Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Communication
  • Published:

Socio-economic status and puberty are the main factors determining anaemia in adolescent girls and boys in East Java, Indonesia

European Journal of Clinical Nutrition volume 55, pages 932–939 (2001)Cite this article

Abstract

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.

Sponsorship: This survey was funded by USAID through the OMNI project.

European Journal of Clinical Nutrition (2001) 55, 932–939

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  • ACC/SCN (1997) Third report on the world nutrition situation Geneva: WHO

  • Ahmed F, Khan MR, Karim R, Taj S, Hyderi T, Faruque MO, Margetts BM & Jackson AA (1996) Serum retinol and biochemical measures of iron status in adolescent schoolgirls in urban Bangladesh Eur. J. Clin. Nutr. 50 346–351

    CAS  PubMed  Google Scholar 

  • Angeles-Agdeppa I, Schultink W, Sastroamidjojo S, Gross R & Karyadi D (1997) Weekly micronutrient supplementation to build iron stores in female Indonesian adolescents Am. J. Clin. Nutr. 66 177–183

    Article  CAS  Google Scholar 

  • Antilla R & Siimes MA (1996) Serum transferrin and ferritin in pubertal boys: relations to body growth, pubertal stage, erythropoiesis, and iron deficiency Am. J. Clin. Nutr. 63 179–183

    Article  Google Scholar 

  • Basta SS, Soekirman, Karyadi D & Scrimshaw NS (1979) Iron deficiency anemia and the productivity of adult males in Indonesia Am. J. Clin. Nutr. 31 916–925

    Article  Google Scholar 

  • Bloem MW (1995) Interdependence of vitamin A and iron: an important association for programmes of anaemia control Proc. Nutr. Soc. 54 501–508

    Article  CAS  Google Scholar 

  • Brabin L & Brabin BJ (1992) The cost of successful adolescent growth and development in girls in relation to iron and vitamin A status Am. J. Clin. Nutr. 55 955–958

    Article  Google Scholar 

  • Bruner AB, Joffe A, Duggan AK, Casella JF & Brandt J (1996) Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls Lancet 348 992–996

    Article  CAS  Google Scholar 

  • Cameron N (1993) Growth and maturation data during adolescence In The Use and Interpretation of Anthropometry in Adolescents, 5–7 April 1993 Geneva: WHO

    Google Scholar 

  • Chwang L, Soemantri AG & Pollitt E (1988) Iron supplementation and physical growth of rural Indonesian children Am. J. Clin. Nutr. 47 496–501

    Article  CAS  Google Scholar 

  • Dallman PR (1992) Changing Iron Needs from Birth Through Adolescence, ed. SJ Fomon & S Zlotkin pp 29–38 New York: Raven Press

  • Dallman PR & Siimes MA (1979) Iron deficiency in infancy and childhood A report of the International Nutritional Anemia Consultancy Group. Washington, DC: INACG

  • DeMaeyer E & Adiels-Tegman M (1985) The prevalence of anaemia in the world World Health Stat Q 38 302–316

    PubMed  Google Scholar 

  • De Pee S, Bloem MW, Halati S, Soekarjo D, Sari M, Martini E, Kiess L, Muita M, Davis D, Sakya N & Gorstein J (1999) 24-VASQ method for estimating vitamin A intake: reproducibility and relationship with vitamin A status. Report of the XIX International Vitamin A Consultative Group Meeting, p 96. Washington, DC: IVACG

  • Fairweather-Tait S (1996) Iron requirements and prevalence of iron deficiency in adolescents. An overview In Iron Nutrition in Health and Disease, ed. L Hallberg & N-G Asp. London: John Libbey

  • Greger L, Higgins MM, Abernathy RP, Kirksey A, DeCorso B & Baligar P (1978) Nutritional status of adolescent girls in regard to zinc, copper, and iron Am. J. Clin. Nutr. 31 269–275

    Article  CAS  Google Scholar 

  • Hershko C (1993) Iron, infection and immune function Proc. Nutr. Soc. 52 165–174

    Article  CAS  Google Scholar 

  • Kretchmer N, Beard JL & Carlson S (1996) The role of nutrition in the development of normal cognition Am. J. Clin. Nutr. 63 997–1001S

    Article  Google Scholar 

  • Lawless JW, Latham MC, Stephenson LS, Kinoti SN & Pertet AM (1994) Iron supplementation improves appetite and growth in anemic Kenyan primary school children J. Nutr. 124 645–654

    Article  CAS  Google Scholar 

  • Scholl TO & Hediger ML (1994) Anemia and iron-deficiency anemia: compilation of data on pregnancy outcome Am. J. Clin. Nutr. 59 492S–501S

    Article  Google Scholar 

  • Scholz BD, Gross R, Schultink W & Sastroamidjojo S (1997) Anaemia is associated with reduced productivity of women workers even in less-physically-strenuous tasks Br. J. Nutr. 77 47–57

    Article  CAS  Google Scholar 

  • Seshadri S & Gopaldas T (1989) Impact of iron supplementation on cognitive functions in preschool and school-aged children: the Indian experience Am. J. Clin. Nutr. 50 675–686

    Article  Google Scholar 

  • State Ministry of Population/National Family Planning Coordinating Board & UNICEF (1994) Situation analysis of children and women in Indonesia. Revised draft.

  • Yip R (1994) Iron deficiency: contemporary scientific issues and international programmatic approaches J. Nutr. 124 1479S–1490S

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the Directorate General for Socio-political Affairs of the Internal Department for the permission to conduct this research, and to the Departments of Health and Education at all levels from central to district level for their cooperation. Special gratitude is extended to the schools, teachers and other staff, pupils and parents involved in the study. Without the hard work of the field workers under supervision of Dr Anas Machfud and Dr Sri Umijati, the data collection would not have been possible. This study was funded by USAID through the OMNI project.

Author information

Author notes

  1. DD Soekarjo and MW Bloem: Guarantor: MW Bloem.

  2. S de Pee, MW Bloem, R Tjiong, R Yip, WHP Schreurs and Muhilal: Contributors: DDS supervised and conducted the field work, performed preliminary statistical analyses and drafted the paper; SdP conducted further statistical analyses and contributed to writing the paper; MWB contributed substantially to the design and analytic strategy; RT and RY contributed to the design and gave comments on the draft versions of the manuscript; WHPS and M gave critical comments on the design of the study and interpretation of the results.

Authors and Affiliations

  1. Helen Keller International, Jakarta, Indonesia

    DD Soekarjo, S de Pee, MW Bloem & R Tjiong

  2. UNICEF, Beijing, People's Republic of China

    R Yip

  3. TNO, Zeist, The Netherlands

    WHP Schreurs

  4. Nutrition Research and Development Centre, Bogor, Indonesia

    Muhilal

Authors
  1. DD Soekarjo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S de Pee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. MW Bloem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R Tjiong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Yip
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. WHP Schreurs
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Muhilal
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soekarjo, D., de Pee, S., Bloem, M. et al. Socio-economic status and puberty are the main factors determining anaemia in adolescent girls and boys in East Java, Indonesia. Eur J Clin Nutr 55, 932–939 (2001). https://doi.org/10.1038/sj.ejcn.1601247

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1601247

Keywords

This article is cited by

Search

Advanced search

Quick links