2 and 4 To date, intervention programs that include prevention and treatment of iron deficiency diseases through drug supplementation and food fortification do not appear to be effective or sufficient for reversing the epidemiological picture of these problems, considering MK-8776 purchase the high prevalence

observed. The failure of these programs can be associated with the complexity of other factors involved in the development of anemia, among them, retinol deficiency.4 and 5 Low levels of retinol lead to vitamin A deficiency, which affects 140 million children under 5 years of age worldwide, 127 million at preschool age alone.6 and 7 Several epidemiological studies show a significant association between retinol deficiency and the occurrence of anemia. Mariath et al.,8 for instance, demonstrated an association Nutlin-3 clinical trial between nutritional status of retinol and serum iron in children up to 10 years in Santa Catarina. A study conducted with Brazilian preschoolers showed an association between serum hemoglobin and retinol levels.9 It is believed that retinol deficiency reduces the availability of iron stores from macrophages and the liver to erythropoiesis and, consequently, to the synthesis of hemoglobin. Some studies indicate that this ratio is related to an increased expression of hepcidin, a liver hormone that regulates the availability of iron storage. High concentrations of hepcidin imply that there is an internalization and lysosomal degradation

of ferroportins, transmembrane proteins that allow transport of iron into the blood stream. As there is no available circulating iron, red cell production is impaired, leading to anemia. However, this metabolic process is still hypothetical, with no clear conclusions yet.10 and 11 Considering the above, this study aimed to analyze the occurrence of anemia and iron deficiency in children between 1 and 5 years of age and the association Oxaprozin of these outcomes with retinol deficiency. It is expected to contribute to public health programs concerning the prevention and treatment of iron deficiency and anemia. This was an analytical observational cross-sectional study, conducted in Vitória, ES, Brazil, with children

aged between 1 and 5 years, in the months of April to August of 2008. Mobilization for data collection was carried out by community health agents (CHAs), who invited the parents or legal guardians of children in that age group to present at the Basic Health Unit (BHU) in the area where they resided. Only children who came to the BHU on the scheduled date were included in the study. The city of Vitoria is divided into eight administrative regions – Jardim Camburí, Maruípe, São Pedro, Santo Antônio, Jucutuquara/Bento Ferreira, Continental, Praia do Canto, and Centro – which, in turn, are divided into 28 healthcare areas, each represented by a BHU. The population of children aged 1 to 5 years in the municipality is estimated at 26,967.