肺结核原发综合征32例

目的 提高对儿童肺结核原发综合征的诊断水平,降低该病的误诊率.方法 对肺结核原发综合征32例的临床和影像资料进行回顾性分析.结果 本组2例(6.2%)接种过卡介苗,另外30例(93.7%)未接种卡介苗.有开放性肺结核患儿接触史22例(68.7%).咳嗽13例(40.6%),伴喉间痰鸣和(或)气喘9例(28.1%),食欲缺乏6例(18.7%),消瘦、盗汗、倦怠、乏力23例(71.8%),伴皮疹2例(6.2%).反复高热7例(21.8%),低热16例(50.0%),肺部可闻及干湿啰音11例(34.3%),呼吸音减弱12例(37.5%).白细胞总数升高12例(37.5%),痰涂片和培养阳性11例(34.3%),结核菌素试验阳性27例(84.4%).影像学检查28例(87.5%),均符合肺结核原发综合征影像学改变.结论 儿童肺结核原发综合征以1岁以下婴幼儿多见,结核接触史、卡介苗接种史及结核菌素试验是诊断的重要参考依据.肺内实质病变伴肺门或纵隔淋巴结大是儿童原发肺结核的基本影像学特征.     

The expanded programme on immunization (EPI) in Ondo State, Nigeria

The Expanded Programme of Immunization in Ondo State, Nigeria, which began in 1978 has been reviewed. Non-availability of constant electrical supply needed to keep vaccine at their original potency, shortage of trained health manpower, administrative shortcomings and lack of proper health education have been identified as some of the factors hindering effective implementation of the programme.     

Iodine Deficiency Disorders Among Primary School Children in Eastern Nepal

Objective  

To assess the iodine status among primary school children of Dhankuta and Dharan in eastern Nepal.     

Respiratory Symptoms and Asthma in Primary School Children in Kuala Lumpur

In a Cross-sectional Study of 7 to 12-year-old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor-diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor-diagnosed asthma) was 13.8%, 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor-diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p<0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phelgm (p<0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor-diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor-diagnosed allergy before the age of 2 years.     

Blood Pressure Standards for Shiraz (Southern Iran) School Children in Relation to Height

Objective

This study aims at providing local reference values for blood pressure by height and determining distribution pattern of systolic and diastolic blood pressure in 6.5-11.5 elementary school children for the first time in Shiraz (Southern Iran).

Methods

Height, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured with standard methods in 2270 healthy school children (1174 boys, 1096 girls) who were selected by multi-stage random sampling in 2003-2004 academic years. We produced blood pressure percentiles by height percentiles using Healy-Rasbash-Yang method.

Findings

The blood pressure (both systolic and diastolic) tends to increase with age, but after adjusting the measurements for height no significant correlation was found between either systolic blood pressure or diastolic blood pressure and age (r=-0.03 and P=0.15 for systolic blood pressure, r=-0.005 and P=0.8 for diastolic blood pressure). Then systolic and diastolic blood pressure percentile values by age and height percentiles, and blood pressure smoothed centiles by height in 6.5-11.5 years school children were derived.

Conclusion

Due to genetic, cultural and environmental differences among populations, it is suggested to use local blood pressure standards in Iran. We produced blood pressure percentiles by height instead of age because it seems that it would lead to better evaluation for real hypertensive diagnosis.     

Calcium Intake,Major Dietary Sources and Bone Health Indicators in Iranian Primary School Children

Background:

Adequate calcium intake may have a crucial role with regards to prevention of many chronic diseases, including hypertension, hypercholesterolemia, different types of cancer, obesity and osteoporosis. In children, sufficient calcium intake is especially important to support the accelerated growth spurt during the preteen and teenage years and to increase bone mineral mass to lay the foundation for older age.

Objectives:

This study aimed to assess daily calcium intake in school-age children to ensure whether they fulfill the FGP dairy serving recommendations, the recommended levels of daily calcium intake and to assess the relationship between dietary calcium intake and major bone health indicators.

Patients and Methods:

A total of 501 Iranian school-age children were randomly selected. Calcium intake was assessed using a semi-quantitative food frequency questionnaire. Bone health indicators were also assessed.

Results:

Dairy products contributed to 69.3% of the total calcium intake of the children. Daily adequate intake of calcium was achieved by 17.8% of children. Only 29.8% met the Food guide pyramid recommendations for dairy intake. Dietary calcium intake was not significantly correlated with serum calcium and other selected biochemical indicators of bone health.

Conclusions:

The need for planning appropriate nutrition strategies for overcoming inadequate calcium intake in school age children in the city of Tehran is inevitable.     

Ecological Framework for Primary School Attainment in Ethnic Minority Children in Bangladesh

Ecological framework suggests that poor family socieconomic status and school social capital have negative influences on young children’s proper development, social well-being, and primary school attainment. Using representative sample (young children) aged 5–12 from northwestern primary schools this study examines whether or not family (origin of family, lower socioeconomic status, limited resources), and poor school social capital (language problem, poor social relation with classmate and teacher, and teacher punishment in classroom) are significantly related to primary school attainment (late enrollment and irregular class attendance) in tri-ethnic (e.g., Santal, Oraon & Hindu) children in rural Bangladesh. Applying binary logistic regression results indicate that late enrollement and irregular class attendance are significantly associated with their poor family SES and school social factors. Of the predicting factors, ethnic identity is positively related to late enrollment and irregular class attendance, but lower family income is negatively related to late primary school enrollment. In addition, landlessness and teacher’s punishment are negatively linked to irregular class attendance among the ethnic children in rural Bangladesh. Despite some limitations: randomization and causal or interaction effects of family and school factors by ethnic identity on children’s primary school attainment, the findings may have social policy implications in tri-ethnic children’s primary school attainment, improving ethnic identity status, family SES, and school social capital.     

The Implication of Early Childhood Malnutrition for Age of Entry into Primary School in Nigeria

Using the 2010 Nigeria DHS EdData Survey (2010 NEDS), this research examines the association of early childhood malnutrition and its interaction with female gender, residence in northern Nigeria, rural areas, and/or life in poverty on the age of entry into primary school. Specifically, it investigates whether these relationships vary by maternal education and child’s age bracket. The multi-level linear regression results show that early childhood malnutrition increases the age of entry into primary school, particularly for rural children, children living in poverty and children whose mothers have less than a secondary school education. The results also indicate that regardless of a child’s age bracket, the interaction of early childhood malnutrition and poverty increases the age of entry into school; however, among children seven and older only, the combination of early childhood malnutrition and living in rural areas increases the age of entry into primary school. These findings show that developmental, human capital and economic theories are applicable to the discussion of early childhood nutrition and education in Nigeria. Policies to address the nutritional needs of children must focus on improving the socioeconomic status of households, in conjunction with inclusion of early childhood education and nutrition programs.     

Prevalence of Dental Fluorosis Among Primary School Children in Rural Areas of Karera Block, Madhya Pradesh

Objective

To determine prevalence and severity of dental fluorosis in school going children of ten villages of Karera block of Shivpuri District, Madhya Pradesh.

Methods

Fluoride ion concentration was measured in ten hand pump and two wells waters with a fluoride meter (ORION model 720). For the study total 750 school children were selected from ten government primary schools of ten rural villages. The survey was conducted during the period of November 2007 through December 2009. The dental and oral examination was done by two trained dentists. The occurrence and severity of dental fluorosis was recorded using Dean’s index.

Results

Drinking water sources considered for study were hand pumps, and wells. Out of 750 children surveyed, 341 were found affected with dental fluorosis. The boys had greater prevalence (46.75 %) as compared to girls (42.18 %). Dental fluorosis, as assessed by Dean’s Index shows that 20.8 % children had grade I, 19.47 % grade II, 5.2 % grade III. Overall, 45.46 % of the sample showed some grades of dental fluorosis.

Conclusions

In all the 144 water samples from ten villages fluoride level was higher than permissible limits. The boys had greater prevalence of dental fluorosis over the girls.