Vitamin A status and associated factors in infants attending at Primary
               Health Care in Goiânia, Goiás, Brazil

Silva, Lara Lívia Santos da; Peixoto, Maria do Rosário Gondim; Hadler, Maria Claret Costa Monteiro; Silva, Sara Araújo da; Cobayashi, Fernanda; Cardoso, Marly Augusto

doi:10.1590/1980-5497201500020016

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Original Articles • Rev. bras. epidemiol. 18 (2) • Apr-Jun 2015 • https://doi.org/10.1590/1980-5497201500020016 copy

Vitamin A status and associated factors in infants attending at Primary Health Care in Goiânia, Goiás, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

This study aimed to assess the nutritional status of vitamin A and associated factors in children assisted in Primary Care Health in Goiânia, Goiás, Brazil.

METHODS:

This is a cross-sectional study with a sample of 228 children 12 to 16 months of age. The nutritional status of vitamin A was assessed by serum retinol concentration, determined by high performance liquid chromatography. Multiple linear regression models with hierarchical selection of independent variables were used to evaluate the correlation with serum retinol as the dependent variable.

RESULTS:

The vitamin A deficiency (retinol < 0,7 μmol/L) was observed in 14,0% of the children. Maternal schooling and hemoglobin concentration were positively correlated with serum retinol concentration, while C-reactive protein showed a negative correlation (R² = 0,1648).

CONCLUSION:

The vitamin A deficiency in one-year-old children attended in Basic Health Units in Goiânia configures itself as a moderate public health problem. Actions to promote maternal education, morbidity control and prevention of other micronutrient deficiencies are important for prevention and control of the vitamin A deficiency in this population.

Vitamin A; Micronutrients; Infant; Child health; Nutritional status; Primary health care

Variables	n (%)*
	median (p25 – p75)
	Mean ± SD
Gender (n = 228)
Male	115 (50.4)
Female	113 (49.6)
Age (months) (n = 228)	14 (13 – 14)
Per capita income (R$) (n = 225)	300 (200 – 441.7)
Maternal schooling (years) (n = 225)	11 (8 – 11)
Treatment of drinking water (n = 228)
Inadequate	48 (21.0)
Adequate	180 (79.0)
Sanitary sewer (n = 227)
Without public network	99 (43.6)
With public network	128 (56.4)
Children with < 5 years old in the house (n = 228)
1 child	177 (77.6)
> 1 child	51 (22.4)
Mother’s age (years) (n = 228)	27 (23 – 32)
Number of prenatal appointments (n = 214)	8 (6 – 10)
Weight at birth (kg) (n = 227)	3.2 ± 0.5
Body mass index/age (Z score) (n = 222)	0.3 ± 1.2
Height/age index (Z score) (n = 225)	0.1 ± 1.2
Age of weaning (days) (n = 105)	180 (90 – 240)
Vitamin A and D supplementation (n = 226)
Never used it	193 (85.4)
Has used it or uses it	33 (14.6)
Diarrhea in the past 15 days (n = 228)
No	174 (76.3)
Yes	54 (23.7)
Hemoglobin (g/dL) (n = 227)	12.5 ± 0.9
C-reactive protein (mg/L) (n = 223)	0.5 (0.2 – 1.7)

Variables	Total n (%)	Vitamin A deficiency*
Variables	Total n (%)	n (%)	p-value**
Total	228 (100,0)	32 (14.0)	–
Gender			0.414
Male	115 (50.4)	14 (12.2)
Female	113 (49.6)	18 (15.9)
Maternal scholing (n = 225)			0.027
< 9 schooling years	68 (30.2)	15 (22.1)
≥ 9 schooling years	157 (69.8)	17 (10.8)
CRP (mg/L) (n = 223)			< 0.001
≤ 5	192 (86.1)	19 (9.9)
> 5	31 (13.9)	12 (38.7)

Variables	β*	95%CI	p-value
Per capita income	0.000	-0.000 – 0.000	0.083
Maternal schooling	0.021	0.007 – 0.035	0.003
Treatment of drinking water
Inadequate	1
Adequate	0.091	-0.008 – 0.190	0.070
Sanitary sewer
Without public network	1
With public network	0.030	-0.052 – 0.112	0.468
Children with < 5 years old in the house
1 child	1
> 1 child	-0.083	-0.180 – 0.013	0.091
Mother’s age	0.005	-0.001 – 0.010	0.095
N. of prenatal appointments	-0.001	-0.016 – 0.014	0.907
Weight at birth	-0.000	-0.000 – 0.000	0.473
Body mass index/age	0.012	-0.022 – 0.046	0.496
Height/age index	0.004	-0.031 – 0.039	0.820
Age of weaning	0.000	-0.000 – 0.001	0.500
Vitamin A and D supplementation
Never used it	1
Has used it or uses it	0.0558	-0.059 – 0.171	0.340
Diarrhea in the past 15 days
No	1
Yes	-0.038	-0.133 – 0.057	0.436
Hemoglobin	0.092	0.049 – 0.134	< 0.001
C-reactive protein	-0.020	-0.027 – -0.013	< 0.001

Variables	Adjusted β*	95%CI	p-value	R²	Standardized β**
Block I				0.0232
Per capita income	0.000	-0.000 – 0.000	0.385
Maternal schooling	0.018	0.003 – 0.032	0.017		0.158
Block II				0.0360
Treatment of drinking water
Inadequate	1
Adequate	0.041	-0.061 – 0.143	0.434
N. of children < 5 years old
1 child	1
> 1 child	-0.058	-0.154 – 0.038	0.235
Mother’s age	0.003	-0.002 – 0.009	0.249
Bloco III				0.1648
Hemoglobin	0.049	0.007 – 0.090	0.022		0.151
C-reactive protein	-0.017	-0.024 – -0.010	< 0.001		-0.300

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[1] Corresponding author: Maria do Rosário Gondim Peixoto. Faculdade de Nutrição da Universidade Federal de Goiás. Rua 227, quadra 68, s/n, Setor Leste Universitário, CEP 74605-080, Goiânia, GO, Brasil. E-mail: mrg.peixoto@uol.com.br