Parasitoses, estado nutricional, consumo alimentar e indicadores sociais em crianças e adolescentes residentes em uma área de invasão em Maceió, Alagoas

Abstract

Common problems in the developing countries includes protein-energy undernutrition and iron deficiency anemia. These nutritional deficiencies are commonly associated with intestinal parasites, causing damage to growth and development and increasing the risk to morbidity-mortality. However, studies have shown controversy about this relationship. This study aimed to evaluate the association between parasitic, nutritional status, food intake and social indicators in children and adolescents, living in a slum area of Maceio, Alagoas. A cross-sectional was taken in a public with 367 individuals under 16 years old, living in a substandard settlement in Maceio, Alagoas. Parasitological, socioeconomic and nutritional evaluations were performed. Sedimentation concentration method and Kato-Katz techniques were used for stool examinations. Socioeconomic data was collected through the use of questionnaires addressing issues relating to housing conditions, economic characteristics and behaviors related to sanitation education. The nutritional evaluation included dietary assessment, biochemical examinations and anthropometric measurements. The dietary evaluation used the method of Estimated Average Requirement (EAR) as a cutoff point, and the data collected through 24 hour recall, adjusted for intrapersonal variability. Serum concentrations of hemoglobin (Hb), iron (SI) and ferritin (SF) were measured to assess the organic iron status. Anthropometric measurements were evaluated using the height-for-age index and body mass index for age, expressed as Z scores in relation to anthropometric growth patterns of WHO 2005/2006. The association between variables was performed by bivariate followed by multivariate logistic regression analysis. In all the tests a 5% statistical level of significance was adopted. The population studied lacked basic sanitation and most had an income lower or equal to the minimum salary. The frequency of enteroparasitosis in children and adolescents was 68.0% with 63.7% having polyparasitosis. Of the total number of individuals assessed by anthropometry, 12.3% presented with stature deficit and 3.5% with low weight. The frequencies of short stature and overweight (13.4%) were equivalent. Levels lower than the reference values were found for SF, SI and Hb in 15,9%, 33,2% and 10% of individuals, respectively. With respect to food intake, 5.6% presented with excessive and 3.7% with insufficient energy intake. The frequency of inadequate protein intake ranged from 28.6% to 47.8% between age groups, and consumption of micronutrients was more deficient in the age group from 1 to 3 years. Concerning association between variables, it was not possible to build a final multivariate logistic model for short stature and low weight, because no association was found with these anthropometric deficits and the other variables. The serum concentrations of SF and SI and economic class were associated with anemia. Intestinal parasitosis was associated with economic class and overcrowded living conditions. Because of morbidity caused by parasitic infections and the adverse effects of anemia and nutrition on the growth and development of children and adolescents, the results presented warn of the need for implementation of actions to correct the identified problems.