title: Child undernutrition in one of the cities with greater nutritional risk in Brazil: population-based study in the Western Brazilian Amazon.
abstract: To estimate the prevalence of child undernutrition and associated factors in a municipality with high nutritional risk in Brazil.
  This cross-sectional, population-based study was conducted with a sample of 478 children aged under 5 years in the city of Jordão, Acre, Brazil. The following indicators were calculated: weight for age (W/A), height for age (H/A), and weight for height (W/H), using the growth curves of the WHO as reference, which adopts a cutoff of -2 z scores for identification of malnourished children. Adjusted prevalence ratios (PRs) were obtained using multiple Poisson regression models with robust error estimate (p < 0.05).
  A high prevalence of stunting (35.8%) was observed. Children with indigenous ancestry living in rural areas showed the highest prevalence of malnutrition (59.4%). After controlling for age, gender, and indigenous ancestry, the factors associated with stunting risk were: living in rural area (PR = 1.6; 95%CI 1.2 - 2.1); lower tertile of household wealth index (PR = 1.6; 95%CI 1.1 - 2.3); living in houses made of walking palm (PR = 1.6; 95%CI 1.1 - 2.4); maternal height less than or equal to 146.4 cm (PR = 3.1; 95%CI 1.9 - 5.0); and history of introduction of cow's milk before 30 days of age (PR = 1.4; 95%CI 1.0 - 1.8). Children with updated vaccination cards were inversely associated with stunting risk (PR = 0.7; 95%CI 0.5 - 0.9).
  Child undernutrition remains a serious public health problem in the Amazon, indicating additional difficulties in facing the problem in this region of the country.
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre - Rio Branco (AC), Brasil.|Programa de Pós-graduação em Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil.
authors.forename: Thiago Santos de
authors.initials: TS
authors.lastname: Araújo
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre - Rio Branco (AC), Brasil.
authors.forename: Cristieli Sérgio de Menezes
authors.initials: CS
authors.lastname: Oliveira
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre - Rio Branco (AC), Brasil.
authors.forename: Pascoal Torres
authors.initials: PT
authors.lastname: Muniz
authors.affiliation: Centro de Ciências da Saúde e do Desporto, Universidade Federal do Acre - Rio Branco (AC), Brasil.
authors.forename: Mônica da
authors.initials: MD
authors.lastname: Silva-Nunes
authors.affiliation: Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - São Paulo (SP), Brasil.
authors.forename: Marly Augusto
authors.initials: MA
authors.lastname: Cardoso
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D014504:Urban Health