PATOFISIOLOGI GIS CASE 4 "STUNTING, INFEKSI CACING, DAN ANEMIA DEFISIENSI BESI" - ray

Summary

This transcript discusses a case of malnutrition, ascariasis, and iron deficiency anemia in a 3-year-old child. The boy's health is compromised due to poor sanitation, incomplete immunization, and inadequate nutrition. Ascariasis, caused by roundworms, further exacerbates nutrient deficiencies by impairing absorption in the intestines. Treatment includes medication for the infection, iron supplementation, and a structured multi-phase approach to manage malnutrition. Additionally, improving hygiene practices, nutritional education, and completing immunization schedules are crucial for the child's recovery and long-term health.

Takeaways

• 😀 The child, a 3-year-old male, was diagnosed with stunting, iron deficiency anemia, and ascariasis.
• 😀 Poor sanitation and overcrowded living conditions are major risk factors contributing to the child's condition.
• 😀 The child often plays barefoot, which increases the risk of infection through exposure to harmful pathogens.
• 😀 Long, dirty nails are another risk factor for infection, as they can harbor pathogens that enter the body when the child eats without washing hands.
• 😀 The child has incomplete immunization, making him more susceptible to infections.
• 😀 The child was only breastfed for 4 months instead of the recommended 6 months of exclusive breastfeeding, which can impact immune development and nutrition.
• 😀 Ascariasis infection occurs when the child ingests eggs from contaminated soil or surfaces, often transmitted by unwashed hands or contaminated food.
• 😀 The adult Ascaris worms in the intestines can cause malnutrition by consuming nutrients and impairing nutrient absorption.
• 😀 The child is also consuming sweetened condensed milk (SKM) instead of formula, leading to osmotic diarrhea and further nutrient loss due to high lactose content.
• 😀 Iron deficiency anemia is linked to malnutrition and impacts hemoglobin production, leading to decreased oxygen delivery and fatigue.
• 😀 The treatment plan involves addressing malnutrition and infections with medications (anti-parasitic and iron supplements), and implementing a four-phase management approach (stabilization, transition, rehabilitation, and follow-up).

Q & A

What is the main health condition discussed in the case?

The main health conditions discussed in the case are malnutrition, ascariasis (intestinal worm infection), and iron-deficiency anemia.

What are some risk factors that contribute to the child’s malnutrition and infection?

Risk factors include poor sanitation, living in a densely populated area, poor hygiene (e.g., playing without shoes), incomplete immunization, and improper nutrition.

How does ascariasis affect the child’s health?

Ascariasis leads to nutrient malabsorption as the adult worms in the intestines consume the child's nutrients, causing deficiencies. The worms also disrupt the normal function of the intestines.

What role does iron deficiency play in the child’s condition?

Iron deficiency leads to reduced hemoglobin production, causing anemia. This results in reduced oxygen delivery to tissues, leading to symptoms like fatigue, weakness, and pale skin.

What are the consequences of the child’s poor nutrition and inadequate breastfeeding?

The child experiences protein and energy deficiencies due to inadequate food intake and breastfeeding for only 4 months instead of the recommended 6 months. This leads to stunting, wasting, and further nutritional deficiencies.

What is the impact of consuming sweetened condensed milk (SKM) in the child’s diet?

Sweetened condensed milk is high in sugars (lactose and sucrose), which can cause osmotic diarrhea, especially in young children with low lactase activity. This exacerbates dehydration and worsens nutrient absorption.

How does the child’s body compensate for low glucose levels due to malnutrition?

The body compensates by breaking down stored glycogen (glycogenolysis) or by producing glucose from other sources like lipids and proteins (gluconeogenesis). However, these processes deplete fat and muscle mass.

What stages are involved in the management of severe malnutrition according to the script?

The stages include stabilization (addressing hypoglycemia, dehydration, and infection), transition (from day 3 to day 7), rehabilitation (week 2 to week 6), and follow-up care (week 7 to week 26).

What specific treatments are recommended for ascariasis and iron-deficiency anemia?

For ascariasis, an anti-worm medication (Pirantel pamoate) is recommended. For iron-deficiency anemia, iron supplements (ferrous sulfate) are given to increase hemoglobin levels and improve oxygen transport.

What non-pharmacological interventions are important for managing the child’s health?

Important non-pharmacological interventions include improving sanitation, ensuring exclusive breastfeeding, providing balanced nutrition, and addressing hygiene and immunization gaps.