Suplementasi Seng dan Probiotik pada Diare Akut Cair Anak

Abstract

Backgrounds: Clinical trials have demonstrated that zinc supplement during diarrhea episodes reduces the duration and severity of illness. Studies have shown that probiotic may be useful in treating acute diarrhea. Study that evaluated diet enriched with zinc and probiotic showed significant reduction on the duration of diarrhea. Whether this combination is better than either supplementation of zinc or probiotic alone is unknown. The objective of the study was to compare the duration of diarrhea among children with acute watery diarrhea given zinc, probiotic and combined zinc - probiotic supplementation.
Methods: Consecutive sampling from 6-24 months old hospitalized children with acute watery diarrhea in Kariadi hospital was done. There were 77 subjects randomized into 4 study groups. Three groups were supplemented daily with zinc, probiotic, or zinc and probiotic and one group as control. Each group had received standard therapy including rehydration and dietetic. Data were analyzed with Chi-square test, t test and one way ANOVA.
Results: There were no differences in age, breastfeeding history, nutritional and social economic status, day before admission, and level of zinc serum among groups. Supplemented group showed significant reduction on the duration of diarrhea compared with control (p=0.02). There was no significant difference on the duration of diarrhea between zinc-probiotic and zinc or probiotic groups (p=0.15). Zinc-probiotic supplemented group had the lowest duration of diarrhea among groups.
Conclusions: Zinc and probiotic are able to reduce the duration of acute watery diarrhea.

ABSTRAK
Latar belakang: Berbagai uji klinis menunjukkan suplementasi seng menurunkan durasi dan beratnya diare. Suplementasi probiotik juga menunjukkan manfaat pada terapi diare akut. Penelitian tentang diet yang difortifikasi seng dan probiotik menunjukkan penurunan durasi diare secara bermakna. Belum diketahui apakah suplementasi seng dan probiotik secara kombinasi lebih baik dari pada suplementasi seng dan probiotik secara terpisah. Penelitian ini bertujuan membandingkan durasi diare pada anak yang dirawat dengan diare akut cair yang diberikan suplementasi seng, probiotik, kombinasi seng dan probiotik serta kontrol.
Metoda: Subjek diambil secara konsekutif dari anak usia 6-24 bulan yang dirawat dengan diare akut cair di RSUP Dr. Kariadi Semarang. Didapatkan 77 subjek dan diacak menjadi 4 kelompok. Tiga kelompok diberi perlakuan berupa suplementasi seng saja, suplementasi probiotik saja atau kombinasi seng dan probiotik serta satu kelompok sebagai kontrol. Setiap kelompok mendapat terapi standar berupa rehidrasi dan dietetik. Data dianalisis dengan menggunakan uji Chi-square, t test dan one way ANOVA.
Hasil: Tidak terdapat perbedaan bermakna pada umur, riwayat pemberian ASI, status gizi dan sosial ekonomi, lama sakit sebelum dirawat, dan kadar seng serum diantara keempat kelompok. Kelompok suplementasi mempunyai penurunan durasi diare yang bermakna dibandingkan kontrol (68,6 vs 83,8 jam, p=0,02). Tidak didapatkan perbedaan bermakna antara kelompok kombinasi seng dan probiotik dibandingkan kelompok seng atau probiotik saja (p=0,15). Kelompok seng dan probiotik mempunyai durasi diare paling pendek dibandingkan kelompok lain.