Anaemia and iron deficiency between 2003 and 2007 in Amazonian children under 2 years of age: trends and associated factors.

Abstract

To describe trends in the prevalence of anaemia and Fe deficiency in children under 2 years of age living in a town in western Brazilian Amazonia. Temporal analysis of two cross-sectional population-based surveys. Information on socio-economic status, morbidity and breast-feeding was obtained using a structured questionnaire. Child weight and length were measured for anthropometric evaluation. Concentrations of blood Hb, plasma ferritin and soluble transferrin receptor were measured. The town of Acrelândia, state of Acre, north-west Brazil. A total of 170 and 224 participants of the 2003 and 2007 surveys, respectively. Comparison between the 2003 and 2007 surveys revealed no statistically significant differences in the prevalence of anaemia (48 (95% CI 39, 56)% to 40 (95% CI 33, 47)%) or Fe-deficiency anaemia (39 (95% CI 30, 48)% to 37 (95% CI 30, 45)%), respectively. However, an increase in the overall prevalence of Fe deficiency from 62 (95% CI 51, 68)% to 81 (95% CI 75, 86)% was observed (χ2 test, P≤0.001). In age- and sex-adjusted analyses for risk of Fe deficiency, only early introduction of cow's milk (<90 d) was associated with Fe deficiency in 2003 (prevalence ratio (PR)=0.76; 95% CI 0.57, 1.01), while caesarean section (PR=1.18; 95% CI 1.03, 1.35) and birth weight <3500 g (PR=1.15; 95% CI 1.00, 1.34) were associated with Fe deficiency in 2007. No improvements were observed in the prevalence of anaemia, exposing a worrying scenario for public health, while a significant increase was found in the prevalence of Fe deficiency in the studied infants and toddlers.