RESUMO
BACKGROUND: To reduce health inequities in paediatric patients with complex diseases, our hospital developed a food security programme in 2022. The programme aims to mitigate food insecurity (FI) in paediatric patients with oncological, transplantation and congenital cardiovascular diagnoses, by providing a monthly nutritious food supply that covers up to 50% of the patient's family food intake, accompanied by social and nutritional follow-up. In this study, we aimed to assess the effect of the programme on FI and nutritional status and describe its implementation. METHOD: We conducted a before-and-after study of patients who entered the programme in a 14-month period. We used the Escala Latinoamericana y Caribeña de Seguridad Alimentaria (ELCSA) scale score, FI level and nutritional status measures to assess the effect of the programme. We used the Wilcoxon and McNemar tests to assess changes in scores and proportions of patients with moderate and severe FI, respectively, 31.5%-14.4% (p=0.0008) and of moderate FI from 68.5% to 36.9%. RESULTS: 111 patients were included. They had a baseline median (IQR) ELCSA score=8 (7-11) that changed to 6 (4-9) (p<0.0001). Severe FI according to ELCSA changed from 31.5% to 14.4% (p<0.001) and moderate from 68.5% to 36.9% (p<0.001). We found no differences in nutritional status regarding height for age (49.5% vs 51.3%, p=0.76), weight for height (42.5% vs 59.1%, p=0.75) or body mass index for age (38% vs 46%, p=0.42) CONCLUSION: The programme reduced FI in families by improving its level to mild or moderate. Children who entered the programme maintained an appropriate nutritional status despite the considerable risk of malnutrition described for oncological paediatric patients and paediatric solid organ transplantation receptors.
Assuntos
Segurança Alimentar , Estado Nutricional , Humanos , Masculino , Feminino , Criança , Pré-Escolar , Insegurança Alimentar , Lactente , Avaliação de Programas e Projetos de Saúde , Adolescente , Abastecimento de Alimentos/estatística & dados numéricosRESUMO
La biología y ecología de la mosca blanca de los invernaderos, Trialeurodes vaporariorum (Westwood) (Hemiptera: Aleyroridae), se encuentra ampliamente documentada. Sin embargo, hasta el momento no hay reportes acerca de la tasa de consumo de alimento por este fitófago, un parámetro necesario para modelos de simulación. Por tal motivo, el objetivo de esta investigación fue la medición indirecta del consumo de alimento por el adulto e instares inmaduros de T. vaporariorum basado en metodologías encontradas en la literatura científica. La estimación de la tasa de consumo de alimento por adultos se realizó bajo condiciones de laboratorio, utilizando como unidad experimental una planta de fríjol de dos semanas de edad. El experimento consistió de dos tratamientos: (T1) plantas libres de cualquier fitófago y (T2) plantas sometidas a infestaciones con T. vaporariorum, cada tratamiento con 20 repeticiones y una réplica en el tiempo de todo el experimento. Se registró el peso fresco diariamente en ambos tratamientos. Para el caso de los inmaduros, la unidad experimental consistió en una hoja cotiledónea de fríjol, infestada con una población determinada de inmaduros de cada instar de mosca blanca teniendo así cinco tratamientos (Instar I, II, III, IV y Control) cada uno con 17 repeticiones. Se registró diariamente el peso fresco de las hojas. Se obtuvo un consumo promedio de alimento por el adulto de 0,277 ± 0,0042 mg.dia-1. Para los dos primeros instares ninfales se estimó una tasa de consumo de 0,052 mg.dia-1, en el tercer instar de 0,14 mg.dia-1, y para el cuarto instar de 0,19 mg.dia-1. Un adulto de mosca blanca puede consumir en un día seis veces su peso y un inmaduro ocho veces, gracias a su rápido metabolismo y la constante excreción de mielecilla.
The biology and ecology of the greenhouse whitefly, Trialeurodes vaporariorum Westwood (Hemiptera: Aleyroridae), is widely documented. However, so far there are not reports about the rate of consumption of this phytophagous. Therefore, the objective of this research was to measure the food consumption by the adult and immature instars of T. vaporariorum based on indirect methodologies found in the literature. The estimate of the food consumption rate by adults was conducted under laboratory conditions, using as experimental units plant beans two weeks old. The experiment consisted of two treatments: (T1) plants free from any phytophagous and (T2) plants subjected to infestation with T. vaporariorum, with 20 repetitions each treatment and replicated over time. In the case of the immature individuals, the experimental unit consisted of a bean cotyledon leaf infested with a population of immature individuals of each instar of whitefly, having five treatments (Instar I, II, III, IV and Control) each with 17 repetitions. Fresh weight of leaves was recorded daily. An average food consumption of 0.277 ± 0.0042 mg.day-1 was obtained for the adult. For the first two nymphal instars food consumption rate of 0.052 mg.day-1 was estimated, for the third instar 0.14 mg.day-1, and for the fourth instar 0.19 mg.day-1. An whitefly adult can consume in a day six times its weight and an immature eight times, this thanks to the rapid metabolism and a constant excretion of honeydew of the species.