Jurnal Aisyah: Jurnal Ilmu Kesehatan

Volume 6, Issue 2, June 2021, p. 409–414

ISSN 2502-4825 (print), ISSN 2502-9495 (online)

Compress Onions (Allium Cepa) As A Nonpharmacological Therapy

in Febris Toddlers

Roza Erda1*); Mawardi Badar1; Didi Yunaspi1; Yanti Oktavina1

1
Nursing and Professional Education Undergraduate Study Program, Mitra Bunda Batam Health Institute

ARTICLE INFO ABSTRACT

Cases of fever in toddlers are a health problem that continues to increase. WHO statistics
Article history: show there are 18-34 million cases per year. One of the nonpharmacological treatments
that can be done to lower body temperature in toddlers is to compress onions. This study
Received 11 January 2021
Accepted 21 March 2021 aims to find out the effect of giving onion compresses as a decrease in body temperature
Published 25 June 2021 in toddlers aged 1-5 years with febris in the Tanjung Sengkuang Health Center Work Area
of Batam City in 2020. This research design uses experimental Quasi with a one group pre-
test and post-test design approach. Sample withdrawal techniques use purposive
Keyword: sampling. The respondents in this study were 32 respondents. Data analysis techniques
Febris To test the hypothesis is the Paired Sample T-Test test. The results of the data analysis
Toddler were obtained that after the therapy of The Onion Compress experienced a decrease in
Compress body temperature by (p-value < 0.05). Conclusion: onion compresses can be used as an
Onion. alternative to reduce fever in toddlers. The authors suggest the need to increase the role
of nurses in Puskesmas by involving families to utilize alternative therapies based on
*) corresponding author evidence from research results and evidence.
Roza Erda

Email: [email protected]

DOI: 10.30604/jika.v6i2.1097

This open access article is under the CC–BY-SA license.

INTRODUCTION incidence of febrile seizures in the United States and Europe

ranges from 2% - 5%. When compared to the United States and
Fever is an acute response to various diseases, the most Europe, the incidence of fever in Asia, doubled. In Japan the
common of which is infection (Fortunato 1996) which occurs incidence rate of fever is quite high, which is around 8.3% - 9%,
when the body temperature rises above the normal range, even in Guam the incidence of fever reaches 14% (Nijman et
when responding to certain diseases or invasions by al. 2013).
pathogens (Wong et al. 2014). Fever is a physiological Febris is a sign that the body is fighting an infection or
response characterized by an increase in body temperature bacteria that makes it sick. Febris can be a sign that the child's
above normal (De Bont et al. 2015) which is the most common immune system is functioning properly. Febris can also occur
cause in children with prevalence of events ranging from 15- after the child gets immunized. Measurement of body
25% for cases of primary care and emergencies (Sands et al. temperature in various bodies has a limit of the value or
2012) but, it has a low prevalence of primary care services degree of febris namely axilla / armpit >37.2 °C, oral / oral
which is estimated to <1% in serious infections for children. temperature >37.8 °C, rectal / temperature >38 °C, forehead
(Van den Bruel et al. 2007) This number can increase by up to temperature and temperature in the ear membrane above 38
25% in emergencies (Nijman et al. 2013) ° C. Temperature measurements in oral and rectal more
According to data on visits to pediatric health facilities in indicate actual body temperature, but this is not
Brazil, about 19% to 30% of children are examined for fever. recommended unless absolutely certain of safety, especially
Research by Jalil, Jumah, & Al-Baghli in Kuwait shows that in children, Word Health Organization (WHO, 2018) put the
most children aged 3 months to 36 months experience an number of cases of febris in toddlers worldwide reached 18-
average of six fever attacks per year. The incidence and 34 million. Children are susceptible to fever, although the
prevalence of fever incidence of each country is different. The symptoms experienced are milder than adults. In almost all

Available online at: https://aisyah.journalpress.id/index.php/jika/

Email: [email protected]
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 6(2), June 2021, – 410
Roza Erda; Mawardi Badar; Didi Yunaspi; Yanti Oktavina

endemic areas, the incidence of fever occurs in children aged of various diseases. In countries with low-developed
0-5 years. According to data on visits to pediatric health countries are often used as external and internal treatments
facilities in Brazil, about 19% to 30% of children are examined to cure various diseases such as indigestion, skin infections,
for fever. Toddlers who have a fever in Asia are about 10-15% fever etc. (Silambarassan and Ayyamar, 2015; Sharma et al.,
associated with symptoms or signs of a disease. (Nijman et al. 2014; Hayta et al., 2014; Jaradat et al., 2016) Allium
2013) cepa/onion It has been described as a potent antimicrobial
World Health Organization (WHO) estimates the number agent to fight disease infections. Many bacteria, fungi, and
of cases of fever worldwide reaches 16-33 million with 500- viruses are found to be susceptible to different solvents Allium
600 thousand deaths annually (Wardiah, 2016). According to cepa extract sulfur compounds are shown to be the main
data on visits to pediatric health facilities in Brazil, about 19% active antimicrobial agents present in onions (Vazquez-
to 30% of children are examined for fever. Research by Jalil, Armenta et al. 2014)
Jumah, & Al-Baghli in Kuwait shows that most children aged Based on this background, researchers are interested in
3 months to 36 months experience an average of six fever trying to see the effect of the use of onion compresses in
attacks per year. The incidence and prevalence of fever lowering febris in toddlers?
incidence of each country is different. The incidence of febrile
seizures in the United States and Europe ranges from 2% - 5%.
When compared to the United States and Europe, the
incidence of fever in Asia, doubled. In Japan the incidence rate METHOD
of fever is quite high, which is around 8.3% - 9%, even in Guam
the incidence of fever reaches 14%. This study is quasi experimental research that uses a one
Based on 2019 data, it turns out that the number of febris group pre-post test design approach. Sample withdrawal by
fever sufferers in Batam city in 2019 was 591 people purposive sampling technique to test hypotheses is done
according to age (1-5 years) and Batam City health centers, using the Paired Sample T-Test. The study sample amounted
namely: Tanjung Sengkuang (162 people), Tg. Uncang (89 to 32 toddlers (aged ≥ 1-5 years) who experienced febris.
people), Tiban Baru (57 people). Based on the results of data Onion compresses are done on all limbs by giving elusan /
from the dinkes, the highest number of Febris sufferers is in massage on the axilla, back and chest. Compresses are carried
the Health Center of Tanjung Sengkuang Batam City out for 10 minutes with a fever temperature category of
(Munawaroh, 2019). 37.2°C and measured with a digital thermometer. This
Factors that include affecting the frequentness of children research was carried out in the working area of Tanjung
experiencing pain are tropical regions, where Indonesia is Sengkuang Health Center batam city in 2020.
included in tropical climates, so many children suffer from
tropical diseases, tropical areas are good for germs to Tools and Materials
multiply, one of the tropical diseases is influenza, pireksia,
dengue fever, abdominal typhoid, chikungunya fever, morbili, The tools and materials used in this study were grated
diphtheria, pertussis, tetanus and diarrhea. Various diseases onions, telon oil, 4 sium shallots, 1 ceper plate, 1 teaspoon,
are usually increasingly prevalent in the transitional season. kitchen knife, thin clothing, digital thermometer, respondent
The occurrence of weather changes affect changes in data sheet, stopwatch, balpoin and observation sheet
children's health conditions. The condition of the child from
healthy to sick resulting in the body temperature reacting to Processing
increase the temperature referred to as fever. Fever is defined
as an increase in body temperature to >38.0 °C.High fever is The onions that have been provided are thoroughly
the cause of febrile seizures (Sofyan I, 2016). Febris has a washed and stripping on the skin, then shredded and put on a
distinctive feature compared to other fevers. ceper plate that has been provided then add a grated shallot
Negative impacts of febris that can harm children include with 2 teaspoons of telon oil, mix well and compress
dehydration, lack of oxygen, neurological damage, and febrile ingredients ready for use
convulsions. Febris must be handled properly so that the
occurrence of negative dapak becomes inimal (Arisandi & Implementation Stage
Yofita, 2012). The impact of Febris on children include
dehydration (lack of body fluids), lack of oxygen and fever Explain and demonstrate the procedure of compressing
above 42 °C can cause neurological causes. Children under 5 onions to the toddler's family to position the toddler in a
years old (toddlers) especially 6 months to 3 years are at risk comfortable position, close the onion compress material
of febrile seizures. Febris is often accompanied by other (allium cepa), measure the temperature before the action of
symptoms such as headaches, decreased appetite (anorexia), the compress on the toddler, Rub the scouring of onions on
weakness and muscle pain (Arisandi & Yofita, 2012). the child's body parts such as ubun-ubun, back, stomach,
The use of herbs and food crops as a source of thigh folds and axillary of the child for 10 minutes, wear
medicine has become an ancient practice and is considered an clothes that are thin and easily absorb sweat in toddlers, Keep
important aspect of health (Pandey, Rastogi & Rawat 2013). in mind the comfort of the toddler during the action, taking a
Allium Cepa has been used traditionally because of its measurement back to the toddler's body temperature every
improved characteristics in the management of various 15 minutes after the compress action is given. Clean the tools
diseases. (Kabrah, A. 2010). Allium cepa is commonly known and materials that have been used again
by many conventional or other alternative names such as
Egyptian onions, regular onions, onions and many more. Evaluation Stage
Onions are an important spice as well as commercial
vegetables. (Khusro, A., Aarti, C., Preetamraj, J., and Panicker, Pay attention to the child's reaction or response,
S. 2013). But today onions as an alternative treatment are immediately stop the action if the child shows a seizure or
widely used in Asian countries, namely Pakistan and shivering reaction and evaluate the results of the child's body
Indonesia. Among the majority use onions for the treatment temperature measurement on the observation sheet.

Jurnal Aisyah: Jurnal Ilmu Kesehatan ISSN 2502-4825 (print), ISSN 2502-9495 (online)
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 6(2), June 2021, – 411
Roza Erda; Mawardi Badar; Didi Yunaspi; Yanti Oktavina

RESULT AND DISCUSSION The results of the analysis on the table 1 showed that the
majority of respondents were male, namely 19 respondents
The general data in this study is in the form of (59.3%) and and the female gender was 13 respondents
characteristics of frequency distribution respondents from (40.7%). Most of the education levels of mothers of high school
each of the following characteristics educated respondents were 15 (47%), the respondent's body
temperature was mostly with the results of pretest body
Table 1. temperature measurements of 37.6 °C – 37.9 °C which is 29
Distribution of Frequency of Respondent Characteristics (90.62%) and vice versa there was a decrease in body
Based on Gender, Maternal Education and Toddler Body temperature sufferers at postest 37.6 ° C – 37.9 ° C which is 3
Temperature. (9.38%)

Caracteristic n Percentage (%)

Table 2.
Gender
Data Normality Test with Kolmogorov-Smirnov Test
Man 19 59,3
Woman 13 40,7 Kolmogorov Asymp sig
Mother's Education Data Conclusion
sminorv (2- tailed)
Primary school 14 43,7 Sig. (2-tailed) >
Pretest-
Secondary school 15 47 0.131 0.200 0,05 (Normal
Posttest
College 3 9,3 distribution)
Body Temperature (Pretest)
37,2°C – 37,5°C 3 9,38
Normality test results from pretest and posttest using One
37,6°C – 37,9°C 29 90,62
group Pretest and Posttest using Kolmogorov-Smirnov Test
Body Temperature (Posttest)
which shows 0.200 > 0.05 thus can be collected normal
37,2°C – 37,5°C 29 90,62 distribution data.
37,6°C – 37,9°C 3 9,38
Total 32 100

Table 3.
Difference in Body Temperature Drop Before and After Being Given Onion Compress

Mean t N Sig. (2-tailed)

Pair 1 Pretest - Posttest 0.5187 10.944 32 .000

Based on the Paired Sample t-test table obtained a body temperature of children with fever before and after the
significance of 0.000 < 0.05 then it can be concluded that there administration of onions.
is a significant difference between the average value before Onions (Allium cepa) have potential therapeutic benefits
treatment and the average value after treatment where there against acute diseases caused by collagen deposition,
is an influence of onion compresses on the decrease in body inflammatory cell infiltration, and fibrosis. Onions along with
temperature in febris toddlers. The average temperature their bioactive compounds, quercetin, apigenin, and selenium
change after treatment is 0.5187 are known to exert antivirals, antifibrotic antioxidants, anti-
inflammatories, antiasthmatic and hepatoprotective
properties (Kumar & Pandey, 2013; Marefati et al., 2018;
Suleria, Ass, Anjum, Saeed, & Khalid, 2015). Onion (Allium
DISCUSSION cepa) is a plant belonging to the family Alliaceae, popularly
known as bulbs or onions, widely cultivated for thousands of
Based on the Paired Sample t-test table obtained a years is a plant with a rich source of organic sulfur
significance of 0.000 < 0.05 then it can be concluded that there components, s-methyl-cysteine sulfoxide, phenolic acid,
is a significant difference between the average value before cycloaliine, flavonoids, sterols (stigmasterol, -sitosterol and
treatment and the average value after treatment which can be cholesterol), sugar, saponins and very small quantities of
concluded that there is an effect of onion compresses on the essential oil components. Sulfur compounds, including alkyls,
decrease in body temperature in febris toddlers. The average alkenyl sulfoxide and its derivatives, are the main active
temperature change after treatment was 0.5187 the results of compounds present in the components of onion bulbs. Sulfur
this study were in line with the study Vedjia Medhyna & compounds in onions range from 10 mg / g in fresh samples
Utami Putri, (2020) with the title of the effect of onion and 30 mg / g in dry samples (Lawson, 1998). This sulfur
compresses on the decline in the baby's body temperature compound plays an important role in the medicinal properties
during fever Post immunization that is collected onion of onions such as anti-microbial, redox regulation agents,
compresses affect the decrease in the baby's body anti-cancer, anti-diabetes, anti-inflammatory,
temperature during post-immunisas fever. Similar research immunomodulator and cardioprotective properties (Martins
was conducted by Suryono (2012) about the effectiveness of et al. 2016). Cure diseases with plants, it has been around
onions against the decline in body temperature in children since thousands of years ago. Onions (A. cepa) are members of
febris 1-5 years. Obtained the results of body temperature the genus Allium that has been widely used since early Egypt
before 37.98oC, body temperature after 37.58oC, obtained a p and Rome, as shown by the relics of onions found in the burial
value of 0.000 can be concluded there is a difference in the chambers of the pharaohs and reported in the writings of 1st-
century Roman naturalist Pliny the Elder, who claimed onions

Compress Onions (Allium Cepa) As A Nonpharmacological Therapy in Febris Toddlers

 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 6(2), June 2021, – 412
Roza Erda; Mawardi Badar; Didi Yunaspi; Yanti Oktavina

were effective against 28 types of diseases (Block, 1990). by herbalists and traditional practitioner healers for
Onions are not only known as herbal medicine, but also have treatments of diarrhea in the West Bank/Palestine. Journal of
other properties such as antiviral, antihypertensive, Ethnopharmacology. 182: 57-66
antifungal and antiparasitic activity. In addition, onions have, Kabrah, A. (2010). The Antibacterial Activity of Onion on MSSA
antihyperlipidemia, antibacterial, antioxidant, hypoglycemic and MRSA Isolates of
and anti-inflammatory characteristics (Botsoglou, Govaris, Staphylococcus aureus. Biomedical Sciences. 1: 24-64
Christaki, & Botsoglou, 2010).
Khusro, A., Aarti, C., Preetamraj, J., and Panicker, S. (2013). In vitro
Studies on antibacterial activity of aqueous extracts of spices
and vegetables against Bacillus licheniformis strain 018 and
Bacillus tequilensis strain ARMATI. Int J Curr Microbiol Appl
CONCLUSION
Sci. 2: 79-88
From a series of studies that have been done, researchers Kumar, S., & Pandey, A. K. (2013). Chemistry and biological
can draw the conclusion is the onion compress performed on activities of flavonoids: An overview. The Scientific World
all limbs by giving elusan / massage on the axillary, back and Journal, 2013, 1–16. https://doi.org/10.1155/2013/162750
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Lawson, (1998) L.D. Garlic: a review of its medicinal effects and
effective with changes in the average temperature after indicated active compounds. In: L.S. Lawson and R. Bauer,
0.5187. thus the use of onion compresses in ferbir toddlers can Editors, Phytomedicines of Europe: Chemistry and Biological
be used as a nonpharmacological alternative therapy. Activity, ACS Symposium Series 691, American Chemical
Society, Washington, D.C (1998), pp. 176–209

Conflict of Interest statement Marefati, N., Eftekhar, N., Kaveh, M., Boskabadi, J., Beheshti, F., &
Boskabady, M. H. (2018). The effect of Allium cepa extract on
lung oxidant, antioxidant, and immunological biomarkers in
The author declares that there is no potential conflict of
ovalbuminsensitized rats. Medical Principles and Practice,
interest in relation to the authorship and publication of this
27(2), 122–128. https:// doi.org/10.1159/000487885
article.
Martins, N., Petropoulos, S., Ferreira, I.C., 2016. Chemical
Funding composition and bioactive compounds of garlic (Allium
sativum L.) as affected by pre-and post-harvest conditions: A
Not Applicable review. Food Chem. 211, 41-50.

Munawaroh, K., Badri, I. A., & Erda, R. (2019). Kota Batam STIKes
Kontribusi Penulis Mitra Bunda Persada Batam Email :
[email protected] Pengabdian masyarakat
Seluruh penulis memiliki kontribusi yang sama dalam ini dilaksanakan di puskesmas lubuk baja pada hari kamis
penulisan laporan penelitian ini baik dari tahap penyusunan tanggal 3 Januari 2018 di ruang tunggu poli puskesmas lubuk
kerangka berpikir hingga interpretasi hasil dalam laporan baja . Jumlah peserta yaitu 20 pe. 4–6.
penelitian.
Nijman, R.G., Vergouwe, Y., Thompson, M., Veen, M. Van, Van
Meurs, A.H.J., Van Der Lei, J., Steyerberg, E.W., Moll, H.A. &
Oostenbrink, R. (2013). ‘Clinical prediction model to aid
emergency doctors managing febrile children at risk of
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Compress Onions (Allium Cepa) As A Nonpharmacological Therapy in Febris Toddlers

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Jurnal Aisyah: Jurnal Ilmu Kesehatan ISSN 2502-4825 (print), ISSN 2502-9495 (online)