Introduction:

Malnutrition is a pending challenge that negatively influences the development of indigenous children, affecting their potential for growth.

Objective:

To analyze the nutritional status of indigenous children under five years of age in Paraguay and its association with socio- economic factors and other social determinants.

Materials and Methods:

This was a cross- sectional, descriptive, analytical study, using representative data from the nation-wide Indigenous Household Survey (IHS 2008). Variables were: Age, sex, linguistic group, weight, height, access to water, access to basic sanitation, medical insurance, birth weight, breastfeeding, episodes of diarrhea and education. We used the following age groups in our study: under one year of age, ages 1 to 2 years, 2 to 3 years, 3 to 4 years and over 4 years of age. The nutritional diagnosis was made by anthropometry, according to WHO criteria: z score Weight / Age, Weight / Height and Height / Age. Statistics: Average, standard deviation and percentages were used. Student's t test and Pearson's Chi square were also used. Significance was defined as p <0.05.

Results:

555 girls and boys under 5 years of age were studied, the average age 29,1 months (1-59 months), 53,9% were males. The averages of Weight / Age, of Weight / Height and of Height/ Age were -0,56 ± 1,2 SD; 0,64 ± 1,2DE; -1,75 ± 1,6DE, respectively. The prevalence of Global Malnutrition (GM) was 9.8% (at risk of 25.0%), of Acute Malnutrition (AM) was 1.5% (at risk of 5.6%), of Chronic Malnutrition (CM) was 41.7% (at risk of 29.4%), and of Obesity was 9.0% (at risk of 28.6%). No significant association was observed between nutritional status and sex. There was a significant association between age groups and AM (p <0.05), CM (p<0.01), and risk of GM (p<0.05). There was a significant association between linguistic groups and CM, the risk of GM, and overweight (p<0.05). There was greater malnutrition in children without medical insurance (CM 25.0 vs 43.4%, p < 0.01), who had a home delivery (CM 33.2 vs 45.3%; GM 5.0 vs 11.8%; p<0.05), with low birth weight (at risk of GM 14.5 vs 39.9 %; p<0.05), with diarrhea during the previous 3 months (at risk of GM 21.2 vs 34.7%, p<0.01, overweight 21.0 vs 31.6%, p<0.01), with a non-literate mother (at risk of GM 18.6 vs 30.3%, p<0.01), with less access to safe water (CM vs 42.8 vs 27.6% p<0.01) and with a dirt floor (at risk of AM 0.9 vs. 6.2%, p<0.05, DG 0.4 vs. 11.0%, p<0.01).

Conclusions:

There is a high prevalence of chronic malnutrition in indigenous children under the age of 5. Food and nutrition policies and interventions designed for indigenous peoples must continue to adapt in accordance with cultural lifestyles and the food perceptions of communities to improve this situation.

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