Desnutrição infantil em um dos municípios de maior risco nutricional do Brasil: estudo de base populacional na Amazônia Ocidental Brasileira

Abstract

Objective:To estimate the prevalence of child undernutrition and associated factors in a municipality with high nutritional risk in Brazil. Methods: This cross-sectional, population-based study was conducted with a sample of 478 children aged under 5 years in the city of Jordão, Acre, Brazil. The following indicators were calculated: weight for age (W/A), height for age (H/A), and weight for height (W/H), using the growth curves of the WHO as reference, which adopts a cutoff of -2 z scores for identification of malnourished children. Adjusted prevalence ratios (PRs) were obtained using multiple Poisson regression models with robust error estimate (p < 0.05). Results: A high prevalence of stunting (35.8%) was observed. Children with indigenous ancestry living in rural areas showed the highest prevalence of malnutrition (59.4%). After controlling for age, gender, and indigenous ancestry, the factors associated with stunting risk were: living in rural area (PR = 1.6; 95%CI 1.2 -2.1); lower tertile of household wealth index (PR = 1.6; 95%CI 1.1 -2.3); living in houses made of walking palm (PR = 1.6; 95%CI 1.1 -2.4); maternal height less than or equal to 146.4 cm (PR = 3.1; 95%CI 1.9 -5.0); and history of introduction of cow's milk before 30 days of age (PR = 1.4; 95%CI 1.0 -1.8). Children with updated vaccination cards were inversely associated with stunting risk (PR = 0.7; 95%CI 0.5 -0.9). Conclusion: Child undernutrition remains a serious public health problem in the Amazon, indicating additional difficulties in facing the problem in this region of the country.

Crianças menores de 5 anos ainda morrem por desnutrição?

“…However, child malnutrition still remains an obstacle in health services in the Northern region, demarcating the interregional and social inequalities present in the country. 10 In a national level, the North region is responsible for the highest mortality rates due to malnutrition in children under five, presenting double the national average rate and slow regression in mortality when compared to the Northeast region, which evidences improvements concerning infant nutrition. Difficulties with transportation, the constancy of negative socioeconomic indicators, and the great concentration of the national indigenous population are possible factors contributing to the high mortality rates in children under five due to malnutrition in the Northern region of the country.…”

“…Difficulties with transportation, the constancy of negative socioeconomic indicators, and the great concentration of the national indigenous population are possible factors contributing to the high mortality rates in children under five due to malnutrition in the Northern region of the country. 10 The state of Acre presents a marked difference in the prevalence of malnutrition in relation to Latin America, to the Brazilian scenario, and even to the North region. It has similar indices to those registered more than 30 years ago in the country, representing a significant delay when compared to the national context.…”

“…It has similar indices to those registered more than 30 years ago in the country, representing a significant delay when compared to the national context. 10 Several factors may be related to the high mortality rate in the state of Amazonia, such as the geographical and populational situation, which significantly influence the development of this territory. 10 Although the state of Alagoas had a high mortality rate of children under five due to malnutrition in the five-year period 2003-2007, it showed a significant decline in rates for the following years, which may possibly be justified by the drop in indicators of poverty and income inequality in the state.…”

Mortalidade por câncer em populações indígenas no Estado do Acre, Brasil

“…Na Amazônia, os povos indígenas experimentam uma trajetória histórica de subordinação e desvantagem socioeconômica, num cenário de iniquidades que são traduzidas em piores indicadores de saúde, como alta mortalidade infantil, elevadas prevalências de desnutrição infantil, maiores taxas de morbidade e mortalidade por doenças infecto-parasitárias 3,4,5,6,7,8,9 . Entretanto, embora as doenças transmissíveis permaneçam como as principais causas de morbimortalidade indígena, observa-se o crescimento dos agravos externos e doenças crônicas não transmissíveis, com destaque para obesidade, hipertensão arterial, diabetes e neoplasias, no contexto de transição epidemiológica vivenciado por esses povos nas últimas décadas 10,11,12,13 .…”

Estado nutricional de crianças do baixo Amazonas: concordância entre três critérios de classificação

“…The northern region of Brazil is one of the most vulnerable to children's nutritional deficits 7,8 , where the highest prevalence of stature deficit 9 is also found, an aspect that is predominantly associated with precarious living conditions 10 . Among the forms of measurement of…”