Correlation of Malnutrition. Worm Infection. Parents. Income and Knowledge on Anemia Prevalence among 6Ae9 Year Old Students of Liliba Inpres Elementary School Marni Tangkelangi1 Department of Health Analyst. Poltekkes Kemenkes Kupang. Kupang. Indonesia Correspondence: Marni Tangkelangi. Jl. Farmasi. Liliba. Kupang. East Nusa Tengga. Indonesia Zip Code : 85111 Email: tangkelangi@gmail. Received: February 26, 2019 Revised: February 20, 2019 Accepted: April 4, 2019 Abstract Anemia in schoolAeage children will not only cause harm to health but also will have impact on students learning Thus, anemic children will indirectly affect the national development. The aim of this study is to observe the correlation between malnutrition, worm infection, parents income and knowledge on anemia prevalence among 6Ae9 years old children. The method of this research was a cross sectional study with a simple random sampling technique, consisted of 222 participants from Liliba Inpres Elementary School. This study was done by measuring children Body Mass Indeks (BMI)AeforAeage to measure the z score and compare to WHO Children growth standard, by using microscope examination with direct method for identifying helminthiasis, by using questionaries to measure the parent knowledge and parent income and also by measuring haemoglobin values using POCT Device. The results showed that there are correlations between malnutrition and worm infection on anemia prevalence . However, there are no correlations between parentAos knowledge . and parentAos income on anemia prevalence among 6Ae9 years old children on Liliba Inpres Elementary School . In conclusion, these findings confirm that malnutrition and worm infection was correlated with anemia prevalence on Liliba Inpres Elementary School Students so that they are advised to manage their nutritional intake and to practice personal Keywords Anemia, malnutrition, worm infection, knowledge, income Marni Tangkelangi diverse population variation. The students INTRODUCTION Children are one of the vulnerable groups come from different background races, affected by anemia beside pregnant and breastfeeding group and the elderly . The background and parentAos occupation. Six prevalence of anemia on schoolAeaged until nine years old female students were selected as the inclusion criteria because the developed counties was estimated about 42% majority of female students in this range of and 17%, respectively. Anemia prevalence in Indonesian children at age 5Ae14 years is 42. Moreover, the female students are less likely % for boys and 49. 2% for girls . Anemia is a condition where the parentAos vulnerable to have infection, and are in a haemoglobin (H. levels fall below the normal value . g/dL) . Anemia can Therefore, the research aim to happen as a consequence of extrinsic and observe a correlation between malaria and intrinsic factors. The intrinsic factors are blood disorders, low iron intake, and worm knowledge and income on anemia in Liliba Meanwhile, the extrinsic factors Inpres Elementary School students aged Six are poor knowledge about nutrition, level of until nine years old. parentAos parent education, economy status, and lifestyle . MATERIALS AND METHODS Anemia in children can disrupt the This research was an analytical study with a cross sectional study design. The concentration, and are vulnerable to have research setting was at Liliba Inpres other diseases. Research proved that there Elementary School. The research held on was a correlation between hemoglobin level October . nemia statu. on children learning ability. population were students aged 6Ae9 years old Iron deficiency anemia could decrease the who attended Liliba Inpres Elementary child concentration which will further affect School in Oebobo. Kupang. The total amount their study achievement . of students was 338 children. The sample on Liliba Inpres Elementary School is a school that has the most student compared to November The this research were 222 students chosen by simple random sampling technique. The tools used in this research were many as 1. 047 students . This school is not hemoglobinmeter (Easy touchA), hemoglobin only has the most students, but also has very test strips, body scales and height gauge. Ina J Med Lab Sci Tech 2019. : 8-14 all elementary school in Kupang city, as Marni Tangkelangi Nutritional status determined by the z score subjects research were 6Ae7 years old . 2%). based on children BMIAeforAeages compared The body weight of the subject was mostly in to WHO Children Growth Standard. The the range of 17Ae21. 9 kg as many as 130 analysis of worm infection were done directly people . 6%). The highest body height of by microscope observation for wormsAo the subjects were in the range of 1. 11Ae1. The data of parentAos knowledge meters as many as 111 people . %). The and income was conducted by interview occupation of most fathers was private using a questionnaire. Haemoglobin (H. employee as many as 86 people . 7%) and examination was done by taking blood motherAos occupation as many as 91. 9% were haemoglobinmeter and was compared with Table 1 shows the number of subjects anemia at child age school basedAeWHO who had anemia (Hb <11 g / dL), as many as The research using ChiAesquare test 118 people . 2%). The percentage of students who classified as malnutrition (BMIAeforAeage z score years who met the inclusion criteria and 386,139 rupiah /person/ mont. fall in the received written approval from their parents. low category. The subject consisted of 106 boys . and 116 girls . 3%). The majority of the Table 1. Research subject categories Variable Anemia Malnutrition Min Max Mean 9 g/dL 4 g/dL 7 g/dL BMI 8. BMI 30. BMI 13. Score of 13 Score of 38 Score of 26 83,333 IDR/ Capita/Month 1,500,000 IDR/Capita/Month 379,500 IDR/Capita/Month Worms Infections Parents Knowledge Parents Income level Category Anemia Normal Yes Not Positive Negative Low Well Low Ina J Med Lab Sci Tech 2019. : 8-14 Marni Tangkelangi Correlation Malnutrition get enough nutrients that will decrease the erythrocyte synthesis so that it will cause and Anemia Table 2 implicated that there was a anemia in children. significant relationship between malnutrition The six until nine years of age is a crucial and anemia prevalence. The description of moment where a child's body needs nutrients malnutrition in children is obtained by the Z in sufficient quantities in order to grow score (BMIAeforAeage. Table 4. shows that according to the standards of growth. there were 105 children . 3%) who fall in However, lack of consumption of nutritious food can also be caused by the parentAos consistent with the study observed by They cannot provide nutritious food Rosanti . which stated that there was a for their children if the income is lower than strong relationship between nutritional status the average. This . and the incidence of anemia in children in the Benan Ngisor area. Based on the observations, some children with malnutrition showed the signs of anemia The National Heart. Lung and Blood such as weakness, lethargy, pallor, dry lip Institute states that one of the main risk angle and pale eye conjunctiva. If the factors of anemia is consumption of low iron condition of anemia that occurs in children is foods, vitamins and minerals. Nutrients in still at a mild level (Hb 9. 4Ae10. 9 g / d. , it can foods such as protein, folic acid, vitamin B 12 be managed by increasing the intake of and iron are the main raw materials for the nutrients, especially protein and minerals. formation of erythrocytes . Malnutrition is The iron (F. tablets can also increase the Hb a condition where a person does not levels in malnourished children . Table 2. Correlation of malnutrition with the incidence of anemia Anemia condition Total Malnutrition Anemia Normal Yes Not Total Correlation Infection and Anemia Indriati . wrote about the incidence of Sig. 0,000 Supriadi . concluded that there was a significant anemia in school children due to lack of iron and worms infection. In line with that, the Karanganyar Sub district. Ina J Med Lab Sci Tech 2019. : 8-14 Dembol Marni Tangkelangi ChiAesquare test analysis results (Table . time by playing with sand because the concluded that there was a significant location of the elementary school is mostly a relationship between the incidences of land field. Therefore, the chance of worm anemia with helminthiasis from a total of 222 infection is higher when children did not stool samples examined microscopically. wear a footwear when playing on the ground. There were 60 samples that were positive Worms that enter the human body will with the type of infecting worm. live and develop in the large intestine. The Worms are often found in schoolAeage worm will suck blood ("seize" nutrient. children, especially in children who live in needed by the body. In the case of severe with poor sanitation, parasitemia, worms can cause severe anemia unavailability of latrines, lack of clean water in children (<7 g / dL). In addition to sucking supplies, and lack of personal hygiene. Those blood on the surface of the intestine where the are the underlying cause of the occurrence of mouth of the worm attaches, blood leakage helminthiasis in children . This study can also occur. This causes the body to lose involved Six until nine years old children. blood and leads to a decrease in hemoglobin this range of age, most children spend their levels resulting in an anemia condition . Table 3. Worm relationship with the incidence of anemia Anemia degree Worms Anemia Normal Positive Negative Total Sig. 0,000 Correlation between ParentAos Knowledge between family income and the incidence of and Anemia anemia in children in Cilallang Inpres Table 4 shows that 70. 7% parents have Total Elementary School. Makassar. good knowledge about anemia based on The results obtained in this study are in questionnaire filling scores. Based on the line with the research by Ikhmawati . statistical analysis of anemia variables with which concluded there was no relationship parental knowledge, it was concluded that between knowledge and Hb levels. there was no correlation between the addition. Wetipulinge . stated there was incidence of anemia and knowledge of no association between anemia knowledge This is contrary to the research and the incidence of anemia. Based on the conducted by Syafri, et al. which results of interviews to the mothers of the concluded that there was a correlation students, some children who have low Hb Ina J Med Lab Sci Tech 2019. : 8-14 Marni Tangkelangi levels often have problems with eating tend to let their children to eat snack instead Even though their parents have of eating main meal so it decrease the knowledge about anemia and its effects, they childrenAos appetite. Table 4. Worm relationship with the incidence of anemia Anemia degree ParentAos Anemia Normal Knowledge Less Well Sig. Correlation between ParentAos Knowledge between family income and the incidence of and Anemia The parentAos income of Liliba Inpres During the observation, children with Elementary School as much as 67. 1% is in sufficient parentAos income have low Hb levels the low category, with the average income (<11 g/dL), whereas students with low was 379,500 IDR/capita/month (Table . parentAos income have normal Hb levels. This still below the standard of GKM according to condition could happen because even their BPS. IDR/capita/ parents has low income, they could provide Most income comes only from the nutritious food such vegetable which rich in fathersAo income because 91. 9% of mothers Fe minerals that could prevented them from are housewives. being anemic. 386,139 Statistical analysis (Table . showed that Family income will influence the ability there was no relationship between the to buy nutritious food. However, parentAos incidence of anemia and the income of income did not always guarantee that This result is in line with the research children cannot be anemia, especially if by Hendro . which states that there was no parents obey unhealthy eating patterns of relationship between family income and their children. In other words, less income anemia status. Different opinions expressed does not mean that children will suffer from by Liow et al. which stated that there anemia due to malnutrition. Nevertheless, was a significant relationship between having high income tends to provide pocket income and the incidence of anemia. Syafri et money for their children so that the children . stated that there was a relationship consume snacks more often and consume less food provided at home. Ina J Med Lab Sci Tech 2019. : 8-14 Marni Tangkelangi Table 5. Correlation between parental income and anemia Income Weak Intermediate Total Anemia degree Anemia Normal CONCLUSIONS Total Sig. by the intrinsic factor . alnutrition and Anemia prevalence in Liliba Inpres worms infectio. compared to the extrinsic Elementary School students was 52. This ones . arentAos knowledge and incom. research also find out that there were students Parental control on children eating pattern suffer from malnutrition and worm infection. and personal hygiene was recommended to Besides, most of student parents have low decrease the anemia prevalence in children. income although they have good knowledge. Anemia prevalence in students of Inpres CONFLICT OF INTEREST Liliba Elementary School was mostly caused There are no conflicts of interest. REFERENCES