Continuing the previous article about ISPA and ISPA in Toddler classification, then we need to know some risk factors in Toddler ARI. Various publications reported on the risk factors that increase morbidity and mortality of pneumonia. If you made a list of these risk factors are as follows:
a. Risk factors that increase the incidence of pneumonia
· Age <2 months
- Men ·
· Nutrition less
· Low birth weight
· Not get adequate milk
· Air pollution
· Density residential
· Inadequate Immunization
· Membedong children (over exaggerated)
· Deficiency of vitamin A
b. Factors that increase the risk of pneumonia mortality
· Age <2 months
· Low socioeconomic level
· Nutrition less
· Low birth weight
· Level low maternal education
· Level of health coverage to low
· Density residential
· Inadequate Immunization
· Suffering from chronic disease
Generally there are 3 (three) risk factors namely ISPA environmental factors, individual child factors, and behavioral factors.
1. Environmental factors
a. Air pollution in homes
Cigarette smoke and the smoke of burning fuel to cook with high concentrations can damage lung defense mechanisms that will facilitate the emergence of respiratory infection. This can happen at the state house and kitchen ventilation lies less in the house, together with a bedroom, the room where babies and toddlers to play. It is more possible for babies and older toddlers in the house together so that the dose of pollution mother would certainly be higher.
The results obtained by the relationship between ARI and air pollution, of which there is an increased risk of bronchitis, pneumonia in children who live in more polluted areas, where this effect occurs in the age group 9 months and 6 - 10 years.
b. Home ventilation
The process of providing ventilation air, or deployment of air to or from the room either naturally or mechanically. The function of ventilation can be described as follows:
1. Clean air supply of air containing optimum levels of oxygen for breathing.
2. Releasing the air from the room of odors, smoke or dust and substances other pollutant dilution by air.
3. Supplying heat to balance body heat loss.
4. Heat supplying heat loss rooms and buildings.
5. Mengeluakan excess heat radiation caused by the body, condition, evaporation or external circumstances.
6. Temperature Mendisfungsikan evenly.
c. Density residential homes
Density residential in the house according to the health minister's decision 829/MENKES/SK/VII/1999 number of requirements for home health care, one person occupying a minimum area of 8m ² house. With these criteria are expected to prevent the transmission of the disease and launch activities.
State compact housing can increase pollution factors in the existing house. Research shows there is significant relationship between density and mortality from bronchopneumonia in infants, but stated that air pollution, social level, and education gives a high correlation in these factors.
2. Individual child factors
a. Age child
A number of studies suggests that the incidence of respiratory disease by veirus jumped at an early age infants and children and remained decreased for age. ISPA highest incidence at age 6 -12 months.
b. Birth weight
Birth weight to determine growth and physical and mental development in infancy. Infants with low birth weight (BBLR) has a mortality risk greater than normal birth weight, especially in the first few months of birth due to the formation of anti-immune deficient and thus more susceptible to infectious diseases, especially pneumonia and other respiratory illness .
Research shows that weight infants less than 2500 grams associated with increased deaths from respiratory infections and this relationship is settled after adjusted for employment status, income, education. This data is reminded that children with a history of low birth weight did not experience higher rates of respiratory disease, but experienced more severe infection.
c. Nutritional status
Enter the nutrients are obtained on the stage of growth and development of children affected by: age, physical condition, health condition, physiological digestive health, food availability and activity of the child itself. Assessment of nutritional status can be performed among others by antopometri: birth weight, length, height, upper arm circumference.
Poor nutrition situation emerged as an important risk factor for the occurrence of respiratory infection. Several studies have shown the existence of the relationship between malnutrition and lung infections, so that the children who often have poor nutritional pneumonia. Besides, the relationship between malnutrition and the occurrence of measles and other serious viral infections and declining child's immune system against infection.
Toddler with a lack of nutrition are more susceptible to respiratory infection than infants with normal nutrition because immune factors are lacking. Infectious diseases alone will cause a toddler does not have the appetite and cause nutritional deficiencies. In circumstances less nutrition, infants more prone to "ISPA heavy" attacks even longer.
d. Vitamin A
Since 1985 every six months providing integrated health capsules 200,000 IU of vitamin A on the toddlers from the age of one to four years. Toddler who received vitamin A for more than 6 months before the illness or who had never received it was a risk of a disease for 96.6% of the cases and 93.5% in the control group.
Giving vitamin A is done simultaneously with the immunization would lead to increased specific antibody titer, and apparently remains in a high enough value. When antibodies directed against germs and not just a foreign antigen that is not dangerous, it can be expected necessarily a protection against seedling diseases related to the period not too short. Because the bulk of business is the provision of vitamin A and immunization periodically to anal preschool children should not be seen as two separate activities. Both must be considered in a unified whole, which increases the immune system and Indonesia erlindungan against children so that they can grow, develop and set up in a situation best.
e. Immunization Status
Infants and toddlers who had caught measles and survivors will have a natural immunity to pneumonia as a complication of measles. Most of the deaths from respiratory infection that developed respiratory type of disease can be prevented by immunizations such as diphtheria, pertussis, measles, then the increase in immunization coverage will play a major role in the eradication effort ISPA. To reduce the factors that improve mortality, respiratory infection, complete immunization effort. Infants and toddlers who have a complete immunization status when suffering from respiratory illness can be expected perkenbangan will not become more severe.
The way that proved most effective when it is the provision of measles immunization and pertussis (DPT). With an effective measles immunization approximately 11% of pneumonia deaths can be prevented and toddlers with pertussis immunization (DPT) 6% lematian pneumonia can be prevented.
3. Behavioral factors
Behavioral factors in the prevention and control of respiratory disease in infants and toddlers in this case is the practice of respiratory treatment in the family both by the mother or other family members. The family is the smallest unit of society who gathered and lived in a household, one with the other interdependent and interact. If one or several family members have health problems, it will affect other family members.
Active role the family / community in dealing with ISPA is important because respiratory disease is a disease that is day-to-day in the community or family. This needs serious attention by all of us because the disease is much attacking a toddler, so the toddler's mother and family members who most closely with toddlers learn and skillful handling of this respiratory disease when her son was sick.
Families need to know and observe signs of pneumonia early complaints and when to seek help and reference to the health care system so that disease toddler does not become more severe. Based on this clearly means that the role of families in the practice of early treatment for infant respiratory illness is important, because if the practice of family-level respiratory treatment less / worse will influence the course of the disease from mild to gain weight.
Respiratory rate in the handling of the whole family can be classified into 3 (three) categories, namely: supporting the mother's care toddlers; immediate action and observation of the infant disease progression; search for help on health services.
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