Lenir Vaz Guimarães

Anemia in children under 3 years of age in public day care centers

OBJECTIVE: To study the prevalence of anemia in children aged less than 36 months in public day care centers in the city of Cuiabá, state of Mato Grosso, Brazil. METHODS: Cross-sectional study with all children (n=271) less than 36 months of age who attended public day care centers in mid-1997. Children were evaluated as to their hemoglobin levels (venous blood, analyzed at the Central State Laboratory) and anthropometric indicators (weight/age, height/age, weight/height). RESULTS: A high prevalence (63%) of anemia associated with age, weight and height deficit, and time of admittance at kindergarten was observed. The prevalence of malnutrition was 0.8% according to the weight/height ratio, 5.0% according to weight/age deficit, and showed an inadequacy of 10.3% as to the height/age ratio. Thus, the percentage of anemic children was six times higher than the height deficit and twelve times higher than the weight deficit. Malnutrition was not in fact associated with anemia, but at extreme anthropometric cut-off points of height and weight for age (< -2 z score), there is an association between these conditions. CONCLUSION: The high prevalence of anemia is regarded as a severe public health problem among preschool children in the city of Cuiabá.

Fatores associados ao sobrepeso em escolares

OBJECTIVE: To identify the variables associated with overweight among schoolchildren in Cuiaba, MT, Brasil. METHODS: A case-control study was conducted in a sample of schoolchildren aging from 6 to 11 years. The study consisted of 158 overweight schoolchildren (body mass index >85th percentile) and 316 children with body mass index 30 (OR=7.27 and 2.65, respectively), birth weight >3,500g (OR=2.27) and female gender (OR=2.15). CONCLUSION: The results pointed out variables, at different hierarchical levels, correlated with overweight among schoolchildren. Interventions should consider the complex pattern of obesity determination and the groups at higher vulnerability.

Fatores de risco para a ocorrência de déficit estatural em pré-escolares

A case-control study was conducted to know the magnitude of the effect of main risk factors for short stature of pre-school children in a city in Sao Paulo State, in 1995. An anthropometric survey carried out with all children (1201) attending public pre-school classes was used to select the case and the control groups. It was selected a random sample of 165 children among those with stature/age £ -1 Z score (case) and another sample of 165 among those with stature/age ³ +1 Z score (control). The mothers or persons responsible for these children were interviewed in order to obtain information on demographic, maternal and socio-economic variables. The multiple logistic hierarchical analysis showed the following variables as associated with pre school childrens short stature: mothers educational level (OR = 2,1; CI: 1,1-3,8); per capita family income £ 0,5 SM (OR = 3,4; CI: 1,5-8,0); number of persons in the house ³ 6 (OR = 3,7; CI: 1,5-9,0); number of domestic equipment £ 1 (OR = 4,4; CI: 1,8-10,7); birth length < 48 (OR = 7,4; CI: 2,3-23,7), mothers stature £ 156,6 (OR = 5,9; CI: 3,1-11,0) and fathers stature (OR = 4,2; CI: 2,1-8,6). We was found that even in a population of preschool children without nutritional deficiency (as measured by the usual anthropometric index) it is possible to observe the effect of socio economic variables in children stature.A case-control study was conducted to know the magnitude of the effect of main risk factors for short stature of pre-school children in a city in Sao Paulo State, in 1995. An anthropometric survey carried out with all children (1201) attending public pre-school classes was used to select the case and the control groups. It was selected a random sample of 165 children among those with stature/age (-1 z score (case) and another sample of 165 among those with stature/age ( +1 z score (control). The mothers or persons responsible for these children were interviewed in order to obtain information on demographic, maternal and socio-economic variables. The multiple logistic hierarchical analysis showed the following variables as associated with pre school childrens short stature: mothers educational level (OR = 2,1; CI: 1,1-3,8); per capita family income (0,5 SM (OR = 3,4; CI: 1,5-8,0); number of persons in the house (6 (OR = 3,7; CI: 1,5-9,0); number of domestic equipment (1 (OR = 4,4; CI: 1,8-10,7 ); birth length <48 cm (OR = 7,4; CI: 2,3-23,7 ), mothers stature ( 156,6 cm (OR = 5,9 CI 3,1-11,0) and fathers stature (169,5 cm (OR = 4,2; CI: 2,1-8,6). We found that even in a population of preschool children without nutritional deficiency (as measured by the usual anthropometric index) it is possible to observe the effect of socio economic variables in children stature.

Differences between the nutritional status of children in public preschools and nutritional transition

OBJECTIVE: to verify if there are different patterns of nutritional status among preschool children, and if these patterns deserve special interventions. METHODS: this cross-sectional study included 1,200 children from public preschools in Cosmopolis, a small town in the state of Sao Paulo. The z scores indices for height/age, weight/age, and weight/height were analyzed in terms of age, sex, type of school, and school location. RESULTS: anthropometric indices were similar to those of the reference population (NCHS). Males had lower indices than females. Important differences in anthropometric indices were found among children from different schools. Higher prevalence of moderate deficits in height and weight was observed in children from non-downtown areas, while higher prevalence of obesity was found in children from downtown areas. However, the prevalence of obesity was higher than the prevalence of malnutrition even in schools located in non-downtown areas. CONCLUSIONS: we concluded that even in a small city and in a relatively homogeneous group, it is possible to detect different nutritional patterns in subgroups of the population. The differences related to nutritional status, and the high prevalence of obesity among children from public schools, point out the need for different approaches and interventions.

Hipertensão arterial e estilo de vida em Sinop, Município da Amazônia Legal

BACKGROUND Hypertension is highly prevalent and is an important cardiovascular risk factor. OBJECTIVE To estimate the prevalence of hypertension and its association with lifestyle. METHODS This was a cross-sectional population-based study conducted through a household survey in Sinop-MT (n = 690). The study sample was obtained by simple sampling in two steps. Blood pressure was measured three times and, for the analysis, the average of the last two measures was taken into account. The individuals who had BP > 140/90 mmHg and/or reported use of antihypertensive drugs were considered hypertense. The analysis of hierarchical multiple logistic regression was used to test the association between hypertension and independent variables. RESULTS The prevalence of hypertension was 23.2% (95% CI: 20.1 - 26.6). The only variable related to lifestyle associated with hypertension was the consumption of alcoholic beverages, and this variable was protective for women who consumed up to 15g ethanol/day (OR = 0.49, 95% CI: 0.26-0.93), and deleterious for men who consumed more than 30g ethanol/day (OR = 2.94, 95% CI: 1.28 to 6.77). CONCLUSION Hypertension was independently associated with alcohol consumption among men and women.FUNDAMENTO: La hipertension arterial presenta alta prevalencia y es un importante factor de riesgo cardiovascular. OBJETIVO: Estimar la prevalencia de la hipertension arterial y su asociacion con el estilo de vida. METODOS: Estudio transversal, de base poblacional, por medio de encuesta domiciliaria llevada a cabo en Sinop-MT (n = 690). La muestra de la investigacion se obtuvo por muestreo simple en dos etapas. La presion arterial se tomo tres veces y para el analisis, el promedio de las dos ultimas mediciones. Se considero como hipertensos aquellos que presentaron PA > 140/90 mmHg y/o que refirieron uso de farmacos antihipertensivos. El analisis de regresion logistica multiple jerarquizada se utilizo para probar la asociacion entre la hipertension y las variables independientes. RESULTADOS: La prevalencia de hipertension arterial fue de un 23,2% (IC 95%: 20,1 - 26,6). La unica variable relacionada al estilo de vida asociada a la hipertension arterial fue el consumo de bebidas alcoholicas, siendo protector para las mujeres que consumian hasta 15 g de etanol/dia (OR=0,49;IC 95%: 0,26 - 0,93) y deletereo para los varones que consumian mas de 30 g de etanol/dia (OR=2,94;IC 95%: 1,28 - 6,77). CONCLUSION: La hipertension arterial se asocio independientemente al consumo de bebidas alcoholicas, entre varones y mujeres.

Desenvolvimento de Questionário de Frequência Alimentar para adultos em amostra de base populacional de Cuiabá, Região Centro-Oeste do Brasil

OBJETIVO: Descrever a construcao de um Questionario de Frequencia Alimentar (QFA) para utilizacao em estudos que visem a obtencao de dados sobre o consumo alimentar de adultos de Cuiaba, MT. METODOS: Um inquerito recordatorio de 24 horas (R24h) foi aplicado em uma subamostra de 104 individuos, de ambos os sexos, selecionados aleatoriamente a partir de uma amostra probabilistica de estudo de base populacional. Considerando-se frequencia de citacao e contribuicao para o consumo de energia e nutrientes dos alimentos citados nos R24h foram selecionados 81 itens alimentares e as respectivas porcoes de referencia, que foram aquelas mais frequentemente relatadas nos R24h. A lista do QFA foi gerada com oito categorias de resposta para a frequencia de consumo. RESULTADOS: Os itens alimentares citados por mais de 50% da amostra foram o acucar, cafe, feijao, arroz, carne, pao e refrigerante, sendo que os quatro ultimos tambem foram os que mais contribuiram para o consumo energetico. Nao se observaram diferencas entre homens e mulheres nos alimentos que mais contribuiram para a ingestao de macro e micronutrientes. CONCLUSAO: O QFA foi desenvolvido com a inclusao dos itens alimentares de maior relevância para a dieta da populacao adulta de Cuiaba, Mato Grosso. Comprovadas sua validade e reprodutibilidade, este instrumento sera util em investigacoes epidemiologicas e clinicas sobre o possivel papel da dieta no desenvolvimento de enfermidades nessa populacao.

As diferenças de estado nutricional em pré-escolares de rede pública e a transição nutricional

OBJECTIVE: to verify if there are different patterns of nutritional status among preschool children, and if these patterns deserve special interventions. METHODS: this cross-sectional study included 1,200 children from public preschools in Cosmopolis, a small town in the state of Sao Paulo. The z scores indices for height/age, weight/age, and weight/height were analyzed in terms of age, sex, type of school, and school location. RESULTS: anthropometric indices were similar to those of the reference population (NCHS). Males had lower indices than females. Important differences in anthropometric indices were found among children from different schools. Higher prevalence of moderate deficits in height and weight was observed in children from non-downtown areas, while higher prevalence of obesity was found in children from downtown areas. However, the prevalence of obesity was higher than the prevalence of malnutrition even in schools located in non-downtown areas. CONCLUSIONS: we concluded that even in a small city and in a relatively homogeneous group, it is possible to detect different nutritional patterns in subgroups of the population. The differences related to nutritional status, and the high prevalence of obesity among children from public schools, point out the need for different approaches and interventions.

Prevalência e fatores de risco para asma em adolescentes de 13 a 14 anos do Município de Cuiabá, Mato Grosso, Brasil

The objective of this study was to estimate the prevalence of active asthma and identify associated risk factors in adolescents 13 to 14 years of age in Cuiabá, Mato Grosso State, Brazil. A cross-sectional population-based and a subsequently a nested case-control study was conducted in 2008 using the protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). Risk factor analysis used the chi-square test, Fishers exact test, and binary logistic regression. Variables with p < 0.20 in the bivariate analysis entered the logistic regression model, with six variables remaining in the final model (p < 0.05). Prevalence of active asthma was 19.1%. Risk factors for active asthma (p = 0.01) were: smoking during pregnancy, exclusive breastfeeding < 6 months, family income < 3 minimum wages, female gender, pets currently in the home, and absence of fish in the diet. Prevalence of active asthma was high, but with a significant reduction compared to 1998.

Prevalência de escoliose idiopática e variáveis associadas em escolares do ensino fundamental de escolas municipais de Cuiabá, MT, 2002

OBJECTIVE To estimate the prevalence of idiopathic scoliosis and its associated factors in schoolchildren of elementary public schools. METHODS Cross sectional two-phase study, the first of which in classrooms. Those considered Adams positive were invited for the second phase, which consisted of an interview for associated factors and a scoliosis exam. Those with a confirmed test in the second phase were submitted to x-rays for scoliosis and other factors. To estimate the prevalence, curves with > 5 and > 10 Cobb degrees were used as cut off. RESULTS In the first phase, 382 students were counted as Adams positive; of these 210 came for the second phase, 142 of which with a confirmed test. Using a chi-square test to compare the variables age, sex and color of the lost group (n = 172) to the group that accepted the invitation (n = 210), no statistical significance was observed, allowing statistical inference for the sample studied (n = 3,105). The estimated prevalence of scoliosis in the sample studied was 5.3% for curves > 5 Cobb degrees and 2.2% for curves > 10 Cobb degrees. Thoracic curves were observed in 44.8%, Risser grade 1 in 97.4%, and vertebral rotation degree I in 3.2%. Statistical significance was observed (p < 0.05) for the association of scoliosis with: physical activity, hump, and flexibility of the spine to the right. CONCLUSION The estimated prevalence of scoliosis in our study is comparable to those from other studies. However, its diagnosis and follow-up are important to health promotion and to the prevention of more severe disorders.

Prevalência e fatores associados à hipertensão arterial em idosos de municípios da Amazônia Legal, MT

Este estudo teve como objetivo analisar as caracteristicas epidemiologicas da hipertensao arterial e os fatores associados na populacao idosa residente nos municipios da Amazonia Legal no Estado de Mato Grosso - Alta Floresta, Sinop, Sorriso e Diamantino. Trata-se de estudo transversal, de base populacional, realizado por meio de inquerito domiciliar com 312 idosos. A amostra da pesquisa foi obtida por amostragem complexa. Consideraram-se hipertensos aqueles que apresentaram pressao arterial >140/90mmHg e/ou que referiram uso de medicacao anti-hipertensiva. A analise de regressao de Poisson foi utilizada para testar a associacao entre a hipertensao e as variaveis independentes. A prevalencia da hipertensao foi de 67,4%. As variaveis associadas a hipertensao nos homens foram situacao conjugal (p=0,012) e indice de massa corporal (p=0,025). Ja entre as mulheres, foram faixa etaria (p=0,026), tabagismo (p=0,030) e indice de massa corporal (p=0,034). Entre os idosos, observou-se que 78,3% tinham conhecimento de sua condicao de hipertenso; destes, 97,7% estavam em tratamento. Entre os que estavam em tratamento, apenas 43,7% apresentavam sua pressao arterial controlada. A alta prevalencia da hipertensao, a associacao a fatores de risco cardiovascular, assim como o baixo percentual de idosos com pressao arterial controlada, reforcam a necessidade de implementar politicas publicas, visando a acoes de prevencao, controle e promocao da saude da populacao idosa.