MANAJEMEN KLINIS MARASMUS : SEBUAH TINJAUAN LITERATUR MENGGUNAKAN METODE PRISMA
DOI:
https://doi.org/10.31004/prepotif.v9i3.52508Keywords:
malnutrisi energi-protein, manajemen klinis, marasmus, PRISMA, terapi nutrisiAbstract
Marasmus merupakan bentuk malnutrisi energi-protein yang paling berat dan tetap menjadi tantangan kesehatan global dengan angka morbiditas serta mortalitas yang tinggi, terutama pada negara berpenghasilan rendah dan menengah. Literature review ini bertujuan untuk merangkum dan mensintesis bukti ilmiah terkini mengenai manajemen klinis marasmus yang mencakup aspek penilaian, stabilisasi awal, terapi nutrisi, tata laksana komplikasi, hingga pemantauan jangka panjang. Melalui pencarian sistematis pada database PubMed, Scopus, dan Google Scholar menggunakan metode PRISMA, sebanyak 18 artikel yang memenuhi kriteria inklusi dianalisis secara mendalam. Hasil tinjauan menunjukkan bahwa keberhasilan tata laksana marasmus sangat bergantung pada deteksi dini dan penerapan protokol intervensi yang ketat. Strategi utama meliputi fase stabilisasi untuk mengatasi kegawatdaruratan seperti hipoglikemia, hipotermia, dan dehidrasi, yang dilanjutkan dengan pemberian nutrisi secara bertahap menggunakan formula khusus untuk mencegah refeeding syndrome. Penanganan agresif terhadap komplikasi infeksi dan koreksi ketidakseimbangan elektrolit juga menjadi faktor penentu kesembuhan pasien. Lebih lanjut, ulasan ini menekankan bahwa keberhasilan klinis tidak hanya berhenti pada fase rumah sakit, tetapi juga memerlukan keterlibatan aktif keluarga dalam perawatan lanjutan dan edukasi gizi untuk memastikan pemulihan yang berkelanjutan. Secara keseluruhan, literature review ini menegaskan pentingnya pendekatan multidisiplin yang terintegrasi dalam tata laksana marasmus guna menurunkan angka kematian secara signifikan serta meningkatkan prognosis kesehatan jangka panjang bagi anak-anak yang terdampak.References
Afolabi, O. T., Adedokun, B. O., & Adebayo, A. M. (2021). Effects of zinc supplementation on recovery in children with severe acute malnutrition: A randomized controlled trial. Journal of Tropical Pediatrics, 67(3), 1–9.
Ahmed, T., Hossain, M., & Sanin, K. I. (2019). Global burden of malnutrition and clinical management of severe acute malnutrition. The Lancet Child & Adolescent Health, 3(1), 28–37.
Alemu, T., Teklu, T., & Gebre, A. (2020). Long‐term outcomes among children treated for severe acute malnutrition in Ethiopia: A cohort study. BMC Pediatrics, 20(1), 1–9.
Bahwere, P., Banda, T., & Collins, S. (2017). Effectiveness of ready‐to‐use therapeutic food (RUTF) in the management of severe acute malnutrition. Nutrition Journal, 16(1), 1–11.
Becker, K. W., & Sakkas, H. (2015). Immune dysfunction in protein-energy malnutrition. Clinical Nutrition, 34(4), 686–694.
Bhutta, Z. A., Das, J. K., Rizvi, A., Gaffey, M. F., Walker, N., et al. (2013). Evidence-based interventions for maternal and child nutrition: What can be done and at what cost? The Lancet, 382(9890), 452–477.
Boateng, L., Nyarko, R., & Asante, K. O. (2016). Electrolyte abnormalities in children with severe acute malnutrition: Implications for refeeding. Journal of Nutrition & Metabolism, 2016, 1–9.
Departemen Kesehatan Republik Indonesia. (2011). Pedoman tatalaksana gizi buruk. Kementerian Kesehatan RI.
Hidayati, E., & Kartasurya, M. I. (2018). Faktor risiko malnutrisi energi protein pada balita di Indonesia: Literature review. Jurnal Gizi Indonesia, 7(2), 75–84.
Kerac, M., Bunn, J., Seal, A., Thindwa, M., Tomkins, A., et al. (2014). Probiotics and therapeutic feeding in severe acute malnutrition: A randomized controlled trial. Journal of Pediatric Gastroenterology and Nutrition, 59(4), 544–549.
Krisnana, I., Widjanarko, B., & Astuti, R. (2019). Faktor penyebab gizi buruk pada balita di wilayah pedesaan Indonesia. Media Kesehatan Masyarakat Indonesia, 15(1), 12–20.
Lenters, L., Wazny, K., & Bhutta, Z. A. (2013). Management of severe acute malnutrition in children: A systematic review. BMC Public Health, 13(Suppl 3), 1–12.
Modi, P., Patel, K., & Desai, S. (2018). Clinical profile and predictors of outcome in children with protein-energy malnutrition. International Journal of Contemporary Pediatrics, 5(4), 1238–1244.
Olatunbosun, S., Akinyemi, O., & Onayade, A. (2021). Electrolyte imbalances in children admitted with severe acute malnutrition: Prevalence and predictors. Pan African Medical Journal, 38, 1–10.
Rahman, A., Chowdhury, S., & Alam, M. (2018). Mortality reduction after implementation of WHO guidelines for severe acute malnutrition: Evidence from a tertiary hospital. Public Health Nutrition, 21(13), 2420–2427.
Rahayu, S., & Supariasa, I. D. N. (2017). Hubungan pola makan dan penyakit infeksi dengan kejadian gizi buruk pada balita. Jurnal Gizi Klinik Indonesia, 13(2), 87–94.
Santos, L. P., Gigante, D. P., & Victora, C. G. (2022). Stabilization phase in the management of severe acute malnutrition: Challenges and strategies. Maternal & Child Nutrition, 18(1), 1–12.
Singh, R., & Kumar, V. (2020). Role of empiric antibiotic therapy in severe acute malnutrition: A review. Journal of Pediatric Infectious Diseases, 15(2), 89–95.
Tadesse, E., Berhane, Y., & Ekström, E. C. (2017). Risk factors for severe acute malnutrition in children under five: A case-control study. Ethiopian Journal of Health Development, 31(2), 88–95.
World Health Organization. (2013). Guidelines for the management of severe acute malnutrition in infants and children. WHO Press.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Yusuf Baidenggan, Ine Wahyuni Dean, Shinta Lisa Purimahua
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
