ABSTRACT
La pobreza es un síndrome situacional en el que se asocian desnutrición, precarias condiciones de vivienda, bajos niveles educacionales, malas condiciones sanitarias, inestabilidad en el aparato productivo, poca participación en los mecanismos de integración social y quizás la adscripción a una escala particular de valores diferenciada de alguna manera de la del resto de la sociedad. Se evaluaron antecedentes de morbilidad y déficit nutricional y su relación con pobreza estructural en 257 niños entre 2-18 años, de un barrio del Sur de Valencia, Estado Carabobo. Metodología. Evaluación socioeconómica según Graffar; registro de antecedentes biomédicos, diagnóstico nutricional antropométrico. Resultados. Edad promedio de la población 7,76 ± 2,6 años. Estrato socioeconómico predominante IV con 55,6%. Predominio de cohabitación de hasta 5 personas por familia con estructura monofamiliar; profesión del jefe de familia, obrero especializado 49,1 %; madres con educación primaria, 47,9 %. Estado nutricional con déficit nutricional, 36,6 %. No hubo asociación significativa entre diagnóstico nutricional y número de personas por familia. Se encontró 78,3% de desnutridos en grupos familiares de más de una familia por vivienda, p<0,05. Prevalencia de diarrea e infecciones respiratorias inferiores (55,3% y 64,9%, respectivamente) en familias de más de 5 personas. El grado de instrucción de la madre mostró relación significativa con el antecedente de infecciones respiratorias inferiores. Se concluye que el déficit nutricional se relaciona con variables de pobreza estructural (número de familias por vivienda), indicativo de que los métodos de medición de pobreza permiten mostrar una evaluación integral de las poblaciones vulnerables.
Poverty, a highly predominant condition in Latin America, is associated with insufficient food intake, undernutrition, poor living conditions, low education, lack of insertion in the productive system and in the social integration network, despair and anomia. In this context, the influence of structural poverty associated variables on nutritional status was assessed in 257 children andadolescents (2-18 years of age), from a poor neighborhood in southern Valencia, Carabobo State. Methodology: Socioeconomic evaluation (Graffar-Méndez Castellano), biomedical history, anthropometric nutritional assessment (body composition, body dimension and mixed indicators) were performed. Results: Families living in Stratum IV were predominant, as well as the unifamiliar structure and 5 people per family or household. 36.6% of nutritional deficit was observed. A significant association between undernutrition and number of families per household was found, and alsobetween a history of diarrhea and acute lower respiratory infections and the number of persons per family, with more prevalence in family groups of more than 5 people. The educational level of the mother also showed a statistically significant relationship with a history of lower respiratory infections, when mothers had primary education or were literate. It is concluded that there is a strong relationship between nutritional deficit and structural poverty variables (number of families per household). The most significant association was observed between poverty measurement methods and nutritional diagnosis of deficit. Inclusion of this method in community research will allow a comprehensive assessment of vulnerable populations.
ABSTRACT
Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malnutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group : 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, B1, B2, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both caloric and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfolds thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit I the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of FSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferring concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferring concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients ar needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.