DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM INSTITUT PERTANIAN BOGOR
BOGOR 2014
GROWTH PATTERN OF CHILDREN 0-5 YEARS OLD
IN BANTUL SPECIAL REGION YOGYAKARTA
PERNYATAAN MENGENAI SKRIPSI DAN SUMBER
INFORMASI SERTA PELIMPAHAN HAK CIPTA
Dengan ini saya menyatakan bahwa skripsi saya berjudul Growth Pattern of Children 0-5 Years Old in Bantul Special Region Yogyakarta adalah benar karya saya dengan arahan dari komisi pembimbing dan belum diajukan dalam bentuk apa pun kepada perguruan tinggi mana pun. Sumber informasi yang berasal atau dikutip dari karya yang diterbitkan maupun tidak diterbitkan dari penulis lain telah disebutkan dalam teks dan dicantumkan dalam Daftar Pustaka di bagian akhir skripsi ini.
Dengan ini saya melimpahkan hak cipta dari karya tulis saya kepada Institut Pertanian Bogor.
Bogor, Juli 2014
Rizky Cahya Windari
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ABSTRACT
RIZKY CAHYA WINDARI. Growth Pattern of Children 0-5 Years Old in Bantul Special Region Yogyakarta. Supervised by BAMBANG SURYOBROTO and TETRI WIDIYANI.
Growth is one of the phases in the human life cycle. Growth may be defined as a quantitative increase in size or mass. The aim of this study is to determine the growth patterns of children 0 – 5 years old in Bantul Special Region Yogyakarta. The subjects of this research were 320 children 0 – 5 years old who consist of 150 boys and 170 girls. The pattern of growth can be determined by anthropometric procedures that are measured of body weight, body height/lenght, sitting height, upper arm circumference and head circumference. Average growth of boys bigger than girls at every age group. Body weight in boys range between 5.41 kg − 17.29 kg and girls 5.40 kg – 16.73 kg. Body height in boys range between 57.71 cm – 107.5 cm and girls 57.22 cm – 106.2 cm. Sitting height of boys range between 36.77 cm – 57.32 cm and girls only range between only 36.25 cm – 56.30 cm. Upper arm circumference boys range between 13.79 cm – 16.69 cm and girls 13.67 cm − 16.62 cm. Head circumference boys range between 39.30 cm – 50.27 cm and girls 38.60 cm – 49.73 cm.
Keywords: growth,children, anthropometry, bantul
ABSTRAK
RIZKY CAHYA WINDARI. Pola Pertumbuhan Anak Usia 0-5 tahun di Bantul, Daerah Istimewa Yogyakarta. Dibimbing oleh BAMBANG SURYOBROTO dan TETRI WIDIYANI.
Pertumbuhan merupakan salah satu tahapan dalam siklus kehidupan manusia. Pertumbuhan didefinisikan sebagai peningkatan kuantitatif dalam ukuran atau massa. Tujuan dari penelitian ini adalah untuk mengetahui pola pertumbuhan anak usia 0 - 5 tahun di Bantul Daerah Istimewa Yogyakarta. Subyek penelitian ini adalah 320 anak 0 - 5 tahun yang terdiri dari 150 laki-laki dan 170 perempuan. Pola pertumbuhan dapat ditentukan dengan prosedur antropometri yang diukur dari pengukuran berat badan, tinggi badan/panjang badan, tinggi duduk, lingkar lengan atas dan lingkar kepala. Pertumbuhan rata-rata anak laki-laki lebih besar daripada perempuan pada setiap kelompok usia. Berat badan pada anak laki-laki berkisar antara 5,41 kg - 17,29 kg dan anak perempuan 5,40 kg - 16,73 kg. Tinggi badan anak laki-laki berkisar antara 57,71 cm - 107,5 cm dan anak perempuan 57,22 cm - 106,2 cm. Tinggi duduk anak laki-laki berkisar antara 36.77 cm - 57.32 cm, dan anak perempuan 36,25 cm - 56,30 cm. Lingkar lengan atas anak laki-laki berkisar antara 13,79 cm - 16,69 cm dan anak perempuan 13,67 cm - 16.62 cm. Lingkar kepala anak laki-laki berkisar antara 39,30 cm – 50,27 cm dan anak perempuan 38,60 cm – 49,73 cm.
RIZKY CAHYA WINDARI
Skripsi
sebagai salah satu syarat untuk memperoleh gelar Sarjana Sains
pada
Departemen Biologi
DEPARTEMEN BIOLOGI
FAKULTAS MATEMATIKA DAN ILMU PENGETAHUAN ALAM INSTITUT PERTANIAN BOGOR
BOGOR 2014
Judul Skripsi : Growth Pattern of Children 0-5 Years Old in Bantul Special Region Yogyakarta
Nama : Rizky Cahya Windari NIM : G34100040
Disetujui oleh
Dr Bambang Suryobroto Pembimbing I
Dr Tetri Widiyani SSi MSi Pembimbing II
Diketahui oleh
Dr Ir Iman Rusmana, M.Si Ketua Departemen
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FOREWORDS
Praises and thanks to Allah SWT for the blessings and His mercy i can finishing this study. My research was conducted from Februari until April 2014 in Bantul with the tiltle is Growth Pattern of Children 0-5 Years Old in Bantul Special Region Yogyakarta.
Biggest acknowledgements are sending to Dr Bambang Suryobroto as my first Supervisor and Dr Tetri Widiyani as my second Supervisor for all their the guidance and advice. I also want to thanked Dr. Dorly, M.Si as an examiner for examination and suggestion. Writer sending a special acknowledgement to my family, my lovely mom and brother mas Wawan for all their love and support. Dr Bambang Suryobroto, Dr Tetri Widiyani, Eneng Nunuz M.Si, Siti Nur Fauziah S.Si, Nurul Huda S.Si, Arvina S.Si, Sarah Nila MSi. To Vita as my cousins for her home in bantul, my home mates Dinasti, Novi and Dyka. Thankfull for my beloved friends Biology 47, Zoo Family, BSH family for the support and the togetherness. Thanks to my big family in Central Java and East Java, to my grandfather and grandmother for their prayers. I also want thankfull to instances, kindergarden, play group, posyandu, hospitals and subject wich belong in this research. And last, thanks to my daddy. This thesis special for my mom and daddy.
I hope this research will be usefull for all the readers.
Bogor, Juli 2014
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DAFTAR TABEL
1 The number of probands based on age and sex 2
2 The number of expulsion 3
DAFTAR GAMBAR
1 Growth pattern in body wight of boys (a) and girls (b) 4 2 Growth pattern of body height in boys (a) and girls (b) 5 3 Growth pattern of sitting height in boys (a) and girls (b) 5 4 Growth pattern of upper arm circumference in boys (a) and girls (b) 6 5 Growth pattern of head circumference in boys (a) and girls (b) 7
DAFTAR LAMPIRAN
1 The number of probands based on location 13
2 The questionnaire of proband 14
3 Comparison of body weigth and body height in boys and girls between American's child, Bogor's Child, Betawi's child and Bantul
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INTRODUCTION
Background
Growth is one of the phases in the human life cycle. Growth and development begins from the time of conception to adulthood. Growth may be defined as a quantitative increase in size or mass, while development is defined as progession of changes, either quantitative or qualitative, that lead from an undifferentiated or immature state to highly organized, specialized, and mature state (Bogin 1999). Growth is influenced by internal factors and external factors. Internal factor is genetic, hormone, ethnicity or nation, family, age and chromosomal abnormalities. External factors is environment, social economi and phsycology (Fox 2002).
Physical measurement of children is required to assess whether the growth is normal or not. This measurement is important to determine the nutritional status (Amarita and Veronica 1992), detecting the presence of chronic diseases, and aberrations in individual growth (Jacob 1981). These assessment need a normal growth pattern to be used as reference.
The pattern of growth can be determined by anthropometric procedures. Anthropometry in neonatal and children for assessing nutritional status and growth that are deemed to be important are measurement of body weight, body height/lenght, sitting height, upper arm circumference and head circumference. Suhardjo (1989) explain that a child's weight is a good indicator and overview of body mass, especially for children under five years old. In this age, body mass is very sensitive to sudden changes, such as infectious disease, decrease in appetite or decreasing amount of food consumed (Supariasa & Bakri 2002). Growth of height is relatively less sensitive than growth of weight in relation to the problem of malnutrition. Effect of nutrient deficiency on height will only appear in a relatively long time (Wong 2004). Sitting height is positively correlated with body mass index in adults, so sitting height can also be used to assess the nutritional state of children. More over, sitting lenght measurements can also be used to detect Marfan syndrome and hypochondroplasia syndrome (Bogin and Beydoun 2007). Upper arm circumference tend to increase according to the increase in the nutritional status of children as well as with increasing age of the child. Head circumference as an important reflection of growth and development of the brain, especially in early childhood. Head circumference is also a sensitive anthropometric indicator of prolonged malnutrition during infancy, so clinicians use head circumference as a measure of failure to thrive (Bouthoorn 2012). These anthropometric data are important indicators of the achievement of physical growth in children (Kuczmarski et al . 2002).
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Aim
The aim of this study is to determine the growth patterns of children 0 – 5 years old in Bantul Special Region Yogyakarta.
MATERIALS AND METHOD
Time and Place
Data was collected during February until April 2014 in Bantul,Yogyakarta. The sampling was done in four Kindergartens school level, two Integrated Community Service Post or Pos Pelayanan Terpadu (Posyandu), three Hospitals, and two by door to door visits (Appendix 1). Data analysis was accomplished in Section of Biosystematics and Ecology of Animal, Department of Biology, Bogor Agricultural University.
Sample
The subjects of this research were 320 children 0-5 years old in Bantul Special Region Yogyakarta. The number of probands based age and sex are shown in Table 1. Range of age class measured to early birthday. The children in 0 years old is 0 – 6 months, 1 year old is 7 months – 1.5 years old, 2 years old is 1.6 years old – 2.5 years old, 3 years old is 2.6 years old – 3.5 years old, 4 years old is 3.6 years old – 4.5 years old, and 5 years old is 4.6 years old – 5.5 years old.
Table 1. The number of probands based on age and sex
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Table 2. The number of expulsion
Informed Consent
The parents or guardians of children were given detailed information and they signed the informed consent and completed questionnaires if they agree to participate.
Measurement
Growth pattern was calculated based on five antrophometric dimensions; that are, body weight, body height, sitting height, upper arm circumference, and head circumference.
Body weight was measured by putting baby lying on the baby scale. For toddlers, body weight was measured using digital weight scale of Uchida. Proband standing calmly and look straight ahead.
Lenght of baby was measured using measuring board. Proband was placed in the supine position on a measurements board. They view straight up, their head hit on the boards. Body and legs of proband were placed horizontal, heel straightened. For toodlers, body height was measured using stadiometer. Proband stand upright and relaxed, look straight ahead, heels and knees straightened.
Sitting height was measured as the length from head to rump using measuring tape. Upper Arm circumference was measured using measuring tape at the proband’s upper left arm, between the shoulder and elbow, wrapped around not tensioned. Head circumference was measured using measuring tape. Wrapped tape around the baby’s head in the part of largest. This is above the eyebrows and the tops of the ears.
Statistical Analysis
4 Figure 1. Growth pattern in body wight of boys (a) and girls (b)
Body Heigth
Growth pattern of body heigth in boys and girls are shown in Figure 2. Mean of body height in boys is higher than mean body height in girls. Mean of 0 years in boys is 57.71 cm and in girls is 57.22 cm. Mean of 1 years in boys is 74.33 cm and in girls 72.31 cm. Mean of 2years old in boys is 83.98 cm and girls is 83.82 cm. Mean of 3years in boys is 94.04 cm and girls is 91.71 cm. Mean of 4 years old in boys is 101.70 cm and girls is 99.19 cm. Mean of 5 years old in boys is 107.5 and girls is 106.2 cm.
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Figure 2. Growth pattern of body height in boys (a) and girls (b)
Sitting Height
Growth pattern of sitting heigth in boys and girls are shown in Figure 3. Mean of sitting height in boys higher than mean body height’s girls. Mean of 0 years in boys is 36.77 cm and in girls is 36.25 cm. Mean of 1 years in boys is
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Growth Pattern of upper arm circumference in boys and girls are shown in Figure 4. Mean of upper arm circumference in boys is bigger than girls. Mean of 0 years in boys is 13.73 cm and in girls is 13.67 cm. Mean of 1 years in boys is Figure 4. Growth Pattern of upper arm circumference of boys (a) and girls (b)
Head Circumference
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Figure 5. Growth pattern of head circumference in boys (a) and girls (b)
DISCUSSION
Body Weight
Anthropometric data are valuable objective indicators of attained size and physical growth in children. Body weight and body height are the mostly anthropometric data that use to determinate nutritional status of children. Malnutrition more influence to body weight than body height (Khomsan 2004).
Up to five years old, children’s weight gain significantly. Body mass is very sensitive to sudden changes, such as infectious disease, decreased appetite or decreasing the amount of food consumed (Supariasa & Bakri 2002). The pattern of body weight curves indicates that body mass increases rapidly from birth to approximately 5 years old. Body weight gain on average 2 − 4 kg every year during preschool age.
Body weight in boys 0 - 5 years old in Bantul old is bigger than body weight in girls at each age group. This is because boy have a muscle mass, body mass and metabolic rate greater than girls (Watson and Lowrey 1951). Body weight in boys vary for each age which range between 5.41 kg − 17.29 kg, while girls only range between 5.40 kg − 16.73 kg.
Growth curves are an essential tool in pediatric practice. Their value resides in helping to determine the degree to which physiological needs for growth and development are being met during the important childhood period. However, their usefulness goes far beyond assessing children’s nutritional status (De Onis 2009).
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proband in 0.90 percentiles to 0.97 percentiles were having overweight and proband in above 0.97 percentiles were having obesity in their each age group.
Generally, the child's body weight in Bantul is lower than American children (De Onis et al. 2006), Bogor children (Yuliana 2006) and Betawi children (Widiastuty 2013) (Appendix 3). This is probably because the socio-economic conditions in Bantul was lower than America, Bogor and Betawi tribe. therefore , it has enviromental, and genetic is different also.
Body Height
The growth pattern of body height much affected by the condition of malnutrition in the short term. But if prolonged nutritional deficiency and severe, then the growth pattern of body height can be affected even interfere with the maturation process. Body height can be inhibited by a protein deficiency despite sufficient intake energy. The fastest height growth occurs during puberty along with sexual maturity. Added height and weight along with increasing proportions of the body (Khomsan 2004).
Body height anthropometric describes the state of skeletal growth. In normal condition, body height grows with age. Body Height growth unlike weight, its relatively less sensitive to the problem of malnutrition in a short time. Effect of nutrient deficiency on height will appear in a relatively long time (Wong 2004).
The pattern of body height curves indicate that body height increases rapidly from birth to approximately 3 years old. Body height gain average in 0 − 3 years old is 9 − 16 cm and in 4 − 5 years old average 5 − 8 cm. Body weight in boys 0 - 5 years old in Bantul is bigger than body weight in girls. Body height in boys vary for each age which range between 57.71 cm − 107.5 cm, while girls only range between 57.22 cm − 106.2 cm.
Somatotropin or Growth Hormone (GH) is a major regulator of the growth framework. Added height is strongly influenced by this hormone. GH stimulates the formation of somatomedin which then affects the cartilage (Soetjiningsih 1995).
Body height is obtaine similar results with body weight, in which the child's body height in Bantul is also lower than body height of America children (De Onis et al. 2006), Bogor children (Yuliana 2006), and Betawi tribe children (Widiastuty 2013) (Appendix 3).
Sitting Height
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hands and foot. Hypochondroplasia is a genetic disorder with mostly caused by mutations in FGFR3 gene (Matsui et al. 1998).
Widiastuty (2012) reported that, can adjust the length of sitting height. If a child has a higher height , then a child has sitting height longer also.
The pattern of sitting height curves indicates that sitting height increases rapidly from birth to approximately 3 years old. Body height gain average in 0 − 3 years old is 5 − 7 cm and in 4 − 5 years old gain average 2 cm. Sitting height of boys vary for each age 0 to 5 years which range between 36.77 cm − 57.32 cm, while girls only range between 36.25 cm − 56.30 cm.
Upper Arm Circumference
Upper arm circumference is a reflection of the growth and development of fat tissue and muscle. Upper arm circumference was used to assess nutrition or growth and development in the preschool age group (Sulistyawati 2014).
The results showed that Upper arm circumference boys is bigger than girls. Upper arm circumference boys 0 to 5 years old range between 13.79 cm − 16.69 cm and while girls only range between 13.67 cm − 16.62 cm. Upper arm circumference gain on average 2 cm every year.
Head Circumference
The aim of head circumference measurment for determine childs's head circumference within the normal range or not. (Bouthoorn et all. 2012) reported that, several studies recognized head circumference (HC) as an important reflection of growth and development of the brain, especially in early childhood. HC is also a sensitive anthropometric indicator of prolonged malnutrition during infancy, so clinicians use HC as a measure of failure to thrive.
Growth of head circumference associated with brain development. The most critical period and rapid of brain development is from the fetus in gestation period until after birth to 2 years old. Brain development is related to the multiplication and increase size of brain cells quickly. Size cells only increase after 2 years old (Khomsan 2004).
The pattern of head circumference curves indicates that head circumference increases rapidly from birth to approximately 2 years old and gain sicnificantly on average 8 cm. Head circumference boys vary for each age 0 to 5 years old which range between 39.30 cm − 50.27 cm, while girls only range between 38.60 cm − 49.73 cm.
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CONCLUSION
The growth pattern of children 0 − 5 years old in Bantul Special Region Yogyakarta, showed a similiar pattern in body weight, body height, sitting height, upper arm circumference and head circumference, which is likely increase. Average growth of boys bigger than girls at every age group.
REFERENCES
Almarita, Veronica L. 1992. Penggunaan indeks massa tubuh (Body Mess Index) sebagai indikator status gizi orang dewasa. Gizi Indonesia 17 (1) : 50 – 56. Bogin B , Beydoun N. 2007. The relationship of sitting height ratio to body mass
index and fatness in the United States 1988-1999. Human Ecology 15: 1-8. Bouthoorn SH, Van Lenthe FJ, Koelega A, Moll AH, Tiemeier H, Hofman A,
Mackenbach JP, Jaddoe V, Raat H. 2012. Head Circumference of Infants Born to Mothers with Different Educational Levels; The Generation R Study. PLoS ONE . 7(6): e39798. doi:10.1371/journal.pone.0039798.
De Onis, Mercedes. 2009. Growth Curves for School-age Children and Adolescents. Indian Pediatric. 46 : 463 – 465.
De Onis et al. 2006. WHO child growth standards : length/height-for-age, weight-for-age, weight-for-length, weight-forheight and body mass index-for-age :
methods and development. Switzerland (FR) : WHO Press.
Fox SI. 2002. Human Physiology. Ed ke-7. New York (US) : McGraw-Hill. Jacob T. 1981. Norma Pertumbuhan Untuk Indonesia. Berkala ilmu kedokteran
Gajah Mada Jilid 13. Cetak ulang dalam Indriati E, Editor. 2002.
Antropometri Biologis. Jakarta (ID) : Direktorat Jenderal Pendidikan Tinggi
Departemen Pendidikan Nasional.
Khomsan, A. 2004. Pangan dan gizi untuk kesehatan. Jakarta (ID) : PT. Raja Grafindo Persada.
Loeys BL et al. 2010. The revised Ghent nosology for the Marfan syndrome. J
Med Genet. 47: 476-485.
Matsui Y, Yasui, Kimura T, Tsumaki, Kawabata, Ochi. Genotype and phenotype correlation in achondroplasia and hipokondroplasia. 1998. Journal Bone
Joint Surgery. 88: 1052-1057
Pemerintah Daerah D.I Yogyakarta. 2013. Peraturan Gubernur Provinsi Daerah Istimewa Yogyakarta No. 279/2013 tentang Upah Minimum Provinsi Tahun 2013.
R Development Core Team. 2012. R: A Language and Environment for Statistical Computing. R Fondation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0. http://www.rproject.org/.
Soetjiningsih. 1995. Tumbuh Kembang Anak. Jakarta (ID) : Penerbit Buku Kedokteran EGC.
Stasinopoulos DM, Rigby RA. 2005. Generalized additive models for location scale and shape (GAMLSS) in R. Journal Statistics Software. 55:1-64. Supariasa B, Bakri I F. 2002. Penilaian Status Gizi. Jakarta (ID): Penerbit Buku
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Watson EH, Lowrey GH. 1951. Growth and Development of Children. Ed ke-2. USA (US) : Year Book.
Widiastuty, H. 2013. Pola Pertumbuhan Anak Usia 1–5 Tahun di Perkampungan Budaya Betawi Setu Babakan, Jakarta Selatan [Skripsi]. Bogor (ID) : Fakultas Matematika dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor. Wong. 2004. Pedoman Klinis Keperawatan Pediatrik. Edisi 4. Jakarta (ID):
Penerbit Buku Kedokteran EGC.
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Appendix 1. The number of probands based on location
Location
TK. Aisyiyah Bustanul Alfath Krapyak Wetan
TK. Kuncup Harapan Sewon
TK. Taat Insan Mulia Kec. Kasihan
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Appendix 2. The questionnaire of probands
KUISIONER PENELITIAN
Pemberian ASI sampai usia :
Umur berapa mulai non ASI (makan) : Frekuensi makan per hari :
Pengeluaran perbulan :
Tinggal di bantul sejak (tanggal/bulan/tahun/) :
Data Orang Tua
Pendapatan keluarga per bulan untuk makan (pilih salah satu) :
1. X < Rp. 500.000 4. Rp. 1.000.000 ≤ X < Rp. 1.250.000
2. Rp. 500.000 ≤ X < Rp. 750.000 5. Rp. 1.250.000 ≤ X < Rp. 1.500.000
3. Rp. 750.000 ≤ X < Rp. 1.000.000 6. Rp. X ≥ Rp. 1.500.000
Ket : X = Total pengeluaran keluarga per bulan untuk makan
Data Pengukuran
No Parameter Kode Hasil Pengukuran
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Appendix 3. Comparison of body weigth and body height in boys and girls between American’s child, Bogor’s child, Betawi’s child and Bantul’s child
Comparison in body weight of 50th percentile Age
(year)
America
Children Bogor Children Betawi Children Bantul Children
B G B G B G B G
Comparison in body height of 50th percentile Age
(year)
America
Children Bogor Children Betawi Children Bantul Children
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RIWAYAT HIDUP
Penulis dilahirkan di Biak pada tanggal 24 Agustus 1992 dari ayah Suyanto (Alm) dan ibu Rossiyem. Penulis adalah anak kedua dari dua bersaudara. Tahun 2010 penulis menyelesaikan pendidikan di SMAN 1 Biak Kota dan pada tahun yang sama penulis melanjutkan studi pada Jurusan Biologi, Fakultas Matematika dan Ilmu Pengetahuan Alam, Institut Pertanian Bogor melalui jalur USMI.
Selama mengikuti perkuliahan, penulis aktif sebagai bendahara di Divisi Infokom HIMABIO sebagai bendahara pada tahun 2012/2013 dan pada tahun 2013/2014 penulis menjadi asisten praktikum Fisiologi Prokariot.
Penulis melakukan Studi Lapangan dengan judul Invertarisasi Fauna Air di Taman Nasional Gunung Pangrango pada tahun 2012 dan melakukan Praktik Lapangan dengan judul Perawatan dan pengamatan tingkah laku Snow Leopard
