Maria José Cariri Benigna

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).

Estudo caso-controle sobre exposição precoce ao leite de vaca e ocorrência de Diabetes Mellitus tipo 1 em Campina Grande, Paraíba

OBJECTIVES: to study the relationship between early exposure to cows milk and Diabetes Mellitus, type 1 among children under 18 years old seen at the Hospital Universitario Alcides Carneiro, in Campina Grande. METHODS: case-control study. Sample of 128 individuals of both sexes. Sixty-four mothers with Diabetes Mellitus type 1 and 64 mothers of a control group. Univariate and multivariate analysis was accomplished through logistic and conditional regression. RESULTS: 84,4% of diabetic individuals were exposed to cow mild before four months of age while in the control group this percentage was 64,1%. Univariate analysis determined a significant statistic association between early exposure to cows milk and Diabetes (p = 0,01). In multivariate analysis this association remained and estimated odds ratio was of 4,09 (95% CI: 14,04; p = 0,01). CONCLUSIONS: results indicate a strong association between children with early exposure to cows milk and Diabetes Mellitus type 1 events in the population studied. Therefore, children with early exposure to cows milk have a higher chance of acquiring the disease when compared with those who were exclusively breastfed until at least until four months old.

Crescimento e estado nutricional de crianças de 0-11 anos, Estado da Paraíba (nordeste brasileiro)

Compara-se o crescimento do peso-idade e da altura-idade de 7.990 criancas de 0-11 anos, aleatoriamente selecionadas e medidas em 1981-1982 no Estado da Paraiba (nordeste do Brasil), com o de estudo global realizado no nordeste em 1974-1975, com as curvas de crescimento das referencias nacional e internacional. Os resultados colocam em evidencia um deficit de crescimento muito acentuado, sobretudo com relacao a referencia internacional. A 11 anos nitidas diferencas se manifestam: 8 ou 9 quilos para o peso, segundo o sexo, e em torno de 11 cm para a altura. Os deficits de crescimento observados poderiam ser atribuidos a grande seca de 1978-1983, em particular o deficit de crescimento do peso em funcao da idade. No entanto, o deficit de crescimento da altura em funcao da idade mostra a existencia de alteracoes mais profundas e mais insidiosas, ao longo do crescimento, manifestando-se por ma nutricao cronica, atribuida sobretudo a fatores de ordem estrutural socioeconomica. Constata-se, portanto, no decorrer da ultima decada, que eles tem sido cada vez mais deteriorados, como testemunham as alteracoes do modelo de crescimento - ele mesmo exprimindo o agravamento da situacao nutricional da regiao.Compara-se o crescimento do peso-idade e da altura-idade de 7.990 criancas de 0-11 anos, aleatoriamente selecionadas e medidas em 1981-1982 no Estado da Paraiba (nordeste do Brasil), com o de estudo global realizado no nordeste em 1974-1975, com as curvas de crescimento das referencias nacional e internacional. Os resultados colocam em evidencia um deficit de crescimento muito acentuado, sobretudo com relacao a referencia internacional. A 11 anos nitidas diferencas se manifestam: 8 ou 9 quilos para o peso, segundo o sexo, e em torno de 11 cm para a altura. Os deficits de crescimento observados poderiam ser atribuidos a grande seca de 1978-1983, em particular o deficit de crescimento do peso em funcao da idade. No entanto, o deficit de crescimento da altura em funcao da idade mostra a existencia de alteracoes mais profundas e mais insidiosas, ao longo do crescimento, manifestando-se por ma nutricao cronica, atribuida sobretudo a fatores de ordem estrutural socioeconomica. Constata-se, portanto, no decorrer da ultima decada, que eles tem sido cada vez mais deteriorados, como testemunham as alteracoes do modelo de crescimento - ele mesmo exprimindo o agravamento da situacao nutricional da regiao.

Relationship between hemoglobin, serum retinol and habitual meat consumption in the elderly: a population-based study.

Considering the scarcity of data on the relationship between hemoglobin, serum retinol and habitual meat consumption in the elderly, a cross-sectional population-based study was performed, which was representative of the population of a state capital in Northeastern Brazil, including 176 elderly aged between 60 and 90 years, who responded to questionnaires about habitual food consumption and socioeconomic aspects. Blood counts and serum retinol analyses were carried out. The prevalence of anemia was 9.58%, and 96% of elderly showing adequate serum retinol levels. The consumption of vitamin A and iron was adequate in 93.75% and 85%, respectively. There was no correlation between serum retinol and hemoglobin values (p=0.56), and as expected, there was a positive association between meat consumption and hemoglobin (p=0.02). Based on results obtained in this study, it was concluded that the maintenance of adequate vitamin A and meat intake in this population should be encouraged, which appears to be an effective intervention strategy to achieve appropriate serum retinol and hemoglobin values, and hence lower iron deficiency anemia rates.