Anemia Threatens Child Intelligence

Anemia is often regarded as an ordinary disease. In fact, iron deficiency in infancy, especially the first 5 years of life are not addressed can lead to serious consequences that are difficult restored, especially intelligence.

Anemia, which in layman's language is called anemia, is characterized by reduced hemoglobin levels below normal according to age. Based on WHO criteria, anemia in children less than 5 years are marked with a value of less than 11 hemoglobin and hematocrit less than 33. To find out necessary blood tests in the laboratory.

Prof.dr.Djajadiman Gatot, Sp.A (K), from the Division of Hematology Oncology Department of Children Studies Faculty of medicine / RSCM explained iron deficiency anemia (IDA) is a case of anemia most often encountered.

"Every age group of children vulnerable to this, but the group most highly experienced ADB is a toddler 0-5 years," he told a seminar for Iron Deficiency Anemia Action held Indonesian Pediatric Association (IDAI) in Jakarta some time ago.

Iron deficiency anemia is generally caused by factors of malnutrition, poor food absorption, the rapid growth of infants and adolescents, worm infection, chronic infection, or disease that causes destruction of red blood cells.

"Excessive pollution that enters the body also can shift the levels of iron," added Djajadiman that is currently the chairman of Iron Deficiency Anemia task force IDAI it.

Based on Household Health Survey 2001, 47 percent of toddlers suffer from iron deficiency anemia. This figure did not move much on Riskesdas 2007 that found one in four primary school age children suffer from iron deficiency. Asian Development Bank says about 22 million Indonesian children affected by anemia.

Anemia is a serious problem. According dr.Soedjatmiko, Sp.A (K), iron-deficient children in infancy have an increased risk of growth disturbance and serious long-term development, such as concentration problems learning and intelligence of children declined.

"Iron deficiency in the womb until age 2 years would interfere with the development of the branches and connections between brain cells so that the lower children's intelligence," said Soedjatmiko.

Moreover, iron deficiency also inhibits the formation of an important neurotransmitter substances to control emotions, concentration of attention and behavior of children. "As a result of children vulnerable to disturbances such as aggressive behavior and low problem-solving capacity," he said.

Although during this stage of anemia is better known for causing the typical symptoms such as pale, weak, tired, and lethargic, but in fact, according to Prof.Djajadiman, actually had iron deficiency can occur before the cause of symptoms.

"When anemia occurs in the long term, despite low hemoglobin levels, may not show typical symptoms because the body has adapted," he said.

He added, anemia does not happen overnight but through three stages. The first is the depletion of iron or iron deficiency early stage of the body. "At this stage in the body's iron reserves began to decrease but still normal iron in the plasma as well as hemoglobin and hematocrit values," he said.

The next stage is iron deficiency without anemia in which the reserves of iron, iron in plasma has also been reduced but hemoglobin is normal. At more advanced levels of iron deficiency anemia have occurred in which the iron in plasma and hemogloin value has decreased.

That is why, according to actual examination Djajadiman hemoglobin alone is not enough to know whether a child has the ADB or not. "Please also check serum ferritin levels indicating the total reserves of iron," he added.

Supplementation

Anemia is not addressed clearly will affect the quality of future generations because the consequences of anemia in childhood will continue into adulthood.

Currently IDAI has issued guidelines for iron supplementation to children and infants to avoid the ADB. Iron supplementation is also in line with WHO guidelines in 1998 stating that the prevalence countries anemianya more than 40 percent should be given iron supplementation without screening.

"If only rely on foods that contain iron is not enough because children have to eat foods in large amounts, whereas the stomach capacity of a child," said Djajadiman. Doing skirining on all children at risk ADB also considered too expensive.

Added by Soedjatmiko, iron supplementation has been proven safe. "Several studies have already proved, in a low dose iron supplementation is not harmful" he said. He cited the results of research in Chile to 1123 healthy infants who were born just months with normal hemoglobin levels and iron supplementation given entirely. As a result, infants who received iron becomes fussy and increased social interaction.

Iron supplementation, according to dr.Badriul Hegar, Sp.A (K), chairman IDAI, accompanied by efforts to increase understanding of the dangers of anemia and its prevention efforts. "Not only fixated on iron alone but improved diet as a whole, starting with pregnant women," she said.