Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil.

INTRODUCTION: Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host's nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS: This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS: Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS: Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.

Nutritional status and vitamin A and zinc levels in patients with kala-azar in Piauí, Brazil

Abstract INTRODUCTION: Malnutrition and kala-azar (or visceral leishmaniasis) are significant public health problems in different parts of the world. Immunity and susceptibility to infectious and parasitic diseases are directly linked to the host's nutritional state, but little is known about the interaction between nutrition and kala-azar. This study aimed to evaluate nutritional status with kala-azar and correlate these findings with the clinical and laboratory manifestations of the disease, and zinc and retinol levels. METHODS: This was a cross-sectional study of 139 patients with kala-azar. Nutritional status classification was performed according to international recommendations. Parametric or nonparametric tests were applied whenever indicated in a two-sided test with a 5% significance level. RESULTS: Weight loss and malnutrition were more frequent in adults. Body mass index-for-age, fat area of the arm, and upper arm muscle area were significantly associated with probability of death. The presence of human immunodeficiency virus, hepatomegaly, and splenomegaly was correlated with nutritional assessment. Blood leukocyte and lymphocyte, serum creatine, and vitamin A levels were significantly higher in adult men. Vitamin A levels were highly associated with the level of hemoglobin and C-reactive protein (CRP) in multivariate analysis. All patients had reduced plasma zinc levels, but this finding had no association with the outcome variables. CONCLUSIONS: Malnutrition was correlated with severe disease and was more prevalent in older people with kala-azar. Vitamin A deficiency was associated with hemoglobin and CRP. Zinc levels were reduced in patients with kala-azar.

Caracterização dos recém-nascidos pré-termo nascidos no estado do Piauí entre 2011 a 2015 / Characterization of newborns preterm born in the state of Piauí among 2011 to 2015 / Caracterización de los recién nacidos prematuros nacidos en el estado del Piauí entre los años 2011-2015

O parto pré-termo, é aquele que ocorre antes da 37ª semana de gestação, e é o problema perinatal atual mais importante, pois está associado à morbidade e mortalidade significativas no início da vida. O objetivo do estudo foi caracterizar o nascimento de pré-termos entre mulheres residentes no Estado do Piauí, no período entre 2011 a 2015. Trata-se de estudo descritivo utilizando os dados do Sistema de Informações sobre Nascidos Vivos (SINASC) coletados do banco de dados do Departamento de Informática do Sistema Único de Saúde (DATASUS). A população foi constituída por 23.754 nascidos vivos, sendo 26.182 pré-termos. Houve aumento percentual do número de recém-nascidos pré-termos entre os anos estudados. Observou-se que idade materna variou entre 20 e 34 anos, a maioria das mães eram casadas, com escolaridade de 8 a 11 anos, de gravidez única, com 7 consultas pré-natal ou mais, recém-nascido de raça/cor parda relacionaram-se com o nascimento pré-termo. Partos vaginais, recém-nascidos do sexo masculino, também se relacionaram à prematuridade, assim como, a influência da situação socioeconômica. Os recém-nascidos pré-termos caracterizaram-se principalmente por serem de 32 a 36 semanas, sexo masculino, pardos e peso normal ao nascer. Assim, os dados obtidos permitem concluir que o conhecimento e a avaliação do perfil das mães e o número e a situação do nascimento dessas crianças é importante no planejamento de estratégias de saúde eficazes na atenção materno-infantil, objetivando aprimorar políticas públicas para a sobrevivência do recém-nascido e a consequente redução da ocorrência da prematuridade(AU)

Preterm birth is one that occurs before the 37th week of gestation, and is the most important current perinatal problem, since it is associated with significant morbidity and mortality in early life. The objective of the study was to characterize preterm birth among women residing in the State of Piauí, in the period between 2011 and 2015. This is a descriptive study using data from the Information System on Live Births (SINASC) collected from the database of the Department of Information Technology of the National Health System (DATASUS). The population consisted of 23,754 live births, with 26,182 preterms. There was a percentage increase in the number of preterm newborns between the years studied. It was observed that maternal age varied between 20 and 34 years, most of the mothers were married, with education from 8 to 11 years of single pregnancy, with 7 prenatal consultations or more, newborn of race / brown color related with preterm birth. Vaginal births, newborn males, were also related to prematurity, as well as the influence of socioeconomic status. The preterm newborns were mainly characterized as being from 32 to 36 weeks, male, brown and normal birth weight. Thus, the data obtained allow us to conclude that the knowledge and evaluation of the mothers' profile and the number and situation of the birth of these children is important in the planning of effective health strategies in maternal and child care, aiming at improving public policies for the survival of the child. newborn and consequent reduction in the occurrence of prematurity(AU)

El parto pre-término, es el que ocurre antes de la 37ª semana de gestación, y es el problema perinatal actual más importante, pues está asociado a la morbilidad y mortalidad significativas al inicio de la vida. El objetivo del estudio fue caracterizar el nacimiento de pre-términos entre mujeres residentes en el Estado de Piauí, en el período entre 2011 a 2015. Se trata de un estudio descriptivo utilizando los datos del Sistema de Información sobre Nacidos vivos (SINASC) recogidos de la base de datos del Departamento de Informática del Sistema Único de Salud (DATASUS). La población fue constituida por 23.754 nacidos vivos, siendo 26.182 pre-términos. Se observó un aumento porcentual del número de recién nacidos pre-términos entre los años estudiados. Se observó que la edad materna varía entre 20 y 34 años, la mayoría de las madres estaban casadas, con escolaridad de 8 a 11 años, de embarazo único, con 7 consultas prenatales o más, recién nacido de raza / color parda relacionadas con el nacimiento pre-término. Partos vaginales, recién nacidos del sexo masculino, también se relacionaron con la prematuridad, así como la influencia de la situación socioeconómica. Los recién nacidos pre-términos se caracterizaron principalmente por ser de 32 a 36 semanas, sexo masculino, pardos y peso normal al nacer. Así, los datos obtenidos permiten concluir que el conocimiento y la evaluación del perfil de las madres y el número y la situación del nacimiento de estos niños es importante en la planificación de estrategias de salud eficaces en la atención materno-infantil, con el objetivo de mejorar políticas públicas para la supervivencia del niño, el recién nacido y la consiguiente reducción de la ocurrencia de la prematuridade(AU)