Meningkatkan imunitas dan memastikan tumbuh

kembang optimal anak di masa pandemi Covid-19

Pokok Bahasan
• Dampak penurunan imunitas terhadap peningkatan risiko
gangguan tumbuh kembang anak
• Pentingnya peningkatan imunitas bayi dan balita dalam
mencegah penyakit infeksi
• Cara meningkatkan imunitas dan memastikan saluran cerna
yang sehat pada bayi dan balita
• Cara memastikan tumbuh kembang anak optimal di masa
pandemic covid-19
Pengertian Sistem Imun

• Sistem yang kompleks terdiri dari

Sistem interaksi berbagai sel tubuh dengan
imun tujuan mengenal, membedakan dan
mengeliminasi antigen
• Respon tubuh berupa suatu urutan
Respon kejadian yang kompleks thd
imun antigen,untuk mengeliminasi
antigen tersebut.
Respon imun
• Non spesifik/innate/alamiah : mekanisme pertahanan yang
tidak ditujukan hanya untuk satu jenis antigen tetapi untuk
berbagai macam antigen. Imunitas alami sudah ada sejak
bayi lahir
• Spesifik /adaptif/ didapat : mekanisme pertahanan yang
ditujukan khusus terhadap satu jenis antigen, karena itu
tidak dapat berperan terhadap jenis antigen lain.
Pertahanan tubuh spesifik harus kontak dulu atau
ditimbulkan dulu oleh antigen tertentu baru ia akan
terbentuk.
Nutrients 2018, 10, 1531; doi:10.3390/nu10101531
Perkembangan sistem imun pada anak
Sistem imun alamiah Sistem imun didapat

Georgountzou A and Papadopoulos NG (2017) Postnatal

Innate Immune Development: From Birth to Adulthood.
Front. Immunol. 8:957.
Peran sistem imun

The Effect of Nutritional Elements on the Immune

System. J Obes Wt Loss Ther 2: 152.
doi:10.4172/2165-7904.1000152
 Hal-hal yang mempengaruhi perkembangan
sistem imun

Nutrisi

Genetik
Sistem Lingkungan

imun

Vaksinasi

Parasitology (2011), 138, 1508–1518.

doi:10.1017/S0031182011000588
Hal-hal yang mempengaruhi perkembangan
sistem imun

(Pediatr Res 69: 465–472, 2011

Peran nutrisi pada sistem imun

The Immune System in Children with Malnutrition—A

Systematic Review. PLoS ONE 9(8): e105017.
doi:10.1371/journal.pone.0105017
 Nutrisi untuk tumbuh optimal

Makan makanan yang

Makro Mikro
bervariasi dengan gizi
nutrien nutrien
seimbang
 MAKRONUTRIEN MIKRONUTRIEN

KARBOHIDRAT
VITAMIN DAN
MINERAL

PROTEIN

LEMAK

Minyak, santan, margarin,

butter
Peran nutrisi dalam perkembangan sistem imun

Nutrients 2020, 12, 1039; doi:10.3390/nu12041039

Pengaruh nutrisi pada sistem imun

The Effect of Nutritional Elements on the Immune

System. J Obes Wt Loss Ther 2: 152.
doi:10.4172/2165-7904.1000152
Mikronutrien

International Journal of Health Sciences and

Research (www.ijhsr.org) 96 Vol.10; Issue: 8;
August 2020
Nutrients 2020, 12, 236; doi:10.3390/nu12010236
Makronutrien
Karbohidrat
• Carbohydrate is an important fuel cell for immune
system. That anaerobic glycolysis showing an increase on
lymphocytes, stimulated in mitogens, indicates the
increase of glucose as a fuel. However during the
lymphocyte proliferation, usage of carbohydrates for
energy decreases. In this case, glycol tic mid products
are directed to purine and pyrimidine nucleotide
synthesis for cell growth.
• Carbohydrates are nutriments largely found in vegetative
foods containing carbon, hydrogen and oxygen
molecules. They are classified as simplistic (sugar) and
complicated (starch) Glue ides are found in sugar , fruits
and fruit juice. On the other hand complicated starch is
found in vegetables, legumes and cereals. Carbohydrates
are situated in human body as glycogen in a small
amount. Glycogen is mostly in liver. In other organs and
muscles a little amount of glycogen exists.
Protein
• Proteins make up frame work for cells. They are also
framework of body defence systems, enzymes that
control body functions, and some hormones
• Proteins are nutriments that contain nitrogen, carbon,
hydrogen and oxygen in their chemical structures.
Many immune mechanisms rely on production of
active protein compounds or cell replication. In protein
deficiency, functions of immune system decrease. It is
thought that the negative effect of protein deficiency
on immunity is connected with the effect of immune
system regulator for some amino acids. Deficiency in
essential amino acid can also cause repression on
immune system. Too much consumption of some
amino acids can cause diverse effect on immune system
functions. The latest studies show that protein
metabolism play an important role in formation of
natural and acquired immunity against infections.
Makronutrien
Lemak
• Fats are among the most important nutrition
sources for our lives. Fats take an active pole in
some biological functions such as; absorption of
vitamins A, D, E and K needed for human and
animal nutrition, being a source of omega 3 and
omega 6 oil acid, being functional at neuritis
functions, provision of permeability and stability
for cell membranes
• Linoleic acid also decreases allergic sensitization.
Diets, containing high amount of fats can also
decrease cellular inflammatory activity and
immune response. It is a well known fact that
omega 3 fat acids lower blood pressure and
plasma aggregation and inflammative response. It
also features in controlling cellular immune
response

• Fats are important energy sources 1 gram fat

provides twice the energy as protein and
carbohydrate does [16]. Fat acids are powerful
modulators of immune response. Studies on
animals verify that conjugated linoleic acid
available in meat and dairy products stimulates
the immune system and prevent breast cancer.
Vitamin dan mineral
Vitamin A
• Vitamin A is referred to as “antiinflammation
vitamin” as it aids to support the immune system
and protect against infections by keeping
stomach, intestines and respiratory system
healthy
• It has a central role in the regulation of cellular
and humoral immune response
• (Huang et al 2018). Vitamin A is important for
epithelial cell integrity and immune function of
the mucosa. The WHO recommends the vitamin
A supplementation for children with measles at
risk of vitamin A deficiency
International Journal of Health Sciences and Research (www.ijhsr.org) 100 Vol.10; Issue: 8; August 2020
Vitamin D
• Vitamin D, another fat-soluble vitamin, that plays a vital
role in modulating both innate and adaptive immune
responses. Epidemiological data has linked vitamin D
deficiency to increased susceptibility to acute viral
respiratory infections.
• Vitamin D, another fat-soluble vitamin, that plays a vital
role in modulating both innate and adaptive immune
responses. Epidemiological data has linked vitamin D
deficiency to increased susceptibility to acute viral
respiratory infections
• A systematic review on the role of vitamin D in the
prevention of acute respiratory infections, which
included 39 studies (4 cross-sectional studies, 8 case-
control studies, 13 cohort studies and 14 clinical trials),
noted that observational studies predominantly report
statistically significant associations between low vitamin
D status and increased risk of both upper and lower
respiratory tract infections
Vitamin E
• Vitamin E acts as a powerful antioxidant by
protecting cell membranes against attack by free
radicals. The free radicals occur in the body as a
result of metabolic processes like immunological
reactions and the effect of environmental
influences.
• Mocchegiani E. et al 2014, findings reveals that
vitamin E can stimulate the immune system by
acting on the mast cells (mastocytes), which
belong to the leukocyte (white blood cell) group
thus play a role in wound healing and avert
pathogens.
• A study by Lee and Hang 2018, reported the
protective role against infectious diseases.
Vitamin C
• Vitamin C is known as an essential antioxidant and
enzymatic co-factor for many physiological reactions in
the body, such as hormone production, collagen
synthesis and immune potentiation
• Vitamin C helps in the protection of against infections
and inflammation by supporting various cellular
function of both innate and adaptive immune system.
• It boosts antibodies as well as white blood cell
(leukocytes, lymphocytes, T cells) and macrophages,
prolonging their function, and can stimulate the release
of the signaling molecule interferon, which is involved
in the defense against viruses.
Selenium Iron
• It is a crucial element which is needed for the • Both deficiency and superabundance have an
progression of both natural and acquired effect on immune system. Virus and bacteria need
immune system. In serious diseases, deficiency in iron for proliferation. There for during acute
selenium increases the fatality rate considerably. infectious diseases, giving iron should be avoided.
In iron deficiency, transportation of white blood
• It ensures the integrity of cell membrane and cells toward infectious areas decreases and
prevents DNA damage. It reduces the fatality rate destruction of microbes that entered in cells
in sepsis treatment, infections rate in ambitions; abates
consequently it reduces the antibiotic usage. Copper
• Copper plays an important role in immune
system development and continuation. Even
though, both deficiency and superabundance
cause some negative effects on immune system,
in take with food is generally sufficient and
immunity problems relating to capper deficiency
aren’t encountered
The Effect of Nutritional Elements on the Immune System. J Obes Wt Loss Ther 2: 152. doi:10.4172/21657904.1000152
 Probiotic supplements
• Probiotics are defined as live micro-organisms
that confer a health benefit to the host, including
on the gastrointestinal tract, when administered
in adequate amounts.

• They also stimulate immune response by

increasing the antibody production. The results
of a meta-analysis by Kang et al. implied that
probiotics have a modest effect in common cold
reduction.

British Journal of Nutrition (2002), 88, S165–S176

Paparan Lingkungan

Memakai Mencuci
Menjaga jarak
masker tangan

Aktivitas fisik Tidur yang

yang cukup cukup
Tidur cukup
• Several studies have highlighted that sleep is vital
for the immune system. The National Sleep
Foundation (NSF) reported that too much sleep
will not necessarily prevent sickness, but could
instead adversely affect the immune system. On the
other hand, sleep loss and sleep deprivation impair
immune function, since the release of cytokines, a
protein that targets infection and inflammation,
will decrease. Moreover, the infection-fighting
antibodies and cells are reduced during periods
when humans do not get enough sleep
• Thus, sleep influences the immune system through
the action of centrally produced cytokines which
are regulated during sleep. Therefore, it is
recommended to get enough sleep each night to
fight off infectious diseases
Aktivitas fisik
• The currently available body of scholarly evidence
indicates that regular exercise is beneficial for the
immune system and reduces the risk of
contracting certain types of infection, such as
upper respiratory tract infections (URTIs)
• Recently Simpson et al, stated that it is
imperative to maintain recommended exercise
levels during this COVID-19 pandemic to
mitigate the deleterious effects of inactivity and
social isolation stress on our immune system
 Vaksinasi/Imunisasi

adalah suatu upaya untuk

menimbulkan/meningkatkan
kekebalan seseorang secara aktif
terhadap suatu penyakit sehingga
bila suatu saat terpajan dengan
penyakit tersebut tidak akan sakit
atau hanya mengalami sakit ringan.
Jenis imunisasi berdasarkan
penyelenggaraannya

Imunisasi program Imunisasi pilihan

• Imunisasi rutin
 Imunisasi dasar
 Imunisasi lanjutan
• Imunisasi tambahan
• Imunisasi khusus
 Diberikan pada bayi sebelum
Imunisasi dasar usia 1 tahun
• hepatitis B • Pneumonia dan meningitis
yang disebabkan oleh
• Poliomyelitis Hemophilus Influenza tipe
• Tuberkulosis b (Hib)
• Difteri • Campak
• Pertusis
• Tetanus
Imunisasi lanjutan
• ulangan Imunisasi dasar untuk mempertahankan tingkat kekebalan dan untuk
memperpanjang masa perlindungan anak yang sudah mendapatkan Imunisasi
dasar
• diberikan pada:
a. anak usia bawah dua tahun (Baduta);
b. anak usia sekolah dasar; dan
c. wanita usia subur (WUS).
Imunisasi tambahan dan khusus
• Imunisasi tambahan : jenis Imunisasi tertentu yang
diberikan pada kelompok umur tertentu yang paling
berisiko terkena penyakit sesuai dengan kajian
epidemiologis pada periode waktu tertentu
• Imunisasi khusus dilaksanakan untuk melindungi
seseorang dan masyarakat terhadap penyakit tertentu pada
situasi tertentu. Contoh : meningitis meningokokus, yellow
fever (demam kuning), rabies, dan poliomyelitis.
Imunisasi pilihan
• Pneumonia dan meningitis
yang disebabkan oleh
pneumokokus;
• Diare yang disebabkan oleh
rotavirus;
• Influenza ;
• Cacar air (varisela);
• Gondongan (mumps);
• Campak jerman (rubela);
• Demam tifoid;
• Hepatitis A;
• Kanker leher rahim yang
disebabkan oleh Human
Papillomavirus;
• Japanese Enchephalitis;
• Herpes zoster;
• Hepatitis B pada dewasa; dan
• Demam berdarah
 Tumbuh kembang anak optimal
Pola asuh
TUMBUH
Prooses bertambahnya
ukuran/dimensi tubuh akibat
bertambahnya sel dan bertambah Aktivitas
Lingkungan
besarnya sel tsb fisik
BB, TB, LK

Dipengaruhi
KEMBANG

Proses pematangan/maturasi Nutrisi Genetik

fungsi organ tubuh, berkembang
ssesuai kemampuan, intelegensia
dan perilaku anak
Paparan
penyakit
Cara memastikan anak tumbuh dan kembang
optimal???

PEMANTAUAN
APA SAJA YANG DIPANTAU???
Perkembangan
sesuai
n , usia/milestone
d a va
b a , la k
at TB pa sin
e r B/ ke as
B P ar i
gk
n
Li
Apa saja yang harus dilakukan ???
1. Ukur dan
timbang BB,
PB/TB, LK
2. Plotkan pada
kurva
pertumbuhan
3. Interpretasi hasil
 Loss of
growth
Normal

Interpretasi

Flatt of Catch up
growth

Failure to
thrive
Interpretasi
a. Failure to thrive
b. Catch up growth
c. Normal
d. Flat of growth
e. Loss of growth
KESIMPULAN
• Sistem imun/kekebalan anak dipengaruhi berbagai hal diantaranya
nutrisi, paparan lingkungan dan vaksinasi
• Konsumsi nutrisi dengan gizi seimbang diperlukan untuk mendukung
sistem imun anak
• Usaha mengurangi paparan penyakit dapat dilakukan dengan 3M
(memakai masker, menjaga jarak, mencuci tangan)
• Vaksinasi sesuai jadwal untuk mencegah penyakit serta meningkatkan
sistem imun terutama di era pandemi
• Pemantauan tumbuh dan kembang anak harus tetap dilakukan secara
teratur di era pandemi untuk memastikan tumbuh kembang anak
yang optimal
TERIMA KASIH