Isolated and combined risks for anemia in children attending the nurseries of daycare centers

Abstract

Objective: To identify and quantify isolated and combined risk factors for anemia, providing a comprehensive view of the likelihood of its occurrence. Methods:Cross-sectional study with 482 children aged 4 to 29 months attending the nurseries of philanthropic and public daycare centers in the city of São Paulo, Brazil, who participated in two surveys (2004 and 2007). Mothers were interviewed, blood was collected using digital puncture, and anthropometry was performed. Anemia was characterized by hemoglobin levels below 11 g/dL. Unconditional logistic regression was adjusted for anemia risk factors. A value of p ≤ 0.05 indicated statistically significant associations. Post-test odds and likelihood ratios were calculated to define post-test probabilities. Epi-Info TM 2000 and Stata 10.0 software packages were used for statistical analysis.Results: Prevalence of anemia was 43.6% (95%CI 39.1-48.1). The final logistic model included five categorical variables: mother's age less than 28 years (OR = 1.50; p = 0.041), per capita income below half a minimum wage (OR = 1.56; p = 0.029), exclusive breastfeeding less than 2 months (OR = 1.71; p = 0.009), decrease in weight/age z score from birth to survey (OR = 1.47; p = 0.050), and age less than 17 months (OR = 2.44; p < 0,001). Post-test probabilities in the associations of isolated and combined risk factors for anemia ranged from 54.5 to 100%. Conclusions:The probability of anemia progressively increased as the identified risk factors were added. This calculation provides a simple and rapid tool for suspicion of anemia in children both in clinical practice and population screening. Resultados: A prevalência de anemia foi de 43,6% (IC95% -39,1 a 48,1%). O modelo logístico final incluiu cinco variáveis: idade materna inferior a 28 anos (OR = 1,50; p = 0,041), renda per capita inferior a meio salário mínimo (OR = 1,56; p = 0,029), aleitamento materno exclusivo inferior a 2 meses (OR = 1,71; p = 0,009), perda de escore z peso/idade do nascimento ao inquérito (OR = 1,47; p = 0,050) e idade inferior a 17 meses (OR = 2,44; p < 0,001). As probabilidades pós-teste nas associações de fatores de risco de anemia isolados e agregados apresentaram-se entre 54,5 e 100%. J Pediatr (Rio J) Conclusões:A probabilidade de anemia aumentou quanto mais agregados estiveram os cinco fatores de risco identificados. Esse cálculo disponibiliza instrumento simples e rápido de suspeição de anemia em crianças em triagem clínica ou populacional. Não foram declarados conflitos de interesse associados à publicação deste artigo. Artigo submetido em 31.10.08, aceito em 27.01.09. J Pediatr (Rio J)

Prevalência da anemia e fatores associados em crianças de seis a 59 meses de Pernambuco

“…Greater numbers of children in the household implies more domestic work and worse quality of care for the children, and also means greater demand for foods to supply the needs of all members of the family, which may contribute towards greater risk of anemia. 9,23 In the rural area, the number of children under the age fi ve years in the household did not have any impact on the prevalence of anemia. However, this does not indicate that people living in the rural area had better living conditions.…”

Temporal trends and anaemia-associated factors in 6- to 59-month-old children in Northeast Brazil

“…In the 2006 survey, the variables that showed statistical significance in the final multiple regression model were: child's age; level 1 5 maternal education; level 2 5 environmental index and economic to 67?6 % in Africa, over the period [1993][1994][1995][1996][1997][1998][1999][2000][2001][2002][2003][2004][2005], showing that anaemia is a problem of global nature (1) . In addition to the survey in Pernambuco, other studies conducted in Brazil (2,12) have shown prevalence rates of anaemia above the 29?3 % value estimated by WHO for the Americas (1) . Prevalence rates above 40 % in the country, mainly in children under 2 years of age in rural areas (2,8) , match what WHO states regarding Brazil being among the countries where anaemia is deemed a serious public health problem (1) .…”

Estado nutricional e prevalência de anemia em crianças menores de 36 meses

“…Já a região Nordeste diagnosticou 25,5% das crianças como anêmicas. Resultados superiores ao presente estudo foram encontrados nos estados da Paraíba (19) (25,1%), Minas Gerais (20) (30,6%), Acre (15) (29,2%), Pernambuco (21) (55,6%) e São Paulo (22) (43,6%), para faixa etária semelhante.…”

“…Resultados semelhantes também foram encontrados em outros estudos (29,32) . Em São Paulo, estudo realizado em creches públicas e filantrópicas concluiu que a renda familiar per capita foi uma das variáveis indicadora dos processos estruturais da sociedade que se associou de forma estatisticamente significante com anemia, cujas crianças de família com renda per capita de até 0,5 SM tiveram um risco adicional de 56% de apresentar anemia (22) . Apesar de não ter sido associada à anemia, observou-se no presente estudo que quanto menor a renda, maior foi a prevalência de anemia, constatação essa também relatada em outros estudos (14,30,38) .…”