Brazilian Preschool Children Research Articles

Dental pain in Brazilian preschool children: association with the severity of dental caries and impact on oral health-related quality of life.

This study aimed to verify the association between dental pain and severity of dental caries (caries morbidity stages) and the impact on oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study with 199 children (2-5years old) enrolled at preschools in Capão do Leão-RS, Brazil. The self-report of mothers of children with a history of dental pain in the last 6months and perception of their child's OHRQoL (ECOHIS) were obtained through a structured questionnaire. This questionnaire also collected independent variables. Children's oral examination was performed using the CAST instrument to determine caries morbidity stage. Crude and adjusted Poisson regression analysis was performed. The prevalence of dental pain was 14.57%. The chance of the occurrence of dental pain was higher among children diagnosed in morbidity [Prevalence ratio-PR: 5.29 (95% confidence interval-95% CI 1.91-14.61); p = 0.001] and severe morbidity [RP = 6.12 (95 CI% 2.25-16.64); p < 0.001] stages. Children with dental pain presented higher scores in the total ECOHIS [rate ratio = 7.11 (95% CI 4.55-11.09); p < 0.001] and in all of the domains of this instrument. Furthermore, children with a history of dental trauma [PR = 2.41 (95% CI 1.15-5.04); p < 0.001] and those whose reason for last visit to the dental office was for restorative/endodontic/extraction treatment [PR = 1.29 (95% CI 1.01-6.19); p = 0.049] had a higher prevalence of dental pain. A substantial prevalence of dental pain in the last 6months and negative impact on children's OHRQoL was identified in this sample. Children diagnosed with carious dentin lesions and abscess and fistula were more likely to have dental pain.

The oral health impact profile and well-being on mothers and preschool children

Objectivesto verify the contribution of mothers’ oral health impact profile to their children’s oral health profile and the contribution of mothers’ well-being and the caries index (dmft) to children’s well-being.MethodsThis is a cross-sectional observational study. Mothers and pre-school children enrolled in public schools in the municipality of Araraquara-SP took part. The Oral Health Impact Profile Questionnaire (OHIP-14), Satisfaction with Life Scale (SWLS), Early Childhood Oral Health Impact Scale (ECOHIS) and the Autoquestionnaire Qualité de Vie Enfant Imagé (AUQEI) were used. To diagnose caries, a clinical examination was carried out to calculate the dmft index. Path analysis was carried out and the path coefficients were estimated (β) and evaluated using the z-test (α = 5%).Results443 children took part (5.19 ± 0.64 years; 52.4% boys) with an mean dmft of 1.31 ± 2.19. The mean age of the mothers was 33.4 ± 7.01 years. There was a significant impact of dmft and maternal well-being on the child’s subjective well-being (s2explained = 43%). The mothers’ oral health impact profile and the child’s caries experience had a significant influence on both the child (OHIP: β = 0.22; p < 0.001; dmft: β = 0.48; p < 0.001) and the family (OHIP: β = 0.29; p < 0.001; dmft: β = 0.32; p < 0.001). The child’s dmft (β=-0.10; p = 0.005) and the mothers’ subjective well-being (β=-0.61; p < 0.001) had a significant impact on the child’s subjective well-being.ConclusionThe mothers’ oral health impact profile and the child’s caries experience had an impact on both the child and the family. Mothers’ subjective well-being and caries experience should be considered when assessing the subjective well-being of Brazilian preschool children.

Association between Sleep Problems and Psychopathologies among Preschoolers: A Brazilian Cross-Sectional Study.

Objective To evaluate the relationship between sleep problems and psychopathologies in Brazilian preschool children. Materials and Methods The present is a cross-sectional study with162 children: 81 with sleep problems referred for treatment (mean age: 3.67 years), matched by gender/age with 81 participants without sleep problems. Sleep problems were identified through a clinical interview with a specialist. Psychopathologies were evaluated using the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Results Having sleep problems was a predictor of all forms of psychopathologies on the CBCL scales, except for the withdrawn scale. Aggressive behavior, depression/anxiety, affective problems, and oppositional defiant disorder were associated with presence of sleep problems. Conclusion Given the probable bidirectionality of the association between sleep problems and psychopathologies in children, it is suggested that regular assessments of both phenomena should be performed in children referred for treatment of sleep problems and mental health problems in general.

Ultra-processed food consumption and nutritional status in Uruguayan and Brazilian children between three to five years

Introduction. There is growing consensus globally that the consumption of ultra- processed food (UPF) can negatively affect the nutritional status of children. Objective. The present study aims to evaluate associations between the consumption of UPF and the nutritional status in a sample of Uruguayan and Brazilian preschoolers belonging to two studies: the ENDIS Study and the Pelotas 2015 Birth Cohort. Materials and methods. We conducted a cross-sectional analysis. The main outcome measure was obesity defined as BMI for age and sex ≥ +3 z-scores. The score of UPF consumption was the main exposure measured. Each positive answer of habitual intake was added up to create a UPF score ranging from zero to six or more UPF. Crude and adjusted logistic regressions were performed for the associations between UPF consumption and nutritional status in preschoolers. Results. The final sample consisted of 8,687 preschool children, 50.8% belonging to the Uruguayan study, while the remaining 49.2% belonged to the Brazilian study. Nearly 5% of the sample of young children were obese. We didn’t observe a relationship between the score of UPF consumption and obesity, the odds ratio (OR) was 1.04 (95% CI, 1.00–1.09). Adjustments resulted in modest attenuation of the relationship and a lack of statistical significance. However, in children under 48 months, the score of UPF consumption was directly associated with childhood obesity. Conclusions. Results suggest that higher consumption of UPF is associated with obesity in Uruguayan and Brazilian preschool children under 4 years of age. These findings suggest that actions to reduce ultra- processed food consumption could lead to diminish obesity patterns and bring important public health benefits.

Comparison of Physical Activity and Sedentary Behavior among Brazilian Preschool Children during the COVID-19 Physical Distancing Period

Comparison of Physical Activity and Sedentary Behavior among Brazilian Preschool Children during the COVID-19 Physical Distancing Period

Impact of parental attributes on the oral health-related quality of life of Brazilian preschool children.

Considering the importance of parental attitudes and their influence on children's oral health, it is important to know which characteristics may impact it. The aim of this population study was to evaluate the impact of the parental sociodemographic characteristics on the oral health-related quality of life (OHRQoL) of preschool children from southeastern Brazil. A population-based study was conducted with a sample of 321 children aged 2 to 5years old who underwent a calibrated clinical oral examination to assess oral health status and their parents were asked to answer the two following questionnaires: (1) sociodemographic conditions and (2) Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). Descriptive analysis, Mann-Whitney and Kruskal-Wallis tests and adjusted Poisson regression models were used. Younger mothers (RP: 1.47; 95% CI: 1.11-1.95), lower household income (RP: 1.47; 95% CI: 1.11-1.96) and the presence of dental caries (RP: 2.28; 95% CI: 1.74-3.0) were more likely to have a negative impact on the OHRQoL B-ECOHIS total scores (P < 0.01). The characteristics of mothers, such as age, schooling and salary, influenced the mean B-ECOHIS total score; however, paternal attributes were not associated with a negative impact on the children's quality of life. Also, dental caries and household income influenced the children's oral health-related quality of life.

Prevalence of negative behaviour in the dental setting and association with sociodemographic, oral health-related and psychosocial factors amongst Brazilian preschool children.

To investigate the prevalence of negative behaviour in preschool children attending dental clinics and its association with sociodemographic, oral health-related and parental psychosocial factors. A cross-sectional study was carried out with 145 parents/guardians and their children aged 4-6years attending paediatric dentistry training programmes in a capital city of Midwest Brazil. Data were obtained from children's dental records, interviews, and questionnaires for parents/guardians. The outcome was negative child behaviour, based on the dentists' use or indication of behavioural control measures during the dental appointments, as registered in the children's dental records. Covariates were sociodemographic, clinical and parent/guardian psychosocial factors religiosity (DUREL index) and Sense of Coherence (SOC-13 scale). Bivariate analyses and Poisson regression with robust variance were performed. The prevalence of negative behaviour was 24.1% (95% CI = 17.9-31.7). In the bivariate analyses, the variables initially selected for the regression models (p < 0.25) were the parent/guardians' number of children and religiosity, and the children's dental pain and caries status in deciduous teeth. After adjustment, the prevalence of negative behaviour was 2.12 higher in children with teeth extracted due to caries. The prevalence of negative behaviour was high and associated with the presence of missing teeth due to caries, regardless of sociodemographic, psychosocial, and other oral health factors.

Family income modifies the association between frequent sugar intake and dental caries.

The aim of this cross-sectional study was to investigate whether family income modifies associations between dental caries and sex, age, mother's education, type of preschool, sugar intake, and toothbrushing. Dental caries is a multifactorial dyanamic disease primarily mediated by biofilm and sugar. A randomly selected sample of 308 Brazilian preschool children aged 1-3 years underwent a clinical oral examination for the assessment of moderate/extensive dental caries using codes 3-6 of the International Caries Detection and Assessment System. Mothers were asked to fill out a form addressing the child's demographic and socioeconomic characteristics as well as the frequency of sugar intake. Statistical analysis involved descriptive statistics, the chi-squared test, and Poisson regression models. The prevalence of moderate/extensive dental caries was 42.5%. The adjusted model revealed that within low-income families (<2 times the monthly minimum wage), the prevalence of dental caries was higher among children with a high frequency of sugar intake (≥ twice per day) than in those with a low frequency of sugar intake (< twice a day) (RR=1.79; CI: 1.38-2.33). In families with higher income (≥2 times the monthly wage), no significant association between sugar intake and dental caries was, however, found. In conclusion, monthly family income can modify the association between the high frequency of sugar intake and dental caries.

Time-trend analysis (2006 to 2019) of nutritional indicators among Brazilian pre-school children: making progress on child health inequalities.

Time-trend analysis (2006 to 2019) of nutritional indicators among Brazilian pre-school children: making progress on child health inequalities.

Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study

BackgroundPrevious studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4–5-year-old Brazilian children.MethodsAdherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow’s milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios.ResultsSeventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow’s milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child’s current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E.ConclusionsDairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.

Adherence to 24-hour movement guidelines among rural Brazalian preschool children: associations with parenting practices

Background:Young children residing in rural areas of low-and-middle income countries (LMICs) such as Brazil are at greater risk of obesity and related chronic health conditions. Yet, the extent to which rural preschool children from Brazil aged 3- to 6-years meet the World Health Organisation (WHO) 24-hour movement guidelines is unknown. Parents play a central role in the development of children’s movement behaviors with logistic support, co-participation, modelling, and setting rules and limits recognized as influential parenting practices. However, the bulk of parenting research has been conducted in families from high income countries (HICs) and little is known about the relationship between parenting practices and children’s movement behaviors in LMIC communities. Therefore, the aims of this study were two-fold: (1) report the proportion of preschool children from low-income families in rural Brazil meeting the WHO 24-hour movement guidelines; and (2) determine associations with theory-based parenting practices related to physical activity, screen time, and sleep.Methods:A representative sample of 324 families from a rural district in north-eastern Brazil completed a validated, culturally adapted interviewer-administered survey assessing child physical activity, screen time and sleep, and associated parenting practices. The proportion of children meeting the physical activity, screen time, and sleep recommendations and all combinations of these recommendations was calculated. Forward selection logistic regression was used to determine which parenting practices were associated with meeting the individual recommendations and the 24-hour movement guidelines.Results:Less than half of the children (47.5%) met the physical activity recommendation, 22% met the screen time recommendation, 62% met the sleep recommendation, with just over 10% meeting all three recommendations in the 24-h movement guidelines. Having fewer rules and restrictions around indoor and outdoor play, limiting, or monitoring screen time, and maintaining a consistent bedtime routine were key parenting practices associated with children´s adherence to the 24-hour movement guidelines.Conclusion:Only 1 in 10 rural Brazilian preschool children meet the 24-hour movement guidelines. These findings underscore the need for family-based interventions targeting parenting practices to support healthful movement behaviors in young children from LMICs.

Parental report of dental pain and discomfort in preschool children is associated with sleep disorders: a cross-sectional study in Brazilian families.

To evaluate the prevalence of sleep disorders in Brazilian preschool children and its associations with parental report of dental pain and discomfort. This cross-sectional study involved 604 Brazilian preschoolers (4-5 years old). Sleep disorders (SD) and the parental report of dental pain and discomfort (DPD) were evaluated using the Brazilian versions of the Sleep Disturbance Scale for Children (SDSC) and the Dental Discomfort Questionnaire (DDQ-B), respectively. Bivariate and multivariate Poisson regression analyses with robust variance were performed to analyze the association between SDSC and DP. Prevalence of SD ranged from 7 to 21%. 7.9% of the children had DPD indicating the need for more invasive dental procedures (DDQ-B ≥ 5). Significant associations were found between DPD and the following SDSC domains: sleep hyperhidrosis (p = 0.024; PRa = 1.38; 95% CI: 1.04-1.83), disorders of initiating and maintaining sleep (p < 0.001; PRa = 1.41; 95% CI: 1.15-1.73), parasomnias (p < 0.001; PRa = 1.82; 95% CI: 1.39-2.37), and sleep-wake transition disorders (p = 0.018; PRa = 1.28; 95% CI: 1.04-1.58). Children with higher prevalence of DPD presented 20% higher prevalence of SD than children lower prevalence of DPD (p = 0.039; PRa = 1.20; 95% CI: 1.01-1.44). Preschool children with higher prevalence of DPD are more likely to have SD, such as hyperhidrosis, disorders of initiating and maintaining sleep, parasomnias, and sleep-wake transition.

Blood mercury levels of Brazilian preschool children and associated risk factors

Blood mercury levels of Brazilian preschool children and associated risk factors

Association of the prevalence and severity of untreated traumatic dental injuries with body mass index among Brazilian preschool children

Children with excess weight may be more predisposed to traumatic dental injuries (TDI). The aim of this study was to investigate the association between overweight/obesity and TDI presence and severity in Brazilian preschool children. A cross-sectional study was conducted of 347 children aged three to five years. The main exposure was evaluated based on the body mass index (BMI). Socioeconomic-demographic characteristics and harmful oral habits were investigated using a questionnaire sent to the parents/guardians. Oral clinical examinations were performed to determine overjet (criteria proposed by Foster and Hamilton), and the presence and severity of TDI (criteria proposed by Andreassen). Descriptive statistics were performed. Univariate and multivariate Poisson regression analyses were conducted for each outcome. The prevalence of TDI in the sample was 41.5% and 16% of the children had enamel and dentin fractures. In the multivariate analysis, BMI and overjet were associated with the presence and severity of TDI (PR: 2.04 and 1.78, respectively) of TDI (PR: 2.27 and 2.24, respectively) (p<.001 for all associations). Overweight/obesity was associated with both the presence and severity of TDI in early childhood.

Cesarean Delivery and Risk of Excess Weight Among Brazilian Preschool Children

To study the relationship between cesarean Delivery (CD) and overweight in preschool children, considering the presence of birth aspects and demographic characteristics that have been associated with the risk of excess weight. This retrospective cross-sectional analysis used representative data of children from 2 to 6years of age at municipal daycare centers in Taubaté, São Paulo, Brazil. The sample included 752 preschoolers. Weight and height were collected in daycare centers, and the nutritional status classification was performed using z scores of Body Mass Index (zBMI). Data analysis was performed in the bivariate and multivariate manner, the latter with the inclusion of another possible risk factor. Adjustments were made for daycare centers time, sex, birth length and weight and maternal schooling. The mean age of preschool children was 4.7years, and 53.8% were boys. The prevalence of overweight children was 21.7%. The median zBMI of the children born by CD was higher than that of vaginal Delivery (p = 0.0194). The prevalence of overweight showed association with CD (p = 0.0196; PR = 1.397 with 95% CI of 1065-1831). Logistic binary multivariate regression analysis confirmed the association, even in the presence of other possible risk factors (CR: 1.580, 95% CI: 1.072-2.330). Birth by CD is one of the factors that are associated with the early development of overweight in preschoolers.

Transcultural adaptation and psychometric properties of the International Development and Early Learning Assessment (IDELA) in Brazilian pre-school children

Early childhood is a sensitive period for development, and it is important to use psychometrically sound instruments to assess the child's developmental abilities. The International Development and Early Learning Assessment (IDELA) represents an innovative, feasible and low-cost assessment tool for preschool children that evaluates motor development, pre-numeracy, pre-literacy, and socioemotional development. These areas of development represent “key” skills for early development and school readiness. The objectives of this study were to translate the IDELA to Brazilian Portuguese, to conduct its cultural adaptation to the Brazilian population, to analyze its content validity, to assess its inter-rater reliability, to analyze the internal consistency of its sub-domains and to investigate associations between the child's IDELA scores and sociodemographic characteristics of the family. This was a descriptive, cross-sectional study, in which a sample of 565 preschool children were assessed with the IDELA in the city of Embu das Artes, São Paulo. Results indicated that the IDELA was successfully translated and culturally adapted to the Brazilian population, presenting adequate content validity, good internal consistency of its sub-domains and very high inter-rater reliability. Among the evaluated children, the girls' mean scores were higher than the boys' mean scores; 5-year-old children had higher scores than 4-year-old children; a positive correlation was observed between maternal education and the children's mean scores in the total IDELA, the pre-mathematics and the socioemotional subdomains. In conclusion, the Brazilian version of the IDELA proved to be feasible, adequate and reliable to assess early childhood development and school readiness of preschool age children in Brazil. Future studies could use the IDELA to provide relevant data about the children's development and school readiness in other Brazilian regions that will be useful in the planning of public health and education policies to improve children's integral development and their academic achievement.

Dental caries severity and oral health‐related quality‐of‐life in Brazilian preschool children

The impact of dental caries on oral health-related quality-of-life (OHRQoL) may be influenced by disease severity. This study evaluated the impact of caries severity on OHRQoL in preschool children. A school-based, cross-sectional study was conducted with 205 children (aged 2-5years) in Southern Brazil. Parents answered the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS) and provided sociodemographic information. The Caries Assessment Spectrum and Treatment criteria were used to evaluate caries severity, and Poisson regression with robust variance estimation conducted to determine the rate ratio (RR) and 95% confidence intervals (CIs) of the mean OHRQoL scores according to severity level. Most children had at least one tooth in the morbidity (37%) or pre-morbidity (35%) stages, and the prevalence of impacts on OHRQoL was 40%. Caries severity was associated with the impact scores: after adjustments, the mean B-ECOHIS scores were 6.31 (95% CI: 4.24-9.38) higher for children in the morbidity stage, and 10.84 (95% CI: 6.51-18.05) higher in the severe morbidity stage, than for healthy children [RR=10.84 (95% CI: 6.51-18.05)]. Children with carious lesions into dentine or with pulpally-involved or abscessed teeth had poorer OHRQoL than children without such lesions.

Blood total mercury levels of Brazilian preschool children and associated risk factors: preliminary results

BACKGROUND AND AIM: Environmental exposure to mercury in preschool children can impact their health by increasing its blood levels, which can cause negative health outcomes. This study aimed to set the reference value for blood mercury in preschool children from a megacity in Brazil, and investigating associated risk factors. METHODS: Blood samples were collected of 2,463 children and the present study reports preliminary results from 1,020 1-4-year-old children attending 29 daycare centers (DCC) located in São Paulo, Brazil, 2013. Guardians answered sociodemographic and potential risk factors questionnaires. DCC and metal contaminated-sites (MCS) were georeferenced (QGIS™). Blood total mercury levels (BTM) were determined by Cold Vapor Atomic Absorption Spectrophotometry (CV-AAS). BTM was dichotomized (low/high levels) in a cut-off point of 1.06 μg.L⁻¹, which represents the 95th percentile reference value for total mercury established by the U.S. Centers for Disease Control and Prevention (CDC). Summary data and multiple logistic regression were performed (p0.05). RESULTS:The geometric mean for BTM was 1.71 μg.L⁻¹ (95%CI: 1.64-1.78 μg.L⁻¹) and the 95th percentile was 5.43 μg.L⁻¹ (95%CI: 4.89-6.26 μg.L⁻¹). DCCs located in the Northwest geographic zone were associated with high BTM when the model was adjusted for fish intake, age, sex, geographic zone, mother schooling, and amalgam (p=0.018). No associations were found between high BTM and fish consumption, amalgam teeth fillings, and georeferenced vicinity of the DCC to MCS. CONCLUSIONS:BTM in Brazilian preschoolers (95th percentile) was more than five times higher than U.S. children’s levels. Even the Brazilian geometric mean was higher than the U.S. BTM 95th percentile. More studies are necessary to identify potential mercury exposure sources for preschool children. Nevertheless, these results showed the need to formulate public health policies, intending to better understand and eliminate mercury sources. Funded by Fapesp (2011/13076-0, 2011/23272-0, 2012/21840-4) and Capes. KEYWORDS: Mercury, Preschool children, Environmental exposure, Public Health, Blood, Potentially Toxic Elements

Relations between theory of mind and family environment among Brazilian preschool children

Given the importance of the environment for the development of the theory of mind (ToM) in childhood, as well as the scarcity of studies in low-income Latin American countries, we aimed to investigate the relation between family environment characteristics and performance in ToM tasks in a group of Brazilian children. A total of 49 children participated, whose ages ranged between 3 and 5 years (M = 4.43; SD = 0.71), all of whom attended a public kindergarten school located in the metropolitan region of São Paulo, Brazil, and took the Theory of mind test for children (TMTC). The observation of the characteristics of the family environment was conducted by using the Home Observation for Measurement of the Environment (HOME) instrument in the very home setting of each participating child. By controlling the effects of children’s age, intelligence, vocabulary, and mother’s and father’s educational level, a consistent positive, significant, and low-magnitude correlation was found between HOME’s Responsiveness subscale with the total score in TMTC. A robust regression analysis also showed that individual and contextual variables (above cited, plus sex) and Responsiveness accounted for 28.4% of ToM variance. This study corroborates previous findings on the relation between family aspects and ToM, specifically highlighting parents’ responsiveness.

Deficiência de vitamina A em crianças brasileiras: uma revisão sistemática da literatura

RESUMO: Introdução: A deficiência de vitamina A (DVA) é considerada um problema de saúde pública em muitos países em desenvolvimento, como o Brasil, acometendo principalmente a população infantil. Objetivo: Revisar os artigos que abordavam a hipovitaminose A em crianças pré-escolares no Brasil nos anos seguintes a implementação do “Programa Vitamina A Mais”. Procedimentos metodológicos: Foi realizada uma revisão sistemática de artigos de delineamento transversal, publicados no período de janeiro de 2005 a abril 2020, nas bases de dados eletrônicas SciELO, MedLine e LILACS. A estratégia de busca incluiu os seguintes descritores em português: “deficiência de vitamina A”, “criança” e “Brasil” (e seus respectivos correspondentes nos idiomas inglês e espanhol). Resultados: Foram identificados 183 artigos, dos quais 15 foram incluídos. O percentual de crianças com DVA variou de 7,0% a 45,4%. A prevalência média ponderada de DVA pelos respectivos tamanhos amostrais foi de 20,6%. Os principais fatores associados à ocorrência de DVA englobaram aspectos relacionados à criança (menor idade, sexo masculino, baixo peso ao nascer, elevadas concentrações de proteína C-reativa, baixas concentrações de ferritina e de hemoglobina, e baixo consumo de proteína), fatores maternos (menor idade materna, baixo peso e baixa concentração de hemoglobina), e fatores socioeconômicos e ambientais desfavoráveis. Conclusão: Estudos apontam a DVA como um problema de saúde pública grave em crianças brasileiras menores de cinco anos, mesmo após a implementação do Programa Nacional de Suplementação de Vitamina A.&#x0D; PALAVRAS-CHAVE: Nutrição da Criança, Deficiência de Vitamina A, Brasil.