• Marilia de Carvalho Lima, Maria Eugênia Farias Almeida Motta, Eliane Cavalcanti Santos, and Pontes da SilvaGisélia AlvesGA.
• Department of Pediatrics, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil. mlima@truenet.com.br
• Sao Paulo Med J. 2004 May 6; 122 (3): 117123117-23.

ContextProtein energy malnutrition constitutes a public health problem, especially in less affluent countries. The identification of amenable predictive risk factors is of major importance for policy makers to plan interventions to reduce infant malnutrition.ObjectiveTo identify risk factors for protein energy malnutrition among hospitalized low-income children aged 6 to 24 months.Type Of StudyCase-control study.SettingTwo public hospitals in Recife, Brazil.ParticipantsThe cases were 124 infants with length-for-age below the 10th percentile of the National Center for Health Statistics curve and the controls were 241 infants with length-for-age equal to or above the 10th percentile who were recruited in the same infirmary.MethodsCases and controls were compared in relation to a variety of sociodemographic, environmental and reproductive factors, and their healthcare, previous feeding practice and morbidity. Logistic regression analysis was used to investigate the net effect of risk factors on infant malnutrition, after adjusting for potential confounding variables.ResultsThe mother's age, possession of a TV set, type of water supply, family size and location of the home were significantly associated with child malnutrition in the bivariate analysis. However, these associations lost their significance after adjusting for other explanatory variables in the hierarchical logistic regression analysis. This analysis showed that low birth weight contributed the largest risk for impaired growth. Increased risks of infant malnutrition were also significantly associated with households that had no toilet facilities or refrigerator, high parity for the mother, no breastfeeding of the infant, inadequate vaccination coverage and previous hospitalization for diarrhea and pneumonia.DiscussionThe literature shows that chronic malnutrition, as assessed by low length-for-age indexes, is often related to low income. However, this was not the case in this study, in which other variables had greater impact on child growth.ConclusionsIn view of the multiple causes of malnutrition, the interrelationship among its determinants should be taken into account when adopting strategies for its reduction and prevention.

16 keywords...

hide…