Anemia among indigenous women in Brazil: findings from the First National Survey of Indigenous People's Health and Nutrition.

Maria Carolina Borges,Carlos E A Coimbra,James R Welch,Romina Buffarini,Bernardo L Horta,Andrey M Cardoso,Luiza Garnelo,Ricardo V Santos

doi:10.1186/s12905-016-0287-5

Abstract

BackgroundAnemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People’s Health and Nutrition in Brazil.MethodsData were collected from Indigenous women between 15 and 49 years old based on a nationwide sample of villages. The outcomes of interest were hemoglobin levels (g/dL) and anemia (< 12 g/dL for nonpregnant and < 11 g/dL for pregnant women). Multilevel models were used to explore associations with contextual (village) and individual (household/woman) level variables.ResultsBased on data for 6692 Indigenous women, the nationwide mean hemoglobin level was 12.39 g/dL (95 % CI: 12.29–12.50). Anemia prevalence was high (33.0 %; 95 % CI: 30.40–35.61 %) and showed pronounced regional disparities. No village-level characteristics were associated with anemia or hemoglobin levels in the multilevel model. Even after controlling for upper level variables, socioeconomic status, parity, body mass index, and having been treated for malaria were associated with anemia and hemoglobin levels.ConclusionThe prevalence of anemia in Brazilian Indigenous women was 12 % greater than the national estimates for women of reproductive age. Anemia prevalence and mean hemoglobin levels among Indigenous women appear to be partly explained by some previously recognized risk factors, such as socioeconomic status, body mass index, and malaria; however, part of the variability in these outcomes remains unexplained. Knowledge of health status and its potential determinants is essential to guide public policies aimed at controlling anemia burden in Indigenous communities.

Highlights

Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations
This study reports for the first time on the prevalence of anemia and associated factors among Indigenous women of childbearing age in Brazil based on a nationwide representative sample
Anemia prevalence was slightly higher among Indigenous women than has been documented for women in the general Brazilian population, suggesting they are somewhat disadvantaged in terms of nutritional and overall health

Summary

Introduction

Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People’s Health and Nutrition in Brazil. Anemia is recognized as a major public health problem, affecting over 1.2 billion people worldwide [1]. There is limited information available on the epidemiology of anemia among adult Indigenous women, despite the vulnerabilities of this group, which often include bearing a first child at an early age and high parity throughout their reproductive years [11,12,13]. In the Suruí from Southern Amazonia, anemia prevalence rates of 67.3 % and 81.8 % were observed for non-pregnant and pregnant women, respectively, in conjunction with a negative association between the occurrence of anemia and socioeconomic status [15]

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