Nutritional anemia in Indonesia children and adolescents: Diagnostic reliability for appropriate management

Background: Nutritional anemia in Indonesian children and adolescents is generally regarded and treated as iron-deficient anemia, as it is in individuals in other age groups. Objectives: Yet, it remains a public health threatwithout comprehensive management or a sustained solution. Methods: This review seeks to improve understandingof impediments to its resolution. Relevant studies reported in the past 5 years were identified in PubMed, ScienceDirect, Crossreff, Google Scholar, and Directory of Open Access Journals databases. Results: In all, 12studies in several Indonesian cities provided the basis for the review. Most were conducted in schools, indicatingthe potential of these institutions as targets for intervention but pointing to serious deficiencies in identification ofthe problem across the archipelago and in remote and rural areas. No study has evaluated coexistent anemia andmalnutrition, which likely would have revealed the multi-factoriality of nutritional anemia. Data regarding nutritioneducation, food-based innovation, and supplementation, which may alleviate anemia in children and adolescents,are available, although study lengths and sample sizes have limited interpretation and comparison. Conclusions:Broadly, three intervention approaches to nutritional anemia have been undertaken, namely food-based interventions,nutrient supplementation, and nutrition education. Some progress has been made with these approaches,presumably through increases in iron intake. More information is needed regarding the underlying causalityand pathogenesis, suboptimal food patterns, and comorbidities, any of which might limit the effectivenessof programs designed to resolve childhood and adolescent anemia in Indonesia © 2021 Elsevier B.V., All rights reserved.