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Prevalence of anemia and associated factors among indigenous children in Brazil: results from the First National Survey of Indigenous People’s Health and Nutrition

Maurício S Leite1, Andrey M Cardoso2, Carlos EA Coimbra2, James R Welch2*, Silvia A Gugelmin3, Pedro Cabral I Lira4, Bernardo L Horta5, Ricardo Ventura Santos26 and Ana Lúcia Escobar7

Author affiliations

1 Departamento de Nutrição, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, SC 88040-900, Brazil

2 Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz, Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ 21041-210, Brazil

3 Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa 2367, Cuiabá, MT 78060-900, Brazil

4 Departamento de Nutrição, Universidade Federal de Pernambuco, Avenida Professor Moraes Rego 1235, Recife, PE 50670-901, Brazil

5 Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Rua Marechal Deodoro 1160, Pelotas, RS 96020-220, Brazil

6 Departamento de Antropologia, Museu Nacional, Universidade Federal do Rio de Janeiro, Quinta da Boa Vista s/n, Rio de Janeiro, RJ 20940-040, Brazil

7 Departamento de Ciências Biomédicas, Universidade Federal de Rondônia, Rodovia BR-364 Km 9.5, Porto Velho, RO 76801-059, Brasil

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Citation and License

Nutrition Journal 2013, 12:69  doi:10.1186/1475-2891-12-69

Published: 28 May 2013



Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the country. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil.


The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations.


Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North.


The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.

Brazil; Indigenous peoples; Health surveys; Nutrition surveys; Health status indicators; Anemia; Child health