Morbidity and malnutrition risk factors in children followed up by a child health care program

Abstract

The objective of this study was to identify risk factors associated with malnutrition and morbidity in the population of children accompanied by the Child Health Care Program in Embu, São Paulo (Brazil), with the aim of giving a better direction to health activities. The case-study was constituted by a cross-section of 1,024 children, corresponding to 25.0% (probabilistic sistematic sample) of the total of children under 12 months registered in six primary health care centers in the Municipality, during the period from July 1988 to July 1989. The risk factors were analyzed according to the presence or absence of hospitalization and weight evolution - favorable or unfavorable - until two years of age. For the statistical analysis the multivaried approach was used, through the tecnique of logistic regression. Of a total of 1,024 children, 428 (39.1%) were classified as high risk, 658 (60.1%) as low risk and 8 (0.8%) presented pathologies at their first appointment, being excluded from the analysis. Prematurity (adjusted RR = 3.35), serious illness in the newborn (adjusted RR = 4.12) and the death of a younger brother or sister of less than five years (adjusted RR = 2.70) constituted risk factors for hospitalization in the first two years of life. Weight at birth between 2,500 and 2,750 g (adjusted RR = 2.46), brother or sister with malnutrition (adjusted RR = 4.17) and maternal age of 18 years old or less (adjusted RR = 1.87) constituted risk factors for unfavourable weight evolution. These results, as well as the process of carrying out this study, supported the reformulation of the Child Health Care Program in Embu, permitting differentiated action for the highest risk group, thus garanteeing the essential for all.