Desnutrição crônica e desigualdades socioeconômicas em um município remoto da Amazônia ocidental brasileira: um estudo de base populacional
Data
2024-07-30
Autores
Silva, Ludmilla Barros Araujo e 
Orientadores
Medeiros, Maria Angélica Tavares de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A persistência da desnutrição crônica infantil em crianças menores de 5 anos, somada ao prolongamento das desigualdades sociais, da pobreza e da insegurança alimentar, configura um grave problema de saúde pública na Amazônia Ocidental Brasileira. Objetivo: Identificar e analisar a desnutrição crônica e seus fatores associados, em crianças menores de cinco anos, residentes na zona urbana de um município da Amazônia Ocidental Brasileira. Métodos: Trata-se de um estudo transversal, do tipo inquérito domiciliar de base populacional, realizado com 557 crianças em idade pré-escolar, inserido na pesquisa “Segurança Alimentar e Nutricional de crianças e suas mães no município de Coari, Amazonas, Brasil: estudo de base populacional”. Selecionou-se amostra probabilística sistemática da Zona Urbana do município de Coari. Para o presente estudo selecionaram-se variáveis referentes a: características individuais da criança; características maternas, familiares e domiciliares. Para avaliar (in)segurança alimentar utilizou-se a Escala Brasileira de Insegurança (EBIA) de 14 itens; a coleta de dados antropométricos foi realizada segundo recomendações da Organização Mundial de Saúde. Para a análise de dados utilizou-se o programa estatístico Stata®, versão 15.1. Para verificar possíveis associações entre o desfecho principal e demais variáveis de exposição, realizou-se análise por regressão múltipla de Poisson, a partir da qual foram estimadas razões de prevalência (RP) e seus respectivos intervalos de confiança (IC-95%), em modelos brutos (p<0,20) e ajustados (p<0,05). No modelo ajustado permaneceram as variáveis com nível de significância menor que 0,05 (p<0,05). O estudo foi aprovado pelo Comitê de Ética e Pesquisa da Universidade Federal de São Paulo (CEP 0204/2018). Resultados: Encontrou-se alta prevalência de desnutrição crônica (35,5%) em crianças menores de cinco anos, associada ao baixo peso ao nascer (p= 0,003), que aumentou conforme a escalada da severidade da insegurança alimentar (leve, moderada e grave). Conclusão: O efeito negativo das desigualdades sociais e econômicas, especialmente a IA sobre o estado nutricional, especialmente nas formas moderada e grave, pode contribuir para o baixo peso ao nascer e para a instalação da desnutrição crônica na infância.
The persistence of chronic child malnutrition in children under 5 years of age, added to the prolongation of social inequalities, poverty, and food insecurity, constitutes a serious public health problem in the Western Brazilian Amazon. Objective: To identify and analyze chronic malnutrition and its associated factors in children under five years of age living in the urban area of a municipality in the Western Brazilian Amazon. Methods: This is a cross-sectional population-based household survey conducted with 557 preschool children, as part of the research "Food and Nutritional Security of children and their mothers in the municipality of Coari, Amazonas, Brazil: a population-based study". A systematic probabilistic sample from the Urban Zone of the municipality of Coari was selected. For the present study, variables were chosen referring to individual characteristics of the child; and maternal, family, and household characteristics. To assess food (in)security, the 14-item Brazilian Insecurity Scale (EBIA) was used; anthropometric data were collected according to the recommendations of the World Health Organization. The statistical program Stata®, version 15.1, was used for data analysis. To verify possible associations between the main outcome and other exposure variables, Poisson multiple regression analysis was performed, from which prevalence ratios (PR) and their respective confidence intervals (95%CI) were estimated in crude (p<0.20) and adjusted (p<0.05) models. In the adjusted model, variables with a significance level of less than 0.05 (p<0.05) remained. The study was approved by the Research Ethics Committee of the Federal University of São Paulo (CEP 0204/2018). Results: A high prevalence of chronic malnutrition (35.5%) was found in children under five years of age, associated with low birth weight (p= 0.003), which increased with the escalation of the severity of food insecurity (mild, moderate and severe). Conclusion: The negative effect of social and economic inequalities, especially FI on nutritional status, especially in moderate and severe forms, may contribute to low birth weight and the onset of chronic malnutrition in childhood.
The persistence of chronic child malnutrition in children under 5 years of age, added to the prolongation of social inequalities, poverty, and food insecurity, constitutes a serious public health problem in the Western Brazilian Amazon. Objective: To identify and analyze chronic malnutrition and its associated factors in children under five years of age living in the urban area of a municipality in the Western Brazilian Amazon. Methods: This is a cross-sectional population-based household survey conducted with 557 preschool children, as part of the research "Food and Nutritional Security of children and their mothers in the municipality of Coari, Amazonas, Brazil: a population-based study". A systematic probabilistic sample from the Urban Zone of the municipality of Coari was selected. For the present study, variables were chosen referring to individual characteristics of the child; and maternal, family, and household characteristics. To assess food (in)security, the 14-item Brazilian Insecurity Scale (EBIA) was used; anthropometric data were collected according to the recommendations of the World Health Organization. The statistical program Stata®, version 15.1, was used for data analysis. To verify possible associations between the main outcome and other exposure variables, Poisson multiple regression analysis was performed, from which prevalence ratios (PR) and their respective confidence intervals (95%CI) were estimated in crude (p<0.20) and adjusted (p<0.05) models. In the adjusted model, variables with a significance level of less than 0.05 (p<0.05) remained. The study was approved by the Research Ethics Committee of the Federal University of São Paulo (CEP 0204/2018). Results: A high prevalence of chronic malnutrition (35.5%) was found in children under five years of age, associated with low birth weight (p= 0.003), which increased with the escalation of the severity of food insecurity (mild, moderate and severe). Conclusion: The negative effect of social and economic inequalities, especially FI on nutritional status, especially in moderate and severe forms, may contribute to low birth weight and the onset of chronic malnutrition in childhood.
Descrição
Citação
SILVA, Ludmilla Barros Araujo e. Desnutrição crônica e desigualdades socioeconômicas em um município remoto da Amazônia ocidental brasileira: um estudo de base populacional. 2024. 98 f. Dissertação (Mestrado em Nutrição) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2024.