In the Amazon, hunger increased by 76% the risk of children having Covid-19

Food insecurity greatly contributes to a child showing symptoms of Covid-19. The conclusion is from a study carried out by Brazilian researchers published this Monday (18) in the journal PLOS Neglected Tropical Diseases.

The results were obtained within the scope of the “MINA Study – maternal-infant in Acre: birth cohort of the Brazilian western Amazon”, carried out since 2015 in the municipality of Cruzeiro do Sul, in Acre, with support from Fapeps (read more at: https: //agencia.fapesp.br/36352/ and https://agencia.fapesp.br/38817/).

“Among children with serological evidence of previous SARS-CoV-2 infection, those whose households went hungry in the month prior to the interviews were 76% more likely to have Covid-19 when compared to children who had not been exposed to food insecurity” , says Marly Augusto Cardoso, professor at FSP-USP (School of Public Health at the University of São Paulo) and coordinator of the study.

On two occasions, first in January and then in June and July 2021, antibody tests for SARS-CoV-2 were performed on 660 of the 1,246 children born in 2015 or 2016 initially followed up by the study, in addition to interviews with mothers or children. caregivers.

The researchers asked about the presence of symptoms of Covid-19 in children, such as coughing, difficulty breathing and loss of taste and smell. A questionnaire also defined the occurrence of household food insecurity, which indicates whether the family had been hungry in the previous month.

“Usually, adults prioritize children’s food, and they may go hungry in order to feed their children. If the child in the house is hungry, it is a sign of a very difficult situation for the whole family”, explains the researcher.

More than half of the participants’ households (54%) were characterized as being in a state of food insecurity. Among these, 9.3% reported symptoms of Covid-19 compared to 4.9% of children whose families did not report food insecurity, which shows a 76% greater vulnerability of this group to the clinical manifestation of SARS-CoV-2 infection. . The higher occurrence of infection showed a relationship with worse housing conditions, in addition to lower education and skin color of the mothers, most of whom were non-white.

In total, 297 children (45%) had antibodies to SARS-CoV-2 detected. Of these, only 11 (3.7%) had tested for Covid-19 before the study and 48 (16.2%) had symptoms such as coughing, breathing difficulties and loss of smell and taste. Among the poorest, the presence of symptoms was higher.

Underreporting

“There are studies showing that socioeconomic status and nutrition influence a greater occurrence of infectious diseases. There is not enough data yet for Covid-19, but both in our study and in research carried out in other countries there is evidence that this correlation also exists “, says Cardoso.

The researcher’s group is currently analyzing samples of the gut microbiota of study participants in order to make correlations between diet and the occurrence of diseases, including Covid-19.

Although nearly half of the children had antibodies to SARS-CoV-2, only 5% of mothers reported a previous episode of Covid-19 in their children, suggesting that eight out of nine infections went undiagnosed and therefore not reported. .

This underreporting, the researchers warn, has consequences for public health, such as the false perception that children are less susceptible to the disease. In other contexts, for example, the lower occurrence of a clinical picture of Covid-19 in children was a justification for parents to postpone or even refuse to vaccinate their children of age to be vaccinated.

The fact that they are largely asymptomatic, however, means that children and adolescents are transmitters to the rest of the family, including people who are more susceptible to serious conditions, such as the elderly and people with comorbidities.

In the study published now, most of the infected children had relatives with Covid-19, especially their mothers. When not the mother, father, siblings, grandparents or neighbors had shown symptoms of the disease. In situations of food insecurity or when the mother was non-white (black, mixed race or indigenous), there was a higher prevalence of the clinical manifestation of the disease.

A limitation of the study was the fact that participants in this segment of the MINA that studied the prevalence of SARS-CoV-2 lived in urban or accessible rural areas. The researchers believe that in more distant locations, with less access to health services, it is possible that the situation is even worse.

“In the remote rural area, it is difficult to continue monitoring and we lost contact with many of the participants. This also occurs with the poorest, who are more difficult to locate because they change a lot of address and even region. over five years of follow-up”, says Cardoso.

Another fact that drew attention was the lower manifestation of symptoms in children born to mothers with more than 12 years of schooling. The manifestation of Covid-19 was greater as the number of years of formal education of the parents decreased.

“Importantly, children from the poorest families and those with less educated mothers were significantly more likely to be seropositive for SARS-CoV-2. This reflects a better socioeconomic status than those who studied longer and also greater access information and survival alternatives, which are reflected in better health care for children”, says the researcher.

“We also observed this in the studies we carried out on malaria, child development and nutritional status. Investing in mothers’ education also has an impact on children’s quality of life”, he concludes.