Anemia as a Part of the Triple Burden Among Children Under-Five with Stunting and Tuberculosis in Bandung, Indonesia

Background/Objectives : Children with stunting are at risk of immune function disruption and micronutrient deficiencies, leading to nutritional anemia and susceptibility to infection. This study determined the prevalence and etiology of anemia in children under five with stunting and tuberculosis (TB) and analyzed the associated factors. Methods : A cross-sectional study was conducted among children under five with stunting from 30 May to 13 June 2022. Participants were selected via the proportionate stratified random sampling of 74 community health centers in Bandung City, Indonesia. An anthropometric measurement was performed to determine stunting and conduct TB diagnosis, and hematology tests were performed to elaborate the anemia profiles. Results : In total, 138 participants were included, among which 80 (58.0%) had TB and 57 (41.3%) had anemia, mostly caused by iron deficiency anemia (IDA)-38/57 (66.7%). The coexistence of anemia in children with stunting and TB was present in 33 (23.9%) and it was associated with nutritional status (weight-for-length), p = 0.026. Conclusions : Anemia, as a part of the triple burden among children under five with stunting and TB was highly prevalent, mostly due to IDA; in this study, only nutritional status was associated with the triple burden.