Socio-Economic Status and Puberty are the Main Factors Determining Anemia in Adolescent Girls and Boys in East Java, Indonesia

Objective: To determine prevalence and contributing factors of anaemia in adolescents.

Design: Cross-sectional study of anaemia prevalence, socio-economic status and puberty.

Setting: Schools in East Java, Indonesia.

Subjects: Male and female adolescent pupils (age 12-15 y; n=6486).

Results: Anaemia prevalence was 25.8% among girls (n=3486), 24.5% among pre-pubertal boys (n=821), and 12.1% among pubertal boys (n=2179). Socio-economic status, indicated by type of school attended, was an important factor determining the risk of anaemia. Girls had a higher risk when they attended a poor school (OR poorest school, 1.00; other schools, 0.67-0.87), had reached puberty (OR, 1.25), had lower retinol intake (OR 1st-4th quartiles-1.00, 0.97, 0.89, 0.77) and higher vitamin A intake from plant sources (OR 1st-4th quartiles-1.00, 1.10, 1.31, 1.04). Boys had a higher risk of anaemia when they attended a poor school (OR poorest school 1.00, other schools 0.54-0.63), were younger (OR per year=0.79), had not yet reached puberty (OR not yet, 1.00; already, 0.78), were shorter (OR per cm 0.95), had smaller mid-upper-arm circumference (MUAC) (OR per mm 0.99) and lower retinol intake (OR 1st-4th quartile 1.00, 0.67, 0.74, 0.68).

Conclusions: Anaemia in adolescents should be reported separately for pre-pubertal and pubertal subjects and for different ages, and the population's socio-economic status should be specified. The results of this survey call for treatment of anaemia in adolescents. Given Indonesia's current situation, micronutrient intake of adolescents should be increased using supplements for all girls and for pre-pubertal boys. 

European Journal of Clinical Nutrition
Soekarjo DD, de Pee S, Bloem MW, Tjiong R, Yip R, Schreurs WH, Muhilal