THE RELATIONSHIP OF INFECTIOUS DISEASES HISTORY AND MOTHER FACTORS TO UNDER RED LINE AMONG TODDLER

Nutrition under the red line is a state of severe nutritional deficiency caused by low consumption of energy and protein from daily food. Sungai Tiung is the village that has the highest number of children under five with under red line (BGM) from other villages in the working area of Rawat Inap Cempaka Health Center. This study aims to know the relationship of infectious diseases history and mother factors to under red line (BGM) among toddler in Sungai Tiung. This research uses cross-sectional design. The samples are 90 respondents. Sampling used purposive sampling. The independent variables are a history of infectious disease, knowledge, education, and mother care pattern. The dependent variable is under red line (BGM). The instrument in this study used questionaire and Kartu Menuju Sehat (KMS). The result showed that there is a relationship history of infectious diseases with BGM (p-value = 0.03). The results also showed no relationship of knowledge (p-value = 0.12), education (p-value = 0.75) and mother care pattern (p-value = 0.32) with BGM. There is a relationship history of infectious diseases with BGM. So that, there should be efforts to prevent infectious diseases in toddler.


INTRODUCTION
Toddler period is the second golden period.In this childhood of nutrition plays an important role in the development of a child.In addition, the age of toddlers is the critical age in which a child will grow rapidly both physically and mentally. 1In infancy, a child needs nutrients from various sources and foods.A toddler usually requires about 1000 -1400 calories per day.Proper and complete nutrition will have a positive impact on the growth of the brain and also physical. 2utrition under the red line is a state of severe nutritional deficiency caused by low consumption of energy and protein from everyday food and occurs in a long time which is a state of vigilance in order not to experience malnutrition.Clinical signs of malnutrition in the outline can be distinguished marasmus, kwashiorkor or marasmic-kwashiorkor. 3 Based on research on BGM toddler illustration shows that nutritional status in BGM under five is in the category of under nutrition as much as 17 people (100%). 4The BGM situation is detailed according to malnutrition (BB / U <-3 SD) and malnutrition (BB / U <-2 SD to ≥-3 SD).Toddlers BGM is a weighted toddler who is on the red line or below the red line on Kartu Menuju Sehat (KMS). 5ased on the data of Nutrition Information System in July 2016, BGM's largest number of children under five in Banjarbaru is at Cempaka Health Center, with an incidence of 502 BGM from the number of under-five weighed by 2,051 infants (2.4%). 6Data from Dinas Kesehatan Banjarbaru City in October 2016 found that Cempaka in July 2016 had the most BGM toddler that is 43 children from the total of 125 BGM children in Banjarbaru City 7 , while data from Puskesmas Cempaka found that in August 2016 in Cempaka there are 13 BGM, in Sungai Tiung there are 24 BGM, in Bangkal there are 4 BGM, and in Palam there are 2 BGM among toddlers.Sungai Tiung is the village that has the highest number of children under five from other villages in the working area of Rawat Inap Cempaka Health Center.The percentage of BGM incidence in the Sungai Tiung Region in August was 2.6%, 8 although the incidence of BGM in the Sungai Tiung region was not > 5% or was an exceptional occurrence, but it should still be a concern for BGM children not to experience malnutrition later as well as trying to reduce the incidence of BGM among toddlers.
According to Soekirman (2000), the incidence of nutritional problems among children under five consist of direct causes of infectious diseases and inadequate food consumption, whereas indirect causes are food availability, maternal education level, mother's level of knowledge, family income level, and health services, as well as participation to posyandu. 10This study aims to analyze the relationship of the history of infectious diseases and maternal factors (mother's education level, mother's level of knowledge, pattern of parenting) with the incidence of the Under Red Line (BGM) among toddlers in Sungai Tiung Sub district, Cempaka District, South Kalimantan.

RESEARCH METHODS
This research is an observational analytic research using cross-sectional design.The population in this study were all mothers who had children aged 12 -59 months who visited Posyandu in Sungai Tiung Subdistrict, Cempaka District.The sample in this study is 90 people.Sampling in this research using purposive sampling technique.The independent variables used were the history of infectious diseases, maternal education level, mother's knowledge level, and pattern of parenting.The dependent variable used is the incidence of under red line (BGM) among toddler.Data analysis was completed using statistics software.To determine statistical significance in bivariate analyses χ2 tests of differences in proportions ( Chi Square test) were used.P-value ≤ 0.05 was considered to be statistically significant.

RESULTS AND DISCUSSION
Based on the results of research on 90 respondents obtained the frequency distribution of respondents based on the history of infectious diseases, maternal factors (mother's education level, mother's level of knowledge, pattern of parenting) and the under red line (BGM) presented in table 1 below:  2 shows that the percentage of BGM occurs in infants with the history of infectious diseases.The results of statistical tests show the value of p-value of 0.03 which means Ho is rejected which means there is a relationship between the history of infectious diseases with the incidence of BGM.Odd Ratio (OR) value indicates 3.36 which means toddler with the history of infectious disease 3.36 bigger risk of having BGM than toddlers who do not have the history of infectious diseases.
The main causes of infectious diseases in children under five namely the amount of food consumed and the health condition concerned.Consumption deficiency in a certain period will cause the weight of the child under five declines so that the immune system decreases and will be susceptible to infectious diseases.In addition, due to lack of food availability and public awareness that is still lacking regarding the nutritional status of their children, there is a very strong relationship between malnutrition and death of children under five suffering from malnutrition accompanied by infectious diseases. 11he results of this study are in line with Novitasari (2016) which states that infectious disease is one of the factors associated with the incidence of BGM (pvalue 0.024). 12Infectious diseases in this study are diseases caused by infections, viruses, bacteria, and parasites that disrupt the metabolism and disrupt the function of immunity, causing weight loss.Then the measurement for infectious diseases started the last one month by interviewing the respondents, then obtained the results of 25 children under five suffer from infectious diseases, namely diarrhea.This is in line with research Wilyandari (2014), that respondents who have poor environmental sanitation tend to experience infectious diseases of 78.9% compared with those who do not suffer from an infectious disease that is 21.1%.Where poor environmental sanitation has 14.25 times greater risk of getting infectious diseases than with good environmental sanitation. 13he results of the study in Table 2 show that the incidence of BGM has almost the same percentage between low knowledge mother and high knowledge mother.The results of statistical tests show the value of p-value of 0.12 which means Ho accepted which means there is no relationship between maternal education level with the incidence of BGM.
The results of this study are in line with research conducted by Ni'mah and  Muniroh (2015) which showed no relationship between maternal education level and BGM (P-value 0.581).Maternal education is a basic thing for the achievement of good nutrition of a toddler.The mother's education level is linked to the convenience of mothers in receiving information about nutrition and health from outside.Mothers with higher levels of education will more easily receive information from outside, compared with mothers who have lower levels of education.The level of education for poor families is mostly in the low category, due to the economic limitations experienced so that they are unable to continue their education at higher levels. 14n this study, mothers with low levels of education did not necessarily have toddlers with more BGM problems than mothers with higher levels of education.This is because maternal education is a basic cause of malnutrition, and there are many other factors that can affect the occurrence of malnutrition, especially wasting and stunting in poor families.
The results also showed no difference in the percentage of BGM incidence between mothers with less knowledge with mothers with good knowledge.The results of statistical tests show the value of pvalue of 0.75 which means Ho accepted which means there is no relationship between the level of knowledge of the mother with the incidence of BGM.
One of the indirect causes of malnutrition in children is education and knowledge of parents, especially mother's knowledge.The higher the educational level of a person the easier it is given an understanding of an information and the easier it is to implement its knowledge in behavior especially in terms of health and nutrition. 15According to the Depkes RI (2003), a mother with low education level, her toddler is twice as likely to face health problems compared to mothers with high education.
No association in this study is consistent with research conducted by Ni'mah and Muniroh (2015) indicating that knowledge is not related to the nutritional state of infants (p-value 0.632). 14A high level of knowledge of mothers does not guarantee to have a toddler with normal nutritional status.Mothers who have good knowledge are expected to apply the knowledge possessed in everyday life.However, behavior other than influenced by the level of knowledge is also influenced by other factors, such as socioeconomic, socio-cultural, and environmental. 16he results of the study in Table 2 shows the incidence of BGM in respondents who get support from husbands and who do not get the support of husbands almost equal percentage The results of statistical tests showed the value of p-value of 0.32 which means Ho accepted, which means there is no relationship between mother's parenting pattern with the incident BGM.
The results of this study are in line with research by Ni'mah and Muniroh  (2015) which shows no relationship between parenting patterns with nutritional status of children (p-value 0.72).Maternal care pattern has a role in work and nutrition status of toddler because intake of food in toddler fully arranged by her mother.Mothers with good parenting tend to have toddlers with better nutritional status than mothers with poor parenting. 14ut in this study the mother with good parenting does not necessarily have a toddler with a BGM problem is smaller than the mother with less care pattern.This may be because despite good mother care pattern, in low-income families there are limitations in fulfilling daily needs so that mother's parenting does not affect the occurrence of BGM problems in infants.

Table 1 .
Distribution of Frequency Based on The History of Infectious Diseases, Maternal Factors (Mother's Education Level, Mother's Level Of Knowledge, Pattern Of Parenting) and The Under Red Line (BGM)

Table 2 .
The Relationship of The history of Infectious Diseases and Mother Factors (Maternal Education Level, Mother's knowledge level, and Pattern of Parenting) With The Under Red Line (BGM)