Prevalence of childhood anaemia in Brazil: still a serious health problem: a systematic review and meta-analysis

Nogueira‐de‐Almeida, Carlos Alberto; Ued, Fábio da Veiga; Ciampo, Luíz Antônio Del; Martinez, Edson Zangiacomi; Ferraz, Ivan Savioli; Contini, Andrea Aparecida; Cruz, Franciele Carolina Soares da; Silva, Raquel Farias Barreto; Nogueira-de-Almeida, Maria Eduarda; Lamounier, Joel Alves

doi:10.1017/s136898002100286x

Cited by 11 publications

(4 citation statements)

References 145 publications

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“…In Brazil, an estimated national prevalence of childhood anaemia was 33 %. However, they were lower in the southern region, where this study was performed (28 %) [53].…”

Section: Discussionmentioning

confidence: 63%

Helicobacter pylori Chronic Gastritis in Children and Adolescents was not Associated with Anaemia

Carvalho

Oliveira

Silva

et al. 2022

EJMED

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Background: Helicobacter pylori (H. pylori) colonizes the gastric mucosa, leading to chronic inflammation. Epidemiological studies have demonstrated that H. pylori infection is high in areas with a high prevalence of anaemia. Consequently, patients infected with H. pylori are at a higher risk of anaemia. However, the relationship between H. pylori and anaemia remains controversial. Therefore, a study conducted among children with chronic abdominal pain with organic dyspepsia (chronic gastritis due to H. pylori and (or?) Esophagitis), and a functional disorder (Irritable Bowel Syndrome), will be appropriate. Objective: Compare the prevalence of Anaemia in children and adolescents with chronic abdominal pain, divided into: 1) Non-ulcer dyspepsia associated with H. pylori gastritis., 2) Dyspepsia associated with chronic Esophagitis, and Irritable Bowel Syndrome. Methods: The study was a single-centre, observational retrospective cohort. Inclusion and Exclusion Criteria. All children must be well categorized with signs and symptoms consistent with chronic abdominal pain and aged between 5-and 18 years. Exclusion criteria: genetic, metabolic, immune, cardiac, hepatic or renal diseases, neurodevelopmental delay, and previous surgery. Laboratory tests were performed for all patients: complete blood cell count, Erythrocyte Sedimentation Rate, urinalysis, stool for ova & parasites, and H. pylori serology. Another diagnostic test was decided at the discretion of the gastroenterology team. The chronic dyspeptic syndrome with non-ulcer dyspepsia associated with H. pylori if they presented both results: the rapid urease test positive and the histological examination of the gastric mucosa confirming the presence of the bacterium. Dyspepsia associated with chronic Esophagitis was based on clinical symptoms/signs and endoscopic and histologic evaluation. Patients with IBS were diagnosed according to Rome Criteria. Results: Three hundred and seven children/adolescents: H. pylori gastritis (154, 50%), Esophagitis (41, 14%), and IBS (112, 36%) were included. There was a non-statistically significant difference in the baseline characteristics (sex, first-born child, age of mothers, age of fathers, crowding index, duration of pain symptoms, headache and limb pain, overweight/obesity and malnutrition) between the three groups. Clinical characteristics demonstrated: H. pylori and Esophagitis have epigastric pain and IBS periumbilical pain. There was a non-statistically significant difference in haemoglobin values and red cell parameters between the three groups in laboratory investigation. The prevalence of anaemia was very low, with no difference between the groups. Urinalysis and stool for ova & parasites were negative in all children. Conclusion: Anaemia was not present in children with chronic abdominal pain, both organic and functional disorders. Age, good nutritional status, good sanitation and hygiene may have contributed to the results in this study.

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“…In Brazil, an estimated national prevalence of childhood anaemia was 33 %. However, they were lower in the southern region, where this study was performed (28 %) [53].…”

Section: Discussionmentioning

confidence: 63%

Helicobacter pylori Chronic Gastritis in Children and Adolescents was not Associated with Anaemia

Carvalho

Oliveira

Silva

et al. 2022

EJMED

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“…However, the level of vitamin D fortification is important, as countries with mandatory fortification e.g. Canada and the US, still report high levels of vitamin D inadequacy [27][28][29].…”

Section: Impact Of Increasing Dairy Consumption On Micronutrient Adeq...mentioning

confidence: 99%

“…Iron and zinc are key nutrients for growth and development at this stage. Although iron inadequacy is relatively low in this population, a recent publication reports that 1 in 3 Brazilian children are anaemic [28]. This may be due to the high consumption of rice and beans in the Brazilian diet, as these plant-based sources of iron and zinc are not as bioavailable compared to animal food sources [30].…”

Section: Impact Of Increasing Dairy Consumption On Micronutrient Adeq...mentioning

confidence: 99%

Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study

et al. 2022

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Background Previous studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4–5-year-old Brazilian children. Methods Adherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow’s milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios. Results Seventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow’s milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child’s current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E. Conclusions Dairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.

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“…Anemia is a serious global public health problem particularly affecting young children and pregnant women (1). In Brazil, a recent nationwide meta-analysis observed a prevalence of anemia of 38,36,35, and 28% in the Northeast, Midwest, South and Southeast regions of Brazil, respectively, in children from 0 to 7 years old (2). Data obtained by the ENANI study showed prevalences of 10% for the country as a whole, but reaching 17% in the North and 19 % for children under 2 years of age (3).…”

Section: Introductionmentioning

confidence: 99%

Low bioavailability of dietary iron among Brazilian children: Study in a representative sample from the Northeast, Southeast, and South regions

Nogueira‐de‐Almeida

Prozorovscaia²,

Mosquera³

et al. 2023

Front. Public Health

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BackgroundDespite all efforts, iron deficiency anemia remains a serious public health problem among Brazilian children.ObjectiveTo evaluate dietary iron intake and dietary practices that interfere with the absorption of this nutrient from three regions of Brazil.MethodsBrazil Kids Nutrition and Health Study is a cross-sectional dietary intake study in children aged 4–13.9 years old designed to investigate nutrient intakes and gaps of Brazilian children in a representative sample of households from Northeast, Southeast and South regions. Nutrient intake was assessed based on multiple-pass 24-h dietary recall and U.S. National Cancer Institute method was used to estimate usual micronutrients intakes and compliance with Dietary Reference Intakes.ResultsFive hundred sixteen individuals participated in the study (52.3% male). The top three most consumed food sources of iron were products of plant origin. Food sources of animal origin contributed with <20% of the total iron intake. Vitamin C intake was adequate, but the concomitant consumption of food sources of vitamin C with plant food sources of iron was not common. On the other hand, the concomitant intake of plant food sources of iron with food sources of iron chelators (e.g., coffee and teas) was frequent.ConclusionsAdequate iron intake was observed in all three regions in Brazil. Children's diet showed low iron bioavailability and insufficient consumption of food sources of iron absorption stimulants. Frequent presence of iron chelators and inhibitors of iron absorption might help to explain the high prevalence of iron deficiency in the country.

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Prevalence of childhood anaemia in Brazil: still a serious health problem: a systematic review and meta-analysis

Cited by 11 publications

References 145 publications

Helicobacter pylori Chronic Gastritis in Children and Adolescents was not Associated with Anaemia

Helicobacter pylori Chronic Gastritis in Children and Adolescents was not Associated with Anaemia

Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study

Low bioavailability of dietary iron among Brazilian children: Study in a representative sample from the Northeast, Southeast, and South regions

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