Jornal de Pediatria (Aug 2005)
Vigilância do estado nutricional das crianças de um distrito de saúde no Sul do Brasil Nutritional status surveillance of children in a health district in southern Brazil
Abstract
OBJETIVO: Investigar o estado nutricional de crianças encaminhadas para o Programa de Vigilância do Estado Nutricional (Prá-Crescer) pelos serviços básicos de saúde e a evolução das crianças em situação de risco em um Distrito de Saúde de Porto Alegre (RS). MÉTODOS: Foi estudada uma coorte retrospectiva com 674 crianças, de 6 a 59 meses, avaliadas pela rede básica e encaminhadas ao Prá-Crescer. Para a avaliação do estado nutricional, foram utilizados os índices altura/idade, peso/altura e peso/idade, os pontos de corte percentil 3 e 10 e a população de referência a do NCHS. Estudou-se a evolução do estado nutricional de 391 crianças em risco nutricional durante 12 meses. A associação entre as variáveis de interesse foi investigada com o teste do qui-quadrado. RESULTADOS: Encontravam-se com déficit nutricional 58% das crianças avaliadas. Dessas, 38,1% eram desnutridas (OBJECTIVE: To investigate the nutritional status of children referred by a primary care center to the Nutritional Surveillance Program (Prá-Crescer), and to follow up children at risk in a health district of Porto Alegre (RS), Brazil. METHODS: A retrospective cohort study was conducted with 674 children, aged between 6 and 59 months, referred to the Prá-Crescer Program. Height-for-age, weight-for-height and weight-for-age indices were used to evaluate nutritional status. The cutoff points were the 3rd and 10th percentiles of the NCHS standards. The nutritional status of 391 children at nutritional risk was followed up for 12 months. The chi-square test was used to analyze associations between variables. RESULTS: Fifty-eight percent of the children had nutritional deficit. Of these, 38.1% were undernourished (< P3), and 61.9% were at nutritional risk (between P3 and P10). Height-for-age deficit was the most frequent, and the age group mostly affected was 12 to 24 months. Among those at nutritional risk, 50.1% completed the follow-up, 33.5% did not start follow-up, and 16.4% were lost to follow-up. 41.3% recovered nutritional health, 10.2% showed some improvement, without correcting their anthropometric deficits. 39.8% did not show any improvement, and 8.7% had worsening of their deficits. Recovery of nutritional health occurred, on average, within 7.5 months. CONCLUSIONS: This study showed the importance of following up children at nutritional risk and indicates that some aspects should be improved in surveillance programs. Such improvements may reduce the number of children lost to follow-up.
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