Prevalence and determinants of child undernutrition and stunting in semiarid region of Brazil.
OBJECTIVE
To analyze the evolution in the prevalence and determinants of malnutrition in children in the semiarid region of Brazil.


METHODS
Data were collected from two cross-sectional population-based household surveys that used the same methodology. Clustering sampling was used to collect data from 8,000 families in Ceará, Northeastern Brazil, for the years 1987 and 2007. Acute undernutrition was calculated as weight/age < -2 standard deviation (SD); stunting as height/age < -2 SD; wasting as weight/height < -2 SD. Data on biological and sociodemographic determinants were analyzed using hierarchical multivariate analyses based on a theoretical model.


RESULTS
A sample of 4,513 and 1,533 children under three years of age, in 1987 and 2007, respectively, were included in the analyses. The prevalence of acute malnutrition was reduced by 60.0%, from 12.6% in 1987 to 4.7% in 2007, while prevalence of stunting was reduced by 50.0%, from 27.0% in 1987 to 13.0% in 2007. Prevalence of wasting changed little in the period. In 1987, socioeconomic and biological characteristics (family income, mother's education, toilet and tap water availability, children's medical consultation and hospitalization, age, sex and birth weight) were significantly associated with undernutrition, stunting and wasting. In 2007, the determinants of malnutrition were restricted to biological characteristics (age, sex and birth weight). Only one socioeconomic characteristic, toilet availability, remained associated with stunting.


CONCLUSIONS
Socioeconomic development, along with health interventions, may have contributed to improvements in children's nutritional status. Birth weight, especially extremely low weight (< 1,500 g), appears as the most important risk factor for early childhood malnutrition.
Luciano Lima
LL
Correia
Anamaria Cavalcante e
AC
Silva
Jocileide Sales
JS
Campos
Francisca Maria de Oliveira
FM
Andrade
Márcia Maria Tavares
MM
Machado
Ana Cristina
AC
Lindsay
Alvaro Jorge Madeiro
AJ
Leite
Hermano Alexandre Lima
HA
Rocha
Antonio José Ledo Alves da
AJ
Cunha
D001938:Brazil / Q000453:epidemiology; D015362:Child Nutrition Disorders / Q000453:epidemiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009749:Nutrition Surveys; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors