Faktor-faktor yang memengaruhi kejadian anemia pada siswi SMP

Abstract

Background: Anemia is a condition in which hemoglobin (Hb) and erythrocyte levels are lower than normal limits. Anemia has various negative impacts on adolescents, such as affecting physical work capacity and reproductive physiology which then has an impact on work productivity as adults. The results of a survey conducted at junior high schools in the working area of ​​the Simpur health center technical service unit, Bandar Lampung City in November 2023 from 80 junior high school students whose hemoglobin Hb levels were checked, showed that 29 (36.2%) students had anemia, with an average Hb range of 8.6-10.4 gr/dl. Purpose: To analyze the factors that influence the incidence of anemia in junior high school students. Method: Observational analytical research with a cross-sectional design, conducted at junior high schools in the work area of ​​the Simpur Health Center technical service unit, Bandar Lampung City in April–June 2024. The dependent variable in this study was the incidence of anemia, while the independent variables were iron intake, energy, carbohydrates, fat, protein, menstrual cycle, and nutritional status, fulfillment of iron supplement tablet consumption, nutritional /sports activities, nutritional knowledge, and health status. The number of samples was determined by the Slovin formula using a proportional random sampling technique, so that the total sample used was 158 respondents. Univariate analysis to determine the distribution of respondent characteristics and bivariate chi-square to determine the relationship between the two variables. Results: It is known that several factors are related to the incidence of anemia, namely iron intake (p<0.001), protein intake (p<0.002), duration of menstruation (p<0.019), compliance with iron tablet consumption (p<0.001), and nutritional knowledge (p<0.001). Several variables that do not have a relationship with the incidence of anemia are energy intake (p<1.000), carbohydrate intake (p<0.434), fat intake (p<0.900), nutritional status (p<0.782), physical activity/exercise (p<0.998), and history of acute infectious diseases (p<0.436). The most dominant variable influencing the incidence of anemia is compliance with iron tablet consumption (p<0.001 and OR value 43.5). Conclusion: There is an influence between the variables of iron intake, protein intake, duration of menstruation, compliance with iron tablet consumption, and nutritional knowledge on the incidence of anemia. However, there was no influence between the variables of energy intake, carbohydrates, fat, nutritional status, physical activity/sports, history of acute infectious diseases on the incidence of anemia. Suggestion: The Health Center together with the school can try to procure a control card for the consumption of iron supplement tablets to increase student compliance in consuming iron supplement tablets. Keywords: Anemia; Hemoglobin (Hb); Adolescent Girls. Pendahuluan: Anemia adalah suatu keadaan kadar hemoglobin (Hb) dan eritrosit lebih rendah dari batas normal. Anemia memiliki berbagai dampak negatif bagi remaja, seperti memengaruhi kapasitas kerja fisik dan fisiologi reproduksi yang kemudian berimbas pada produktivitas kerja saat mereka dewasa. Hasil survei yang dilakukan di SMP wilayah kerja UPT Puskesmas Simpur Kota Bandar Lampung bulan November 2023 dari 80 siswi SMP yang dilakukan pemeriksaan kadar hemoglobin Hb, didapatkan sebanyak 29 (36.2%) siswi mengalami anemia, dengan rerata Hb kisaran 8.6-10.4 gr/dl. Tujuan: Untuk menganalisis faktor-faktor yang berpengaruh terhadap kejadian anemia pada siswi SMP. Metode: Penelitian analitik observasional dengan desain cross-sectional, dilakukan di SMP wilayah kerja UPT Puskesmas Simpur Kota Bandar Lampung pada bulan April–Juni 2024. Variabel dependen dalam penelitian ini adalah kejadian anemia, sedangkan variabel independen adalah asupan zat besi, energi, karbohidrat, lemak, protein, siklus menstruasi, status gizi, pemenuhan konsumsi tablet tambah darah (TTD), aktivitas gizi/olahraga, pengetahuan gizi, dan status kesehatan. Jumlah sampel ditentukan menggunakan rumus Slovin teknik proportional random sampling, sehingga total sampel yang digunakan sebanyak 158 responden. Analisis univariat untuk mengetahui distribusi karakteristik responden dan bivariat chi-square untuk mengetahui hubungan dua variabel. Hasil: Diketahui beberapa faktor yang berhubungan dengan kejadian anemia yaitu asupan zat besi (p < 0.001), asupan protein (p 0.002), lama menstruasi (p 0.019), kepatuhan konsumsi TTD (p < 0.001), dan pengetahuan gizi (p < 0.001). Beberapa variabel yang tidak ada hubungan terhadap kejadian anemia yaitu asupan energi (p 1.000), asupan karbohidrat (p 0.434), asupan lemak (p 0.900), status gizi (p 0.782), aktivitas fisik/olahraga (p 0.998), dan riwayat penyakit infeksi akut (p 0.436). Variabel dengan kejadian anemia yang paling dominan adalah kepatuhan konsumsi TTD (p < 0.001 dan nilai OR 43.5). Simpulan: Ada pengaruh antara variabel asupan zat besi, asupan protein, lama menstruasi, kepatuhan konsumsi TTD, pengetahuan gizi terhadap kejadian anemia. Namun, tidak ada pengaruh antara variabel asupan energi, karbohidrat, lemak, status gizi, aktivitas fisik/olahraga, riwayat penyakit infeksi akut terhadap kejadian anemia. Saran: Pihak Puskesmas bersama pihak sekolah dapat mengupayakan pengadaan kartu kontrol konsumsi TTD untuk meningkatkan kepatuhan siswi dalam mengonsumsi TTD. Kata Kunci: Anemia; Hemoglobin (Hb); Remaja Putri.