Methodological aspects of the micronutrient assessment in the Brazilian National Survey on Child Nutrition (ENANI-2019): a population-based household survey

• Published in: Cadernos de saúde pública 2021-01, Vol.37 (8), p.e00301120-e00301120
• Main Authors: Castro, Inês Rugani Ribeiro de, Normando, Paula, Alves-Santos, Nadya Helena, Bezerra, Flávia Fioruci, Citelli, Marta, Pedrosa, Lucia de Fatima Campos, Jordão Junior, Alceu Afonso, Lira, Pedro Israel Cabral de, Kurscheidt, Fábio Augusto, Silva, Paulo Ricardo Portella da, Salvatte, Keronlainy, Lacerda, Elisa Maria de Aquino, Anjos, Luiz Antonio dos, Boccolini, Cristiano Siqueira, Kac, Gilberto
• Format: Article
• Language: English
• Subjects: Infant; Laboratory Test; Methods; Micronutrients; Preschool Child; PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
• ISSN: 0102-311X; 1678-4464; 1678-4464
• DOI: 10.1590/0102-311x00301120

This article aims to present methodological aspects on the collection, analyses, coverage, challenges, and the lessons learned from laboratory assessment of micronutrients on the Brazilian National Survey on Child Nutrition (ENANI-2019). This is a household survey on a probability sample of children under five years of age from 123 Brazilian municipalities in all 26 states and the Federal District. Blood samples were drawn by venipuncture at the homes of children 6 to 59 months of age. This procedure was performed by experienced phlebotomists from the laboratories located in the selected municipalities and scheduled in advance. Blood and serum levels were measured for biomarkers of nutritional status, using the services of a clinical test laboratory with nationwide coverage, for the following micronutrients: iron (hemoglobin and ferritin), zinc, selenium, folic acid, and vitamins A, B1, B6, B12, D, and E. C-reactive protein was analyzed as a marker of inflammation. A barcode identifier was used to track the blood samples and to link the biochemical test results to the other data collected in the survey. A total of 14,558 children were studied. Of the 12,598 eligible children, 8,829 (70.1%) had blood samples drawn. Of the total number of children who had samples drawn, 91.8% (n = 8,025) have results for at least nine of the 12 analyses performed. Coverage of the analysis varied from 95% (for vitamins A and E) to 84.2% (for folic acid). Aliquots of whole blood and serum were stored in a biorepository for future analyses. The results of this pioneering study in the country will back the formulation and, when necessary, the reorientation of public policies in food and nutrition. O objetivo deste artigo é apresentar os aspectos metodológicos referentes à coleta e análise de dados laboratoriais do Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019), a cobertura das análises laboratoriais, os desafios enfrentados e as lições aprendidas. Trata-se de um inquérito populacional de base domiciliar de crianças menores de cinco anos realizado em 123 municípios dos 26 estados da Federação e o Distrito Federal. A coleta de sangue por punção venosa foi realizada em domicílio em crianças com idade entre 6 e 59 meses, por coletador experiente de laboratório(s) existente(s) nos municípios amostrados. Foram determinadas as concentrações sanguíneas e séricas de biomarcadores do estado nutricional utilizando os serviços de um laboratório de análises clínicas com abra