Pengaruh Infeksi Soil Transmitted Helminth terhadap Kemampuan Kognitif Anak

Abstract

Background Soil transmitted helminth infection affects one quarter of world population. School age children were reported to have the highest prevalences and intensities, which result in impaired cognitive function, malnutrition and morbidity. Objective To examine the difference of cognitive function before and after treating soil transmitted helmintiasis in children. Methods A randomized, open labeled, clinical trial is conducted since November 2008 until March 2009 in Aek Nabara, Kabupaten Labuhan Batu, North Sumatera province, among primary school age children. Before the interventions, data on age, sex, nutritional status, soil transmitted helminthiasis status and cognitive function were collected. Subjects were divided into two groups. Group I received albendazole 400 mg and group II received placebo. Three months after interventions, we re-examine the cognitive function of the children in both groups. Results Cognitive tests with Weschler Intelligence Scale for Children were performed in 120 children infected with soil transmitted helminth. These children were randomly separated into two groups, 60 children received albendazole 400 mg and 60 children received placebo. Eight children were excluded in this study due to IQ score below 70 and sick during examination. Three months after the intervention, the cognitive function was evaluated and resulted in significant cognitive improvement in group I, in comprehension (P=0.017), coding (P=0.002), performance IQ score (P=0.004) and full IQ score (P<0.001). We also found significant differrence between both groups in digit span (P=0.24) and full IQ score (P=0.027). Conclusion Treatment toward soil transmitted helminthiasis improves cognitive function of children in comprehension, coding and digit span test. Performance dan full IQ score is also improved after treatment.

Latar belakang Infeksi soil transmitted helminth mempengaruhi lebih dari seperempat populasi dunia. Anak usia sekolah dilaporkan mempunyai prevalensi dan intensitas tertinggi yang mengakibatkan gangguan kognitif, malnutrisi dan morbiditas. Tujuan Untuk mengetahui pengaruh pemberian obat antihelmentik terhadap kemampuan kognitif anak dengan infeksi soil transmitted helminth. Metode Dilakukan uji klinis acak terbuka pada November 2008 hingga Maret 2009 di Aek Nabara, Kabupaten Labuhan Batu, provinsi Sumatera Utara, pada anak usia sekolah dasar. Sebelum intervensi, dikumpulkan data usia, jenis kelamin, status nutrisi, status infeksi soil transmitted helminth dan kemampuan kognitif. Sampel dibagi ke dalam dua kelompok. Kelompok I diberi Albendazole 400 mg dan kelompok II diberi plasebo. Tiga bulan setelah intervensi, dilakukakn uji kognitif ulangan pada sampel di kedua kelompok. Hasil Uji kognitif dengan Weschler Intelligence Scale for Children dilakukan terhadap 120 anak yang terinfeksi dengan soil transmitted helminth. Anak anak tersebut dirandomisasi blok kemudian dibagi dalam dua kelompok, 60 anak mendapat Albendazole 400 mg dan 60 anak mendapat plasebo. Delapan anak dieksklusikan dalam penelitian ini karena memilik nilai IQ di bawah 70 dan sakit selama pemeriksaan. Tiga bulan setelah intervensi, uji kognitif diulangi dan didapatkan peningkatan kemampuan kognitif yang bermakna pada kelompok I meliputi bidang comprehension (P=0.017), coding (P=0.002), nilai performance IQ (P=0.004) dan total IQ (P<0.001). Kami juga mendapatkan peningkatan bermakna antara kedua kelompok pada bidang digit span (P=0.24) dan nilai IQ total (P=0.027). Kesimpulan Pengobatan terhadap infeksi soil transmitted helminth akan meningkatkan kemampuan kognitif pada bidang comprehension, coding dan digit span. Nilai IQ performance dan total juga meningkat setelah pengobatan.