The prevalence of malnutrition and its risk factors in children attending outpatient clinics in the city of Manaus, Amazonas, Brazil.

Abstract

O objetivo do estudo foi determinar a preval?ncia de desnutri??o e fatores de risco em crian?as de 0-10 anos, atendidas em ambulat?rios em Manaus, Amazonas, Brasil. Foi conduzido um estudo epidemiol?gico transversal em uma amostra de 347 crian?as. As entrevistas foram realizadas com os pais ou respons?veis, foram coletados dados socioecon?mico e de consumo alimentar de cada crian?a. Para avalia??o diet?tica utilizou-se um question?rio semiquantitativo de freq??ncia alimentar. Amostras de fezes foram examinas por microsc?pio ?tico. Medidas antropom?tricas foram transformadas em percentis e z-escore e o estado nutricional foi avaliado pelos indicadores do National Center for Health Statistics (NCHS) e do Centers for Disease Control (CDC). Fatores de risco associados ? desnutri??o foram analisados usando modelo de regress?o log?stica com efeito aleat?rio. As preval?ncias de baixo peso, d?ficit de estatura e d?ficit de peso foram 18,1, 15,5 e 10,7% pela refer?ncia do CDC e 14,3, 17,3 e 4,4% do NCHS. A preval?ncia de d?ficit de peso foi maior quando estimada pelo CDC em compara??o ao NCHS (p=0,02). A preval?ncia de parasitoses intestinais foi de 58,8%. Os fatores de risco associados a desnutri??o foram: baixo n?vel educacional dos respondentes (OR=4.55), ingest?o cal?rica <54.5 kcal/kg (OR=4.55), crian?as na faixa et?ria de 6-10 anos (OR=3.54), e consulta pedi?trica como motivo de visita ao ambulat?rio (OR=2.71). Na popula??o estudada, desnutri??o (baixo peso, d?ficit de estatura e d?ficit de peso) e infec??o parasit?ria ainda representam um problema de sa?de p?blica. Os fatores de risco confirmam a influ?ncia dos fatores s?cio econ?micos no estado nutricional das crian?as.The objective of this study was to determine the prevalence of malnutrition and its risk factors in children aged 0-10 years attending outpatient clinics in Manaus, Amazonas, Brazil. A cross-sectional epidemiological study of a population of 347 children was conducted. Data concerning socio-economic levels and food consumption were obtained by interviewing the accompanying guardian of each child. Dietetic evaluation was conducted using a semi-quantitative food frequency questionnaire, and faecal samples were examined by optical microscopy. Anthropometric measurements were transformed into percentiles and z-scores, and nutritional status was evaluated by reference to National Center for Health Statistics (NCHS) and Centers for Disease Control (CDC) indicators. Factors associated with undernutrition were analysed using a random-effects logistic regression model. The overall prevalences of underweight, stunting and wasting were 18.1, 15.5 and 10.7%, respectively, with reference to CDC growth curves, and 14.3, 17.3 and 4.4%, respectively, with reference to NCHS growth curves. The overall prevalence of wasting was statistical higher according to the CDC reference than that estimated using the NCHS reference (P=0.02). The prevalence rate of intestinal parasites was 58.8%. Risk factors associated with malnutrition were: low educational level of guardian respondent (OR=4.55), energy intake <54.5 kcal/kg (OR=4.55), children in age group 6-10 years (OR=3.54), and attendance at outpatient clinic for paediatric visit (OR=2.71). In the studied population, malnutrition (stunting, underweight and wasting) and parasite infection still represent serious public health problems. The risk factors identified in the present study confirm the influence of socio-economic factors on the nutritional status of children