Anemia and hypovitaminosis A among rural women in East Java, Indonesia
Kusin, J.A.; Kardjati, S.; Suryohudoyo, P.; De With, C.
Tropical and Geographical Medicine 32(1): 30-39
1980
ISSN/ISBN: 0041-3232 PMID: 7394892 Document Number: 165472
In 2 nutrition surveys in East Java, in 9 regencies representing the ecological areas of the province, haemoglobin and haematocrit were measured in 1229 nonpregnant nonlactating, 825 lactating and 151 pregnant mothers. The mean Hb values for the 3 subgroups, respectively, ranged from 12.4 to 13.2, 12.1 to 13.1 and 11.0 to 11.8 g/100 ml. The difference between pregnant and nonpregnant mothers only was significant. Prevalence of anaemia showed regency differences. The mean haematocrit values were within the normal range for all subgroups of mothers and differences between regencies were less. Iron deficiency was the main cause of anaemia. Serum vitamin A was estimated in the same subgroups of women. The same regional differences were found as for Hb. In the total sample 45% of nonpregnant nonlactating, 34% of nonlactating and 43% of pregnant mothers had low and deficient serum vitamin A values. Food consumption was measured in a follow-up survey a year later as no major change in patterns had occurred. Range of iron intakes was wide. The median daily intake was very low for all subgroups of women; only a small proportion had intakes above that recommended. The main sources of iron were the staple foods and those foods varied among regencies. However, the prevalence of anaemia did not correspond to the staple food and prevailing dietary patterns; the underlying reasons for this are not clear. Perinatal mortality and the prevalence of anaemia during infancy were high. Pregnant women therefore are a priority group in the distribution of iron and folate supplements. The feasability of iron fortification of some common foods was investigated to cover subjects outside the range of the Health Services and as a preventive measure for all women of reproductive age. The same priority for oral supplements of vitamin A should be given to pregnant women in their third trimester and after delivery, as the pathogenesis of vitamin A deficiency in children may have its root in the vitamin A status of their mothers. The survey emphasizes the widespread problem of xerophthalmia in Indonesia.