Vitamin A deficiency and associated risk factors in children aged 12-59 months living in poorest municipalities in the South Region of Brazil

巴西南部最贫困城市 12-59 个月儿童维生素 A 缺乏症及相关风险因素

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作者:Camila Dallazen, Daniela Cardoso Tietzmann, Sara Araújo da Silva, Eduardo Augusto Fernandes Nilson, Vivian Siqueira Santos Gonçalves, Regina Maria Ferreira Lang, Sandra Patricia Crispim, Júlia Dubois Moreira, Solange Cristina Garcia, Márcia Regina Vítolo

Conclusions

VAD did not represent a public health problem for children living in socio-economically vulnerable municipalities in the South Region of Brazil, suggesting a new panorama of this nutritional deficiency even in regions of low socio-economic conditions in these three states. Thus, in view of the current nutritional transition scenario, it is necessary to continuously monitor and improve public policies related to vitamin A supplementation in the country.

Objective

To estimate the prevalence of vitamin A deficiency (VAD) in children and associated risk factors. Design: Analysis of data from a cross-sectional multicentre study performed in the primary care units of the municipalities from January to June 2015. The children's legal guardians answered a socio-economic questionnaire, and the children's blood samples were obtained by venipuncture. Plasma retinol was determined by HPLC. Plasma retinol values of <0·70 μmol/l were considered VDA. Poisson multiple regression with robust variance was used. Values of P < 0·05 were considered significant. The data were analysed in the SPSS software, 21.0. Setting: Forty-eight poorest municipalities in the South Region of Brazil. Participants: Children (n 1503) aged 12-59 months.

Results

The prevalence of VAD in the sample was 1·9 % (95 % CI (0·5, 6·8)). The following risk factors were associated with the outcome in the final explanatory model: family received Bolsa Familia program benefits (PR = 3·19; 95 % CI (1·69, 6·02)), child was not being breastfed (PR = 5·22; 95 % CI (1·68, 16·18)) and stunting (PR = 4·75; 95 % CI (2·10, 10·73)). Conclusions: VAD did not represent a public health problem for children living in socio-economically vulnerable municipalities in the South Region of Brazil, suggesting a new panorama of this nutritional deficiency even in regions of low socio-economic conditions in these three states. Thus, in view of the current nutritional transition scenario, it is necessary to continuously monitor and improve public policies related to vitamin A supplementation in the country.

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