Disadvantaged pre-schoolers attending day care in Salvador, Northeast Brazil have a low prevalence of anaemia and micronutrient deficiencies

作者：Lander Rebecca L; Bailey Karl B; Lander Alastair G; Alsaleh Abdulmonem A; Costa Ribeiro Hugo C; Mattos Angela P; Barreto Danile L; Houghton Lisa A; Morison Ian M; Williams Sheila M; Gibson Rosalind S^*

来源：Public Health Nutrition, 2014, 17(9): 1984-1992.

DOI：10.1017/S1368980013002310

• Anaemia
• Micronutrient deficiencies
• Predictors
• Pre-schoolers
• Disadvantaged
• Northeast Brazil

Objective: To examine the micronutrient status of disadvantaged pre-schoolers from Northeast Brazil, following the introduction of pro-poor policies, by assessing the prevalence of anaemia and micronutrient deficiencies and the role of sociodemographic factors, genetic Hb disorders and parasitic infections. %26lt;br%26gt;Design: In a cross-sectional study, data on sociodemographic status, health, growth, genetic Hb disorders, parasites and nutrient supply from day-care meals were obtained. Fasting blood samples were collected and analysed for Hb, serum ferritin, transferrin receptor, folate, vitamin B-12, retinol, Zn and Se. %26lt;br%26gt;Setting: Seven philanthropic day-care centres serving urban slums in Salvador, Northeast Brazil. %26lt;br%26gt;Subjects: Pre-schoolers aged 3-6 years from disadvantaged households. %26lt;br%26gt;Results: Of the 376 sampled children, 94% were of black or mixed race; 33% and 29% had at least one genetic Hb disorder and intestinal parasite, respectively. Stunting and underweight were %26lt;= 5%; 14% were overweight. Day-care centres supplied micronutrient-dense meals and snacks each weekday. Less than 10% of pre-schoolers had anaemia and micronutrient deficiencies. Predictors (P%26lt;0.05) of Hb were a 3.7 thalassaemia, Se and retinol (but not ferritin). Micronutrient predictors (P%26lt;0.05) were: elevated alpha(1)-glycoprotein for ferritin, Hb AS and BMI Z-score %26gt;1 for transferrin receptor, Zn and elevated alpha(1)-glycoprotein for retinol, sex and helminths for Se, helminths for vitamin B-12, and Giardia intestinalis infection for serum folate. %26lt;br%26gt;Conclusions: Impaired growth, anaemia and micronutrient deficiencies were uncommon among these disadvantaged pre-schoolers attending day care. A range of interventions including provision of micronutrient-dense, fortified day-care meals, deworming and vitamin A supplementation likely contributed to improved micronutrient status, suggesting expanded coverage of these programmes.

• 出版日期2014-9