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1.
Nutrients ; 13(7)2021 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-34371849

RESUMO

The double burden of malnutrition (DBM) affects many low- and middle-income countries. However, few studies have examined DBM at the individual level, or undernutrition and overnutrition co-occurring within the same person. This study aims to investigate the prevalence and determinants of DBM among adults in the Philippines. Data from the 2013 National Nutrition Survey were used. The sample size in the analysis was 17,010 adults aged ≥20 years old, after excluding pregnant and lactating women. DBM was defined as the co-occurrence of overweight/obesity and anemia (definition #1), overweight/obesity and anemia or vitamin A deficiency (definition #2), and overweight/obesity and anemia or vitamin A deficiency or iodine insufficiency (definition #3). Anthropometric measurements and biochemical markers were used for DBM assessment. Data were analyzed using descriptive statistics, the chi-square test, and logistic regression by R software. Results showed that definition #3 is the predominant type of DBM (7.0%) in the general population, whereas the prevalence of DBM has increased to 23.7% in overweight/obese persons. Sex, age, educational attainment, marital status, household size, wealth quintile, and smoking status were the determinants of DBM. This study revealed that Filipino adults experience malnutrition critically and must be addressed through food and nutrition interventions.


Assuntos
Desnutrição/epidemiologia , Micronutrientes/deficiência , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Determinantes Sociais da Saúde/etnologia , Adulto , Anemia/epidemiologia , Anemia/etnologia , Antropometria , Comorbidade , Feminino , Inquéritos Epidemiológicos , Humanos , Iodo/deficiência , Modelos Logísticos , Masculino , Desnutrição/etnologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Obesidade/etnologia , Hipernutrição/epidemiologia , Hipernutrição/etnologia , Sobrepeso/etnologia , Filipinas/epidemiologia , Filipinas/etnologia , Prevalência , Fatores Socioeconômicos , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina A/etnologia , Adulto Jovem
3.
Cancer Invest ; 39(6-7): 457-465, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33961512

RESUMO

We analyzed the effect of anemia on tumor response of patients with primary invasive breast cancer (BC) receiving neoadjuvant chemotherapy (NACT). The patient collective was very homogenous; finally, 74 BC patients with identical medication and duration of NACT were enrolled. After completion of NACT, 49 patients (66.2%) had a post-NACT Hb level <12 g/dl. In the anemic group, we found a tendency of lower median tumor response compared to nonanemic patients at this time (15 versus 17 mm, retrospectively, p = 0.18). Age at diagnosis significantly correlated with the difference of Hb [before initiation - after completion of NACT] (correlation coefficient = 0.40, p < 0.001).


Assuntos
Anemia/etnologia , Neoplasias da Mama/tratamento farmacológico , Quimioterapia Adjuvante/efeitos adversos , Terapia Neoadjuvante/efeitos adversos , Adulto , Idade de Início , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
4.
Nutrients ; 13(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800575

RESUMO

In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Anemia/etnologia , Anemia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Antropometria , Botsuana/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etnologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Gestantes/etnologia , Prevalência , Magreza/epidemiologia , Magreza/etnologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etnologia , Adulto Jovem
5.
Isr J Health Policy Res ; 9(1): 71, 2020 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-33256830

RESUMO

BACKGROUND: Anemia is common during pregnancy and the puerperium. The association of ethnicity as well as other characteristics with anemia and compliance with healthcare recommendations has not been studied sufficiently and needs to be explored in order to implement a targeted health policy. We examined the association between ethnicity and the risk for prenatal and puerperium anemia and the compliance with healthcare recommendations. This effort aims to guide reforms in policies and practices that will assist in decreasing anemia prevalence in Israel. METHODS: This study was a secondary analysis of a prospective cohort study database including 1558 women who delivered vaginally at Emek Medical Center. Anemia was assessed before delivery by obtaining a complete blood count (CBC). After delivery, CBCs were taken in cases of postpartum hemorrhage, symptoms consistent with anemia, prenatal anemia or other clinical indications. The study population was divided according to their ethnicity (Jews and Arabs). The primary outcomes were anemia before delivery, anemia in the immediate postpartum and 6 weeks postpartum, and compliance with healthcare recommendations, which was defined as the rate of women who performed a routine CBC test 6-weeks-postpartum. RESULTS: The rates of anemia before delivery and in the puerperium period were similar between Jews and Arabs (before delivery: 88 (11%) versus 98 (14%); 6 weeks postpartum: 55 (21%) vs 68 (28%), respectively;p > 0.05). Iron supplementation was high in both groups during pregnancy (~ 90%) and lower during the postpartum for Jews compared to Arabs (72% vs 83%,respectively; P < .0001). Only one third of the patients performed a CBC 6-weeks-postpartum regardless of ethnicity. CONCLUSION: Overall compliance with health recommendation was high during pregnancy but low postpartum and was reflected in anemia persistence regardless of ethnicity. Because of the adverse long term impact of anemia on patient's health, new policies need to be developed to improve patient's compliance postpartum. A possible strategy is to combine the follow-up of the mother with the one of the newborn in the family health stations (Tipat Halav) and the community clinics similarly to the close follow-up during pregnancy. Additional methods may include active summoning for CBC test and assuring iron supplement consumption.


Assuntos
Anemia/epidemiologia , Política de Saúde , Compostos de Ferro/administração & dosagem , Complicações Hematológicas na Gravidez/epidemiologia , Adulto , Anemia/etnologia , Árabes/estatística & dados numéricos , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Israel , Judeus/estatística & dados numéricos , Cooperação do Paciente/etnologia , Cooperação do Paciente/estatística & dados numéricos , Período Pós-Parto , Gravidez , Complicações Hematológicas na Gravidez/etnologia , Estudos Prospectivos , Adulto Jovem
6.
Matern Child Health J ; 24(8): 979-985, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32495246

RESUMO

OBJECTIVES: To identify maternal and perinatal risk factors associated with childhood anaemia. METHODS: A retrospective cohort study was conducted in three remote Katherine East Aboriginal communities in Northern Territory, Australia. Children born 2004-2014 in Community A and 2010-2014 in Community B and C, and their respective mothers were recruited into the study. Maternal and child data were linked to provide a longitudinal view of each child for the first 1000 days from conception to 2-years of age. Descriptive analyses were used to calculate mean maternal age, and proportions were used to describe other antenatal and perinatal characteristics of the mother/child dyads. The main outcome was the prevalence of maternal anaemia in pregnancy and risk factors associated with childhood anaemia at age 6 months. RESULTS: Prevalence of maternal anaemia in pregnancy was higher in the third trimester (62%) compared to the first (46%) and second trimesters (48%). There was a strong positive linear association (R2 = 0.46, p < 0.001) between maternal haemoglobin (Hb) in third trimester pregnancy and child Hb at age 6 months. Maternal anaemia in pregnancy (OR 4.42 95% CI 2.08-9.36) and low birth weight (LBW, OR 2.62, 95% CI 1.21-5.70) were associated with an increased risk of childhood anaemia at 6 months of age. CONCLUSIONS FOR PRACTICE: This is the first study to identify the association of maternal anaemia with childhood anaemia in the Australian Aboriginal population. A review of current policies and practices for anaemia screening, prevention and treatment during pregnancy and early childhood would be beneficial to both mother and child. Our findings indicate that administering prophylactic iron supplementation only to children who are born LBW or premature would be of greater benefit if expanded to include children born to anaemic mothers.


Assuntos
Anemia/complicações , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Nascimento Prematuro/etiologia , Anemia/etnologia , Anemia/fisiopatologia , Estudos de Coortes , Correlação de Dados , Feminino , Humanos , Recém-Nascido de Baixo Peso/sangue , Recém-Nascido de Baixo Peso/fisiologia , Recém-Nascido , Masculino , Northern Territory/epidemiologia , Northern Territory/etnologia , Grupo com Ancestrais Oceânicos/etnologia , Nascimento Prematuro/sangue , Nascimento Prematuro/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
7.
Int J Lab Hematol ; 42(4): 403-410, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32297477

RESUMO

OBJECTIVE: To determine the presence of racial/ethnic differences in patients with anemia and serum folate deficiency. METHODS: We performed a retrospective analysis of data from patient samples collected from January 2010 to October 2018. Reference laboratory ranges were determined by Mayo Clinic Reference Laboratories. Race and ethnicity were classified according to National Institutes of Health categories. RESULTS: The analysis comprised 197 974 samples. Hemoglobin, hematocrit, and SF results were available for 173 337, 173 056, and 129 760 samples, respectively. Of the samples, 46 505 (26.8%) showed anemia, with a higher prevalence among American Indian/Alaskan Natives (AI/AN) 42.9% and African Americans (AA) 47.2% (P < .001). SF deficiency was present in 897 (0.7%), with a higher prevalence among AI/AN (9, [1.4%]) and AA (78, [1.2%]) and a lower prevalence in non-Hispanic whites (NHW) (758, [0.7%]), Hispanics (40, [0.6%]), and Asians (8, [0.3%]). In multivariable analysis, the prevalence of anemia was higher in all non-NHW racial/ethnic groups: AA (OR, 3.67, [95%CI: 3.47-3.88, P < .001]), AI/AN (OR, 3.25, [95%CI: 2.71-3.90, P < .001]), Asians (OR, 1.62, [95%CI: 1.47-1.77, P < .001]), and Hispanics (OR, 1.41, [95%CI: 1.32-1.50, P < .001]). SF deficiency was more common in AA (OR, 1.48, [95%CI: 1.17-1.88, P.001]) and less common in Asians (OR, 0.35, [95%CI: 0.17-0.70, P = .003]), compared with NHW. CONCLUSIONS: We showed significant racial/ethnic differences in anemia and SF deficiency. Differences were observed especially among NHW, AA, and Asians. We believe that these differences may be explained by social determinants of health. More research is needed regarding the causes of these differences and their clinical implications at a population level.


Assuntos
Anemia , Grupos de Populações Continentais , Grupos Étnicos , Deficiência de Ácido Fólico , Adulto , Idoso , Anemia/epidemiologia , Anemia/etnologia , Feminino , Deficiência de Ácido Fólico/epidemiologia , Deficiência de Ácido Fólico/etnologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estados Unidos/epidemiologia , Estados Unidos/etnologia
8.
J Nutr ; 150(4): 929-937, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883009

RESUMO

BACKGROUND: Anemia is a major concern for children in Nepal; however, little is known about context-specific causes of anemia. OBJECTIVE: We used cross-sectional data from the 2016 Nepal National Micronutrient Status Survey to evaluate factors associated with anemia in a nationally representative, population-based sample of children 6-59 mo (n = 1367). METHODS: Hemoglobin, biomarkers of iron status and other micronutrients, infection, inflammation, and blood disorders were assessed from venous blood samples. Soil-transmitted helminth (STH) and Helicobacter pylori infections were assessed from stool. Anthropometry was measured with standard procedures. Sociodemographic and household characteristics, diet, micronutrient powder (MNP) intake, pica, and morbidity recall were ascertained by caregiver interview. Multivariable logistic regression that accounted for complex sampling design, determined predictors of anemia (hemoglobin <11.0 g/dL, altitude adjusted); candidate predictors were variables with P < 0.05 in bivariate models. RESULTS: Anemia prevalence was 18.6% (95% CI: 15.8, 21.4). MNP intake [adjusted OR (AOR): 0.25, 95% CI: 0.07, 0.86], log (ln) ferritin (µg/L) (AOR: 0.49, 95% CI: 0.38, 0.64), and ln RBP (µmol/L) (AOR: 0.42, 95% CI: 0.18, 0.95) were associated with reduced odds of anemia. Younger age (6-23 mo compared with 24-59 mo; AOR: 2.29, 95% CI: 1.52, 3.46), other Terai ethnicities (AOR: 2.59, 95% CI: 1.25, 5.35) and Muslim ethnicities (AOR: 3.15, 95% CI: 1.30, 7.65) relative to Brahmin/Chhetri ethnicities, recent fever (AOR: 1.68, 95% CI: 1.08, 2.59), ln C-reactive protein (mg/L) (AOR: 1.23, 95% CI: 1.03, 1.45), and glucose-6-phosphate dehydrogenase deficiency (AOR: 2.84, 95% CI: 1.88, 4.30) were associated with increased odds of anemia. CONCLUSION: Both nonmodifiable and potentially modifiable factors were associated with anemia. Thus some but not all anemia might be addressed through effective public health policy, programs, and delivery of nutrition and infection prevention and control.


Assuntos
Anemia/etiologia , Anemia/genética , Grupos Étnicos , Doença de Depósito de Glicogênio Tipo I/genética , Micronutrientes/administração & dosagem , Anemia/epidemiologia , Anemia/etnologia , Biomarcadores/sangue , Feminino , Humanos , Lactente , Inflamação , Masculino , Nepal/epidemiologia
9.
Indian J Med Res ; 150(4): 385-389, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823920

RESUMO

Background & objectives: The haemoglobin (Hb) cut-off is a single value for all populations. It is possible that different populations might have slightly different cut-off values; but, this needs to be evaluated in healthy populations with low possibility of inadequate dietary intakes of haematopoietic nutrients. This study was conducted to assess the existence of race-specific Hb cut-offs for mild anaemia in healthy populations and their potential implications. Methods: In this study the Hb distributions of healthy White, Black, Mexican and Hispanic and Asian non-pregnant women obtained from nine rounds of the National Health and Nutrition Examination Survey (NHANES) and two rounds of National Diet and Nutrition Survey (NDNS), was examined to check the existence of race-specific Hb cut-off for mild anaemia, by standard statistical methods. Results: The mean Hb of Blacks, Mexicans and Hispanics and Asians were lower than Whites, consistent with previous literature. The Hb cut-off for mild anaemia in Asians was lower at 11.22 g/dl. Interpretation & conclusions: Using the Hb cut-off derived in this study in place of the World Health Organization, cut-off of 12 g/dl would result in a 17.9 per cent decrease in the prevalence of anaemia in India. This points to the need for re-examining race-specific cut-off for mild anaemia and points to the need for alternative methods, perhaps linked to risk of unhealthy outcomes.


Assuntos
Anemia/sangue , Hemoglobinas/análise , Inquéritos Nutricionais , Adolescente , Adulto , Anemia/epidemiologia , Anemia/etnologia , Feminino , Humanos , Índia/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem
10.
Isr Med Assoc J ; 21(8): 546-551, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31474018

RESUMO

BACKGROUND: The Bedouins living in southern Israel are a Muslim-Arab population that is transitioning from a nomadic lifestyle to life in permanent settlements. The population has unique characteristics that could affect hemoglobin A1c (HbA1c) measurements. The objective of this study was to describe the socio-demographic and unique morbidity characteristics of this community and their effect on HbA1c measurements. Consanguinity, especially among cousins in the Bedouin population, results in a high prevalence of autosomal recessive genetic diseases such as thalassemia (underestimate of HbA1c), hemoglobinopathies (underestimate and overestimate), Gilbert's disease, and glucose-6-phosphate dehydrogenase deficiency, an X-linked disorder, which can cause hyperbilirubinemia with an overestimate of HbA1c. Furthermore, nutritional deficiencies, autosomal recessive diseases, high birth rates, parasitic infections, and poverty can all cause high rates of anemia (iron and vitamin B12 deficiencies) that can raise HbA1c levels. Congenital dyserythropoietic anemia is found among Bedouin tribes in the Negev region and can lead to an underestimation of HbA1c levels. Pregnancy can also affect HbA1c levels. Medical teams working in the Bedouin community and in other Muslim populations with similar morbidity characteristics throughout the world should identify patients with medical conditions that can affect HbA1c measurements and be aware of possible measurement alternatives such as fructosamine and glycated albumin.


Assuntos
Anemia/etnologia , Hemoglobina A Glicada/análise , Hemoglobinopatias/etnologia , Desnutrição/etnologia , Complicações na Gravidez/etnologia , Anemia/sangue , Anemia/complicações , Árabes , Feminino , Hemoglobinopatias/sangue , Hemoglobinopatias/complicações , Humanos , Islamismo , Israel/etnologia , Masculino , Desnutrição/sangue , Desnutrição/complicações , Gravidez , Complicações na Gravidez/sangue , Reprodutibilidade dos Testes , Fatores Socioeconômicos
11.
Clin Lab ; 65(6)2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31232029

RESUMO

BACKGROUND: Anemia is a common cause among the elderly for increased mortality. Hemoglobin concentration can be affected by many factors, but the reference interval defined by the World Health Organization has not been adjusted for the previous half century. METHODS: Through using the dataset generated by the National Health Insurance (NHI) health screening program of Republic of Korea, here we attempt to present a close to actual hemoglobin concentration of the Korean population. Between January 2009 and December 2013, a total of 57,409,872 health screening events were registered in the NHI database. Following the exclusion criteria, 6,759,566 participants were enrolled for analyses. RESULTS: Significant portion of the study population was considered 'anemic', while the mean value (2.5% ~ 97.5%) of hemoglobin concentration from the study was 14.8 (12.5 ~ 16.8) g/dL in men and 12.8 (10.6 ~ 14.7) g/ dL in women. Concordant results of hemoglobin concentration declining with age were observed as previous studies have described, supporting the need for separate, possibly lower cutoff in the elderly. CONCLUSIONS: A considerable portion of the participants being categorized as anemia contests the accuracy of the current lower cutoff for anemia. From a large representative dataset, the need for adjustment to the lower cutoff for anemia is suggested.


Assuntos
Anemia/sangue , Hemoglobinas/análise , Programas de Rastreamento/métodos , Programas Nacionais de Saúde/estatística & dados numéricos , Sistema de Registros/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia/diagnóstico , Anemia/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , República da Coreia , Adulto Jovem
12.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(3): 330-333, 2019 Mar 06.
Artigo em Chinês | MEDLINE | ID: mdl-30841678

RESUMO

In this study, 1 065 infants and young children aged 24 months below in ethnic minorities gathering in poor rural areas in poor rural areas of Liangshan Yi Autonomous Prefecture of Sichuan Province and Gannan Tibetan Autonomous Prefecture of Gansu Province were investigated for their anemia status from October to November 2014, and the association between anemia and the utilization of maternal and child health services was analyzed. The prevalence of anemia in this area was 52.68%(561/1 065). After the adjustment of socio-demographic characteristics of mothers and infants, compared with infants aged 2-5 months, Han ethnic group, and infants whose mother was not anemic, the OR(95%CI) values of infant anemia for infants aged 6-12 months, 13-8 months, 19-24 months, ethnic minorities group, and infants whose mother was anemic were 11.65 (7.09-19.14), 9.91 (5.99-16.38), 5.87 (3.39-10.16), 1.55 (1.10-2.18) and 1.52 (1.14-2.04), respectively; Compared with infants whose child examination times not up to standard, and who were not only non-hospital delivered but also received inadequate number of inoculation, the OR (95%CI) values of infant anemia for infants whose child examination times up to standard, and who were not only hospital delivered but also received adequate number of inoculation were 0.60 (0.38-0.94) and 0.71 (0.52-0.98), respectively. The infants anemia is associated with the utilization of maternal and child health services.


Assuntos
Anemia/etnologia , Grupos Étnicos/estatística & dados numéricos , Serviços de Saúde Materno-Infantil/estatística & dados numéricos , Grupos Minoritários/estatística & dados numéricos , Áreas de Pobreza , População Rural/estatística & dados numéricos , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Gravidez , Prevalência
13.
Afr Health Sci ; 19(3): 2654-2659, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32127838

RESUMO

Background: Anemia is a major public health problem in Morocco especially among vulnerable groups including pregnant women. Several studies have confirmed that anemia is associated with demographic, socioeconomic and cultural factors. Objective: The objective of this study is to describe the socioeconomic, cultural and demographic profile of a group of anemic pregnant women and to determine the conditions influencing the development of anemia in the Moroccan context. Methods: A retrospective cross-sectional study was conducted by structured interview among a group of Moroccan pregnant women (300 of anemic women and 425 of non-anemic). Data were collected on biodemographic and socio-economic variables, the socio-cultural conditions of the women, the characteristics of the pregnancy and information relating to anemia. Results: Using the WHO classification criterion according to the severity of anemia, 40.6%, 56.6% and 2.8% of anaemic women were respectively mildly, moderately and severely anemic. Primiparity, unemployment, lower socio-economic level and illiteracy, were found to be associated with the development of anemia in pregnant women. Conclusion: In Morocco, nutritional problems hamper human development and improvement of health status. Knowledge of the strictness of deficiencies and factors associated are necessary to develop adapted strategies intervention to the national context.


Assuntos
Anemia/etnologia , Gestantes/etnologia , Fatores Socioeconômicos , Adolescente , Adulto , Fatores Etários , Estudos Transversais , Características Culturais , Feminino , Humanos , Pessoa de Meia-Idade , Marrocos/epidemiologia , Estado Nutricional , Gravidez , Prevalência , Características de Residência , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
14.
Women Health ; 59(6): 660-671, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30462581

RESUMO

Maternal anemia is a frequent problem during pregnancy, especially in developing countries, such as Pakistan. In this context, the present study was conducted to determine factors associated with maternal anemia prevalent among women of different age groups visiting different hospitals in Lahore from February to April 2017. The current study used a cross-sectional design involving 390 pregnant women. Data related to demographic area, maternal age, gestational age/period, educational and income level, as well as socioeconomic status of all the participants were collected. Also, hemoglobin levels of the participants were obtained for assessment of maternal anemia. A total of 57.7% of participants were anemic (34.4 % mild and 23.3% moderate anemia). Bivariate analysis showed that less education (p = 0.01), occupation as housewife (p = 0.03), lower income (p = 0.001), rural residence (p = 0.028), and greater number of house members (p = 0.04) were significantly associated with maternal anemia. Results of multivariable logistic regression showed that low income was the only significant factor independently associated with maternal anemia. These results suggest that interventions, such as the Nutrition Support Program, to improve nutritional status of pregnant women by providing free food supplements with focus on the poor and marginalized communities are recommended to prevent anemia.


Assuntos
Anemia/epidemiologia , Complicações Hematológicas na Gravidez/epidemiologia , Gestantes/etnologia , Adulto , Anemia/etnologia , Estudos Transversais , Feminino , Humanos , Estado Nutricional , Paquistão/epidemiologia , Pobreza , Gravidez , Prevalência , Fatores de Risco , Fatores Socioeconômicos
15.
J Matern Fetal Neonatal Med ; 32(17): 2897-2904, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29534635

RESUMO

Objective: As anemia in pregnancy is associated with adverse perinatal outcomes, we sought to define the mean and the fifth percentile of Hb and Ht using a contemporary multiethnic large cohort of low-risk pregnancies, and assess potential racial differences. Methods: We conducted a retrospective cohort study on women who delivered between 1 January 2008 and 31 December 2013 in Reggio Emilia County, Italy. Linear mixed effects models were used to describe changes in mean Hb and Ht, while quantile regression with matrix-design bootstrap defined changes in the fifth percentile of Hb and Ht, controlling for race, maternal age, smoking, and pregnancy number. Results: We analyzed 23,657 hemograms from 7318 pregnancies and 6870 women. Multivariate analysis showed that when compared to Caucasians', African women's mean Hb and Ht were respectively 0.24 (95%CI 0.3-0.17) g/dl and 0.7 (95%CI 0.8-0.5) % lower, while Asian mothers' were 0.11 (95%CI 0.19-0.03) g/dl and 0.3 (95%CI 0.5-0.1) % inferior. Similarly, both African and Asian women had lower fifth Ht percentiles (-1, 95%CI -1.3 to -0.6, and -0.4, 95%CI -0.7 to -0.04) than Caucasians, while African mothers also had lower fifth Hb percentile (0.3, 95%CI 0.5-0.1). The fifth percentile for Hb and Ht were, respectively, 11.3 (95%CI 11-11.5) g/dl and 32.8 (95%CI 32.3-33.4) % in the first trimester, 10.4 (95%CI 10.1-10.6) g/dl and 30.2 (95%CI 29.6-30.8) % in the second trimester, 10.1 (95%CI 9.8-10.3) g/dl and 30.6 (95%CI 30-31.1) % in the third trimester. Conclusions: We provided contemporary references to define anemia in pregnancy, and we confirmed that even in pregnancy, African and Asian women have lower Hb and Ht than Caucasian. Racial and population-specific references may have significant clinical and public health implication for more accurate disease diagnosis and appropriate treatment.


Assuntos
Anemia/etnologia , Hematócrito , Hemoglobinas/metabolismo , Complicações Hematológicas na Gravidez/etnologia , Adulto , Grupo com Ancestrais do Continente Africano , Anemia/sangue , Grupo com Ancestrais do Continente Asiático , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Itália/epidemiologia , Paridade , Gravidez , Complicações Hematológicas na Gravidez/sangue , Valores de Referência , Estudos Retrospectivos
16.
São Paulo; s.n; 2019. 109 p.
Tese em Português | LILACS | ID: biblio-1006649

RESUMO

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


Assuntos
Humanos , Feminino , Pré-Escolar , Saúde da Família/etnologia , Segurança Alimentar , Comportamento Alimentar , Determinantes Sociais da Saúde , Anemia/etnologia , Mães , Mulheres , Estudos Transversais , Nutrição Materna , Nutrição do Lactente
17.
BMJ Open ; 8(11): e025694, 2018 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-30391922

RESUMO

OBJECTIVES: The objectives were to characterise the haematological profile of screen-detected chronic kidney disease (CKD) participants and to correlate the complete blood count measures with the commonly advocated kidney function estimators. METHODS: The current cross-sectional study used data, collected between February 2015 and November 2016, of 1564 adults of mixed-ancestry, who participated in the Cape Town Vascular and Metabolic Health study. Kidney function was estimated using the Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and anaemia as haemoglobin level <13.5 g/dL (men) and <12 g/dL (women). RESULTS: Based on the MDRD and CKD-EPI equations, the crude prevalence of CKD was 6% and 3%. Irrespective of the equation used, median red blood cell (RBC) indices were consistently lower in those with CKD compared with those without CKD (all p<0.0001). Despite not showing any significant difference in total white blood cell (WBC) count between the two groups, the number of lymphocytes were lower (p=0.0001 and p<0.0001 for MDRD and CKD-EPI, respectively) and neutrophil count (both p<0.0297) and the ratio of lymphocytes to neutrophil (both p<0.0001) higher in the CKD group compared with those without CKD; with the remaining WBC indices similar in the two groups. The platelet count was similar in both groups. Of the screen-detected CKD participants, 45.5% (MDRD) and 57.8% (CKD-EPI) were anaemic, with the prevalence increasing with increasing severity of CKD, from 37.2% (stage 3) to 82.4% (stages 4-5). Furthermore, CKD-EPI-estimated kidney function, but not MDRD, was positively associated with RBC indices. CONCLUSION: Though it remains unclear whether common kidney function estimators provide accurate estimates of CKD in Africans, the correlation of their estimates with deteriorating RBC profile, suggests that advocated estimators, to some extent approximate kidney function in African populations.


Assuntos
Contagem de Células Sanguíneas , Grupos Étnicos , Falência Renal Crônica/sangue , Adulto , Idoso , Anemia/sangue , Anemia/diagnóstico , Anemia/etnologia , Antropometria , Estudos Transversais , Índices de Eritrócitos , Feminino , Taxa de Filtração Glomerular , Hemoglobinometria , Humanos , Falência Renal Crônica/diagnóstico , Falência Renal Crônica/etnologia , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Valores de Referência , África do Sul
18.
Aust N Z J Public Health ; 42(5): 456-462, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30151954

RESUMO

OBJECTIVE: Data collection 'silos' can be linked for health research. Anaemia in early childhood is a long-recognised health issue in remote Aboriginal communities of the Northern Territory and Western Australia, but information is lacking for Queensland. The objective of this work was to compile existing information from health and education data collections to investigate anaemia among Aboriginal and Torres Strait Islander mothers and their children in Far North Queensland. METHODS: Data mapping identified four health data collections and one education data collection holding relevant information. Data Custodians' approval was secured for release of linked de-identified information. RESULTS: Approval processes and preparation of the dataset for release took 23 months. Birth information was obtained for 2,205 mother-child pairs where the Aboriginal and/or Torres Strait Islander child was born in Far North Queensland between 2006 and 2010. Pathology information from before/during pregnancy was obtained for 2,126 mothers (96.4%), growth and haemoglobin information for 982 children (44.5%), and childhood development indicators at school entry for 963 children (43.7%). CONCLUSION: Linking existing information 'silos' enables research into key public health issues. Implications for public health: Information linkage is particularly valuable in respect of vulnerable populations including rural and remote Aboriginal and Torres Strait Islander peoples.


Assuntos
Anemia/etnologia , Armazenamento e Recuperação da Informação , Mães , Grupo com Ancestrais Oceânicos/estatística & dados numéricos , Feminino , Humanos , Masculino , Queensland/epidemiologia
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