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Factors Associated with Anemia among Adults and the Elderly Family Farmers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127371. [PMID: 35742619 PMCID: PMC9224523 DOI: 10.3390/ijerph19127371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
The majority of studies on anemia are focused on children and women of reproductive age. Although the disease is a widespread public health problem, studies that include the rural population are scarce. This study determined the prevalence of anemia and associated factors in adults and the elderly living in the rural area of a municipality in Minas Gerais. Twelve rural communities were included. During home visits, hemoglobin levels were measured using a hemoglobinometer to check for the presence or absence of anemia. Additionally, anthropometric data and food insecurity data based on the Brazilian Food Insecurity Scale (EBIA) were collected. A questionnaire about socioeconomic, demographic, and housing conditions was applied. Analyses were performed using the Stata software version 13.0. Spearman correlation and regression analysis logistics were performed (p < 0.05) on 124 families (n = 297 farmers). The prevalence of anemia was 41.1%, being higher among women (55.7%). Additionally, 40.1% of the farmers were food insecure; 52.7% and 80.5% presented excess weight and cardiovascular risk, respectively. Poverty was a reality for 39.7% of individuals. A positive correlation between hemoglobin levels and per capita income was found as well as a negative correlation with EBIA scores and cardiovascular risk. Multivariate analysis showed that individuals experiencing food insecurity, the elderly, and those who do not own a property, were more likely to be anemic. Farmers with per capita income above 1/2 minimum wage were less likely to have anemia. The prevalence of anemia in the group studied was higher than previous studies. The disease is associated with factors that also predispose to food insecurity. The improvement of the determinants of insecurity can contribute to the fight against anemia.
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Macena M, Praxedes D, De Oliveira AD, Paula D, Barros M, Silva Júnior A, Araújo W, Pureza I, de Melo IS, Bueno N. Prevalence of iron deficiency anemia in Brazilian women of childbearing age: a systematic review with meta-analysis. PeerJ 2022; 10:e12959. [PMID: 35194530 PMCID: PMC8858579 DOI: 10.7717/peerj.12959] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/27/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Iron deficiency anemia (IDA) is among the most common micronutrient deficiencies in women of childbearing age and may affect children's development. Brazil has several national programs to tackle this condition, such as food fortification and supplementation for pregnant women, but IDA prevalence in this population has not been systematically reviewed. We sought to determine the prevalence of IDA in Brazilian women of childbearing age through a systematic review with metanalysis. METHODOLOGY A protocol was previously published on the PROSPERO platform under the code CRD42020200960. A panel of the National Council for Scientific and Technological Development (CNPq) approved the protocol of this study under the public call number 26/2019. The main databases searched were MEDLINE, Web of Science, Scopus, Lilacs, and SciELO. In gray literature, the Brazilian Digital Library of Theses and Dissertations and the annals of the Brazilian Congress of Epidemiology and the Brazilian Congress of Public Health were accessed. The search strategy involved terms related to the condition (IDA) and the age group of the population of interest (teenagers and adults). Studies that had assessed the prevalence of IDA in Brazilian women of childbearing age (10-49 years) were included. Three independent reviewers read all titles and abstracts and extracted data from the included studies. Random effects meta-analyses using the Freeman-Tukey arcsine transformation were carried out with prevalence data, and meta-regression was conducted to test for subgroup differences. The quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS From 21,210 unique records screened, 237 full-texts were retrieved, of which 91 were included in the qualitative synthesis, and 83 were included in the meta-analysis. The overall IDA prevalence was 25% (95% CI [23-28], 83 studies). The subgroup of studies that used random sampling showed a prevalence of 22% (95% CI [17-27], 22 studies), whereas in those with non-random sampling, the prevalence was 27% (95% CI [23-30], 61 studies), without significant differences between subgroups in the metaregression (P = 0.13). High prevalence of IDA were found in the subgroups of studies conducted in the North and Northeast regions (30%; 95% CI [24-37]; seven studies, and 30%; 95% CI [26-34]; 27 studies, respectively), in studies conducted with indigenous population (53%; 95% CI [27-78], four studies), and with studies that had their collections after 2015 (28%; 95% CI [23-34], nine studies). CONCLUSIONS IDA in women of childbearing age remains a public health problem in Brazil, especially in the North and Northeast region. The national programs should be strengthened and more thoroughly supervised to decrease this condition nationally.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Nassib Bueno
- Universidade Federal de Alagoas, Maceió, Brazil,Universidade Federal de São Paulo, São Paulo, Brazil
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Garnelo L, Horta BL, Escobar AL, Santos RV, Cardoso AM, Welch JR, Tavares FG, Coimbra Jr CEA. Avaliação da atenção pré-natal ofertada às mulheres indígenas no Brasil: achados do Primeiro Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas. CAD SAUDE PUBLICA 2019; 35Suppl 3:e00181318. [DOI: 10.1590/0102-311x00181318] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 12/14/2018] [Indexed: 01/15/2023] Open
Abstract
Resumo: Este estudo avalia a atenção pré-natal de mulheres indígenas com idades entre 14-49 anos, com filhos menores de 60 meses no Brasil. O Primeiro Inquérito Nacional de Saúde e Nutrição dos Povos Indígenas avaliou 3.967 mulheres que atendiam a tais requisitos, sendo 41,3% da Região Norte; 21,2% do Centro-oeste; 22,2% do Nordeste; e 15% do Sul/Sudeste. O pré-natal foi ofertado a 3.437 (86,6%) delas. A Região Norte registrou a maior proporção de mulheres que não fizeram pré-natal. A cobertura alcançada foi de 90,4%, mas somente cerca de 30% iniciaram o pré-natal no 1º trimestre e apenas 60% das elegíveis foram vacinadas contra difteria e tétano. Somente 16% das gestantes indígenas realizaram 7 ou mais consultas de pré-natal. Ter acesso a pelo menos um cuidado clínico-obstétrico foi observado em cerca de 97% dos registros, exceto exame de mamas (63%). Foi baixa a solicitação de exames (glicemia 53,6%, urina 53%, hemograma 56,9%, citologia oncótica 12,9%, teste de sífilis 57,6%, sorologia para HIV 44,2%, hepatite B 53,6%, rubéola 21,4% e toxoplasmose 32,6%) e prescrição de sulfato ferroso (44,1%). No conjunto, a proporção de solicitações de exames laboratoriais preconizados não ultrapassou 53%. Os percentuais de realização das ações do pré-natal das indígenas são mais baixos que os encontrados para mulheres não indígenas no conjunto do território nacional, e até mesmo para as residentes em regiões de elevada vulnerabilidade social e baixa cobertura assistencial como a Amazônia Legal e o Nordeste. Os resultados reafirmam a persistência de desigualdades étnico-raciais que comprometem a saúde e o bem-estar de mães indígenas.
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Bezerra AGN, Leal VS, Lira PICD, Oliveira JS, Costa EC, Menezes RCED, Campos FACDSE, Andrade MISD. Anemia and associated factors in women at reproductive age in a Brazilian Northeastern municipality. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2018; 21:e180001. [PMID: 30088588 DOI: 10.1590/1980-549720180001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 02/23/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the prevalence of iron-deficiency anemia and associated factors in women at reproductive age in the city of Vitoria de Santo Antão, Pernambuco. METHODS Cross-sectional study with a representative sample of 322 women aged between 15 and 49 years. Anemia was diagnosed by measuring hemoglobin below 12 g/dL. The independent variables were: demographic and socioeconomic conditions (age, race/color, education, literacy, presence of children aged < 5 years in the household, regime of residence occupation, ownership of assets, and per capita income), housing conditions (number of people in the household, number of bedrooms, and basic sanitation), food and nutrition security and women's health conditions (menarche, number of pregnancies, history of miscarriages, body mass index, and ferritin). Poisson regression was used to analyze the factors associated with anemia. RESULTS The mean age of women surveyed was 31.1 ± 6.61 years old (standard deviation - SD) and the prevalence of anemia was 18.6% (95%CI 14.7 - 23.3). After multivariate analysis, anemia was significantly associated with age ≤ 19 years and low ferritin. CONCLUSION The prevalence of anemia is characterized as a mild public health problem and follows the world trend in developing countries.
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Affiliation(s)
- Adriana Guimarães Negromonte Bezerra
- Programa de Pós-Graduação em Saúde Humana e Meio Ambiente, Centro Acadêmico de Vitória de Santo Antão, Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brazil
| | - Vanessa Sá Leal
- Centro Acadêmico de Vitória de Santo Antão, Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brazil
| | | | - Juliana Souza Oliveira
- Centro Acadêmico de Vitória de Santo Antão, Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brazil
| | - Emilia Chagas Costa
- Centro Acadêmico de Vitória de Santo Antão, Universidade Federal de Pernambuco, Vitória de Santo Antão, PE, Brazil
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Lício JSA, Fávaro TR, Chaves CRMDM. [Anemia in indigenous women and children in Brazil: a systematic review]. CIENCIA & SAUDE COLETIVA 2018; 21:2571-81. [PMID: 27557030 DOI: 10.1590/1413-81232015218.00532015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 06/18/2015] [Indexed: 11/22/2022] Open
Abstract
Iron-deficiency anemia can be considered the most important nutritional deficiency in Brazil. The scope of this article was to conduct a systematic review of the literature in order to describe the frequency of anemia in indigenous women and children in Brazil, and gather information on associated factors. A search of the PubMed, Scopus and Lilacs databases was conducted. Seventeen studies were selected. The rates of prevalence of anemia ranged from 23.1%-74.6%; 42.9%-92.3% and 29.6%-84%, for children aged 6 to 119 months, 6 to 23 months and 6 to 59 months, respectively. Two studies were conducted with women of childbearing age and rates of 67% were found among the Suruí and 16.1% among the Xukuru of Ororubá. The majority of authors attribute the prevalence of anemia to inadequate sanitary conditions, diets deficient in iron and essential micronutrients and a lack of access to basic health services. The findings highlight the importance of anemia among the indigenous peoples studied, which has been reflected by a substantial increase in research over the last twenty years.
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Borges MC, Buffarini R, Santos RV, Cardoso AM, Welch JR, Garnelo L, Coimbra CEA, Horta BL. Anemia among indigenous women in Brazil: findings from the First National Survey of Indigenous People's Health and Nutrition. BMC Womens Health 2016; 16:7. [PMID: 26831904 PMCID: PMC4736153 DOI: 10.1186/s12905-016-0287-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 01/27/2016] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People's Health and Nutrition in Brazil. METHODS Data were collected from Indigenous women between 15 and 49 years old based on a nationwide sample of villages. The outcomes of interest were hemoglobin levels (g/dL) and anemia (< 12 g/dL for nonpregnant and < 11 g/dL for pregnant women). Multilevel models were used to explore associations with contextual (village) and individual (household/woman) level variables. RESULTS Based on data for 6692 Indigenous women, the nationwide mean hemoglobin level was 12.39 g/dL (95% CI: 12.29-12.50). Anemia prevalence was high (33.0%; 95% CI: 30.40-35.61%) and showed pronounced regional disparities. No village-level characteristics were associated with anemia or hemoglobin levels in the multilevel model. Even after controlling for upper level variables, socioeconomic status, parity, body mass index, and having been treated for malaria were associated with anemia and hemoglobin levels. CONCLUSION The prevalence of anemia in Brazilian Indigenous women was 12% greater than the national estimates for women of reproductive age. Anemia prevalence and mean hemoglobin levels among Indigenous women appear to be partly explained by some previously recognized risk factors, such as socioeconomic status, body mass index, and malaria; however, part of the variability in these outcomes remains unexplained. Knowledge of health status and its potential determinants is essential to guide public policies aimed at controlling anemia burden in Indigenous communities.
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Affiliation(s)
- Maria Carolina Borges
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96001-970 Brazil
| | - Romina Buffarini
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96001-970 Brazil
| | - Ricardo V. Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210 Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ 20940-040 Brazil
| | - Andrey M. Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210 Brazil
| | - James R. Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210 Brazil
| | - Luiza Garnelo
- Centro de Pesquisas Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Terezina 476, Manaus, AM 69057-070 Brazil
| | - Carlos E. A. Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210 Brazil
| | - Bernardo L. Horta
- Programa de Pós-Graduação em Epidemiologia, Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96001-970 Brazil
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Leite MS, Cardoso AM, Coimbra CEA, Welch JR, Gugelmin SA, Lira PCI, Horta BL, Santos RV, Escobar AL. Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People's Health and Nutrition. Nutr J 2013; 12:69. [PMID: 23714275 PMCID: PMC3681561 DOI: 10.1186/1475-2891-12-69] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. The First National Survey of Indigenous People's Health and Nutrition in Brazil, conducted in 2008-2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil. METHODS The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations. RESULTS Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North. CONCLUSIONS The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.
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Affiliation(s)
- Maurício S Leite
- Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil
| | - Andrey M Cardoso
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Carlos EA Coimbra
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - James R Welch
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
| | - Silvia A Gugelmin
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa 2367, Cuiabá, MT 78060-900, Brazil
| | - Pedro Cabral I Lira
- Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE 50670-901, Brazil
| | - Bernardo L Horta
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96020-220, Brazil
| | - Ricardo Ventura Santos
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil
- Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ 20940-040, Brazil
| | - Ana Lúcia Escobar
- Departamento de Ciências Biomédicas, Universidade Federal de Rondônia, Rodovia BR-364 Km 9.5, Porto Velho, RO 76801-059, Brasil
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Pereira JF, Oliveira MAA, Oliveira JS. Anemia em crianças indígenas da etnia Karapotó. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2012. [DOI: 10.1590/s1519-38292012000400004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: identificar a prevalência e fatores associados à anemia em crianças indígenas Karapotó. MÉTODOS: estudo transversal em que foi realizada dosagem de hemoglobina com fotômetro portátil Hemocue, coletadas medidas de peso e estatura e dados socioeconômicos de 99 crianças de 6 a 59 meses da etnia karapotó. Foi analisada a associação entre a prevalência de anemia e variáveis referentes às crianças, às mães e às famílias utilizando teste qui-quadrado ou teste exato de Fisher. RESULTADOS: a prevalência de anemia nas crianças foi de 57,6%, as prevalências de baixa estatura para idade, baixo peso para estatura e baixo peso para idade entre as crianças foram de 15,6%, 3,0% e 2,0%, respectivamente. A ocorrência de anemia associou-se à menor idade da criança, a um menor tempo de estudo materno, a um maior número de membros da família, à menor posse de itens de consumo e à moradia fora da aldeia (desaldeados). CONSLUSÕES: os resultados evidenciam que a anemia é um grave problema de saúde entre as crianças Karapotó, principalmente naquelas desaldeadas, coexistindo com problemas como sobrepeso e déficit estatural.
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