Isolated and combined prevalence of anemia, vitamin A deficiency and zinc deficiency in preschool children 12-72 months for the government of Paraíba

Prevalence of iron-deficiency anaemia in Brazilian children under 5 years of age: a systematic review and meta-analysis

Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.

Vitamin A deficiency in Brazilian Children younger than 5 years old: a systematic review

Abstract Objectives: to examine the nutritional status of vitamin A in Brazilian children under 5 years old, delimiting their deficiency and associated factors. Methods: this is a systematic review of articles published between 2008 and 2018, using the SciELO, Bireme, and PubMed electronic databases. A validated instrument critically evaluated the studies. The summary measures were obtained by the random effect model, and their results are presented using the Forest Plot graph. The qualitative synthesis was based on the description of the main factors associated with Vitamin A Deficiency. Results: we included 14 cross-sectional studies with observations in basic health units, daycare centers, and households. The summary measure indicated Vitamin A Deficiency of 20% (CI95%= 17% - 23%), with high homogeneity according to the source of the sample. Lower age of the child, low birth weight, poor iron nutritional status, diarrhea, subclinical infection, inadequate basic sanitation conditions, younger mothers and less maternal educa-tion represented the main exposures associated with the outcome. Conclusion: the results show Vitamin A Deficiency as a public health problem in Brazilian children under 5 years old, especially when related to the development of infectious processes and maternal and child characteristics that show greater susceptibility.

Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

OBJECTIVE

To update the estimation of the prevalence of anaemia in Brazilian children according to four different epidemiological scenarios.

DESIGN

A new systematic review was conducted with a meta-analysis of the results published between 2007 and May 2019. Literature search was carried out in the PubMed and LILACS databases using keywords anaemia, child and Brazil. A total of thirty-seven articles (17 741 children) were selected and categorised according to the origin of their respective samples: childcare centres (Childcare; n 13 studies/2697 individuals), health services (Services; n 4/755), populations with social inequities (Inequities, n 7/6798) and population-based studies (Populations; n 13/7491). Assuming a prevalence of 20·9 % as reference (Health National Survey; n 3455), the combined prevalence ratios (PR) were calculated. A random-effects model was used.

PARTICIPANTS

Brazilian children 6-60 months of age.

RESULTS

The prevalence of anaemia, by scenario, was: Childcare 24·8 % (PR 1·06; 95 % CI 0·81, 1·40); Services 39·9 % (PR 1·76, 95 % CI 1·33, 2·35); Inequities 51·6 % (PR 2·02, 95 % CI 1·87, 2·18); and Populations 35·8 % (PR 1·42, 95 % CI 1·23, 1·64). Therefore, the values were all higher than the national prevalence; the Inequities had the highest prevalence, and only Childcare did not reach statistical significance. Concerning the previous meta-analysis, there was a reduction in anaemia prevalence in all scenarios: -52·3, -33·7, -22·4 and -10·7 %, respectively.

CONCLUSIONS

Compared to the situation revealed in the previous meta-analysis, anaemia, although observed to a lesser extent, remains an important public health problem in the different scenarios analysed, especially for children living in Inequities. Access to Childcare mitigates the risk for this condition.

Factores asociados a las concentraciones de hemoglobina en preescolares

Resumen El presente estudio buscó identificar en niños preescolares la asociación de las concentraciones de hemoglobina con características socio-ambientales, maternas, biológico-nutricionales y las condiciones de salud; así como con las concentraciones séricas de zinc y retinol. Estudio transversal con muestra de 335 individuos, representativa de los niños de jardines infantiles del municipio de Campina Grande, Paraíba. En los 294 niños estudiados, el modelo ajustado mostró menores concentraciones de hemoglobina en casos de tipo de casa diferente de ladrillo; ausencia de red de escoto; colecta no pública de la basura; no tratamiento del agua para beber; dificultades maternas para leer, escribir o hacer cuentas; edad entre 9-24 meses; peso/edad < - 2 escore Z y problemas de salud en los últimos 15 días, bien como en casos de bajas concentraciones séricas de zinc y retinol. La multicausalidad de concentraciones inferiores de hemoglobina comprendió condiciones socio-ambientales y características materno-infantiles que refuerzan la importancia de medidas que prioricen los niños de menor edad, de madres con menor nivel educacional y con prejuicios en su peso, estado de salud y condición nutricional de otros micronutrientes importantes en el crecimiento.

Brazilian studies on zinc deficiency and supplementation: emphasis on children

Abstract Objectives: to review the literature of studies developed in Brazil on zinc deficiency and the effects of supplementation. Methods: a literature review based on bibliographic research was carried out in SciELO, LILACS and MEDLINE/PUBMED databases. A total of 133 studies on zinc deficiency and 116 on the effects of supplementation were identified. Thirty-two articles, 16 of which were observational and 16 interventional, were analyzed. Results: the studies focused mainly on children (75.0% of the observational and 81.25% of the experimental studies). Biochemical deficiency of zinc in children presented great variability, from 0.0% to 74.3%, with expressive prevalence in most studies. Dietary inadequacy among children presented variability from 16.6% to 46.0%. Five from seven studies showed a positive effect of zinc supplementation on micronutrient nutritional status. Conclusions: there is evidence of zinc deficiency in children as a public health problem, preventable through micronutrient supplementation.