ANEMIA AND INFECTION IN SCHOOL-AGED EGYPTIAN CHILDREN

Iron-deficiency anemia and infection are deterrents to optimal child health in many developing countries. We investigated the prevalence of anemia and elevated erythrocyte sedimentation rate (ESR), which reflects chronic background infection, recent illness, and diet for 190 children aged 10 to 13 years in 1995 in a Nile Delta village. The children exhibited a high prevalence of anemia (61.6%) and elevated ESR (54.9%). One-third of the children reported a minor illness within the past week, and more than 75 per cent had one or more parasites evident in stool or urine samples. There was no relationship of socioeconomic or dietary indicators to anemia or elevated ESR. Mothers' evaluation of the child's health status had no relationship to anemia or elevated ESR, with 43.6 per cent of mothers reporting their child's health status as excellent or good. Maternal report of the child's health as poor was related to recent illness. We speculate that where anemia and chronic infection are hyperendemic, both children and mothers may become habituated to the associated symptoms and consider them normal.     

An outbreak of measles in a highly immunised population: immunisation status and vaccine efficacy

Abstract: An outbreak of 18 cases of measles in a primary school in the Australian Capital Territory in August and September 1993 provided the opportunity to study measles immunisation status and measles vaccine efficacy. Parents of 384 (78 per cent) of 491 children answered a questionnaire on recent illness consistent with measles and measles immunisation. Parents transcribed details of measles immunisation from the personal health record of the child to the questionnaire. Thirty-three per cent of cases and 3.4 per cent of the other children had not been immunised. Overall, 95 per cent of children had been immunised. The efficacy for all measles vaccines was estimated to be 90 per cent (95 per cent confidence interval (CI) 75 to 96) and for measles-mumps vaccine 87 per cent (CI 70 to 95). All of the immunised cases had received measles-mumps vaccine. There was no increased risk of measles infection in those who had been immunised at under 15 months of age compared with those immunised at 15 months or older, or in those who could not provide a date of immunisation compared with those who could. None of the children who had received two doses of vaccine caught measles. The date of immunisation was provided by 65 per cent of the respondents who said their children had been immunised. Asking parents to provide this date instead of viewing the health record is a less expensive way of assessing immunisation status but this method needs to be evaluated. Measles outbreaks still occur in highly immunised populations when vaccine efficacy appears to be acceptable.     

中国儿童营养状况15年变化分析——5岁以下儿童贫血状况

目的根据中国食物营养监测系统15年监测结果,对5岁以下儿童的贫血状况进行分析。方法根据世界卫生组织和联合国儿童基金会提出6个月至6岁以下儿童血红蛋白小于110克/升的儿童贫血的诊断标准。采用氰化高铁法和HemoCue法(血红蛋白测定仪)测定血红蛋白含量,对于海拔1000米以上至3000米的点的贫血标准进行调整,并计算贫血率。通过同时测定儿童与母亲血红蛋白值的方法,研究儿童贫血与母亲贫血的关系。结果1992~2005年间中国城市、农村5岁以下儿童贫血率在16%~20%之间徘徊,没有显著改善;儿童贫血率随年龄变化,6~12月是患病高峰;对于儿童贫血,母亲贫血的相对危险度为2.31;儿童贫血会造成腹泻病的增加;4~23月儿童贫血与母亲贫血、母乳喂养、辅助食品添加有关,24~59月儿童贫血与母亲贫血和儿童生长迟缓有关。结论必须采取有效行动,同时改善儿童贫血和母亲贫血问题。     

Giardiasis in an infant and toddler swim class.

A Giardia infected Washington State child was found to participate in an infant and toddler swim class. A stool survey of 70 child participants revealed a 61 per cent prevalence of Giardia infection. Also, 39 per cent of 53 mothers and 28 per cent of 21 fathers were Giardia positive. None of the non-swimming playmates were positive. Thirty-five per cent of 23 children exposed only at a better maintained pool to which the classes had been moved four weeks prior to the survey were positive. No evidence of transmission to non-swim class pool users was found.     

Childhood iron deficiency anemia, maternal nutritional knowledge, and maternal feeding practices in a high-risk population.

BACKGROUND: Despite the proven success of national efforts such as the Special Supplementary Food Program for Women, Infants, and Children (WIC) to curb childhood iron deficiency anemia (IDA) in the United States, aggregate programmatic data may not accurately represent the experience of particularly high risk groups, such as the children of adolescent mothers of low socio-economic status. METHODS: This study evaluated the prevalence and severity of childhood anemia and associated risk factors, at one urban teen health center serving primarily low-income adolescent mothers and their children. A total of 175 pediatric WIC charts were reviewed to abstract hemoglobin status and other data. Additionally, 81 mothers were interviewed with regard to their nutritional knowledge and feeding practices; these findings were compared with the measured hemoglobin (Hgb) of their children. RESULTS: A total of 34.9% of children in the study population were found to be anemic (Hgb 相似文献   

Relationship of Maternal Knowledge of Anemia with Maternal and Child Anemia and Health-Related Behaviors Targeted at Anemia Among Families in Indonesia

Our specific aim was to characterize maternal knowledge of anemia and its relationship to maternal and child anemia and to behaviors related to anemia reduction. We examined the relationship between maternal knowledge of anemia and anemia in the mother and the youngest child, aged 6–59 months, in 7,913 families from urban slums and 37,874 families from rural areas of Indonesia. Knowledge of anemia was defined based upon the mother’s ability to correctly name at least one symptom of anemia and at least one treatment or strategy for reducing anemia. Hemoglobin was measured in both the mother and the child. In urban and rural areas, respectively, 35.8 and 36.9% of mothers had knowledge of anemia, 28.7 and 25.1% of mothers were anemic (hemoglobin <12 g/dL), and 62.3 and 54.0% of children were anemic (hemoglobin <11 g/dL). Maternal knowledge of anemia was associated with child anemia in urban and rural areas, respectively (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.79, 1.02, P = 0.10; OR 0.93, 95% CI 0.87, 0.98, P = 0.01) in multivariate logistic regression models adjusting for potential confounders. There was no significant association between maternal knowledge of anemia and maternal anemia. Maternal knowledge of anemia was significantly associated with iron supplementation during pregnancy and child consumption of fortified milk. There was no association of maternal knowledge of anemia with child deworming. Maternal knowledge of anemia is associated with lower odds of anemia in children and with some health behaviors related to reducing anemia.     

Births, gestation and birthweights in South Tees 1990-1996

BACKGROUND: The UK government has specified that all health authorities are to develop local health improvement programmes. Birthweight and gestational age are important health determinants, and therefore indicators of the health status of children in a community. They also have important resource implications for health and social services. Data regarding birthweight and its relationship to gestational age are not routinely available. This paper describes the results of the measurement of the birthweights and gestational ages of children born to residents in a UK health district, and their relationship with deprivation. METHODS: Routinely collected birthweight and gestational age data for children born to parents resident in the South Tees district during the period 1990-1996 inclusive were downloaded from the community child health department mainframe computer. The data were analysed and compared with national standards. RESULTS: The analysis showed that, despite the high levels of deprivation, birthweights were close to or slightly above average for most gestational ages. However, when compared with the average district in England and Wales, 8 per cent more low-birthweight children, of which 42 per cent were less than 28 weeks gestation, were born in the area. Materially deprived mothers were more likely to give birth to pre-term and light for gestational age infants. CONCLUSIONS: This study has shown that it is now possible to use routine sources of information to monitor local trends in birthweight and gestation, and their relationship with deprivation.     

A retrospective cohort study of childhood immunisation status in northern Sydney

Abstract: A survey of their children's immunisation status was conducted among mothers of babies from a three-month birth cohort (January to March 1990) in the Northern Sydney Area in 1992. Its aims were to determine the uptake of immunisation in the area, to examine factors associated with immunisation status, and to assess agreement between the parent's reporting of this status and records of councils and general practitioners. Fifty-eight per cent of the questionnaires (1004) were returned. The full immunisation rate was 86 per cent, 14 per cent were partially immunised and only four children had received no immunisations. Between 74 per cent and 82 per cent of vaccinations were on time at two, four and six months; the rate dropped to 21 per cent at 12 months. Logistic regression analysis showed that premature babies are significantly more likely to be fully immunised, whereas children who have had a serious childhood illness, those with a single mother, or whose mothers are more highly educated, are significantly less likely to be fully immunised. There was 60 per cent agreement between the parent's report of immunisation status and a subgroup of 197 council and 82 general practitioner records. Although all councils in the Northern Sydney Area have a reminder system, most immunisations were found to be done in general practices (64 per cent), where reminder systems are not common.     

0~6岁儿童残疾与母亲孕前及孕期相关因素的关联

  目的  了解甘肃省0~6岁儿童在视力、听力、肢体、智力、孤独症以及多重残疾等6类残疾的患病情况,并分析母亲孕前及孕期健康状况等相关因素与儿童残疾的相关性。  方法  从甘肃省0~6岁儿童残疾筛查项目数据库中提取2017年1月1日-2017年12月31日数据并进行整理,采用Logistic回归分析模型对数据进行分析。  结果  203名(6.64‰)儿童被确诊为残疾,其中男童128名,现患率为7.2‰,女童75名,现患率为5.86‰。Logistic回归分析模型分析结果显示与儿童残疾相关的因素有12个,其中最主要的因素有早产自娩、既往分娩缺陷、孕前6个月服用过促进排卵药物、孕期疾病史有慢性呼吸系统疾病、居住地周围有排放环境污染物的化工厂及矿场、食用腌晒食品>350 g/周、室内经常有人吸烟(均为P < 0.05)。  结论  肢体残疾、智力残疾和视力残疾为重点预防残疾种类;母亲孕前、孕期的健康状况和生活习惯与儿童残疾的发生有关,提示女性应当注重孕期健康和饮食习惯,预防儿童残疾的发生。     

Racial Disparities in Children’s Health: A Longitudinal Analysis of Mothers Based on the Multiple Disadvantage Model

This secondary data analysis of 4373 mothers and their children investigated racial disparities in children’s health and its associations with social structural factors, social relationships/support, health/mental health, substance use, and access to health/mental health services. The study drew on longitudinal records for mother–child pairs created from data in the Fragile Families and Child Wellbeing Study. Generalized estimating equations yielded results showing children’s good health to be associated positively with mother’s health (current health and health during pregnancy), across three ethnic groups. For African-American children, good health was associated with mothers’ education level, receipt of informal child care, receipt of public health insurance, uninsured status, and absence of depression. For Hispanic children, health was positively associated with mothers’ education level, receipt of substance-use treatment, and non-receipt of public assistance. Implications for policy and intervention are discussed.     

Can mothers identify malnutrition in their children?

To assess mothers' perceptions about malnutrition and theirability to identify malnutrition in their own children, 339children aged 3–35 months and their mothers were studiedin two urban hospitals in Dhaka, Bangladesh, and in a communityclinic. The weight, height, and mid-upper arm circumferenceof the children were measured, and their mothers were interviewed.Child nutritional status according to their mother's statementand anthropometrically assessed nutritional status were compared.Sixty per cent of the mothers correctly identified better nutritionalstatus (weight/age >75% of NCHS median) and 67% mothers correctlyidentified malnutrition (weight/age < 75% of NCHS median)in their children. Sixty-one per cent of mothers with less than5 years of formal education correctly identified better nutrition(weight/age >75%) whereas 38% mothers with more than 5 yearsof education correctly identified better nutrition. Correctidentification of malnutrition was made by 70% of mothers withless than 5 years of formal education, and 74% of educated mothersdid the same. As regards causes of malnutrition, 33% of mothers stated thatlack of food at home resulted in undernutri-tion in their children(mean weight-for-age of these children was 65% of the NCHS median).Mothers' suggestions for improving child health were: betterfood in 31% cases; treatment of illnesses in 22% cases; andboth in 42% cases. The results suggest that most of the mothersare able to identify malnutrition in their children, and 95%of them are aware of ways to improve it, and that the provisionof adequate food and health care may improve child nutritionalstatus.     

Acute lower respiratory illness in under-five children in Rio Grande, Rio Grande do Sul State, Brazil: prevalence and risk factors

This study aimed to determine the prevalence of acute lower respiratory illness and to identify associated factors among children less than five years of age in the city of Rio Grande, southern Brazil. Using a cross-sectional survey, a standardized household questionnaire was applied to mothers or guardians. Information was collected on household conditions, socioeconomic status, and parental smoking. Prenatal care attendance, nutritional status, breastfeeding pattern, and use of health services for the children were also investigated. Data analysis was based on prevalence ratios and logistic regression, using a conceptual framework. Among 771 children studied, 23.9% presented acute lower respiratory illness. The main risk factors were previous episodes of acute lower respiratory infection or wheezing, crowding, maternal schooling less than five years, monthly family income less than US$ 200, four or more people per room, asthma in family members, and maternal smoking. Mothers 30 years or older were identified as a protective factor. These results can help define specific measures to reduce morbidity and mortality due to acute lower respiratory illness in this setting.     

Psychological health status of mothers and the admission of children to hospital for gastroenteritis

The prevalence of psychological distress was measured by the 30-item general health questionnaire in two populations of mothers: those who had children hospitalized for gastroenteritis and those who cared for children with gastroenteritis at home. Significant differences emerged, with mothers of hospitalized children reporting higher levels of psychological distress. There were no differences in severity of the children's illness between the two groups as indicated by blind ratings of symptomatology from six infectious diseases hospital doctors. Thus hospitalization of children for gastroenteritis was not contingent on medical symptomatology. Instead the evidence indicates that the psychological status of mothers may influence doctors' management decisions on childhood gastroenteritis. Significant positive associations between poor psychological status and poor social resources illustrate the social context in which maternal vulnerability may influence child health care generally. The impact of maternal psychological status on decisions about paediatric care is discussed.     

Determinant of factors associated with child health outcomes and service utilization in Ghana: multiple indicator cluster survey conducted in 2011

Background

The effects of National Health Insurance Scheme in Ghana and its impact on child health outcome and service utilization cannot be underestimated. Despite the tremendous improvement in child health care in Ghana, there are still some challenges in relation to how National health insurance membership, socioeconomic status and other demographic factors impacts on child health outcomes. The study seeks to determine the association between NHIS membership, socio-economic status, geographic location and other relevant background factors, on child health service utilization and outcomes.

Methods

Secondary data from the Multiple Indicator Cluster Survey conducted in 2011 was used. Multivariate analysis based on Binary Logistic Regression Models and Multiple linear regression techniques was applied to determine factors associated with child health outcomes and service utilization. Collection of best models was based on Hosmer-Lemeshow Goodness-Of-Fit as one criterion of fit and the Akaike Information Criterion.

Results

Controlling for confounding effect of socioeconomic status, age of the child, mothers education level and geographic location, the odds of a child developing anemia for children with National Health Insurance Scheme Membership is 65.2% [95% CI: 52.9-80.2] times less than children without National Health Insurance Scheme Membership. The odds of being fully immunized against common childhood illnesses for children with NHIS membership is 2.3[95% CI: 1.4-3.7] times higher than children without National Health Insurance Scheme Membership. There was no association between National Health Insurance Scheme Membership and stunted growth in children.

Conclusions

National Health Insurance Scheme Membership was found to be related to child health service utilization (full immunization) of children under five a child’s anemia status. Children with NHIS are more likely to be fully immunized against common childhood diseases and are less likely to develop anemia. Stunted growth of children was not associated with National Health Insurance Scheme Membership. Health Education on the registration and the use of the National Health Insurance should be made a national priority to enable the Ministry of Health achieve routine Immunization targets and to reduce to the bearers minimum prevalence of anemia.

     

AIDS in the family and community: The impact on child health in Malawi

Pediatric HIV infections jeopardize children’s health and survival. Much less is known about how the experiences of being orphaned, living with chronically ill parents, or living in a severely affected community impact child health. Our study responds by examining which HIV/AIDS-related experiences place children at greatest risk for poor health. Data from the 2004–2005 Malawi Integrated Household Survey were analyzed using logistic multilevel modeling to examine whether HIV/AIDS-related experiences within the family and community predicted reported health status among children age 6–17 years. We found higher burdens of acute and chronic morbidity for children whose parents have an AIDS-related illness. No other AIDS-related exposure, including orphanhood and recent household deaths, demonstrated a clear relationship with health status. Children living with sick parents may be at increased risk due to the spread of infectious disease and receiving limited adult care. Community home-based care programs are best situated to identify children in these difficult circumstances and to mitigate their disadvantage.     

北京市东城区2007-2011年0~6岁散居儿童营养发育状况研究

目的 探讨北京市东城区2007-2011年间0~6岁散居儿童营养状况的变化趋势,发现儿童健康管理中存在的问题,以采取相应的措施改善儿童的营养状况。 方法 对东城区2007-2011年5年散居儿童健康状况进行分析,采用SPSS趋势χ²检验儿童营养状况指标随时间的变化趋势。结果 全区0~6岁散居儿童营养不良(低体重、发育迟缓、消瘦)的患病率由2007年的1.159%下降为2010年的0.479%,2011年略有回升;3~6岁儿童的患病率高于0~2岁儿童;呈现逐年下降的趋势(P<0.05)。儿童贫血患病情况以轻度贫血为主,发病率介于3.08%到6.09%之间;中度贫血患病率介于0.23%到0.53%之间。肥胖患病率为介于3.08%和3.89%之间;0~2岁儿童贫血、肥胖的患病率高于3~6岁儿童。儿童贫血、肥胖患病率未表现出逐年下降的趋势(P＞0.05)。 结论1)全区儿童营养状况良好,儿童营养不良患病率呈下降趋势;2)应重点对0~2岁儿童进行肥胖和营养性贫血的干预,进行综合防治。     

CHARACTERISTICS OF HUMAN ECOLOGICAL,CHILD CARING PRACTICES AND NUTRITIONAL STATUS OF CHILDREN 0–60 MONTHS AND THEIR MOTHERS IN A LOWLAND BOLIVIAN COMMUNITY

A multifaceted, cluster-sample population survey was carried out among 600 children aged 0 to 60 months (mo) and their respective mothers or female caretakers in the province of Ichilo, Santa Cruz, in the lowlands of Bolivia. The purpose was to document attitudes, practices, and nutritional and health status on which to base cost-effective intervention strategies to reduce child morbidity and mortality. Rural poverty, perhaps less severe than in the Bolivian high altitudes, is found in Ichilo Province’s tropical lowlands. In children 0–60 mo, approximately one-fifth (22.5%) were severely stunted with rates increasing with age, 6.5% were severely undernourished, and 1.2% were severely wasted. Close to half (41.7%) of children (95% CI 37.7–45.6%) were anemic with rates lowest in the first semester of life (11.9%) and highest in the 2nd and 4th semesters (65.3%), tapering down to 22% by the 5th year. Forty percent of women were anemic. An infection prevalence of 62.1% was found in a subgroup of 131 children providing fecal samples and in 74.8% in the corresponding adults in the dyads. Fecal organisms found included protozoa (Entamoeba histolytica, Giardia lamblia) and helminths (Ascaris lumbricoides, Trichuris trichuria and hookworms). Breastfeeding was exclusive for 3 to 6 months, and 50% of children exclusively breastfed were completely weaned at 15 months. Almost 80% of the study group population experienced an episode of acute infectious illness every 2 weeks. Our findings indicate that cost-effective public-health interventions directed at anemia, growth faltering, recurrent infections, and intestinal parasites are warranted.     

Non-consulters and high consulters in general practice: cardio-respiratory health and risk factors.

The 1990 General Practitioner contract requires that health promotion and illness prevention services should be provided to all patients aged 16-74 years. Consultation rates over a period of three years were examined in 7010 middle-aged men in Great Britain to compare the cardio-respiratory health and risk factor status of non-consulters (men who did not consult in three years) with those of average consulters (men who consulted 3-5 times in three years) and high consulters (men who consulted 24 or more times in three years) to assess their relative need for health promotion and illness prevention services. The non-consulters (n = 1025) were remarkably similar to the average consulters (n = 1585) in health and lifestyle characteristics. The high consulters (n = 306) had a greater burden of ill-health and a less healthy lifestyle. Chest pain on exertion, chronic bronchitis, breathlessness or wheeze were present in 23 per cent of non-consulters, 27 per cent of average consulters and over 50 per cent of high consulters. Similarly, 48 per cent of the non-consulters smoked, drank heavily or were obese compared with 47 per cent of the average consulters and 61 per cent of the high consulters. The prevalence of recall of high blood pressure which had been diagnosed by a doctor rose from 6 per cent in non-consulters and 10 per cent in average consulters to 29 per cent in high consulters.(ABSTRACT TRUNCATED AT 250 WORDS)     

Children of mothers with mental ilness: attachment,emotional and behavioural problems

This study describes the pattern of emotional and behavioural difficulties of children whose mothers have mental illness, and explores the relationship between children’s behavioural and emotional difficulties and maternal perceptions of attachment. Thirteen mothers previously admitted to psychiatric hospital for mental illness completed a measure of their own symptoms (Brief Symptom Inventory), their children’s emotional and behavioural problems (Strengths and Difficulties Questionnaire (SDQ)), and attachment security (Parent/Child Reunion Inventory) (n?=?21). Mean scores for child SDQ profiles were found to be within the ‘normal’ range, although (on some indices) mothers reported more ‘case’ scores for their children, than would be expected from standardized norms. It was found that there were significant positive correlations between ‘insecurity’ scores and all problem scales of the SDQ. Best predictors from the Parent/Child Reunion Inventory factors for each SDQ scale are reported and discussed.     

上海某区学龄期儿童家庭功能现状及其影响因素研究

目的调查学龄期儿童家庭功能现状,探索相关影响因素,为学龄期儿童身心健康发展提供相关策略支持和指导。方法通过简单随机抽样选取上海某区四所小学,按照班级进行整群抽样,对抽取的1124名学生家长进行社会人口学信息、家庭亲密度与适应性量表调查。调查学龄期儿童的家庭基本状况和家庭功能。结果此次调查显示学龄期儿童家庭适应性得分(48.31±8.43)分,家庭亲密度得分(71.62±10.33)分;父亲受教育程度、父亲周末照看孩子的时间、家庭人均月收入、母亲周末照看孩子的时间、及是否留守儿童与儿童家庭适应性得分显著相关(P<0.05);父亲周末照看孩子的时间、家庭人均月收入、父亲受教育程度、母亲周末照看孩子时间、家庭类型及留守儿童与家庭亲密度得分显著相关(P<0.05)。结论学龄期儿童家庭功能影响因素较多,在针对儿童身心健康制定相应策略支持时应综合考虑家庭环境因素,特别是对特殊家庭功能的儿童进行重点干预。