Favorable factors for recovering clinical features of anemic children: an exploratory study

OBJETIVO: investigar a existência de aspectos do ambiente familiar de crianças anêmicas que possam ser considerados favoráveis à recuperação do quadro de anemia e ao desenvolvimento da linguagem. MÉTODOS: trata-se de um estudo de caso de crianças com anemia. As crianças (n = 11) foram submetidas anteriormente ao tratamento clínico e avaliação da linguagem. Após 12 meses, foram reavaliadas nos aspectos clínicos e da linguagem, acrescentando-se a investigação dos recursos do ambiente familiar. Deste grupo, foram selecionados três casos que refletem diferentes evoluções do quadro clínico da anemia e do desenvolvimento da linguagem, a fim de explorar as contribuições do ambiente familiar na melhora desses aspectos. RESULTADOS: a comparação das variáveis entre as crianças que obtiveram melhora ou não no tratamento medicamentoso mostra diferença estatisticamente nos valores de hemoglobina e tempo de aleitamento materno (p<0,05). A análise dos três casos revela que a situação ambiental pode ser agravante do quadro clínico da criança. CONCLUSÕES: a qualidade dos recursos domiciliares, o tempo de aleitamento materno e as práticas parentais em relação à criança podem ter contribuído para a adequada recuperação da criança nos aspectos focalizados.PURPOSE: to investigate the existence of familial environmental aspects of anemic children that may be regarded as favorable for the recovery of anemia and the language development. METHODS: this is a case study of anemic children. The children (n = 11) were previously submitted to clinical treatment and language assessment. After 12 months, children were reassessed in clinical and language aspects, adding investigation of Home Environment Resources Scale. From this group, three cases were selected, reflecting different evolutions in clinical features' anemia and language development in order to explore the contributions of the familial environment in the improvement of those aspects. RESULTS: the comparison of the variables between the children who had gotten improvement or not in the clinical treatment showed to be differing statistically as for the values of hemoglobin and maternal breastfeeding's period (p<0.05). The analysis of the three cases shows that the environmental situation can aggravated the child's clinical features. CONCLUSION: the quality of the familial resources, the time of maternal breastfeeding and the parental practices in relation to the child might have contributed to the child's appropriate recovery in the focused aspects

Fatores associados à anemia em lactentes nascidos a termo e sem baixo peso

Objective: To investigate the factors involved in the genesis of infant iron deficiency anemia. Methods: This is a cross-sectional study, which evaluated 104 children in their second year of life who were born at term with adequate weight in Viçosa, Minas Gerais, Brazil. An in terview, a 24-hour recall to parents, and anthropometric assessment were used. Laboratory exams included blood count, ferritin, and serum retinol. This study was approved by the Ethics Committee of UFMG and UFV. Statistical analyses were conducted using the Epi Info and SPSS softwares. Poisson generalized linear regression model was used to determine the asso ciation of anemia with the study variables, with results expressed as prevalence ratio. Results: Vitamin A deficiency and anemia were identified in 9.6% e 26% of the children, respectively. Infant anemia was associated with the date of onset of prenatal care, maternal use of iron after childbirth, paternal working status, prior use of iron by the child, and duration of breastfeeding. Thus, in the second year of life, lactating children of women who began prenatal care late and did not use iron compounds after birth, with unemployed parents, who never received iron compounds, and who were predominantly breastfed for more than four months had significantly higher prevalence of anemia. Conclusion: The results have demonstrated the importance of nutrition during pregnancy and infancy in the prevention of anemia in children.Keywords: Feeding; anemia; pregnancy; prevalence ratio; vitamin AOBJETIVO: Investigar os fatores envolvidos na gênese da anemia ferropriva em lactentes. MÉTODOS: Trata-se de um estudo transversal, no qual foram avaliadas 104 crianças no segundo ano de vida, que nasceram a termo e sem baixo peso, no município de Viçosa, Minas Gerais. Foi aplicada entrevista aos pais, realizado recordatório 24 horas e avaliação antropométrica. Os exames laboratoriais foram eritrograma, ferritina e retinol sérico. O estudo foi aprovado pelos Comitês de Ética com seres humanos da UFMG e UFV. As análises estatísticas foram conduzidas no Epi Info e SPSS. O Modelo de Regressão Linear generalizado de Poisson, com resultados expressos como razões de prevalências, foi utilizado para verificar a associação da anemia com as variáveis do estudo. RESULTADOS: A deficiência de vitamina A e a anemia estiveram presentes em 9,6% e 26% das crianças, respectivamente. A anemia dos lactentes se associou ao uso de composto ferroso no pós-parto pela mãe, uso anterior de composto ferroso pela criança, início do pré-natal, tempo de aleitamento materno predominante e condição de trabalho do pai. Assim, no segundo ano de vida, os lactentes filhos de mulheres que iniciaram o pré-natal tardiamente e não usaram o composto ferroso após o parto, com pais em situação de desemprego, que nunca receberam composto ferroso e que mantiveram o aleitamento materno predominante por mais de quatro meses, apresentaram significantemente maior prevalência de anemia. CONCLUSÃO: Os resultados demonstraram a importância da nutrição durante a gestação e durante a infância na prevenção da anemia em crianças

Estado nutricional e programa bolsa família no semiárido mineiro: um estudo longitudinal/ Nutritional status and the bolsa família program in minas gerais : a longitudinal study

Introduction: The nutritional status during child growth is the measure that best defines the child's health, and further, it is an indicator of economic inequality. To improve the food and nutritional status, social programs, such as the Bolsa Família Program (BFP), have been enforced in Brazil with the objective of increasing the income of families with a low socioeconomic status.Objective: This study aimed to verify the association between enrollment in this program and the nutritional status of adolescents living in the city of Berilo who were evaluated in the preschool phase in 2004 and reassessed in 2016.Methods: The nutritional status was evaluated based on the height and body mass index according to the age. Statistical analysis was conducted using the Chi-square test of homogeneity, and the final model was analyzed using the logistic regression method. Results: There was an association between the access of the participants to the BFP and the socioeconomic condition of the household. On comparing the nutritional status of the children between 2004 and 2016, it was verified that the incidence of malnutrition decreased from 13.0% to 1.5% and that of being overweight increased from 5.1% to 17.8%; however, these changes were not associated with enrollment in the program.Conclusion: The nutritional status of the adolescents assessed improved between 2004 and 2016, regardless of enrollment in BFP.Introduction: The nutritional status during child growth is the measure that best defines the child's health, and further, it is an indicator of economic inequality. To improve the food and nutritional status, social programs, such as the Bolsa Família Program (BFP), have been enforced in Brazil with the objective of increasing the income of families with a low socioeconomic status. Objective: This study aimed to verify the association between enrollment in this program and the nutritional status of adolescents living in the city of Berilo who were evaluated in the preschool phase in 2004 and reassessed in 2016. Methods: The nutritional status was evaluated based on the height and body mass index according to the age. Statistical analysis was conducted using the Chi-square test of homogeneity, and the final model was analyzed using the logistic regression method. Results: There was an association between the access of the participants to the BFP and the socioeconomic condition of the household. On comparing the nutritional status of the children between 2004 and 2016, it was verified that the incidence of malnutrition decreased from 13.0% to 1.5% and that of being overweight increased from 5.1% to 17.8%; however, these changes were not associated with enrollment in the program. Conclusion: The nutritional status of the adolescents assessed improved between 2004 and 2016, regardless of enrollment in BFP

Excess weight and factors associated in preschool of southwest of Bahia

Objectives: this study aimed to evaluate the environmental factors associated with excess weight in preschool children. Methods: a cross-sectional study involving 664 full-time preschoolers enrolled in public childcare centers in Vitória da Conquista (BA). The excess weight status has been defined according to the BMI/Age index and score Z above +2. The independent variables were grouped into maternal characteristics, socioeconomic, related to children and child care. We conducted multiple logistic regression to assess the association between excess weight and the variables studied. Results: a prevalence of excess weight was 5.7 %; 3.9% were overweight and 1.8% were obese. The factors associated with excess weight in children were cesarean delivery (OR: 2.59; IC95%: 1.11; 6.01); being singletons (OR: 3.32; IC95%: 1.44; 7.67); and exclusive breastfeeding of less than 4 months (OR: 2.59; IC95%: 1.12; 5.99). Conclusions: the results show that interventions to reduce and/or prevent excess weight should begin prenatally, with promotion of exclusive breastfeeding and natural birth, as well as nutritional advice for mothers with singletons.

Los primeros determinantes del sobrepeso y la obesidad a los 5 años de edad en preescolares del interior de Minas Gerais, Brasil

Introduction: Brazil is experiencing a nutritional transition characterized by a reduction in the prevalence of nutritional deficits and an increase in overweight and obesity, not only in adults but also in children and adolescents.Objectives: This study was designed to evaluate the factors associated with overweight and obesity in Brazilian 5-year-old preschoolers.Methods: A cross-sectional study of a cohort of 232 preschoolers born in Diamantina/Minas Gerais, Brazil, was undertaken. the data, including socioeconomic status, anthropometry, diet, previous history of the preschoolers and family history, were collected between July of 2009 and July of 2010. To identify the factors associated with overweight and obesity, a logistic regression and a hierarchical model were undertaken.Results: Overweight and obesity occurred in 17.2% of the preschoolers. After adjusting for mother's obesity, per capita income, protective food intake, weight gain at age 0-4 months and time spent playing, the factors associated with overweight and obesity that reached statistical significance were mother's obesity [OR = 3.12 (95% CI 1.41-6.91), P = 0.01], weight gain of more than 0.85 kg/month in the first four months of life [OR = 2.16 (95% CI 1.01-4.64), P = 0.041 and lower per capita income [OR = 0.32 (95 %CI 0.13-0.79), P = 0.01].Conclusion: the results show that more weight gain during the first four months of life and being born of mothers with obesity increased the odds of overweight/obesity in the preschoolers, while lower per capita income was a protective factor.Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG)Fed Univ Vales Jequitinhonha & Mucuri, Dept Nutr, BR-39100000 Diamantina, MG, BrazilUniv Fed Minas Gerais, Dept Med, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Dept Nutr, São Paulo, BrazilFederal Univ Sao Joao Del Rei, Dept Med, Divinopolis, MG, BrazilUniv Fed Vicosa, Dept Nutr, Vicosa, MG, BrazilUniversidade Federal de São Paulo, Dept Nutr, São Paulo, BrazilFAPEMIG: APQ-00428-08Web of Scienc

Prevalence of anemia and determinants of hemoglobin concentration in pregnant women

Background Anemia is characterized by reduced hemoglobin concentration and, during pregnancy is associated with increased fetal and maternal morbidity and mortality. Objective To evaluate the prevalence of anemia and the determinants factors of hemoglobin concentration in pregnant women. Methods Cross-sectional study with a sample of 328 pregnant women patients of the urban Health Units of Vitória da Conquista, Bahia. We applied a questionnaire, anthropometric evaluation, and collected blood by capillary puncture for dosage of haemoglobin using a portable β-hemoglobinometer. Were considered anemic those pregnant women with hemoglobin <11 g/dL. The determinants of serum hemoglobin concentration were identified through multiple linear regression. Results We observed anemia in 18.9% of the participants, and the mean hemoglobin concentration was 11.9 g/dL (standard deviation: 1.2). We observed lower mean of hemoglobin concentration among pregnant women who started prenatal care in the second trimester (β: -0.28; 95% CI: -0.54 to -0.02) and who did not used iron supplementation (β: -0.51, 95% CI: -0.79 to -0.23), while a higher mean was observed among primigavidae women (β: 0.34, 95% CI: 0.06 to 0.62). Conclusion Anemia in the population evaluated is a mild public health problem, and hemoglobin concentrations were associated to obstetric factors and prenatal care.Introdução A anemia é caracterizada pela reduzida concentração de hemoglobina e, durante a gestação, está associada à maior morbimortalidade fetal e materna. Objetivo Avaliar a prevalência de anemia e os fatores determinantes da concentração de hemoglobina em gestantes. Método Estudo transversal com uma amostra de 328 gestantes atendidas nas unidades de saúde urbanas de Vitória da Conquista, na Bahia. Foram realizadas a aplicação de questionário, a avaliação antropométrica e a coleta de sangue por punção capilar para dosagem de hemoglobina em β-hemoglobinômetro portátil. Foram consideradas anêmicas as gestantes com hemoglobina < 11 g/dL. Os determinantes da concentração de hemoglobina sérica foram identificados por meio da regressão linear múltipla. Resultados A prevalência de anemia foi de 18,9%, e a média de hemoglobina, de 11,9 g/dL (desvio-padrão: 1,2). Foram observadas menores médias de concentração de hemoglobina entre as gestantes que iniciaram o pré-natal no segundo trimestre (β: -0,28; IC95%: -0,54 a -0,02) e que não usavam suplemento de ferro (β: -0,51; IC95%: -0,79 a -0,23), enquanto a maior média foi verificada entre as mulheres primigestas (β: 0,34; IC95%: 0,06 a 0,62). Conclusão A anemia nas gestantes avaliadas é um leve problema de saúde pública, e as concentrações de hemoglobina foram associadas aos fatores obstétricos e à assistência pré-natal

Análise hierarquizada dos fatores associados à anemia em lactentes

Objective: To evaluate the prevalence of anemia and the associated factors in infants assisted in health units of Vitória da Conquista, Bahia, Northeast Brazil.Methods: Cross‑sectional study with a representative sample of 366 children aged 6 to 23 months. A questionnaire was applied to the caregiver, and the children’s anthropometric measurements and hemoglobin levels were collected. The associations were identified by Poisson regression with robust variances based on a hierarchical analysis model.Results: The prevalence of anemia was 26.8%, and the associated factors were: family income equal to or lower than one minimum wage (PR: 1.50; 95%CI 1.03–2.18), number of household members higher than five (PR: 1.50; 95%CI 1.07–2.11), use of unfiltered water (PR: 1.68; 95%CI 1.11–2.56), number of offspring higher than three (PR: 1.64; 95%CI 1.01–2.68), consumption of meat and/or viscera less than once/week (PR: 1.78; 95%CI 1.24–2.58) and age 6‑11 months (PR: 1.75; 95%CI 1.20–2.55).Conclusions: Anemia in the infants assessed is a moderate public health problem, which is associated with socioeconomic, demographic, and dietary factors; thus, measures are necessary for its prevention.Objetivo: Avaliar a prevalência e os fatores associados à anemia em lactentes assistidos por Unidades de Saúde de Vitória da Conquista, Bahia. Métodos: Estudo transversal com uma amostra representativa de 366 crianças de 6 a 23 meses. Realizou‑se aplicação de questionário ao cuidador, avaliação antropométrica e dosagem de hemoglobina das crianças. As associações foram identificadas por meio da regressão de Poisson com variâncias robustas com seleção hierárquica das variáveis independentes.Resultados: A prevalência de anemia foi de 26,8%, e os fatores associados foram: renda familiar igual ou inferior a um salário mínimo (RP: 1,50; IC95% 1,03–2,18), número de moradores no domicílio superior a cinco (RP: 1,50; IC95% 1,07–2,11), utilização de água não filtrada (RP: 1,68; IC95% 1,11 –2,56), número de filhos maior que três (RP: 1,64; IC95% 1,01–2,68), consumo de carne e/ou vísceras menor que uma vez por semana (RP: 1,78; IC95% 1,24–2,58) e idade de 6 a 11 meses (RP: 1,75; IC95% 1,20–2,55). Conclusões: A anemia nos lactentes avaliados é um moderado problema de saúde pública, a qual está associada a fatores socioeconômicos, demográficos e dietéticos. Dessa forma, medidas são necessárias para sua prevençã