Variations in the Prevalence of Childhood Anemia by Ethnicity Before and During the COVID-19 Pandemic in Peru.

We aimed to determine the variations in the prevalence of childhood anemia according to the ethnic group before and during the COVID-19 pandemic in Peru. Secondary analysis of the Demographic and Family Health Survey during 2016-2021. The outcome variable was anemia, and the exposure variable was maternal ethnicity. Also, we included sociodemographic and clinical confounding variables. We constructed generalized linear models of the Poisson family with a logarithmic link function. We evaluated 85,905 records; 30.34% had anemia, 50.83% were mestizo, 25.98% were Quechua, and 2% were Aymara. Compared with mestizos, Quechua children (PR: 1.11; 95% CI: 1.07-1.15; p < 0.001), Aymara (PR: 1.35; 95% CI: 1.27-1 .44; p < 0.001), natives of the Amazon (PR: 1.20; 95% CI: 1.12-1.28; p < 0.001) and those who belonged to other indigenous peoples (PR: 1.29; 95% CI: 1.05-1.57; p = 0.013) had a higher prevalence of childhood anemia. On the contrary, compared to mestizos, white children had a lower prevalence of anemia (PR: 0.93; 95% CI: 0.89-0.99; p = 0.019). During the COVID-19 pandemic, compared to mestizos, only Quechua (PR: 1.15; 95% CI: 1.08-1.23; p < 0.001) and Aymara (PR: 1.38; 95% CI: 1.23-1.55; p < 0.001) had a higher prevalence of childhood anemia. Except for Afro-descendants, children from 6 to 59 months of age who belong to an ethnic minority had a higher probability of having childhood anemia than mestizos. However, only Quechua and Aymara children had higher odds of anemia during the COVID-19 pandemic than mestizos.

Prática alimentar e determinantes sociais na anemia em famílias atendidas pela Estratégia Saúde da Família no estado do Maranhão - estudo de base populacional / Food practice and social determinants of anemia in families attended by Family Health Strategy in the state of Maranhão - a population-based study

Introdução: A anemia é extremamente relevante no contexto da saúde pública. As prevalências em países em desenvolvimento, como o Brasil, são altas e, a despeito de todo o avanço no conhecimento, no diagnóstico e no tratamento, ainda são subestimadas pelo poder público no seu impacto. Objetivo: Avaliar a prática alimentar e determinantes sociais na anemia em mães atendidas pela Estratégia Saúde da Família no estado do Maranhão. Método: Estudo transversal de base populacional que fez parte do projeto \"Prevalência e Determinantes da Anemia em Mulheres e Crianças no Estado do Maranhão\". Foram utilizados dados do questionário socioeconômico e demográfico, do questionário de frequência alimentar (QFA), dados bioquímicos referentes à dosagem de hemoglobina das mulheres e escore de altura para idade das crianças. Para a análise das informações com base no QFA das mulheres (n=779), verificou-se a associação das variáveis com a presença ou ausência de anemia e seus determinantes sociais, a presença de marcadores de alimentação saudável (n=779) e o crescimento linear e anemia com os determinantes sociais (n=966). Resultados: As condições socioeconômicas das famílias não favoreceram o consumo regular de alimentos fonte de ferro e a proteção contra a anemia. A presença frequente de marcadores de alimentação saudável foi destacada pelo consumo de feijão (83,4%), peixe (53,7) e laranja (55,2%). A prevalência de baixa estatura para a idade foi de 9,7% para o estado e entre as variáveis estudadas apenas o Programa Bolsa Família atuou como uma proteção contra a anemia (p<0,003). Conclusão: A elevada demanda de ferro seria facilmente alcançada pela dieta desde que os alimentos considerados fonte fossem consumidos regularmente. Os resultados do estado do Maranhão e os determinantes sociais não mostraram associação direta, pois estão permeados pela pobreza. O Programa Bolsa Família contribuiu para amenizar a vulnerabilidade social da população beneficiária e a inserção na atenção básica, por meio da ESF, como forma de proteção

Introduction: Nutritional anemia is extremely relevant in the context of public health. Its prevalence in developing countries, such as Brazil, are high and, in spite of all advances in knowledge, diagnosis and treatment, its impact is still underestimated by the public power. Objective: To evaluate the feeding practice and social determinants of anemia in mothers assisted by Family Health Strategy (FHS) in the state of Maranhão. Methods: A population-based cross-sectional study that was part of the project \"Prevalence and Determinants of Anemia in Women and Children in the State of Maranhão\". Data from the socioeconomic and demographic questionnaire, the food frequency questionnaire (FFQ), biochemical data on the hemoglobin dosage of women and height-for-age children´s score were used. For the analysis of information based on women FFQ (n = 779), the association of the variables with the presence or absence of anemia and its social determinants was verified, the presence of healthy food markers (n = 779) and linear growth and anemia with social determinants (n = 966). Results: Socioeconomic conditions of families did not favor the regular consumption of iron source foods and the protection against anemia. The frequent presence of healthy food markers was highlighted by the consumption of beans (83.4%), fish (53.7) and orange (55.2%). The prevalence of short stature for age was 9.7% for the state and among the variables studied only Bolsa Família Program acted as a protection against anemia (p<0.003). Conclusion: High demand for iron would be easily achieved by the diet provided that the foods considered as source were consumed regularly. The results of the state of Maranhão and the social determinants showed no direct association, since they are permeated by poverty. Bolsa Família Program helped to alleviate the beneficiary population social vulnerability and the insertion in primary care, through the ESF, as a form of protection

Anemia among indigenous women in Brazil: findings from the First National Survey of Indigenous People's Health and Nutrition.

BACKGROUND: Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People's Health and Nutrition in Brazil. METHODS: Data were collected from Indigenous women between 15 and 49 years old based on a nationwide sample of villages. The outcomes of interest were hemoglobin levels (g/dL) and anemia (< 12 g/dL for nonpregnant and < 11 g/dL for pregnant women). Multilevel models were used to explore associations with contextual (village) and individual (household/woman) level variables. RESULTS: Based on data for 6692 Indigenous women, the nationwide mean hemoglobin level was 12.39 g/dL (95% CI: 12.29-12.50). Anemia prevalence was high (33.0%; 95% CI: 30.40-35.61%) and showed pronounced regional disparities. No village-level characteristics were associated with anemia or hemoglobin levels in the multilevel model. Even after controlling for upper level variables, socioeconomic status, parity, body mass index, and having been treated for malaria were associated with anemia and hemoglobin levels. CONCLUSION: The prevalence of anemia in Brazilian Indigenous women was 12% greater than the national estimates for women of reproductive age. Anemia prevalence and mean hemoglobin levels among Indigenous women appear to be partly explained by some previously recognized risk factors, such as socioeconomic status, body mass index, and malaria; however, part of the variability in these outcomes remains unexplained. Knowledge of health status and its potential determinants is essential to guide public policies aimed at controlling anemia burden in Indigenous communities.

[Health and nutrition of indigenous and nonindigenous children in the Peruvian Amazon]. / Situación de salud y nutrición de niños indígenas y niños no indígenas de la Amazonia peruana.

PURPOSE: Evaluate the nutritional status of indigenous and nonindigenous children under 5 in two provinces in the Peruvian Amazon. METHODS: . Descriptive cross-sectional representative study of families with children under 5 in the provinces of Bagua and Condorcanqui in Peru. The study consisted of an interview with the child's or children's mother or caregiver, anthropometric assessment, capillary hemoglobin measurement, screening for intestinal parasites in children under 5, access to health services, history of acute respiratory infections and acute diarrheal diseases, socioeconomic status, and intake of inadequately iodized salt. Using generalized linear methods, the determinants of chronic malnutrition and anemia in children were identified in each study population. RESULTS: . A total of 986 families and 1 372 children were assessed. The prevalence of chronic malnutrition was higher in the indigenous population than in the nonindigenous population (56.2% versus 21.9%); likewise for anemia (51.3% versus 40.9%). The determinants of chronic malnutrition in the two populations differed. In the indigenous population, the main determinants were an age of more than 36 months (OR 2.21; CI95% 1.61-3.04) and substandard housing (OR 2.9; CI95% 1.19-7.11), while in the non-indigenous population, they were extreme poverty (OR 2.31; IC95% 1.50-3.55) and institutional birth (OR 3.1; IC95% 2.00-4.83). CONCLUSIONS: There are marked gaps between the indigenous population and the nonindigenous population in terms of living conditions, access to health services, and the nutritional status of children under 5. Particular attention should be paid to the indigenous population to improve the way state programs and services are delivered in these contexts.

Anemia in a cohort of HIV-infected Hispanics: prevalence, associated factors and impact on one-year mortality.

BACKGROUND: Anemia occurs frequently in HIV-infected patients and has been associated with an increased risk of death in this population. For Hispanic subjects, information describing this blood disorder during HIV is scarce. Therefore, the present study examined data from a cohort of HIV-positive Hispanics to determine the prevalence of anemia, identify its associated factors, and evaluate its relationship with one-year mortality. METHODS: This study included 1,486 patients who enrolled between January, 2000 and December, 2010 in an HIV-cohort in Bayamón, Puerto Rico. Data were collected through personal interviews and medical record abstractions. To determine the factors independently associated with anemia, a multivariable logistic regression model was used. Kaplan-Meier and Cox proportional hazards models were also performed to estimate survival time and to predict death risk. RESULTS: The prevalence of anemia at enrollment was 41.5%. Factors independently associated with increased odds of anemia were: unemployment (OR = 2.02; 95% CI 1.45-2.79), CD4 count <200 cells/µL (OR = 2.66; 95% CI 1.94-3.66), HIV viral load ≥100,000 copies/mL (OR = 1.94; 95% CI 1.36-2.78), white blood cell count <4,000 cells/µL (OR = 2.42; 95% CI 1.78-3.28) and having clinical AIDS (OR = 2.39; 95% CI 1.39-4.09). Overweight (OR = 0.43; 95% CI 0.32-0.59) and obese (OR = 0.44; 95% CI 0.29-0.67) BMI's were independently associated with reduced odds of anemia. Survival differed significantly by anemia status (log-rank test: p < 0.001). One-year mortality estimates were: 30.8%, 23.3%, 8.4% and 2.5%, for patients with severe, moderate, mild and no anemia, respectively. Having anemia at baseline was independently associated with an increased one-year mortality risk (severe anemia: HR = 9.06; 95% CI: 4.16-19.72; moderate anemia: HR = 6.51; 95% CI: 3.25-13.06; mild anemia: HR = 2.53; 95% CI: 1.35-4.74). CONCLUSIONS: A high prevalence of anemia at enrollment was observed in this cohort of HIV-infected Hispanics. Unemployment and several adverse prognostic features of HIV infection were independently associated with this blood disorder. Anemia resulted to be the strongest predictor of one-year mortality, evidencing a dose-response effect. Further investigations are needed to evaluate whether recovering from anemia is associated with longer survival, and to identify the types of anemia affecting this particular group of HIV patients.

Vitamin D, race, and risk for anemia in children.

OBJECTIVE: To examine the association between 25-hydroxyvitamin D [25(OH)D] deficiency and anemia in a cohort of otherwise-healthy children and to determine whether race modifies the association between 25(OH)D status and hemoglobin (Hgb). STUDY DESIGN: Cross-sectional study of 10,410 children and adolescents ages 1-21 years from the 2001-2006 National Health and Nutrition Examination Survey. Anemia was defined as Hgb less than the 5th percentile for age and sex based on National Health and Nutrition Examination Survey III (1988-1994) data. RESULTS: Lower 25(OH)D levels were associated with increased risk for anemia; <30 ng/mL, adjusted OR 1.93, 95% CI 1.21-3.08, P = .006, and <20 ng/mL, OR 1.47, 95% CI 1.14-1.89, P = .004. In linear regression, small but significant increases in Hgb were noted in the upper quartiles of 25(OH)D compared with the lowest quartile (<20 ng/mL) in the full cohort. Results of race-stratified linear regression by 25(OH)D quartile in white children were similar to those observed in the full cohort, but in black children, an increase in Hgb in the upper 25(OH)D quartiles was only apparent compared with the lowest black race-specific quartile (<12 ng/mL). CONCLUSION: 25(OH)D deficiency is associated with increased risk of anemia in healthy US children, but the 25(OH)D threshold levels for lower Hgb are lower in black children in comparison with white children.

Association of elevated α1-acid glycoprotein (AGP) and the prevalence of anemia in Nicaraguan preschool children.

BACKGROUND: Anemia status is frequently assessed in cross-sectional surveys. Recently, the assessment of acute phase proteins (APPs) has become more common, primarily for iron and vitamin A biomarkers. Although the so-called "anemia of infection" has been known for years, the relationship between APPs and anemia has been infrequently presented. OBJECTIVE: To assess the relationship between elevated α1-acidglycoprotein (AGP) and the prevalence of anemia among preschool children. METHODS: A nationally representative household-based cross-sectional survey was conducted in 2003-05 in Nicaragua. Blood samples were collected from preschool children 6 to 59.9 months of age and tested for hemoglobin and AGP. Data were also obtained on sex, weight, height, use of iron supplements, maternal education, and urban or rural status. RESULTS: Among the 1420 children assessed, the overall prevalence of anemia was 20.2% and the prevalence of elevated AGP was 24.0%. Children with elevated AGP had an anemia prevalence of 27.9%, compared with 17.8% among those with a normal AGP, for a crude prevalence odds ratio (POR) of 1.8 (p = .010). Accounting for age, maternal educational level, and year of survey using logistic regression, the adjusted POR for the association between elevated AGP and anemia was 1.5 (p = .053). CONCLUSIONS: Children in this survey with an elevated AGP had a higher prevalence of anemia, although after controlling for covariates the p-value did not indicate a statistically significant difference (p = .053). It may be helpful to account for APPs, when this information is available, for purposes of comparing anemia prevalence across populations or within a population over time.

Validity and correspondence of non-invasively determined hemoglobin concentrations by two trans-cutaneous digital measuring devices.

Hemoglobin (Hb) concentration is the central diagnostic indicator for anemia, including nutritional anemia. The objective of this study was to compare the Hb values determined by two portable, non-invasive devices across a wide Hb spectrum against formal laboratory measurements, and with each other. Eighty Guatemalan adults (40 highland men, 40 lowland pregnant women) provided venous blood for formal Hb colorimetric determination. Hb was also registered sequentially on the Rad-87™ pulse CO-Oximeter with Rainbow Set technology (Masimo) and Haemospect® (MBR Optical Systems) by non-invasive skin-probe contact procedures as per manufacturers' instructions. Whole blood Hb concentrations ranged from 7.8 to 18.5 g/dL (mean, 12.9±2.3 g/dL and median, 13.3 g/dL). Corresponding descriptive statistics were: range, 9.6 to 16.2 g/dL; mean, 12.1±1.5 g/dL; and median, 11.9 g/L, respectively, with the Rad-87™ (nail bed). They were: range, 8.7 to 15.8 g/dL; mean, 12.7±1.8 g/dL; and median13.0 g/dL for the Hemospect® for forearm contact. They were: range, 9.1 to 17.5 g/dL; mean, 13.2±2.1 g/dL; and median, 13.4 g/dL for palm contact. The Pearson correlation coefficient of venous blood Hb with the former device's Hb values was r=0.59 (p<0.001), and r=0.94 (p<0.001) and r=0.90 (p<0.001) with those of the latter device at the palm and forearm, respectively. The inter-site Lin coefficient was r=0.84. Sensitivity and specificity were variable across devices, depending on Hb cut-off and measurement procedures. With Hb cut-off values of <12.0 g/dL for adult (non-pregnant women and <13.0 g/dL for adult men), the Haemospect device's performance here would provide adequate potential for screening purposes.

Prevalência e fatores associados à anemia em mulheres indígenas Suruí com idade entre 15 e 49 anos, Amazônia, Brasil / Prevalence of and factors associated with anemia in indigenous Surui women aged between 15 and 49 years in the Brazilian Amazon

OBJETIVOS: investigar a prevalência e os fatores associados à ocorrência de anemia em mulheres indígenas Suruí com idade entre 15 e 49 anos. MÉTODOS: estudo transversal realizado a partir de levantamento censitário em 2005 na terra indígena Sete de Setembro, localizada em Rondônia, Brasil. A dosagem de hemoglobina (Hb) foi realizada pelo aparelho β-hemoglobinômetro portátil. Pontos de corte de anemia: Hb <12,0 g/dL nas não gestantes; Hb <11,0 g/dL nas gestantes. Dados demográficos e de status socioeconômico (SSE) foram obtidos por meio da aplicação de questionário padronizado. A primeira etapa da análise estatística incluiu os testes: qui-quadrado; qui-quadrado de tendência linear; t de Student; linearidade e análise de variância. Na segunda etapa, o modelo logístico final foi ajustado. RESULTADOS: a prevalência global de anemia nas não gestantes foi de 67,3 por cento e nas gestantes de 81,8 por cento. A análise multivariada demonstrou que as mulheres com um ou dois filhos anêmicos com idade entre 6 e 35 meses tiveram três vezes mais chances de serem anêmicas; mulheres do estrato SSE baixo apresentaram 3,5 vezes mais chance de serem anêmicas. A chance de uma mulher Suruí do SSE baixo ter anemia aumentou em 26 por cento em relação às do estrato SSE alto. CONCLUSÕES: a anemia é um grave problema de saúde nas mulheres Suruí e é influenciada por características familiares/domiciliares, incluindo descendentes com anemia e condições socioeconômicas. Argumenta-se que medidas de tratamento e prevenção voltadas ao controle da anemia nos Suruí devem considerar tais fatores.

OBJECTIVES: to investigate the prevalence of and factors associated with the occurrence of anemia in indigenous Surui women aged between 15 and 49 years. METHODS: a cross-sectional study was carried out based on the 2005 census of Sete de Setembro indigenous territory in the Brazilian State of Rondônia. Hemoglobin measurement (Hb) was carried out using a portable β-hemoglobinometer. The cut-off points for anemia were Hb <12.0 g/dL in non-pregnant women and Hb <11.0 g/dL in pregnant women. Demographic and socio-economic data were gathered using a standardized questionnaire. The first stage of statistical analysis included the: chi-square; the chi-square linear tendency test; Student's t; a test for linearity and analysis of variance. In the second stage, the final logistic model was adjusted. RESULTS: the overall prevalence of anemia in non-pregnant women was 67.3 percent and, in pregnant women, 81.8 percent. Multivariate analysis showed that women with one or two anemic children aged between 6 and 35 months were three times more likely to be anemic; women from the lowest socio-economic stratum were 3.5 times more likely to be anemic. The likelihood of a Surui woman of low socio-economic status being anemic was 26 percent higher than that of one from the highest socio-economic stratum. CONCLUSIONS: anemia is a serious health problem among Surui women and is influenced by household factors, such as having children with anemia and socio-economic circumstances. It is suggested that measures to treat and prevent anemia among the Surui take these factors into account.

[Anemia prevalence and associated factors among adult women in São Leopoldo, Rio Grande do Sul, Brazil]. / Prevalência de anemia e fatores associados em mulheres adultas residentes em São Leopoldo, Rio Grande do Sul, Brasil.

A cross-sectional population-based study was conducted to investigate the prevalence of anemia and associated factors in adult women. A representative sample was selected with 312 women aged 20 to 60 in São Leopoldo, Rio Grande do Sul State, Brazil. The bivariate analyses included the chi-squared test, prevalence ratios, and 95% confidence intervals. Poisson regression was used to adjust effects in the multivariate analyses. Anemia prevalence was 19.2% (95%CI: 14.8-23.6) for all women in the sample. The highest prevalence was in black women (54%). After controlling for confounding factors, the risk of anemia in black women was three times that of whites (PR = 3.17; 95%CI: 1.85-5.41; p < 0.001). A protective effect against anemia (PR = 0.44; 95%CI: 0.19-1.07; p = 0.07) was found in women over 50 as compared to younger women (20-29 years). These findings suggest the need for public health policies for anemia prevention in black women.

[Anaemia in adopted children, not always iron deficiency]. / Anemie bij adoptiekinderen, niet altijd ijzergebrek.

Anaemia was diagnosed in four adopted children during a standard screening examination 1-4 weeks after arrival. Further investigation revealed a number of causes which could then be specifically treated. The children were a girl aged 14 months from China with iron-deficiency anaemia, a boy aged 16 months from Nigeria with sickle cell anaemia, a girl aged 5 from Haiti who had alpha-thalassaemia, and a boy aged 7 from Brazil with spherocytosis. Iron deficiency is the most common cause of anaemia in childhood. However, in adopted children from sub-tropical areas other causes of anaemia like haemoglobinopathies or erythrocyte membrane defects should be borne in mind, particularly as a history of disease and family history are often lacking. Additional investigations may be necessary. An incorrect diagnosis of iron deficiency may result in ongoing and unjustified iron supplementation leading to harmful iron accumulation in thalassaemia and a delay in the correct treatment in sickle cell anemia or spherocytosis which could carry considerable risk.

[Nutritional status of Terena indian children from Mato Grosso do Sul, Brazil: follow up of weight and height and current prevalence of anemia]. / Estado nutricional de crianças índias terenas: evolução do peso e estatura e prevalência atual de anemia.

OBJECTIVE: This study of Terena Indian children less than 10 years old was undertaken in order to compare weight and height in 1995 and 2002 and to evaluate anemia prevalence in 2002. METHODS: This was a cross-sectional study of the Limão Verde and Córrego Seco tribes, located in Aquidauana, Mato Gosso do Sul, Brazil. The study enrolled all 253 children who were less than 10 years old in 1995 and 244 who were under 10 in 2002. Their nutritional status was evaluated comparing weight and height with the NCHS (National Center for Health Statistics) reference values (Epi-Info version 6.2). Hemoglobin was assayed using a portable photometer. RESULTS: The percentages of children with weight for age deficit (z score < -2 standard deviations) were 4 and 2.9% in 1995 and 2002 respectively. Percentages of weight for height deficits were 3.6 and 0.8% respectively. Percentages of height for age deficits were 15 and 11.1% respectively. The median z scores for weight, age and weight, and height showed a statistically significant increase during the period between 1995 and 2002 in infants. Between 24 and 60 months, there were increments in median z scores for weight for age and height for age. There was no statistically significant decrease in any of the anthropometric indicators, with reference to z scores. The prevalence rates of anemia were 86.1% for infants 6 to 24 months old (n = 43), 50.8% for those 24 to 60 months (n = 65) and 40.7% for children aged 60 to 120 months (n = 59). CONCLUSION: Weight and height both increased during period from 1995 to 2002. Anemia was highly prevalent, calling for immediate corrective measures.

Estado nutricional de crianças índias terenas: evolução do peso e estatura e prevalência atual de anemia / Nutritional status of Terena indian children from Mato Grosso do Sul, Brazil: follow up of weight and height and current prevalence of anemia

OBJETIVO: Comparar o peso e a estatura de crianças índias Terenas menores de 10 anos avaliadas em dois períodos diferentes (1995 e 2002) e verificar a prevalência de anemia nessa população no ano de 2002. MÉTODOS: O estudo foi transversal, sendo avaliadas 253 crianças índias Terenas menores de 10 anos em 1995 e 244 em 2002, pertencentes às aldeias Limão Verde e Córrego Seco, em Aquidauana (MS). O peso e a estatura foram relacionados com a referência do NCHS (Epi-Info versão 6.2). A concentração da hemoglobina foi determinada com o emprego de um fotômetro portátil. RESULTADOS: As proporções de crianças com déficit (escore z < -2 desvios padrão) de peso para a idade foram 4 e 2,9 por cento, respectivamente, em 1995 e 2002. Os déficits de peso para a estatura foram 3,6 e 0,8 por cento, respectivamente. Os déficits de estatura para a idade foram, respectivamente, 15 e 11,1 por cento. A comparação das medianas dos escores z entre 1995 e 2002 revelou aumento estatisticamente significante (p < 0,05) nos seguintes indicadores: peso-idade e peso-estatura nos menores de 24 meses, peso-idade e estatura-idade entre os 24 e 60 meses. Não se observou redução estatisticamente significante de nenhum dos indicadores nas três faixas etárias. A prevalência de anemia foi 86,1 por cento entre as idades de 6 e 24 meses (n = 43), 50,8 por cento entre os 24 e 60 meses (n = 65) e 40,7 por cento entre 60 e 120 meses (n = 59). CONCLUSÃO: Entre 1995 e 2002, observou-se melhora nos indicadores nutricionais de peso e estatura. A prevalência de anemia é muito elevada, indicando a necessidade de seu combate com celeridade.

Saúde e nutrição de crianças indígenas Suruí de Rondônia, Amazônia, Brasil / Health and nutrition of indians infants Suruí of Rondonia, Amazonia, Brazil

Foi realizado inquérito antropométrico e de dosagem de hemoglobina em crianças Suruí menores de 10 anos em 2005. Além disso, foi realizado levantamento dos registros de morbidade hospitalar disponíveis em hospitais na cidade de Cacoal para o período de 2000-2004. Este estudo buscou incluir o maior número de crianças possíveis com idade < 10 anos (81,6 por cento da população total). O estado nutricional foi avaliado com base na população-referência do NCHS. A dosagem de hemoglobina foi obtida mediante β-hemoglobinômetro portátil (Hemocue). A prevalência de anemia em crianças com idades de 6 a 119 meses foi de 80,6 por cento. As crianças com idades de 6 a 35 meses foram as que apresentaram as maiores prevalências de anemia (89,7 por cento). Na análise comparativa com inquérito similar, conduzido em 1987, foram verificadas importantes reduções nos déficits de estatura e de peso para a idade nas crianças Suruí. Contudo, os déficits de retardo do crescimento permanecem em patamares elevados nas crianças Suruí quando comparados à população de crianças não indígenas da região nordeste do país. No levantamento dos registros de morbidade hospitalar, as principais causas de internação nas crianças < 10 anos foram atribuídas às doenças do aparelho respiratório, com destaque para as infecções respiratórias agudas e a asma, seguidas pelas doenças infecciosas e parasitárias, especialmente as diarréias e as gastroenterites. O tempo médio de permanência das crianças Suruí internadas no hospital público revelou ser bem superior ao observado entre as crianças internadas no hospital privado. Este estudo permitiu evidenciar que as condições gerais de saúde e nutrição da criança Suruí são precárias, notando-se elevadas prevalências de retardo do crescimento e anemia. Nas internações hospitalares predominaram as causas passíveis de prevenção e manejo no nível primário, indicando problemas estruturais nos serviços de atenção à saúde.

Clinical status and parasitic infection in a Wichí Aboriginal community in Salta, Argentina.

In a study, carried out in 2000, of the clinical and parasitological status of a Wichi Aboriginal community living in the suburbs of Tartagal, northern Salta, Argentina, 154 individuals were screened for parasitic infections. Ninety-five faecal samples were also obtained from the same population. Ninety-three percent of the subjects were positive for 1 or more of the parasites investigated by direct test and 70.5% of them had parasitic superinfection. The most frequent helminths were Strongyloides stercoralis (50.5%) and hookworm (47.4%). We found low reinfection rates and a long reinfection period after treatment and provision of safe water and sanitation. Serum reactivity of these patients was analysed by enzyme-linked immunosorbent assay and indirect immunofluorescent assay and 22.1% of them had anti-Toxocara antibodies, 16.2% were positive for a complex antigen of Leishmania braziliensis, 29.9% were positive for a complex Trypanosoma cruzi antigen, and 17.5% were positive for a specific Trypanosoma cruzi antigen, Ag 163B6/cruzipain.

Testing the weathering hypothesis among Mexican-origin women.

OBJECTIVE: To examine the "weathering hypothesis," as proposed by Geronimus (1986; 1987; 1992; 1996), among US-born and foreign-born Mexican-origin women. This hypothesis specifically argues that the relationship between age and a variety of reproductively related heath outcomes varies by socioeconomic and environmental context. METHODS: 1989-1991 National Center for Health Statistics (NCHS) linked birth-death files. These files include all women who experienced a live birth in the United States and whose infants were issued a birth certificate during the years 1989 to 1991 (NCHS 1995). Age and nativity specific distributions on infant mortality, low birth weight, anemia, pregnancy related hypertension, and smoking were estimated for Mexican-origin women. RESULTS: For the foreign-born, levels of neonatal mortality are highest for younger women and tend to increase again in women at the oldest ages. For the US born, the lowest levels are for women aged 17 and 18 years, and 27-29 years. Levels for women aged 19-24 years and 30-34 years are higher than those for 17-and 18-year-olds. For both groups of women, giving birth to infants with low birth weight is most common at the earlier ages, declining more or less until the mid twenties when the rate begins to rise again slowly. Patterns for the maternal health indicators vary, with pregnancy related hypertension most strongly following the pattern suggested by weathering. CONCLUSION: Overall, this analysis suggests that there is evidence of weathering within the Mexican-origin population, particularly for the US-born population, and this is most clearly seen in levels of neonatal mortality and pregnancy related hypertension.

Clinical and immunological manifestations in 134 Puerto Rican patients with systemic lupus erythematosus.

To gain a better understanding of systemic lupus erythematosus (SLE) in Puerto Ricans we studied the clinical and serologic manifestations in a cohort of 134 patients. The female to male ratio was 18:1. Mean age at diagnosis was 32 +/- 12 y. The mean duration of disease and follow-up were 7.4 +/- 6.0 and 5.8 +/- 6.0 years respectively. Mortality was 3%. Photosensitivity (76.9%) and malar rash (71.9%) were the most common clinical manifestations. Arthritis was observed in 67.5% of patients. Anemia was seen in 67.2% of patients, but only 12.7% had autoimmune hemolytic anemia. Leukopenia (41.8%) and lymphopenia (64.9%) were also common. Serositis was observed in only 28%. Severe kidney damage such as nephrotic syndrome (14.2%) or renal failure (4%) was infrequent. Cardiovascular (12.7%) and neurologic (9.0%) manifestations were also uncommon. Antinuclear antibodies (ANA) were detected in 93.3%, anti-dsDNA antibodies in 54.5%, anti-Ro antibodies in 30.1% and anti-La antibodies in 14.2%. Low C3 and low C4 were observed in 38.3% and 35.7% respectively. This study suggests that Puerto Ricans with SLE present a mild form of disease predominantly manifested by cutaneous, musculoskeletal and hematologic involvement, but low prevalence of major organ damage and low mortality.

Intestinal helminthiasis and anaemia in youngsters from Matriz da Luz, district of Säo Lourenço da Mata, State of Pernambuco, Brazil

A group of youngsters (4-18 years old) in northeast Brazil was studied to stablish the prevalence of anaemia and intestinal parasitism, as well as to analyse the correlation between them. Two criteria were used to determine the state of anaemia, the level of haemoglobin and the mean of corpuscular volume. The first was considered a single criterion and the second an associated criteria, used in an attempt to correlate anaemia with iron deficiency. The prevalence of intestinal parasitism was 93 per cent while the prevalence of anaemia was 43.1 per cent and 16.1 per cent according to the criteria employed (single or associated respectively). Anaemia was significantly associated with both sex and age. No significant statistical difference was observed when the association was made between each parasite and anaemia even with those more related to anaemia.