Leonor Maria Pacheco Santos

Magnitude, geographic distribution and trends of anemia in preschoolers, Brazil

OBJECTIVE To assess the magnitude, geographical distribution and trends of the prevalence of nutritional anemia among preschoolers and to identify risk groups in the state of Paraiba, Brazil. METHODS A cross-sectional survey with multistage random sampling procedure was conducted in 8 urban municipalities of three mid-regions (Zona da Mata, Agreste and Sertão) in the state of Paraíba in 1992. A total of 1,287 preschoolers of both sexes were selected. Hemoglobin was determined by the cyanometahemoglobin method in venous blood, employing <11 g/dl as the cut-off for anemia. Statistical analysis of proportions employed the chi Square test, whereas for means Mann-Whitney and Kruskal-Wallis were the choice, all with confidence interval of 95%. RESULTS The prevalence of anemia was 36.4% (CI 33.7 - 39.1) in the state of Paraiba, greater (p=0.00) than that observed (19.3%, CI 17.3 - 21.5) in 1982. Only 1.0% (CI 0.61 - 1.8) and 6.8% (CI 5.5 - 8.3) of anemia cases were classified as severe and moderate, respectively. Boys presented lower mean hemoglobin concentration (p=0.00), and children under age 3 comprised the biological group of highest susceptibility for deficiency status (p= 0.00). It was found that the second year of life is the most critical for developing nutritional deficiency (p= 0.00). The Agreste mid-region revealed to be the geographical area of highest risk (p= 0.00), outlining a new epidemiological dynamics when compared to the year 1982, when the drought-ridden Sertão region were the geographical area at greatest risk of deficiency. CONCLUSIONS According to international epidemiological criteria, anemia in the studied regions represents a public health problem of moderate degree Assuming the analytical comparability of the 1982 and 1992 cross-sectional surveys, it suggests an increasingly prevalence of nutritional anemia (+88.5%) in all 3 mid-regions in a 10-year-period (1982-92).

Childhood anemia prevalence and associated factors in Salvador, Bahia, Brazil

A cross-sectional study was conducted in 1996 to estimate the prevalence of anemia in a stratified sample of 603 preschool children and identify factors associated with the disease. Hemoglobin assays were conducted in finger-prick blood samples using a Hemocue hemoglobinometer. Anemia was defined as hemoglobin below 11.0 g/dl. Logistic regression analysis was used to evaluate the potential associations. Observed anemia prevalence was 46.3%. Associated factors were: the 6-12-month and 12-24-month age brackets, the lowest tertiles for iron density and protein content dietary intake, and any degree of deficit in the height-for-age anthropometric parameter. Inadequate physical, sanitary, and environmental conditions in the home were associated with a significantly increased risk of anemia. Anemia constitutes an important health problem in this studys child population. Improvements in living conditions and dietary quality could contribute to a reduction in anemia prevalence.

Consumo alimentar entre crianças brasileiras com idade de 6 a 59 meses

The aim of this study was to assess food consumption in Brazilian children 6 to 59 months of age by region of the country and area of residence. This was a descriptive cross-sectional study of 4,322 children in the National Demographic and Health Survey (2006-2007). The data showed low daily consumption of leafy vegetables (12.7%), vegetables (21.8%), and meat (24.6%) and high consumption (1-3 times a week) of soft drinks (40.5%), fried foods (39.4%), salty snacks (39.4%), and sweets (37.8%). Comparing the regions of Brazil, children in the South, Southeast, and Central-West consumed more rice, bread, potatoes, beans, greens, vegetables, and meat, but they also ate more foods not recommended for their age, like sweets and soft drinks (soda). Rural children showed lower consumption of foods recommended for their age and also those not recommended for their age, as compared to their urban counterparts. According to this study, food consumption in these young children fails to meet the recommendations for healthy eating in this age bracket.

Estimativas de insegurança alimentar grave nos municípios Brasileiros

Prevalence of severe food insecurity was estimated for Brazilian municipalities based on the 2004 National Household Sample Survey (PNAD). First, a logistic regression model was developed and tested with this database. The model was then applied to the 2000 census data, generating severe food insecurity estimates for the Brazilian municipalities, which were subsequently analyzed according to the proportion of families exposed to severe food insecurity. Severe food insecurity was mainly concentrated in the North and Northeast regions, where 46.1% and 65.3% of municipalities showed high prevalence of severe food insecurity, respectively. Most municipalities in the Central West region showed intermediate prevalence of severe food insecurity. There was wide intra-regional variation in severe food insecurity, while the South of Brazil showed the most uniform distribution. In conclusion, Brazil displays wide inter and intra-regional variations in the occurrence of severe food insecurity. Such variations should be identified and analyzed in order to plan appropriate public policies.

Transferência de renda e segurança alimentar no Brasil: análise dos dados nacionais

OBJECTIVE: The 2004 National Household Survey Data was analyzed to test the hypothesis that cash transference from government social programs is associated with household food security. METHODS: Secondary data were used from the National Household Sample Survey which interviewed residents of 112,716 households. The present analysis included permanent and temporary private households, where food security items were informed by a resident of the household, restricting the collection of data to households with per capita monthly income of up to 1 minimum wage, representing 51.2% of the sample. Three models for estimating the amount of cash transference were developed; model 3 was chosen because it was less likely to overestimate effects. To analyze how cash transference affected the prevalence of food security, only households that received cash transference were included in the analysis, representing 14.2% of the interviewed households. The association between food security and cash transference, controlled for other independent variables, was estimated using a logistic regression model with stepwise method for each of the three income strata. RESULTS: The mean per capita cash transference was of R

Avaliação de políticas públicas de segurança alimentar e combate à fome no período 1995-2002: 4 - Programa Nacional de Alimentação Escolar

81.68 per family. Multiple logistic regression showed an increased chance of food security of 8% per each R

Growth faltering in childhood related to diarrhea: a longitudinal community based study

10.00 contributed by social programs. Rural residence, male head of household, and Caucasian head of household were factors that also presented a higher chance of food security. CONCLUSION: The hypothesis was confirmed, showing a positive association between cash transfer and household food security, regardless of the effects of other explanatory factors.

Prevalência da hipovitaminose A em pré-escolares no Estado de Sergipe, 1998

This study evaluated the Brazilian National School Nutrition Program from a structure-process-results perspective. The methodology involved document research and a case study in 45 counties and 73 schools in the State of Bahia, including program manager interviews and household questionnaires involving 3,367 children (7-14 years of age). Relating to program structure, the study analyzed the evolution of normative instruments and some infrastructure aspects. Managers reported problems with the installations for preparing and distributing meals in 28% of the counties. Decentralization to the county (municipal) level was present in 93% of cases and to the school level in about 20%; however, nearly 70% of the schools received the food supplies directly. Although Social Control Councils were created, members were not always chosen democratically. Acceptability of the meals was good, as expected considering the widespread poverty in the target population. Overall program coverage was high (95%), but 77% of schoolchildren in the interior and 39% in the capital city did not receive meals every day. So far, irregular school meal distribution has frustrated the programs aspirations to become a universal social policy and ensure a basic right for children.

Efeito da fortificação com ácido fólico na redução dos defeitos do tubo neural

Objective:This study aimed to evaluate the association of diarrhea and acute lower respiratory tract infections (ALRI) with growth of preschool children.Design:A longitudinal community-based study over a 12-month period. Children were followed up with thrice-weekly household visits for collection of morbidity data. Every 4 months (round) clinical and anthropometric examinations were performed. At baseline a questionnaire was used to collect socioeconomic family data and environmental household variables. Generalized estimating equation was used in the statistical analysis. The variations in weight-for-age or height-for-age Z-scores in each round were the dependent variables, while the main independent variables were the number of days with diarrhea and ALRI.Setting:Serrinha, located in Northeast Brazil.Subjects:In total, 487 children, aged 6–48 months at baseline, with 1-y complete follow-up.Results:The number of sick days with diarrhea or ALRI was not associated with mean changes in weight-for-age Z-scores. However, the mean of height-for-age Z-scores was found to decrease in those children with 7 or more days of diarrhea (β=−0.0472; P=0.016) but not with 1 or more days of ALRI (β=0.0022; P=0.406) in all rounds of the follow-up period.Conclusion:Results of the study reinforce the concept of diarrhea burden as a major determinant of poor growth in children under 5 y of age. Actions targeted to decrease the risk factors for the occurrence of diarrhea may represent an important component of interventions aimed to ensure satisfactory child growth.Sponsorship:Financial support was provided by the World Health Organization (CDD), PRONEX/CNPq/MCT of the Brazilian Government (Agreement no. 661086/1998-4) and UNICEF (NY).

National Immunization Day: a strategy to monitor health and nutrition indicators

OBJETIVO: Determinar a prevalencia da deficiencia de vitamina A em uma amostra de base populacional de criancas. METODOS: Trata-se de um estudo de corte transversal realizado de maio a junho de 1998, no Estado de Sergipe, envolvendo 607 criancas de seis a 60 meses de idade. As informacoes foram obtidas por meio de entrevistas domiciliares com os responsaveis pelas criancas. A coleta de sangue foi realizada por venipuntura e a dosagem do retinol serico pelo metodo da cromatografia liquida de alta resolucao. Para a analise simultânea das variaveis do estudo, aceitou-se o valor de p<0,05 para testar as associacoes de significância estatistica. RESULTADOS: Encontrou-se um valor medio de retinol serico de 0,87 µmol/l (±0,38) entre as criancas investigadas. A prevalencia de niveis considerados baixos (0,35 a 0,69 µmol/l) foi de 22,5% e de niveis considerados deficientes (<0,35 µmol/l), de 9,6%, resultando em 32,1% de criancas com niveis inadequados de retinol serico. A distribuicao de retinol serico se mostrou associada com a renda per capita e o indicador peso/idade. Nao foi encontrada associacao estatisticamente significante com idade e sexo das criancas e com as variaveis maternas. CONCLUSAO: A deficiencia de vitamina A das criancas pre-escolares constitui um importante problema de saude publica. A hipovitaminose-A esta relacionada principalmente a baixa renda per capita da familia e baixo peso infantil.