ABSTRACT
This study analyzed the evolution of socioeconomic, sanitary, and personal factors as well as spatiotemporal changes in the prevalence of helminthiasis and giardiasis in urban Amazonian children between 2003 and 2011. Child age, lack of sanitation, and lack of access to bottled water were identified as significant associated factors for helminthiasis and giardiasis. There was an overall improvement in socioeconomic and sanitary conditions in the city resulting in decreased helminth prevalences from 12.42 to 9.63% between 2003 and 2010, but the prevalence increased to 15.03% in 2011 due to migratory movement and unstable sanitary conditions. As for Giardiasis, socioeconomic and environmental changes were not enough to reduce prevalence (16% in 2003 and 23% in 2011). Spatial analysis identified a significant cluster for helminthiasis in an area of poor housing conditions. Control programs in the Amazon need to target high-risk areas focusing changes in sanitation, water usage, and health education.
Subject(s)
Giardiasis/epidemiology , Helminthiasis/epidemiology , Socioeconomic Factors , Child , Child, Preschool , Cities , Female , Giardiasis/economics , Helminthiasis/economics , Humans , Male , Prevalence , Risk Factors , SanitationABSTRACT
OBJECTIVE: To assess the nutritional status and dietary practices of 0-24-month-old children living in Brazilian Amazonia. DESIGN: Cross-sectional study. Information on children's dietary intakes was obtained from diet history data. Weight and length were measured for anthropometric evaluation. Fe status was assessed using fasting venous blood samples; Hb, serum ferritin and soluble transferrin receptor concentrations were measured. SETTING: The towns of Assis Brasil and Acrelândia in the state of Acre, north-west Brazil. SUBJECTS: A total of sixty-nine randomly selected 0-24-month-old children. RESULTS: Of these children, 40.3 % were anaemic, 63.1 % were Fe-deficient, 28.1 % had Fe-deficiency anaemia and 11.6 % were stunted. Breast-feeding was initiated by 97.1 % of mothers, followed by early feeding with complementary foods. The dietary pattern reflected a high intake of carbohydrate-rich foods and cow's milk, with irregular intakes of fruit, vegetables and meat. All infants and 92.3 % of toddlers were at risk of inadequate Fe intakes. Fe from animal foods contributed on average 0.5 % and 14.3 % to total dietary Fe intake among infants and toddlers, respectively. CONCLUSIONS: Poor nutritional status and inadequate feeding practices in this study population reinforce the importance of exclusive breast-feeding during the first 6 months of life. Greater emphasis is required to improve the bioavailability of dietary Fe during complementary feeding practices.
Subject(s)
Anemia, Iron-Deficiency/epidemiology , Feeding Behavior , Infant Nutritional Physiological Phenomena/physiology , Iron Deficiencies , Nutritional Status , Weaning , Anemia, Iron-Deficiency/prevention & control , Anthropometry , Biological Availability , Bottle Feeding , Brazil/epidemiology , Breast Feeding , Cross-Sectional Studies , Female , Ferritins/blood , Humans , Infant , Infant Food , Infant, Newborn , Iron/blood , Iron, Dietary/administration & dosage , Iron, Dietary/pharmacokinetics , Male , Nutrition Assessment , Receptors, Transferrin/bloodABSTRACT
The prevalences of intestinal parasitic infections were investigated, between 1995 and 1996, in a household-based sample of 1044 children aged <5 years who lived in the city of São Paulo, Brazil. Only 10.7% of the children were infected, the most prevalent parasites being Giardia duodenalis (5.5%), Ascaris lumbricoides (4.4%) and Trichuris trichiura (1.0%). A comparison between these data and results from two previous population-based surveys, completed in São Paulo in 1974 and 1985, revealed a dramatic decrease in the prevalence of intestinal helminths in this age-group, with less marked changes in the prevalence of Giardia, over the two past decades. Despite the low prevalence of malnutrition (2.4% of stunting and 0.6% of wasting) and intestinal parasites in this population, there was a significant association (P=0.05, after controlling for potential confounding variables) between helminth (but not Giardia) infection and height. The helminth-infected children had a mean height-for-age z-score of-0.412 [95% confidence interval (CI)=-0.637--0.186], compared with one of 0.015 (CI=-0.049-0.079) for the non-infected children. No significant relationship between intestinal parasitic infection and children's weight was detected. In conclusion, a small but significant negative relationship between intestinal helminthic infections and children's growth was detected in an urban environment with low prevalences of both intestinal parasitic infection and malnutrition.
