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[巴西东北部栗色社区五岁以下儿童的营养状况及与发育迟缓相关的因素]

[Nutritional status and factors associated with stunting in children under five years of age in maroon communities in Northeast Brazil].

作者信息

Neves Félix de Jesus, Ferreira Aline Alves, Welch James R

机构信息

Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brasil.

Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.

出版信息

Cad Saude Publica. 2021 Jul 19;37(7):e00060220. doi: 10.1590/0102-311X00060220. eCollection 2021.

Abstract

Quilombolas, or members of maroon communities in Brazil, are part of the country's ethnic/racial minorities exposed to health inequities, reflecting a historical process of harsh socioeconomic disadvantages. The study aimed to assess nutritional status and factors associated with stunting in quilombola children under five years of age living in land-deeded quilombola communities in Northeast Brazil. The study used secondary data from the Survey on Food and Nutritional Security in Land-Deeded Quilombola Communities (2011). The target outcomes were stunting (height-for-age < -2z), excess weight (weight-for-height > 2z), and underweight (weight-for-age < -2z). Chi-square test was used to assess the significance of differences between prevalence rates. Multivariate analysis used a hierarchical conceptual model on stunting. Prevalence rates for excess weight and underweight were 2.8% and 6,1%, respectively. Stunting was diagnosed in 14.1% of the sample. The hierarchical model for stunting evidenced higher prevalence rates among children without access to primary healthcare (PR = 1.63; 95%CI: 1.11; 2.41) and safe water (PR = 2.09; 95%CI: 1.42; 3.08) and those with a history of low birthweight (PR = 2.19; 95%CI: 1.33; 3.61). The high prevalence of stunting showed that the quilombola' population in the Northeast experiences unfavorable health condition, reflecting lack of access to primary healthcare and precarious sanitation.

摘要

基隆波拉人,即巴西黑人社区的成员,是该国面临健康不平等问题的少数族裔/种族群体的一部分,这反映了一个长期存在严重社会经济劣势的历史进程。该研究旨在评估巴西东北部拥有土地契约的基隆波拉社区中5岁以下基隆波拉儿童的营养状况以及与发育迟缓相关的因素。该研究使用了来自《拥有土地契约的基隆波拉社区粮食和营养安全调查》(2011年)的二手数据。目标结果包括发育迟缓(身高别年龄<-2z)、超重(身高别体重>2z)和体重不足(年龄别体重<-2z)。采用卡方检验评估患病率之间差异的显著性。多变量分析使用了一个关于发育迟缓的分层概念模型。超重和体重不足的患病率分别为2.8%和6.1%。14.1%的样本被诊断为发育迟缓。发育迟缓的分层模型表明,无法获得初级医疗保健(PR = 1.63;95%CI:1.11;2.41)和安全饮用水(PR = 2.09;95%CI:1.42;3.08)的儿童以及有低出生体重史的儿童(PR = 2.19;95%CI:1.33;3.61)的患病率更高。发育迟缓的高患病率表明,东北部的基隆波拉人群健康状况不佳,这反映出他们无法获得初级医疗保健且卫生条件不稳定。

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