Prevalence of anaemia in Brazilian children in different epidemiological scenarios: an updated meta-analysis

Objective: To update the estimation of the prevalence of anaemia in Brazilian children according to four different epidemiological scenarios. Design: A new systematic review was conducted with a meta-analysis of the results published between 2007 and May 2019. Literature search was carried out in the PubMed and LILACS databases using keywords anaemia, child and Brazil. A total of thirty-seven articles (17 741 children) were selected and categorised according to the origin of their respective samples: childcare centres (Childcare; n 13 studies/2697 individuals), health services (Services; n 4/755), populations with social inequities (Inequities, n 7/6798) and population-based studies (Populations; n 13/7491). Assuming a prevalence of 20 center dot 9 % as reference (Health National Survey; n 3455), the combined prevalence ratios (PR) were calculated. A random-effects model was used. Participants: Brazilian children 6-60 months of age. Results: The prevalence of anaemia, by scenario, was: Childcare 24 center dot 8 % (PR 1 center dot 06; 95 % CI 0 center dot 81, 1 center dot 40); Services 39 center dot 9 % (PR 1 center dot 76, 95 % CI 1 center dot 33, 2 center dot 35); Inequities 51 center dot 6 % (PR 2 center dot 02, 95 % CI 1 center dot 87, 2 center dot 18); and Populations 35 center dot 8 % (PR 1 center dot 42, 95 % CI 1 center dot 23, 1 center dot 64). Therefore, the values were all higher than the national prevalence; the Inequities had the highest prevalence, and only Childcare did not reach statistical significance. Concerning the previous meta-analysis, there was a reduction in anaemia prevalence in all scenarios: -52 center dot 3, -33 center dot 7, -22 center dot 4 and -10 center dot 7 %, respectively. Conclusions: Compared to the situation revealed in the previous meta-analysis, anaemia, although observed to a lesser extent, remains an important public health problem in the different scenarios analysed, especially for children living in Inequities. Access to Childcare mitigates the risk for this condition.