Lima Daniela Braga, Damiani Lucas Petri, Fujimori Elizabeth
Universidade Federal de Alfenas, Alfenas, MG, Brasil.
Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Paul Pediatr. 2018 Apr-Jun;36(2):176-185. doi: 10.1590/1984-0462/;2018;36;2;00013. Epub 2018 Mar 23.
To analyze the variables associated with vitamin A deficiency (VAD) in Brazilian children aged 6 to 59 months, considering a hierarchical model of determination.
This is part of the National Survey on Demography and Health of Women and Children, held in 2006. Data analysis included 3,417 children aged from six to 59 months with retinol data. Vitamin A deficiency was defined as serum retinol <0.7 mol/L. Univariate and multiple Poisson regression analysis were performed, with significance level set at 5%, using a hierarchical model of determination that considered three conglomerates of variables: those linked to the structural processes of community (socioeconomic-demographic variables); to the immediate environment of the child (maternal variables, safety and food consumption); and individual features (biological characteristics of the child). Data were expressed in prevalence ratio (PR).
After adjustment for confounding variables, the following remained associated with VAD: living in the Southeast [PR=1,59; 95%CI 1,19-2,17] and Northeast [PR=1,56; 95%CI 1,16-2,15]; in urban area [RP=1,31; 95%CI 1,02-1,72]; and mother aged ≥36 years [RP=2,28; 95%CI 1,37-3,98], the consumption of meat at least once in the last seven days was a protective factor [PR=0,24; 95%CI 0,13-0,42].
The main variables associated with VAD in the country are related to structural processes of society and to the immediate, but not individual, environment of the child.
考虑到分层决定模型，分析巴西6至59个月大儿童中与维生素A缺乏症（VAD）相关的变量。
这是2006年进行的全国妇女和儿童人口与健康调查的一部分。数据分析纳入了3417名6至59个月大且有视黄醇数据的儿童。维生素A缺乏症定义为血清视黄醇<0.7 μmol/L。进行了单变量和多变量泊松回归分析，显著性水平设定为5%，使用了一个分层决定模型，该模型考虑了三组变量：与社区结构过程相关的变量（社会经济人口统计学变量）；与儿童直接环境相关的变量（母亲变量、安全性和食物消费）；以及个体特征（儿童的生物学特征）。数据以患病率比（PR）表示。
在对混杂变量进行调整后，以下因素仍与VAD相关：居住在东南部[PR = 1.59；95%置信区间1.19 - 2.17]和东北部[PR = 1.56；95%置信区间1.16 - 2.15]；居住在城市地区[PR = 1.31；95%置信区间1.02 - 1.72]；以及母亲年龄≥36岁[PR = 2.28；95%置信区间1.37 - 3.98]，过去七天内至少食用一次肉类是一个保护因素[PR = 0.2
