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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

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

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