STUDI KEPATUHAN KONSUMSI TABLET TAMBAH DARAH (TTD) DAN ASUPAN ZAT GIZI TERKAIT ANEMIA PADA SISWA PEREMPUAN DI SEKOLAH MENENGAH KEJURUAN (SMK) KOTA BEKASI, INDONESIA

Muh Nur Hasan Syah; Hana Novianti; Alfi Fairuz Asna; Silvia Mawarti Perdana

doi:10.22435/mgmi.v13i2.5156

Muh Nur Hasan Syah Program Studi Gizi, Fakultas Ilmu Kesehatan, Universitas Pembangunan Nasional Veteran Jakarta https://orcid.org/0000-0003-2698-7619
Hana Novianti STIKes Mitra Keluarga
Alfi Fairuz Asna Fakultas Kesehatan Masyarakat, Universitas Diponegoro
Silvia Mawarti Perdana Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Jambi

DOI: https://doi.org/10.22435/mgmi.v13i2.5156

Keywords: anemia, adolescent nutrition, iron-folic acid (IFA) supplementation, nutrient intake

Abstract

Background. Anemia is a global nutrition problem, especially in developing countries. Several studied found that around 30 percent of the adolescent was anemia, especially in girls. Compliance with iron-folic acid (IFA) tablet consumption is the most influential factor in the successful improvement of iron status and combat anemia. Objective. This study aimed to know the relationship between compliance of IFA tablet consumption and anemi-related nutrient intake with the anemia among girl-students in Vocational High School in Bekasi City, Indonesia. Method. This study was a cross-sectional study conducted in five vocational high schools, with 345 samples. Samples were collected with a purposive sampling technique. Inclusive criteria for the sample are age between 12 and 18, healthy and able to be a subject, and excluded girls that were fasting and or menstruation. Hemoglobin (Hb) measured with the cyanmethemoglobin method, Hb under 12 g/dl was categorized as anemia. The compliance was assessed with a validated questionnaire and a validated food frequency questionnaire (FFQ) to measure and determine the nutrients intake. Data analyzed by univariate and bivariate. Results. The study found that 30.7 percent of girls were anemia and 48.1 percent as mild anemia (Hb 11–11.9 g/dl). From 74 percent who have not a compliant consumed IFA tablet, 34.3 percent was anemia. Most students have enough intake of protein and other macronutrients. In contrast, the study found more than 60 percent of students have less iron, vitamin C, and vitamin B12. There was no significant relationship among compliance IFA, energy intake, protein intake, fat intake, carbohydrates intake, iron intake, vitamin A intake, vitamin B12 intake, and vitamin C intake with the anemia (p>0.05). Conclusion. There was no relationship between compliance and nutrient intake with anemia. Nevertheless, nutrient intake can be related to anemia as well as compliance with iron tablet consumption. Research suggested that nutrition programs at school should be established, well monitoring, and evaluated.

References

Yadav D, Chandra J. Iron Deficiency: Beyond Anemia. Indian J Pediatr. 2011;78(1):65–72.

Martini M. Faktor-Faktor yang Berhubungan dengan Kejadian Anemia pada Remaja Putri di MAN 1 Metro. J Kesehat Metro Sai Wawai. 2015;8(1):1–7.

Syah MNH, Asna AF. Risiko Gangguan Makan dan Kejadian Anemia pada Mahasiswa Putri Program Studi S1 Gizi STIKES Mitra Keluarga. Ghidza J Gizi dan Kesehat. 2018;2(1):1–6.

Sekhar DL, Murray-Kolb LE, Kunselman AR, Weisman CS, Paul IM. Differences in Risk Factors for Anemia Between Adolescent and Adult Women. J women’s Heal. 2016;25(5):505–13.

Kementerian Kesehatan RI. Riset Kesehatan Dasar (Riskesdas) 2018. Jakarta: Kementerian Kesehatan RI; 2018.

Syah MNH, Asna AF, Wahono DN. Nutrition Balanced Guideline: Irregular Weight Monitoring is Associated with Overweight-Obesity in Adolescents (High School Students) at Bekasi. J Nutr Sci Vitaminol (Tokyo). 2020;66(Supplement):S137–40.

Djokic D, Drakulovic MB, Radojicic Z, Radovic LC, Rakic L, Kocic S, et al. Risk Factors Associated with Anemia Among Serbian School-Age Children 7-14 Years Old: Results of The First National Health Survey. Hippokratia. 2010;14(4):252.

Asna AF, Perdana SM, Amelia R, Syah MNH. Anemia, Nutritional Status, and Dietary Patterns in Adolescent Girls of Vocational High School Students in Bekasi, Indonesia. In: Annals of Nutrition and Metabolism 2019;75(suppl 3). Abstract of The 13th Asian Congress of Nutrition 2019; 4–7 August 2019; Kuta Selatan; 2019. p. 280.

Nadiyah, Dewanti LP, Mulyani EY, Jus’ at I. Nutritional Anemia: Limitations and Consequences of Indonesian Intervention Policy Restricted to Iron and Folic Acid. Asia Pac J Clin Nutr. 2020;29(Suppl 1):S55–73.

Fadila I, Kurniawati H. Upaya Pencegahan Anemia pada Remaja Puteri sebagai Pilar Menuju Peningkatan Kesehatan Ibu. Dalam: Santoso A, Noviyanti R, Susilo A, Mustafa D, Nursantika D. Prosiding Seminar Nasional FMIPA-UT 2018; 4 Oktober 2018; Tangerang Selatan; 2018. p. 78–89.

Fitriana F, Pramardika DD. Evaluasi Program Tablet Tambah Darah pada Remaja Putri. Indonesia J Heal Promot. 2019;2(3):200–7.

More S, Shivkumar VB, Gangane N, Shende S. Effects of Iron Deficiency on Cognitive Function in School Going Adolescent Females in Rural Area of Central India. Anemia. 2013;2013:1–5.

Azarkhish I, Raoufy MR, Gharibzadeh S. Artificial Intelligence Models for Predicting Iron Deficiency Anemia and Iron Serum Level Based on Accessible Laboratory Data. J Med Syst. 2012;36(3):2057–61.

Siu AL. Screening for Iron Deficiency Anemia and Iron Supplementation in Pregnant Women to Improve Maternal Health and Birth Outcomes: US Preventive Services Task Force Recommendation Statement. Ann Intern Med. 2015;163(7):529–36.

Yi SW, Han YJ, Ohrr H. Anemia Before Pregnancy and Risk of Preterm Birth, Low Birth Weight and Small-For-Gestational-Age Birth in Korean Women. Eur J Clin Nutr. 2013;67(4):337–42.

Rahayu I. Evaluasi Kinerja Alat Hematologi Analyzer Sysmex XN-550 Di Rumah Sakit Universitas Airlangga. Surabaya: Universitas Airlangga; 2020.

Sumarlan ES, Windiastuti E, Gunardi H. Iron Status, Prevalence and Risk Factors of Iron Deficiency Anemia among 12 to 15-Year-Old Adolescent Girls from Different Socioeconomic Status in Indonesia. Makara J Health Res. 2018;22(1):46–52.

Aditianti A, Permanasari Y, Julianti ED. Pendampingan Minum Tablet Tambah Darah (TTD) Dapat Meningkatkan Kepatuhan Konsumsi TTD pada Ibu Hamil Anemia. J Nutr Food Res. 2015;38(1):71–8.

Paputungan SR. Hubungan antara Asupan Zat Besi dan Protein dengan Kejadian Anemia pada Siswi Kelas VIII dan IX di SMPN 8 Manado. Pharmacon. 2016;5(1):348–54.

Loliana N, Nadhiroh SR. Asupan dan Kecukupan Gizi antara Remaja Obesitas dengan Non Obesitas. Media Gizi Indones. 2015;10(2):141–5.

World Health Organization. Haemoglobin Concentrations for The Diagnosis of Anaemia and Assessment of Severity. Geneva: World Health Organization; 2011.

Ali SA, Khan U, Feroz A. Prevalence and Determinants of Anemia among Women of Reproductive Age in Developing Countries. JCPSP. 2020;30(2):177–86.

Mantadakis E, Chatzimichael E, Zikidou P. Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy. Mediterr J Hematol Infect Dis. 2020;12(1):e2020041.

Kementerian Kesehatan RI. Pedoman Pencegahan dan Penanggulangan Anemia pada Remaja Putri dan Wanita Usia Subur (WUS). Jakarta: Kementerian Kesehatan RI; 2018.

Amir N, Djokosujono K. Faktor-Faktor yang Berhubungan dengan Konsumsi Tablet Tambah Darah (TTD) pada Remaja Putri di Indonesia: Literatur Review. J Kedokt Dan Kesehat. 2019;15(2):119–29.

Willows ND, Barbarich BN, Wang LCH, Olstad DL, Clandinin MT. Dietary Inadequacy is Associated with Anemia and Suboptimal Growth among Preschool-Aged Children in Yunnan Province, China. Nutr Res. 2011;31(2):88–96.

Oh R, Brown DL. Vitamin B12 Deficiency. Am Fam Physician. 2003;67(5):979–86.

Hisano M, Suzuki R, Sago H, Murashima A, Yamaguchi K. Vitamin B6 Deficiency and Anemia in Pregnancy. Eur J Clin Nutr. 2010;64(2):221–3.

Semba RD, Bloem MW. The Anemia of Vitamin A Deficiency: Epidemiology and Pathogenesis. Eur J Clin Nutr. 2002;56(4):271–81.

Jalambo MO, Karim NA, Naser IA, Sharif R. Prevalence and Risk Factor Analysis of Iron Deficiency and Iron-Deficiency Anaemia Among Female Adolescents in the Gaza Strip, Palestine. Public Health Nutr. 2018;21(15):2793–802.

Crichton R. Iron Metabolism: From Molecular Mechanisms to Clinical Consequences. Chichester: John Wiley & Sons; 2016.

Purba RB, Djendra IM, Kindangen RZ, Ranti IN, Paruntu O, Langi GK, et al. Eating Behavior and Protein Intake in Adolescent Girls with Anemia in Junior High School Krispa Silian the Regency of Southeast Minahasa North Sulawesi Indonesia. Int J Pharma Med Biol Sci. 2019;8(2):53–7.

Krisnanda R. Vitamin C Helps in the Absorption of Iron in Iron Deficiency Anemia. J Penelit Perawat Prof. 2020;2(3):279–86.

Ghatpande NS, Apte PP, Naik SS, Kulkarni PP. Fruit and Vegetable Consumption and Their Association with The Indicators of Iron and Inflammation Status among Adolescent Girls. J Am Coll Nutr. 2019;38(3):218–26.

Sefaya KT, Nugraheni SA, Pangestuti DR. Pengaruh Pendidikan Gizi terhadap Pengetahuan Gizi dan Tingkat Kecukupan Gizi terkait Pencegahan Anemia Remaja (Studi pada Siswa Kelas XI SMA Teuku Umar Semarang). J Kesehat Masy. 2017;5(1):272–82.

Danty FR, Syah MNH, Sari AE. Hubungan Indeks Gizi Seimbang dengan Status Gizi pada Remaja Putri di SMK Kota Bekasi. J Kesehat Indones. 2019;10(1):43–54.

Restuti AN, Susindra Y. Hubungan antara Asupan Zat Gizi dan Status Gizi dengan Kejadian Anemia pada Remaja Putri. J Ilm Inov. 2016;1(2):163–7.

Lonn EM. The Role of Vitamins in The Prevention of Coronary Artery Disease. Evid Based Cardiovascular Med. 2000;4(3):59–61.

Almatsier S. Prinsip Dasar Ilmu Gizi. Jakarta: PT. Gramedia Pustaka Utama; 2009.

Hooda J, Shah A, Zhang L. Heme, an Essential Nutrient from Dietary Proteins, Critically Impacts Diverse Physiological and Pathological Processes. Nutrients. 2014;6(3):1080–102.

Nuradhiani A, Briawan D, Dwiriani CM. Dukungan Guru Meningkatkan Kepatuhan Konsumsi Tablet Tambah Darah pada Remaja Putri di Kota Bogor. J Gizi dan Pangan. 2017;12(3):153–60.

Ningtyias FW, Quraini DF, Rohmawati N. Perilaku Kepatuhan Konsumsi Tablet Tambah Darah Remaja Putri di Jember, Indonesia. J Heal Promot Heal Educ. 2020;8(2):154–62.

Malhotra S, Yadav K, Kusuma YS, Sinha S, Yadav V, Pandav CS. Challenges in Scaling Up Successful Public Health Interventions: Lessons Learnt from Resistance to A Nationwide Roll-Out of The Weekly Iron-Folic Acid Supplementation Programme for Adolescents in India. Natl Med J India. 2015;28(2):81–5.

Sedlander E, Long MW, Mohanty S, Munjral A, Bingenheimer JB, Yilma H, et al. Moving Beyond Individual Barriers and Identifying Multi-Level Strategies to Reduce Anemia in Odisha India. BMC Public Health. 2020;20:457.