Estado nutricional e prevalência de anemia em crianças que freqüentam creches em Belo Horizonte, Minas Gerais

Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study

The objective of the study was to determine the diagnostic accuracy of Mentzer Index in children with hypochromic microcytic anemia by taking serum ferritin levels as a gold standard. This cross-sectional study was conducted in the Department of Pediatric Medicine, Liaquat National Hospital Karachi, from 1st January to 30th June 2022. Children age 1 to 5 years and both genders were included in this study. Children who have had a history of blood transfusion in the past 3 months or Thalassemia or blood disorders, chronic liver disease or kidney diseases, and children with malignancy and congenital abnormalities were excluded. Eligible children were enrolled after taking written informed consent. Complete blood count (CBC) and serum ferritin were sent to the laboratory. Sensitivity, specificity, diagnostic accuracy, and likelihood ratio were calculated taking serum ferritin levels as a gold standard. A total of 347 subjects were enrolled. The median age was 26 (IQR-18) months and 42.9% were males. The most common symptom was fatigue 40.9%. The sensitivity of the Mentzer index was 80.7% while the specificity was 77.7%. Similarly, the positive predictive value (PPV) was 56.8% while the negative predictive value (NPV) was 91.6%. Finally, the accuracy of the Mentzer index in determining iron deficiency anemia was 78.4%. Diagnostic accuracy was 78.4% and the likelihood ratio was 3.6. Mentzer index is a valuable tool in the early detection of IDA in children. It has got high sensitivity, specificity diagnostic accuracy, and likelihood ratio.

Prevalence of childhood anaemia in Brazil: still a serious health problem: a systematic review and meta-analysis

OBJECTIVE

To estimate the prevalence of anaemia in Brazilian children up to 83·9 months old.

DESIGN

Systematic review and meta-analysis, using databases PubMed, Scopus, SciELO, Lilacs, Google Scholar, Periódicos Capes, Arca, Biblioteca Virtual em Saúde, Microsoft Academic Search and Cochrane Library using search terms: anaemia, prevalence, child and Brazil. PROSPERO Registration number: CRD42020208818.

SETTING

Cross-sectional, cohort, case-control and intervention studies published between 2007 and 2020 were searched, excluding those who assessed children with an illness or chronic condition. The main outcome was anaemia prevalence. Random effects models based on the inverse variance method were used to estimate pooled prevalence measures. Sensitivity analyses removed studies with high contribution to overall heterogeneity.

PARTICIPANTS

From 6790 first screened, 134 eligible studies were included, totalling 46 978 children aged zero to 83·9 months analysed, with adequate regions representativeness.

RESULTS

Pooled prevalence of anaemia was 33 % (95 % CI 30, 35). Sensitivity analyses showed that withdrawal of studies that contributed to high heterogeneity did not influence national average prevalence.

CONCLUSIONS

Childhood anaemia is still a serious public health problem in Brazil, exposing 33 % of Brazilian children to the anaemia repercussions. The main limitation of the study is the estimation of national prevalence based on local surveys, but a large number of studies were included, with representation in all regions of the country, giving strength to the results. In Brazil, more public policies are needed to promote supplementation, fortification and access to healthy eating to reduce the high level of anaemia among children.

Prevalence of iron-deficiency anaemia in Brazilian children under 5 years of age: a systematic review and meta-analysis

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.

Usefulness of the StrongKids Screening Tool in Detecting Anemia and Inflammation in Hospitalized Pediatric Patients

Objective: To assess whether the nutritional risk classified by StrongKids is associated with anemia and inflammation (total leukocytes and C-reactive protein (CRP)), as well as to compare the ability of StrongKids with anthropometry in identifying these changes in hospitalized pediatric patients.Methods: Cross-sectional study with patients admitted to the pediatric ward of a public hospital in Brazil, from 2014 to 2018. The experimental protocol included: nutritional risk screening by StrongKids; weight and height measurements; and biochemical tests (complete blood count and C-reactive protein - CRP). Sensitivity, specificity, positive predictive value and negative predictive value were calculated to assess the ability of StrongKids and anthropometry to identify patients with the biochemical changes.Results: The study included 482 patients (54.2% male), with a median age of 2.7 years. The frequency of nutritional risk (medium or high) was 85.9% and the prevalence of malnutrition (acute and/or chronic) was 20.2%. Overall, of the patients evaluated, 40.2% had anemia, 28.2% leukocytosis, and 78.0% high CRP. Children and adolescents classified as at nutritional risk (moderate/high) had lower levels of hemoglobin and higher levels of CRP and total leukocytes, as well as a higher frequency of leukocytosis, high CRP and the three alterations combined when compared with individuals at low risk. No association was found between anthropometric variables and biochemical alterations. The sensitivity of nutritional screening was high to detect all biochemical alterations and was superior to the anthropometric assessment.Conclusion: StrongKids was associated with alterations in biochemical parameters with a better performance than anthropometry.

Influence of infant feeding practices on the occurrence of malnutrition, malaria and anaemia in children ≤5 years in the Mount Cameroon area: A cross sectional study

BACKGROUND

The objective of this study was to evaluate the influence of different infant feeding habits on the occurrence of malnutrition, Plasmodium falciparum parasitaemia and anaemia in children ≤5 years in the Mount Cameroon area.

METHODOLOGY

A total of 1227 children ≤5 years of age were recruited in a descriptive cross-sectional study. Socio demographic data and information on the different infant feeding habits was obtained by the use of semi-structured questionnaire. Nutritional status was assessed by the use of anthropometric measurements. Plasmodium was detected by light microscopy and haemoglobin was measured by use of an auto-haematology analyser. Anaemia as well as its severity was classified based on WHO standards. The associations between variables were assessed using logistic regression analysis.

RESULTS

The prevalence of exclusive breast feeding (EBF) was 22.6%, mixed feeding (MF) was 60.1% and those not breastfed (NBF) at all was 17.3%. The prevalence of malnutrition, P. falciparum parasitaemia and anaemia was 32.6%, 30.4% and 77.3% respectively. Children who had EBF had significantly lower (P <0.001) prevalence of malaria parasite (16.2%) than those NBF at all (61.3%). The prevalence of anaemia was significantly higher (P <0.001) in children who had MF (80.5%) while, severe and moderate anaemia was highest in those NBF at all (6.6%, 67.1% respectively; P = 0.029) than their counterparts. The significant predictors of anaemia were age group (P <0.001), marital status (P <0.001) and educational level of parent (P <0.001), that for malaria parasitaemia was infant feeding habit (MF: P< 0.001 and NBF: P <0.001) and malnutrition was age group (≤2 years: P <0.008 and 2.1-4.0 years: P = 0.028).

CONCLUSION

The infant feeding habit significantly influenced the occurrence of malaria parasite infection and not malnutrition and anaemia, hence EBF should be encouraged in malaria endemic zones.

Effectiveness of mussels (Mytella falcata) in malnourished children’s recovery living in the slums in Maceió, Alagoas

Abstract Objectives: to assess the efficacy of mussels (Mytella falcata) in malnourished children’s recovery. Methods: 64 chronically malnourished children were accompanied for 12 months and attended at the Centro Recuperação e Educação Nutricional (Recovery Center and Educational Nutrition). The children were paired by age and malnutrition level forming three groups, which they received a balanced diet for nutritional recovery differing only on protein source. The group was offered (1) preparation of red meat, group (2) preparation of mussels and group (3) preparation of mussels in coconut milk. Results: the anthropometric assessment revealed that the children obtained a mean increase in the Z score in A-I indice of 0.70 for the group who red meat, 0.62 for the group who had mussels and 0.57 the group who had mussels cooked in coconut milk (p<0,05). An observation was made on a reduction in the prevalence of anemia with 22,8% (p=0,002), 27.8% (p=0.,007) and 42.4% (p 0.001) in groups 1, 2 and 3, respectively. Conclusion: the preparation of mussels cooked in or not in coconut milk can be an effective substitution for meat in combating child malnutrition and anemia and may be included in the children's institutions menus and in the programs that aim for children’s nutritional recovery.

[Micronutrient deficiencies in Brazilian children attending daycare centers: a review of the literature]

The scope of the study was to review the scientific publications on the nutritional status of iron, vitamin A and zinc among Brazilian children attending daycare centers, focusing on diagnostic methods, the prevalence of respective deficiencies and associated factors. A review of the literature was conducted in the PubMed, LILACS and SciELO databases. Observational studies with random representative samples using biochemical indicators to evaluate the nutritional status of iron, vitamin A and zinc of children attending public daycare centers were included. The average weighted prevalence for anemia and vitamin A deficiency was estimated. The variables associated with anemia were computed. Twenty-one observational studies were included, in which the nutritional status of iron, vitamin A and zinc were analyzed in 17, 4 and 3, respectively. The average weighted prevalence of anemia and vitamin A deficiency were 42.7% and 12.5%, respectively. Young children and children living in less favorable socioeconomic situations represented the main explanatory conditions predominantly associated with the occurrence of anemia. The results suggest a high prevalence of anemia, as well as vitamin A deficiency in Brazilian children attending daycare centers, with etiological prospects focused on infectious diseases.

PREVALÊNCIA E FATORES ASSOCIADOS À ANEMIA EM CRIANÇAS DE CRECHES: UMA ANÁLISE HIERARQUIZADA

RESUMO Objetivo: Determinar a prevalência e os fatores associados à anemia em crianças menores de cinco anos assistidas em creches públicas de um município no sudoeste da Bahia. Métodos: Estudo transversal com uma amostra de 677 crianças matriculadas nas creches públicas de Vitória da Conquista, Bahia. Para determinação da hemoglobina por meio de punção digital, utilizou-se hemoglobinômetro portátil, considerando-se valores de hemoglobina <11 g/dL como ponto de corte para o diagnóstico da anemia. Aplicou-se questionário aos pais ou responsáveis para coleta de informações socioeconômicas, características maternas e de saúde e nutrição da criança. Medidas antropométricas de peso e estatura foram utilizadas para avaliação do estado nutricional da criança. Análise de regressão de Poisson com variância robusta e seleção hierárquica das variáveis foi usada para verificar fatores associados com anemia. Resultados: A prevalência de anemia foi de 10,2% e houve mais prevalência nas crianças cujas moradias não apresentavam instalação sanitária (RP 3,36; IC95% 1,40-8,03); naquelas que não receberam aleitamento materno exclusivo (RP 1,80; IC95% 1,12-2,91); nas crianças com idade inferior a 36 meses (RP 1,85; IC95% 1,19-2,89) e com baixa estatura para a idade (RP 2,06; IC95% 1,10-3,85). Conclusões: A prevalência de anemia pode ser considerada um problema de Saúde Pública menor em crianças de creches populares nesse município. Crianças com condições sanitárias inadequadas, que não receberam leite materno exclusivo, bem como as em idades mais precoces e com déficit nutricional foram mais suscetíveis.

[Characterization of anthropometric assessment studies of Brazilian children attending daycare centers]

OBJECTIVE

To obatin an overview of available information on the anthropometric assessment of Brazilian children attending daycare centers.

DATA SOURCE

A literature search was carried out in the PubMed, LILACS and SciELO databases of studies published from 1990 to 2013 in Portuguese and English languages. The following search strategy was used: (nutritional status OR anthropometrics OR malnutrition OR overweight) AND daycare centers, as well as the equivalent terms in Portuguese. In the case of MEDLINE search, the descriptor Brazil was also used.

DATA SYNTHESIS

It was verified that the 33 studies included in the review were comparable from a methodological point of view. The studies, in general, were characterized by their restrictive nature, geographical concentration and dispersion of results in relation to time. Considering the studies published from 2010 onwards, low prevalence of acute malnutrition and significant rates of stunting and overweight were observed.

CONCLUSIONS

Despite the limitations, considering the most recent studies that used the WHO growth curves (2006), it is suggested that the anthropometric profile of Brazilian children attending daycare centers is characterized by a nutritional transition process, with significant prevalence of overweight and short stature. We emphasize the need to develop a multicenter survey that will more accurately define the current anthropometric nutritional status of Brazilian children attending daycare centers.

Fatores associados ao estado nutricional de crianças pré-escolares brasileiras assistidas em creches públicas: uma revisão sistemática

O presente artigo tem como objetivo realizar uma revisão sistemática da produção do conhecimento sobre fatores associados ao estado nutricional de crianças brasileiras assistidas em creches públicas. Foi feita busca bibliográfica nas bases MedLine, Lilacs e SciELO, e revisão dos estudos publicados até 2013. Foi utilizada a seguinte estratégia de busca: ("estado nutricional" OR "antropometria" OR "desnutrição" OR "sobrepeso") AND "creches". No caso da busca no MedLine, o descritor Brazil também foi usado. Foram selecionados 24 manuscritos. Os fatores associados à desnutrição crônica mais citados pelos autores foram a idade da criança, o peso ao nascer, o número de irmãos, a renda familiar, a escolaridade da mãe e o tempo de frequência à creche. Apresentaram-se evidências positivas sobre a relação entre frequência à creche e melhoria do estado nutricional. Apesar do número reduzido de estudos sobre o estado nutricional de crianças que frequentam creches e sua concentração geográfica, os trabalhos apresentados mostram a importância de variáveis de índole biológica (relação inversa) - como idade e peso ao nascer da criança -, e socioeconômica (relação inversa), bem como da frequência à creche (relação positiva).

Anemia entre pré-escolares - um problema de saúde pública em Belo Horizonte, Brasil

O artigo tem por objetivo determinar a prevalência de anemia em crianças matriculadas em creches da regional Centro-Sul de Belo Horizonte (MG), identificando fatores biológicos e socioeconômicos associados. Estudo transversal descritivo realizado em 18 creches. Foram avaliadas 373 crianças com base em amostragem estratificada por instituição participante. A hemoglobina (Hb) sérica foi determinada por punção capilar e leitura em β-hemoglobinômetro, adotando-se pontos de corte para anemia de Hb < 11,0g/dL para crianças de seis a 60 meses e Hb < 11,5g/dL para aquelas com idade superior, preconizados pela OMS. O estado nutricional foi definido por aferição do peso e altura e confecção dos índices Peso/Idade (P/I), Estatura/Idade (E/I) e IMC/Idade (IMC/I). Entre os participantes 54% eram meninas. A média de idade foi de 38,1 ± 6,2 meses. A prevalência global de anemia foi de 38,3%, sendo superior nas crianças com idade inferior ou igual a 24 meses (56,1%). Encontrou-se associação significativa entre anemia e os fatores menor idade da criança, menor idade materna e baixa renda familiar. O estudo mostrou que anemia em crianças de creches de Belo Horizonte constitui relevante problema de saúde pública, sinalizando a necessidade de se implantar ações específicas para mitigação dos riscos por ele apontados.

Prevalência de anemia e sua associação com aspectos sociodemográficos e antropométricos em crianças de Vitória, Espírito Santo, Brasil

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.

Crescimento e deficiências de micronutrientes: perfil das crianças assistidas no núcleo de creches do governo da Paraíba, Brasil

O objetivo deste artigo é avaliar o perfil de crescimento das crianças assistidas no Núcleo de Creches do Governo da Paraíba e a contribuição relativa das deficiências de vitamina A, ferro e zinco. Estudo transversal em 240 crianças pré-escolares. Foram consideradas as categorias de diagnóstico nutricional: déficit ponderal, déficit de estatura e sobrepeso. As concentrações séricas de retinol, zinco e de hemoglobina foram determinadas para avaliar a deficiência de vitamina A (< 0,70 µmol/L), deficiência de zinco (< 65 Μmol/L) e anemia (< 110 g/L), respectivamente. A prevalência de déficit de estatura foi de 5,8%, a de sobrepeso de 3,8%, e a de déficit de peso de 0,4%. A média de Escore-Z para o índice P/E foi menor e estatisticamente significante quando a mãe da criança foi diagnosticada com baixa estatura ou com baixo peso e nas crianças de 12-36 meses de idade. Para o índice E/I, a média de Escore-Z foi menor e estatisticamente significante quando a criança nasceu com baixo peso e quando a mãe da criança apresentou baixa estatura. Crianças de 12-36 meses e sem o beneficio do Programa Bolsa Família tiveram média de hemoglobina menor. Verificou-se ausência de associação significante entre as deficiências de vitamina A, ferro e zinco e os índices antropométricos estudados.

Prevalence of anemia in under five-year-old children in a children's hospital in Recife, Brazil

INTRODUCTION

Anemia is a nutritional problem of global importance. It is estimated that at least one-third of the population has been at one time anemic.

OBJECTIVE

To evaluate the prevalence of anemia and associated factors in patients of a children's hospital in Recife.

METHODS

A cross-sectional study was developed involving 595 male and female children aged from 6 to 59 months old, who were hospitalized in 2007.

RESULTS

Children with a hemoglobin concentration less than 11 g/dL were considered anemic. The relationship between studied variables and anemia was evaluated by Poisson regression analysis. There was a 56.6% prevalence of anemia (95% CI: 46.6-54.6). Anemia was significantly correlated with low weight (Prevalence ratio - PR = 1.39; 95% CI: 1.18-1.64), young age (PR = 2.01; 95% CI: 1.57-2.56) and a diagnosis of acute lower respiratory disease (PR = 1.57; 95% CI: 1.27-1.96).

CONCLUSION

The high prevalence of anemia suggests that it may contribute as a causal factor for hospitalization, especially because the period of hospitalization was short and the patient was likely to be anemic at the time of admission. This study stresses the importance of evaluating the overall nutritional status of patients, including their ingestion of microelements. This is especially important in children, because of their greater susceptibility to anemia. Measures directed at the prevention and control of anemia, including increased coverage of supplementation and fortification programs are strongly recommended.

Fatores associados ao estado nutricional em crianças de creches públicas do município de Recife, PE, Brasil

Objetivo: Avaliar o perfil nutricional de crianças frequentadoras de creches do município de Recife e identificar potenciais fatores determinantes. Métodos: Trata-se de um estudo transversal conduzido com 321 crianças de 6 a 30 meses no período de agosto a outubro de 2004. A classificação do estado nutricional foi realizada a partir dos índices comprimento/idade, peso/idade, peso/comprimento e de massa corpórea/idade, utilizando o padrão de referência da Organização Mundial da Saúde. A análise de regressão linear multivariada avaliou o efeito das condições socioeconômicas e demográficas maternas e relacionadas às crianças sobre o índice comprimento/idade. Resultados: O percentual de desnutrição (< -2 escores Z) foi de 13,4%, 2,8%, 0,6% e 0,6% para os índices comprimento/idade, peso/idade, peso/comprimento e de massa corpórea/idade, respectivamente. O modelo final da análise de regressão linear multivariada mostrou que as condições socioeconômicas (tipo de teto e abastecimento de água) e biológicas da criança (peso ao nascer, idade e concentração de hemoglobina) foram as variáveis que significantemente influenciaram a variação do índice comprimento/idade, explicando 3,8% e 12,8%, respectivamente. Conclusão: Entre as variáveis estudadas, os fatores biológicos da criança tiveram uma influência maior na variação do índice comprimento/idade do que as socioeconômicas.

Severity of anemia among children under 36 months old in rural western China

OBJECTIVE

To describe severity of anemia and explore its determinants among children under 36 months old in rural western China.

STUDY DESIGN

The family information of 6711 children was collected and their hemoglobin was measured in 2005. A generalized estimated equation (GEE) linear model was used to identify the determinants of severity of childhood anemia.

RESULTS

The prevalence of mild, moderate and severe anemia among these children was 27.4%, 21.9% and 3.2% respectively. GEE model analysis showed that province-level region and severity of maternal anemia affected the severity of childhood anemia not only in 0-5 months but also beyond 5 months. In addition, children aged 0-5 months in families using iron pot (coefficient = -0.26 95%CI -0.41,-0.12) had seldom more severe anemia, and children aged 6-36 months in families more than 4 members (coefficient = -0.03 95%CI -0.06,-0.01) or of Han ethnicity (coefficient = -0.08 95%CI -0.13,-0.04) seldom had more severe anemia but boys (coefficient = 0.03 95%CI 0.01,0.06) or younger children (6-11 month vs 30-36 month: coefficient = 0.23 95%CI 0.17, 0.28; 12-17 month vs 30-36 month: coefficient = 0.19 95%CI 0.15,0.24; 18-23 vs 30-36 month: coefficient = 0.09 95%CI 0.04,0.13) had more severe anemia.

CONCLUSION

The prevalence of moderate-to-severe anemia in these children was about 25%. Province-level region, iron pot use, family size, ethnicity, age and gender of children and severity of maternal anemia were important determinants of the severity of childhood anemia. These findings have some important implications for health policy decision for childhood anemia in rural western China.

Prevalência da anemia em crianças avaliada pela palidez palmar e exame laboratorial: implicações para enfermagem

Buscou-se analisar a prevalência de anemia ferropriva em crianças e comparar os dados obtidos pelo método clínico "palidez palmar" e exame laboratorial em uma Estratégia de Saúde da Família no município de Panambi/RS. Pesquisa exploratória/descritiva, quantitativa, realizada de março a junho de 2009. Foram sujeitos 41 crianças de 2 meses a 5 anos. Os dados foram analisados pela estatística descritiva. Das crianças, 51,2% eram do sexo masculino; 41,46% estavam na faixa etária de 0 a 12 meses; 53,6% das famílias situavam-se no nível social D e 43,9% dos chefes de família tinham o Ensino Fundamental completo ou o Ensino Médio incompleto. Pela palidez palmar, a prevalência de anemia foi de 51,2% e pelo exame laboratorial, de 58,53%. O estudo mostra que a palidez palmar e o exame laboratorial, quando usados juntos, fornecem um diagnóstico mais preciso da anemia ferropriva, podendo ser inseridos na prática assistencial da enfermagem na ESF.

Social and biological determinants of iron deficiency anemia

This cross-sectional study aimed to identify the social and biological determinants of anemia in children enrolled in the Brazilian Income Transfer Program (PBF). The study evaluated 446 children (69.1% of the total enrolled) ranging from 6 to 84 months of age, of whom 262 were receiving the income transfer (60.2% of the beneficiaries) and 184 were not (87.6% of the non-beneficiaries). Testing for anemia was performed with the Hemocue portable hemoglobinometer, and the cutoff points were set at 11.0 and 11.5g/dL, according to age bracket. The data were analyzed using Poisson hierarchical regression with robust variance for multivariate analysis. There was no difference in the anemia prevalence rates between the beneficiary and non-beneficiary groups. Risk factors for anemia were low paternal schooling, cesarean birth, consumption of untreated water, stunting, and age less than 24 months. Prevalence of anemia in the group of non-beneficiary children under two years of age was significantly higher than in the beneficiary group in the same age bracket, suggesting the importance of the PBF income transfer for preventing anemia in children.