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Biete A, Gonçalves VSS, Franceschini SCC, Nilson EAF, Pizato N. The Prevalence of Nutritional Anaemia in Brazilian Pregnant Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1519. [PMID: 36674275 PMCID: PMC9859559 DOI: 10.3390/ijerph20021519] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Despite the global tendency of maternal anaemia to decline, the persistence of anaemia in Brazil is an important health problem given its vulnerability to deficiencies and the significant increase in nutritional requirements during pregnancy. The aim of this study was to estimate the prevalence of anaemia in Brazilian pregnant women through a systematic literature review and meta-analysis. The systematic review was carried out according to Systematic Reviews and Meta-Analyses PRISMA checklist recommendations and using the following electronic databases: Medline, Scopus, Embase, Web of Science, Lilacs, Scielo, Google Scholar, and CAPES Catalog of Theses and Dissertations. Studies that presented a prevalence of anaemia data in Brazilian pregnant women, considering all gestational trimesters, were included. The total sample included 12,792 pregnant women covering all gestational trimesters. The pooled prevalence of anaemia in Brazilian pregnant women was 23% (95% CI: 20-27), with the highest prevalence in the Northeast Region at 26% (95% CI 23-29), while the lowest prevalence was observed in the North Region with 17% (95% CI 14-20). Among the subgroups, no statistical difference was observed. The prevalence of anaemia status in Brazil is still classified as a moderate public health problem according to the World Health Organization maternal anaemia classification.
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Affiliation(s)
- Amanda Biete
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Sylvia C. C. Franceschini
- Graduate Program in Nutrition Sciences, Department of Nutrition and Health, Federal University of Viçosa, Viçosa 36570-900, Brazil
| | - Eduardo A. F. Nilson
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo 05508-060, Brazil
- Oswaldo Cruz Foundation (Fiocruz) Brasilia, Brasilia 70904-130, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
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Ibeji JU, Mwambi H, Iddrisu AK. Bayesian spatio-temporal modelling and mapping of malaria and anaemia among children between 0 and 59 months in Nigeria. Malar J 2022; 21:311. [PMID: 36320061 PMCID: PMC9623970 DOI: 10.1186/s12936-022-04319-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 10/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND/M&M A vital aspect of disease management and policy making lies in the understanding of the universal distribution of diseases. Nevertheless, due to differences all-over host groups and space-time outbreak activities, data are subject to intricacies. Herein, Bayesian spatio-temporal models were proposed to model and map malaria and anaemia risk ratio in space and time as well as to ascertain risk factors related to these diseases and the most endemic states in Nigeria. Parameter estimation was performed by employing the R-integrated nested Laplace approximation (INLA) package and Deviance Information Criteria were applied to select the best model. RESULTS In malaria, model 7 which basically suggests that previous trend of an event cannot account for future trend i.e., Interaction with one random time effect (random walk) has the least deviance. On the other hand, model 6 assumes that previous event can be used to predict future event i.e., (Interaction with one random time effect (ar1)) gave the least deviance in anaemia. DISCUSSION For malaria and anaemia, models 7 and 6 were selected to model and map these diseases in Nigeria, because these models have the capacity to receive strength from adjacent states, in a manner that neighbouring states have the same risk. Changes in risk and clustering with a high record of these diseases among states in Nigeria was observed. However, despite these changes, the total risk of malaria and anaemia for 2010 and 2015 was unaffected. CONCLUSION Notwithstanding the methods applied, this study will be valuable to the advancement of a spatio-temporal approach for analyzing malaria and anaemia risk in Nigeria.
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Affiliation(s)
- Jecinta U. Ibeji
- grid.16463.360000 0001 0723 4123School of Mathematics, Statistics and Computer Science, University of KwaZulu Natal, Durban, South Africa
| | - Henry Mwambi
- grid.16463.360000 0001 0723 4123School of Mathematics, Statistics and Computer Science, University of KwaZulu Natal, Durban, South Africa
| | - Abdul-Karim Iddrisu
- grid.449674.c0000 0004 4657 1749School of Science, Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
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Hailegebreal S, Nigatu AM, Mekonnen ZA, Endehabtu BF. Spatio-temporal distribution and associated factors of anaemia among children aged 6-59 months in Ethiopia: a spatial and multilevel analysis based on the EDHS 2005-2016. BMJ Open 2021; 11:e045544. [PMID: 34404697 PMCID: PMC8372819 DOI: 10.1136/bmjopen-2020-045544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Anaemia is a global public health problem with major health and socioeconomic consequences. Though childhood anaemia is a major public health problem in Ethiopia, there is limited evidence on the spatio-temporal variability of childhood anaemia over time in the country. Therefore, this study aimed to assess the spatio-temporal distribution and associated factors of childhood anaemia using the Ethiopian Demographic and Health Survey (EDHS) data from 2005 to 2016. DESIGN Survey-based cross-sectional study design was employed for the EDHS. SETTING Data were collected in all nine regions and two city administrations of Ethiopia in 2005, 2011 and 2016. PARTICIPANTS The source population for this study was all children in Ethiopia aged 6-59 months. A total of 21 302 children aged 6-59 months were included in this study. OUTCOME MEASURE The outcome variable was child anaemia status. RESULTS The prevalence of anaemia declined from 53.9% in 2005 to 44.6% in 2011, but it showed an increase in 2016 to 57.6%. The spatial analysis revealed that the spatial distribution of anaemia varied across the regions. The spatial scan statistics analysis indicated a total of 22 clusters (relative risk (RR)=1.5, p<0.01) in 2005, 180 clusters (RR=1.4, p<0.01) in 2011 and 219 clusters (RR=1.4, p<0. 0.01) in 2016, significant primary clusters were identified. The child's age, mother's age, maternal anaemia status, wealth index, birth order, fever, stunting, wasting status and region were significant predictors of childhood anaemia. CONCLUSIONS In this study, childhood anaemia remains a public health problem. The spatial distribution of childhood anaemia varied significantly across the country. Individual-level and community-level factors were associated with childhood anaemia. Therefore, in regions with a high risk of childhood anaemia, individual-level and community-level factors should be intensified by allocating additional resources and providing appropriate and tailored strategies.
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Affiliation(s)
- Samuel Hailegebreal
- Department of Health Informatics, Arba Minch University, Arba Minch, Southern Nations, Ethiopia
| | - Araya Mesfin Nigatu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | | | - Berhanu Fikadie Endehabtu
- Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia
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Silva DLF, Höfelmann DA, Taconeli CA, Lang RMF, Dallazen C, Tietzmann DC, Moreira JD, Silva SAD, Nilson EAF, Gonçalves VSS, Crispim SP. Individual and contextual predictors of children's hemoglobin levels from Southern Brazilian municipalities in social vulnerability. CAD SAUDE PUBLICA 2021; 36:e00166619. [PMID: 33440420 DOI: 10.1590/0102-311x00166619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 05/06/2020] [Indexed: 11/21/2022] Open
Abstract
Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children's hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals' data were collected using a structured questionnaire, and secondary and ecological data of children's municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.
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Affiliation(s)
| | | | | | | | - Camila Dallazen
- Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil
| | - Daniela Cardoso Tietzmann
- Departamento de Nutrição, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil
| | - Julia Dubois Moreira
- Departamento de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - Sara Araújo da Silva
- Coordenação Geral de Alimentação e Nutrição, Ministério da Saúde, Brasília, Brasil
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Prevalence of iron-deficiency anaemia in Brazilian children under 5 years of age: a systematic review and meta-analysis. Br J Nutr 2020; 126:1257-1269. [PMID: 33371907 DOI: 10.1017/s000711452000522x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Fe-deficiency anaemia is considered an important public health problem both in wealthier countries and in those of medium and low income, especially in children under 5 years of age. The shortage of studies with national representativity in medium-income countries, such as Brazil, prevents the knowledge of the current situation and its associated factors. We conducted a systematic review and meta-analysis to estimate the pooled prevalence of Fe-deficiency anaemia in Brazilian children under 5 years of age and determined the factors involved in the variability of the estimates of prevalence. We collected fifty-seven studies from the databases MEDLINE, LILACS and Web of Science, along with the reference lists of included articles. We contacted authors for unpublished data. We did not restrict publication timespan and language. This systematic review and meta-analysis was reported according to the guidelines by PRISMA. The pooled prevalence of anaemia in Brazil was 40·2 (95 % CI 36·0, 44·8) %. The age range of the child and the period of data collection were associated with the anaemia prevalence. The pooled prevalence of anaemia was higher in children under 24 months of age (53·5 v. 30·7 %; P < 0·001) and in studies with data collected before 2004 (51·8 v. 32·6 %; P = 0·001). The efforts made by the Brazilian government were successful in the reduction of anaemia in children under 5 years of age in Brazil in the evaluated period. However, prevalence remains beyond acceptable levels for this population group.
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Rocha ÉMB, Lopes AF, Pereira SM, Leone C, Abreu LCD, Vieira PD, Szarfarc SC. IRON DEFICIENCY ANEMIA AND ITS RELATIONSHIP WITH SOCIOECONOMIC VULNERABILITY. ACTA ACUST UNITED AC 2020; 38:e2019031. [PMID: 32520297 PMCID: PMC7274531 DOI: 10.1590/1984-0462/2020/38/2019031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 05/14/2019] [Indexed: 11/22/2022]
Abstract
Objective: To analyze the association of anemia with the socioeconomic vulnerability of preschoolers in public day care centers, in the city of Taubaté, SP, Brazil. Methods: This is a cross-sectional study with a probabilistic sample that analyzed 363 children assisted in public day care centres in low-income and high-income areas of Taubaté, SP, Brazil. The hemoglobin concentration (Hb), dependent variable, was obtained by digital puncture, considering anemic children with Hb concentration <11.0 g/dL. The independent variables such as socioeconomic and demographic conditions were collected by a semi-structured questionnaire. Results: The prevalence of iron deficiency anemia was 19.3% among preschoolers. Children from day care centers with high socioeconomic vulnerability had lower Hb concentration than those from a non-vulnerable area (p<0.05). Conclusions: The lower concentration of hemoglobin in preschoolers is associated with the location of day care centers in an area of socioeconomic vulnerability. Children attending these day care centers face adverse family conditions such as low income, working mothers, and mothers with low schooling, though they receive social benefits and monitoring by public health services.
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Affiliation(s)
| | - Amanda Forster Lopes
- Institute of Health and Biotechnology, Universidade Federal do Amazonas, Coari, AM, Brazil
| | - Silvia Maira Pereira
- Department of Nursing and Nutrition, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Claudio Leone
- School of Public Health, Universidade de São Paulo, São Paulo, SP, Brazil
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Vieira RCDS, do Livramento ARS, Calheiros MSC, Ferreira CMX, dos Santos TR, de Assunção ML, Ferreira HDS. Prevalence and temporal trend (2005-2015) of anaemia among children in Northeast Brazil. Public Health Nutr 2018; 21:868-876. [PMID: 29183408 PMCID: PMC10260909 DOI: 10.1017/s1368980017003238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 09/19/2017] [Accepted: 10/03/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Anaemia is the main nutritional deficiency in Brazil, and a prevention and control programme (National Program for Iron Supplementation) has been developed since 2005. Studies on the temporal evolution of anaemia prevalence contribute to assessment of the effectiveness of the actions undertaken. The present study aimed to identify the prevalence and temporal trend of anaemia in children. DESIGN Study based on two cross-sectional household surveys carried out in 2005 and 2015. Anaemia was defined as Hb<11 g/dl (HemoCue®). Trend analysis was performed using the prevalence ratio (PR), calculated by Poisson regression with a robust adjustment of the variance. Differences were significant when P<0·05 in both crude analyses and those adjusted for possible confounding factors (e.g. socio-economic, demographic and health variables). SETTING Alagoas, Brazil. SUBJECTS In total, 666 and 782 children in the first and second Alagoas State Health and Nutrition Survey, respectively (probabilistic samples). RESULTS In 2005 and 2015, anaemia prevalence was 45·1 and 27·4 %, respectively (-39·1 %; PR=0·61; 95 % CI 0·52, 0·70). In both surveys, children aged ≤24 months were more affected (P24 months (67·2 v. 40·7 %; 27·0 v. 19·3 %, respectively). CONCLUSIONS The prevalence of anaemia reduced significantly in the evaluated period. Thus, it may no longer be a severe public health problem but can instead be considered a problem of moderate magnitude. It remains, however, above the level considered acceptable according to WHO criteria. These results justify the implementation of prevention and control actions.
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Affiliation(s)
- Regina Coeli da Silva Vieira
- Institute of Biological and Health Sciences, Federal University of Alagoas, Maceió, AL, Brazil
- Institute for Health and Biotechnology, Federal University of Amazonas, Manaus, AM, Brazil
- 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
| | | | | | | | | | - Monica Lopes de Assunção
- 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 da Silva Ferreira
- 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
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ANDRÉ HP, VIEIRA SA, FRANCESCHINI SDCC, RIBEIRO AQ, HERMSDORFF HHM, PRIORE SE. Factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years. REV NUTR 2017. [DOI: 10.1590/1678-98652017000300007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective To evaluate factors associated with the iron nutritional status of Brazilian children aged 4 to 7 years in the city of Viçosa, Minas Gerais state, Brazil. Methods This is a cross-sectional study of 357 children aged 4-7 years who had been followed-up up for during their first six months of life by the Breastfeeding Support Program. Socioeconomic and demographic characteristics, feeding practices, nutritional status (height-for-age and body mass index-for-age), and serum ferritin and hemoglobin concentrations were evaluated. Multiple linear regression analysis was carried out to evaluate factors independently associated with iron nutritional status (hemoglobin and ferritin), considering α=0.05 as the significance level. Results The prevalence of anemia and iron deficiency was (34) 9.52% and (11) 11.00%, respectively. The factors independently associated with anemia were younger child age, low maternal education, low height-for-age Z-scores, and children of single and separated mothers or widows. Iron deficiency was associated with child younger age and consumption of chocolates and chocolate flavored milk. Conclusion The results obtained allow us to conclude that anemia among children 4-7 years of age is a public health problem in the city of Viçosa, Minas Gerais. Therefore, there is a need for intervention measures targeting children in this age group. These measures can be implemented through food and nutritional education by encouraging the consumption of iron-rich foods.
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Schümann K, Solomons NW. Perspective: What Makes It So Difficult to Mitigate Worldwide Anemia Prevalence? Adv Nutr 2017; 8:401-408. [PMID: 28507005 PMCID: PMC5421119 DOI: 10.3945/an.116.013847] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Anemia can be related to decreased production or increased loss of erythrocytes, or both, leading to many underlying and often overlapping causes. A largely cereal-based diet with plenty of phytates, polyphenols, and other ligands that inhibit intestinal iron absorption predominated in preindustrial Europe and predominates in present-day developing countries alike. In both situations, we find poor hygienic conditions, which frequently lead to anemia of inflammation. The large number of possible causes and their interaction shows why it is so difficult to mitigate anemia prevalence. Diagnostic biomarkers are required to differentiate the different types of anemia and to treat them appropriately. Some of them are well established in adults [e.g., concentrations of serum ferritin, soluble transferrin receptor (sTfR), and serum iron or the ratio of sTfR to log ferritin]. Others, such as serum hepcidin, hold considerable promise, although they are not yet widely used. A particular issue is to establish reference values for biomarkers in infants and children at different ages. The fact that resource-rich postindustrial societies have a very low prevalence of iron-deficiency anemia offers hope that common types of anemia can be eliminated. In contrast, inborn forms of anemia, such as thalassemia, and anemias related to underlying diseases (e.g., bleeding tumors or peptic ulcers, gynecologic blood losses, or renal diseases) require an operational health system to be addressed appropriately.
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Affiliation(s)
- Klaus Schümann
- Molecular Nutrition Unit, Central Institute for Nutrition and Food Science, Research Center for Nutrition and Food Science, Technische Universität München, Freising, Germany; and
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging, and Metabolism (CeSSIAM), Guatemala City, Guatemala
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Vasconcelos PND, Cavalcanti DS, Leal LP, Osório MM, Batista Filho M. Tendência temporal e fatores determinantes da anemia em crianças de duas faixas etárias (6-23 e 24-59 meses) no Estado de Pernambuco, Brasil, 1997-2006. CAD SAUDE PUBLICA 2014; 30:1777-87. [DOI: 10.1590/0102-311x00117313] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 02/10/2014] [Indexed: 11/22/2022] Open
Abstract
Para analisar a tendência temporal da anemia e de fatores associados em crianças de 6-23 e de 24-59 meses no Estado de Pernambuco, Brasil, foram utilizados os dados de dois inquéritos de saúde e nutrição. As amostras totalizaram 777 e 993 crianças de 6-59 meses, respectivamente na II PESN/1997 e na III PESN/2006. As variáveis exploratórias foram agrupadas em cinco níveis hierárquicos: fatores socioeconômicos; índice econômico e índice ambiental; fatores maternos; assistência à saúde e nutrição; morbidade e estado nutricional, analisadas pela regressão múltipla de Poisson. Entre os dois inquéritos, as prevalências de anemia apresentaram uma diminuição de 11,7% e 33,4%, respectivamente, para as crianças de 6-23 e de 24-59 meses. Na análise de tendência temporal apenas o tercil inferior do índice ambiental permaneceu como fator determinante da anemia para as crianças de 6-23 meses, e o tercil inferior do índice econômico se manteve estatisticamente significativo nas crianças de 24-59 meses. Conclui-se que houve diminuição mais significativa da anemia no grupo de 24-59 meses.
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Oliveira APDND, Pascoal MN, Santos LCD, Pereira SCL, Justino LEH, Petarli GB, Kitoko PM. Prevalência de anemia e sua associação com aspectos sociodemográficos e antropométricos em crianças de Vitória, Espírito Santo, Brasil. CIENCIA & SAUDE COLETIVA 2013. [DOI: 10.1590/s1413-81232013001100017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
É reconhecida a alta prevalência da deficiência de ferro na população, mas ainda não existem estudos suficientes que expliquem os motivos deste problema em nível local e nacional. Assim, o objetivo deste estudo foi avaliar a prevalência de anemia e sua relação com aspectos sociodemográficos e antropométricos de crianças residentes no município de Vitória, ES. Trata-se de um estudo transversal realizado com indivíduos de 12 a 72 meses, cujos dados foram coletados em Unidades Básicas de Saúde e envolveu a dosagem de hemoglobina, aferição de peso e estatura, além de aplicação, aos responsáveis legais, de questionário semiestruturado com informações sociodemográficas. Foram avaliadas 980 crianças, 51,1% do sexo feminino e mediana de idade de 46,00 (IC95%: 45,52-48,09) meses. Constatou-se 37% de anemia, sendo 11,4 (IC95%: 11,15-11,36) g/dL o valor mediano de hemoglobina. A estatura/idade da criança (p = 0,049) e o número de pessoas na família (p < 0,001) apresentaram-se como determinantes da anemia, e a idade como fator protetor desta carência (p = 0,010). A elevada prevalência de anemia e sua forte relação com dados sociodemográficos e antropométricos sugerem a necessidade de políticas públicas mais efetivas do que apenas a fortificação e a suplementação de alimentos.
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