title: Factors associated with Hb concentration in children aged 6-59 months in the State of Pernambuco, Brazil.
abstract: In 1997, the prevalence of anaemia was 40.9 % among children aged 6-59 months in the State of Pernambuco, north-east Brazil. Using the same sample of children, we have investigated possible reasons for this high prevalence. A representative sample was selected through a three-stage process: proportional systematic random sampling of municipalities in the State, systematic random sampling of census sectors within these municipalities, and finally, simple random sampling of households with children aged 6-59 months to obtain the sample of 650 children. Data collection included demographic, environmental, socio-economic and maternal variables, and nutritional status and dietary intakes of the children. Multiple linear regression analysis was based on a hierarchical model of factors associated with Hb concentration. The mean Hb concentration of children aged 6-23 months was 10 g/l lower than that of older children. In the regression analysis, child age explained 8.3 % of the variance in Hb concentration. The intake of bioavailable Fe explained a further 3.3, serum retinol 2.7, diarrhoea 2.4, water treatment 1.7, sanitation 1.3 and low birth-weight 0.5 %. The final model explained 23.4 % of the variance in Hb concentration. We conclude that child age, bioavailable-Fe intake, serum retinol concentration, diarrhoea, water treatment, sanitation and low birth-weight are independently associated with Hb concentration. In north-east Brazil, anaemia prevention programmes among children should focus on those aged <2 years and should consider feasible strategies to improve intakes of bioavailable Fe and vitamin A, and reduce infection. Supplemental Fe should be given to low birth-weight infants.
authors.affiliation: Departamento de Nutriçāo, Universidade Federal de Pernambuco, 50670-860 Campus Universitário--Cidade Universitária, Recife-PE, Prazil.
authors.forename: Mônica M
authors.initials: MM
authors.lastname: Osório
authors.forename: Pedro I C
authors.initials: PI
authors.lastname: Lira
authors.forename: Ann
authors.initials: A
authors.lastname: Ashworth
mesh_terms: D000367:Age Factors; D000740:Anemia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D000886:Anthropometry; D001682:Biological Availability; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D019266:Iron, Dietary / Q000008:administration & dosage; D008297:Male; D009752:Nutritional Status; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D006454:Hemoglobins; D019266:Iron, Dietary