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

Abstract

Objective: 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. Design: 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. Setting: The town of Acrelandia, state of Acre, north-west Brazil. Subjects: A total of 170 and 224 participants of the 2003 and 2007 surveys, respectively. Results: 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 (chi(2) 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. Conclusions: 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.