OBJETIVO: Avaliar a magnitude, a distribuição espacial e a tendência temporal da anemia em pré-escolares no Estado da Paraíba, Brasil. MÉTODOS: Corte transversal com amostra aleatória, do tipo multietapas, em oito cidades da zona urbana, de três mesorregiões do Estado da Paraíba, no ano de 1992, pela qual foram selecionados aleatoriamente 1.287 pré-escolares de ambos os sexos. A hemoglobina foi dosada pelo método da cianometa-hemoglobina em sangue venoso, empregando <11,0 g/dl como ponto de corte para anemia. A análise estatística de proporções incluiu o teste do qui-quadrado e a de médias, os de Mann-Whitney e Kruskal-Wallis, com intervalo de confiança de 95%. RESULTADOS: A prevalência da anemia no Estado da Paraíba foi de 36,4% (IC 33,7-39,1), maior (p= 0,00) do que a de 1982, que foi de 19,3% (IC 17,3-21,5). Apenas 1,0% (IC 0,6-1,8) e 6,8% (IC 5,5-8,3) dos casos de anemia foram categorizados nas formas grave e moderada, respectivamente. Crianças do sexo masculino apresentaram concentrações médias de hemoglobina mais baixas (p=0,00), e crianças menores de três anos constituíram o grupo biológico de maior suscetibilidade ao desenvolvimento do quadro carencial (p=0,00). O segundo ano de vida mostrou-se como o período vital mais crítico à exacerbação da deficiência nutricional (p=0,00). A mesorregião do Agreste configurou-se como o espaço geográfico de maior risco (p=0,00), desenhando uma outra dinâmica epidemiológica do problema, comparada àquela de 1982, em que a mesorregião do Sertão representava a área geográfica de maior risco para a deficiência. CONCLUSÕES: Os resultados mostraram que a anemia é um problema de saúde pública do tipo moderado, segundo os critérios internacionais para caracterizar a endemia em escala epidemiológica. Admitindo-se a comparabilidade entre os dois cortes transversais em análise, concluiu-se pelo caráter evolutivo ascendente na prevalência da anemia nutricional (+88,5%) em todas as três mesorregiões, no período de 10 anos, entre 1982-1992.

OBJECTIVE:To analyze medication use and associated factors among the elderly. METHODS:A population-based cross-sectional study was carried out with a sample of 400 elderly people aged over 60 living in the urban area covered by the Family Health Strategy program in Recife, Northeastern Brazil in 2009. Individuals were selected by systematic random sampling and household data were collected. Demographic, socio-economic, lifestyle factors including nutrition practices and health variables were evaluated. Medication use was the independent variable. Univariate and multivariate statistical analysis were performed. RESULTS:The prevalence of medication use was 85.5%. Polypharmacy (> 5 drugs) occurred in 11% of cases. Of the 951 drugs reported, 98.2% were prescribed by doctors and 21.6% were considered unsafe for the elderly. The most commonly prescribed groups were: cardiovascular drugs (42.9%), central nervous system agents (20.2%) and drugs with an effect on the digestive tract and metabolism (17.3%). The use of polypharmacy was associated with education (p = 0.008), self-reported health (p = 0.012), self-reported chronic disease (p = 0.000) and the number of doctor appointments per year (0.000). CONCLUSIONS:The results of this study indicate a high proportion of medication use among the elderly, including of those considered unsuitable, and inequality among groups of elderly individuals regarding the use ofmedication, when education, number of doctor appointments and self-reported health are considered .

IntroductionAnemia is a nutritional problem of global importance. It is estimated that at least one-third of the population has been at one time anemic.ObjectiveTo evaluate the prevalence of anemia and associated factors in patients of a children's hospital in Recife.MethodsA cross-sectional study was developed involving 595 male and female children aged from 6 to 59 months old, who were hospitalized in 2007.ResultsChildren with a hemoglobin concentration less than 11 g/dL were considered anemic. The relationship between studied variables and anemia was evaluated by Poisson regression analysis. There was a 56.6% prevalence of anemia (95% CI: 46.6-54.6). Anemia was significantly correlated with low weight (Prevalence ratio - PR = 1.39; 95% CI: 1.18-1.64), young age (PR = 2.01; 95% CI: 1.57-2.56) and a diagnosis of acute lower respiratory disease (PR = 1.57; 95% CI: 1.27-1.96).ConclusionThe high prevalence of anemia suggests that it may contribute as a causal factor for hospitalization, especially because the period of hospitalization was short and the patient was likely to be anemic at the time of admission. This study stresses the importance of evaluating the overall nutritional status of patients, including their ingestion of microelements. This is especially important in children, because of their greater susceptibility to anemia. Measures directed at the prevention and control of anemia, including increased coverage of supplementation and fortification programs are strongly recommended.

Este estudo objetivou estimar a prevalência de excesso de peso e obesidade abdominal em escolares segundo antropometria e maturação sexual. Foi um estudo transversal, incluindo 1.405 escolares de 10-14 anos, de ambos os sexos, residentes no Recife, Pernambuco, Brasil, em 2007. Foi avaliado o índice de massa corporal (IMC), a circunferência da cintura (CC) e razão da cintura-estatura (RCEst). A maturação sexual foi auto-avaliada, definindo-se como precoce quando o escolar apresentava idade cronológica inferior à mediana de idade para o referido estágio. A prevalência de excesso de peso foi de 20,4% (IC95%: 18,3-22,6) e a de obesidade abdominal foi de 14,9% (IC95%: 13,1-16,9) para CC e 12,6% (IC95%: 10,9-14,4) para RCE. O IMC, a CC e a RCEst apresentaram uma forte correlação positiva (rho ≅ 0,8; p < 0,001). A prevalência de excesso de peso e de obesidade abdominal foi maior (p < 0,05) nos estágios finais de maturação sexual em ambos os sexos. A alta prevalência de excesso de peso requer medidas urgentes de prevenção e controle desse distúrbio, sendo recomendada a inclusão da maturação sexual na avaliação do estado nutricional.

Cad. Saúde Pública, Rio de Janeiro, 29 (2) de 27,1% (IC95%: 23,7) no sexo masculino e 69, 9% (IC95%: 66,8) no feminino (p < 0,001

Padrão alimentar de risco para as doenças crônicas não transmissíveis e sua associação com a gordura corporal -uma revisão sistemáticaDietary risk patterns for non-communicable chronic diseases and their association with body fat -a systematic review

OBJECTIVE:To estimate the prevalence of vitamin A defi ciency and its associated factors in children. METHODS:A cross-sectional population-based study, involving 1,211 children of both sexes, aged between six and 59 months old, was carried out in the urban zone of 9 cities in the state of Paraiba, Northeastern Brazil. Vitamin A status was assessed by serum retinol levels (high performance liquid chromatography -HPLC) and subclinical infection was assessed by C-reactive protein concentrations. Socioeconomic, demographic and sanitation conditions, as well as vitamin A supplement intake, were also evaluated. Children with serum retinol concentrations RESULTS:The prevalence of vitamin A deficiency was 21.8% (95%CI 19.6;24.2), showing an association with subclinical infection and lack of indoor plumbing. The prevalence of vitamin A defi ciency was 21.8% (95%CI 19.6;24.2). After adjustment, vitamin A defi ciency was found to be linked with subclinical infection and lack of indoor plumbing. Vitamin A defi ciency was four times higher (CI95% 1.49;10.16) in children with subclinical infection whose homes were without indoor plumbing, compared to children who were not infected and with indoor plumbing in their homes. CONCLUSIONS:Despite activities aimed at the prevention and control of vitamin A defi ciency, hypovitaminosis A, remains a public health concern among children under fi ve.

Objective: The study was set up to determine to what extent the addition of a supplement of vitamin A alone or in combination with zinc would improve standard iron treatment and correction of iron de®ciency anaemia. Design: 216 non-pregnant anaemic women of 15 ± 45 years of age with haemoglobin levels 100 gal were randomly assigned to three treatment groups. One group (A) received iron alone, a second group (B) received iron and vitamin A, and a third group (C) received iron, vitamin A and zinc. Every woman was given one iron capsule per day for 60 days as FeSO 4 containing 60 mg of elemental iron. In addition, groups B and C received 200 000 IU of vitamin A, given as a supervised dose, on the ®rst day of the treatment after collection of the blood sample. Group C received one zinc tablet per day for 60 days as zinc gluconate containing 15 mg of elemental zinc. Setting: The north-western part of Bangladesh in the urban slums of Dinajpur district between February and August 1995. Subjects: To select women with a haemoglobin level of 100 gal, all the women of four randomly selected municipal slums of the district in the targeted age group (328) were invited to take part in the study. Blood samples were analysed for haemoglobin, serum iron, total iron binding capacity (TIBC), ferritin, retinol and zinc. Results: Out of the 328 women screened, 254 (77.5%) had a haemoglobin level 100 gal and 322 (98%) 120 gal. The three treatment schedules signi®cantly increased haemoglobin levels and improved iron parameters, except for serum iron in the group who received iron alone. The group who received iron, vitamin A and zinc responded best with an increase in haemoglobin of 17.9 gal as compared to the group receiving iron alone (13.4 gal). Iron and vitamin A treatment gave an intermediate response of 15.9 gal. However, these differences are only statistically signi®cant only for the group who received iron, vitamin A and zinc and only for the increase in haemoglobin, P 0.03. Conclusion:The results are suggestive that the addition of vitamin A and zinc to the treatment for anaemia can increase haemoglobin levels more than with iron alone. Sponsorship: The present study was ®nanced by grant FWO 1.5.092.96 and Nutrition Tiers Monde.