Abstract
Anemia has been acknowledged as worldwide problem, including in Indonesia. This cross-sectional study aims to explore dietary determinants as risk factors for anemia in children aged 6–36 months living in a poor urban area of Jakarta. The study was done in Kampung Melayu sub-district in Jakarta, Indonesia. Data was collected within two weeks in September–October 2020. A structured questionnaire for a 24-h recall and a semi-quantitative Food Frequency Questionnaire (FFQ) were used to collect the dietary intake data, and venous blood was withdrawn to determine the hemoglobin levels. Bivariate chi-square and multiple logistic regression tests were executed to explore the dietary determinant factors for anemia. We recruited 180 subjects. The average hemoglobin concentration was 11.4 ± 1.7 mg/dL; the anemia prevalence was 29.4%. The following variables were significantly associated with higher risk of anemia: no cow’s milk formula consumption, inadequate intake of fats, protein, calcium, vitamin D, iron, zinc, vitamin A, vitamin C, vitamin B6, and vitamin B12. Only cow’s milk formula consumption and zinc intake were revealed as the determinant factors of anemia. In conclusion, the prevalence of anemia was 29.4% among children aged 6–36 months old. Anemia was significantly associated with two dietary determinants as risk factors that are cow’s milk formula consumption and zinc intake.
Highlights
Using bivariate analysis (Table 5) to explore the dietary determinants of anemia among children aged 6–36 months, this study found significant associations between anemic status and inadequate dietary intake of fats (OR = 2.675), protein (OR = 3.3526), calcium (OR = 4.663), iron (OR = 3.681), zinc (OR = 3.960), vitamin A (OR = 4.525), vitamin
Based on further analysis using the logistic regression (Table 5) after controlling for fathers’ education and household income, this study found still two dietary determinant factors that significantly contributed to anemic status among children aged 6–36 months: inadequate dietary intake of zinc (OR = 4.262) and not consuming cow’s milk formula (OR = 8.651)
This study shows that almost 30% of infants and toddlers in this selected population suffer from anemia
Summary
Anemia has been acknowledged as a worldwide health problem that young children are vulnerable. The data from the World Health Organization (WHO) shows that anemia prevalence in children aged 6–59 months in Indonesia are 43.9% in 2000 and. A similar anemia prevalence (38.5%) is reported from Indonesian national data in 2018 [2]. Another study in Indonesian rural area in 2009–2010 showed that the prevalence of anemia and iron deficiency anemia (IDA) in children aged 6–59 months were 56.9 and 29.4%, respectively [3]. The prevalence was higher than the WHO data in 2000 or the latest national data in 2018 that might indicate higher risk of anemia in the rural area. Childhood anemia contributes to poor motor and cognitive development resulting in poor school performance, and results in increased morbidity and mortality [4]
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