suatu penelitian telah dilakukan untuk membandingkan prevalensi gondok pada anak ,sekolah dan menilai parameter UEI dan TSH bumil-busui di daerah pantai dan non-pantai di Pati sebagai daerah GAKI yang membaik dan Jepara sebagai daerah dengan median UEI terendah di Jateng. Penelitian dilakukan di 2 kecamatan pantai dan 2 non-pantai di masing-masing kabupaten. Tiga desa dengan penduduk tertinggi di tiap kecamatan diambil sebagai penelitian. Sampel diambil secara acak di antara anak sekolah (untuk data TGR) dan bumil-busui (Untuk data UEI dan TSH).
pantai pada satu kabupaten yang ada adalah antar kabupaten ;(4) berdasarkan parameter status bumil dan busui ,Jepara lebih baik daripada Pati , namun lebih baik keadaanya daripada Pati lebih baik keadaaanya daripada Jepara berdasarkan parameter UEI
berdasar atas temuan diatas, penelitian ini mengusulkan bahwa untuk menilai status iodium suatu masyarakat secara lebih tepat perlu dilakukan pemeriksaan : (1) ultrasonographi kelenjar gondok sebagai cara yang lebih sensitif daripada dengan palpasi kelenjar gondok ;(2) kadar thiosonat dalam urine didaerah yang tinggi sumber pangan goitrogenik seperti Pati dan Jepara.
One of the major piutritional problems in Indonesia is iodine deficiency. Iodine deficiency at different levels impairs the growth and development of foetus, infant and affects pregnant and lactating women as other vulnerable group. Goiter survey in 1980/1982 revealed that 21 out of 31 regencies (kabupaten) in Central Java had high prevalence of goiter (30%-80%). Through an 1DD control program, all areas showed substantial decrease in goiter prevalence. However, from that 1996 mapping. Pati is still high in goiter prevalence, while .Jepara is considered as an endemic area based on the median urinsry excreted iodine (UEl) parameter It has the lowest median UEI compared to the Other 35 kodya/kabupatens in Central Java.
A study was carried out to compare the TGR prevalence in school children and UEI and TSH in pregnant and lactating women living in the coastal and non-coastal villages of Pati as an improving goiter area and .Jepara an area with the lowest median of UEI in Central Java. The study was carried out in 8 districts (kecamatan). four in Pati and another 4 in .Jepara. Two out of the four kecamatan in each kabupaten are low-land/coastal kecamatan, while the other two are in the inner/high land areas. Three villages with highest population were chosen from each kecamatan. Samples and respondents of the study were pregnant/lactating ,women, mother of the under—five year—old children Irom different economic status and formal leaders, School children from each village were taken randomly for TGR data. Data are presented in tables of frequency distributions, and the difference between TGR, UEI, and TSH level of the coastal and non – coastal kecamatan in two kabupaten were wnwlyzed.
The study revealed that (1) based on TGR parameter, there was a different between prevalence of goiter among children in the non—coastal and coastal kecamatan in Pati, both in 1996 and 1998, however there is a substantial decrease in 1998; (2) As for Jepara. there was differences between TGR Among school children living in coastal and non—coastal area. However there is a tendency of an increment (3) there us no significant differences between the median UEI and TSH the pregnant and, lactating women of the coastal and ,ion—coastal kecamatan whithin each kabupaten, the difference is found only between kabupaten (4) among pregnant and lactating women . Jepara is better in TSH parameter in UEI than Pati, but Pati is better than Jepara in UEI parameter
Based on the above findings, this study recommend.s’ that to assess iodine status in certain area more precisely there are needs. (I) to do thyroid scanning as a more sensitive parameter for TGR (2) To include the examination of urinary thiocianate to interpret the UEI result in areas with many goitrogenic foods in combination with TSH parameters