RESUMO
Objective: to evaluate the complementary feeding practices for infants, focusing on the main pureed baby foods, and verify adherence to the guidelines adopted in Brazil. Methods: through cross-sectional study, aspects of complementary feeding of 404 healthy infants between 4 and 9 months of age (São Paulo, Curitiba and Recife) were evaluated. Socio-demographic data, history and food habits were collected. Mothers described three recipes (preparations) usually used in key baby foods. The findings were compared with those recommended by the Brazilian Society of Pediatrics. Results: the average age was 6.9±1.6 months. Among infants, 241/404 (59.6%) were still breastfeeding. Among those who received another type of milk, 193/368 (52.4%) received whole cow's milk, while 151/368 (41.0%) drank infant or follow-on formulas. Regarding baby food recipes salted reported by mothers, it was seen that 30% and 60% contained meat and vegetables, respectively. The percentages less suitable for feeding in general were observed for use of cow's milk and added sugar, chocolate and cereal in feeding bottles; 79% and 80.5% of the families interviewed would adopted such practices. Conclusion: the early termination of exclusive/predominant breastfeeding and the practice of an inadequate transition diet have shown a picture of quantitatively and qualitatively inadequate feeding, with the risk of causing serious nutritional problems in later ages, such as anemia and vitamin A deficiency, or excess of nutrients, leading to obesity, diabetes and dyslipidemias. .
Objetivo: avaliar as práticas relacionadas à alimentação complementar de lactentes, com ênfase nas papas principais, e verificar a concordância com as recomendações atualmente adotadas no Brasil. Métodos: por meio de estudo transversal, foram avaliados os aspectos da alimentação complementar de 404 lactentes saudáveis entre 4 e 9 meses de vida (São Paulo, Recife e Curitiba). Coletaram-se dados sociodemográficos de antecedentes e hábitos alimentares. As mães descreveram três receitas (preparações) que costumam utilizar nas papas principais. Os achados foram comparados ao preconizado pela Sociedade Brasileira de Pediatria. Resultados: a média de idade foi de 6,9±1,6 meses. Cerca de 241 lactentes (59,6%) permaneciam em aleitamento materno. Entre os que recebiam outro tipo de leite, 193 dos 368 (52,4%) recebiam leite de vaca integral, e 151 dos 368 (41%), fórmulas infantis ou de seguimento para lactentes. Em relação às receitas de papas salgadas relatadas pelas mães, foi possível observar que 30 e 60% delas continham leguminosas e carnes, respectivamente. Os piores percentuais de adequação na alimentação, em geral, foram observados para uso de leite de vaca e adição de açúcar, achocolatado e cereais em mamadeiras; 79 e 80,5% das famílias entrevistadas adotavam essas práticas. Conclusão: o abandono precoce do aleitamento materno exclusivo/predominante e a prática de uma dieta de transição inadequada têm mostrado um quadro de consumo quantitativa e qualitativamente inapropriado, com riscos de acarretar graves problemas nutricionais nas faixas etárias posteriores, como anemia e hipovitaminose A, ou excessos de nutrientes, como obesidade, diabete e dislipidemias. .
Assuntos
Animais , Bovinos , Feminino , Humanos , Lactente , Masculino , Comportamento Alimentar/etnologia , Alimentos Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Alimentação com Mamadeira , Brasil/epidemiologia , Estudos Transversais , Leite Humano , Política Nutricional/tendências , Inquéritos Nutricionais , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Inquéritos e Questionários , Fatores SocioeconômicosRESUMO
Background: Diabetes mellitus (DM) could be an important factor in identifying people with a high risk of tuberculosis (TB) in Chile, thus, we aim at studying the force of the relationship of these two pathologies. Methods: A case-control study was undertaken using secondary data from the SSMS population group. The cases (n = 473) were defined as first episodes of confirmed TB patients 15 years and older, registered between 2006 and 2009. The controls (n = 507) were non TB cases, residents in the same Health Service area, randomly selected from the population registered under the public health care system. Risk factors were taken from SIGGES (system for health information and management) files. Logistic regression adjusting for age and social vulnerability was used to estimate the OR (+/- CI 95 percent). Results: The higher frequency of DM among cases OR = 3.3 (95 percent CI 2.2-5.0) was confirmed. The inclusion of confounders -age, health insurance and residence in poorer counties- in the model yields produced an adjusted OR = 2.3 (95 percent CI 1.5-3.6). Conclusions: DM is strongly associated with TB in Chilean settings, therefore it may be anticipated that adding this diabetes criteria in screening of TB would help to increase earlier and inclusive diagnosis.
Introducción: La diabetes mellitus (DM) puede ser un importante factor para la identificación de personas con alto riesgo de tuberculosis (TBC) en Chile, por lo que se pretende estudiar la asociación entre estas dos patologías. Métodos: Se efectuó un estudio de caso-control con datos secundarios, obtenidos ambos de la población asignada al Servicio de Salud Metropolitano Sur. Los casos (n = 473) son pacientes de 15 o más años con un primer episodio de tuberculosis confirmada, entre los años 2006y 2009. Los controles (n = 507) son residentes del mismo Servicio, pero sin diagnóstico de TBC, seleccionados aleatoriamente de la población de inscritos en el Sistema Público de atención. Los factores de riesgo considerados son los consignados en el sistema de información para la gestión de garantías en salud (SIGGES). La estimación de asociación entre TBC y DM se efectuó mediante regresión logística, ajustando por edad y vulnerabilidad social para la estimación del OR (+/- IC95 por ciento). Resultados: Se confirma la mayor frecuencia de diabetes mellitus entre los casos, OR = 3,3 (IC95 por ciento 2,2-5,0). La inclusión en el modelo de las variables de confusión: edad, riesgo previsionaly residencia en una comuna más pobre que la Región Metropolitana, identifica un estimador (OR) ajustado de 2,3 (IC95 por ciento 1,5-3,6). Conclusiones: La DM se asocia con un mayor riesgo de enfermar de TBC. Orientando intervenciones diagnósticas, con pesquisa dirigida a los diabéticos aumentaría el diagnóstico precoz de la tuberculosis.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Diabetes Mellitus/epidemiologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Chile/epidemiologia , Complicações do Diabetes/epidemiologia , Estudos de Casos e Controles , Fatores Socioeconômicos , Fatores de Risco , Grupos de Risco , Prognóstico , Tuberculose/etiologiaRESUMO
Background:HIV/AIDS is one of the major barriers for community development. HIV epidemic in India is mainly concentrated among Most at Risk Groups (MARGs)/ High Risk Groups (HRGs) i.e. Injecting Drug Users (IDUs), Female Sex Workers (FSWs), Men who have sex with men (MSM) & Transgender and their sexual partners. National AIDS Control Programme (NACP) phase- II (year 1999-2006) & phase-III (year 2007-2012) envisaged and implemented Targeted Interventions (TIs) across country which has helped in somewhat containing the HIV epidemic among HRGs in various pockets. The implementation of Targeted Intervention programme has remained invariably different based on the response of respective State AIDS Control Societies (SACS). Objective:To analyze the shifting trends of HIV epidemiology among MARGs, identify lessons learnt and examine future aspects of public health interventions among MARGs. Materials and Methods:Present research has systematically reviewed HIV epidemiology among Most at Risk Groups (MARGs) using 16 peer reviewed research papers, HIV Sentinel Surveillance Survey (HSS) reports (years 2007 and 2008-09), National Family Health Survey (NFHS)-3 report, epidemiological studies, public health intervention reports via online database ‘PubMed’ and ‘Web of Science’ are analysed. Results:Findings of various studies defining the HIV prevalence among MARGs highlights HIV prevalence ranging between 3.0 % to 70.0% in some pockets. These findings may not be generalized considering the limited sample size used in such studies. Annual rounds of HIV Sentinel Surveillance Survey (HSS) are considered more reliable and generalizeable. The trend of HIV prevalence among MARGs based on three years moving average show a consistent fall in HIV prevalence among FSWs in erstwhile high prevalence states. Whereas the trend of HIV prevalence among MSM & Transgender show initial decrease between period 2003 to 2006 and then rise from 2006 to 2007. HIV prevalence among IDUs show decrease from 2003 to 2008 in Manipur, Nagaland, and Chennai and notable increase reported in Meghalaya, Mizoram, West Bengal, Mumbai, Kerala and Punjab. There are regional variations in HIV prevalence among MSM & Transgender and Injecting Drug Users. Conclusion:Review has outlined that despite reduction of new HIV infections (by 50% from 2000 to 2009) and reported decline in HIV prevalence among Female Sex Workers, a sustained focus on prevention is required among MARGs and their partner to contain HIV. However selection bias, non response bias, under reporting bias, surveillance bias in these studies might have also affected the results. There is felt need for more qualitative and behavioural researches to corroborate with HIV epidemiology and trends among MARGs.