A 15-year study on the treatment of undernourished children at a nutrition rehabilitation centre (CREN), Brazil.
OBJECTIVE
To build a life table and determine the factors related to the time of treatment of undernourished children at a nutrition rehabilitation centre (CREN), São Paulo, Brazil.


METHODS
Nutritional status was assessed from weight-for-age, height-for-age and BMI-for-age Z-scores, while neuropsychomotor development was classified according to the milestones of childhood development. Life tables, Kaplan-Meier survival curves and Cox multiple regression models were employed in data analysis.


METHODS
CREN (Centre of Nutritional Recovery and Education), São Paulo, Brazil.


METHODS
Undernourished children (n 228) from the southern slums of São Paulo who had received treatment at CREN under a day-hospital regime between the years 1994 and 2009.


RESULTS
The Kaplan-Meier curves of survival analysis showed statistically significant differences in the periods of treatment at CREN between children presenting different degrees of neuropsychomotor development (log-rank = 6·621; P = 0·037). Estimates based on the multivariate Cox model revealed that children aged ≥24 months at the time of admission exhibited a lower probability of nutritional rehabilitation (hazard ratio (HR) = 0·49; P = 0·046) at the end of the period compared with infants aged up 12 months. Children presenting slow development were better rehabilitated in comparison with those exhibiting adequate evolution (HR = 4·48; P = 0·023). No significant effects of sex, degree of undernutrition or birth weight on the probability of nutritional rehabilitation were found.


CONCLUSIONS
Age and neuropsychomotor developmental status at the time of admission to CREN are critical factors in determining the duration of treatment.
1 Departamento de Fisiologia, Disciplina de Fisiologia da Nutrição, Universidade Federal de São Paulo, Vila Clementino, 04023-060 São Paulo, SP, Brazil. marianafachim@ig.com.br
Mariana B F
MB
Fernandes
Rossana V M
RV
López
Maria P
MP
de Albuquerque
Anna C
AC
Marchesano
Ana P G
AP
Clemente
Vinícius J B
VJ
Martins
Ana L
AL
Sawaya
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D001835:Body Weight; D001938:Brazil; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D044342:Malnutrition / Q000534:rehabilitation*; D009752:Nutritional Status; D016016:Proportional Hazards Models; D012047:Rehabilitation Centers; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult