Paparan malaria maternal dan bayi berat lahir rendah: studi kasus-kontrol di daerah endemik malaria Papua, Indonesia: Maternal malaria exposure and low birth weight: a case-control study in malaria-endemic Papua, Indonesia

Masrif; I Rai Ngardita; Muhamad Sahiddin; Mustika Pramestiyani; Harlyanti Mashar; Itma Annah

doi:10.47539/jktp.v8i1.431

Authors

Masrif Jurusan Gizi, Politeknik Kesehatan Gorontalo, Gorontalo
I Rai Ngardita Department of Nutrition, Politeknik Kesehatan Jayapura, Jayapura
Muhamad Sahiddin Department of Nursing, Politeknik Kesehatan Jayapura, Jayapura
Mustika Pramestiyani Department of Midwifery, Politeknik Kesehatan Jayapura, Jayapura
Harlyanti Mashar Department of of Nutrition, Politeknik Kesehatan Palangkaraya, Palangkaraya
Itma Annah Department of of Midwifery, Politeknik Kesehatan Palangkaraya, Palangkaraya

Keywords:

Malaria maternal, infeksi plasmodium, Papua

Abstract

Malaria selama kehamilan merupakan salah satu faktor risiko utama terjadinya malnutrisi pada bayi. Hubungan malaria dan kejadian BBLR di daerah endemik tinggi malaria seperti Papua perlu dikaji sebagai upaya mengatasi kedua masalah kesehatan tersebut. Penelitian ini bertujuan untuk mengevaluasi hubungan antara paparan malaria selama kehamilan dan kejadian BBLR di Papua. Penelitian ini menggunakan desain case-control yang dilakukan tahun 2024 di Papua pada 21 puskesmas. Sampel penelitian berjumlah 288 responden, terdiri dari 96 kasus (BBLR) dan 192 kontrol (bayi dengan berat lahir normal) dipilih dengan simple random sampling. Pengumpulan data dilakukan dengan pemeriksaan rekam medis dan wawancara terstruktur menggunakan kuesioner. Analisis data dilakukan menggunakan uji chi-square dan regresi logistik untuk analisis multivariat. Hasil penelitian jenis plasmodium yang paling banyak ditemukan adalah Plasmodium vivax (malaria tertiana) (45,9%) dan diikuti oleh Plasmodium falciparum (malaria tropika) (41,0%). Selama kehamilan paparan malaria paling banyak terjadi pada trimester kedua (39,3%). Kejadian malaria selama kehamilan (OR adjusted= 2,09; CI 95%: 1,14–3,84) dan tidak menggunakan kelambu anti nyamuk pada masa kehamilan (OR adjusted= 1,83; CI 95%: 1,09–3,08) merupakan faktor risiko BBLR. Selain itu, karakteristik usia ibu yang berada pada kategori berisiko juga menunjukkan hubungan signifikan dengan kejadian BBLR (OR adjusted= 2,18; CI 95%: 1,24–3,86). Paparan malaria selama kehamilan dan usia ibu yang berisiko merupakan faktor yang memengaruhi kejadian BBLR di Papua. Intervensi kesehatan masyarakat yang terfokus pada pencegahan malaria, seperti penggunaan kelambu berinsektisida, dan pengobatan antimalaria yang aman untuk mengurangi risiko BBLR di wilayah endemik tinggi malaria.

Malaria during pregnancy is one of the primary risk factors for infant malnutrition. The association between malaria and LBW incidence in high malaria-endemic regions such as Papua needs further examination to address these two health issues. This study aims to evaluate the relationship between malaria exposure during pregnancy and LBW incidence in Papua. The study used a case-control design conducted in 2024 across 21 community health centers (puskesmas) in Papua. The sample consisted of 288 respondents, including 96 cases (LBW) and 192 controls (infants with normal birth weight), selected through simple random sampling. Data were collected through medical record reviews and structured interviews using questionnaires. Data analysis was performed using chi-square tests and multivariate logistic regression. The results showed that the most frequently identified Plasmodium species were Plasmodium vivax (tertian malaria) (45.9%), followed by Plasmodium falciparum (tropical malaria) (41.0%). Malaria exposure during pregnancy most commonly occurred in the second trimester (39.3%). Malaria during pregnancy (adjusted OR = 2.09; 95% CI: 1.14–3.84) and non-use of insecticide-treated bed nets during pregnancy (adjusted OR = 1.83; 95% CI: 1.09–3.08) were identified as risk factors for LBW. Additionally, maternal age in the high-risk category was significantly associated with LBW incidence (adjusted OR = 2.18; 95% CI: 1.24–3.86). Malaria exposure during pregnancy and high-risk maternal age were factors influencing LBW incidence in Papua. Public health interventions focused on malaria prevention, such as the use of insecticide-treated bed nets and safe antimalarial treatment, are essential to reduce LBW risk in high malaria-endemic regions.

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