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The impact of iron supplementation toward hemoglobin levels on teenage

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DOI: 10.18203/2320-6012.ijrms20173539

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International Journal of Research in Medical Sciences
Arini N et al. Int J Res Med Sci. 2017 Aug;5(8):3454-3457
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012

DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20173539
Original Research Article

The impact of iron supplementation toward hemoglobin levels on

teenage girls in Bangli regency, Bali, Indonesia
Novia Arini*1, Made Bakta2, Desak Made Citrawati3

1
Department of Midwifery, Akademi Kebidanan Kartini, Bali, Indonesia
2
Department of Medicine, Universitas Udayana, Bali, Indonesia
3
Department of Biologi Education, Universitas Pendidikan Ganesha, Bali, Indonesia

Received: 29 May 2017

Accepted: 27 June 2017

*Correspondence:
Dr. Novia Arini,
E-mail: [email protected]

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: The prevalence of anemia in teenage girls in Indonesia was 33.1%. Department of health’s data in
2009, showed that 33.7% of teenage girls suffered anemia and the prevalence of anemia in Indonesia amounted to
57.1% suffered by teenage girls. Assorted studies showed the negative impact of anemia due to iron deficiency of
nutrients to the growth and development of children and adolescents. Anemia in children and adolescents will lead to
growth and development that are not optimal and reduce learning achievement because easy to get tired, loss of
passion and cannot concentrate. Besides that, iron deficiency anemia will also cause low of Intelligent Quotient (IQ)
as well as a decrease in the learning ability. One of the efforts to control anemia in teenage girls is to provide iron
supplementation.
Methods: The method used in this research was the one group pretest-posttest design. The study was conducted on all
the teenage girls who were in 7 juniors high school (SMP) in Bangli regency with total of 1556 respondents. The
criteria used for adolescents was when Hbg <12 g/dl then it is called anemia.
Results: The average prevalence of anemia among teenage girls in Bangli regency was 36.8%. The highest incidence
number of anemia in teenage girls in SMP 4 Tembuku by 66.7% and the lowest incidence of anemia in SMP 3 Susut
by 22.4%. That iron supplementation in teenage girls suffered anemia had a significant impact on the reduction of
anemia incidence in teenage girls. The average reduction in the incidence of anemia in teenage girls was 24.9%.
Conclusions: Iron supplementation at a dose twice a week for 3 consecutive months can decrease the prevalence of
anemia in teenage girls as much as 24.9% with an increase in hemoglobin levels ranged from 1.42 to 2.20 g/dl.
Statistically, showed that iron supplementation had a significant impact on the reduction of anemia incidence in
teenage girls.

Keywords: Iron supplementation, Indonesia, Hemoglobin levels, Teenage girls

INTRODUCTION height will increase significantly. In term of age, World

health organization (WHO) defined that teenage is human
Adolescence is transition from childhood to the who is 12 till 24 years old, while the range of adolescence
adulthood. In this time, there will be rapid physical is divide into three groups that are early adolescence in
change. Teenage girls will begin to experience 12-15 years old, middle adolescence in 15-18 years old,
menstruation, breast starts growing, and weight and and late adolescence in 18-24 years old.1,2

International Journal of Research in Medical Sciences | August 2017 | Vol 5 | Issue 8 Page 3454
 Arini N et al. Int J Res Med Sci. 2017 Aug;5(8):3454-3457

WHO said nutritional problem in adolescents is often check) with brand easy touch. This tool was selected
neglected, whereas adolescents are the human resources because it was easy to operate and practical to conduct
that must be protected because they have enormous research in the field and the results was standardized and
potential to improve the quality of the nation. Anemia there was no difference between digital methods and
caused due to deficiency of nutrients iron (Fe) is one of cyanmethemoglobin methods. Posttest was done after
the main nutritional problems in Asia, including in adolescence get iron supplementation for three months
Indonesia. In children of school age, the highest consecutively as much as once a day. The dose of iron
prevalence of anemia was found in Southeast Asia with tablet given is 60 mg with 400 mcg folic acid.
an estimated 60% of children suffer from anemia.3
RESULTS
The prevalence of anemia in teenage girls in Indonesia
was 33.1%.4 Department of health’s data in 2009, showed From the research that have done, obtained that the
that 33.7% of teenage girls suffered anemia and the average prevalence of anemia among teenage girls in
prevalence of anemia in Indonesia amounted to 57.1% Bangli regency was 36.8% with the following details
suffered by teenage girls.5,6 Results of research found a (Table 1).
significant difference of the prevalence of anemia in
teenage girls living in villages and in cities, 31.6% of Table 1: Incidence number of anemia in teenage girls
teenage girls who live in the village have anemia while in bangli regency.
the incidence of anemia in teenage girls who live in the
city only 10%.7 The study of teenage girls in middle Frequency
school found that 59.3% suffered anemia.8 Anemia
School distribution
Status
F %
Various studies showed the negative impact of anemia SMP 1 Tembuku Anemia 129 46,1
due to iron deficiency of nutrients to the growth and Non-anemia 151 53,9
development of children and adolescents. Anemia in SMP 2 Tembuku Anemia 58 28,4
children and adolescents will lead to growth and Non-anemia 146 71,6
development that are not optimal and reduce learning
SMP 3 Tembuku Anemia 37 26,4
achievement because easy to get tired, loss of passion and
cannot concentrate. Besides that, iron deficiency anemia Non-anemia 103 73,6
will also cause low of Intelligent Quotient (IQ) as well as SMP 4 Tembuku Anemia 116 66,7
a decrease in the learning ability.9-12 Non-anemia 58 33,3
SMP 1 Susut Anemia 135 33,8
One of the efforts to control anemia in teenage girls is to Non-anemia 265 66,2
provide iron supplementation. Brabina and Brabin SMP 2 Susut Anemia 82 33,9
recommend a program of prevention of anemia with iron Non-anemia 160 66,1
supplementation more targeted to teenage girls than in SMP 3 Susut Anemia 26 22,4
children, adult women or pregnant women. This is Non-anemia 90 77,6
because supplementation to teenage girls will give greater
impact on reproductive health and the success of Obtained information, the highest incidence number of
reproductive process compared with supplementation anemia in teenage girls in SMP 4 Tembuku by 66.7% and
only during pregnancy.13 Indonesian pediatric association the lowest incidence of anemia in SMP 3 Susut by 22.4%.
recommend iron supplementation in adolescents aged 12-
18 years are given three consecutive months every year at Table 2: Incidence number of anemia in teenage girls
a dose of 60 mg of elemental iron plus 400 mcg of folic
before and after iron supplementation.
acid for 2 times a week.14
Before iron After iron
METHODS School supplementation supplementation
F % F %
The method used in this research was the one group SMP 1 Tembuku 129 46,1 33 11,8
pretest-posttest design. The study was conducted on all SMP 2 Tembuku 58 28,4 8 3,9
the teenage girls who were in 7 juniors high school SMP 3 Tembuku 37 26,4 8 5,7
(SMP) in Bangli regency with total of 1556 respondents SMP 4 Tembuku 116 66,7 23 13,2
(280 respondents in SMP 1 Tembuku, 204 respondents in SMP 1 Susut 135 33,8 53 13,3
SMP 2 Tembuku, 140 respondents in SMP 3 Tembuku,
SMP 2 Susut 82 33,9 58 24,0
174 respondents in SMP 4 Tembuku, 400 respondents in
SMP 3 Susut 26 22,4 2 11,7
SMP 1 Susut, 242 respondents in SMP 2 Susut, 116
respondents in SMP 3 Susut). The criteria used for
adolescents was when Hbg <12 g/dl then it is called In the following Table, we will clarify the change of
anemia.15 The level of hemoglobin was done by using prevalence number of anemia in teenage girls after being
digital hemoglobin (hemoglobin testing system quick- given iron supplementation at a dose of 2 times a week

International Journal of Research in Medical Sciences | August 2017 | Vol 5 | Issue 8 Page 3455
 Arini N et al. Int J Res Med Sci. 2017 Aug;5(8):3454-3457

for three consecutive months as recommended by the Giving iron supplements twice a week in adolescent’s
Indonesian pediatric association in 2011 (Table 2). effective in increasing hemoglobin levels. Average
increase of hemoglobin in a day is about 0.25 to 0.4
From Table 2 shows that iron supplementation in teenage mg/dl during the first 7-10 days. Then hemoglobin levels
girls suffered anemia had a significant impact on the will increase of 0.1 mg/dl/day within 3-4 weeks.25-27
reduction of anemia incidence in teenage girls. The
average reduction in the incidence of anemia in teenage CONCLUSION
girls was 24.9%. The highest decrease of anemia
incidence was in SMP 4 Tembuku with decrease Iron supplementation at a dose twice a week for 3
percentage 53.5% and the lowest decrease was in SMP 2 consecutive months can decrease the prevalence of
Susut with the decrease percentage of incidence number anemia in teenage girls as much as 24.9% with an
was 9.9%. The average increase in levels of hemoglobin increase in hemoglobin levels ranged from 1.42 to 2.20
after iron supplementation twice a week for three g/dl. Statistically, showed that iron supplementation had a
consecutive months in Susut regency was 1.42 g/dl and significant impact on the reduction of anemia incidence
the Tembuku regency was 2.20 g/dl. in teenage girl.

DISCUSSION Funding: No funding sources

Conflict of interest: None declared
Subjects in this study were teenage girls who were in the Ethical approval: The study was approved by the
junior high school (SMP). The subjects of this study Institutional Ethics Committee
included into early adolescence with age range 12-15
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