Fatores associados à hipovitaminose A em crianças menores de cinco anos

Abstract

OBJETIVOS: identificar os fatores associados à hipovitaminose A em crianças da região semiárida de Alagoas. MÉTODOS: estudo transversal com amostra probabilística de 551 crianças menores de cinco anos. Os níveis séricos de retinol foram aferidos usando-se cromatografia líquida de alta eficiência. Na identificação da associação entre as variáveis independentes e hipovitaminose A (retinol <20 µg/dL) utilizou-se a razão de prevalência (RP) e respectivo IC95% calculados por regressão de Poisson com ajuste robusto da variância, tanto na análise bruta quanto na ajustada. Nesta, foram incluídas todas as variáveis que naanálise bruta atingiram p<0,1. Associações foram consideradas estatisticamente significantes quando p<0,05. RESULTADOS: a prevalência de hipovitaminose A foi de 45,4% e as variáveis que se mantiveram associadas após análise multivariável foram a baixa escolaridade materna (RP=1,66; IC95%: 1,12-2,44), obaixo peso ao nascer (RP=1,41; IC95%: 1,01-1,98) eter de 12,1 a 24 meses (RP=1,45; IC95%: 1,04-2,02). CONCLUSÕES: evidencia-se a relevância epidemiológica da hipovitaminose A em crianças do semiárido alagoano. Crianças nascidas com baixo peso, com mães de baixa escolaridade e no segundo ano de vida devem receber atenção prioritária.

Estado nutricional de crianças em amamentação exclusiva prolongada no Estado de Pernambuco

“…Contrary to conventional thinking, instead of the predicted deficit in the protein-calorie nutrition state expected by insufficient protein and energy intake from human milk after six months of breastfeeding, what has surprisingly occurred was a high prevalence of overweight (overweight/obesity) of 28.7%, statistically equivalent to the comparison group. This result still reflects the situation also found in children of the state of Pernambuco, of the region and of the country [20][21][22] . It should be pointed out that, in itself, that is to say, without considering the issue of anemia and VAD, this situation represents a worrying result, in technical terms, depending on the conventional foundations of the nutritional status of children.…”

“…That is, the possible VAD, represented by deficient and low levels of serum retinol (≤ 1.05 μmol/L) -4.4% in the BF group and 0.5% in the comparison group -is fully compatible with a situation in which VAD does not manifest itself as a health problem 18 . By the way, these occurrences are well below prevalences found in population-based surveys of Brazilian children 20,21 , including in the state of Pernambuco 22 . Therefore, based on these observations, it could not be said that prolonged BF as the only food source for children aged six to 14 months acted as a risk factor for VAD under biochemical criteria.…”

Prevalence and factors associated to vitamin A deficiency in children attending public day care centers in the Southwest of Bahia

“…25 The city of Vitória da Conquista is situated in an endemic area for hypovitaminosis A and should be distributed by the Vitamin A Program, but 91.7% of the children did not receive the supplementation for the past 6 months, indicating inadequate coverage of the program in the city. There was no association statistically significant differences found in the previous supplementation of vitamin A with inadequate levels of serum retinol according to another study, 21 however, other studies found benefits in the supplementation of vitamin A. 19,26 In this present study preschool children were assessed probably already received the preventive supplementation for a longer time, so the delay on the last dose could not interfere in the stocks of vitamin A.…”

“…12 The differences in prevalence rates may be associated to the children´s age range although studies that work with infants have greater prevalence in relation to preschool children. 21 It is important to highlight the influence of the infectious process in the nutritional status of vitamin A. Studies show an overestimation of 2.0 to 4.6% in the prevalence of hypovitaminosis A when infants have an infection.…”

“…10,19 However, no association was found on income with inadequate levels of retinol in this present study, similar found in other studies. 3,21,26,28 It is likely that the homogeneity displayed by the studied population has made it difficult to identify these statistical associations. In addition, one may speculate that these children remain most of the days in the week at the day care centers, where they receive food and care, the socioeconomic factors role has its influence reduced.…”