ABSTRACT
Abstract Objective: To determine the prevalence of vitamin A deficiency (VAD) and serum concentrations of retinol, correlating them with IGF-1 concentrations in preschoolers with DS. Methods: Cross-sectional study was conducted on 47 children with DS aged 24 to 72 months, in Ribeirão Preto, Brazil. VAD was determined by the relative dose-response (RDR) test. Retinol serum concentration ≤ 0.70 μmol/L and IGF-1 serum concentration below the 3rd percentile for sex and age were considered to represent deficiency. C-reactive protein (CRP) was determined at the beginning of the study. Weight, height, and information about fever and/or diarrhea were obtained at the beginning of the study. Results: VAD prevalence was 25.5% (12/47), and 74.5% (35/47) of the children had deficient retinol before the intervention. CRP was not associated with VAD. Mean IGF-1 were 103.5 ng/mL (SD = 913) for the group with VAD and 116.3 ng/mL (SD = 54.9) for the group with no VAD (p-value = 0.85); 8.5% (4/47) of the children showed deficient IGF-1, but without VAD. No association was observed between VAD and IGF-1 deficiency. A moderate positive correlation was observed between pre-intervention retinol and IGF-1 (ρ = 0.37; p-value = 0.01). Conclusion: a high prevalence of VAD and deficient retinol was observed and there was a positive correlation between serum retinol and IGF-1.
Subject(s)
Humans , Child, Preschool , Child , Vitamin A Deficiency/epidemiology , Insulin-Like Growth Factor I/analysis , Down Syndrome , Vitamin A , Brazil/epidemiology , Prevalence , Cross-Sectional StudiesABSTRACT
Abstract Objectives: to examine the nutritional status of vitamin A in Brazilian children under 5 years old, delimiting their deficiency and associated factors. Methods: this is a systematic review of articles published between 2008 and 2018, using the SciELO, Bireme, and PubMed electronic databases. A validated instrument critically evaluated the studies. The summary measures were obtained by the random effect model, and their results are presented using the Forest Plot graph. The qualitative synthesis was based on the description of the main factors associated with Vitamin A Deficiency. Results: we included 14 cross-sectional studies with observations in basic health units, daycare centers, and households. The summary measure indicated Vitamin A Deficiency of 20% (CI95%= 17% - 23%), with high homogeneity according to the source of the sample. Lower age of the child, low birth weight, poor iron nutritional status, diarrhea, subclinical infection, inadequate basic sanitation conditions, younger mothers and less maternal educa-tion represented the main exposures associated with the outcome. Conclusion: the results show Vitamin A Deficiency as a public health problem in Brazilian children under 5 years old, especially when related to the development of infectious processes and maternal and child characteristics that show greater susceptibility.
Resumo Objetivos: examinar o estado nutricional de vitamina A em crianças brasileiras menores de 5 anos, delimitando sua deficiência e fatores associados. Métodos: trata-se de uma revisão sistemática de artigos publicados entre 2008 e 2018, a partir das bases eletrônicas SciELO, Biremee PubMed. Os estudos foram avaliados critica-mente utilizando-se um instrumento validado. As medidas de sumário foram obtidas pelo modelo de efeito aleatório, e os seus resultados apresentados por intermédio do gráfico Forest Plot. A síntese qualitativa baseou-se na descrição do principais fatores associados à Deficiência de Vitamina A. Resultados: foram incluídos 14 estudos de delineamento transversal com observações em unidades básicas de saúde, creches e domiciliares. A medida sumária apontou Deficiência de Vitamina A de 20% (IC95%= 17% - 23%), com alta homogeneidade segundo a procedência da amostra. Menor idade da criança, baixo peso ao nascer, estado nutricional de ferro defi-ciente, diarreia, infecção subclínica, condições inadequadas de saneamento básico, mães mais jovens e menor escolaridade materna representaram as principais exposições associ-adas ao desfecho. Conclusão: os resultados mostram a Deficiência de Vitamina A como problema de saúde pública nas crianças brasileiras menores de 5 anos, principalmente quando relacionada ao desenvolvimento de processos infecciosos e a características materno-infantis que denotam maior suscetibilidade.
Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Vitamin A Deficiency/epidemiology , Brazil/epidemiology , Nutritional Status , Risk FactorsABSTRACT
Introducción. La deficiencia de vitamina A (DVA) ha sido reconocida como un importante problema de salud pública en países en vías de desarrollo. Los niños en edad preescolar son grupos de riesgo en poblaciones vulnerables. El objetivo fue determinar la prevalencia de DVA y los factores asociados en una muestra de niños de edad preescolar. Material y métodos. Estudio de corte transversal que incluyó a niños de 1 a 6 años beneficiarios de planes sociales, atendidos en centros de atención primaria de la periferia de la ciudad de la Plata, Buenos Aires. Se determinó el contenido de vitamina A midiendo retinol sérico, por cromatografía líquida, y se registraron parámetros antropométricos e ingesta alimentaria. Se utilizó un modelo de regresión logística multinomial para evaluar la asociación entre las variables. Resultados. Se analizaron datos de 624 niños. La media geométrica de retinol fue 23,8 pg/dl (IC 95 %: 23,3-24,3). Las prevalencias de DVA y riesgo de DVA fueron 24,3 % y 57,4 %, respectivamente. Los niveles de retinol fueron significativamente menores en niños varones, con bajo peso y aquellos con bajo consumo (menor del primer tercilo de distribución). El análisis multivariable mostró asociación significativa entre DVA y el sexo masculino (OR: 1,93; IC 95 %: 1,15-3,24) y con el bajo consumo (OR: 1,48; IC 95 %: 1,15-2,62). Conclusión. La prevalencia de DVA hallada (24,3 %) constituye un importante problema de salud pública en esta población. Los factores asociados a dicha deficiencia fueron el sexo masculino y el bajo consumo.
Introduction. Vitamin A deficiency (VAD) has been recognized as an important public health problem in developing countries. Preschoolers account for risk groups within vulnerable populations. The objective of this study was to determine the prevalence of VAD and associated factors in a sample of preschoolers. Material and methods. Cross-sectional study with children aged 1-6 years receiving social assistance and seen at primary health care centers in the outskirts of the city of La Plata, Buenos Aires. Vitamin A levels were determined by measuring serum retinol with a liquid chromatography; anthropometric parameters and dietary intake were recorded. A multinomial logistic regression model was used to assess the association among outcome measures. Results. Data from 624 children were analyzed. The geometric mean of retinol was 23.8 pg/dL (95 % CI: 23.3-24.3). The prevalence of VAD and the risk for VAD were 24.3 % and 57.4 %, respectively. Retinol levels were significantly lower among boys, low-weight children, and those with low intake (below the first tertile of distribution). The multivariate analysis showed a significant association between VAD and male sex (odds ratio: 1.93; 95 % CI: 1.15-3.24) and between VAD and low intake (odds ratio: 1.48; 95 % CI: 1.15-2.62). Conclusion. The prevalence of VAD (24.3 %) is a major public health problem in this population. VAD-associated factors were male sex and low vitamin A intake.
Subject(s)
Humans , Infant , Child, Preschool , Child , Vitamin A Deficiency/blood , Vitamin A Deficiency/epidemiology , Risk Factors , Argentina , Poverty , Cross-Sectional StudiesABSTRACT
RESUMO Objetivo: Analisar variáveis associadas à deficiência de vitamina A (DVA) em crianças brasileiras de 6 a 59 meses de idade, considerando um modelo hierárquico de determinação. Métodos: Trata-se de um recorte da Pesquisa Nacional de Demografia e Saúde da Criança e da Mulher (PNDS), realizada em 2006. A análise dos dados incluiu 3.417 crianças de seis a 59 meses com dados de retinol. A DVA foi definida como retinol sérico <0,7 mmol/L. Realizaram-se análises univariada e ajustada por regressão múltipla de Poisson, com nível de significância de 5%, utilizando-se modelo hierárquico de determinação que considerou três blocos de variáveis: vinculadas aos processos estruturais da sociedade (variáveis socioeconômicas e demográficas); ao ambiente imediato da criança (variáveis maternas, de segurança e consumo alimentar); e individuais (características biológicas da criança). Os dados foram expressos em razão de prevalência (RP). Resultados: Após ajuste para variáveis de confusão, permaneceram associadas à DVA: residir no Sudeste [RP=1,59; IC95% 1,19-2,17] e no Nordeste [RP=1,56; IC95% 1,16-2,15]; em zona urbana [RP=1,31; IC95% 1,02-1,72]; ter mãe com idade ≥36 anos [RP=2,28; IC95% 1,37-3,98]; sendo proteção consumir carne pelo menos uma vez nos últimos sete dias [RP=0,24; IC95% 0,13-0,42]. Conclusões: As principais variáveis associadas à DVA no país relacionam-se aos processos estruturais da sociedade e ao ambiente imediato da criança, e não aos individuais.
ABSTRACT Objective: To analyze the variables associated with vitamin A deficiency (VAD) in Brazilian children aged 6 to 59 months, considering a hierarchical model of determination. Methods: This is part of the National Survey on Demography and Health of Women and Children, held in 2006. Data analysis included 3,417 children aged from six to 59 months with retinol data. Vitamin A deficiency was defined as serum retinol <0.7 mol/L. Univariate and multiple Poisson regression analysis were performed, with significance level set at 5%, using a hierarchical model of determination that considered three conglomerates of variables: those linked to the structural processes of community (socioeconomic-demographic variables); to the immediate environment of the child (maternal variables, safety and food consumption); and individual features (biological characteristics of the child). Data were expressed in prevalence ratio (PR). Results: After adjustment for confounding variables, the following remained associated with VAD: living in the Southeast [PR=1,59; 95%CI 1,19-2,17] and Northeast [PR=1,56; 95%CI 1,16-2,15]; in urban area [RP=1,31; 95%CI 1,02-1,72]; and mother aged ≥36 years [RP=2,28; 95%CI 1,37-3,98], the consumption of meat at least once in the last seven days was a protective factor [PR=0,24; 95%CI 0,13-0,42]. Conclusions: The main variables associated with VAD in the country are related to structural processes of society and to the immediate, but not individual, environment of the child.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Vitamin A Deficiency/epidemiology , Brazil , Risk FactorsABSTRACT
Resumo Revisão sistemática da caracterização nutricional e sociodemográfica de lactantes, por meio da literatura publicada entre 2004-2014, indexadas na Biblioteca Virtual de Saúde e Medline. Foram identificados 561 artigos com os descritores: "Leite Humano" e "Bancos de Leite"; palavras-chave: "Perfil", "Nutricional", "Doadoras de leite", "Nutriz" e "Nutrizes"; resumos disponíveis; data e idioma. Destes, 84,1% foram excluídos por não atenderem a temática, 1,8% por se tratarem de revisão e 7,5% por estarem indisponíveis para consulta. Foram selecionados 37 artigos, dos quais, 18,9% analisaram o perfil da doadora de LH. Do total, 89,2% referiram a idade, maioria entre 20 e 30 anos. Nível de escolaridade foi mencionado em 32,4%, variando entre ensino fundamental e superior. Quanto à renda, encontrou-se predominância de baixo nível socioeconômico. No âmbito nutricional, 45,9% dos estudos avaliaram o Índice de Massa Corporal e 29,4% o relataram na faixa de excesso de peso. Observaram-se carências, sobretudo de vitamina A, com as frequências de inadequações entre 9-26%. Observou-se predominância de adultas jovens, escolaridade variada, baixa renda e deficiências nutricionais demandando intervenções para contribuir na melhoria da saúde e aumento das doações de LH.
Abstract A systematic review of nutritional and sociodemographic characteristics of nursing mothers, using the published literature from 2004 to 2014 in the Biblioteca Virtual de Saúde and Medline databases. Using the following key words, 561 articles were identified: "Human Milk" and "Milk Banks"; keywords: "Profile," "Nutritional," "Milk Donor," "Nursing Mother" and "Nursing Mothers"; available abstracts; date and language. From these, 84.1% were excluded for not dealing with the established subject, 1.8% for being a review and 7.5% for the unavailability of abstracts for study. Thirty-seven articles were selected, of which 18.9% analyzed the profile of the HM donor. Of the total, 89.2% reported age, the majority between 20 and 30 years of age. The level of schooling was mentioned in 32.4% ranging from elementary school and higher education. With respect to income, a higher prevalence of low socioeconomic status was observed. About the nutritional status, 45.9% of the studies measured the body mass index and 29.4% reported the predominance of excess weight. There were deficiencies, particularly of vitamin A, with frequencies between 9% and 26%. A majority of young adult mothers, varied schooling, low income and nutritional deficiencies were noted, demanding interventions to improve health and increase HM donations.
Subject(s)
Humans , Female , Adult , Young Adult , Lactation , Nutritional Status , Mothers , Socioeconomic Factors , Vitamin A Deficiency/epidemiology , Body Weight , Breast Feeding , Body Mass IndexABSTRACT
OBJECTIVE: To analyze adherence to the recommended iron, zinc and multivitamin supplementation guidelines for preemies, the factors associated with this adherence, and the influence of adherence on the occurrence of anemia and iron, zinc and vitamin A deficiencies. METHODS: This prospective cohort study followed 58 preemies born in 2014 until they reached six months corrected age. The preemies were followed at a referral secondary health service and represented 63.7% of the preterm infants born that year. Outcomes of interest included high or low adherence to iron, zinc and multivitamin supplementation guidelines; prevalence of anemia; and prevalences of iron, zinc, and vitamin A deficiencies. The prevalence ratios were calculated by Poisson regression. RESULTS: Thirty-eight (65.5%) preemies presented high adherence to micronutrient supplementation guidelines. At six months of corrected age, no preemie had vitamin A deficiency. The prevalences of anemia, iron deficiency and zinc deficiency were higher in the low-adherence group but also concerning in the high-adherence group. Preemies with low adherence to micronutrient supplementation guidelines were 2.5 times more likely to develop anemia and 3.1 times more likely to develop zinc deficiency. Low maternal education level increased the likelihood of nonadherence to all three supplements by 2.2 times. CONCLUSIONS: Low maternal education level was independently associated with low adherence to iron, zinc and vitamin A supplementation guidelines in preemies, which impacted the prevalences of anemia and iron and zinc deficiencies at six months of corrected age.
Subject(s)
Humans , Male , Female , Infant , Anemia, Neonatal/drug therapy , Anemia, Neonatal/epidemiology , Iron/deficiency , Medication Adherence/statistics & numerical data , Micronutrients/administration & dosage , Vitamin A Deficiency/epidemiology , Zinc/deficiency , Age Factors , Anemia, Iron-Deficiency/epidemiology , Brazil/epidemiology , Dietary Supplements/statistics & numerical data , Infant, Premature , Iron/blood , Prevalence , Prospective Studies , Reference Values , Regression Analysis , Risk Factors , Socioeconomic Factors , Statistics, Nonparametric , Time Factors , Treatment Outcome , Vitamin A Deficiency/blood , Zinc/bloodABSTRACT
Resumo Objetivos Revisar os artigos sobre o estado nutricional de ferro, vitamina A e zinco em crianças brasileiras assistidas em creches, enfocando métodos diagnósticos, prevalências das respectivas deficiências e fatores associados. Métodos A pesquisa de artigos foi efetuada nas bases PubMed, Lilacs e SciELO. Foram incluídos estudos observacionais com amostras representativas aleatórias que utilizaram indicadores bioquímicos para avaliar o estado nutricional de ferro, vitamina A e zinco de crianças assistidas em creches. Calcularam-se as prevalências médias ponderadas de anemia e de deficiência de vitamina A. Computaram-se as variáveis associadas à anemia. Resultados Foram incluídos 21 estudos, nos quais o estado nutricional de ferro, vitamina A e zinco foi analisado em 17, quatro e três, respectivamente. As prevalências médias ponderadas de anemia e de deficiência de vitamina A foram de 42,7% e 12,5%, respectivamente. Crianças de menor idade e de pior condição socioeconômica representaram as principais condições explicativas para a ocorrência de anemia. Conclusões Os resultados sugerem altas prevalências de anemia e de deficiência de vitamina A entre as crianças brasileiras assistidas em creches com perspectivas etiológicas centradas nas doenças infecciosas.
Abstract The scope of the study was to review the scientific publications on the nutritional status of iron, vitamin A and zinc among Brazilian children attending daycare centers, focusing on diagnostic methods, the prevalence of respective deficiencies and associated factors. A review of the literature was conducted in the PubMed, LILACS and SciELO databases. Observational studies with random representative samples using biochemical indicators to evaluate the nutritional status of iron, vitamin A and zinc of children attending public daycare centers were included. The average weighted prevalence for anemia and vitamin A deficiency was estimated. The variables associated with anemia were computed. Twenty-one observational studies were included, in which the nutritional status of iron, vitamin A and zinc were analyzed in 17, 4 and 3, respectively. The average weighted prevalence of anemia and vitamin A deficiency were 42.7% and 12.5%, respectively. Young children and children living in less favorable socioeconomic situations represented the main explanatory conditions predominantly associated with the occurrence of anemia. The results suggest a high prevalence of anemia, as well as vitamin A deficiency in Brazilian children attending daycare centers, with etiological prospects focused on infectious diseases.
Subject(s)
Humans , Child , Vitamin A Deficiency/epidemiology , Zinc/deficiency , Iron/deficiency , Socioeconomic Factors , Brazil/epidemiology , Child Day Care Centers , Nutritional Status , Prevalence , Micronutrients/deficiency , Anemia/epidemiologyABSTRACT
OBJECTIVE: to estimate survival, mortality and cause of death among users or not of hydroxyurea with sickle cell disease. METHOD: cohort study with retrospective data collection, from 1980 to 2010 of patients receiving inpatient treatment in two Brazilian public hospitals. The survival probability was determined using the Kaplan-Meier estimator, survival calculations (SPSS version 10.0), comparison between survival curves, using the log rank method. The level of significance was p=0.05. RESULTS: of 63 patients, 87% had sickle cell anemia, with 39 using hydroxyurea, with a mean time of use of the drug of 20.0±10.0 years and a mean dose of 17.37±5.4 to 20.94±7.2 mg/kg/day, raising the fetal hemoglobin. In the comparison between those using hydroxyurea and those not, the survival curve was greater among the users (p=0.014). A total of 10 deaths occurred, with a mean age of 28.1 years old, and with Acute Respiratory Failure as the main cause. CONCLUSION: the survival curve is greater among the users of hydroxyurea. The results indicate the importance of the nurse incorporating therapeutic advances of hydroxyurea in her care actions. .
OBJETIVO: estimar a sobrevida, mortalidade e causa de morte em usuários ou não de hidroxiureia com doença falciforme. MÉTODO: coorte retrospectiva de 1980 a 2010, de pacientes internados em dois hospitais públicos brasileiros. Determinou-se a probabilidade de sobrevida com Kaplan-Meier, cálculos de sobrevida (SPSS versão 10.0), comparação entre curvas de sobrevida e método Log Rank. Nível de significância p=0,05. RESULTADOS: de 63 pacientes, 87% estavam com anemia falciforme, sendo 39 em uso de hidroxiureia, com média de idade na instituição do fármaco de 20,0±10,0 anos e dosagem média de 17,37±5,4 a 20,94±7,2mg/kg/dia, elevando a hemoglobina fetal. Na comparação de usuários e não usuários de hidroxiureia, a curva de sobrevida foi maior nos usuários (p=0,014). Ocorreram 10 óbitos, com idade média de 28,1 anos, tendo como causa principal a Insuficiência Respiratória Aguda. CONCLUSÃO: a curva de sobrevida é maior nos usuários de hidroxiureia. Os resultados apontam a importância do enfermeiro incorporar avanços terapêuticos da hidroxiureia em suas ações assistenciais. .
OBJETIVO: estimar la sobrevida, la mortalidad y la causa de muerte de usuarios y no usuarios de hidroxiurea con enfermedad falciforme. MÉTODO: cohorte retrospectiva de 1980 a 2010 de pacientes internados en dos hospitales públicos brasileños. Se determinó la probabilidad de sobrevida con Kaplan-Meier, cálculos de sobrevida (SPSS versión 10.0), comparación entre curvas de sobrevida, método Log Rank. Nivel de significado p=0,05. RESULTADOS: de 63 pacientes, 87% estaban con anemia falciforme, siendo que 39 usaban hidroxiurea, promedio de edad en la institución del fármaco de 20,0±10,0 años y dosificación promedio de 17,37±5,4 a 20,94±7,2mg/kg/día, elevando la hemoglobina fetal. En la comparación de usuarios y no usuarios de hidroxiurea, la curva de sobrevida fue mayor en los usuarios (p=0,014). Ocurrieron 10 muertes, edad promedio de 28,1 años, siendo la Insuficiencia Respiratoria Aguda la causa principal. CONCLUSIÓN: la curva de sobrevida es mayor en los usuarios de hidroxiurea. Los resultados apuntan la importancia de que el enfermero incorpore los avances terapéuticos de la hidroxiurea en sus acciones asistenciales. .
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Anemia, Iron-Deficiency/epidemiology , Malnutrition/epidemiology , Nutritional Status , Vitamin A Deficiency/epidemiology , alpha-Thalassemia/epidemiology , Anemia, Iron-Deficiency/complications , Cross-Sectional Studies , Hemoglobins , Kenya/epidemiology , Logistic Models , Multivariate Analysis , Malnutrition/blood , Nutrition Assessment , Vitamin A Deficiency/complications , alpha-Thalassemia/complications , alpha-Thalassemia/geneticsABSTRACT
OBJECTIVE: To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. METHODS: This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n = 692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. RESULTS: The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p < 0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p < 0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r = 0.597; p < 0.001) and hemoglobin vs. retinol serum (r = 0.770; p < 0.001). CONCLUSIONS: Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency. .
OBJETIVO: Analisar a ocorrência de anemia e de deficiência de ferro em crianças de 1 a 5 anos e a associação destes desfechos com a deficiência de retinol. MÉTODOS: Trata-se de um estudo observacional analítico do tipo transversal, realizado no município de Vitória - ES, entre abril e agosto de 2008, com crianças (n = 692) saudáveis de 1 a 5 anos, residentes em áreas de abrangência de Unidades Básicas de Saúde. Foram avaliados dados sociodemográficos, econômicos, dietéticos (ingestão de energia, proteína, ferro e vitamina A), antropométricos (índice de massa corporal-por-idade e estatura-por-idade) e bioquímicos (níveis séricos de ferritina, hemoglobina e retinol). RESULTADOS: Detectou-se anemia, deficiência de ferro e deficiência de retinol em 15,7%, 28,1% e 24,7% das crianças, respectivamente. A análise univariada evidenciou maior ocorrência de anemia (RP: 4,62; IC 95%: 3,36; 6,34, p < 0.001) e de deficiência de ferro (RP: 4,51; IC 95%: 3,30; 6,17, p < 0.001) entre crianças que apresentavam deficiência de retinol. As mesmas relações se mantiveram após o ajuste pelas variáveis socioeconômicas, demográficas, dietéticas e antropométricas. Houve relação positiva entre os valores de ferritina sérica vs. retinol (r = 0,597; p < 0,001) e hemoglobina vs. retinol (r = 0,770; p < 0,001). CONCLUSÕES: A anemia e a deficiência de ferro mostraram-se associadas com baixos níveis de retinol em crianças de 1 a 5 anos, e houve correlação positiva dos níveis de retinol com os de ferritina sérica e hemoglobina. Isto torna importante iniciativas que estimulem o desenvolvimento de novos tratamentos e a ampliação de pesquisas em relação à deficiência ...
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Anemia, Iron-Deficiency/complications , Anemia/complications , Iron/deficiency , Vitamin A Deficiency/complications , Vitamin A/blood , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/epidemiology , Anemia/blood , Anemia/epidemiology , Body Height , Body Weight , Brazil/epidemiology , Cross-Sectional Studies , Dietary Supplements , Feeding Behavior , Ferritins/blood , Hemoglobins/analysis , Socioeconomic Factors , Vitamin A Deficiency/blood , Vitamin A Deficiency/epidemiologyABSTRACT
Objective: To identify the prevalence and factors associated with vitamin A deficiency (VAD) in children and adolescents. Methods: This was a cross-sectional study involving 546 schoolchildren, aged between 7 and 14 years, of both genders, enrolled in public elementary schools. Blood was collected for measurement of serum retinol. The retinol concentration in the samples was determined by high performance liquid chromatography (HPLC). Data were collected on anthropometrics, dietary, demographic, and socioeconomic factors. Polytomous logistic regression was used to evaluate the associations of interest. Results: Approximately 27.5% of the students had retinol values < 30 μg/dL. The multivariate analysis showed, after the appropriate adjustments, a positive and statistically significant association of moderate/severe VAD (OR = 2.19; 95% CI 1.17 to 4.10) and marginal VAD (OR = 2.34; 95% CI 1.47 to 3.73) with age < 10 years. There was also association of VAD moderate/severe (OR = 2.01; 95% CI 1.01 to 5.05) and borderline VAD (OR = 2.14; 95% CI: 1.08 to 4.21) with the anthropometric status of underweight. Lower intake of retinol was detected among those with severe VAD. Conclusion: VAD is a health concern among children and adolescents. Lower weight and younger schoolchildren had greater vulnerability to VAD. .
Objetivo: Identificar prevalência e fatores associados à deficiência de vitamina A (DVA) entre crianças e adolescentes. Métodos: Estudo transversal envolvendo 546 escolares, com idade entre 7 e 14 anos, de ambos os sexos, matriculadas na rede pública do ensino fundamental. O sangue foi coletado para dosagem dos níveis séricos de retinol. A concentração de retinol das amostras foi determinada pelo método da cromatografia líquida de alta eficiência (CLAE). Coletaram-se dados antropométricos, alimentares, demográficos e socioeconômicos. Utilizou-se da regressão logística politômica para avaliar as associações de interesse. Resultados: Aproximadamente 27,5% dos estudantes apresentaram valores de retinol < 30 μg/dL. Em análise multivariada, verificou-se, após devidos ajustes, associação positiva e estatisticamente significante da DVA moderada/grave (OR = 2,19; IC 95%: 1,17-4, 10) e da DVA marginal (OR = 2,34; IC 95%: 1,47-3,73) com a idade < 10 anos. Verificou-se, igualmente, associação da DVA moderada/grave (OR = 2,01; IC 95%: 1,01-5,05) e DVA marginal (OR = 2,14; IC 95%: 1,08-4,21) com o estado antropométrico magreza. Menor consumo de retinol foi detectado entre aqueles com DVA grave. Conclusão: A deficiência de vitamina A configura-se como um problema de saúde preocupante entre os escolares e adolescentes. Constatou-se maior vulnerabilidade dos escolares de baixo peso e mais jovens à DVA. .
Subject(s)
Adolescent , Child , Female , Humans , Male , Vitamin A Deficiency/blood , Vitamin A Deficiency/epidemiology , Vitamin A/blood , Age Factors , Body Height , Brazil/epidemiology , Chromatography, Liquid , Cross-Sectional Studies , Prevalence , Risk Factors , StudentsABSTRACT
O objetivo do presente estudo foi descrever a prevalência e os fatores associados à anemia e à deficiência de vitamina A (DVA) em crianças menores de cinco anos assistidas pela Estratégia Saúde da Família. Estudo transversal, realizado em Pernambuco, Brasil, em 2006. Foram selecionadas crianças entre 6 e 59 meses de idade, que tiveram realizadas dosagens de hemoglobina e retinol sérico, perfazendo amostras de 945 e 563 crianças respectivamente. A presença de anemia foi determinada pelo nível de hemoglobina < 11 g/dL e DVA pelo nível de retinol sérico < 0,70 μmol/L. Realizaram-se análises univariada e ajustada por regressão múltipla de Poisson, utilizando modelo hierarquizado. A prevalência de anemia foi de 35%, diminuindo com o aumento do número de pessoas por cômodo, idade materna e idade da criança. No que concerne à DVA, sua prevalência foi de 16%, aumentando em locais onde o destino do lixo era inadequado e em crianças que apresentaram diarreia nos últimos quinze dias. A prevalência de anemia foi maior que o dobro encontrada para a DVA, chamando atenção a influência dos fatores ambientais sobre a DVA.
The scope of this study was to describe the prevalence and factors associated with anemia and vitamin A deficiency (VAD) in children under five years old assisted under the Family Health Program. A cross-sectional study was conducted in Pernambuco, Brazil, in 2006. Children between 6 and 59 months-old, who had performed measurements of hemoglobin and serum retinol, were selected using samples from 945 and 563 children respectively. Anemia was determined by the hemoglobin level < 11 g/dL and VAD by serum retinol < µmol/L. Univariate and multivariate analyses were performed by Poisson multiple regression using a hierarchical model. Anemia prevalence was 35%, decreasing with the increase number of people per room, maternal age and the child's age. With respect to VAD, its prevalence was 16%, rising in places where garbage disposal was inadequate and in children who had suffered from diarrhea in the previous fifteen days. The prevalence of anemia was more than double that found for VAD, highlighting the influence of environmental factors on VAD.
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Anemia/epidemiology , Vitamin A Deficiency/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Family Health , Government Programs , PrevalenceABSTRACT
El presente estudio buscó analizar la asociación entre la (in)seguridad alimentaria y el estado nutricional de niños preescolares asistidos en jardines infantiles. La seguridad alimentaria fue evaluada a través de la Escala Brasileña de Inseguridad Alimentaria (EBIA). El estado nutricional se evaluó a través del peso/edad, talla/edad, hemoglobina, retinol sérico y zinc sérico. Fueron encontradas prevalencias de déficit de estatura (6,2%), déficit de peso/edad (2,1%), deficiencia de vitamina A (24,4%), anemia (15,5%) y deficiencia de zinc (15,0%). La inseguridad alimentaria familiar fue caracterizada en 64,2% de las familias predominando la forma leve (32,6%). El estudio concluye que la inseguridad alimentaria estimada por la EBIA no se asoció a los Escore-z de crecimiento ni a las concentraciones de retinol sérico, hemoglobina y zinc sérico.
This study sought to examine the association between the food (in)security and nutritional status of preschool children attended in daycare centers. Food security was assessed using the Brazilian Food Insecurity Scale. The nutritional status was evaluated using the weight/height, weight/age, height/age, hemoglobin, serum retinol and serum zinc status. The prevalence of stunting (6.2%), overweight (3.1%), underweight (2.1%), vitamin A deficiency (24.4%), anemia (15.5%), and zinc deficiency (15%) was established. Food insecurity was found in 64.4% of the families, predominantly in its mild form (32.6%). This study concludes that food insecurity as measured by the EBIA was not associated with Z-score growth or with vitamin A, hemoglobin and zinc biochemical concentrations.
Subject(s)
Humans , Male , Female , Child, Preschool , Food Supply , Growth , Hemoglobins/analysis , Nutritional Status , Vitamin A/blood , Zinc/blood , Body Height , Body Weight , Brazil , Cross-Sectional Studies , Deficiency Diseases/epidemiology , Hemoglobins/deficiency , Vitamin A Deficiency/epidemiology , Zinc/deficiencyABSTRACT
Identificar os fatores associados à hipovitaminose A em crianças da região semiárida de Alagoas. MÉTODOS: estudo transversal com amostra probabilística de 551 crianças menores de cinco anos. Os níveis séricos de retinol foram aferidos usando-se cromatografia líquida de alta eficiência. Na identificação da associação entre as variáveis independentes e hipovitaminose A (retinol <20 µg/dL) utilizou-se a razão de prevalência (RP) e respectivo IC95 por cento calculados por regressão de Poisson com ajuste robusto da variância, tanto na análise bruta quanto na ajustada. Nesta, foram incluídas todas as variáveis que naanálise bruta atingiram p<0,1. Associações foram consideradas estatisticamente significantes quando p<0,05. RESULTADOS: a prevalência de hipovitaminose A foi de 45,4 por cento e as variáveis que se mantiveram associadas após análise multivariável foram a baixa escolaridade materna (RP=1,66; IC95 por cento: 1,12-2,44), obaixo peso ao nascer (RP=1,41; IC95 por cento: 1,01-1,98) eter de 12,1 a 24 meses (RP=1,45; IC95 por cento: 1,04-2,02). CONCLUSÕES: evidencia-se a relevância epidemiológica da hipovitaminose A em crianças do semiárido alagoano. Crianças nascidas com baixo peso, com mães de baixa escolaridade e no segundo ano de vida devem receber atenção prioritária...
To identify the factors associated with hypovitaminosis A in children in the semi-arid region of the Brazilian State of Alagoas. METHODS: a cross-sectional study was carried outwith a probabilistic sample of 551 children aged under five years. Serum levels of retinol were measured using high-efficiency liquid chromatography. In order to identify any associations between the independent variables and hypovitaminosis A (retinol <20 µg/dL) the prevalence ration (PR) was used with a confidence interval of 95 percent calculated using the Poisson regression, with a robust adjustment for variance, both in the raw analysis and in theadjusted one. The latter included all the variables from the raw analysis for which p<0.1. Associations were considered statistically significant when p<0.05. RESULTS: the prevalence of hypovitaminosis A was 45.4 percent and the variables that remained associated in the multivariable analysis were low maternal schooling (PR=1.66; CI95 percent: 1.12-2.44), low birthweight (RP=1,41; IC95 percent: 1,01-1,98) and being agedbetween 12.1 and 24 months (PR=1.45; CI95 percent: 1.04-2.02). CONCLUSIONS: this reveals that hypovitaminosis A is epidemiologically significant in children in the semi-arid region of Alagoas. Low birth weight newborns in the second year of life, born to mothers with a low level of education, should therefore receive priority health care...
Subject(s)
Humans , Child, Preschool , Child , Vitamin A Deficiency/epidemiology , Vitamin A Deficiency/ethnology , Public Policy , Social Vulnerability , Deficiency Diseases/ethnology , Epidemiologic FactorsABSTRACT
OBJETIVO: Analisar a prevalência da deficiência de vitamina A em crianças e os fatores associados. MÉTODOS: Estudo de corte transversal de base populacional realizado com 1.211 crianças de seis a 59 meses de idade, de ambos os sexos, procedentes da área urbana de nove cidades do estado da Paraíba, Brasil. O estado nutricional de vitamina A foi avaliado pelas concentrações séricas de retinol e presença de infecção subclínica avaliada pelas concentrações de proteína C-reativa. Foram investigadas as condições socioeconômicas, demográficas, de saneamento, além da suplementação prévia com vitamina A. Foram consideradas com deficiência de vitamina A as crianças com concentrações de retinol sérico < 0,70 µmol/L. Níveis séricos de vitamina A < 0,70 µmol/L com prevalência ≥ 20% foram considerados como grave problema de saúde pública. Análises uni e multivaridas foram conduzidas para testar associações estatísticas (p < 0,05). RESULTADOS: A prevalência de deficiência de vitamina A foi de 21,8% (IC95% 19,6;24,2), mostrando associação com a presença de infecção subclínica e ausência de água no domicílio. A prevalência de deficiência de vitamina A foi de 21,8% (IC95% 19,6;24,2). Após ajuste para confundimento, a deficiência de vitamina A mostrou-se associada com a presença de infecção subclínica e com a ausência de água no domicílio. A ocorrência da deficiência de vitamina A foi quatro vezes maior (IC95% 1,49;10,16) em crianças com infecção subclínica e sem água no domicilio, comparativamente às crianças ...
OBJECTIVE To estimate the prevalence of vitamin A deficiency and its associated factors in children. METHODS A cross-sectional population-based study, involving 1,211 children of both sexes, aged between six and 59 months old, was carried out in the urban zone of 9 cities in the state of Paraiba, Northeastern Brazil. Vitamin A status was assessed by serum retinol levels (high performance liquid chromatography – HPLC) and subclinical infection was assessed by C-reactive protein concentrations. Socioeconomic, demographic and sanitation conditions, as well as vitamin A supplement intake, were also evaluated. Children with serum retinol concentrations RESULTS The prevalence of vitamin A deficiency was 21.8% (95%CI 19.6;24.2), showing an association with subclinical infection and lack of indoor plumbing. The prevalence of vitamin A deficiency was 21.8% (95%CI 19.6;24.2). After adjustment, vitamin A deficiency was found to be linked with subclinical infection and lack of indoor plumbing. Vitamin A deficiency was four times higher (CI95% 1.49;10.16) in children with subclinical infection whose homes were without indoor plumbing, compared to children who were not infected and with indoor plumbing in their homes. CONCLUSIONS Despite activities aimed at the prevention and control of vitamin A deficiency, hypovitaminosis A, remains a public health concern among children under five. .
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Vitamin A Deficiency/epidemiology , Brazil/epidemiology , C-Reactive Protein , Cross-Sectional Studies , Nutritional Status , Prevalence , Risk Factors , Socioeconomic Factors , Urban Population/statistics & numerical data , Vitamin A Deficiency/blood , Vitamin A Deficiency/etiologyABSTRACT
Analisou-se a prevalência e os fatores associados à deficiência de vitamina A (DVA) em mães (664) e seus filhos (790) menores de cinco anos em Pernambuco/2006. Estudo transversal populacional, com amostra representativa do meio urbano e rural. A DVA foi definida como níveis de retinol sérico < 20µg/dL para os dois grupos (mães e filhos). Análises bi e multivariadas foram realizadas utilizando o modelo log-log complementar como função de ligação adotando-se modelo de ordenação hierárquica explicativa da DVA para as crianças e modelo logístico para as mães. A prevalência de DVA foi 6,9% nas mães e 16,1% em seus filhos, com ocorrências semelhantes para cada grupo na comparação urbano x rural. Na área urbana, o regime de ocupação da moradia teve relação significante com a DVA nas mães. Para crianças urbanas, após o ajuste final do modelo, figuraram como variáveis preditivas a idade da mãe; nº de consultas pré-natais e peso ao nascer. No meio rural a DVA materna se associou à DVA dos filhos RP = 3,99 (IC:1,73-9,19), ao peso ao nascer e diarreia nos últimos 15 dias. A DVA mantém-se como um problema de saúde pública em Pernambuco, com marcantes diferenças de prevalência e fatores associados em mães e filhos.
The prevalence and risk factors associated with vitamin A deficiency (VAD) were analyzed in 664 mothers and their 790 children under the age of five in Pernambuco in 2006. A population-based cross-sectional study, with a representative sample in urban and rural areas was conducted. VAD was defined as serum retinol levels < 20 mg/dL for both groups (mothers and children). Bi and multivariate analysis were performed using the complementary log-log model as a link function adopting a model of explanatory hierarchical order of VAD to children and a logistic model for mothers. The prevalence of VAD was 6.9% in mothers and 16.1% in their children, with similar statistics for urban and. rural groups. In the urban area, the housing occupation regime had a significant association with VAD in mothers. After the final adjustment of the model for urban children, the mother's age, the number of pre-natal consultations and birth weight were featured as predictive variables. In rural areas, VAD in mothers is associated with VAD in children; PR= 3.99 (95% CI:1.73-9.19), with their birth weight and the incidence of diarrhea in the previous 15 days. VAD continues to be a public health issue in the state of Pernambuco, with marked variations in prevalence and associated factors in mothers and children.
Subject(s)
Adolescent , Adult , Child, Preschool , Female , Humans , Infant , Middle Aged , Young Adult , Family Health , Vitamin A Deficiency/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Mothers , Prevalence , Risk Factors , Rural PopulationABSTRACT
OBJETIVO: Quantificar a concentração de vitamina A no leite maduro de nutrizes assistidas em maternidade pública no município do Rio de Janeiro e avaliar a sua relação com variáveis sociodemográficas e grau de conhecimento de nutrição. MÉTODOS: Para a quantificação do retinol, foram coletadas amostras de 10 mL de leite maduro. Os pontos de corte adotados para identificação da deficiência de vitamina A e constituição de reserva hepática foram de < 1,05 µmol/L e > 2,3 µmol/L, respectivamente. Foram avaliadas, ainda, as variáveis: grau de conhecimento de nutrição, sexo, idade, renda familiar, escolaridade, condições de saneamento básico, número de moradores na residência, idade materna e assistência pré-natal. Resultados: Participaram do estudo 196 nutrizes, com concentração média de vitamina A no leite maduro de 1,76±0,85 µmol/L e prevalência de 20,5% de deficiência de vitamina A. Não houve diferença na concentração de vitamina A no leite das nutrizes segundo as variáveis sociodemográficas e conhecimento de nutrição. Apenas 38,9% das nutrizes apresentavam concentração de vitamina A no leite suficiente para constituição de reserva hepática dos lactentes. RESULTADOS: Participaram do estudo 196 nutrizes, com concentração média de vitamina A no leite maduro de 1,76±0,85 µmol/L e prevalência de 20,5% de deficiência de vitamina A. Não houve diferença na concentração de vitamina A no leite das nutrizes segundo as variáveis sociodemográficas e conhecimento de nutrição. Apenas 38,9% das nutrizes apresentavam concentração de vitamina A no leite suficiente para constituição de reserva hepática dos lactentes. CONCLUSÕES: Os achados aqui apresentados revelam alta prevalência de inadequação do estado nutricional de vitamina A materno e do lactente, concordante com a prevalência nacional descrita em mulheres em idade fértil e crianças brasileiras, e que as medidas de intervenção para combate à carência devem ser estendidas a todas as gestantes e puérperas, independentemente das condições sociodemográficas e do grau de conhecimento de nutrição, visando melhorar a saúde do binômio mãe/filho.
OBJECTIVE: To quantify vitamin A levels in mature milk of 196 nursing women who were treated at the Maternity School of Rio de Janeiro and to evaluate its correlation with sociodemographic variables and degree of nutrition knowledge. METHODS: To quantify retinol concentrations, 10 mL of mature milk were collected by manual expression of one breast, 2 hours after the last feed, in the morning period. Values below 1.05 µmol/L and 2.3 µmol/L were considered inadequate to meet satisfactory intake and to constitute vitamin A liver reserve, respectively. The following variables were also assessed: sex, age, familiar income, maternal education, basic sanitation conditions, number of people in the household, maternal age, prenatal care, and degree of nutrition knowledge. RESULTS: Among the 196 lactating mothers analyzed, the average vitamin A concentration observed in mature milk was 1.76±0.85 µmol/L and prevalence of vitamin A deficiency was observed in 20.5% mothers. There was no significant difference between vitamin A levels in maternal milk and the variables socioeconomic status and nutrition knowledge. Only 38.9% of lactating women presented enough vitamin A concentrations in milk for the infants' liver reserves (2.3 µmol/L). CONCLUSIONS: These findings reveal high prevalence of inadequate vitamin A nutritional status of mothers and infants, consistent with the national prevalence reported in women of childbearing age and Brazilian children, and that the intervention measures to fight this shortage should be extended to all pregnant and postpartum women, regardless of sociodemographic conditions and degree of nutrition knowledge, in order to improve the health of mother and child.
Subject(s)
Adult , Female , Humans , Young Adult , Dietary Supplements/analysis , Health Knowledge, Attitudes, Practice , Milk, Human/chemistry , Vitamin A Deficiency/epidemiology , Vitamin A/analysis , Breast Feeding , Brazil/epidemiology , Maternal Age , Nutritional Status , Prevalence , Socioeconomic FactorsABSTRACT
Assessing the vitamin A status among pre-school-age children is essential for evaluating the magnitude and public health status of vitamin A deficiency in a population. This cross-sectional study assessed the vitamin A status of children aged 6 to 59 months resident in the National Capital District (NCD), Papua New Guinea. Children attending the Children's Outpatient Clinic at Port Moresby General Hospital participated in this study. Informed consent was obtained from parents before using blood samples from their children. Assay of plasma retinol was carried out using the 'Clin-Rep' complete kit for assay of vitamins A and E in plasma by high performance liquid chromatography (HPLC). A commercial enzyme immunoassay kit was used to assay C-reactive protein (CRP) in plasma. Of the 132 children in the study 108 (82%) had received vitamin A capsules. The median plasma retinol concentration of the 132 children was 0.98 micromol/l and the interquartile range 0.65-1.38 micromol/l. Of the 132 children, 35 (27%) had a plasma retinol concentration below 0.70 micromol/l. 75 children (57%) had normal plasma CRP levels and in 57 (43%) the CRP levels were elevated. The median plasma retinol concentration of the children with normal plasma CRP was 1.19 micromol/l and the interquartile range 0.93-1.50 micromol/l. The prevalence of vitamin A deficiency (VAD) in the children with normal plasma CRP was 11%, indicating a moderate public health problem. 74 (56%) males and 58 (44%) females were included in the study. The prevalence of VAD in the male and female children with normal plasma CRP was 14% and 8%, respectively, indicating a moderate public health problem among the male children and a mild public health problem among the female children. The prevalence of subclinical (mild to moderate) and marginal VAD among the children with and without elevated CRP strongly suggests the need for continuous monitoring of the vitamin A status of the vulnerable groups in NCD.
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , C-Reactive Protein/analysis , Cross-Sectional Studies , Papua New Guinea/epidemiology , Prevalence , Vitamin A/blood , Vitamin A Deficiency/epidemiologyABSTRACT
Antecedentes: La deficiencia de vitamina A (DVA) es un problema nutricional de salud pública en el mundo. Durante el embarazo se ha asociado con incremento en la morbilidad y mortalidad materno-infantil. Objetivo: Determinar en adolescentes no gestantes y gestantes venezolanas, el estado nutricional de la vitamina A (ENVA). Método: Se realizó un estudio transversal, descriptivo y controlado, en 235 adolescentes mujeres (edad: 16,76 +/- 1,48 años); 75 no gestantes y 160 gestantes. El ENVA fue evaluado según valores de retinol sérico (RS) por cromatografía líquida de alta eficacia (HPLC) y citología de impresión conjuntival (CIC). Resultados: En gestantes y no gestantes la prevalencia de CIC anormal (37,5 por ciento vs 48 por ciento; p>0,05) y afectación del ENVA (41,24 por ciento vs 13,34 por ciento; p=0,0001) fue alta; significativamente mayor durante el segundo y tercer trimestre de gestación (p<0,0002). Las gestantes mostraron una disminución significativa de los valores promedio RS (p<0,0001), una correlación inversa no significativa con la edad gestacional y 4,56 veces mayor probabilidad de presentar afectación del ENVA (OR=4,56; IC95 por ciento: 2,0-10,23) que las no gestantes. Conclusión: La alta prevalencia de DVA observada en este trabajo, representa un problema de salud pública en adolescentes venezolanas, por lo que este grupo vulnerable requiere intervención inmediata.
Background: Vitamin A deficiency (VAD) is a public health nutrition problem in the developing world. VAD had been associated with increased risk of maternal and childhood mortality and morbidity. Objective: To determine vitamin A status (VAS) between non pregnant and pregnant adolescents from Maracaibo-Vene-zuela. Methods: A cross-sectional and descriptive study was conducted in 235 female adolescents (16.76 +/- 1.48y old); non pregnant (n=75) and pregnant (n=160). Vitamin A status was assessed by using serum retinol concentrations (SRC) and conjuctival impression cytology (CIC). SRC were measured by high-performance liquid chromatography and CIC. Results: In pregnant and non pregnant adolescents the prevalence of CIC abnormal (37.50 percent vs 48 percent) and non normal VAS (41.24 percent vs 13.34 percent; p=0.0001) were high, predominantly in the second and third trimester of pregnancy (p<0.0002). Pregnant adolescents showed significative reduction of the mean SRC values (p<0.0001), while gestational age had a negative and no significant relationship with SRC. The odds ratio for pregnant adolescents with non normal VAS was 4.56 (95 percentIC: 2.0-10.23), resulting significantly more frecuent non normal VAS in pregnant adolescents than non pregnant adolescents. Conclusions: The high prevalence of VAD found in this work, is a public health problem in venezuelan female adolescents and this vulnerable group require immediate interventions.
Subject(s)
Humans , Adolescent , Female , Pregnancy , Vitamin A Deficiency/epidemiology , Vitamin A Deficiency/blood , Chromatography, High Pressure Liquid , Cross-Sectional Studies , Cytological Techniques , Conjunctiva/cytology , Nutritional Status , Prevalence , Reference Values , Socioeconomic Factors , Venezuela/epidemiologyABSTRACT
Determinar a prevalência de anemia e hipovitaminose A e analisar a associação da (in)segurança alimentar com os níveis de hemoglobina e retinol sérico de menores de 5 anos. Estudo transversal, realizado com 501 e 458 famílias em Gameleira e São João do Tigre, respectivamente. A avaliação da (in)segurança alimentar foi realizada através da Escala Brasileira de Insegurança Alimentar. Os níveis de hemoglobina e retinol sérico foram classificados de acordo com a OMS. Foram analisadas as associações com os indicadores socioeconômicos, habitação e biológicos sobre os níveis de hemoglobina e retinol sérico. As prevalências de anemia e hipovitaminose A foram mais elevadas em Gameleira quando comparadas com São João do Tigre. A (in)segurança alimentar moderada e grave das famílias foi de 75 por cento em Gameleira e 64 por cento em São João do Tigre. Na análise de regressão para os níveis de hemoglobina em Gameleira foram identificadas como significantes: escolaridade materna, renda familiar per capita, não possuir TV colorida, água de consumo sem tratamento, piso de barro e idade abaixo de 24 meses, enquanto para São João do Tigre o modelo final ficou resumido à falta de motocicleta e idade da criança. Quanto aos teores de retinol sérico, o modelo final de variáveis associadas ficou sendo renda per capita e sexo para Gameleira, e ausência de telefone celular e de esgotamento sanitário para São João do Tigre. A situação nutricional dessas populações, com prevalências semelhantes de insegurança alimentar, pode apresentar grandes diferenciações, sobretudo na prevalência de carências nutricionais específicas, especialmente, em relação aos fatores determinantes.
The objective of this study was to determine the prevalence of anemia and vitamin A deficiency and to analyze the association of food insecurity with hemoglobin levels and serum retinol in children under 5 years of age. This was a cross-sectional study with 501 families from Gameleira and 458 families from São João do Tigre. Food insecurity was assessed according to the Brazilian Food Insecurity Scale. Hemoglobin and serum retinol levels were classified according to the WHO. Socioeconomic and environmental conditions and biological indicators of children were analyzed as hemoglobin and serum retinol determinants. The prevalence of anemia and vitamin A was higher in Gameleira compared to São João do Tigre. Moderate and severe food insecurity of families was 75 percent in Gameleira and 64 percent in São João do Tigre. Maternal education, per capita family income, not having a color TV, untreated water supply, type of flooring (dirt), and child age (< 2 years) in Gameleira were associated with hemoglobin levels in the linear regression analysis. In São João do Tigre the association with hemoglobin levels was only for (no) motorcycle and child age. Variables per capita family income and sex in Gameleira and no mobile phone and lack of sanitation in São João do Tigre were statistically associated with serum retinol levels. The nutritional status of these populations is similar in terms of food insecurity but may present great differences in terms of the prevalence of specific nutritional deficits and their determinants.