Almeida Mayron Morais, Monteiro Kerla Joeline Lima, Bacelar Polyanna Araújo Alves, Santos Jéssica Pereira Dos, Freitas Simone Patrícia Carneiro de, Evangelista Brenda Bulsara Costa, Leal Daniella Nobre, Silva Denilson de Araújo E, Cardoso Aline Borges, Nascimento Elaine Ferreira do, Moraes Neto Antonio Henrique Almeida de, Carvalho-Costa Filipe Anibal
Fundação Oswaldo Cruz, Instituto Oswaldo Cruz, Laboratório de Epidemiologia e Sistemática Molecular, Rio de Janeiro, Rio de Janeiro, Brazil.
Escritório Técnico Regional Fiocruz Piauí, Teresina, Piauí, Brazil.
Rev Inst Med Trop Sao Paulo. 2020 Sep 30;62:e73. doi: 10.1590/S1678-9946202062073. eCollection 2020.
Poverty, malnutrition and neglected tropical diseases such as soil-transmitted helminthiases (STHs) interact in a multi-causal feedback network. This study aimed to assess the relationships between STHs, income and nutritional status of children in impoverished communities in the city of Caxias, Maranhao State, Northeastern Brazil. A cross-sectional survey (n=259 children) was carried out with the collection of fecal samples and assessment of sociodemographic, anthropometric, dietary and sanitation data. Hookworm infection and ascariasis presented prevalence rates of 14.3% and 9.3%, respectively. The logistic regression analysis showed that hookworm infection was more frequent in males (odds ratio [OR]=3.43; 95% confidence interval [CI]=1.45-8.08), children aged 11-15 years old (OR=3.72; 95% CI=1.19-11.62), children living in poor families (OR=2.44; 95% CI=1.04-5.68) and those living in rented houses (OR=5.74; 95%CI=1.91-17.25). Concerning ascariasis, living in the Caldeiroes community (OR=0.01; 95%CI=0-0.17) and belonging to the 11-15 years age group (OR=0.21; 95%CI=0.04-1.02) were protection factors. Poor children have a significantly lower frequency of consumption of meat, milk, vegetables, tubers and fruits than not poor children. The frequent consumption of meat, milk and tubers was associated with significant higher values in the parameter height-for-age, whereas the consumption of meat and milk positively influenced the weight-for-age. The frequencies of stunting, underweight and wasting were 8.1%, 4.9% and 2.9%, respectively. The multivariate model demonstrated that stunting was significantly associated with economic poverty (OR=2.82; 95%CI=1.03-7.70) and low weight was associated with male sex (OR=6.43; 95% CI=1.35-30.68). In conclusion, the study describes the interactions between the dimensions of development represented by income, STHs and nutritional status revealing the importance of raising income levels to improve the living conditions of families in impoverished communities in Northeastern Brazil.
贫困、营养不良与土壤传播的蠕虫病等被忽视的热带病在一个多因果反馈网络中相互作用。本研究旨在评估巴西东北部马拉尼昂州卡希亚斯市贫困社区儿童的土壤传播蠕虫病、收入与营养状况之间的关系。开展了一项横断面调查（n = 259名儿童），收集粪便样本并评估社会人口学、人体测量学、饮食和卫生数据。钩虫感染和蛔虫病的患病率分别为14.3%和9.3%。逻辑回归分析显示，男性（优势比[OR]=3.43；95%置信区间[CI]=1.45 - 8.08）、11 - 15岁儿童（OR = 3.72；95% CI = 1.19 - 11.62）、生活在贫困家庭的儿童（OR = 2.44；95% CI = 1.04 - 5.68）以及居住在出租屋的儿童（OR = 5.74；95% CI = 1.91 - 17.25）感染钩虫的频率更高。关于蛔虫病，生活在卡尔代罗斯社区（OR = 0.01；95% CI = 0 - 0.17）和属于11 - 15岁年龄组（OR = 0.21；95% CI = 0.04 - 1.02）是保护因素。贫困儿童食用肉类、牛奶、蔬菜、块茎和水果的频率明显低于非贫困儿童。经常食用肉类、牛奶和块茎与年龄别身高参数值显著较高相关，而食用肉类和牛奶对年龄别体重有积极影响。发育迟缓、体重不足和消瘦的发生率分别为8.1%、4.9%和2.9%。多变量模型表明，发育迟缓与经济贫困显著相关（OR = 2.82；95% CI = 1.03 - 7.70），体重过低与男性性别相关（OR = 6.43；95% CI = 1.35 - 30.68）。总之，该研究描述了收入、土壤传播蠕虫病和营养状况所代表 的发展维度之间的相互作用，揭示了提高收入水平对改善巴西东北部贫困社区家庭生活条件的重要性。
