Prevalence and Determinants of Anemia among Adolescent Girls: A School-Based Survey in Central Java, Indonesia

Abstract

Squamous cancer of the oesophagus has been, for almost a century, a major cause of morbidity and mortality in East and Southern Africa, and has been referred to as endemic in many high-incidence regions. Uncertainty about aetiology has inhibited effective preventive initiatives. 
 
 The aims of this study are to assess why some African regions and countries have a very high incidence of oesophageal cancer; to assess evidence-based associations and risk factors for population susceptibility and for individual susceptibility; to identify which of these are amenable to change; to put forward possible strategies to achieve change.
 
 A literature review identified the well-evidenced associations with high incidences of squamous oesophageal cancer to be maize, maize meal, and tobacco. A predominantly maize-based diet, and high use of maize meal are associated with population susceptibility. Tobacco is associated with individual susceptibility within a susceptible population. Alcohol, polycyclic aromatic hydrocarbons and wild vegetables are possible risk factors; other proposed risk factors are improbable.
 
 Possible actions are discussed for countries where there is a very high incidence of squamous cancer of the oesophagus. Measures to reduce population susceptibility include regulation of commercially produced maize meal to reduce content of free fatty acids at the time of consumption and supplementation of the diet with omega-3 fatty acid. Fortification of maize meal with zinc and selenium, and health education about production and consumption of fruit and vegetables may be helpful.
 
 Legislation to reduce tobacco consumption will reduce individual susceptibility.

Factors related to the level of iron adequacy of adolescent girls in Indonesia

“…National Health Survey data revealed that the prevalence of anemia in Indonesia at the age of 5-14 years was 26,4% and 15-24 years was 18,4%; 32% in 2013 increased for ages 5-14 years to 26,8% and 32% in 2018 (Kemenkes RI, 2013;Kemenkes RI, 2018). Several studies related to the prevalence of anemia in adolescent girls in Indonesia show that the prevalence of anemia is still above 20% (ranging from 21 to 45%) (Permatasari et al, 2020;Agustina et al, 2020;Masfiah et al, 2021;Rahfiludin et al, 2021). The prevalence of anemia is included in the moderate category of public health problems, so it requires special attention (WHO, 2011).…”