Resumo

AMAYA-CASTELLANOS, Daisy et al. Deficiencia de Vitamina A y Estado Nutricional Antropométrico en niños MarginalesUrbanos y Rurales en el Estado Zulia, Venezuela. Invest. clín [online]. 2002, vol.43, n.2, pp.89-106. ISSN 0535-5133.

The present transversal study was carried out to estimate the prevalence of both vitamin A deficiency (VAD) and protein-energy malnutrition among children (24 to 85 months) from three urban slums (n=173) in Maracaibo city, Zulia State, Venezuela and a rural slum area (n=34), vicinal to Maracaibo, by measuring serum retinol and z score of anthropometric indices Height//Age (H//AZ); Weight//Age (W//AZ) and Weight//Height (W//HZ), compared to NCHS-WHO reference values. The Graffar’s methodology adapted to Venezuela by Méndez Castellano (1986) confirmed the underprivileged socio-economic condition of the children population. For serum retinol analysis, peripheral venous blood was drawn and serum was treated according to the Bieri et al. (1979) technique and HPLC procedure. Values were recorded in µg/dL. Statistical analysis was done by using Epi Info 2000, release 1.0 and SAS release 6.0 (1996) computer programs. The prevalence of VAD (serum retinol < 20 µg/dL) in the total children population (n=207) was 22.2%, being higher in urban children than in rural children (22.5% vs 20.5%). No clinical signs of VAD were detected in the children. The nutritional status analysed by Z score of anthropometric indices revealed that 27.4% of children suffered from undernutrition (Z score = -2 to > -3 SD), being 15.4% stunted, 9.6% wasted and 2.6% with acute protein-energy malnutrition. Neither severe malnutrition nor overweight were detected. According with the H//AZ index, 54.6% of children had adequate nutrition. However 23% of them suffered from VAD. In children at risk of developing undernutrition (Z score = -1 to > -2 SD), 20.9% had VAD and of the stunted children, 21.9% presented VAD. With W//AZ, 60.3%, 29.9% and 9.1% of children were with adequate nutrition, at risk, or wasted respectively; of each group, 25.6%, 17,7% and 15%, respectively had serum retinol values below 20 µg/dL. The Z score of W//HZ indicator revealed that 87.4%, 10.4% and 2.4% of children were in good nutrition, at risk, or with acute protein-energy malnutrition, respectively. In the three groups 22.1%, 23.8% and 20%, respectively were affected by VAD. These results indicate that VAD coexists indistinctly in healthy, adequately nourished children, as in those malnourished ones. Our VAD prevalence results and others from Venezuela, are higher than the criteria laid down by WHO and PAHO which warrant wide community intervention. This public health problem becomes more significant because children are apparently healthy and, if timely vitamin A supplementation is not given, any intercurrent infection is likely to worsen the vitamin A status, increasing the widely known consequences.

Palavras-chave : Nutritional status; protein energy malnutrition; vitamin A deficiency; children; serum retinol.