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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Prevalence of and factors associated with anemia in school children from Maceió, northeastern Brazil

Authors: Haroldo da Silva Ferreira, Myrtis Katille de Assunção Bezerra, Monica Lopes de Assunção, Risia Cristina Egito de Menezes

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Anemia is a major public health problem in preschool children in Alagoas, Brazil, especially in the younger population, because of a positive correlation between hemoglobin level and age. However, due to the lack of studies, it is not known how widespread this condition is among older children or how it is associated with socioeconomic status. The aim of this study was to investigate the prevalence of and factors associated with anemia in school children from the city of Maceió, Alagoas state, Brazil. The analysis was stratified to identify any effect modification according to whether they attend public or private schools.

Methods

A cross-sectional study was conducted using probability sampling of 1518 children (9.8 ± 0.5 years of age) attending public (n = 931) and private (n = 587) elementary schools in the municipality. Semi-structured questionnaires were used to obtain socioeconomic, demographic, anthropomorphic, hemoglobin (Hb), and dietary data. Anemia (Hb <11.5 g/dL) was the dependent variable. The measure of association used was prevalence ratio (PR) and respective CI95 %, calculated by Poisson regression with robust variance adjustment, for the crude and adjusted analyses.

Results

The prevalence of anemia was found to be higher amongst the public school children than the private school children (10.8 % vs. 7.0 %; PR = 1.54; CI95 %: 1.1; 2.2). At the public schools, the variables that remained significantly associated with anemia after the multivariate analysis were “consumption of fruits/fruit juices < 2 portions/day” (PR = 2.19; CI95 %: 1.18; 4.06) and “male” (PR = 1.51; CI95 %: 1.001; 2.30). At the private schools, these variables were “working mother” (PR = 2.83; CI95 %: 1.23; 6.52) and “monthly school fees < R$ 188.00” (PR = 3.20; CI95 %: 1.46; 7.03).

Conclusions

In the population under study, anemia constitutes a major health problem, especially among children from public schools. Considering the associated factors and the fact that these children are in a school environment, the promotion of healthy eating habits could constitute an important approach for reducing the prevalence of anemia.
Literature
1.
World Health Organization. Iron deficiency anaemia: assessment, prevention, and control. A guide for programme managers. Geneva: WHO; 2001.
2.
Mujica-Coopman MF, Brito A, Lopez de Romana D, Rios-Castillo I, Coris H, Olivares M. Prevalence of Anemia in Latin America and the Caribbean. Food Nutr Bull. 2015;36 Suppl 2:S119–28.CrossRefPubMed
3.
Higdon JV, Frei B. Coffee and health: a review of recent human research. Crit Rev Food Sci Nutr. 2006;46(2):101–23.CrossRefPubMed
4.
Hurrell R, Egli I. Iron bioavailability and dietary reference values. Am J Clin Nutr. 2010;91(5):1461s–7.CrossRefPubMed
5.
Thankachan P, Walczyk T, Muthayya S, Kurpad AV, Hurrell RF. Iron absorption in young Indian women: the interaction of iron status with the influence of tea and ascorbic acid. Am J Clin Nutr. 2008;87(4):881–6.PubMed
6.
Oliveira MAA, Osório MM, Raposo MCF. Fatores socioeconômicos e dietéticos de risco para a anemia em crianças de 6 a 59 meses de idade. J Pediatr. 2007;83:39–46.CrossRef
7.
World Health Organization. Global database on anemia. Geneva: World Health Organization; 2008.
8.
Osorio MM, Lira PI, Ashworth A. Factors associated with Hb concentration in children aged 6–59 months in the State of Pernambuco, Brazil. Br J Nutr. 2004;91(2):307–15.CrossRefPubMed
9.
Borges CQ, Silva RC, Assis AM, Pinto EJ, Fiaccone RL, Pinheiro SM. [Factors associated with anemia in children and adolescents in public schools in Salvador, Bahia State, Brazil]. Cad Saude Publica. 2009;25(4):877–88.CrossRefPubMed
10.
11.
Felt BT, Peirano P, Algarin C, Chamorro R, Sir T, Kaciroti N, Lozoff B. Long-term neuroendocrine effects of iron-deficiency anemia in infancy. Pediatr Res. 2012;71(6):707–12.CrossRefPubMedPubMedCentral
12.
COSTA EQ, RIBEIRO VM, RIBEIRO EC. Programa de alimentação escolar: espaço de aprendizagem e produção de conhecimento. Rev Nutr. 2001;14:225–9.
13.
Ferreira HS, Lucio GM, Assuncao ML, Silva BC, Oliveira JS, Florencio TM, Geraldes AA, Horta BL. High blood pressure among students in public and private schools in Maceio, Brazil. PLoS One. 2015;10(11):e0142982.CrossRefPubMedPubMedCentral
14.
Vieira RC, Ferreira HS, Costa AC, Moura FA, Florêncio TM, Torres ZM. Prevalência e fatores de risco para anemia em crianças pré-escolares do Estado de Alagoas, Brasil. Revista Brasileira de Saúde Materno Infantil. 2010;10:107–16.CrossRef
15.
Ferreira HS, Moura FA, Cabral Júnior CR. Prevalência e fatores associados à anemia em gestantes da região semi-árida do Estado de Alagoas. Revista Brasileira de Ginecologia e Obstetrícia. 2008;30:445–51.CrossRef
16.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Atenção Básica. Manual operacional do Programa Nacional de Suplementação de Ferro. Brasília: Ministério da Saúde; 2005.
17.
Szarfarc SC. Políticas públicas para o controle da anemia ferropriva. Rev Bras Hematol Hemoter. 2010;32:02–8.CrossRef
18.
Gondim SS, Diniz AS, Souto RA, Bezerra RG, Albuquerque EC, Paiva AA. [Magnitude, time trends and factors associate with anemia in children in the state of Paraiba, Brazil]. Rev Saude Publica. 2012;46(4):649–56.CrossRefPubMed
19.
20.
Luiz RR, Magnanini MM. A lógica da determinação do tamanho da amostra em investigações epidemiológicas. Cadernos de Saúde Coletiva. 2000;8(2):9–28.
21.
World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva: World Health Organization; 2011.
22.
23.
Frisancho AR. Anthropometric standards for the assessment of growth and nutritional status. Ann Arbor: University of Michigan Press; 1990.CrossRef
24.
World Health Organization. AnthroPlus for Personal Computers Manual: Software for assessing growth of the world’s children and adolescents. Geneva: World Health Organization; 2009.
25.
Associação Brasileira de Empresas de Pesquisa - ABEP. Critérios de Classificação Econômica Brasil. 2011.
26.
Assis MA, Benedet J, Kerpel R, Vasconcelos Fde A, Di Pietro PF, Kupek E. [Validation of the third version of the Previous Day Food Questionnaire (PDFQ-3) for 6-to-11-years-old schoolchildren]. Cad Saude Publica. 2009;25(8):1816–26.CrossRefPubMed
27.
Fisberg RM, Marchioni DML, Colucci ACA. Avaliação do consumo alimentar e da ingestão de nutrientes na prática clínica. Arq Bras Endocrinol Metabol. 2009;53:617–24.CrossRefPubMed
28.
Brasil. Ministério da Saúde. Guia alimentar para a população brasileira: promovendo a alimentação saudável. Brasília; 2006.
29.
Batista Filho M, Souza AI, Bresani CC. Anemia como problema de saúde pública: uma realidade atual. Ciên Saúde Colet. 2008;13:1917–22.CrossRefPubMed
30.
Santos CD, Santos LM, Figueiroa JN, Marroquim PM, Oliveira MA. [Anemia in public school first graders in the city of Maceio, Alagoas, Brazil]. Cad Saude Publica. 2002;18(6):1757–63.CrossRefPubMed
31.
Batista Filho M, Rissin A. [Nutritional transition in Brazil: geographic and temporal trends]. Cad Saude Publica. 2003;19 Suppl 1:S181–91.CrossRefPubMed
32.
Ferreira HS, Florêncio TMTM, Fragoso MAC, Melo FP, Silva TG. Hipertensão, obesidade abdominal e baixa estatura: aspectos da transição nutricional em uma população favelada. Rev Nutr. 2005;18:209–18.CrossRef
33.
Oliveira AP, Pascoal MN, Santos LC, Pereira SC, Justino LE, Petarli GB, Kitoko PM. [The prevalence of anemia and its association with socio-demographic and anthropometric aspects in children living in Vitoria, State of Espirito Santo, Brazil]. Cien Saude Colet. 2013;18(11):3273–80.CrossRefPubMed
34.
Assunção MCF, Santos IS, Barros AJD, Gigante DP, Victora CG. Anemia em menores de seis anos: estudo de base populacional em Pelotas, RS. Rev Saude Publica. 2007;41:328–35.CrossRefPubMed
35.
Domellof M, Lonnerdal B, Dewey KG, Cohen RJ, Rivera LL, Hernell O. Sex differences in iron status during infancy. Pediatrics. 2002;110(3):545–52.CrossRefPubMed
36.
Gregory JA, Gordon DM. Iron physiology and pathophysiology in humans. London: Humana Press; 2012.
37.
Soekarjo DD, de Pee S, Bloem MW, Tjiong R, Yip R, Schreurs WH, Muhilal. Socio-economic status and puberty are the main factors determining anaemia in adolescent girls and boys in East Java, Indonesia. Eur J Clin Nutr. 2001;55(11):932–9.CrossRefPubMed
38.
Garanito MP, Pitta TS, Carneiro JD. Deficiência de ferro na adolescência. Rev Bras Hematol Hemoter. 2010;32:45–8.CrossRef
39.
Currie C, Ahluwalia N, Godeau E, Nic Gabhainn S, Due P, Currie DB. Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study. J Adolesc Health. 2012;50(6):621–6.CrossRefPubMed
40.
Assis MAA, Calvo MCM, Kupek E, Vasconcelos FAG, Campos VC, Machado M, Costa FF, Andrade DF. Qualitative analysis of the diet of a probabilistic sample of schoolchildren from Florianópolis, Santa Catarina State, Brazil, using the Previous Day Food Questionnaire. Cad Saúde Pública. 2010;26:1355–65.CrossRefPubMed
41.
Conceição SI, Santos CJ, Silva AA, Silva JS, Oliveira TC. Consumo alimentar de escolares das redes pública e privada de ensino em São Luís, Maranhão. Rev Nutr. 2010;23:993–1004.CrossRef
42.
Netto MP, Rocha DS, Franceschini SC, Lamounier JA. Fatores associados à anemia em lactentes nascidos a termo e sem baixo peso. Rev Assoc Med Bras. 2011;57:550–8.CrossRefPubMed
43.
Corrêa EN, Corso ACT, Moreira EAM, Kazapi IAM. Alimentação complementar e características maternas de crianças menores de dois anos de idade em Florianópolis (SC). Revista Paulista de Pediatria. 2009;27:258–64.CrossRef
44.
Balarajan Y, Ramakrishnan U, Ozaltin E, Shankar AH, Subramanian SV. Anaemia in low-income and middle-income countries. Lancet (London, England). 2011;378(9809):2123–35.CrossRef
45.
Oliveira FC, Cotta RM, Sant’Ana LF, Priore SE, Franceschini SC. Programa Bolsa Família e estado nutricional infantil: desafios estratégicos. Ciên Saúde Colet. 2011;16:3307–16.CrossRef
46.
Burrows TL, Truby H, Morgan PJ, Callister R, Davies PS, Collins CE. A comparison and validation of child versus parent reporting of children’s energy intake using food frequency questionnaires versus food records: who’s an accurate reporter? Clin Nutr (Edinburgh, Scotland). 2013;32(4):613–8.CrossRef
47.
Augusto RA, Cobayashi F, Cardoso MA. Associations between low consumption of fruits and vegetables and nutritional deficiencies in Brazilian schoolchildren. Public Health Nutr. 2015;18(5):927–35.CrossRefPubMed
48.
Antunes MM, Sichieri R, Salles-Costa R. [Food intake among children under three years of age in an area with high food insecurity]. Cad Saude Publica. 2010;26(8):1642–50.CrossRefPubMed
49.
Olivares M, Walter T. Causas y consecuencias de la deficiencia de hierro. Rev Nutr. 2004;17:05–14.CrossRef
Metadata
Title
Prevalence of and factors associated with anemia in school children from Maceió, northeastern Brazil
Authors
Haroldo da Silva Ferreira
Myrtis Katille de Assunção Bezerra
Monica Lopes de Assunção
Risia Cristina Egito de Menezes
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3073-2

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