Mapping anemia prevalence across Indonesia.

Background and objectives: Anemia is a major health problem worldwide, with complex etiologies and significantly affecting the quality of life and health outcomes. In Indonesia, anemia is a public health concern with a complex interplay between genetic, environmental, and infectious disease factors. The prevalence tends to increase in Indonesia from 2007 to 2018. This study aims to explore factors contributing to anemia in Indonesia.

Methods and study design: We used archived data from various population studies collected between 1995 and 2023. A total of 5,486 subjects from 17 study populations in Indonesia were included in the analyses.

Results: The proportions of anemic women are higher than anemic men (p<0.001), and the anemia prevalence in Indonesia is diverse in various populations. More than 50% of this study subjects were microcytic hypochromic anemia with 35% indicative of iron deficiency and 13% of thalassemia based on Mentzer Index and RDW index cut-off. Hb analysis showed that HbA2 and HbF proportions above normal were significantly higher in the anemic group (p<0.001). We also found beta thalassemia proportions were higher in the anemic group (p<0.001) indicating genetic disorders are prevalent in Indonesia.

Conclusions: The anemia prevalence in Indonesia is high, and the etiology is very complex, with nutritional and non-nutritional factors. Therefore, anemia mitigation in the Indonesian population should consider nutritional and non-nutritional factors. Policy makers should consider intervention programs beyond nutrient-specific strate-gies such as genetic background of the individuals.