Estimativas da prevalencia de desnutricao infantil nos municipios brasileiros em 2006 (original) (raw)
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[Estimates of the prevalence of child malnutrition in Brazilian municipalities in 2006]
Revista de saúde pública, 2013
To estimate the prevalence of malnutrition in children for all Brazilian municipalities. A multilevel logistic regression model was used to estimate the individual probability of malnutrition in 5,507 Brazilian municipalities in 2006, in terms of predictive factors grouped according to hierarchical levels. The response variable was child malnutrition (children aged from six to 59 months with height for age and sex below -2 z-scores, according to the World Health Organization standard). The predictive variables were determinants of malnutrition measured similarly by the National Demographics and Health Survey-2006 and the Sample from the 2000 Demographic Census. At level 1 (individual): sex and age, level 2 (household): socioeconomic variables, water and indoor plumbing, urban or rural area and level 3 (municipal): location of the municipality and coverage of the Family Health Strategy (FHS) in 2006. The study detected a statistically significant chance of malnutrition in male childr...
Determinants of mild-to-moderate malnutrition in preschoolers in an urban area of …
Public health …, 2008
Objective: To investigate the determinants of mild-to-moderate malnutrition in preschoolers. Design: Cross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socioeconomic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-forage and height-forage Z-scores. Results: Family monthly income under US$67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-forage and height-forage deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-forage and height-forage deficits. Among the immediate determinants, age above 6 months and dietary caloric availability in the lowest tertile (,930 kcal day 21) were also associated with weight-forage deficits. In addition to these, hospitalisation in the 12 months preceding the interview was shown to be a predictor of mild-to-moderate weightfor-age and height-forage deficits. Conclusion: Adverse social and economic factors interact with family environmental factors to define food consumption and morbidity patterns that culminate in a high prevalence of mild-to-moderate malnutrition. The strengthening and restructuring of nutrition and healthcare actions, the definition of public policies that improve family income, and the adequate insertion of women in the labour market are possible strategies to reduce mild-to-moderate malnutrition and to sustain the decline already observed in severe malnutrition. Keywords Mild-to-moderate malnutrition Determinants Preschoolers Brazil Hierarchical approach Recent studies have revealed a decline in the prevalence of malnutrition of severe and moderate intensities in several regions of the world 1 , including Brazil 2,3. Although this represents a promising perspective for infant health and nutrition, the fact that high rates of mild malnutrition still persist has epidemiological relevance, because mortality risk may also increase 4,5. In developing countries, taking into account diarrhoea, pneumonia, measles and all of these together as causes of death, the risk of death for preschoolers with a mild deficit of the weight-forage indicator (Z-score 22.0 to ,21.0) is 1.73-2.32 times higher than for children with adequate weight-forage. This risk increases from 3.01 to 5.39 times if the child is moderately malnourished (Z-score 23.0 to ,22.0), reaching 5.22 to 12.50 times in those severely malnourished (Z-score ,23.0) 5. Similar relative risks have been also estimated by other authors 6. In analysing data from 28 studies in African and Asian countries, Pelletier 5 estimated that mild-to-moderate malnutrition contributes to 50-75% of deaths in the first years of life.
Risk factors for malnutrition in Brazilian children: the role of social and environmental variables
Bulletin of the World Health Organization, 1986
The article reports the effects of several socioeconomic and environmental indicators on the nutritional status (stunting, underweight, and wasting) of a sample of 802 children aged 12-35.9 months in urban and rural areas of southern Brazil. Of the social variables studied, family income and father's education level were the two risk factors that showed the strongest associations with nutritional status. The mother's education level, employment status of the head of the family, number of siblings, and family's ethnic background also showed some degree of association, but these were less significant when family income was included in the analysis. Environmental variables, particularly the type of housing, degree of crowding, and type of sewage disposal, were also strongly associated with malnutrition. The effects of having access to piped or treated water were only apparent on stunting and wasting.
Public Health Nutrition, 2008
ObjectiveTo investigate the determinants of mild-to-moderate malnutrition in preschoolers.DesignCross-sectional study conducted in October and November 1996, with a representative sample of 1740 children less than 5 years old from the city of Salvador, situated in the Brazilian Northeastern region. Socio-economic and dietary data were collected through a structured questionnaire. Anthropometric measures were performed in duplicate and data analysis was based upon the hierarchical model approach. Logistic regression analysis was used to estimate the prevalence ratio and to identify the determinants of mild-to-moderate deficits in weight-for-age and height-for-age Z-scores.ResultsFamily monthly income under US$67.00 per capita and family headed by a woman were the main basic determinants of mild-to-moderate weight-for-age and height-for-age deficits in the studied children. Household agglomeration, an underlying determinant, was associated with weight-for-age and height-for-age defici...
Desnutrición infantil, desarrollo social y servicios médicos en la región andina
2005
This paper analyzes the social, ethnic and regional determinants of child malnutrition, as well as the effects of access to health services in the Andean region, by comparing conditions in Ecuador, Peru and Bolivia. These three countries are marked by a high prevalence of stunting and by wide socioeconomic, regional and ethnic disparities. The analysis used Demographic and Health Survey (DHS) data from Peru (1992Peru ( , 1996Peru ( and 2000 and Bolivia (1997), and Living Standards Measurement Study (LSMS) data for Ecuador (1998). The paper adopts an international comparative perspective, analyzing Ecuador in particular detail.
Factors affecting malnutrition in children and the uptake of interventions to prevent the condition
BMC Pediatrics, 2015
Background: Malnutrition is a major cause of child morbidity and mortality. There are several interventions to prevent the condition but it is unclear how well they are taken up by both malnourished and well nourished children and their mothers and the extent to which this is influenced by socioeconomic factors. We examined socioeconomic factors, health outcomes and the uptake of interventions to prevent malnutrition by mothers of malnourished and well-nourished in under-fives attending Princess Marie Louise Children's Hospital (PML). Methods: An unmatched case control study of malnourished and well-nourished children and their mothers was conducted at PML, the largest facility for managing malnutrition in Ghanaian children. Malnourished children with moderate and severe acute malnutrition were recruited and compared with a group of well-nourished children attending the hospital. Weight-for-height was used to classify nutritional status. Record forms and a semi-structured questionnaire were used for data collection, which was analysed with Stata 11.0 software. Results: In all, 182 malnourished and 189 well-nourished children and their mothers/carers participated in the study. Children aged 6-12 months old formed more than half of the malnourished children. The socio-demographic factors associated with malnutrition in the multivariate analysis were age ≤24 months and a monthly family income of ≤200 GH Cedis. Whereas among the health outcomes, low birth weight, an episode of diarrhoea and the presence of developmental delay were associated with malnutrition. Among the interventions, inadequate antenatal visits, faltering growth and not de-worming one's child were associated with malnutrition in the multivariate analysis. Immunisation and Vitamin A supplementation were not associated with malnutrition. Missed opportunities for intervention were encountered. Conclusion: Poverty remains an important underlying cause of malnutrition in children attending Princess Marie Louise Children's Hospital. Specific and targeted interventions are needed to address this and must include efforts to prevent low birthweight and diarrhoea, and reduce health inequalities. Regular antenatal clinic attendance, de-worming of children and growth monitoring should also be encouraged. However, further studies are needed on the timing and use of information on growth faltering to prevent severe forms of malnutrition.
Malnutrition and child mortality: are socioeconomic factors important?
Journal of Biosocial Science, 1989
SummaryThe influences of household economic condition, maternal education, sex, and nutritional status of children on mortality were examined using multivariate analytical techniques. Weights of around 1700 children aged 2–60 months in five villages of Matlab, Bangladesh, were taken during the first half of 1981. The children were followed for 18 months and their survival was recorded. The severely malnourished children had a risk of death nine times that of their counterparts with better nutritional status. Female children had a higher risk of death than the males. Mother's education and economic condition of household also showed negative relationships with the risk of death, but the effect of…
Malnutrition in school children in an urban-rural region of the extreme South of São Paulo city
Einstein (São Paulo), 2011
Objective: To evaluate the persistence of nutritional deficit in a sample of schoolchildren. Methods: A cross-sectional study of 1,761 schoolchildren between 6 and 10 years from 3 schools. They were assessed by Z scores of weight for height and height for age, according to the World Health Organization. The variables studied were gender, age, grade and school year. The χ² test was used to relate the nutritional deficit with the variables. Results: Of all children 8.5% were malnourished according to the weight for height Z score, 21.6%, according to height for age. The analysis of the weight for height Z score revealed that 59.7% were male and 40.3% female. The mean age was 8.9 years. As to the Z score of height for age, 53.9% were males and 46.1% females. The risk of malnutrition was higher among boys: 59.7% for the weight for height index and 53.9% for height for age. There was no statistical difference between schools, gender and school year. As to nutritional status, school perio...