Seroprevalence of Dengue, Chikungunya, and Zika viruses antibodies in a cohort of asymptomatic pregnant women in a low-income region of Minas Gerais, Brazil, 2018-2019.

Dengue, Chikungunya, and Zika viruses are arthropod-borne viruses (arboviruses) that infect millions of individuals in tropical and subtropical regions. In the Americas, arboviruses represent a major public health problem, especially among vulnerable groups such as the elderly, children, and pregnant women. In this study, the seroprevalence of IgM or IgG against these arboviruses in pregnant, young women in the city of Diamantina, Minas Gerais, Brazil, and the influence of sociodemographic factors on the incidence/prevalence of infection in this group were investigated. A cross-sectional investigation was conducted on a total of 135 pregnant women for Dengue and Chikungunya IgM and 88 pregnant women for Zika IgG. Dengue IgM was found on the serum of twenty participants (14.8%) and only one woman (0.7%) tested positive for Chikungunya IgM. Zika IgG was found in three (3.4%) participants and 2 women who tested positive for Zika virus were also positive for Dengue virus IgM. Although the arboviruses seroprevalence was higher frequency among young (20-25 years old), brown and high school women, with a monthly income of 1-3 minimum wages, no association between these sociodemographic factors and arboviruses seroprevalence was found.

Uso de psicofármacos por profissionais da Atenção Primária à Saúde e fatores associados / Use of psychotropic drugs by professionals in Primary Health Care and associated factors

RESUMO Objetivo: Identificar a prevalência do uso de psicofármacos entre profissionais da Atenção Primária à Saúde e os fatores associados. Métodos: Este é um estudo epidemiológico, de base populacional, transversal e analítico, realizado com 290 profissionais que atuam na Atenção Primária da Região de Saúde de Diamantina, Minas Gerais, Brasil. A coleta de dados foi realizada por meio de um questionário contendo informações sociodemográficas e econômicas, e sobre hábitos de vida, uso de medicamentos e condições de trabalho. Utilizou-se a regressão logística múltipla para obter estimativas do efeito das variáveis no uso de psicofármacos. Resultados: Observou-se prevalência de uso de psicofármacos em 10,7% (IC95%: 7-14) dos entrevistados. Entre os profissionais da Atenção Primária à Saúde, as variáveis associadas ao uso de psicofármacos foram ter idade > 31 anos ( odds ratio ajustado [ORA] = 2,33; IC95% = 1,06-5,09; p = 0,034) e ter realizado horas extras (ORA = 2,28; IC95% = 1,06-4,89; p = 0,034). Conclusão: As condições de trabalho, como carga horária excessiva, podem contribuir para o adoecimento e, consequentemente, a necessidade de uso de psicofármacos por profissionais de saúde. Assim, é importante abordar a questão, desde a assistência à saúde até o desenvolvimento de políticas de recursos humanos para o Sistema Único de Saúde (SUS) que atentem para as condições de trabalho.

ABSTRACT Objective: Identify the prevalence of psychotropic drug use among Primary Health Care professionals and associated factors. Methods: This is an epidemiological, population-based, cross-sectional and analytical study, carried out with 290 professionals working in Primary Care in the Health Region of Diamantina, Minas Gerais, Brazil. Data collection was carried out through a questionnaire containing sociodemographic and economic information, life habits, use of medication and working conditions. Multiple logistic regression was used to obtain estimates of the effect of variables on the use of psychotropic drugs. Results: A prevalence of psychotropic drug use was observed in 10.7% (CI95%: 7-14) of respondents. Among primary health care professionals, the variables associated with the use of psychotropic drugs were age > 31 years (adjusted odds ratio [ORA] = 2.33; 95%CI = 1.06-5.09; p = 0.034) and having performed overtime (ORA = 2.28; 95%CI = 1.06-4.89; p = 0.034). Conclusion: Working conditions, such as excessive workload, are conditions that can contribute to illness and, consequently, the need for the use of psychotropic drugs by health professionals. It is important to address the issue, from health care to the development of human resources policies in the Health System that meet the working conditions.

Brazilian Food Banks: Overview and Perspectives.

In recent decades food banks have become a worldwide response to the contradicting the coexistence of food losses and waste, on the one hand, and hunger and food insecurity on the other. In Brazil, food banks had a rapid expansion, becoming the object of public policy on Food and Nutrition Security and of non-profit private institutions. Our study presents an unprecedented overview of all the food banks currently active in the Brazilian territory, discussing their performances and perspectives. We conducted descriptive research, aiming to characterize the number, spatial distribution, performance, and modalities of operation of the Brazilian food banks. We mapped 217 active food banks and they all participated in the study. The results revealed the important capillarity of the food banks, which exist in all 27 Brazilian federative units, but also demonstrate the potential and need for expansion. Most of the Brazilian food banks has commercial establishments as their largest donor partners and have fruits and vegetables as their most donated items. They mostly complement the feeding of families at social risk and children served by social institutions. Food and nutrition education actions are offered by all the studied units to donor partners and beneficiary institutions and families.

RELATIONSHIP BETWEEN THE DIET QUALITY INDEX IN NURSING MOTHERS AND THE FATTY ACID PROFILE OF MATURE BREAST MILK.

OBJECTIVE: To evaluate the relationship between the maternal diet quality and the fatty acid composition of breast milk in the first trimester of lactation. METHODS: This is an observational cross-sectional epidemiological study of nursing mothers. The data collection instruments were a semi-structured questionnaire for sample characterization and a recall of usual intake. Diet quality was assessed based on the healthy eating index (HEI). Samples of mature breast milk were obtained by hand milking. Milk fat was extracted using the Bligh-Dyer method and methylated with 0.25 mol/L sodium methoxide in methanol diethyl ether. A gas chromatograph equipped with a flame ionization detector determined the milk fatty acid profile. Pearson's and Spearman's correlation tests evaluated association between the variables. Subsequently, a multiple linear regression model was built and multivariate regression analysis was applied. RESULTS: Our findings revealed an inverse relationship between the consumption of total fruits and the polyunsaturated fatty acid profile and a direct association of the intake of total fruits and total grains with monounsaturated and saturated fatty acids. CONCLUSIONS: The results of this study suggest that maternal diet quality affects the fatty acid composition of breast milk.

Relationship between the diet quality index in nursing mothers and the fatty acid profile of mature breast milk / Relação entre o índice de qualidade da dieta de nutrizes e o perfil de ácidos graxos do leite materno maduro

ABSTRACT Objective: To evaluate the relationship between the maternal diet quality and the fatty acid composition of breast milk in the first trimester of lactation. Methods: This is an observational cross-sectional epidemiological study of nursing mothers. The data collection instruments were a semi-structured questionnaire for sample characterization and a recall of usual intake. Diet quality was assessed based on the healthy eating index (HEI). Samples of mature breast milk were obtained by hand milking. Milk fat was extracted using the Bligh-Dyer method and methylated with 0.25 mol/L sodium methoxide in methanol diethyl ether. A gas chromatograph equipped with a flame ionization detector determined the milk fatty acid profile. Pearson's and Spearman's correlation tests evaluated association between the variables. Subsequently, a multiple linear regression model was built and multivariate regression analysis was applied. Results: Our findings revealed an inverse relationship between the consumption of total fruits and the polyunsaturated fatty acid profile and a direct association of the intake of total fruits and total grains with monounsaturated and saturated fatty acids. Conclusions: The results of this study suggest that maternal diet quality affects the fatty acid composition of breast milk.

RESUMO Objetivo: Avaliar a relação entre a qualidade da dieta materna e a composição do leite humano em ácidos graxos no primeiro trimestre de lactação. Métodos: Trata-se de um estudo epidemiológico observacional e transversal com nutrizes. Os instrumentos de coleta dos dados foram questionário semiestruturado para caracterização da amostra e o recordatório de ingestão habitual. A qualidade da dieta foi avaliada por meio do índice de alimentação saudável (IAS). Amostras de leite materno maduro foram obtidas por meio de ordenha manual. A extração da gordura do leite ocorreu mediante o método de Bligh-Dyer, e essa gordura foi metilada com metóxido de sódio 0,25 mol/L em metanol dietil éter. O perfil de ácidos graxos do leite foi determinado por um cromatógrafo a gás equipado com detector por ionização de chamas. Realizaram-se teste de correlação de Pearson e teste de Spearman para verificar associação entre as variáveis. Posteriormente se aplicaram o modelo de regressão linear múltiplo e a análise de regressão multivariada. Resultados: Foi possível observar relação inversa entre o consumo de frutas totais e o perfil de ácidos graxos poli-insaturados e relação direta entre o consumo de frutas totais e cereais totais e os ácidos monoinsaturados e saturados. Conclusões: Sugere-se que a qualidade da dieta reflete na composição de ácidos graxos do leite materno.

Composition in fatty acids of mature milk of nursing mothers / Composição em ácidos graxos do leite maduro de nutrizes

Abstract Objectives: to determine the fatty acid composition of mature milk of nursing mothers and its distribution according to some maternal variables. Methods: this is a cross-sectional observational epidemiological study based on the eva-luation of the fatty acid profile of mature human milk. Samples of mature breast milk were taken from 106 nursing mothers, by manual milking and who were after the 5th postpartum week. The milk fat extraction was carried out by using the Bligh and Dyer method and methy-lated with 0.25 mol/L sodium methoxide in methanol diethyl ether. The fatty acid of the milk profile was determined by a Gas Chromatograph equipped with a flame ionization detector. Results: among the saturated fatty acids, the highest values were observed for palmitic (C16:0), stearic (C18:0), myristic (C14:0) and lauric (C12:0) fatty acids, respectively. Among the monounsaturated fatty acids, there was a higher contribution of oleic (C18:1) and palmi-toleic (C16:1) fatty acids, respectively. The total essential fatty acids (linoleic and α-linolenic) was 14.94%. Conclusions: a low content of essential fatty acids in the breast milk of the nursing mothers was observed in the present study, which are important for infant growth and deve-lopment. We suggest the need to implement nutrition education strategies aimed for pregnant women and nursing mothers who should be advised to eat healthier foods.

Resumo Objetivos: determinar a composição em ácidos graxos do leite maduro de nutrizes e sua distribuição segundo algumas variáveis maternas. Métodos: trata-se de um estudo epidemiológico observacional, transversal realizado a partir da avaliação do perfil de ácidos graxos do leite humano maduro. Amostras de leite materno maduro foram obtidas de 106 nutrizes, a partir da 5ª semana pós-parto, por meio de ordenha manual. A extração da gordura do leite foi realizada através do método de Bligh e Dyer, e metiladas com metóxido de sódio 0,25 mol/L em metanol dietil - éter. O perfil de ácidos graxos do leite foi determinado por um Cromatógrafo a Gás equipado com detector por ionização de chamas. Resultados: dentre os ácidos graxos saturados, foram observados valores mais elevados para os ácidos graxos palmítico (C16:0), esteárico (C18:0), mirístico (C14:0) e láurico (C12:0), respectivamente. Entre os ácidos graxos mono-insaturados, verificou-se maior contribuição dos ácidos graxos oleico (C18:1) e palmitoleico (C16:1), respectivamente. O total de ácidos graxos essenciais (linoleico e α- linolênico) foi de 14,94%. Conclusões: foi observado baixo teor de ácidos graxos essenciais no leite materno das nutrizes do presente estudo, que são importantes para o crescimento e desenvolvimento do lactente, sugerindo-se a necessidade de implementação de estratégias de educação nutricional direcionadas a gestantes e nutrizes que devem ser orientadas a consumir alimentos mais saudáveis.

Growth and development and their environmental and biological determinants / Crescimento e desenvolvimento e seus determinantes ambientais e biológicos

Abstract Objective To investigate child growth, cognitive/language development, and their environmental and biological determinants. Methods This was a cross-sectional, predictive correlation study with all 92 children aged 24-36 months who attended the municipal early childhood education network in a town in the Vale do Jequitinhonha region, in 2011. The socioeconomic profile was determined using the questionnaire of the Associação Brasileira de Empresas de Pesquisa. The socio-demographicand maternal and child health profiles were created through a self-prepared questionnaire. The height-for-age indicator was selected to represent growth. Cognitive/language development was assessed through the Bayley Scale of Infant and Toddler Development. The quality of educational environments was assessed by Infant/Toddler Environment Scale; the home environment was assessed by the Home Observation for Measurement of the Environment. The neighborhood quality was determined by a self-prepared questionnaire. A multivariate linear regression analysis was performed. Results Families were predominantly from socioeconomic class D, with low parental education. The prevalence of stunted growth was 14.1%; cognitive and language development were below average at 28.6% and 28.3%, respectively. Educational institutions were classified as inadequate, and 69.6% of homes were classified as presenting a risk for development. Factors such as access to parks and pharmacies and perceived security received the worst score regarding neighborhood environment. Biological variables showed a greater association with growth and environmental variables with development. Conclusion The results showed a high prevalence of stunting and below-average results for cognitive/language development among the participating children. Both environmental and biological factors were related to growth and development. However, biological variables showed a greater association with growth, whereas environmental variables were associated with development.

Resumo Objetivo Investigar o crescimento e desenvolvimento cognitivo/linguagem de crianças e seus determinantes ambientais e biológicos. Método Estudo transversal, correlacional preditivo, com todas as 92 crianças entre 24-36 meses, frequentadoras da rede municipal de educação infantil de uma cidade no Vale do Jequitinhonha, ano 2011. Traçou-se o perfil econômico utilizando-se o questionário da Associação Brasileira de Empresas de Pesquisa. O perfil sociodemográfico e saúde materno-infantil por questionário próprio. Elegeu-se o indicador estatura/idade para representar o crescimento. O desenvolvimento cognitivo/linguagem foi avaliado por meio do Bayley Scale of Infant and Toddler Development. Avaliou-se os ambientes educacionais pelo Infant/Toddler Environment Scale, e o ambiente domiciliar pelo Home Observation for Measurement of the Environment. Aferiu-se a qualidade da vizinhança através de questionário próprio. Foram realizadas análises de regressão linear multivariada. Resultados As famílias eram predominantemente da classe D com baixa escolaridade dos pais. A prevalência de déficit de estatura foi 14,1%; desenvolvimento abaixo da média na linguagem 28,6% e cognitivo 28,3%. As instituições educacionais classificaram-se como inadequadas e 69,6% dos domicílios como de risco para o desenvolvimento. Aspectos como, disponibilidade de praças e farmácias e segurança foram aspectos de pior pontuação no ambiente vizinhança. Variáveis biológicas demonstraram maior associação com o crescimento e variáveis ambientais ao desenvolvimento. Conclusão Observou-se elevado déficit de estatura e de resultados abaixo da média para desenvolvimento cognitivo/linguagem entre as crianças participantes. Fatores ambientais e biológicos relacionaram-se tanto ao crescimento quanto ao desenvolvimento. Entretanto, variáveis biológicas demonstraram maior associação com o crescimento e variáveis ambientais com o desenvolvimento.

Growth and development and their environmental and biological determinants.

OBJECTIVE: To investigate child growth, cognitive/language development, and their environmental and biological determinants. METHODS: This was a cross-sectional, predictive correlation study with all 92 children aged 24-36 months who attended the municipal early childhood education network in a town in the Vale do Jequitinhonha region, in 2011. The socioeconomic profile was determined using the questionnaire of the Associação Brasileira de Empresas de Pesquisa. The socio-demographicand maternal and child health profiles were created through a self-prepared questionnaire. The height-for-age indicator was selected to represent growth. Cognitive/language development was assessed through the Bayley Scale of Infant and Toddler Development. The quality of educational environments was assessed by Infant/Toddler Environment Scale; the home environment was assessed by the Home Observation for Measurement of the Environment. The neighborhood quality was determined by a self-prepared questionnaire. A multivariate linear regression analysis was performed. RESULTS: Families were predominantly from socioeconomic class D, with low parental education. The prevalence of stunted growth was 14.1%; cognitive and language development were below average at 28.6% and 28.3%, respectively. Educational institutions were classified as inadequate, and 69.6% of homes were classified as presenting a risk for development. Factors such as access to parks and pharmacies and perceived security received the worst score regarding neighborhood environment. Biological variables showed a greater association with growth and environmental variables with development. CONCLUSION: The results showed a high prevalence of stunting and below-average results for cognitive/language development among the participating children. Both environmental and biological factors were related to growth and development. However, biological variables showed a greater association with growth, whereas environmental variables were associated with development.

Determinants of Iron Deficiency Anemia in a Cohort of Children Aged 6-71 Months Living in the Northeast of Minas Gerais, Brazil.

Iron deficiency anemia is one of the most common nutritional disorders worldwide. The aim was to identify the prevalence and incidence of anemia in children and to identify predictors of this condition, including intestinal parasites, social, nutritional and environmental factors, and comorbidities. A population-based cohort study was conducted in a sample of 414 children aged 6-71 months living in Novo Cruzeiro in the Minas Gerais State. Data were collected in 2008 and 2009 by interview and included socio-economic and demographic information about the children and their families. Blood samples were collected for testing of hemoglobin, ferritin and C-reactive protein. Anthropometric measurements and parasitological analyses of fecal samples were performed. To identify risk factors associated with anemia multivariate analyses were performed using the generalized estimating equations (GEE). In 2008 and 2009, respectively, the prevalence rates of anemia were 35.9% (95%CI 31.2-40.8) and 9.8% (95%CI 7.2-12.9), the prevalence rates of iron deficiency were 18.4% (95%CI 14.7-22.6) and 21.8% (95%CI 17.8-26.2), and the incidence rates of anemia and iron deficiency were 3.2% and 21.8%. The following risk factors associated with anemia were: iron deficiency (OR = 3.2; 95%CI 2.0-.5.3), parasitic infections (OR = 1.9; 95%CI 1.2-2.8), being of risk of or being a low length/height-for-age (OR = 2.1; 95%CI 1.4-3.2), and lower retinol intake (OR = 1.7; 95%CI 1.1-2.7), adjusted over time. Nutritional factors, parasitic infections and chronic malnutrition were identified as risk factors for anemia. These factors can be verified in a chronic process and have been classically described as risk factors for these conditions.

[Iodine deficiency and associated factors in infants and preschool children in an urban community in the semiarid region of Minas Gerais State, Brazil, 2008]. / Deficiência de iodo e fatores associados em lactentes e pré-escolares de um município do semiárido de Minas Gerais, Brasil, 2008.

The aim of this study was to evaluate the prevalence of iodine deficiency in children aged 6 to 71 months in Novo Cruzeiro, Minas Gerais State, Brazil. A total of 475 children, allocated by stratified probability sampling, were analyzed with respect to the iodine concentrations in the salt consumed by the family and urinary iodine. Iodine deficiency was verified in 34.4% of the children, of which 23.5% showed slight deficiency, 5.9% moderate and 5% serious deficiency. A difference in the distribution of iodine deficiency was observed between the urban and the rural environments (p < 0.001) where average urinary iodine concentrations of 150.8 and 114.3µg/L respectively were found. A greater proportion of iodine deficiency was observed among children where the proportion of iodine in the salt consumed was below the recommended level. Although expressive, iodine deficiency in Novo Cruzeiro is not a public health problem according to World Health Organization (WHO), The limitrophe distribution of the urinary iodine associated with low iodine levels in salt suggests that efforts to control this deficiency are not yet complete.

Deficiência de iodo e fatores associados em lactentes e pré-escolares de um município do semiárido de Minas Gerais, Brasil, 2008 / Iodine deficiency and associated factors in infants and preschool children in an urban community in the semiarid region of Minas Gerais State, Brazil, 2008

O objetivo do estudo foi avaliar a prevalência de deficiência de iodo em crianças de 6 a 71 meses em Novo Cruzeiro, Minas Gerais, Brasil. Foram analisadas 475 crianças alocadas por amostragem probabilística estratificada em relação às concentrações de iodo no sal de consumo familiar e excreção urinária de iodo. Observou-se excreção deficiente de iodo em 34,4 por cento das crianças; entre as quais, 23,5 por cento apresentaram deficiência leve; 5,9 por cento, moderada; e 5 por cento, grave. Diferença na distribuição da deficiência de iodo urinário foi constatada entre o meio urbano e rural (p < 0,001), registrando concentrações medianas de iodúria de 150,8µg/L e 114,3µg/L, respectivamente. Observou-se alta proporção de deficiência entre crianças cujo teor de iodo no sal de consumo encontrava-se abaixo da recomendação. A deficiência de iodo em Novo Cruzeiro não constitui problema de saúde pública segundo a Organização Mundial da Saúde (OMS), embora apresente prevalência ainda expressiva. A distribuição limítrofe de iodúria associada a baixos níveis de iodo no sal sugere que as ações de controle dessa carência ainda não são completas no país.

The aim of this study was to evaluate the prevalence of iodine deficiency in children aged 6 to 71 months in Novo Cruzeiro, Minas Gerais State, Brazil. A total of 475 children, allocated by stratified probability sampling, were analyzed with respect to the iodine concentrations in the salt consumed by the family and urinary iodine. Iodine deficiency was verified in 34.4 percent of the children, of which 23.5 percent showed slight deficiency, 5.9 percent moderate and 5 percent serious deficiency. A difference in the distribution of iodine deficiency was observed between the urban and the rural environments (p < 0.001) where average urinary iodine concentrations of 150.8 and 114.3µg/L respectively were found. A greater proportion of iodine deficiency was observed among children where the proportion of iodine in the salt consumed was below the recommended level. Although expressive, iodine deficiency in Novo Cruzeiro is not a public health problem according to World Health Organization (WHO), The limitrophe distribution of the urinary iodine associated with low iodine levels in salt suggests that efforts to control this deficiency are not yet complete.

Deficiencia de vitamina a em crianças residentes na região metropolitana de Belo Horizonte, Minas Gerais / Vitamin a deficiency in children living in the metropolitan region of Belo Horizonte, Minas Gerais / Deficiencia de vitamina a en ninos de la region metropolitana de Belo Horizonte, Minas Gerais

Este é um estudo descritivo com o objetivo de avaliar a prevalência de deficiência de Vitamina A em crianças de 6 a 24 meses,residentes nos municípios de Vespasiano e Santa Luzia, Região Metropolitana de Belo Horizonte-MG. Foram realizadas medidas antropométricas e dosagem de retinol plasmático, por HPLC, em 173 crianças de ambos os sexos. Aplicou-se aos responsáveis pela criança um questionário que contemplava questões biológicas, socioeconômicas e demográficas, a fim de investigar a relação entre as variáveis de interesse e os níveis de retinol. O nível médio de retinol plasmático encontrado foi de 1,0 μmol/L (DP=0,4). Níveis inadequados de retinol (< 0,7 μmol/L) foram observados em 17,7% das crianças avaliadas.Não foram constatadas associações entre nenhuma das variáveis analisadas e os níveis de retinol plasmático. Concluiu-seque a prevalência de hipovitaminose A representa um problema moderado de saúde pública na população estudada.Evidencia-se, assim, a necessidade do desenvolvimento de programas de educação nutricional para o incentivo ao consumo de alimentos fontes de vitamina A e prevenção do problema em longo prazo nesta população.

This descriptive study had as its objective the evaluation of the frequency of vitamin A deficiency in children aged from6 to 24 months, residents in the municipalities of Vespasiano and Santa Luzia, located in the Belo Horizonte metropolitan region, state of Minas Gerais, Brazil. Anthropometry and plasma retinol levels were quantified in 173 children of both genders, and a questionnaire was applied to mothers or guardians in order to measure biological, social economic and demographic indicators so as to investigate the relationship between the variables of interest and the retinol levels.Average level of plasma retinol was 1, 0 μmol/L (SD = 0, 4 μmol/L). An inadequate level of plasma retinol (< 0, 7 μmol/L)was observed in 17.7% (31) of the tested children. There was no association between the questionnaire variables and plasma retinol levels. We conclude that the prevalence of hypo vitamin A represents a moderate public health problem in the population under study. It was evident that the development of programs on nutrition education is necessary to stimulate the consumption of food rich in vitamin A to prevent its deficiency in the long run.

El objeto del presente estudio descriptivo ha sido de evaluar la prevalencia de la deficiencia de vitamina A en niños de 6 a24 meses de edad, residentes de los municipios de Santa Luzia y Vespasiano, en la región metropolitana de Belo Horizonte,Minas Gerais, Brasil. Se valoraron la antropometría y los niveles de retinol plasmático en 173 niños de ambos sexos.También se aplicó un cuestionario a los responsables de los niños referente a asuntos biológicos, sociales, económicos y demográficos con miras a investigar la relación entre las variables de interés y los niveles de retinol. El promedio deretinol plasmático fue de 1,0 μmol /L (SD = 0,4 μmol/L). Se observó que el nivel de retinol era inadecuado (< 0,7 μmol/L)en 17,7% (31) de los niños evaluados. No hubo asociación entre las variables del cuestionario y los niveles plasmáticos de retinol. Se concluye que la prevalencia de hipovitaminosis A constituye un problema de salud pública moderada en la población en estudio. Es evidente que habría que desarrollar programas de educación nutricional para estimular el consumo de alimentos fuente de vitamina A y para prevenir el problema a largo plazo en dicha población.