journal nutrisi bayi

7/22/2019 Journal Nutrisi Bayi

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pertumbuhan kronis goyah antara

kelompok kelahiran anak-anak India mulai

sebelum penyapihan dan sangat lazim padatiga tahun

Andrea M Rehman1Andrea M Rehman1 , Beryl P Gladstone2, Gladstone P Beryl2

, Valsan P Verghese3, P Valsan Verghese

3 , Jayaprakash Muliyil2, Jayaprakash

Muliyil2 , Shabbar Jaffar1, Shabbar Jaffar1 and Gagandeep Kang4dan

Gagandeep Kang4

1MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine,

London, WC1E 7HT, UK 1MRC Epidemiology Group Tropis, London School of Hygiene &

Tropical Medicine, London, 7HT WC1E, Inggris

2Department of Community Health, Christian Medical College, Vellore, 632 004, India 2

Departemen Kesehatan Masyarakat, Medical College Kristen, Vellore, 632 004, India

3Department of Child Health, Christian Medical College, Vellore, 632 004, India 3Departemen Kesehatan Anak, Fakultas Kedokteran Kristen, Vellore, 632 004, India

4Department of Gastrointestinal Sciences, Christian Medical College, Vellore, 632 004, India4Departemen Ilmu gastrointestinal, College Medical Kristen, Vellore, 632 004, India

author email penulis email corresponding author email sesuai penulis email

Nutrition Journal2009, 8 :44 doi:10.1186/1475-2891-8-44Jurnal Gizi2009, 8:44 DOI:

10.1186/1475-2891-8-44

The electronic version of this article is the complete one and can be found online at:

http://www.nutritionj.com/content/8/1/44Versi elektronik dari artikel ini adalah yang

lengkap dan dapat ditemukan secara online di:http://www.nutritionj.com/content/8/1/44

Received: Diterima: 8 June 2009 8 Juni 2009

Accepted: Diterima: 29 September 2009 29 September 2009Published: Diterbitkan:29 September 2009 29 September 2009

2009 Rehman et al; licensee BioMed Central Ltd. 2009 Rehman et al; licensee BioMed

Central Ltd

This is an Open Access article distributed under the terms of the Creative Commons

Attribution License (http://creativecommons.org/licenses/by/2.0), which permits

unrestricted use, distribution, and reproduction in any medium, provided the original work is

properly cited. Ini adalah Akses Terbuka artikel didistribusikan di bawah ketentuan Creative

Commons Attribution License (http://creativecommons.org/licenses/by/2.0), yang

memungkinkan tidak dibatasi penggunaan, distribusi, dan reproduksi dalam media apapun,

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Abstract Abstrak

Background Latar belakang

Poor growth of children in developing countries is a major public health problem associated

with mortality, morbidity and developmental delay. Miskin pertumbuhan anak-anak di negaraberkembang merupakan masalah kesehatan masyarakat yang utama terkait dengan mortalitas,

morbiditas dan keterlambatan perkembangan. We describe growth up to three years of age

and investigate factors related to stunting (low height-for-age) at three years of age in a birth

cohort from an urban slum. Kami menggambarkan pertumbuhan sampai tiga tahun dan

menyelidiki faktor yang berhubungan dengan pengerdilan (tinggi-rendah untuk-usia) pada

usia tiga tahun pada kelompok kelahiran dari daerah kumuh perkotaan.

Methods Metode

452 children born between March 2002 and August 2003 were followed until their third

birthday in three neighbouring slums in Vellore, South India. 452 anak yang lahir antara

Maret 2002 sampai Agustus 2003 diikuti sampai ulang tahun ketiga mereka dalam tiga

daerah kumuh tetangga dalam hal Vellore, India Selatan. Field workers visited homes to

collect details of morbidity twice a week. pekerja Lapangan mengunjungi rumah-rumah

untuk mengumpulkan rincian morbiditas dua kali seminggu. Height and weight were

measured monthly from one month of age in a study-run clinic. Tinggi dan berat badan

diukur setiap bulan dari usia satu bulan di klinik studi-lari. For analysis, standardised z-scores

were generated using the 2006 WHO child growth standards. Untuk analisis, standar z-skor

yang dihasilkan dengan menggunakan standar anak WHO 2006 pertumbuhan. Risk factors

for stunting at three years of age were analysed in logistic regression models. Faktor risiko

untuk pengerdilan pada tiga tahun dianalisis dalam model regresi logistik. A sensitivityanalysis was conducted to examine the effect of missing values. Analisis sensitivitas

dilakukan untuk menguji pengaruh nilai-nilai yang hilang.

Results Hasil

At age three years, of 186 boys and 187 girls still under follow-up, 109 (66%, 95%

Confidence interval 58-73%) boys and 93 (56%, 95% CI 49-64%) girls were stunted, 14 (8%,

95% CI 4-13%) boys and 12 (7%, 95% CI 3-11%) girls were wasted (low weight-for-height)

and 72 (43%, 95% CI 36-51) boys and 66 (39%, 95% CI 31-47%) girls were underweight

(low weight-for-age). Pada usia tiga tahun, dari 186 anak laki-laki dan 187 perempuan masih

dalam tindak lanjut, 109 (66%, 95% Confidence interval 58-73%) anak laki-laki dan 93(56%, 95% CI 49-64%) gadis itu terhambat, 14 (8%, 95% CI 4-13%) anak laki-laki dan 12

(7%, 95% CI 3-11%) gadis-gadis itu terbuang (berat-rendah-tinggi) dan 72 (43%, 95% CI 36

- 51) anak laki-laki dan 66 (39%, 95% CI 31-47%) perempuan adalah kurus (berat-rendah

untuk-usia). In total 224/331 (68%) children at three years had at least one growth deficiency

(were stunted and/or underweight and/or wasted); even as early as one month of age 186/377

(49%) children had at least one growth deficiency. Total 224 / 331 (68%) anak pada tiga

tahun memiliki setidaknya satu kekurangan pertumbuhan (yang terhambat dan / atau berat

badan dan / atau terbuang), bahkan sejak satu bulan usia 186/377 (49%) anak-anak di

setidaknya satu kekurangan pertumbuhan. Factors associated with stunting at three years

were birth weight less than 2.5 kg (OR 3.63, 95% CI 1.36-9.70) 'beedi-making' (manual

production of cigarettes for a daily wage) in the household (OR 1.74, 95% CI 1.05-2.86),maternal height less than 150 cm (OR 2.02, 95% CI 1.12-3.62), being stunted, wasted or


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underweight at six months of age (OR 1.75, 95% CI 1.05-2.93) and having at least one older

sibling (OR 2.00, 95% CI 1.14-3.51). Faktor yang terkait dengan pengerdilan pada tiga tahun

yang berat lahir kurang dari 2,5 kg (OR 3,63, 95% CI 1,36-9,70) 'beedi-membuat' (manual

produksi rokok untuk upah harian) dalam rumah tangga (OR 1,74, 95% CI 1,05-2,86), tinggi

ibu kurang dari 150 cm (OR 2,02, 95% CI 1,12-3,62), yang kerdil, terbuang atau kurus pada

usia enam bulan (OR 1,75, 95% CI 1,05-2,93) dan memiliki setidaknya satu saudara yanglebih tua (OR 2,00, 95% CI 1,14-3,51).

Conclusion Kesimpulan

A high proportion of urban slum dwelling children had poor growth throughout the first three

years of life. Sebagian besar dari anak-anak hunian kumuh perkotaan memiliki pertumbuhan

yang buruk selama tiga tahun pertama kehidupan. Interventions are needed urgently during

pregnancy, early breastfeeding and weaning in this population. Intervensi diperlukan segera

selama kehamilan, awal menyusui dan menyapihnya dalam populasi ini.

Background Latar belakang

In developing countries, poor growth of children under five is a major public health problem.

Di negara-negara berkembang, pertumbuhan yang buruk dari anak balita merupakan masalah

kesehatan masyarakat yang utama. Children with poor growth have high rates of mortality

and morbidity Anak-anak dengan pertumbuhan yang buruk memiliki tingkat tinggi mortalitas

dan morbiditas [1,2] and can suffer motor and mental developmental delay [1,2] dan

dapat menderita dan keterlambatan perkembangan mental motor [3,4]. [3,4]. One of the

WHO's millennium development goals is to halve by 2015 the proportion of children under

five who are stunted, wasted or underweight from 1990 levels. Salah satu WHO tujuan

pembangunan milenium adalah untuk membagi dua tahun 2015 proporsi anak balita yangterhambat, terbuang atau kurus dari tingkat tahun 1990. In 2005, the WHO estimated that of

all children under five living in developing countries, 32% were stunted and 10% were

wasted Pada tahun 2005, WHO memperkirakan bahwa dari semua anak balita yang tinggal di

negara-negara berkembang, 32% adalah terhambat dan 10% adalah terbuang [5] using the

WHO's new child growth standards [5] dengan menggunakan standar WHO anak

pertumbuhan baru [6]. [6]. In a nationwide survey in 2005-6, Indian estimates of stunting

were 38%, of wasting were 19% and of underweight were 46% among children under 3 years

of age Dalam sebuah survei nasional di 2005-6, perkiraan India pengerdilan adalah 38%,

membuang-buang adalah 19% dan gizi kurang adalah 46% di antara anak di bawah 3 tahun [

7]. [7]. A different growth standard to the WHO was used to calculate the Indian estimates

Suatu pertumbuhan yang berbeda standar WHO digunakan untuk menghitung perkiraan India[8], which may have underestimated the proportion of children with poor growth [8], yang

mungkin telah meremehkan proporsi anak-anak dengan pertumbuhan miskin [9,10]. [9,

10]. India therefore has a larger than average proportion of children who are stunted, wasted

and underweight. India sehingga memiliki rata-rata lebih besar daripada proporsi anak-anak

yang terhambat, terbuang dan berat badan.

There are large urban slums in India and it has been suggested that between 50-94% of

children are underweight in different slum populations in Northern India Ada kumuh kota

besar di India dan telah menyarankan bahwa antara 50-94% dari anak-anak berat badan pada

populasi kumuh yang berbeda di India Utara [11]. [11]. However the studies which have

reported these findings were mostly cross-sectional, and were varied in the growth standardsused, so have limited use when comparing with other estimates. Namun studi yang telah
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4/21

melaporkan temuan ini sebagian besar cross-sectional, dan bervariasi dalam standar

pertumbuhan digunakan, sehingga dapat menggunakan terbatas ketika membandingkan

dengan perkiraan lainnya.

We have conducted a longitudinal birth cohort in an urban slum community in Vellore, South

India and measured children's growth monthly for three years. Kami telah melakukan suatukohort longitudinal lahir di sebuah komunitas kumuh perkotaan di Vellore, India Selatan dan

diukur pertumbuhan bulanan anak-anak selama tiga tahun. We describe here growth

throughout the first three years of life and the factors related to poor growth within this

population. Kami jelaskan di sini pertumbuhan selama tiga tahun pertama kehidupan dan

faktor-faktor yang berhubungan dengan pertumbuhan miskin dalam populasi ini.

Methods Metode

The design of the study has been reported previously Desain penelitian telah dilaporkan

sebelumnya [12,13]. [12,13]. In brief, the primary aim of the study was to investigate the

natural history of rotavirus infections in children. Secara singkat, tujuan utama dari penelitian

ini adalah untuk mengetahui riwayat alami infeksi Rotavirus pada anak-anak. The study was

conducted in three neighbouring urban slums in Vellore measuring 2.2 sq. km with a

population density of approximately 17,000 per sq. km. Penelitian ini dilakukan di tiga

daerah kumuh perkotaan di Vellore berukuran 2,2 km persegi dengan kepadatan penduduk

sekitar 17.000 per km persegi. A common occupation in the area is 'beedi work', the manual

production of cigarettes for a daily wage. 'Kerja beedi' A pendudukan umum di daerah

tersebut adalah, produksi rokok manual untuk upah harian. Pregnant women were identified

during a survey conducted in 2002. wanita hamil yang diidentifikasi selama survei yang

dilakukan pada tahun 2002. Infants were recruited from birth between March 2002 and

August 2003 following written informed consent from the mother. Bayi direkrut dari lahirantara Maret 2002 dan Agustus 2003 setelah persetujuan tertulis dari ibu. Those living in

brick-built houses with more than four rooms (n = 46) or who had birth weight less than 1.5

kg (n = 2) were excluded. Mereka tinggal di rumah-rumah bata-dibangun dengan lebih dari

empat kamar (n = 46) atau yang memiliki berat lahir kurang dari 1,5 kg (n = 2) dikeluarkan.

Socio-economic status within this relatively homogenous population was stratified as

previously described status sosial-ekonomi dalam populasi relatif homogen itu bertingkat-

tingkat sebagaimana telah dijelaskan sebelumnya [13]. [13]. Field workers visited infants

at home soon after birth and twice weekly thereafter collecting details of morbidity and

referring children to a physician-run study clinic as necessary. pekerja lapangan mengunjungi

bayi di rumah segera setelah lahir dan dua kali setiap minggu pengumpulan rincian

morbiditas dan anak-anak merujuk ke klinik dokter-lari studi yang diperlukan. Follow-upcontinued until the child's third birthday. Tindak lanjut berlanjut sampai ulang tahun ketiga

anak. The last child was followed up in August 2006. Anak yang terakhir ini diikuti di bulan

Agustus 2006. Breastfeeding uptake was high in this population with 445 (98%) of the 452

enrolled children known to start. Menyusui serapan tinggi pada populasi dengan 445 (98%)

dari 452 anak yang diketahui terdaftar untuk memulai.

Height and weight at birth, where available, were obtained from delivery records available at

the first home visit. Tinggi dan berat badan saat lahir, jika tersedia, diperoleh dari catatan

pengiriman yang tersedia pada kunjungan rumah pertama. Subsequently, height and weight

were obtained by field workers at the study clinic using single measurements. Selanjutnya,

tinggi dan berat badan diperoleh oleh petugas lapangan di klinik penelitian denganmenggunakan pengukuran tunggal. Weight was measured using a Salter weighing scale to the
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nearest 100 grams. Berat diukur dengan menggunakan skala Salter seberat 100 gram ke

terdekat. Recumbent length was measured using a standard infantometer up to the child's first

birthday or until the child was able to stand, and subsequently using a stadiometer, both to the

nearest millimetre. telentang panjang diukur dengan menggunakan infantometer standar

sampai ulang tahun pertama anak atau sampai anak itu bisa berdiri, dan kemudian

menggunakan stadiometer, baik ke milimeter terdekat. The instruments were calibrated atleast once a week. Instrumen yang digunakan dikalibrasi setidaknya sekali seminggu. Field

workers were retrained and procedures standardised once every three months. pekerja

lapangan dilatih ulang dan prosedur standar sekali setiap tiga bulan.

We calculated total duration of illness; we defined major illness as diarrhoea, lower

respiratory infection, tuberculosis, jaundice, central nervous system infection, seizures or

convulsions, neonatal sepsis, neonatal jaundice, congenital diseases, burns, scalds, fracture,

crush injuries, dengue, and physician diagnosed malnutrition; and defined minor illness as

fever, cough or cold, asthma, wheezing, bronchiolitis, exanthematous fever (except measles),

skin morbidities, eye morbidities, ear, nose and throat morbidities, incessant crying, abrasions

and bites, pica, aphthous ulcer, localised infections, anaemia and loss of appetite. Kamimenghitung total durasi penyakit, kita pasti penyakit berat seperti diare, infeksi saluran

pernafasan lebih rendah, TBC, sakit kuning, infeksi sistem saraf pusat, kejang atau kejang-kejang, sepsis neonatorum, penyakit kuning neonatal, penyakit bawaan, luka bakar, luka

bakar, fraktur, luka menghancurkan, demam berdarah , dan dokter didiagnosa kekurangan

gizi, dan penyakit ringan didefinisikan sebagai demam, batuk atau dingin, asma, mengi,

bronkiolitis, demam exanthematous (kecuali campak), morbiditas kulit, morbiditas mata,

telinga, hidung dan tenggorokan morbiditas, tak henti-hentinya menangis, lecet dan gigitan,

pica, maag aphthous, infeksi lokal, anemia dan kehilangan nafsu makan. These comprised

caregiver diagnosis of minor illness during field worker visits and physician diagnosis of

minor and major illness from visits to the study clinic and from hospital admissions Pengasuh

diagnosis ini terdiri dari penyakit ringan selama kunjungan pekerja lapangan dan diagnosis

dokter penyakit ringan dan utama dari kunjungan ke klinik belajar dan dari penerimaan

rumah sakit [13]. [13].

Respiratory illness was common, occurring at a rate of 7.4 episodes per child year (and a

median of 48 days of illness) in the first year of life penyakit pernafasan adalah biasa, terjadi

pada tingkat 7,4 episode per tahun anak (dan rata-rata 48 hari penyakit) pada tahun pertama

kehidupan [13], 7.1 episodes (and a median of 67.5 days of illness) in the second year of life

and 6.6 episodes (and a median of 50 days of illness) in the third year of life (Gladstone et al.

unpublished). [13], 7.1 episode (dan rata-rata 67,5 hari sakit) pada tahun kedua kehidupan

dan 6,6 episode (dan rata-rata 50 hari sakit) pada tahun ketiga kehidupan (Gladstone et al.tidak dipublikasikan). Gastro-intestinal illness was more common in the first year of life than

in the second and third years, occurring at a rate of 3.6 episodes per child year (and a median

of 8 days of illness) in the first year of life penyakit Gastro-intestinal lebih umum pada tahun

pertama kehidupan daripada di tahun kedua dan ketiga, terjadi pada tingkat 3,6 episode per

tahun anak (dan rata-rata 8 hari sakit) pada tahun pertama kehidupan [13], 1.6 episodes (and

a median of 3 days of illness) in the second year of life and 1.2 episodes (and a median of 1

day of illness) in the third year of life (Gladstone et al. unpublished). [13], 1,6 episode (dan

rata-rata 3 hari sakit) pada tahun kedua kehidupan dan 1,2 episode (dan rata-rata 1 hari sakit)

pada tahun ketiga kehidupan (Gladstone et al.tidak dipublikasikan). Peak rates of illness

were experienced between 3 and 5 months of age, around the time of weaning Puncak tingkat

penyakit yang dialami antara 3 dan 5 bulan usia, sekitar waktu menyapih [13]. [13]. Therate of hospitalisation was low, 0.28 per child year in the first year, 0.11 in the second year
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and 0.07 in the third (Gladstone et al. unpublished). Tingkat rumah sakit masih rendah, 0,28

per tahun anak di tahun pertama, 0,11 pada tahun kedua dan 0,07 di ketiga (et alGladstone

tidak dipublikasikan.).

Poor growth was quantified as the percentage of children stunted (low height-for-age),

wasted (low weight-for-height) and underweight (low weight-for-age). Miskin pertumbuhandihitung sebagai persentase anak-anak stunted (tinggi-rendah untuk-umur), terbuang (berat-

rendah-tinggi badan) dan kurus (berat-rendah untuk-usia). 'Low' was characterised as less

than -2 standard deviations from the growth reference. 'Rendah' ditandai sebagai kurang dari -

2 standar deviasi dari referensi pertumbuhan. We used the 2006 WHO child growth standards

Kami menggunakan WHO 2006 standar pertumbuhan anak [6] as the reference population

to calculate height-for-age (HAZ), weight-for-height (WHZ) and weight-for-age (WAZ) z-

scores. [6] sebagai populasi acuan untuk menghitung tinggi-untuk-umur (HAZ), berat

badan-untuk-tinggi (WHZ) dan berat-untuk-umur (WAZ) z-skor. Plots of individual's growth

curves revealed some discrepancies in height measurements. Plot pertumbuhan individu

kurva mengungkapkan beberapa perbedaan dalam pengukuran tinggi. Therefore

measurements which were more than three standard deviations different from the nearest fourmeasurements were set to missing height a priori. Oleh karena itu pengukuran yang lebih

dari tiga deviasi standar yang berbeda dari pengukuran terdekat empat yang ditetapkan untukhilang tinggi apriori.All measurements relate to attained month of age, for example a

measurement taken on a day of life between six times 30.4375 (183 days) and seven times

30.4375 (213 days) relates to six months of age. Semua pengukuran berhubungan dengan

bulan mencapai usia, misalnya pengukuran yang diambil pada hari hidup antara enam kali

30,4375 (183 hari) dan tujuh kali 30,4375 (213 hari) berkaitan dengan usia enam bulan. The

first measurement in an attained month of age was used in analysis. Pengukuran pertama

dalam bulan mencapai usia digunakan dalam analisis.

As stunting is considered to be a long-term deficit in growth and it was the dominant growth

faltering seen at three years of age, we investigated the probability of being stunted at three

years using logistic regression with potential risk factors defined a priori. Seperti

pengerdilan dianggap menjadi defisit jangka panjang dalam pertumbuhan dan itu adalah

pertumbuhan yang dominan goyah terlihat pada usia tiga tahun, kita menyelidiki

kemungkinan menjadi kerdil pada tiga tahun dengan menggunakan regresi logistik dengan

faktor-faktor risiko potensial didefinisikan a priori.We investigated whether temporal

changes in both duration of major illness or duration of all illness were associated with

stunting at 36 months, but found no patterns. Kami menyelidiki apakah perubahan temporal

pada kedua durasi penyakit utama atau lama semua penyakit dikaitkan dengan pengerdilan di

36 bulan, namun tidak menemukan pola. We therefore present the association with totalduration of major illness over three years. Oleh karena itu kami menyajikan hubungan dengan

total durasi penyakit utama selama tiga tahun. We investigated causes of missing values, in

both stunting at 36 months and in potential risk factors, using observed data. Kami

menyelidiki penyebab nilai-nilai yang hilang, dalam pengerdilan baik di 36 bulan dan pada

faktor risiko potensial, menggunakan data yang diamati. To be conservative we included all

potential risk factors in a multivariate model, whether associated with the outcome or with

missing values Untuk menjadi konservatif kami memasukkan semua faktor risiko potensial

dalam model multivariat, baik yang terkait dengan hasil atau dengan nilai-nilai yang hilang [

14]. [14]. We investigated whether risk factors were gender-dependent by testing

interaction terms between the risk factor and gender including interactions with likelihood

ratio p < 0.05. Kami menyelidiki apakah faktor risiko adalah gender tergantung denganmenguji persyaratan interaksi antara faktor risiko dan gender, termasuk interaksi dengan
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Results Hasil

There were 914 pregnancies eligible and 48 ineligible for the study. Ada 914 kehamilan yang

memenuhi syarat dan 48 tidak memenuhi syarat untuk penelitian. A total of 462 (48%)

mothers refused, primarily due to the common practice of pregnant women returning to their

mother's house to give birth and stay for three months afterwards, thus making their children

not available for follow up according to the study protocol. Sebanyak 462 (48%) ibu

menolak, terutama karena praktek umum ibu hamil kembali ke rumah ibu mereka untuk

melahirkan dan tinggal selama tiga bulan kemudian, sehingga membuat anak-anak mereka

tidak tersedia untuk ditindaklanjuti sesuai dengan protokol penelitian. Mothers who were not

recruited to the study did not differ from mothers who were recruited in terms of their age,

socio-economic status and their child's birth weight and gender. Ibu yang tidak direkrut untuk

penelitian ini tidak berbeda dari ibu yang direkrut dari segi usia, status sosial-ekonomi dan

berat lahir anak mereka dan gender.

Between March 2002 and November 2003 452 children began follow-up. Antara Maret 2002

dan November 2003 452 anak-anak mulai tindak lanjut. By six months of age 403 (89%)

were still under follow-up and 373 (83%) were still under follow-up at three years of age.

Pada usia enam bulan 403 (89%) masih dibawah tindak lanjut dan 373 (83%) masih di bawah

follow-up di tiga tahun. Of the 79 children that left the study, 44 moved away from the study

area and 30 discontinued mainly because of the fear of serum collection. Dari 79 anak-anak

yang meninggalkan studi ini, 44 pindah jauh dari wilayah studi dan 30 dihentikan terutamakarena takut koleksi serum. There were five deaths, including three children who suffered

diarrhoea and dehydration in their first year of life Ada lima kematian, termasuk tiga anak-

anak yang menderita diare dan dehidrasi pada tahun pertama hidup mereka [13] and two

children who died in hospital, one of a congenital cardiopulmonary disorder in their first year

of life and one of seizures in their third year of life. [ 13] dan dua anak yang meninggal di

rumah sakit, salah satu kelainan bawaan cardiopulmonary pada tahun pertama hidup mereka

dan salah satu dari kejang pada tahun ketiga hidup mereka. The median (Inter-quartile range:

IQR) age on leaving the study was 4.1 months (2.5-11.2 months). Median (kisaran Inter-

kuartil: IQR) usia pada meninggalkan penelitian adalah 4,1 bulan (2,5-11,2 bulan). Children

who did not complete follow-up had less educated mothers (chi-square p = 0.064) and started

complementary foods later (log-rank test p = 0.0004) than children who completed follow-up.Anak-anak yang tidak menyelesaikan tindak lanjut telah ibu kurang berpendidikan (p chi-

square = 0,064) dan mulai makanan pendamping kemudian (log-rank test p = 0,0004)

dibandingkan anak-anak yang menyelesaikan tindak lanjut.

There were 14464 scheduled anthropometry measurements. Ada 14464 pengukuran

antropometri dijadwalkan. Height measurements used for analysis were measured on 12705

(88%) occasions and weight measurements used for analysis were measured on 13083 (90%)

occasions. pengukuran Tinggi digunakan untuk analisis adalah diukur pada 12705 (88%) kali

dan pengukuran berat digunakan untuk analisis adalah diukur pada 13.083 (90%) kali. Fifty

four (0.004%) height measurements were set to missing due to discrepancy and 1461 (10%)

measurements taken later in the same attained month of age as another measurement wereexcluded from analysis as described above. Lima puluh empat (0,004%) pengukuran tinggi
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yang ditetapkan untuk hilang karena kesenjangan dan 1.461 (10%) pengukuran yang

dilakukan kemudian pada bulan yang sama mencapai usia sebagai alat ukur lain dikeluarkan

dari analisis seperti dijelaskan di atas.

Two hundred and 81 (62%) mothers were of low socio-economic class with the remainder of

lower middle class. Dua ratus dan 81 (62%) ibu adalah kelas sosial-ekonomi yang rendahdengan sisa kelas menengah ke bawah. Mean age of the mothers was 24 (SD: 4) years. Usia

rata-rata dari ibu adalah 24 (SD: 4) tahun. Most (313, 69%) mothers had received at least

some primary education. Sebagian besar (313, 69%) ibu telah menerima setidaknya beberapa

pendidikan dasar. The mean height of 363 mothers who had height available was 152 cm

(SD: 6.6 cm). Ketinggian rata-rata 363 ibu yang memiliki ketinggian yang tersedia adalah

152 cm (SD: 6,6 cm). The Kaplan-Meier estimate of the median age complementary foods

were introduced was 3.0 months (IQR: 1.9-4.0 months). Perkiraan Kaplan-Meier dari usia

rata-rata makanan pendamping diperkenalkan adalah 3,0 bulan (IQR: 1,9-4,0 bulan).

Table Tabel1, Table1, Tabel2, and Figure2, dan Gambar1show the growth data for

boys and girls.1menampilkan data pertumbuhan anak laki-laki dan perempuan. By age 36months, 109 (66%) boys and 93 (56%) girls were stunted, 14 (8%) boys and 12 (7%) girls

were wasted and 72 (43%) boys and 66 (39%) girls were underweight. Pada usia 36 bulan,

109 (66%) anak laki-laki dan 93 (56%) anak perempuan kerdil, 14 (8%) anak laki-laki dan 12

(7%) gadis-gadis itu terbuang dan 72 (43%) anak laki-laki dan 66 (39%) anak perempuan

kurus. By 36 months of age, 120 boys, 72% (95% CI: 65-79%), and 105 girls, 63% (95% CI:

56-71%), were either stunted or underweight or wasted, providing the overall burden of

malnutrition, according to the 2006 WHO standards. Pada usia 36 bulan, 120 anak laki-laki,

72% (95% CI: 65-79%), dan 105 perempuan, 63% (95% CI: 56-71%), entah kerdil atau kurus

atau sia-sia, menyediakan secara keseluruhan beban gizi buruk, menurut standar WHO 2006.

The percentages stunted from above can be broken down into three categories, 46 (28%) boys

and 38 (23%) girls were stunted only (F), 55 (33%) boys and 48 (29%) girls were stunted and

underweight (E) and 8 (5%) boys and 7 (4%) girls were stunted, underweight and wasted (D).

Persentase kerdil dari atas dapat dipecah menjadi tiga kategori, 46 (28%) anak laki-laki dan

38 (23%) gadis-gadis itu hanya kerdil (F), 55 (33%) anak laki-laki dan 48 (29%) gadis-gadis

itu terhambat dan kurus (E) dan 8 (5%) anak laki-laki dan 7 (4%) gadis-gadis kerdil, kurus

dan terbuang (D). There are four other growth categories shown in Figure Ada empat

kategori pertumbuhan lainnya ditunjukkan pada Gambar1, children who were not stunted,

wasted or underweight, 46 (28%) boys and 62 (37%) girls (A), children with only wasting, 2

(1%) boys and 0 (0%) girls (B), children who were wasted and underweight, 4 (2%) boys and

5 (3%) girls (C), and children who were only underweight, 5 (3%) boys and 6 (4%) girls (Y).

1, anak-anak yang tidak terhambat, terbuang atau kurus, 46 (28%) anak laki-laki dan 62(37%) perempuan (A), anak-anak dengan membuang-buang saja, 2 (1%) anak laki-laki dan 0

(0%) perempuan (B) , anak-anak yang terbuang dan kurus, 4 (2%) anak laki-laki dan 5 (3%)

perempuan (C), dan anak-anak yang hanya kurus, 5 (3%) anak laki-laki dan 6 (4%)

perempuan (Y).

Figure 1.Distribution of growth faltering at 36 months of age accordingto WHO growth standards.Gambar 1.Distribusi pertumbuhan tidak baik di 36 bulan

usia sesuai dengan pertumbuhan standar WHO.Key- A: Not malnourished, B: Wasted

only, C: Wasted and underweight, D: Wasted, stunted and underweight, E: Stunted andunderweight, F: Stunted only, Y: Underweight only. Key-J: Tidak kurang gizi, B: Terbuang
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