Fatores associados à concentração de retinol sérico em lactentes

National Vitamin A Supplementation Program in primary care: what is the reality in Minas Gerais, Brazil?

The present study aimed to evaluate the National Vitamin A Supplementation Program in Minas Gerais, adopting the mixed sequential explanatory method. The quantitative approach adopted the multidimensional instrument per the components of vitamin A supplementation and food and nutrition education. We employed an analysis matrix with parameters to define the implementation as adequate, partially adequate, inadequate, and critical. We used semi-structured interviews in the qualitative approach. The "process" dimension was better evaluated than the "structure", with an implementation level (IL) of 84.6% and 78.5%, respectively. The Program's strengths include supplementation planning, achieving goals, recording information, supporting breastfeeding, and the performance of Community Health Workers. Weaknesses are fragmented work, analysis of information limits, access to the Program's actions, implementation of educational actions, and lack of or insufficient availability of nutritionists and training. The Program's reality only partially considered health promotion actions and focused on vitamin A supplementation. Implementing food and nutritional education actions is imperative to face vitamin A deficiency.

Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas

OBJECTIVES

To estimate the coverage of the National Vitamin A Supplementation Program (Programa Nacional de Suplementação de Vitamina A) in children from Alagoas, to identify factors associated with this coverage, and to analyze the adequacy of nutrition education actions.

METHODS

Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers (n=509). Coverage was defined by the percentage of children with supplementation records in the last semester. The association between the independent variables (socioeconomic, demographic, and health) and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95% CI. The mothers' knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions.

RESULTS

Program coverage was 91.9% in children aged 6-11.9 months and 38.6% in children aged 12-59 months. In the adjusted analysis, the factors that were associated with greater coverage were: age between 6-11.9 months (PR=2.50, 95% CI: 2.10-2.96), living in rural areas (PR=1.45, 95% CI: 1.20-1.76) and living in a house with ≤ 4 rooms (PR=1.33, 95% CI: 1.09-1.63). Only 26.1% of the mothers were able to mention some food source of vitamin A and only 19.2% were aware of the consequences of vitamin deficiency for health.

CONCLUSIONS

The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health (except for children <12 months). The factors associated with greater coverage indicate an adequate focus of the program. The nutrition education activities have not demonstrated satisfactory results. This information should guide actions to improve the program.

Consumo habitual de alimentos fonte de vitamina A em pré-escolares da zona rural no Norte de Minas Gerais

Objetivo: Avaliou-se o consumo habitual de alimentos fontes de vitamina A em pré-escolares da zona rural de Montes Claros, Minas Gerais.Métodos: Em estudo do tipo transversal foram pesquisados 337 pré-escolares por meio de entrevista com seus pais. Foram avaliados: a) características socioeconômicas da família; b) recebimento de suplementação de vitamina A provida pelo governo, c) o hábito de consumo de alimentos fontes de vitamina A através de um Questionário de Frequência Alimentar. O hábito de consumo foi classificado entre alto/moderado ou baixo e associado às variáveis socioeconômicas usando-se o modelo de regressão de Poisson para calcular a razão de prevalência e respectivo intervalo de confiança a 95%.Resultados: A maioria das crianças era de famílias de baixa renda. Apenas 51% delas receberam pelo menos 4 doses de suplementação de vitamina A. O hábito de consumo de fontes dessa vitamina inferido pelo Questionário de Frequência Alimentar foi considerado alto/moderado para apenas 75 dos pré-escolares e baixo para 262 deles. O baixo consumo de alimentos fontes de vitamina A foi associado à renda ≤1 salário mínimo (RP=1,178) e consumo habitual de guloseimas (RP=1,256).Conclusão: As crianças avaliadas apresentaram baixo registro de recebimento da suplementação de vitamina A provida pelo governo e baixo consumo de alimentos fonte desse nutriente, sendo este último associado à baixa renda familiar e ao alto consumo de guloseimas.

Vitamin A status and associated factors in infants attending at Primary Health Care in Goiânia, Goiás, Brazil

OBJECTIVE

This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil.

METHODS

This is a cross-sectional study with a sample of 228 children 12 to 16 months of age. The nutritional status of vitamin A was assessed by serum retinol concentration, determined by high performance liquid chromatography. Multiple linear regression models with hierarchical selection of independent variables were used to evaluate the correlation with serum retinol as the dependent variable.

RESULTS

The vitamin A deficiency (retinol < 0,7 μmol/L) was observed in 14,0% of the children. Maternal schooling and hemoglobin concentration were positively correlated with serum retinol concentration, while C-reactive protein showed a negative correlation (R2 = 0,1648).

CONCLUSION

The vitamin A deficiency in one-year-old children attended in Basic Health Units in Goiânia configures itself as a moderate public health problem. Actions to promote maternal education, morbidity control and prevention of other micronutrient deficiencies are important for prevention and control of the vitamin A deficiency in this population.