RESUMEN
Vitamin A deficiency (VAD) has been known to exist in Latin America and the Caribbean since the mid-1960s; however, except for pioneering work by the Institute of Nutrition of Central America and Panama/Pan American Health Organization on sugar fortification in Central America, there was little interest in controlling it because of the low frequency of clinical findings. More recently, implicatons of the effect of subclinical VAD on child health and survival has generated increased interest in assessing the problem and a greater commitment to controlling it. The information available by mid-1997 on the magnitude VAD in countries of the region was extensively reviewed. Internationally accepted methods and cutoff points for prevalence estimations were used to compile information from relevant dietary, biochemical, and clinical studies carried out between 1985 and 1997 in samples of at least 100 individuals. VAD in the region of Latin America and the Caribbean is mostly subclinical. The national prevalence of subclinical VAD (serum retinol <20 ug/d) in children under 5 years of age ranges between 6 percent in Panama and 36 percent in El Salvador. The problem is severe in five countries, moderate in six, and mild in four. There are no recent data from Chile, Haiti, Paraguay, Uruguay, Venezuela, and the English-speaking Caribbean. The population affected amounts to about 14.5 million children under 5 years of age (25 percent of that age group). Schoolchildren and adult women may also have significant VAD. Actions currently implemented to control VAD include (a) universal or targeted supplementation; with sustained high coverage rates through national immunization day in some countries; (b) sugar fortification, which is well established in El Salvador, Guatemala and Honduras ( a significant effect has been documented in Guatemala and Honduras and is under negotiation in Bolivia, Columbia, Costa Rica (to be resumed), Equador, Nicaragua and Peru; and (c) limited dietary diversification activities.(AU)
Asunto(s)
Adulto , Niño , Femenino , Humanos , Masculino , Adolescente , Deficiencia de Vitamina A/epidemiología , Análisis de Varianza , Región del Caribe/epidemiología , América Latina/epidemiologíaRESUMEN
Vitamin A deficiency (VAD) has been known to exist in Latin America and the Caribbean since the mid-1960s; however, except for pioneering work by the Institute of Nutrition of Central America and Panama/Pan American Health Organization on sugar fortification in Central America, there was little interest in controlling it because of the low frequency of clinical findings. More recently, implications of the effect of subclinical VAD on child health and survival has generated increased interest in assessing the problem and a greater commitment to controlling it. The information available by mid-1997 on the magnitude of VAD in countries of the Region was extensively reviewed. Internationally accepted methods and cutoff points for prevalence estimations were used to compile information from relevant dietary, biochemical, and clinical studies carried out between 1985 and 1997 in samples of at least 100 individuals. VAD in the Region of Latin America and the Caribbean is mostly subclinical. The national prevalence of subclinical VAD (serum retinol < 20 mg/dl) in children under 5 years of age ranges between 6% in Panama and 36% in El Salvador. The problem is severe in five countries, moderate in six, and mild in four. There are no recent data from Chile, Haiti, Paraguay, Uruguay, Venezuela, and the English-speaking Caribbean. The population affected amounts to about 14.5 million children under 5 years of age (25% of that age group). Schoolchildren and adult women may also have significant VAD. Actions currently implemented to control VAD include (a) universal or targeted supplementation, with sustained high coverage rates through national immunization days in some countries; (b) sugar fortification, which is well established in El Salvador, Guatemala, and Honduras (a significant effect has been documented in Guatemala and Honduras) and is under negotiation in Bolivia, Colombia, Costa Rica (to be resumed), Ecuador, Nicaragua, and Peru; and...
Se sabe que la deficiencia de vitamina A (DVA) ha existido en América Latina y el Caribe desde mediados de los años sesenta. No obstante, si se exceptúan algunas iniciativas tempranas del Instituto de Nutrición de Centro América y Panamá, había escaso interés en controlarla debido a la detección infrecuente de signos clínicos. En época más reciente, las consecuencias de la DVA para la salud y la supervivencia infantiles ha suscitado gran interés en evaluar el problema y despertado un mayor empeño por controlarlo. La información que estaba disponible a mediados de 1997 sobre la frecuencia de la DVA en países de la Región se revisó minuciosamente. Se aplicaron métodos y puntos de corte aceptados mundialmente para la estimación de la prevalencia a fin de recopilar infomación obtenida de estudios alimentarios, bioquímicos y clínicos efectuados entre 1985 y 1997 con muestras de 100 personas como mínimo. La DVA en la Región de América Latina y el Caribe es eminentemente subclínica. La prevalencia nacional de la forma subclínica de DVA (retinol sérico < 20 µg/dL) en niños menores de 5 años oscila de 6% en Panamá a 36% en El Salvador. El problema es grave en cinco países, moderado en seis y leve en cuatro. No hay datos recientes para Chile, Haití, Paraguay, Uruguay, Venezuela y el Caribe de habla inglesa. En total la población afectada se aproxima a 14,5 millones de niños menores de 5 años (25% de ese grupo de edad). Los escolares y las mujeres en edad adulta también pueden tener una frecuencia elevada de DVA. Las medidas que actualmente están en marcha para controlar la DVA incluyen, entre otras, a) la suplementación dirigida a toda la población o a grupos particulares, con elevadas tasas de cobertura logradas durante los días en que se efectúan las inmunizaciones de alcance nacional en algunos países; b) la fortificación del azúcar, que ya se ha instaurado en El Salvador, Guatemala y Honduras (se ha observado un efecto notable en Guatemala...
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Deficiencia de Vitamina A/epidemiología , Análisis de Varianza , Región del Caribe/epidemiología , América Latina/epidemiologíaRESUMEN
A review of the literature and of the most recent available reports on iodine deficieny and its control programs in Latin America was made, including goiter prevalence, iodine urinary excretion, salt iodization, supplementation of iodized compounds, current legal provisions, and action plans for the prevention and control of iodine deficiency disorders. Likewise, different actions of interagency coordination carried out during 1983-1994 to control iodine deficiency disorders in Latin America were reviewed and analyzed. Results are described in Chapter VII, and summaries of the information from the countries in Chapter VIII. The conclusions and suggestions for future actions are presented in Chapters IX and X, and the data sources and references in Chapter XI. Annex I presents the tables, and Annex II, a form prepared by the WHO Nutrition Unit in Geneva, with the aim that all the countries keep updated standardized data, thus facilitating information exchange and compatibility at international level. Annex III presents the Declaration of the Representatives of the Central American Governments and the salt industry for the Eradication of Iodine Deficienchy Disorders, and Annex IV the Declaration of Quito on Universal Salt Iodization
Asunto(s)
Humanos , Yodo , Deficiencia de Yodo , América Latina/epidemiologíaRESUMEN
Se efectuó una revisión de literatura y de los informes más recientes disponibles sobre la deficiencia de yodo y sus programas de control en América Latina, la que incluyó aspectos como prevalencia de bocio, excreción urinaria de yodo, yodación de la sal, suplementación de compuestos yodados, disposiciones legales vigentes y planes de acción para la prevención y control de los TCY. De igual manera se revisaron y analizaron diferentes acciones de coordinación interagencial realizadas en el período 1983-1994 en apoyo al control de los TCY en América Latina. Los resultados se describen en el Capítulo VII, y los resúmenes de la información procedente de los países se encuentra en el Capítulo VIII. Las conclusiones y las sugerencias para acciones futuras se presentan en los Capítulos IX y X, y las fuentes de información y las referencias en el Capítulo XI. El anexo 1 presenta los cuadros y el anexo 2 un formulario preparado por la Unidad de Nutrición de la OMS en Ginebra, con el fin de que todos los países mantengan actualizada la información de manera estandarizada, facilitándose así el intercambio y compatibilidad de la información a nivel internacional. El anexo 3 contiene la Declaración de los Representantes de los Gobiernos y de la Industria Salinera de Centroamérica para la Eliminación de los Desórdenes Causados por Deficiencia de Yodo y el anexo 4 la Declaración de Quito para la Yodación Universal de la Sal
Asunto(s)
Humanos , Deficiencia de Yodo , Yodo , América Latina/epidemiologíaAsunto(s)
Embarazo , Recién Nacido , Lactante , Preescolar , Humanos , Femenino , Alimentación con Biberón , Lactancia Materna Parcial , Nutrición del Lactante , Destete , América LatinaRESUMEN
Eighty-seven children with moderate and severe malnutrition were treated by means of a supplementary feeding programme in Trinidad. The programme resulted in an average weight increase similar to that obtained by other authors in Nutrition Rehabilitation Centres and Supervised Supplementary Feeding Programmes elsewhere, over a similar period of time. The weight increase, however, is slow when translated into improvement of reference weight for age. Close supervision resulted in a somewhat faster rate of improvement but increase excessively the cost of rehabilitation. Supervision and education of the mothers carried out by Community Aides did not result in continued improvement after discontinuation of the supplement. However, there was a significant improvement in the quality of the diet given to the supervised children four months after the food supplement and supervision had been discontinued. (Summary)
Asunto(s)
Humanos , Niño , Masculino , Femenino , Carbohidratos de la Dieta , Proteínas en la Dieta/administración & dosificación , Atención Ambulatoria , Peso Corporal , Dieta , Educación en Salud , Madres , Trinidad y TobagoAsunto(s)
Humanos , Embarazo , Femenino , Antropometría , Evaluación Nutricional , Estado NutricionalRESUMEN
Between 25 and 50 per cent of the children under 5 years of age in the various parts of the English-speaking Caribbean are underweight for their age. In a great majority of the cases, such undernutrition begins with inadequate maternal food intake during pregnancy, resulting in a newborn with less than optimal birth-weight. Breast milk is often replaced early with highly diluted and contaminated milk formulas. Other contributing factors include inadequate parental knowledge of child nutrition, an unsanitary home environment, repeated episodes of gastroenteritis, and maldistibution of food within the home. The Caribbean territories are highly dependent on imported foods. Partly for this reason, the final solution to the malnutrition problem will undoubtedly depend upon implementation of food and nutrition plans and, indeed, of national developments plans. In the meantime, however, the nutrition worker must continue to work with the community, mainly by educating others about the very basic principles of how to promote breast-feeding, encourage better utilization of available foods, and prevent gastroenteritis and dehydration (AU)