Anemia among children and adolescents in a rural area
Abstract
Background Anemia in children and adolescents affects growthand development. It is a preventable disease, but unfortunately is
often ignored until the symptoms occur. There have been limited
reports on the prevalence of anemia in children and adolescents
in Indonesia, especially from rural areas.
Objective To describe the prevalence of anemia in children and
adolescents in district ofMalinau, a rural area in East Kalimantan
Province.
Methods This cross-sectional study was done in June 20 10 using
laboratory records between July 2009 to January 20 10. Laboratory
records of patients aged between 6 months and 18 years which
investigated were complete blood count (CBC) from ambulatory,
inpatient, and emergency care ofMalinau Public Hospital in East
Kalimantan. Mentzer and England & Fraser indices were used to
differentiate iron deficiency anemia (IDA) and thalassemia among
microcytic hypochromic anemic patients.
Results This study involved 709 laboratory records. Prevalence
of anemia was 53 .9% (95% CI 50.2% to 57 .5%) . The prevalence
of IDA among age groups were as follows: 29.4% (95% CI 24.3
to 34.5%) in 6- 59 months group, 16% (95% CI 11 to 21 %) in
5- 11.9 years, and 15.2% (95% CI 10.2 to 20.2%) in 12- 18 years.
Children aged 6- 59 months tended to have more anemia th an
those aged 5- 11.9 years (OR 2. 184, 95% CI 1.398 to 3.413) or
aged 12- 18 years (OR 2.3 19, 95% CI 1.464 to 3.674).
Conclusion T he prevalence of an emia in children and
adolescents of the Malinau Regency is 53 .9% (95% CI 50.2 to
57.5%), quite similar to that of other developing countries . A
government program to overcome anemia is recommended, n ot
only for pregnant women, but also for children and adolescents.
References
World Health Organization. Worldwide prevalence of anaemia 1993-2005 : WHO global database on anaemia. Geneva: World Health Organization; 2008. p.1-26.
Irwin JJ, Kirchner JT. Anemia in children. Am Fam Physician. 2001;64:1379-86.
World Health Organization. Prevention of iron deficiency anaemia in adolescents: Role of weekly iron and folic acid supplementation. New Delhi: World Health Organization, Regional Office for South-East Asia; 2011. p.2-54.
World Health Organization. Global health risks: Mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization; 2009. p.1-54.
Bates I, McKew S, Sarkinfada E Anaemia: a useful indicator of neglected disease burden and control. PLoS Med. 2007;4:e231.
Grantham-McGregor S, Ani C. A review of studies on the effect of iron deficiency on cognitive development in children. J Nutr. 2001;131:649S-66S; discussion 666S-8S.
Beard J. Iron deficiency alters brain development and functioning. J Nutr. 2003;133:1468S-72S.
Richardson M. Microcytic anemia. Pediatr Rev. 2007;28:5-14.
Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician. 2007;75:671-8.
Ntaios G, Chatzinikolaou A, Saouli Z, Girtovitis F, Tsapanidou M, Kaiafa G, et al. Discrimination indices as screening tests for beta-thalassemic trait. Ann Hematol. 2007;86:487-91.
Okan V, Cigiloglu A, Cifci S, Yilmaz M, Pehlivan M. Red cell indices and functions differentiating patients with the betathalassaemia trait from those with iron deficiency anaemia. J Int Med Res. 2009;37:25-30.
Departemen Kesehatan Republik Indonesia. [National basic health research 2007]. Jakarta: Departemen Kesehatan Republik Indonesia; 2008: p.151.
BPS Kabupaten Malinau. Citizens and workers. 2012; [cited 2012 November 4]; Available from: http://malinaukab.bps.go.id/content/index.php/penduduk-dan-tenaga-kerja.
Khusun H, Yip R, Schultink W, Dillon DH. World Health Organization hemoglobin cut-off points for the detection of anemia are valid for an Indonesian population. J Nutr. 1999;129:1669-1674.
Mentzer WC, Jr. Differentiation of iron deficiency from thalassaemia trait. Lancet. 1973;1:882.
England JM, Fraser PM. Differentiation of iron deficiency from thalassaemia trait by routine blood-count. Lancet. 1973;1:449-52.
dos Reis MC, Nakano AM, Silva IA, Gomes FA, Pereira MJ. Prevalence of anemia in children three to 12 months old in a health service in Ribeirao Preto, SP, Brazil. Rev Lat Am Enfermagem. 2010;18:792-9.
De la Cruz-Gongora V, Villalpando S, Rebollar R, Shamah Levy T, Mendez-Gomez Humaran I. Nutritional causes of anemia in Mexican children under 5 years. Results from the 2006 National Health and Nutrition Survey. Salud Publica Mex. 2012;54:108-15.
Duque X, Flores-Hernandez S, Flores-Huerta S, MendezRamirez I, Munoz S, Turnbull B, et al. Prevalence of anemia and deficiency of iron, folic acid, and zinc in children younger than 2 years of age who use the health services provided by the Mexican Social Security Institute. BMC Public Health. 2007;7:345.
Uddin MK, Sardar MH, Hossain MZ, Alam MM, Bhuya MF, Uddin MM, et al. Prevalence of anaemia in children of 6 months to 59 months in Narayanganj, Bangladesh. J Dhaka Med Coll. 2010;19:126-30.
Vendt N, Grunberg H, Leedo S, Tillmann V, Talvik T. Prevalence and causes of iron deficiency anemias in infants aged 9 to 12 months in Estonia. Medicina (Kaunas). 2007;43:947-52.
Al-Mekhlafi MH, SurinJ, AtiyaAS, Ariffin WA, Mahdy AK, Abdullah HC. Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: an update on a continuing problem. Trans R Soc Trop Med Hyg. 2008;102:1046-52.
De la Cruz-Gongora V, Gaona B, Villalpando S, Shamah-Levy T, Robledo R. Anemia and iron, zinc, copper and magnesium deficiency in Mexican adolescents: National Health and Nutrition Survey 2006. Salud Publica Mex. 2012;54:135-45.
Isik Bald Y, Karabulut A, Gurses D, Ethem Covut I. Prevalence and Risk Factors of Anemia among Adolescents in Denizli, Turkey. Iran J Pediatr. 2012;22:77-81.
Siddharam SM, Venketesh GM, Thejeshwari HL. A study of anemia among adolescent girls in rural area of Hassan district, Karnataka, South India. Int J Biol Med Res. 2011;2:922-4.
Shah BK, Gupta P. Anemia in adolescent girls: a preliminary report from semi-urban Nepal. Indian Pediatr. 2002;39:1126-30.
Basu S, Hazarika R, Parmar V. Prevalence of anemia among school going adolescents of Chandigarh. Indian Pediatr. 2005;42:593-7.
Kulkarni MV, Durge PM, Kasturwar NB. Prevalence of anemia among adolescent girls in an urban slum. Natl J Community Med. 2012;3:108-11.
Kounnavon gS, Sunahara T, Hashizume M, Okumura], Moji K, Boupha B, et al. Anemia and Related Factors in Preschool Children in the Southern Rural Lao People's Democratic Republic. Trop Med Health. 2011;39:95-103.
Ngui R, Lim YA, Chong Kin L, Sek Chuen C, Jaffar S. Association between anaemia, iron deficien cy anaemia, neglected parasitic infections and socioecon omic factors in rural children of West Malaysia. PLoS Neg! Trop Dis. 2012;6:el550.
Cardoso MA, Scopel KK, Muniz PT, Villamar E, Ferreira MU. Underlying factors associated with anemia in Amazonian children: a population-based, cross-sectional study. PLoS One. 2012;7:e36341.
Tympa-Psirropoulou E, Vagenas C, Dafni 0 , Matala A, Skopouli F. Environmental risk factors for iron deficiency anemia in children 12-24 months old in the area ofThessalia in Greece. Hippokratia. 2008;12:240-50.
Ferreira MU, da Silva-Nunes M, Bertolino CN, Malafronte RS, Muniz PT, Cardoso MA. Anemia and iron deficiency in school children, adolescents, and adults: a community-based study in rural Amazonia. AmJ Public Health. 2007;97:237-9.
Adolescent health-Indonesia Factsheet. Adolescent Health at a Glance in South-East Asia Region 2007. New Delhi: WHO-SEARO; 2007. p.4-6.
Janus J, Moerschel SK. Evaluation of anemia in children. Am Fam Physician. 2010;81:1462-71.
Cotta RM, Oliveira Fde C, Magalhaes KA, Ribeiro AQ, Sant'Ana LF, Priore SE, et al. Social and biological determinants of iron deficiency anemia. Cad Saude Publica. 2011;27:S309-20.
Milman N. Iron in pregnancy: How do we secure an appropriate iron status in the mother and child? Ann Nutt Metab. 2011;59:50-4.
Kamal S, Erfan M, Kholoussi SM, Bahgat KAE. Growth pattern in anemic children and adolescents, aged 12-14 years. J Am Sci. 2010;6:1636-46.
Choi HJ, Lee HJ, Jang HB, Park JY, Kang JH, Park KH, et al. Effects of maternal education on diet, anemia, and iron deficiency in Korean school-aged children. BMC Public Health. 2011;11:870.
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Accepted 2016-08-17
Published 2014-04-30
