title: Prevalence of and factors associated with anemia in school children from Maceió, northeastern Brazil.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
authors.affiliation: Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil. haroldo.ufal@gmail.com.
authors.forename: Haroldo
authors.initials: H
authors.lastname: da Silva Ferreira
authors.affiliation: Centro de Pesquisa Aggeu Magalhães, Fundação Oswaldo Cruz, Av. Prof. Moraes Rego, s/n - Campus da UFPE - Cidade Universitária, Recife, PE, Brazil.
authors.forename: Myrtis Katille
authors.initials: MK
authors.lastname: de Assunção Bezerra
authors.affiliation: Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil.
authors.forename: Monica
authors.initials: M
authors.lastname: Lopes de Assunção
authors.affiliation: Faculty of Nutrition, Federal University of Alagoas, Campus A.C. Simões, BR 104 Norte - Km 96.7 - Tabuleiro do Martins, CEP: 57072-970, Maceió, AL, Brazil.
authors.forename: Risia Cristina
authors.initials: RC
authors.lastname: Egito de Menezes
mesh_terms: D000740:Anemia / Q000097:blood / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins; D006801:Humans; D008297:Male; D009035:Mothers / Q000706:statistics & numerical data; D015995:Prevalence; D012574:Schools / Q000706:statistics & numerical data; D012923:Social Class; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins
keywords: Anemia; Associated factors; Food consumption; Schools