HEMOGLOBIN LEVELS OVERVIEW IN CHILDREN AT SUKAWINATAN

DAYCARE PALEMBANG CITY 2023

Adelia Regina Putri
DIII Medical Laboratory Technology, Poltekkes Kemenkes Palembang
Jl. Sukabangun 1 No.1159, Sukabangun, Sukarami, Kota Palembang, Sumatera Selatan,
30151

ABSTRACT
Background: Hemoglobin (Hb) is a globulin protein contained in red blood cells whose main
function is to transport oxygen from the lungs to the tissues and organs in the body and to carry
carbon dioxide to the lungs. The content of hemoglobin in the body is influenced by many
factors including age, gender, activity, nutritional status, diet, lifestyle, and quality of sleep. The
purpose of the research: It is known that the description of hemoglobin levels in children at
TPA Sukawinatan Palembang City in 2023. Types of reserch: Descriptive with cross sectional
approach. Reserch metthodology: The examination used the Point of Care Testing (POCT)
method with the GCHb device meter. Result: Obtained the results of abnormal hemoglobin
levels (40.7%). Age category, school-age children with abnormal hemoglobin levels (45.5%),
and adolescents with abnormal hemoglobin levels levels (20.0%). Gender category, women
with abnormal hemoglobin levels (56.3%) and men with abnormal hemoglobin levels (18.2%).
Dietary habit category, 3 times a day abnormal hemoglobin levels (20.0%), a day abnormal
hemoglolbin level (63.6%), and 1 times a day abnormal hemoglobin level (100.0%). Category
of sleep duration, sufficient sleep duration (>8 hours) abnormal hemoglobin level (35.7%) and
less sleep duration (<8 hours) abnormal hemoglobin level (46.2%). Conclusion: abnormal
hemoglobin levels occur are influenced by age, gender, dietary habit, and sleep duration.
However, in general the respondents had normal hemoglobin levels.There is an abnormal
hemoglobin level affected by age, gender, meal frequency, and sleep duration. However, in
general the respondents had normal hemogobin levels.
Keywords : hemoglobin, children, landfill

INTRODUCTION
Hemoglobin (Hb) is a protein in red blood cells that transports oxygen from the lungs
to tissues and organs and carries carbon dioxide back to the lungs. Hemoglobin testing is usually
part of a complete blood count.
Anemia is a condition where the number of red blood cells or hemoglobin concentration
is lower than normal, often caused by nutritional deficiencies (such as iron, folate, vitamins B12
and A), and infectious diseases like malaria, tuberculosis, HIV, and parasitic infections. Anemia
is a global health issue, especially in low-income countries, with the WHO reporting that 42%
of children under 5 years old and 40% of pregnant women suffer from anemia.
In Southeast Asia in 2016, anemia prevalence was high, with Indonesia ranking fifth
with a prevalence of 28.02%. Anemia is most common among infants, teenagers, and pregnant
women in Indonesia, with a prevalence of 48.9% among pregnant women and 38.5% among
children under 5 years old.
In South Sumatra, the prevalence of mild anemia in 2018 was recorded at 22,681 cases,
highest in Muara Enim, Banyuasin, and Palembang. In 2019, the prevalence increased to 24,404
cases with 1,078 cases of severe anemia, highest in Musi Rawas and Palembang.
Factors influencing hemoglobin levels include age, gender, activity, nutritional status,
diet, and lifestyle factors such as smoking and consumption of substances that inhibit iron
absorption (e.g., caffeine, tannins). Sleep quality also affects hemoglobin levels.
Research shows various prevalence rates of normal and abnormal hemoglobin levels in
children across different regions. For instance, in SDN 1 Bokori in Konawe, 66.7% of children
had normal hemoglobin levels, while 33.3% had abnormal levels. Another study in
Temanggung found that 47.2% of children who ate three meals a day had normal hemoglobin
levels, whereas those who ate once a day more often had abnormal hemoglobin levels. At Al-
Ma’ruf Islamic Boarding School, 45.6% of male students who slept less than 8 hours a day had
normal hemoglobin levels, while 54.4% had abnormal levels.

MATERIALS & METHODS

1. Type of Data
The types of data used in this study are primary data such as hemoglobin levels,
age, gender, diet, and sleep duration.

2. Data Collection Methods

The data collection methods for this study are as follows: blood sample
examination using the POCT method for hemoglobin levels, interviews for age, diet, and
sleep duration, and observation for gender.

3. Data Collection Instrumets

The data collection instruments used for hemoglobin levels include the Easy
Touch GcHb Device Meter and a checklist for age, gender, diet, and sleep duration data.

4. Data processing
a. Data Inspection (Editing):
This involves reviewing and checking the acquired data. The steps include:
Sampling: Children aged 6-18 years at TPA Sukawinatan.
Completion of Informed Consent Forms.
Interview/Observation.
Hemoglobin Level Examination.
Analysis of Examination Results (Normal/Abnormal).
Data Analysis: Univariant and Bivariant.

b. Data Coding:
 Data are separated based on respective categories and types to facilitate data
management, with each category assigned a code.
c. Data Entry:
This step involves transferring or inputting coded data into a computer program using
SPSS software.
d. Tabulating:
Data are arranged in a manner that facilitates summation and are presented in table
format according to the research objectives.
e. Data Cleaning:
Once all data are entered, a thorough review is conducted to identify any coding errors
or incompleteness. Corrections are made to ensure accurate data analysis.

5. Data Analysis
Data are presented in frequency distribution tables, including:
a. Univariate Data Analysis
Presented in frequency tables to describe each dependent variable, i.e., hemoglobin
levels in children at Sukawinatan Daycare.
b. Bivariate Data Analysis
Aimed at illustrating the relationship between the dependent variable (hemoglobin
levels in children at Sukawinatan Daycare) and independent variables (age, gender,
diet, and sleep duration).

RESULTS & DISCUSSION

1. Results
After sampling children in the Sukawinatan Daycare area of Palembang City in
2023, the analysis resulted in the following table:

a. Univariate Analysis
Based on univariate analysis of Hemoglobin Levels in Children at Sukawinatan
Daycare, Palembang City, 2023, the results are presented in a frequency distribution
table as follows:
Fig 1. Frequency Distribution of Hemoglobin Levels in Children at
Sukawinatan Daycare, Palembang City, 2023

Hemoglobin Result Frequency Percentage (%)

Normal !6 59,3

Abnormal 11 40,7

Total 27 100

Based Figure 1 above, the researcher obtained a distribution overview of

hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023. The
 normal category comprises 16 samples (59.3%), while the abnormal category consists
of 11 samples (40.7%).

b. Bivariate Analysis
A. Frequency Distribution of Hemoglobin Levels in Children at Sukawinatan
Daycare, Palembang City, 2023 by Age
Based on the frequency distribution analysis conducted on hemoglobin
levels in children categorized by age, the results are as follows:
Fig 2. Frequency Distribution of Hemoglobin Levels in Children at
Sukawinatan Daycare, Palembang City, 2023 by Age

Hemoglobin Result
Age Total
(Years) Normal Abnormal
n % n % N %
Scool Age Children (6-12) 12 54,5 10 45,5 22 100
Teenagers (>12-18) 4 80,0 1 20,0 5 100
Total 16 60.6 11 39,4 27 100

Based on Figure 2 above, the researcher obtained a distribution overview

of hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023,
based on age. In the school-age children category (6-12 years), 12 samples
(54.5%) had normal hemoglobin levels and 10 samples (45.5%) had abnormal
levels. In the teenagers category (>12-18 years), 4 samples (80.0%) had normal
hemoglobin levels and 1 sample (20.0%) had abnormal levels.
B. Frequency Distribution of Hemoglobin Levels in Children at Sukawinatan
Daycare, Palembang City, 2023 by Gender
Based on the frequency distribution analysis conducted on hemoglobin
levels in children categorized by gender, the results are as follows:
Fig 3. Frequency Distribution of Hemoglobin Levels in Children at
Sukawinatan Daycare, Palembang City, 2023 by Gender

Hemoglobin Result
Total
Gender Normal Abnormal
n % n % N %
Male 9 81,8 2 18,2 11 100
Female 7 43,8 9 56,3 19 100
Total 16 60,6 11 39,4 27 100

Based on Figure 3 above, the researcher obtained a distribution overview

of hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023,
 by gender. In the male category, 9 samples (81.8%) had normal hemoglobin levels
and 2 samples (18.2%) had abnormal levels. In the female category, 7 samples
(43.8%) had normal hemoglobin levels and 9 samples (56.3%) had abnormal
levels.
C. Frequency Distribution of Hemoglobin Levels in Children at Sukawinatan
Daycare, Palembang City, 2023 by Diet
Based on the frequency distribution analysis conducted on hemoglobin
levels in children categorized by diet, the results are as follows:
Fig 4. Frequency Distribution of Hemoglobin Levels in Children at
Sukawinatan Daycare, Palembang City, 2023 by Diet

Hemoglobin Result
Total
Diet Normal Abnormal
n % n % N %
3 times/day 12 80,0 3 20,0 15 100
2 times/day 4 36,4 7 63,6 11 100
1 times/day 0 0,0 1 100 1 100
Total 16 60,0 11 39,4 27 100

Based on Figure 4 above, the researcher obtained a distribution overview

of hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023,
based on diet. In the category of children who eat three times a day, 12 samples
(80.0%) had normal hemoglobin levels and 3 samples (20.0%) had abnormal
levels. In the category of children who eat twice a day, 4 samples (36.4%) had
normal hemoglobin levels and 7 samples (63.6%) had abnormal levels. In the
category of children who eat once a day, no samples had normal hemoglobin
levels, and 1 sample (100.0%) had abnormal levels.
D. Frequency Distribution of Hemoglobin Levels in Children at Sukawinatan
Daycare, Palembang City, 2023 by Sleep Duration
Based on the frequency distribution analysis conducted on hemoglobin
levels in children categorized by sleep duration, the results are as follows:
Fig 5. Frequency Distribution of Hemoglobin Levels in Children at
Sukawinatan Daycare, Palembang City, 2023 by Sleep Duration

Hemoglobin Result
Total
Sleep Duration Normal Abnormal
n % n % N %
> 8 Hours 9 64,3 5 35,7 14 100
< 8 Hours 7 53,8 6 46,2 13 100
 Total 16 60,6 11 39,4 100

Based Figure 5 above, the researcher obtained a distribution overview of

hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023,
based on sleep duration. In the category of children who sleep for at least 8 hours,
9 samples (64.3%) had normal hemoglobin levels and 5 samples (35.7%) had
abnormal levels. In the category of children who sleep less than 8 hours, 7 samples
(53.8%) had normal hemoglobin levels and 6 samples (46.2%) had abnormal
levels.
2. Discussion
a. Limitasions of the Study
The limitation of this study lies in the respondents, some of whom were
reluctant to participate due to fear of the capillary blood sampling needle used. This
made it challenging for the researcher to obtain 33 samples, resulting in only 27
samples being obtained.

b. Overview of Hemoglobin Levels in Children at Sukawinatan Daycare Palembang

City 2023
Based on the research analysis, the researcher found the frequency distribution
of hemoglobin levels in children at Sukawinatan Daycare, Palembang City, 2023, with
normal hemoglobin levels at 59.3% and abnormal levels at 40.7%. This study is
consistent with Palian (2019) in SDN 1 Bokori, Soropia Subdistrict, Konawe Regency,
which concluded that 66.7% of respondents had normal hemoglobin levels and 33.3%
had abnormal levels out of 30 respondents.

According to the research analysis, it shows that the number of normal

hemoglobin levels is higher than abnormal levels. This is related to a healthy lifestyle.
Furthermore, from interviews conducted with several respondents with abnormal
hemoglobin levels, some experienced sleep difficulties, resulting in reduced sleep
duration due to the odor of garbage spreading into the house and garbage transport
vehicles passing by until midnight. Moreover, respondents rarely eat regularly each
day due to the economic conditions of parents with incomes below the provincial
minimum wage, making it difficult to afford food for daily consumption. A good eating
pattern is one that fulfills the iron intake. According to several studies, eating three
times a day is recommended (Utomo, 2016). However, other factors that may cause
abnormal hemoglobin levels include age, gender, activity, nutritional status, eating
pattern, and sleep quality (Fadlilah, 2018).

c. Overview of Hemoglobin Levels in Children at Sukawinatan Daycare Palembang

City 2023 by Age
Based on the research analysis by age criteria, school-age children (6-12 years)
had normal hemoglobin levels of 54.5% and abnormal hemoglobin levels of 45.5%.
This study is consistent with Wara (2019) in Manusak Primary School, Kupang Timur
Subdistrict, Kupang Regency, who concluded that the distribution frequency of normal
hemoglobin levels is higher than abnormal levels (out of 50 respondents aged 6-12,
76% had normal hemoglobin levels, and 24% had abnormal levels).
 Furthermore, adolescent children (>12-18 years) had normal hemoglobin
levels of 80.0% and abnormal hemoglobin levels of 20.0%. This study is consistent
with Lina (2022) in SMP Negeri 2 Mendoyo, Pohsanten Village, Mendoyo Subdistrict,
Jembrana Regency, who concluded that the distribution frequency of normal
hemoglobin levels is higher than abnormal levels (out of 42 respondents aged 12-19,
85.71% had normal hemoglobin levels, and 14.3% had abnormal levels).

Based on the research analysis, the researcher found abnormal hemoglobin

levels in both age groups of children. It is possible that abnormal hemoglobin levels
are found in both age categories because during this age range, children undergo rapid
growth without adequate iron intake, which can lead to decreased hemoglobin levels.
Additionally, the body's ability to absorb necessary substances, especially iron
absorption, may decrease (Qomariyah, 2016).

d. Overview of Hemoglobin Levels in Children at Sukawinatan Daycare Palembang

City 2023 by Gender
Based on the research analysis by gender criteria, male gender had normal
hemoglobin levels of 81.8% and abnormal hemoglobin levels of 18.2%. Furthermore,
female gender had normal hemoglobin levels of 43.8% and abnormal hemoglobin
levels of 56.3%.

Regarding gender, the researcher found that the frequency distribution of

abnormal hemoglobin levels in females (56.3%) is higher than in males (18.2%). This
study is consistent with Putri et al. (2021) at SD Temanggun, who concluded that the
frequency distribution of females is higher than males (out of 90 respondents, females
were 52.1%, and males were 47.9%).

Based on the research analysis, the researcher found that the category of
females had more abnormal hemoglobin levels than males. According to Nugrahani's
theory (2014), which states that several factors affect a person's hemoglobin level, one
of which is gender, females often have more abnormal levels than males. This is
because females are more prone to decreased hemoglobin levels than males, especially
during menstruation, which results in blood loss over several days and a decrease in
hemoglobin levels.

e. Overview of Hemoglobin Levels in Children at Sukawinatan Daycare Palembang

City 2023 by Eating Pattern
Based on the research analysis by eating pattern criteria, a good eating
frequency (3 times a day) had normal hemoglobin levels of 80.0% and abnormal
hemoglobin levels of 20.0%. Eating pattern sufficient (2 times a day) had normal
hemoglobin levels of 36.4% and abnormal hemoglobin levels of 63.6%. Eating pattern
deficient (1 time a day) had normal hemoglobin levels of 0.0% and abnormal
hemoglobin levels of 100.0%.

Based on eating patterns, the researcher found that the frequency distribution
of abnormal hemoglobin levels in the sufficient eating pattern was 63.6%, and in the
 deficient eating pattern, it was 100.0%. This study is consistent with Putri et al. (2021)
at SD Temanggun, who concluded that the distribution frequency of the categories of
2 times a day and 1 time a day is higher than the category of 1 time a day (out of 90
respondents, 2 times a day was 77.3%, and 1 time a day was 14.3%).

Based on the research analysis, the researcher found that the categories of 2
times a day and 1 time a day had more abnormal hemoglobin levels than the category
of 3 times a day. According to Utomo's theory (2016), which states that insufficient
eating frequency can lead to insufficient intake of food containing iron. A good eating
pattern is one that encourages the fulfillment of nutritional intake. According to several
studies, a good eating frequency is three times a day.

f. Overview of Hemoglobin Levels in Children at Sukawinatan Daycare Palembang

City 2023 by Sleep Duration
Based on the research analysis by sleep duration criteria, sufficient sleep
duration (≥8 hours) had normal hemoglobin levels of 64.3% and abnormal hemoglobin
levels of 35.7%, while insufficient sleep duration (<8 hours) had normal hemoglobin
levels of 53.8% and abnormal hemoglobin levels of 46.2%.

Based on sleep duration, the researcher found that the frequency distribution of
abnormal hemoglobin levels in insufficient sleep duration was 46.2%. This study is
consistent with Nurfarida (2018) at Al-Ma'ruf Islamic Boarding School, Bandar Lor
Village, who concluded that the frequency distribution of insufficient sleep duration is
higher than sufficient sleep duration (out of 24 respondents, insufficient sleep duration
was 54.4%).

Based on the research analysis, the researcher found that the category of
insufficient sleep duration (<8 hours) had more abnormal hemoglobin levels than the
category of sufficient sleep duration (≥8 hours). According to Inshani's theory (2020),
insufficient sleep at night can lead to reduced production of red blood cells, and
irregular sleep times can result in a decrease in the supply of oxygen by the blood to
the brain. Lack of sleep at night can also lead to reduced production of red blood cells.

These findings suggest various factors influencing hemoglobin levels in

children at Sukawinatan Daycare, Palembang City, 2023. Understanding these factors
can aid in developing targeted interventions to improve hemoglobin levels and overall
health outcomes among children in similar settings.

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