Daniela da Silva Rocha

Prevalência e fatores determinantes da anemia em crianças assistidas em creches de Belo Horizonte - MG

OBJETIVO: Avaliar a prevalencia e fatores determinantes da anemia em criancas assistidas em creches de Belo Horizonte. METODOS: Trata-se de estudo transversal com 312 criancas, entre 7 e 59 meses, assistidas em creches de um Distrito Sanitario de Belo Horizonte. O diagnostico de anemia foi realizado por puncao digital e leitura em b-hemoglobinometro portatil, considerando-se anemia niveis de hemoglobina inferiores a 11,0g/dL. Foram aferidos peso e altura das criancas, sendo o estado nutricional classificado segundo criterio OMS (2006). As variaveis foram coletadas por meio de questionario aplicado aos pais ou responsaveis pelas criancas, contendo informacoes socioeconomicas, maternas e relacionadas a saude das criancas. Foi realizada a regressao logistica multipla para avaliar a associacao entre as variaveis e a anemia, com o controle das variaveis de confusao. RESULTADOS: A prevalencia de anemia na populacao estudada foi de 30,8%, sendo esta superior nas criancas com idade ≤ 24 meses (71,1%). Os fatores determinantes da anemia na analise ajustada foram: idade menor ou igual a 24 meses (OR: 9,08; IC: 3,96 − 20,83) e altura/idade < − 1 z escore (OR: 2,1; IC: 1,20 - 3,62). CONCLUSOES: A elevada prevalencia de anemia em criancas atendidas em creches de Belo Horizonte, especialmente naquelas menores de 24 meses e nas criancas com altura/idade < − 1 z escore demonstra a importância do cuidado nutricional com os lactentes, e reforca a necessidade de comprometimento das instituicoes de atendimento infantil no combate a esta deficiencia.

Fatores associados à anemia em lactentes nascidos a termo e sem baixo peso

OBJECTIVE: To investigate the factors involved in the genesis of infant iron deficiency anemia. METHODS: This is a cross-sectional study, which evaluated 104 children in their second year of life who were born at term with adequate weight in Vicosa, Minas Gerais, Brazil. An interview, a 24-hour recall to parents, and anthropometric assessment were used. Laboratory exams included blood count, ferritin, and serum retinol. This study was approved by the Ethics Committee of UFMG and UFV. Statistical analyses were conducted using the Epi Info and SPSS softwares. Poisson generalized linear regression model was used to determine the association of anemia with the study variables, with results expressed as prevalence ratio. RESULTS: Vitamin A deficiency and anemia were identified in 9.6% e 26% of the children, respectively. Infant anemia was associated with the date of onset of prenatal care, maternal use of iron after childbirth, paternal working status, prior use of iron by the child, and duration of breastfeeding. Thus, in the second year of life, lactating children of women who began prenatal care late and did not use iron compounds after birth, with unemployed parents, who never received iron compounds, and who were predominantly breastfed for more than four months had significantly higher prevalence of anemia. CONCLUSION: The results have demonstrated the importance of nutrition during pregnancy and infancy in the prevention of anemia in children.

Anemia-associated factors in infants born at term with normal weight

OBJECTIVE To investigate the factors involved in the genesis of infant iron deficiency anemia. METHODS This is a cross-sectional study, which evaluated 104 children in their second year of life who were born at term with adequate weight in Viçosa, Minas Gerais, Brazil. An interview, a 24-hour recall to parents, and anthropometric assessment were used. Laboratory exams included blood count, ferritin, and serum retinol. This study was approved by the Ethics Committee of UFMG and UFV. Statistical analyses were conducted using the Epi Info and SPSS softwares. Poisson generalized linear regression model was used to determine the association of anemia with the study variables, with results expressed as prevalence ratio. RESULTS Vitamin A deficiency and anemia were identified in 9.6% e 26% of the children, respectively. Infant anemia was associated with the date of onset of prenatal care, maternal use of iron after childbirth, paternal working status, prior use of iron by the child, and duration of breastfeeding. Thus, in the second year of life, lactating children of women who began prenatal care late and did not use iron compounds after birth, with unemployed parents, who never received iron compounds, and who were predominantly breastfed for more than four months had significantly higher prevalence of anemia. CONCLUSION The results have demonstrated the importance of nutrition during pregnancy and infancy in the prevention of anemia in children.

ANÁLISE HIERARQUIZADA DOS FATORES ASSOCIADOS À ANEMIA EM LACTENTES

ABSTRACT Objective: To evaluate the prevalence of anemia and the associated factors in infants assisted in health units of Vitória da Conquista, Bahia, Northeast Brazil. Methods: Cross-sectional study with a representative sample of 366 children aged 6 to 23 months. A questionnaire was applied to the caregiver, and the children’s anthropometric measurements and hemoglobin levels were collected. The associations were identified by Poisson regression with robust variances based on a hierarchical analysis model. Results: The prevalence of anemia was 26.8%, and the associated factors were: family income equal to or lower than one minimum wage (PR: 1.50; 95%CI 1.03-2.18), number of household members higher than five (PR: 1.50; 95%CI 1.07-2.11), use of unfiltered water (PR: 1.68; 95%CI 1.11-2.56), number of offspring higher than three (PR: 1.64; 95%CI 1.01-2.68), consumption of meat and/or viscera less than once/week (PR: 1.78; 95%CI 1.24-2.58) and age 6-11 months (PR: 1.75; 95%CI 1.20-2.55). Conclusions: Anemia in the infants assessed is a moderate public health problem, which is associated with socioeconomic, demographic, and dietary factors; thus, measures are necessary for its prevention.

PREVALÊNCIA E FATORES ASSOCIADOS À ANEMIA EM CRIANÇAS DE CRECHES: UMA ANÁLISE HIERARQUIZADA

ABSTRACT Objective: To determine the prevalence and factors associated with anemia in children younger than five years old enrolled in public daycare centers in a city in southwestern Bahia, in the northeast of Brazil. Methods: This was a cross-sectional study that included a sample of 677 children enrolled in public daycare centers in Vitória da Conquista, Bahia, Brazil. A portable hemoglobinometer was used to measure hemoglobin. The concentration of <11 g/dL was considered the cutoff point for a diagnosis of anemia. A questionnaire was applied to parents/guardians in order to collect socioeconomic data, maternal characteristics and information on the child’s health and nutrition. Height and weight were measured to assess the child’s nutritional status. Poisson regression with robust variance and hierarchical selection of variables was used to identify factors associated with anemia. Results: The prevalence of anemia was 10.2% and was more frequent in children whose homes had no sanitary facilities (PR 3.36; 95%CI 1.40-8.03); in those who did not exclusively breastfeed (PR 1.80; 95%CI 1.12-2.91); in children aged less than 36 months (PR 1.85; 95%CI 1.19-2.89) and those who had low height for age (PR 2.06; 95%CI 1.10-3.85). Conclusions: The prevalence of anemia is considered to be a mild public health problem in the children, who are enrolled in daycare centers. Children with inadequate sanitary conditions, and that were not exclusively breastfed, as well as younger children and children with a nutritional deficit, were more likely to present the condition.OBJECTIVE To determine the prevalence and factors associated with anemia in children younger than five years old enrolled in public daycare centers in a city in southwestern Bahia, in the northeast of Brazil. METHODS This was a cross-sectional study that included a sample of 677 children enrolled in public daycare centers in Vitoria da Conquista, Bahia, Brazil. A portable hemoglobinometer was used to measure hemoglobin. The concentration of <11 g/dL was considered the cutoff point for a diagnosis of anemia. A questionnaire was applied to parents/guardians in order to collect socioeconomic data, maternal characteristics and information on the childs health and nutrition. Height and weight were measured to assess the childs nutritional status. Poisson regression with robust variance and hierarchical selection of variables was used to identify factors associated with anemia. RESULTS The prevalence of anemia was 10.2% and was more frequent in children whose homes had no sanitary facilities (PR 3.36; 95%CI 1.40-8.03); in those who did not exclusively breastfeed (PR 1.80; 95%CI 1.12-2.91); in children aged less than 36 months (PR 1.85; 95%CI 1.19-2.89) and those who had low height for age (PR 2.06; 95%CI 1.10-3.85). CONCLUSIONS The prevalence of anemia is considered to be a mild public health problem in the children, who are enrolled in daycare centers. Children with inadequate sanitary conditions, and that were not exclusively breastfed, as well as younger children and children with a nutritional deficit, were more likely to present the condition.

Excess weight and factors associated in preschool of southwest of Bahia

Objetivos: avaliar a prevalencia e os fatores associados ao excesso de peso em pre-esco-lares do sudoeste da Bahia. Metodos: estudo transversal envolvendo 664 pre-escolares matriculados em periodo inte-gral em creches publicas de Vitoria da Conquista (BA). O excesso de peso foi definido considerando o indice IMC/idade maior que + 2 escore Z. As variaveis independentes foram agrupadas em caracteristicas maternas, socioeconomica, relacionadas a crianca e a creche. Realizou-se regressao logistica multipla para verificar a associacao entre excesso de peso e as variaveis estudadas. Resultados: a prevalencia de excesso de peso foi de 5,7%, sendo 3,9% de sobrepeso e 1,8% de obesidade. Os fatores associados ao excesso de peso infantil foram o parto cesareo (Odds Ratio - OR: 2,59; Intervalo de Confianca - IC95%: 1,11; 6,01), ser filho unico (OR: 3,32; IC95%: 1,44; 7,67) e aleitamento materno exclusivo inferior a 4 meses (OR: 2,59; IC95%: 1,12; 5,99). Conclusoes: os resultados mostram que intervencoes para reducao e/ou prevencao do excesso de peso devem comecar no pre-natal com incentivo ao aleitamento materno exclu-sivo e ao parto vaginal, alem de orientacoes nutricionais para maes com apenas um filho.

Prevalence and factors associated to vitamin A deficiency in children attending public day care centers in the Southwest of Bahia

Objectives: to determine the prevalence of vitamin A deficiency and factors associated to children attending public day care centers in the Southwest of Bahia. Methods: a cross-sectional study involving 303 children aged 24 to 60 months attending public day care centers in the city of Vitoria da Conquista, BA. A questionnaire was applied for the parents or legal guardians to answer and the childrens height and weight were measured. Blood samples were collected to analyze serum retinol taking in consideration the values below 0.70 imol/L as inadequate. The vaccination card was verified in relation to the adequacy of vitamin A supplementation. Food weighting was done to evaluate the consuming of lipids and vitamin A. The association between the variables and vitamin A deficiency was verified by logistic regression. Results: the prevalence of inadequate serum retinol levels was 13.1% (1.99 ± 1.17 imol/L); 4.3% were low height and 1.2% of thinness. Most children (91.7%) had their vitamin A doses outdated on their vaccination cards. The variables associated to vitamin A deficiency were children aged less or equal to 34 months (OR: 2.66, 95% CI: 1.23 - 5.74) and maternal age was less than 26 years (OR: 2.39; 95% CI: 1.11 - 5.17). Conclusions: vitamin A deficiency configures as a moderate public health problem in children attending public day care centers in the Southwest of Bahia.

Déficit estatural e fatores associados em crianças de 6 a 24 meses atendidas em unidades de saúde do sudoeste da Bahia

Objective To assess the prevalence and factors associated with stunting among 6 to 24-month old children. Methodology This was a cross-sectional study including 360 children attended in all health units in the urban area of Vitoria da Conquista - BA. A questionnaire was used to collect information and we evaluated anthropometric measures of weight and height. Nutritional status was evaluated according to the cutoff points for anthropometric indexes recommended by the World Health Organization. The association among the studied factors and stunting was assessed by Poisson regression with robust variance. Results The prevalence of stunting in the assessed children was 13.6%. The factors associated with the outcome were: father’s unemployment (PR: 2.46; 95% CI: 1.34 to 4.49) and low birth weight (OR: 2.29; 95% CI: 1.27 to 4.13). Conclusion The results show a significant prevalence of stunting among children under two years old, emphasizing the importance of nutritional monitoring and the influence of obstetric and socioeconomic factors.

Prevalence and factors associated with excessive weight gain in pregnancy in health units in the southwest of Bahia.

OBJECTIVE To determine the prevalence of excessive gestational weekly weight gain and to identify its association with demographic, socioeconomic, obstetric, anthropometric, and behavioral characteristics. METHODS This cross-sectional study included 328 pregnant women attending all health units in the urban area of Vitória da Conquista, Bahia. The data were collected from May 2010 to June 2011. The weekly weight gain was evaluated according to the current recommendations of the Institute of Medicine. The association among the studied factors and the excessive weekly weight gain was observed in pregnant women in the second and third trimesters, using the Poisson regression with robust variance. RESULTS The prevalence rate of excessive weekly weight gain in pregnant women in the second and third trimesters was found to be 42.5%. The determinants of excessive weekly weight gain were family income < 1 minimum wage (PR: 2.65; 95%CI 1.18 - 4.83) and pregestational weight status overweight/obesity (PR: 1.33; 95%CI 1.01 - 1.75). CONCLUSION The results emphasize the importance of monitoring the weight gain during pregnancy. The evaluation of the weekly weight gain enables early interventions with the goal of preventing the excessive total weight gain and its consequences for both the mother and the child.

Iron Fortification Strategies in Brazil

Iron deficiency anemia represents a serious nutritional problem worldwide, and it especially affects children and pregnant women in developing countries, like Brazil. According to World Health Organization, anemia can be considered a major public health problem in Brazil, which requires effective public policies [1] regarding the short- and long-term effects anemia can have on growth in at-risk groups [2].