Background : Indonesia still has to struggle against many kinds of infection and under-nutrition that related to each other which make the Indonesian societyÃ¢â‚¬â„¢s health is not significantly increasing. More than one third (36,1%) of the children of the school age in Indonesia was standardized as stunted during the school age that indicate the existence of chronic under-nutrition. IDD, anemia, infections and stunting have impact on the decreasing of cognitive function in children. Low dietary intake has effect on health and development of children, including the development of brain that influence of cognitive function. Children who live in IDD (Iodine Deficiency Disorder) area have higher risk in famine and lower achievement for IQ score test.
Objectives : The aim of this research was for describing the relationship between nutritional status, anemia, infection status, dietary intake of seven nutrients (energy, protein, iodine, vitamin C, Fe, Zn, Se) and cognitive function of Elementary Schoolchildren who live in (IDD) Endemic Area, and to know the iodine content on soil and water in that area.
Design : This study was an observational research with cross-sectional design.
Methods : The subject of this research was all of the third-grade, fourth-grade and fifth-grade schoolchildren in 3 elementary schools which located in Kismantoro District, Wonogiri Regency, Central Java, Indonesia, an IDD endemic area. The criteria were children aged 9 Ã¢â‚¬â€œ 12 years. There were 69 research subjects. IDD status was determined using palpation method and IUE. We measured the nutritional status by HAZ indicator, anemia by Hemocue method, infection status by interview to parents of the children, dietary intake of seven nutrients were assessed by 3 days of 24 hours food recall method, iodine content in soil and water analysed by ICP-MS (Inductive Coupled Plasma-Mass Spectrometry) and cognitive function by WISC-R. Data were analyzed statistically using computer software.
Results : We found 20 subjects (28.9%) suffer from IDD, 27 subjects (39,1%) with stunting, 17 subjects (24.6%) anemia, 11 subjects (15,9%) with infection (ARI and diarrhea), and 57 subjects (82,6%) with abnormal cognitive function. Bivariate analysis showed that there was no significant relationship between IDD and infections with cognitive function (p>0.05). There was significant relationship between nutritional status and anemia with cognitive function (p<0,05). Together, using multivariate analysis, dietary intake of energy, protein, iodine, vitamin C, Fe, and selenium influence 5,7% IQ score of school-children. The result from laboratory shows the average of iodine in soil and water on the location are 2,49 ppm and 2,7 ppb. Both figures are below the standard.
Conclusion : There was significant relationship between nutritional status and anemia with cognitive function. No significant relationship between IDD and infection status with cognitive function. Dietary intake of energy, protein, iodine, vitamin C, zinc, Fe and Se had no positive association with cognitive function of elementary school-children who lived in IDD endemic area. Average of iodine content in soil and water on the location are below the standard.
Key words : IDD, nutritional status, anemia, infection status, cognitive function
1) Department of Public Health Gadjah Mada University, Jogjakarta, Indonesia.
2) School of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Jogjakarta, Indonesia.
3) Magister of Nutrition, Faculty of Public Health. Diponegoro University, Central Java, Indonesia.