Tendência temporal da anemia, desnutrição e obesidade em crianças de creches públicas de Belo Horizonte - MG

Abstract

This study evaluated the temporal trend of anemia, malnutrition and obesity in children aged six to 72 months enrolled in 25 public daycare facilities in the East Sanitary District of Belo Horizonte, Minas Gerais. For anemia evaluation, capillary blood samples were collected using disposable microcuvettes and analized with a portable hemoglobinometer (HemoCue ®) in order to measure hemoglobin, expressed in g/dL. Children were considered anemic with hemoglobin levels less than 11.0 g/dL for age group six to 60 months, and hemoglobin levels less than 11.5 g/dL for children aged more than 60 months. Nutritional status was determined by children weight and height measurements and expressed in terms of the nutritional indexes W/A, H/A, W/H and BMI/A, according to WHO (2006/2007). The diagnosis was evaluated as z-score and classified according to three groups. Values between 2 and -2 z-score were considered eutrophic values; values less than -2 z-score indicated malnutrition; and for obesity were considered values greater than 2 z-score. In order to obtain children information and maternal and socioeconomic data, it was applied questionnaires to children parents or guardians. The Chi-Square method for statistical analysis was performed to determine the trend and other factors associated with nutritional disorders. The Fisher Exact Test was also applied when it was necessary. For multinomial regression, the Backward method was employed. All analyzes were performed using R software, 2.15.3 version. The anemia prevalence showed no significant variation for the 11 years period considered. In this case, it were found the values of 28.61% for 2001, 26.78% for 2005 and 23.64% for 2011. There was no significant variation for anemia trend among children genders and age groups in the years considered. It was observed the prevalence of anemia inversely proportional to age, especially for children under 24 months, under higher risk for the problem. The nutritional status trend showed the obesity prevalence increase for a period of 7 years, according to the BMI/A index values of 22.2% for 2005 and 32.5% for 2011. In relation to malnutrition, it was observed a reduced number of malnourished children for both years of 2005 and 2011 (1.3% of the samples). In relation to obesity it was observed the prevalence increase for both children genders (for female, from 21.5% in 2005 to 37% in 2011; for male, from 22.7% to 28.20% in the same period). For the 24-48 months aged group there was a significant increase of obesity, ranging from 22.7 % in 2005 to 41% in 2011. The factors that showed to be related to obesity prevalence were the child age, the person who the child lives with, the birth weight and childbirth type. With this study, it was concluded that the anemia trend has tended to linearity for the children evaluated, with a no-significant decrease in the 11 years considered. In relation to the nutritional state trend, it was observed an obesity prevalence increase but no malnutrition variation. These results may contribute for new strategies and public policies formulation in order to prevent and control anemia and obesity in children attended by public daycare centers in the city of Belo Horizonte-MG. Also, the results may serve as a reference for practices adoption in order to decrease the prevalence of these nutritional disorders across the country.