Perfil nutricional das crianças indígenas menores de cinco anos do Distrito Sanitário Especial Indígena Alto Rio Solimões, estado do Amazonas, Brasil

Abstract

This study aimed to analyze the nutritional profile of children under 5 years of age monitored by the Brazilian Indian Food and Nutrition Surveillance System (SISVAN-I) from the Brazilian Indian Special Sanitary District “Alto Rio Solimões” (DSEI-ARS), Amazonas, Brazil. This is a cross-sectional study on the universe of secondary data from SISVAN-I. This data was previously collected on the occasion of the food and nutrition surveillance actions carried out in the Indian communities of DSEI-ARS. Data from all children with records in the SISVAN-I monitoring maps for December 2013 were included. For classifying the nutritional status we used the indices height/age (H/A), weight/age (W/A), weight/height (W/H), and body mass index/age (BMI/A) using the criteria of the curves provided by the World Health Organization (WHO) for 2006 and by the U.S. National Center for Health Statistics for 1977. The indices H/A, W/A, W/H, and BMI/A with values lower than -2 z-score were defined as low height for age, low weight for age, low weight for height (meagreness), and meagreness for age, respectively. Values greater than +2 z-score for the indices W/H, and BMI/A were classified as overweight. The analyses excluded the children who did not meet the eligibility criteria of the study and those that had z-score values outside the biological plausibility limit recommended by the WHO. Univariate and multivariate analyses were performed to identify possible associations between nutritional status and gender, age group, and primary hub. We evaluated the nutritional status of 7,520 children, who represent 85% of the Indian children assisted by DSEI-ARS in December 2013. According to the WHO parameters, 44.9% of the children had a deficit in H/A, 9.2% in W/A, 3.8% in W/H, and 4.3% in BMI/A. According to the NCHS, 36.8% of the children had low H/A, 12.8% had low W/A, and 3.7% had low W/H. Overweight reached 10.8% for BMI/A, according to the WHO, and 8.9% for W/H, according to the NCHS. In the univariate and multivariate analyses, men had a prevalence ratio 1.14 times higher (95% CI: 1.08-1.20) than women for deficit in H/A and 1.17 times higher (95% CI: 1.08-1.20) than women for deficit in W/A. Two out of the eleven primary hubs had a lower prevalence ratio for developing deficit in height for age. As for the deficit in BMI/A, the primary hub “Nova Itália” had a prevalence ratio 2.94 times higher (95% CI: 1.25-6.88) than the reference. The age groups with higher deficit prevalence values were different depending on the indicator. W/H and BMI/A for all age groups from 6 months had a lower prevalence ratio for deficit. SISVAN-I has proved to be a useful tool to evaluate health and nutrition of Indian peoples. It highlights high prevalence values of chronic malnutrition among children and puts in evidence the inequalities faced by Indian children from the upper Solimões river.