title: Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition.
abstract: BACKGROUND
  Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil.
  
  
  METHODS
  The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations.
  
  
  RESULTS
  Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North.
  
  
  CONCLUSIONS
  The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.
authors.affiliation: Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil.
authors.forename: Maurício S
authors.initials: MS
authors.lastname: Leite
authors.forename: Andrey M
authors.initials: AM
authors.lastname: Cardoso
authors.forename: Carlos Ea
authors.initials: CE
authors.lastname: Coimbra
authors.forename: James R
authors.initials: JR
authors.lastname: Welch
authors.forename: Silvia A
authors.initials: SA
authors.lastname: Gugelmin
authors.forename: Pedro Cabral I
authors.initials: PC
authors.lastname: Lira
authors.forename: Bernardo L
authors.initials: BL
authors.lastname: Horta
authors.forename: Ricardo Ventura
authors.initials: RV
authors.lastname: Santos
authors.forename: Ana Lúcia
authors.initials: AL
authors.lastname: Escobar
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007223:Infant; D008297:Male; D009749:Nutrition Surveys; D009752:Nutritional Status; D044382:Population Groups; D015995:Prevalence; D012959:Socioeconomic Factors
chemical_list: D006454:Hemoglobins