A 15-year study on the treatment of undernourished children at a nutrition rehabilitation centre (CREN), Brazil

Public Health Nutr. 2012 Jun;15(6):1108-16. doi: 10.1017/S1368980011002758. Epub 2011 Oct 19.

Abstract

Objective: To build a life table and determine the factors related to the time of treatment of undernourished children at a nutrition rehabilitation centre (CREN), São Paulo, Brazil.

Design: Nutritional status was assessed from weight-for-age, height-for-age and BMI-for-age Z-scores, while neuropsychomotor development was classified according to the milestones of childhood development. Life tables, Kaplan-Meier survival curves and Cox multiple regression models were employed in data analysis.

Setting: CREN (Centre of Nutritional Recovery and Education), São Paulo, Brazil.

Subjects: Undernourished children (n 228) from the southern slums of São Paulo who had received treatment at CREN under a day-hospital regime between the years 1994 and 2009.

Results: The Kaplan-Meier curves of survival analysis showed statistically significant differences in the periods of treatment at CREN between children presenting different degrees of neuropsychomotor development (log-rank = 6·621; P = 0·037). Estimates based on the multivariate Cox model revealed that children aged ≥24 months at the time of admission exhibited a lower probability of nutritional rehabilitation (hazard ratio (HR) = 0·49; P = 0·046) at the end of the period compared with infants aged up 12 months. Children presenting slow development were better rehabilitated in comparison with those exhibiting adequate evolution (HR = 4·48; P = 0·023). No significant effects of sex, degree of undernutrition or birth weight on the probability of nutritional rehabilitation were found.

Conclusions: Age and neuropsychomotor developmental status at the time of admission to CREN are critical factors in determining the duration of treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Birth Weight
  • Body Weight
  • Brazil
  • Child
  • Child Development / physiology*
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Malnutrition / rehabilitation*
  • Nutritional Status*
  • Proportional Hazards Models
  • Rehabilitation Centers*
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Young Adult