Factors Related to Anemia in Adolescents of SMK Bina Am Makmur in Tangerang Regency 2022

Background: There was still a lot of anemia in adolescent girls, which is suspected to be 64% of adolescent girls experiencing anemia related to knowledge about anemia, diet, and activities of adolescent girls at SMK BINA AM MAKMUR in Tangerang Regency. Purpose: To determine the factors related to anemia in adolescents at SMK BINA AM MAKMUR in Tangerang Regency in 2022. Methods: This research design used quantitative methods, non-experimental approaches, and cross-sectional approaches. The study sample amounted to 62 adolescents. The sampling technique used was simple random sampling. The research instrument consisted of questionnaires on anemia, knowledge, diet, and activity. Data analysis used descriptive statistics and kai squared with chi-square formulation to determine the relationship between knowledge, diet, and activity and the incidence of anemia in adolescents. Result: Of the 62 adolescent girls, 48 (77.4%) had anemia. There was a relationship between knowledge (p value = 0.000), diet (p value = 0.007), and activity (p value = 0.004) with the incidence of anemia in adolescents at SMK BINA AM MAKMUR, Tangerang Regency, Banten in 2022. Conclusions: The incidence of anemia in adolescents at SMK BINA AM MAKMUR Tangerang Regency in 2022 is quite high at 77.4%. It is expected that there will be strengthened coordination with all sectors, especially with the Tangerang Regency Health Office regarding the program for handling anemia in adolescents.


Introduction
Adolescence is the stage where a person experiences a transition period to adulthood.Adolescence is an age stage that comes after childhood ends and is characterized by rapid physical growth.Adolescents in society are known by various terms that denote age groups that do not include children but are not adults.In general, anemia is more common in women and adolescent girls compared to men.What is very unfortunate is that most sufferers do not know or do not realize it.Even when you know, you still consider anemia a trivial problem. 1 Young women are prone to suffering from anemia because adolescent girls are growing up and experiencing menstruation every month, which causes iron loss. 2 Anemia is a condition when the number of red blood cells or the concentration of oxygen carriers in the blood (Hb) is insufficient for the physiological needs of the body.
According to WHO and Ministry of Health guidelines from 1999, anemia cut-off points vary between age groups as well as individuals.Certain age groups or groups of individuals were considered more susceptible to anemia than other groups.The reference cut-off point for anemia in toddlers aged 12-59 months is Hb levels below 11.0 g/dL.
Schoolchildren aged 6-12 years were considered anemic if the Hb level is <12.0 g/dL.Pregnant women were considered anemic if their Hb levels are below 11.0 g/ddL.
Meanwhile, men aged 15 years were considered to have anemia if Hb levels are <13.0g/ddL and women of childbearing age 15-49 years experience anemia if Hb levels are <12.0g/dL. 10emia is a nutritional problem around the world, especially in developing countries like Indonesia.The rate of iron deficiency anemia in Indonesia was 72.3%.As many as 60.2% of these anemias are hypochrome microcytic anemia (small cells with a small amount of hemoglobin in the cells), which is mostly caused by iron deficiency anemia.Meanwhile, based on Basic Health Research in 2010, more than 10% of schoolage children in Indonesia have anemia. 10e impact of anemia on adolescent girls includes declining reproductive health, inhibiting motor, mental, and intelligence development, reducing learning ability and concentration, disrupting growth so that height does not reach optimal, reducing physical exercise and fitness levels, and causing pale faces. 8e of the causes of low levels of hemoglobin in the blood is insufficient intake.
Daily nutrient intake is strongly influenced by eating habits.One of the factors influencing adolescent eating habits is knowledge. 6ck of knowledge causes teenagers to choose to eat out or only consume snacks.Another cause is a lack of adequate eating and consuming food sources containing iron; besides that, consumption eats enough, but the food consumed has low iron bioaccessibility, so the amount of iron absorbed by the body is less. 13e results of the previous study showed that factors associated with anemia were the length of menstruation (p = 0.003), the length of the menstrual cycle (p = 0.004), the level of education of parents (mother) (p = 0.000), and the level of income of parents (p = 0.000).A factor not associated with anemia was nutritional status (p = 0.064). 5ung women who received blood-added tablets were 76.2%, received TTD at school as much as 80.9%, and adolescent girls who took blood-added tablets (52 grains) as much as 98.6%.Blood Add Tablets (TTD) is a blood-enhancing nutritional supplement in the form of tablets, caplets, or capsules that can be obtained from the Program or independently. 10sed on a preliminary study conducted on adolescent girls at SMK Bina Am Makmur, Tangerang Regency, in November 2022 by measuring Hb levels using the Microlab-300 brand Hemoglobinometer, it is known that the prevalence of anemia in grade X adolescent girls is 64% (35 out of 55 adolescent girls).At the same time, a brief interview with 55 young women about anemia was conducted, and it was found that 42 young women did not know about anemia.While 13 other adolescent girls know about anemia only in terms of symptoms such as weakness, fatigue, lethargy, fatigue, and paleness, if symptoms of anemia occur in adolescence, it will also have an impact on when she will give birth and cause low birth.They also do not know that anemia is caused by iron deficiency due to a lack of intake, and they say they do not have time to eat breakfast because of the rush, and during school break they prefer to consume fast food such as meatballs, chicken noodles, grilled meatballs, fried foods, instant noodles, and other snacks.SMK Bina Am Makmur Tangerang Regency is one of the Private Vocational Schools in Banten Province, Tangerang Regency, and has never been used as a place for scientific research on health.
Based on the background above, the researchers conducted a study on factors associated with anemia in adolescents of SMK Bina Am Makmur in Tangerang Regency in 2022.

Research design
This study was used quantitative methods, cross-sectional design.

Setting and samples
The location of the research was conducted at SMK Bina Am Makmur in Tangerang

Measurement and data collection
The instruments used in this study were questionnaires and interviews.

Data analysis
Data analysis using the chi-squared statistical test.The results of the analysis found that adolescents who had less knowledge were less likely to experience anemia, which was as much as 40 (90.9%), while adolescents who had good knowledge tended not to experience anemia, which was as much as 10 (55.6%).The results of the chi-square analysis obtained a p value of 0.000, which means that there is a meaningful relationship between knowledge and anemia in adolescents at SMK Bina Am Makmur, Tangerang Regency, Banten in 2023.The OR (Odd Ratio) value is 12,500, so it can be stated that adolescents who have less knowledge tend to experience anemia 12 times more than adolescents who have good knowledge.

Univariate Analysis
The results of research by Budianto show that there is a relationship between knowledge about Anemia and the incidence of Anemia in adolescent girls in Massachusetts.Mathla'ul Anwar Gisting with pvalue = 0.002 < α (0.05), while the results of research by Umriaty and Qudriani M. (2018) found that most female students have good knowledge (51.8%), have a positive perception of vulnerability (55.4%), and have a negative perception of seriousness (56.6%).The number of female students who experience anemia is 13.3%.The results of the analysis showed no significant relationship between knowledge (p value 0.399), perception of vulnerability (p value 0.215), and perception of seriousness (p value 0.145). 3odern patterns and lifestyles make teenagers tend to prefer eating outside the home with their groups.Young women often practice dieting in ways that are not right, such as abstinence or limiting or reducing the frequency of eating to prevent obesity.In general, adolescents have poor eating habits.Some adolescents, especially adolescent girls, often consume food in an unbalanced amount compared to their needs for fear of obesity and call eating not only in the context of consuming staple foods but snacks are also categorized as eating. 2e quantity and quality of food and beverages consumed will affect nutritional intake, which will affect the health of individuals and society as a whole.Important conditions that affect the nutritional needs of this group are rapid growth entering puberty, snacking habits, menstruation, and attention to physical appearance and body image in adolescent girls.Thus, the calculation of nutritional needs for this group must pay attention to these conditions.Especially for adolescent girls, more attention should be paid to their preparation before marriage.
According to the researchers' assumptions, the average teenager consumes food in the school cafeteria, which only provides food such as rice cakes, fried rice, boiled noodles, fried noodles, fried chicken, fried foods (bakwan, tofu, tempeh), meatballs, mini martabak, and snacks.And based on questionnaires given to adolescents in general, adolescents like to eat fast food such as boiled noodles and fried chicken, and some teenagers like snacks or consume snacks that are easy to consume without paying attention to the nutritional content contained in food.So, the lower the level of food intake, the more susceptible adolescents are to becoming anemic.The majority of respondents have a bad diet.The wrong diet can cause weight loss, which results in decreased brain ability, decreased enthusiasm for adolescents in learning, and adolescent anemia.

2 )
Regency.The study was conducted in December 2022.The population in this study was all students of classes X, XI, and XII, totaling 165 students at SMK BINA AM MAKMUR in Tangerang Regency.The sample size calculated with the Slovin formula was 62 respondents.The sampling method uses Simple Random Sampling.a. Inclusion Criteria 1) Class X, XI, and XII Students of SMK Bina AM Makmur in Tangerang Regency in 2022 Students who are not undergoing menstruation 3) Willing to follow research, as evidenced by the signing of approval sheets.b.Exclusion Criteria 1) Students who were not present at the time of the study 2) Female student who is menstruating 3) Student was sick

The relationship between adolescent knowledge and the incidence of anemia at SMK Bina Am Makmur in Tangerang Regency in 2022.
Optimalnutrition is essential for normal growth as well as the physical development and intelligence of infants, children, and all age groups.Good nutrition makes normal or healthy weight possible; the body is not susceptible to infectious diseases; work productivity increases; and the body is protected from chronic diseases and premature death.A good state of nutrition can improve individual and community health.
Balanced Nutrition for adolescents aged 10-19 years (Pre-pubertal and Puberty) This group is the transitional age group from children to young adolescents to adults.