PENGARUH PEMBERIAN PROBIOTIK, PREBIOTIK, SINBIOTIK

TERHADAP KEJADIAN DIARE PADA ANAK SEHAT USIA 1-5 TAHUN

DI TAMAN PENITIPAN ANAK

Laporan Penelitian Karya Ilmiah Akhir Untuk Memenuhi Persyaratan dalam Menyelesaikan Pendidikan Dokter Spesialis I Ilmu Kesehatan Anak

Oleh:

Virany Diana, dr

Pembimbing:

Prof. Dr. Subijanto MS, dr, SpA(K)

Dr. I.G.M. Reza Gunadi Ranuh, dr, SpA(K)

Alpha Fardah Attiyah, dr, SpA

Irwanto, SpA

Budiono, dr, MKes

DEPARTEMEN/SMF ILMU KESEHATAN ANAK

FAKULTAS KEDOKTERAN UNIVERSITAS AIRLANGGA / RSUD DR SOETOMO SURABAYA

2009

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ABSTRACT

The Effects of Probiotic, Prebiotic, and Sinbiotic Administration on the Incidence and Duration of Diarrhea in Healthy Child at Day Care Centre

Background: Day-care attendance is known to be a major risk factor for diarrhea in children. Probiotic, prebiotic, and synbiotic have been widely used as adjunctive therapy of

gastrointestinal diseases. The possible health benefits of gut flora dominated by bifidobacteria

have recognized for treatment and prevention of acute diarrhea in children. Three strategies to

improve the colonisation of normal microflora. The question is whether probiotic, prebiotic, or

synbiotic should be used to reach the best possible effect.

Objective: To investigate whether probiotic, prebiotic, or synbiotic could decrease the incidence

and duration of diarrhea in healthy child in day care centre

Methods: This randomized double blind, placebo controlled clinical study was carried out in 12

day care centres, in similar socioeconomic areas in Surabaya, Gresik and Sidoarjo. Children

aged 1-5 years, healthy condition, stay in day care centre were recruited if parents signed the

informed consent form. Children with history of lactose intolerance, history of cows milk allergy,

not in healthy condition 1 week prior the study, and consumed prebiotic, probiotic, synbiotic 2

weeks prior the study were exclude. Divided into 4 groups (probiotic, prebiotic, synbiotic, and

control), intervention lasted 26 weeks. Parents and day care staff recorded daily any diarrhea

episodes and duration. ANOVA and chi-square to compare differences between the groups.

Results: Total episodes of diarrhea in 6 months were decreased in probiotic, synbiotic, and

prebiotic group compared with control group, but only prebiotic group significantly different.

Duration each episode of diarrhea were decreased also in all intervention group, but not

significantly different.

Conclusion: The use of Probiotic, prebiotic, and synbiotic decrease the incidence of diarrhea in

healthy children.

Keywords: probiotics, prebiotic, synbiotic, incidence, duration, diarrhea

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ABSTRAK

PENGARUH PEMBERIAN PROBIOTIK, PREBIOTIK, SINBIOTIK TERHADAP

KEJADIAN DIARE PADA ANAK SEHAT

USIA 1-5 TAHUN DI TAMAN PENITIPAN ANAK

Latar belakang: TPA salah satu faktor resiko diare. Pencegahan diare memerlukan sistem imun

mukosa yang baik dengan modifikasi mikroflora normal di usus. Tetapi masih menjadi

pertanyaan apakah probiotik, prebiotik, sinbiotik dapat menurunkan angka kejadian dan lama

hari diare pada anak sehat di TPA

Tujuan: Membuktikan pengaruh pemberian probiotik, prebiotik, atau sinbiotik dalam formula

susu terhadap kejadian diare pada anak di TPA

Metoda: Rancangan penelitian ini adalah uji klinis (randomized controlled trial) acak buta ganda

pada anak sehat usia 1-5 tahun, yang diberikan prebiotik, probiotik, sinbiotik ataupun plasebo

dalam formula susu. Dilakukan di 12 Taman Penitipan Anak (TPA) di Surabaya, Gresik, dan

Sidoarjo selama 6 bulan pengamatan. Dengan kriteria inklusi anak sehat, usia 1-5 tahun,

dititipkan di TPA, dan orang tua menandatangani persetujuan. Intoleransi laktosa, alergi susu

sapi, cacat/kelainan bawaan yang mengganggu sistem pencernaan, konsumsi probiotik,

prebiotik, sinbiotik dalam 2 minggu terakhir sebelum dimulainya penelitian tidak diikutkan dalam

penelitian ini. Orang tua dan pengasuh TPA mengisi lembar pengumpulan data tiap hari selama

6 bulan untuk mencatat gejala dan lama hari diare. Analisa statistik yang digunakan ANOVA dan

chi square.

Hasil: Probiotik, prebiotik, dan sinbiotik dapat menurunkan angka kejadian diare dibandingkan

kontrol, tetapi hanya prebiotik yang menunjukkan perbedaan bermakna secara statistik. Ketiga

perlakuan tidak dapat menurunkan lama hari diare secara bermakna.

Simpulan: Probiotik, prebiotik, dan sinbiotik dapat menurunkan angka kejadian diare pada anak sehat usia 1-5 tahun di TPA, tetapi yang terbaik adalah prebiotik.

Kata kunci: Probiotik, prebiotik, sinbiotik, angka kejadian diare, lama hari diare