INTRODUCTION:
The
prevalence of
undernutrition, which is closely associated with socioeconomic and
sanitation conditions, is often higher among indigenous than non-indigenous
children in many countries. In
Brazil, in spite of overall reductions in the
prevalence of
undernutrition in recent decades, the nutritional situation of indigenous
children remains worrying. The First National
Survey of
Indigenous People's
Health and
Nutrition in
Brazil, conducted in 2008-2009, was the first study to evaluate a nationwide representative sample of
indigenous peoples. This
paper presents findings from this study on the
nutritional status of indigenous
children < 5 years of age in
Brazil.
METHODS:
A multi-stage sampling was employed to obtain a representative sample of the
indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by
census or systematic sampling depending on the village
population. The
survey evaluated the
health and
nutritional status of
children < 5 years, in addition to interviewing
mothers or caretakers.
RESULTS:
Height and weight measurements were taken of 6,050 and 6,075
children, respectively.
Prevalence rates of
stunting,
underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the
prevalence rates of
underweight and
stunting were higher among
children in the North region, in
low socioeconomic status households, in households with poorer
sanitary conditions, with anemic
mothers, with low
birthweight, and
who were hospitalized during the prior 6 months. A protective effect of
breastfeeding for
underweight was observed for
children under 12 months.
CONCLUSIONS:
The elevated rate of
stunting observed in indigenous
children approximates that of non-indigenous Brazilians four decades ago, before major
health reforms greatly reduced its occurrence nationwide.
Prevalence rates of
undernutrition were associated with socioeconomic variables including
income,
household goods, schooling, and access to
sanitation services, among other variables. Providing important baseline data for
future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different
scales (local, regional, and national) for the
nutritional status of
indigenous peoples.