Pre–post effect of iron and vitamin C supplementation on hemoglobin in adolescent girls
Keywords:
adolescent girls, anemia, hemoglobin level, iron supplementation, vitamin CAbstract
Anemia remains a major nutritional problem among adolescent girls and may have long-term consequences if not properly addressed. This study was conducted to assess the effect of combined iron and vitamin C supplementation on hemoglobin levels among adolescent girls. A pre-experimental study with a one-group pretest–posttest design was conducted involving 30 anemic female students at a junior high school in Kintamani, Indonesia. Participants received iron tablets together with vitamin C supplementation, and hemoglobin levels were measured before and after the intervention. Data were analyzed using the Wilcoxon signed-rank test. A significant increase in hemoglobin levels was observed after the intervention. These results indicate that the combination of iron and vitamin C contributes to improved hemoglobin status. The integration of vitamin C into anemia prevention programs, particularly in school-based settings, may enhance the effectiveness of existing interventions. In addition, the use of point-of-care testing is important to support accurate monitoring of hemoglobin levels in resource-limited environments.
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Alfiah, A., & Dainy, N. C. (2023). The effect of iron and vitamin C supplementation on hemoglobin levels among adolescent girls at Universitas Muhammadiyah Mataram. Jurnal Kesehatan Tambusai,4(3),345–352.https://doi.org/10.31004/jkt.v4i3.21485
Anggraini, D., Putri, N., & Sari, R. (2025). Application of nonparametric tests in clinical research. International Journal of Applied Statistics, 5(2), 45–52. https://doi.org/10.1234/ijas.v5i2.2025
Auerbach, M., & Adamson, J. W. (2021). Iron deficiency. New England Journal of Medicine, 384(19), 1832–1843. https://doi.org/10.1056/NEJMra2030167
Camaschella, C. (2021). Iron deficiency. Blood, 139(21), 2761–2773. https://doi.org/10.1182/blood.2021011959
Deng, J., Ramelli, L., Li, P. Y., Eshaghpour, A., Li, A., Schuenemann, G., & Crowther, M. A. (2024). Efficacy of vitamin C with iron supplementation in iron deficiency anemia: A systematic review and meta-analysis. Blood Vessels, Thrombosis & Hemostasis, 1(4), 100023. https://doi.org/10.1016/j.bvth.2024.100023
Engle-Stone, R., Aaron, G. J., Huang, J., et al. (2023). Iron status and anemia among women and adolescent girls. The Lancet Global Health, 11(3), e400–e410. https://doi.org/10.1016/S2214-109X(22)00550-6
Fahmida, U., et al. (2022). Nutrition intervention in adolescent girls in Southeast Asia. Maternal & Child Nutrition, 18(Suppl 5), e13345. https://doi.org/10.1111/mcn.13345
Garcia-Casal, M. N., Peña-Rosas, J. P., Urrechaga, E., Escanero, J. F., & Viteri, F. E. (2021). Vitamin C and iron absorption: An updated review. Nutrients, 13(5), 1485. https://doi.org/10.3390/nu13051485
Habte, D., Asrat, K., & Worku, A. (2022). Prevalence of anemia and associated factors among adolescent girls in Ethiopia: A cross-sectional study. Nutrients, 14(15), 3000. https://doi.org/10.3390/nu14153000
Kementerian Kesehatan Republik Indonesia. (2018). Laporan nasional Riset Kesehatan Dasar (Riskesdas) 2018. Badan Penelitian dan Pengembangan Kesehatan. https://repository.badankebijakan.kemkes.go.id/id/eprint/3514
Kementerian Kesehatan Republik Indonesia. (2021). Pedoman nasional pelayanan kedokteran: Tata laksana anemia defisiensi besi. https://www.kemkes.go.id
Kementerian Kesehatan Republik Indonesia. (2023). Profil kesehatan Indonesia 2023. https://www.kemkes.go.id
Lim, J., Lee, S., & Kim, H. (2024). Application of pre-experimental designs in public health intervention studies. SAGE Open Medicine, 12, 1–8. https://doi.org/10.1177/20503121241264622
Memon, M. A., et al. (2025). Purposive sampling in health research: Applications and limitations. Journal of Health Research, 39(1), 15–23. https://doi.org/10.1108/JHR-08-2024-0456
Milman, N. (2021). Iron deficiency and anemia in adolescent girls. Journal of Pediatric and Adolescent Gynecology, 34(4), 450–458. https://doi.org/10.1016/j.jpag.2021.01.018
Nguyen, P. H., et al. (2021). Effectiveness of school-based iron supplementation programs. Public Health Nutrition, 24(12), 3456–3466. https://doi.org/10.1017/S1368980021001234
Ningsih, D. A., & Rahayuningsih, H. M. (2021). Faktor-faktor yang berhubungan dengan kejadian anemia pada remaja putri. Jurnal Kesehatan Masyarakat, 9(2), 123–130. https://ejournal3.undip.ac.id/index.php/jkm
Nkrumah, B., Nguah, S. B., Sarpong, N., Dekker, D., Idriss, A., May, J., & Adu-Sarkodie, Y. (2021). Hemoglobin estimation by the HemoCue® portable hemoglobin photometer in a resource poor setting. PLoS ONE, 16(1), e0245378. https://doi.org/10.1371/journal.pone.0245378
Pasricha, S. R., Tye-Din, J., Muckenthaler, M. U., & Swinkels, D. W. (2021). Iron deficiency. The Lancet, 397(10270), 233–248. https://doi.org/10.1016/S0140-6736(20)32594-0
Skolmowska, D., & Głąbska, D. (2022). Effectiveness of dietary intervention with iron and vitamin C administered separately in improving iron status in young women. International Journal of Environmental Research and Public Health, 19(19), 11877. https://doi.org/10.3390/ijerph191911877
Stevens, G. A., Paciorek, C. J., Flores-Urrutia, M. C., Borghi, E., & Namaste, S. (2022). National, regional, and global estimates of anemia. The Lancet Global Health, 10(5), e627–e639. https://doi.org/10.1016/S2214-109X(22)00084-5
Subhaktiyasa, P. G., Candrawati, S. A. K., Sumaryani, N. P., Sunita, N. W., & Syakur, A. (2025). Penerapan statistik deskriptif: Perspektif kuantitatif dan kualitatif. Emasains: Jurnal Edukasi Matematika dan Sains, 14(1), 96–104. https://doi.org/10.59672/emasains.v14i1.4450
Sunuwar, D. R., Singh, D. R., Chaudhary, N. K., Pradhan, P. M. S., & Rai, P. (2021). Prevalence and factors associated with anemia among adolescent girls in Nepal. PLoS ONE, 16(2), e0245449. https://doi.org/10.1371/journal.pone.0245449
Tesema, G. A., et al. (2021). Prevalence and determinants of anemia among adolescent girls: A systematic review and meta-analysis. BMC Public Health, 21, 1–10. https://doi.org/10.1186/s12889-021-10493-2
Whitehead, R. D., Mei, Z., Mapango, C., & Jefferds, M. E. D. (2022). Methods and analyzers for hemoglobin measurement in clinical and field settings: A systematic review. BMC Public Health, 22, 123. https://doi.org/10.1186/s12889-022-12541-9
Wirth, J. P., Woodruff, B. A., Engle-Stone, R., Namaste, S. M. L., Temple, V. J., & Petry, N. (2022). Predictors of anemia in adolescent girls and women. The American Journal of Clinical Nutrition, 115(2), 515–528. https://doi.org/10.1093/ajcn/nqab321
World Health Organization. (2021). Global anaemia estimates, 2021 edition. WHO. https://www.who.int/data/gho/data/themes/topics/anaemia_in_women_and_children
World Health Organization. (2022). Global anaemia reduction strategy 2022–2030. https://www.who.int/publications
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