[Height deficit in school aged children: a multivariate analysis of possible risk factors, Pernambuco-1997]. / Deficit estatural em crianças em idade escolar: uma análise multivariada de possíveis fatores de risco, Pernambuco--1997.

The nutritional status and some risk factors in 894 school children (ages 6 to 12) in the State of Pernambuco, Brazil, were analyzed based on the data collected by the Second State Research on Nourishment, Health and Nutrition carried out in 1997. The cutoff point used in the nutritional evaluation was the limit referring to -2 score-Z, being the NCHS the reference standard. The prevalence of stunting in the state was of 16.9%. Rural areas were more affected, reaching 27.1%. Bivariate analysis showed that the low socioeconomic level of the children and their families is associated with the occurrence of stunting. The logistic regression model pointed the variables: residence location, gender, access to treated potable water, low education, and per-capita income as the main determinants in stunting. The conjunct analysis of all the factors that explain the malnutrition found among the school children studied showed that the probability of a school-aged child to present height deficit varied from 1.5 to 60.3% depending on the risk factors taken into account, therefore showing different epidemiological "scenarios." The study also concluded that in the State of Pernambuco the height deficit constitutes a public health problem especially for school children in rural areas, showing two very different epidemiologic realities between urban and rural areas.

Déficit estatural em criancas em iade escolar: uma análise multivariada de possiveis fatores de risco Pernambuco 1997 / Heigth deficit in school aged children: a multivariate analysis of possible risk factors Pernambuco 1997

Utilizando dados da II Pesquisa Estadual Sobre Alimentação, Saúde e Nutrição do Estado de Pernambuco-Brasil, desenvolvida em 1997, analisou-se o estado nutricional e alguns fatores de risco de 894 crianças em idade escolar (6 a 12 anos) do Estado de Pernambuco - Brasil. O ponto de corte usado na avaliação nutricional foi o limite referente a -2 escore-Z, tendo como padrão de referência o NCHS. A prevalência do nanismo nutricional no estado foi de 16,9 por cento e o espaço geográfico mais atingido o Interior Rural com 27,1 por cento. A análise bi-variada mostrou que o baixo nível socioeconômico das crianças e de suas famílias está associado à ocorrência do déficit estatural e, o modelo de regressão logística indicou as variáveis: local de residência, gênero, tratamento da água de beber, déficit de escolaridade e renda per capita como principais determinantes do nanismo nutricional. A análise conjunta dos múltiplos fatores explicativos para o déficit estatural encontrado nas crianças estudadas, mostrou que a probabilidade de uma criança em idade escolar apresentar déficit estatural variou, dependendo dos fatores de risco considerados, de 1,5 a 60,3 por cento configurando assim, diferentes "cenários" epidemiológicos. O estudo concluiu ainda que no Estado de Pernambuco o déficit estatural constitui um problema de saúde pública especialmente para as crianças em idade escolar residentes nas áreas rurais, retratando duas realidades epidemiológicas bem diferentes entre os meios urbanos e rurais

Prevalence of anemia in children 6-59 months old in the state of Pernambuco, Brazil.

OBJECTIVE: To determine the prevalence of anemia in children 6-59 months old in Pernambuco, a state in northeastern Brazil, so as to help guide health and nutrition policies there. METHODS: In 1997 a representative sample of 777 young children had their hemoglobin concentration measured. The sampling process was in three stages. First, 18 municipalities were randomly selected to represent the state and its three geographic areas (metropolitan region of Recife, urban interior, and rural interior). Next, using census lists, 45 census sectors were randomly chosen. Finally, 777 children aged 6-59 months old were selected. Blood was collected by venipuncture, and hemoglobin was measured with a portable hemoglobinometer. In the analysis, prevalence was weighted to reflect the census age distribution. RESULTS: The prevalence of anemia among children 6-59 months old was 40.9% for the state as a whole. Prevalence in the metropolitan region of Recife was 39.6%, and it was 35.9% in the urban interior. The rural interior had the highest prevalence, 51.4%. Prevalence was twice as high in children aged 6-23 months as among those 24-59 months old, 61.8% vs. 31.0% (chi 2 = 77.9, P < 0.001). The mean hemoglobin concentrations in the younger and older age groups were 10.4 g/dL (standard deviation (SD) = 1.5) and 11.4 g/dL (SD = 1.4), respectively. There was no statistically significant difference between the sexes in terms of prevalence. CONCLUSIONS: This is the first statewide assessment of anemia prevalence among young children in Brazil. Given the very high prevalence of anemia among the children studied in Pernambuco, especially those in the age group of 6-23 months, public health interventions are needed.

[Incidence and risk factors for diarrhoea and acute respiratory infections in urban communities of Pernambuco, Brazil]. / Incidência e fatores de risco de diarréia e infecções respiratórias agudas em comunidades urbanas de Pernambuco, Brasil.

Magnitude and distribution of Diarrhoea and Acute Respiratory Infections (ARI) in children were studied within a larger broader research that focused on health education. Two household surveys were conducted in a sample of families with at least one child under five years of Recife and Olinda in April-May 1992 and 1994. The total number of children studied was 5,436. The estimated adjusted annual incidence rate (AAIR) of diarrhoea was 2.7 episodes per child. The two-week incidence rate of diarrhoea was 10.2% for both years. Risk factors associated with higher incidence of diarrhoea were age (under two years), lack of sanitation facilities, and absence of electrical appliances in the household. Estimated AAIR of ARI was 9. 5 episodes per child. The two-week incidence rate of ARI was 41.0% in 1992 and 32.6% in 1994. Majority of ARIs affected the upper respiratory tract (75.9%). The only factor consistently associated with a higher risk of ARI was age (under three years). Study results indicate that both pathologies are still an important health problem for children under five in Pernambuco. In particular, in the case of diarrhoea the need for improving the access to basic services, such as water supply and sewage system is urgently needed.

[Use of daily and weekly ferrous sulfate to treat anemic childbearing-age women]. / Uso diário e semanal de sulfato ferroso no tratamento de anemia em mulheres no período reprodutivo.

A blind randomized trial was conducted in a low-income community in the city of Recife, Pernambuco, Brazil, with 193 anemic (Hb <12 mg/dl) and "menstruating" women (age range: 15-45 years) to compare daily and weekly doses of ferrous sulfate (60 mg elemental iron) and treatment compliance. Blood samples were taken from 484 women to determine hemoglobin levels before and after the trial and mean corpuscular volume (MCV) at end of treatment. After 12 weeks' follow-up, 150 women completed the trial, 79 on the alternative weekly regimen and 71 on the conventional daily regimen. Mean corpuscular hemoglobin concentrations (MCHC) prior to treatment were 10.52 g/dl (DP=1.13) and 10.72 g/dl (DP=0.92), respectively, for the alternative and conventional regimens. After the intervention they were 11.83 g/dl (DP=0.97) for the weekly regimen and 11.62 g/dl (DP=1.39) for the daily one. The alternative regimen was better accepted than the conventional one. There was no significant difference (p=0.22) between differences in the mean values of the two regimens, although the cure rate was higher after the alternative treatment. The study concluded that the weekly regimen was no less effective than daily treatment.

[Prevention and treatment of iron-deficiency anemia: new focuses and perspectives] / Prevenção e tratamento da anemia nutricional ferropriva: novos enfoques e perspectivas.

The authors briefly describe the epidemiology of anemia, the goals established by the United Nations to combat the problem worldwide, and the difficulties encountered in applying proven effective strategies in public health services to prevent and cure anemia in pregnant women and children, both of which are prime high-risk groups. They analyze recent research aimed at four objectives related to prevention and cure: improving treatment efficacy; increasing effectiveness; reducing costs; and decreasing unwanted side effects. The study indicates that ongoing research could improve prospects for treatment through public health services.

[Nutritional deficiencies: specific control measures by the health sector]. / Deficiências nutricionais: ações específicas do setor Saúde para o seu controle.

The authors describe and analyze the health sector's role in relation to ways of controlling major endemic nutritional deficiencies by reviewing the theoretical groundwork and establishing possible regression estimates for the various nutritional problems under study. The article is a contribution to the analysis of sectorial alternatives elaborated according to United Nations goals (UNICEF - WHO - FAO) for the year 2000. Among these goals, we stress reduction of the proportion of low birth weight (less than 2500 grams) to less than 10%; reduction of anemia cases to one-third of present cases; a reduction of 50% in prevalence of moderate and severe cases of malnutrition and the virtual control of vitamin A and iodine deficiencies.

[Food and nutritional surveillance in Brazil: background, objectives and approaches]. / Vigilância alimentar e nutricional: antecedentes, objetivos e modalidades. A VAN no Brasil.

The authors describe the concepts, objectives, components and strategic actions that are most frequently recommended for the development of systems of food and nutritional surveillance. The study outlines the importance of a continuous process of data collection, processing and analysis for the follow-up of food and nutritional trends. The System for Food and Nutritional Surveillance could be a valuable instrument for the planning, implementation and analysis of programs and policies of many international agencies of health and nutrition for the year 2000 (UNICEF/FAO/WHO). The study analyzes the evolution and current situation of the food and nutritional surveillance systems in Brazil, and a relationship is drawn between its main problems (coverage, indicators, usage and analytical capacity) for the consolidation of the process.

Acido tranexâmico e hemostasia em cirurgia de revascularizaçäo do miocárdio com circulaçäo extracorpórea / Tranexamic acid and hemostasis in myocardial revascularization with extracorporeal circulation

O antifibrinolítico sintético ácido tranexâmico (Transamin() foi avaliado em seus efeitos hemostáticos e poupadores de transfusoes homólogas, em pacientes submetidos a revascularizaçao do miocárdio com circulaçao extracorpórea (CEC). Quarenta pacientes receberam placebo e 55 pacientes foram operados sob o efeito do ácido tranexâmico na dose de 1Og endovenosa no trans-operatório (2 g administrados na induçao anestésica e os restantes 8 g nas 4 horas seguintes de cirurgia, de modo contínuo). O ácido tranexâmico, na dosagem utilizada, demonstrou possuir efeito hemostático impressionante, promovendo uma reduçao no débito pelos drenos torácicos da ordem de 47 por cento nas 12 horas de P.O., 42,5 por cento nas 24 horas de P.O. e 40,5 por cento até a retirada dos drenos, em relaçao ao grupo-controle (p

[Anemias in preschool children: diagnosis, treatment and evaluation, Recife-PE, Brazil]. / Anemias em pre-escolares: diagnostico, tratamento e avaliação Recife-PE, Brasil.

The diagnosis and the effects of treatment of anemia were assessed in children aged 6-71 months. A total of 1,161 preschool children from a health center of INAMPS (Instituto Nacional de Assistência Médica e Previdência Social) in Recife, Pernambuco, was studied. Hemoglobin was determined by the method described by Hainline. WHO criteria were used to identify anemia. According to their age, nutritional status and family income, the children were divided into groups, and those with anemia were treated with ferrous sulphate and an anti-helminthic (mebendazole). Anemia prevalence was substantially higher in children aged 2 years, and a statistically significant association (0.01 level) was found between anemia and nutritional status and family income. After treatment, hemoglobin values were normal in 40% of the anemic children; simultaneously, mean hemoglobin values increased from 9.11 to 10.3 g/dl which was statistically significant (p less than 0.001). This investigation is part of a collaborative study performed in four Brazilian states to offer "know-how" to a national program for combating iron deficiency anemia.

[Nutritional status of children under 6, according to land tenure, in rural areas of the State of Pernambuco, Northeast of Brazil]. / Estado nutricional de crianças menores de seis anos, segundo posse da terra, em áreas rurais do Estado de Pernambuco, Nordeste do Brasil.

The purpose of this investigation was to analyze the distribution of protein-energy malnutrition, anemia and hypovitaminosis A in relation to accessibility and size of rural lands. About 689 families from the Agreste rural area (Pernambuco, North-East Brazil) were studied. A total of 1,257 children under 6 years of age were distributed in four groups according to the size of the land. The nutritional status was assessed according to the criteria of Gómez, Ariza-Macías and Seoane-Latham, modified by Batista Filho. In accordance with the Gómez' method, 55.1% of the children suffered from some degree of malnutrition. About 67.0% of the landless families suffered from malnutrition, in contrast to 25% of the landowners who had 50 or more than 50 hectares of land (p less than 0.01). Hemoglobin was determined in 976 children; 38.9% of them suffered from anemia. No significant differences were detected among the several groups of land tenants. Serum retinol levels were measured in 412 children and a high incidence of hypovitaminosis A was detected: 24% had serum retinol levels below 20 mcg/100 ml. No significant association was found in relation to the different land tenure groups. These data demonstrate a high prevalence of protein-energy malnutrition, anemia and hypovitaminosis A. A significant correlation between protein-energy malnutrition and the size of the land was also found, demonstrating that this region is one of the most affected by food and nutritional problems.

Desnutricao recente, cronica e pregressa em quatro localidades do Estado de Pernambuco, Brasil. / Recent, chronic and past malnutrition in 4 districts of the State of Pernambuco, Brazil

Foram estudadas 1.712 criancas menores de 6 anos, residentes nas cidades de Recife (Zona Litoranea), Ferreiros (Zona da Mata),Brejo da Madre de Deus (Zona do Agreste) e Afogados da Ingazeira (Zona do Sertao) - Estado de Pernambuco (Brasil) - com o proposito de comparar a prevalencia da desnutricao proteico-energetica (DPE) nas quatro localidades e contribuir para o mapeamento nosografico da desnutricao do Estado. A situacao nutricional das criancas foi determinada atraves dos criterios de Gomez, Ariza-Macias e Seoane-Lathan modificado. A relacao peso/altura nao discrimina muito bem a situacao de tres das comunidades estudadas. Segundo o criterio de Seoane Lathan modificado, sao comprovadas diferencas significativas na prevalencia de desnutricao dos tres tipos (recente, cronica e pregressa) entre o Recife e as cidades do interior, com excecao da situacao na Zona do Agreste (Brejo da Madre de Deus)