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FATORES ASSOCIADOS AO ESTADO NUTRICIONAL DE CRIANÇAS QUILOMBOLAS MENORES DE 5 ANOS NA REGIÃO NORDESTE DO BRASIL
Determinantes Sociais
Epidemiologia
Povos Tradicionais
Nordeste
Neves, Félix de Jesus | Date Issued:
2017
Alternative title
Factors associated with the nutritional status of quilombola children under 5 years of age in the Northeast region of BrazilAuthor
Advisor
Co-advisor
Affilliation
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Abstract in Portuguese
Estudos recentes realizados em comunidades quilombolas no Brasil demonstraram que essa população vive em condições de vulnerabilidade social, com baixo poder aquisitivo, condições inadequadas de habitação, saneamento básico precário, acesso limitado a serviços de saúde e escolaridade baixa. Ademais, apresentam um perfil de morbidade com prevalência elevada de agravos nutricionais, como anemia e desnutrição infantil. Identificar as prevalências de estado nutricional em crianças quilombolas pré-escolares e analisar possíveis associações com fatores socioeconômicos e demográficos é fundamental para entender como atuam os diferentes fatores de risco na saúde dessa população. Frente a isso, o presente estudo teve como objetivo descrever o estado nutricional e analisar os indicadores sociodemográficos, econômicos, de acesso a programas sociais e serviços de saúde, de saneamento e de caracterização domiciliar associados à baixa estatura-para-idade em crianças < 5 anos na região Nordeste, residentes em comunidades quilombolas tituladas. Utilizando os dados da Pesquisa de Avaliação da Situação de Segurança Alimentar e Nutricional em Comunidades Quilombolas Tituladas (2011), foi analisado o universo de 1.265 crianças, sem métodos de amostragem específicos. (...) A elevada prevalência de déficit estatural, associada a condições socioeconômicas, aponta que a população quilombola no Nordeste enfrenta preocupantes desigualdades de saúde em comparação à população não quilombola. São necessárias estratégias de inclusão social visando melhorias nas suas condições de vida, minimizando o quadro encontrado.
Abstract
Recent studies carried out in maroon (quilombola) communities in Brazil have shown that this population lives in conditions of social vulnerability, with low purchasing power, inadequate housing conditions, poor basic sanitation, limited access to health services, and low schooling. In addition, the morbidity profile of the maroon population segment presents a high prevalence of nutritional diseases, such as anemia and child malnutrition. Identifying the prevalence of nutritional indicators in maroon children of pre-school age and possible associations with socioeconomic and demographic factors is fundamental for understanding how different risk factors affect the health of this population. The objective of this study was to describe the nutritional status and analyze socio-demographic, economic, access to social programs and health services, sanitation, and household characteristic indicators associated with stunting among children under 5 years in the Brazil’s Northeast region living in titled maroon communities. Using data from the Food and Nutrition Security Assessment Survey in Maroon Titled Communities (2011), the universe of 1,265 children was analyzed without sampling methods. The prevalence of nutritional indicators based on height-for-age (H/A), weight-for-age (W/A), body mass index-for-age (BMI/A), and weight-for-age (W/H) indexes was described. For low H/A, prevalence ratios and confidence intervals were calculated using the Wald test. In the bivariate and multivariate analyses of low H/A, Poisson regression with robust variance was used. Hierarchical modeling was performed according to five levels. Variables with p < 0.30 in the bivariate analyses were selected. Those with p < 0.05 were retained in the final adjusted model. According to the results, the prevalence of overweight
based on BMI/A and W/H was 3.2% and 2.8%, respectively. Underweight was also identified in 2.8% of the study population. Stunting was encountered in 14.1% of children. Higher prevalence ratios were observed in Maranhão state (20.4%), households without a bathroom, piped water, and treated water (17.5%, 16.4%, and 19.6%, respectively). Indicators associated with low H/A in the final model were: maternal literacy (PR 0.40, 95% CI 0.18 – 0.85), maternal overweight (PR 0.36, 95% CI 0.14 – 0.90), and non-electric illumination in the household (RP 2.67, CI 95% 1.11-6.43). High prevalence of stunting associated with socioeconomic conditions indicates that the maroon population in Northeast Brazil faces worrying health inequalities compared to the non-maroon population. Social inclusion
strategies are needed that promote improvements in the living conditions of the population.
Keywords in Portuguese
Estado NutricionalDeterminantes Sociais
Epidemiologia
Povos Tradicionais
Nordeste
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