RESUMO
Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.
Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.
Assuntos
Humanos , Feminino , Recém-Nascido , Lactente , Adulto , Adulto Jovem , Refugiados , Mães/educação , Síria , Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do LactenteRESUMO
Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.
Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.
Assuntos
Mães , Refugiados , Adulto , Feminino , Humanos , Lactente , Adulto Jovem , Aleitamento Materno , Fenômenos Fisiológicos da Nutrição do Lactente , Mães/educação , Síria , Pré-EscolarRESUMO
Literature describes breast milk as the best food for the newborn, recommending exclusive breastfeeding for up to 6 months of age. However, it is not available for more than 40% of children worldwide. Pharmacological and non-pharmacological models of 3-day early weaning were developed in rodents to investigate later outcomes related solely to this nutritional insult. Thus, the present work aimed to describe biometric, nutritional, biochemical, and cardiovascular outcomes in adult male rats submitted to 3-day early weaning achieved by maternal deprivation. This experimental model comprises not only nutritional insult but also emotional stress, simulating mother abandoning. Male offspring were physically separated from their mothers at 21st (control) or 18th (early weaning) postnatal day, receiving water/food ad libitum. Analysis performed at postnatal days 30, 90, 150, and 365 encompassed body mass and food intake monitoring and serum biochemistry determination. Further assessments included hemodynamic, echocardiographic, and cardiorespiratory evaluation. Early-weaned males presented higher body weight when compared to control as well as dyslipidemia, higher blood pressure, diastolic dysfunction, and cardiac hypertrophy in adult life. Animals early deprived of their mothers have also presented a worse performance on the maximal effort ergometer test. This work shows that 3-day early maternal deprivation favors the development of cardiovascular disease in male rats.
Assuntos
Doenças Cardiovasculares/etiologia , Suscetibilidade a Doenças/etiologia , Privação Materna , Animais , Biometria , Ecocardiografia , Ergometria , Feminino , Masculino , Desnutrição , Gravidez , Angústia Psicológica , Ratos , Ratos Wistar , DesmameRESUMO
BACKGROUND: Undernutrition is a common problem among children with congenital heart disease (CHD) and may lead to poorer surgical outcomes. A higher intake of energy during the postoperative period of CHD surgery seems to be associated with better outcomes. This study aimed to investigate the effect of the use of energy-enriched formula (EE-formula) compared with normocaloric formula during 30 days after CHD surgery. METHODS: A randomized controlled trial with patients undergoing heart surgery in a tertiary hospital in southern Brazil from March 2017 to December 2017 was performed. The intervention group received EE-formula (1 kcal/mL), and the control group received normocaloric formula (0.67 kcal/mL). The researcher in charge of anthropometric evaluation was blinded to the randomization. RESULTS: Fifty-nine patients were included; 30 in control group and 29 in intervention group. There were no statistically significant differences between groups regarding age, gender, anthropometry, and surgical risk classification after randomization. A statistically significant difference in z-score of weight for age and in weight gain variation rate between groups after intervention was observed. Antibiotic use was less frequent in the intervention group, and hospital length of stay was shorter. General gastrointestinal side effects were similar between groups, whereas diarrhea was more frequent in the intervention group. However, this side effect was limited and had spontaneous resolution in 4 out of 6 cases. CONCLUSION: This study demonstrates that EE-formula use after heart surgery of patients with CHD is well tolerated and may improve short-term nutrition outcome, decrease hospital stay, and reduce antibiotic use.
Assuntos
Procedimentos Cirúrgicos Cardíacos , Cardiopatias Congênitas , Fórmulas Infantis , Brasil , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Criança , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Estado NutricionalRESUMO
Background: Malnutrition at admission of paediatric hospitalization is a risk factor for negative evolution and is associated with increased morbidity and mortality. The main objective was to learn about the frequency of malnutrition and undernourishment as well as the nutritional risk at hospital admission, through a sample of paediatric patients. Material and Methods: A descriptive cross-sectional was taken, chosen from long term patients in Hospital Dr. Humberto Notti. A nutritional screening (Strong Kids) was applied, assessing nutritional risk within 48 hours. of hospital admission and nutritional diagnosis was obtained with the corresponding anthropometric data. For the statistical analysis, Fisher Test and Student test were used. Results: 134 patients were admitted (59% women), 4 years of age, (1 to 9 years) (medium sized and IQR), and hospitalization lasted 4 days (3 to 7 days). At the ingress, 17% presented acute malnutrition, and 60% presented moderate nutritional risk. Those who suffered from high nutritional risk, went through more frequent pain, change of weight, less eating, diarrhea, and signs of undernourishment, than those who suffered from moderated nutritional risk. (Fisher < 0, 0001). Conclusion: Malnutrition or undernourishment at hospital admission affects about the 20% of patients and more than half presents moderated nutritional risk. These two observations justify the systematic carrying out of an evaluation of the nutritional status
Introducción: La desnutrición al ingreso de la internación pediátrica es un factor de riesgo de mala evolución y está asociado a mayor morbimortalidad. El principal objetivo fue conocer la frecuencia de desnutrición y riesgo nutricional al inicio de la hospitalización en una muestra de pacientes pediátricos. Población y métodos: Diseño descriptivo, transversal. Se incluyeron pacientes de 1 mes a 14 años internados entre marzo y julio de 2016, en el Hospital Dr. Humberto Notti. Se aplicó un tamizaje nutricional (Strong Kids) valorando riesgo nutricional dentro de las 48hs. de ingreso hospitalario y se obtuvo diagnóstico nutricional con los datos antropométricos correspondientes. Para el análisis estadístico se utilizó Test de Fisher y t de Student. Resultados: Ingresaron 134 pacientes, edad 4 (1 a 9) años (mediana e IQR) y la duración de la internación fue de 4 (3 a 7) días. Al momento del ingreso el 17% presentaba desnutrición aguda y el 60% un riesgo nutricional moderado. Los pacientes con alto riesgo nutricional al ingreso tuvieron más frecuentemente dolor, cambio de peso, menor ingesta, diarrea y signos de desnutrición que los que tuvieron un riesgo nutricional moderado (Fisher < 0,0001). Conclusión: La desnutrición al ingreso de la hospitalización afecta a casi la quinta parte de los pacientes y más de la mitad presenta riesgo nutricional moderado lo que justifica la realización sistemática de la evaluación del riesgo nutricional. Conclusión: La desnutrición al ingreso de la hospitalización afecta a casi la quinta parte de los pacientes y más de la mitad presenta riesgo nutricional moderado lo que justifica la realización sistemática de la evaluación del riesgo nutricional.
Assuntos
Hospitalização/estatística & dados numéricos , Desnutrição/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Desnutrição/epidemiologia , Avaliação Nutricional , Projetos Piloto , Fatores de RiscoRESUMO
BACKGROUND: Levels of child undernutrition have declined in many middle-income countries, whereas overweight and obesity have increased. We describe time trends in nutritional indicators at age 1 year in the 1982, 1993, 2004 and 2015 Pelotas (Brazil) Birth Cohorts. METHODS: Each study included all children born in the urban area of the city, with over 4 200 births in each cohort. Children were measured at approximately 12 months of age. Anthropometric indicators were calculated according to World Health Organization Growth Standards. Stunting and wasting were defined as <-2 Z scores for length for age and weight for length, and overweight as >2 Z scores for weight for length. Prevalence was stratified by sex, maternal skin colour and family income. RESULTS: The prevalence of stunting declined by 53% (from 8.3% to 3.9%) from 1982 to 2015. Wasting prevalence remained stable at low levels (1.8% in 1982 and 1.7% in 2015), whereas overweight increased by 88% (6.5% to 12.2%). Undernutrition was more common among boys, those born to mothers with brown or black skin colour and in the poorest quintile of families. Socioeconomic inequalities in undernutrition decreased markedly over time. Overweight was markedly more common among the rich in 1982, but fast increase among the poor eliminated socioeconomic differences by 2015, when all groups showed similar prevalence. CONCLUSIONS: Our results confirm the rapid nutrition transition in Brazil, with marked reduction in levels and inequalities in undernutrition in parallel with a rapid increase in overweight, which became the main nutritional problem for children.
Assuntos
Antropometria , Transtornos do Crescimento/epidemiologia , Desnutrição/embriologia , Sobrepeso/epidemiologia , Síndrome de Emaciação/epidemiologia , Estatura , Brasil/epidemiologia , Feminino , Humanos , Renda , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Prevalência , Padrões de Referência , Organização Mundial da SaúdeRESUMO
ABSTRACT BACKGROUND: Exclusive breastfeeding for six months is one of the measures with highest impact on prevention of child deaths. The determinants of breastfeeding practices are complex and differ between populations. This study aimed to identify factors associated with the prevalence of exclusive breastfeeding in a suburban area in Angola. DESIGN AND SETTING: Population-based cross-sectional study in the municipality of Cacuaco, Luanda. METHODS: A random sample of children under two years of age and their mothers was included. Prevalence ratios (PR) were estimated using Poisson regression based on a hierarchical model. RESULTS: 749 children and their mothers were surveyed, including 274 children under six months. Theprevalence of exclusive breastfeeding among children under six months was 51.5% (95% confidence interval, CI, 46.3-56.6%). Four variables were positively associated with exclusive breastfeeding at ages of under six months: number of prenatal visits (PR 1.11 for each visit after the first one; 95% CI 1.04-1.18), maternal occupation (other occupations versus self-employed) (PR 1.54; 95% CI 1.05-2.26), younger child age (PR 0.77 for each month; 95% CI 0.71-0.84) and female child (PR 1.34; 95% CI 1.02-1.76). CONCLUSIONS: Our findings showed that the prevalence of exclusive breastfeeding at six months was satisfactory, according to international recommendations. Factors associated with exclusive breastfeeding practices that had never been surveyed before in Angola were identified through this study. These data are particularly relevant in the context of high infant mortality and may be useful in planning actions aimed at improving child health through promotion of exclusive breastfeeding, in Angola and other countries.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , População Suburbana/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Mães/estatística & dados numéricos , Estudos Transversais , Idade Materna , AngolaRESUMO
Objetivou-se descrever a utilização da observação participante (OP) para análise da alimentação de crianças desnutridas menores de dois anos. Foram analisados na íntegra oito diários de campo (DC) para identificar como a OP auxilia na avaliação das práticas alimentares de crianças dessa faixa etária. Os resultados foram agrupados nos seguintes temas: "A entrada em campo"; "O diário de campo: antes, durante e após as observações"; "A observação das práticas alimentares das crianças"; e "A observação que ultrapassa as práticas alimentares das crianças". Verificou-se in loco quais os alimentos preparados, oferecidos e consumidos pela criança, quem preparava, horários e locais das refeições, aspectos de higiene, interações mãe-criança, cuidados dispensados às crianças, situação social e redes de suporte das famílias. A OP revelou aspectos para além da alimentação como ato biológico e ampliou o entendimento sobre a situação da criança frente ao problema de saúde.
This study describes the use of participant observation to analyze the feeding of malnourished children under two years old. Eight field diaries were fully analyzed to identify the usefulness of this tool to evaluate feeding practices of children in this age group. The results were grouped according to the following themes: "Entry into the field"; "The field diary: before, during and after observations"; "Observing the children's feeding practices"; "Observing beyond the children's feeding practices". The kinds of foods prepared, offered and consumed by the child were recorded in loco, as well as who prepared food, the time and places where the meals occurred, hygiene aspects, mother-child interactions, daily childcare and families' social situation and support network. Participant observation revealed aspects beyond feeding as a biological act and improved the understanding of the children's health situation.
Se describió la utilización de observación participante (OP) para evaluar la alimentación de niños malnutridos menores de dos años. Se analizaron ocho diarios de campo (DC) para identificar cómo la OP auxilia en la evaluación de prácticas alimentarias de niños en este grupo de edad. Los resultados se agruparon en: Entrada en campo; El diario de campo: antes, durante y después de las observaciones; Observación de las prácticas alimentarias; y Observación que va más allá de las prácticas alimentarias. Se verificó in loco los alimentos preparados, ofrecidos y consumidos por el niño, quién los preparaba, los horarios y locales de las comidas, los aspectos de higiene, las interacciones madre-niño, los cuidados dispensados, la situación social y las redes de soporte de las familias. La OP reveló aspectos más allá de la alimentación como un acto biológico y amplió la comprensión sobre la situación del niño ante el problema de salud.
Assuntos
Humanos , Lactente , Transtornos da Nutrição do Lactente , Desnutrição , Dieta , LactenteRESUMO
RESUMEN La desnutrición en la niñez conforma un importante problema de salud pública en Argentina, ya sea como causa básica de mortalidad/morbilidad o asociada a distintas patologías que inciden sobre la población infantil. Sin embargo, poco se conoce sobre su magnitud, tendencias y su distribución espacial. Este artículo procuró detectar estas situaciones considerando diferentes escalas geográficas. Se propuso un abordaje cuantitativo mediante la sistematización de estadísticas vitales (mortalidad), egresos hospitalarios (morbilidad), y de bajo peso al nacimiento (natalidad), sobre una población objetivo de 0 a 4 años de edad. Las fuentes de información utilizadas fueron las estadísticas de mortalidad (1999-2013), estadísticas de egresos hospitalarios (2000, 2005-2011) y estadísticas de nacidos vivos (1999-2012) provistos por la Dirección de Estadísticas e Información de Salud (DEIS) del Ministerio de Salud de la Nación. Los resultados advierten comportamientos diferenciados según la escala considerada. Como conclusión, se destaca la necesidad de integrar las vertientes de información analizadas para brindar un panorama más general sobre un problema que, si bien tiende a descender, alcanza magnitudes altas en las zonas más vulnerables. Ciertas áreas del norte presentan las peores condiciones y precisan un abordaje inmediato en materia de pobreza y salud infantil.
ABSTRACT Child malnutrition is an important public health problem in Argentina, both as a primary cause of mortality/morbidity and associated with different pathologies that affect children. However, little is known about its magnitude, trends and spatial distribution. This article seeks to detect such situations considering different geographic scales. A quantitative approach was applied, systematizing vital statistics (mortality), hospital discharges (morbidity), and low birth weight (natality) in children 0-4 years of age. Accordingly, the information sources used were mortality statistics (1999-2013), hospital discharge statistical records (2000, 2005-2011) and live birth statistics (1999-2012) provided by the Office of Statistics and Health Information (DEIS) [Dirección de Estadísticas e Información de Salud] of the National Ministry of Health. The results show differences according to the scale considered. The conclusions highlight the necessity of integrating the different sources of information analyzed in order to provide a more general overview of a problem that, albeit in decline, still registers high magnitudes in the most vulnerable areas. In this way, certain areas of northern Argentina evidence worse conditions, requiring immediate attention be paid to issues of poverty and child health.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Desnutrição/epidemiologia , Argentina/epidemiologia , Pobreza , Estudos Transversais , Desnutrição/diagnóstico , Desnutrição/economiaRESUMO
Abstract Infantile colic is one of the main reasons for consultation in pediatric gastroenterology and pediatric nutrition services. This pathology has multiple etiologies such as family dysfunction, gastrointestinal alterations, food allergies or intolerances, food imbalance and improper eating habits. It is acute, of sudden onset, and tends to disappear between 3 and 6 months of age. To date there is no consensus on the management protocols of this condition or indicators of therapeutic efficacy. Medications, dietary regimens and dietary supplements specific to this pathology (anti-colic) have been developed for some years to help address this issue. This article presents a structural review of evidence on the fundamentals and progress in the treatment of infantile colic, and compiles the characteristics of this pathology, the medical and nutritional therapeutic measures, the clinical approach and the techniques to help the patient and his family. This study seeks to provide technical tools to health professionals whose target population is children younger than 2 years of age.
Resumen El cólico del lactante es uno de los principales motivos de consulta en los servicios de pediatría, gastroenterología y nutrición pediátrica. Esta patología posee múltiples características etiológicas como disfunción de la mecánica familiar, alteraciones gastrointestinales, alergias o intolerancias alimentarias, desbalance alimentario e inadecuados hábitos alimenticios. Es de carácter agudo, con inicio súbito que tiende a desaparecer entre los 3 y 6 meses de edad. Hasta el momento no existe un consenso sobre los protocolos de manejo de esta condición o sobre sus indicadores de eficacia terapéutica. Desde hace algunos años se han desarrollado fármacos, regímenes dietarios y complementos alimentarios específicos para esta patología (anticólico). Este trabajo es una revisión de la evidencia sobre los fundamentos y avances en el tratamiento del cólico del lactante en el que se recopilan las características de esta patología, las medidas terapéuticas médicas y nutricionales, el abordaje clínico y las técnicas para ayudar al paciente y su entorno familiar. El presente estudio busca brindar herramientas técnicas al profesional de la salud cuya población objeto de atención es menor de 2 años.
RESUMO
OBJECTIVE: Peru has implemented various strategies seeking to improve nutritional indicators in children under five years old. However, high prevalence of malnutrition in some regions still remains. The aim of this study was to assess changes in regional prevalence and to determine the presence of district conglomerates with a high prevalence of chronic childhood malnutrition (CCM) in 2010 and 2016. METHODS: A comparative descriptive analysis by regions and a district-level spatial analysis were conducted employing indicators reported by the Nutritional Status Information System. RESULTS: 23.9% (561.090/2.343.806) children under five years evaluated in Peru during 2010 and 18.0% (394.049/2.193.268) evaluated during 2016 were chronic malnutrition (reduction of 5.9 percentage points). We identified a decline of 7.6 percent points in rural areas and the persistence of prevalence above 30% in only one region (Huancavelica). The spatial analysis identified clusters of districts with high prevalence in 20% (379/1834) of Peruvian districts in 2010, and 17.2% (316/1834) of those in 2016, which are mainly spread across the sierra and jungle regions. . CONCLUSIONS: Peru has made significant progress in reducing stunting in children. Nevertheless, it still represents a health problem due to high prevalence in the sierra region, as well as expansion to jungle districts in 2016.
OBJETIVO: En Perú se han implementado diversas estrategias buscando mejorar los indicadores nutricionales en menores de cinco años. No obstante, persisten altas prevalencias de desnutrición en algunas regiones. El objetivo de este estudio fue evaluar los cambios en las prevalencias regionales y determinar la presencia de conglomerados distritales con altas prevalencias de desnutrición crónica infantil (DCI) en los años 2010 y 2016. METODOS: Se realizó un análisis descriptivo comparativo por regiones y un análisis espacial distrital a partir de los indicadores reportados por el Sistema de Información del Estado Nutricional. RESULTADOS: El 23,9% (561.090/2.343.806) de menores de cinco años evaluados en Perú durante el 2010 y el 18,0% (394.049/2.193.268) de evaluados en 2016 presentaron desnutrición crónica (reducción de 5,9 puntos porcentuales). Se identificó una reducción de 7,6 puntos porcentuales en el área rural y la persistencia de prevalencias por encima de 30% en una sola región (Huancavelica). El análisis espacial identificó que en el 2010 existieron agrupaciones distritales de altas prevalencias en el 20% (379/1834) de distritos peruanos y en el 17,2% (316/1834) de distritos para el 2016, los cuales están distribuidos principalmente en la región de la sierra y selva. CONCLUSIONES: En Perú se han logrado importantes avances en reducir la desnutrición crónica infantil, sin embargo, aún representa un problema de salud por las altas prevalencias en la sierra y la expansión hacia distritos de la selva en 2016.
Assuntos
Transtornos do Crescimento/etiologia , Desnutrição/epidemiologia , Estado Nutricional , Criança , Ciências da Nutrição Infantil , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Promoção da Saúde , Humanos , Lactente , Masculino , Peru/epidemiologia , Prevalência , População Rural , Análise EspacialRESUMO
INTRODUCCIÓN: La prevalencia de desnutrición y anemia a nivel nacional en niños preescolares es del 34.1% y 25% respectivamente. El objetivo del presente estudio fue establecer la prevalencia de desnutrición, anemia y su relación con factores asociados (prematurez, bajo peso y baja talla al nacer) en niños de 6 a 59 meses de edad de la parroquia Sinincay (Azuay-Ecuador) durante el año 2015. MÉTODO: Estudio transversal de prevalencia y factores asociados en una población de niños registrados en la matriz del sistema de vigilancia alimentaria y nutricional de enero a julio de 2015. Los datos de filiación se obtuvieron por interrogatorio, la antropometría fetal y edad gestacional fue obtenida de la historia clínica. La antropometría infantil se determinó por observación directa y la presencia de anemia se determinó por el valor de hemoglobina en sangre. Para el análisis se empleó la estadística básica descriptiva, chi-cuadrado y razón de prevalencia con intervalo de confianza al 95%; valores de P 0.05 fueron utilizados para definir significancia estadística. RESULTADOS: Se estudiaron 737 niños, el 47.6% fueron niñas y el 52.4% niños; los lactantes constituyeron el 35.8% y los pre-escolares el 64.2%. El estudio reveló que el 5% de la población padece desnutrición global, el 20.8% desnutrición crónica moderada y el 2.8% desnutrición crónica severa. La prevalencia de anemia fue del 2.4% en niños con bajo peso y de 10.8% en niños con baja talla. Se encontró relación significativa entre anemia, bajo peso al nacer y baja talla al nacer con bajo peso y baja talla según OMS (P<0.05); además de relación entre prematurez y baja talla OMS (P<0.05). CONCLUSIÓN: La prevalencia de desnutrición y sus factores asociados sigue la tendencia reportada en estudios similares. Ésta investigación abre las puertas a intervenciones que permitan detectar factores determinantes de desnutrición y para lograr la "Desnutrición Cero.(au)
BACKGROUND: Prevalence of malnutrition and anemia in Ecuadorian children are 34.1 % and 25% respectively. The objective was to establish the prevalence of malnutrition, anemia and its relation with associated factors (prematurity, low weight at birth and short length at birth) in children aged 6 to 59-months at Sinincay during 2015. METHOD: A cross sectional research that included associated factors of a children population registered in a surveillance nutrition program from January to July of 2015. Filiation data came from direct interview, measurement at birth and gestational age were collected from medical records. Current anthropometry was determined by direct observation and diagnosis of anemia was established by blood-hemoglobin levels. Analysis was performed using basic statistics, chi-square test and prevalence ratio with a 95% confidence interval; P<0.05 were used to determine statistical significance. RESULTS: 737 children were studied, 47.6% of them were female and 52.4% were male children; breastfeeding infants and preschool-aged children were 35.8% and 64.2% respectively. This research revealed that 5% of children had global maltnutrition, 20.8% of them had moderate chronic malnutrition and 2.8% suffered severe malnutrition. Prevalence of anemia was 2.4% in low-weight children and 10.8% in short-height children. Significant relation was established between anemia, low weight at birth, short length and low-weight and short-length at birth according to WHO (P 0.05); furthermore, prematurity and short-length showed this relation as well (P<0.05). CONCLUSION: Prevalence of malnutrition and its associated factors are similar to those reported in other studies. This research encourages the development of new interventions that may detect determinant factors in malnutrition and thereby reach the optimal nutritional status among children population.(au)
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Transtornos da Nutrição Infantil , Transtornos da Nutrição do Lactente , Estudos Transversais , Fatores de Risco , AnemiaRESUMO
The most important event in Chilean public health in the XXth Century was the creation of the National Health Service (NHS), in 1952. Systematic public policies for the promotion of health, disease prevention, medical care, and rehabilitation were implemented, while a number of more specific programs were introduced, such as those on infant malnutrition, complementary infant feeding, medical control of pregnant women and healthy infants, infant and adult vaccination, and essential sanitation services. In 1981, a parallel private health care system was introduced in the form of medical care financial institutions, which today cover 15% of the population, as contrasted with the public system, which covers about 80%. From 1952 to 2014, public health care policies made possible a remarkable improvement in Chile s health indexes: downward trends in infant mortality rate (from 117.8 to 7.2 x 1,000 live births), maternal mortality (from 276 to 18.5 x 100,000), undernourished children < 5 years old (from 63% to 0.5%); and upward trends in life expectancy at birth (from 50 to 79,8 years), professional hospital care of births (from 35% to 99.8%), access to drinking water (from 52% to 99%), and access to sanitary sewer (from 21% to 98.9%). This went hand in hand with an improvement in economic and social indexes: per capita income at purchasing power parity increased from US$ 3,827 to US$ 20,894 and poverty decreased from 60% to 14.4% of the population. Related indexes such as illiteracy, average schooling, and years of primary school education, were significantly improved as well. Nevertheless, compared with OECD countries, Chile has a relatively low public investment in health (45.7% of total national investment), a deficit in the number of physicians (1.7 x 1,000 inhabitants) and nurses (4.8 x 1,000), in the number of hospital beds (2.1 x 1,000), and in the availability of generic drugs in the market (30%). Chile and the USA are the two OECD countries with the lowest public investment in health. A generalized dissatisfaction with the current Chilean health care model and the need of the vast majority of the population for timely access to acceptable quality medical care are powerful arguments which point to the need for a universal public health care system. The significant increase in public expenditure on health care which such a system would demand requires a sustainable growth of the Chilean economy.
Assuntos
Adulto , Feminino , Humanos , Lactente , Gravidez , Atenção à Saúde , Chile , Atenção à Saúde/economia , Atenção à Saúde/organização & administração , Atenção à Saúde/estatística & dados numéricos , Saúde Pública , Fatores SocioeconômicosRESUMO
Background: Neonatal malnutrition defined by birth weight (BW) is a risk factor for obesity and cardio-metabolic diseases in adults. Neonatal ponderal index (NPI) may have better diagnostic value than BW to establish nutritional status. Aim: To determine the effect of neonatal nutritional status, established by the three NPI curves available in Chile, on the risk of Metabolic Syndrome (MS) in obese school children. Material and Methods: A nested case/control study in a sample of 410 obese school children aged 10 to 16 years (57% males) was performed. The dichotomous response variable was the presence of MS defined as International Diabetes Federation (IDF) or Cook’s criteria. The exposure variable was having NPI < percentile (p) 10. Results: The frequency of MS was 36 and 39% according to the IDF and Cook criteria, respectively. The proportion of children with neonatal malnutrition exceeded 20%. A significantly increased risk for MS was only found when PNI was defined according to Lagos´s Table and MS was defined using IDF criteria. Having a PNI > p90, however, showed a trend towards a reduced risk of MS, which only reached significance using Lagos´s Table and Cook´s Criteria. Conclusions: Neonatal malnutrition defined by NPI is common in obese school children. The condition of neonatal under nutrition defined as PNI < p10 may be a risk factor for developing MS. Instead, having a NPI > p90 could be protective.
Assuntos
Adolescente , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Desnutrição/complicações , Síndrome Metabólica/etiologia , Estado Nutricional , Obesidade/complicações , Fatores Etários , Peso ao Nascer , Índice de Massa Corporal , Estudos de Casos e Controles , Chile , Estudos de Coortes , Desnutrição/diagnóstico , Síndrome Metabólica/diagnóstico , Obesidade/diagnóstico , Fatores de RiscoRESUMO
Introducción: la desnutrición infantil y la falta de seguridad alimentaria son un problema de salud pública actual. Objetivos: Conocer la prevalencia de desnutrición crónica en los niños de 0 a 5 años de la población de las Colonias de Pereira y determinar la asociación con factores socioeconómicos y el nivel de inseguridad alimentaria doméstico. Materiales y métodos: Se realizó un estudio de corte transversal, prospectivo en niños de 0 a 5 años y sus familias. Se evaluó la seguridad alimentaria doméstica, variables nutricionales, socio-demográficas, socio-económicas y educativas de la familia. El análisis se hizo con SPSS 20.0 para Windows. Resultados: Se evaluaron 68 niños, el 51,5% eran hombres, con edad promedio 32,4 ± 17,2 meses (rango: 2,1 a 59,9 meses). El 11,8% de los niños tenían algún tipo de desnutrición, el 67,7% de las familias tenían inseguridad alimentaria, con baja capacidad económica para adquirir alimentos. La inseguridad alimentaria se asoció con más de una persona desempleada (p=0,014), aporte familiar a alimentos mensual menor a COP $150000 (p=0,004), comprar alimentos en tienda local (p=0,017) con frecuencia de compra alimentos diaria y quincenal. Discusión: Pese a la existencia de programas de intervención para mejorar las condiciones de alimentación de primera infancia, sigue existiendo inseguridad alimentaria y desnutrición. Se deben reforzar las estrategias que garanticen la alimentación diaria de los niños de 0 a 5 años.
Introduction: child malnutrition and food insecurity are a current public health problem. Objectives: To determine the prevalence of chronic malnutrition in children from 0-5 years old of the rural population of Pereira and determine the association of socioeconomic factors and the level of household food insecurity. Materials and Methods: We performed a prospective crosssectional study in children aged 0-5 years old and their families. We assessed household food security, nutritional, socio-demographic, socio-economic and educational variables of the family. The analyses were run with SPSS 20.0 for Windows. Results: We evaluated 68 children, 51.5% were men; with mean age 32.4 ± 17.2 months (range 2.1 to 59.9 months). The 11.8% of children were malnourished, 67.7% of families have food insecurity, with low economic capacity to purchase food. Food insecurity is associated with more than one-person unemployed (p=0.014), low family contribution to monthly food (low to COP $150,000, p=0.004), buy food at local store (p=0.017) with daily food purchase frequency. Discussion: Despite the existence of intervention programs to improve early childhood nutrition, there is still food insecurity and undernutrition. Strategies should be strengthened to ensure the daily diet of children.
Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Fatores Socioeconômicos , Transtornos da Nutrição Infantil , Demografia , Ciências da Nutrição , Insegurança Alimentar , População Rural , Características da Família , Estratégias de Saúde , Colômbia , Dieta , AlimentosRESUMO
OBJETIVO: Verificar associações entre a qualidade de vida das mães e o estado nutricional de seus filhos. MÉTODOS: Foi realizado um estudo caso-controle com mães de crianças com idade entre zero e cinco anos, moradoras da área de abrangência de uma unidade básica de saúde, no município de Porto Alegre. O cálculo de tamanho amostral foi estimado em 152 mães, sendo 76 mães com filhos em risco nutricional/desnutrição (casos) e 76 mães com filhos eutróficos (controles). Foram coletadas informações referentes à qualidade de vida das mães, medida através do instrumento da Organização Mundial da Saúde, e analisada a associação entre a qualidade de vida materna e o estado nutricional de seus filhos. RESULTADOS: Em relação ao domínio psíquico, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 5,4 crianças em risco nutricional/desnutrição com mães em igual condição. No domínio ambiental, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 2,9 crianças em risco nutricional/desnutrição com mães em igual condição. Em relação ao nível educacional, para cada criança eutrófica cuja mãe tem baixa qualidade de vida existe uma chance de 4,2 crianças em risco nutricional/desnutrição com mães em igual condição. CONCLUSÕES: A baixa qualidade de vida materna mostrou-se associada ao risco nutricional/desnutrição infantil e pode ser um fator de risco para o estado nutricional dos filhos.
OBJECTIVE: Determine associations between the quality of life of mothers and the nutritional status of children. METHODS: case-control study involving 152 mothers of children aged zero to five years, living in the coverage area of a basic health unit in the city of Porto Alegre. The calculation of sample size was estimated as 152 mothers - 76 mothers with children at nutritional risk/malnutrition (cases) and 76 mothers with eutrophic children (controls). Information was collected regarding the quality of life of mothers, measured by the instrument of the World Health Organization, and the association between maternal quality of life and nutritional status of children was examined. RESULTS: In relation to the psychiatric realm, for each eutrophic child whose mother has lower quality of life there is a chance of 5.4 children at nutritional risk/malnutrition with mothers in the same condition. In the environmental field, for each eutrophic child whose mother has lower quality of life there is a chance of 2.9 children at nutritional risk/malnutrition with mothers in the same condition. Regarding educational level, for each eutrophic child whose mother has lower quality of life there is a chance of 4.2 children at nutritional risk/malnutrition with mothers in the same condition. CONCLUSIONS: Mothers' low quality of life was associated with an infant in nutritional risk/malnutrition and may be a risk factor for the nutritional status of children.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Mães , Desnutrição/epidemiologia , Estado Nutricional , Qualidade de Vida , Estudos de Casos e ControlesRESUMO
A prospective, four-year longitudinal study of 209 Peruvian children was conducted to evaluate the effect of a single malnutrition episode occurring at infancy (i.e., < 1 year of age) on dental caries in the primary teeth. Children were recruited into the study at age 6-11 months after they had suffered from a malnutrition episode and were thus classified by anthropometry as either: (1) Normal; (2) Wasted (low weight for height); (3) Stunted (low height for age); or (4) Stunted and Wasted (S and W). Eruption of the primary teeth was significantly delayed in all malnourished children; however, the effect of stunting--that is, retarded linear growth--was more pronounced and lasted longer than that of wasting or acute malnutrition (i.e., 2.5 vs. 1.5 years, respectively). By age 4 years, children from group 4 (S and W) showed a significantly higher caries experience in the primary teeth than did those in any of the other three groups. In summary, this longitudinal study has confirmed previous studies in animals and indirect epidemiological evidence which had suggested a cause-effect relationship between early malnutrition and increased dental caries.
PIP: The study was conducted from 1986 through 1990 among 209 children residing in Canto Grande, a poor community located north of Lima, Peru. The children were recruited as infants, aged 6-11 months, from the outpatient population of the Canto Grande Health Center, or from two other hospitals. All children were of full-term gestation and normal birth weight ( 2500 g). Each child was assigned to 1 of 4 study groups ascertained by weight and height measurements, with the National Center for Health Statistics standards used as the reference: 1) normal; 2) wasted, indicating current acute malnutrition; 3) stunted, indicating past or chronic malnutrition; and 4) stunted and wasted, indicating malnutrition soon after birth. The data, composed of 2700 examinations, were analyzed by the Statistical Analysis System (SAS) General Linear Models (GLM) program for computation of ANOVA tables. The mean numbers of teeth at ages 1 and 1.5 years for normal children were significantly higher than those of the children who were either wasted, stunted, or stunted and wasted as infants. At age 2, normal children had significantly more teeth in the mouth than did stunted children and stunted and wasted children. At age 2.5, the number of teeth in the normal children was still significantly higher than in stunted children. At age 4, all 4 groups had their full 20 teeth. At age 4, children who were stunted and wasted during infancy showed a significantly higher number of decayed, extracted, and filled teeth (def) compared with that of the other 3 groups. When grouped into 4 def categories of low, moderate, high, and very high caries experience, the distribution of the 4th group was distinctly different from that of the other 3 groups. 17.2% of stunted and wasted children had a very high caries experience (i.e., def 13) at age 4, significantly higher than that in any of the other 3 groups (i.e., normal 9.8%, wasted 4.4%, and stunted 3.6%, respectively; p 0.001).
Assuntos
Cárie Dentária/etiologia , Transtornos do Crescimento/etiologia , Transtornos da Nutrição do Lactente/complicações , Erupção Dentária , Dente Decíduo , Análise de Variância , Estatura , Peso Corporal , Índice CPO , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Peru/epidemiologia , Estudos Prospectivos , Desnutrição Proteico-Calórica/complicaçõesRESUMO
PIP: The most important risk of an unwanted pregnancy is induced abortion. Where abortion on demand is legal, the risk attached to an early induced abortion is minimal. Where it is illegal, as in most of South and Central America, the risk for a pregnant woman varies with her economic situation. The poorer the woman, the higher the risk. 2 approaches are used to estimate the number of illegal abortions: the use of hospital statistics for women hospitalized for complications of abortion and a inquiry into the obstetric history of a representative random sample of women of fertile age. The 1st strategy was mostly used in the 1960s, and the data were widely used to justify the use of contraceptives for the prevention of unwanted pregnancies. Although family planning programs, operated by both national governments and by the private sector, are now common in Latin America, all contraceptives have a certain proportion of failures, and some have side-effects which result in discontinuation of use. These factors, among others, help to maintain a high prevalence of illegal abortion. In Cuba, abortion was legalized in 1979 after a study showed that illegal abortions were the major cause of female death in the age group 15-44. Combined with contraceptive counseling, this has led Cuba to have a birth rate as low as Western European countries, and the lowest maternal and infant mortality rates in Latin America. In countries where abortion is illegal, the frequency of unwanted births in high. A study of 2485 pregnant women in a working class district of Santiago, Chile, showed only 33.1% of the women were happy with their pregnancy, 38.4% had mixed feelings, and 28.5% were unhappy. These children were followed up until they were 1 year old. More than 1 appointment at the well-baby clinic was missed by 12.2% of the mothers who had not wanted to be pregnant, as compared to 4.7% of mothers who had wanted to be pregnant. 19.8% of the unwanted children showed nutritional deficiencies at 1 year, while 12.7% of the wanted children did, 28.9% and 17.3% respectively, were undernourished. It is essential that the governments in Latin America increase their efforts to prevent unwanted pregnancies and to start seriously to think about changing their penal codes in order to legalize induced abortion.^ieng
Assuntos
Aborto Criminoso , Aborto Induzido , Aborto Legal , Cuidado da Criança , Educação Infantil , Deficiências Nutricionais , Serviços de Planejamento Familiar , Transtornos da Nutrição do Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Mortalidade Materna , Mortalidade , Distúrbios Nutricionais , Fenômenos Fisiológicos da Nutrição , Filosofia , Gravidez não Desejada , Gravidez , América , Comportamento , Chile , Demografia , Países Desenvolvidos , Países em Desenvolvimento , Doença , Fertilidade , Saúde , América Latina , População , Dinâmica Populacional , Reprodução , Pesquisa , Comportamento Sexual , América do SulRESUMO
PIP: 14 infants with chronic or recurrent diarrhea and evidence of malabsorption or malnutrition took part in a comparative study of weight gain in children with or without diagnosed enteropathies fed with a lactalbumin hydrolysate. The infants, all under 6 months old, were treated at a pediatric hospital in Santo Domingo. The lactalbumin hydrolysate was administered in progressively increasing concentrations according to the response. None of the 14 children were treated with antibiotics. The 5 infected children were aged 3.4 months and weighed 5115 g on average at admission. 3 were malnourished according to their weight for age. The 9 with negative stool cultures were 3.3 months old and weighed 5289 g on average at admission. 8 were malnourished. The infants were hospitalized for 5-18 days. The average weight gain was 6.9% on the 7th day and 9.3% at discharge. The average weight gain was 7% for infected children and 6.8% for those with negative cultures. The average weight gain at 7 days was 8% for malnourished children vs. 5.8% for the 3 adequately nourished children. The study demonstrated the efficacy of an easily digestible nutritional preparation in the nutritional recuperation of malnourished young infants with chronic diarrhea and evidence of maldigestion and absorption, even in the presence of enteropathologies.^ieng
Assuntos
Peso Corporal , Diarreia Infantil , Transtornos da Nutrição do Lactente , Estudos Prospectivos , Pesquisa , Terapêutica , América , Biologia , Região do Caribe , Países em Desenvolvimento , Diarreia , Doença , República Dominicana , América Latina , América do Norte , Distúrbios Nutricionais , FisiologiaRESUMO
PIP: This study analyzed the relationships between breastfeeding, nutritional status, and land ownership in a sample of 225 families in an underdeveloped area in Northeast Brazil. According to weight-for-age standards, 51% of the study infants were malnourished and there was a significant inverse correlation between landholdings and malnutrition. At the time of the survey, 51 of the 225 study infants were being breastfed, 65 had never been breastfed, and 109 had been weaned. 52% of the weaned infants had been breastfed for less than 30 days and 71% had received breast milk for less than 60 days. No cases of grade II or III malnutrition were found in the breastfed infants; in contrast, 30% of the bottle-fed infants fell into these categories. There was no significant association between landholding and the duration of breastfeeding. These findings suggest a need to promote proper infant breastfeeding through both primary health care and community participation strategies. Given the correlation between land ownership and infant nutritional status, modification of the existing agricultural structure could prove essential to the success of public health interventions.^ieng