Incidence of anaemia among scheduled caste pre-school children of Punjab

The incidence of anemia was investigated in 300 scheduled caste preschool children recruited from settlements in rural and urban areas of Amritsar and Faridkot districts of Punjab, India, during 1994-95. 165 children (55%) had hemoglobin levels indicative of anemia. 77 (25.7%) had mild anemia, 58 (19.3%) were moderately anemic, and 30 (10%) had severe anemia. The percentage of children without anemia was only 26.70% in the 1-2 year age group, compared with 62.22% among those 4-5 years old. Similarly, the incidence of severe anemia was highest (17.8%) in the youngest age group and lowest (6.6%) in the oldest age group. The high frequency of anemia among younger children, documented in other studies as well, is presumed to reflect inadequate knowledge on the part of scheduled caste mothers of the importance of iron-rich weaning foods.     

352名学龄前儿童饮食行为调查分析

儿童的饮食行为和习惯不仅影响儿童的生长发育,而且与成年后的健康及多种疾病的发生密切相关。为了解湖北省秭归县幼儿饮食行为情况,及时纠正幼儿的不良饮食习惯,2007年3月上旬,对该县城区12所幼儿园幼儿家长进行了调查。1对象与方法1.1对象该县城区12所幼儿园400名儿童。1.2方     

Patterns of antibiotic use among children in an urban Brazilian slum

Antibiotics are utilized excessively in many areas of the world. To better define how often and why these drugs are used, we prospectively studied antibiotic use among a cohort of 105 children less than five years of age in a poor area of the northeastern Brazilian city of Fortaleza. During a 16-week period, 65 children took 137 courses of antibiotics. Physicians recommended 54% of these, mothers or their associates 39%, and pharmacy workers 7%. Mothers and pharmacy workers recommended drugs for shorter courses than physicians, and were more likely to recommend drugs inappropriate for children. Duration of illness was not a risk factor for antibiotic use, but both poor nutritional status and poor socioeconomic status were. Health care seeking behaviour was further studied in 58 diarrhoea episodes. The type of care sought was related to the duration of illness. Overall, antibiotic use was very common and often inappropriate among children in this poor urban area. More controlled use might decrease the use of potentially dangerous drugs and the use of these drugs when no benefit is likely.     

Bacteremic typhoid fever in children in an urban slum, Bangladesh

We confirmed a bacteremic typhoid fever incidence of 3.9 episodes/1,000 person-years during fever surveillance in a Dhaka urban slum. The relative risk for preschool children compared with older persons was 8.9. Our regression model showed that these children were clinically ill, which suggests a role for preschool immunization.     

Malnutrition among children in an urban Indian slum and its associations

In a cross-sectional study in Bhopal, India, mothers and other family members were surveyed by questionnaire, then 1000 randomly selected slum children were clinically examined, to detect nutritional deficiency diseases. Anthropometric measurements were also taken. Malnutrition classification followed the Harvard classification (weight in relation to the age of the child) modified by the Indian Academy of Pediatrics. The weight of the children was recorded using the Avery personal weighing machine. Of the 1000 children, 520 were males and 480 were females almost matched in age and birth order. The prevalence of various nutritional deficiency diseases comprised: protein calorie malnutrition (63.4%), vitamin A deficiency (23.4%), vitamin B deficiency (16.2%), vitamin C deficiency (2.6%), vitamin D deficiency (9.4%), fluorine deficiency (2.9%), and anemia (7.2%). The prevalence of malnutrition was 65.0% among females compared to 61.9% in males (p 0.05). However, higher grades of malnutrition (III+IV) were 13.12% among females in comparison to 7.87% among males (p 0.05); whereas lower grades of malnutrition (I+II) were 54.04% among males and 51.87% among females (p0.05). The birth order of the children was positively associated with their grades of malnutrition (p 0.05). On the other hand, an inverse relationship was observed between birth interval and grades of malnutrition (p 0.05). The prevalence of malnutrition was significantly higher among those children whose fathers were illiterate (p 0.05). In general, as the literacy status of father increased, the prevalence of malnutrition among children decreased. The prevalence of malnutrition had a positive association (p 0.05) with children's family size: 3 members (47.0%), 4-6 members (63.9%), and 7 members and above (70.6%). On the other hand, an inverse correlation was observed between socioeconomic status and the prevalence of malnutrition (p 0.05). The prevalence of malnutrition was significantly (p 0.05) higher among the children with a history of infection (81.8%) and worm infestation (77.0%) in comparison to those without history of infection (13.1%) and worm infestation (61.9%), respectively. Similarly, nonimmunized children experienced more malnutrition (66.4%) in comparison to immunized children (57.0%).     

A prospective study of persistent diarrhea among children in an urban Brazilian slum. Patterns of occurrence and etiologic agents

Persistent diarrhea is a major health problem among children in developing areas of the world. Since few community-based studies have addressed the epidemiology or etiology of this condition, we undertook prospective diarrheal surveillance among a cohort of 175 children less than 5 years of age over a 28-month period in an urban slum in northeastern Brazil. Very high diarrhea illness burdens were found. The children in this cohort had an average of 11 episodes per year and spent 82 days per year with diarrhea. A total of 65% of children had at least one episode of persistent diarrhea (greater than or equal to 14 days duration). These episodes accounted for 50% of all days of diarrhea and 11% of all episodes. The occurrence of at least one episode of persistent diarrhea identified all children who spent at least 15% percent of days with diarrhea. Among children with and without diarrhea, rotavirus was the agent isolated most frequently, followed by Giardia lamblia and enterotoxigenic coliforms. The agents isolated from children with acute and persistent diarrhea were similar, which suggests that other factors must be operative in the development of persistent diarrhea.     

A profile of diarrhoea in an urban slum area

Researchers followed 90 households (445 people) in Sunderpur slum in Varanasi in Upper Pradesh, India for 1 year and collected stool samples when people were ill with diarrhea to determine diarrhea incidence and causes of diarrheal disease. The water supply consisted of a well, public tap, or house tap with 30 households in each group. They noted 106 diarrheal episodes for an incidence of around 23%. Incidence decreased significantly with age (p.001). For example, it was 62.9% for children 5 years old, 34% in the school age population, and 8.7% in people =or 15 years old. Improved resistance to infection and/or improved personal hygiene could have accounted for this difference. Diarrheal incidence was considerably lower in the autumn (9.3%) and winter months (11.1%) than the spring (49.1%) and summer months [rainy season] (30.5%) (p.001). Researchers found at least 1 parasite in the stool sample of 81.5% of cases. The leading causative agents included Ascaris lumbricoides (42.1%), Entamoeba histolytica (35.2%), hookworm (7.9%), and Escherichia coli (5.7%). Diarrhea incidence was much higher in persons whose water supply was a well (35.8%) compared to 23.2% for those with a public tap, and 12.8% for those with a private tap. These results concerning the water supply corroborated those of the Planning Research and Action Institute's (Upper Pradesh) pilot piped water supply program in the areas of Banki, Parendra, and Mokhampur in which incidence was highest in Banki where the water supply was an open well. The next highest and the lowest incidences were among those whose water supply consisted of public taps and private taps respectively.     

A comparative case study of handicap registers for pre-school children

A comparative study was made of two childhood registers operating on the concept of “handicap”. There were wide variations in both the incidence and prevalence rates of selected conditions including those of interest to educational services. The study demonstrated the need to extend surveillance beyond the first week of life to effectively monitor environmental hazards. Eighteen per cent of the handicapped children currently living in the area covered by one register were those who had migrated in during the study period; indicating the mobility of young families with handicapped children.     

Severe malnutrition in children presenting to health facilities in an urban slum in Bangladesh

Setting:

An urban slum in Kamrangirchar, Bangladesh.

Objectives:

Among children aged 6–59 months seeking medical care from the two Médecins Sans Frontières-supported primary health centres, to determine 1) the prevalence of severe acute malnutrition (SAM) and severe chronic malnutrition (SCM), and 2) the extent of overlap between SAM and SCM.

Design:

In a retrospective record review, data were analysed from out-patient registers on age, sex, height, weight and mid-upper arm circumference (MUAC) of children attending for medical care from April to September 2011. SAM was defined as weight for height < −3 Z scores of the median and/or MUAC <115 mm. SCM was defined as height for age < −3 Z scores of the median. World Health Organization growth standards were used as reference.

Results:

Data were complete in the records of 7318 (98%) children, of whom 322 (4%) had SAM and 1698 (23%) had SCM. Among the 322 children with SAM, 162 (50%) also had SCM.

Conclusion:

In an urban Bangladesh slum, SAM and SCM co-exist, with a predominance of SCM. The current national guidelines for severe malnutrition, which focus on identification and management only for SAM, urgently need to be expanded to include SCM if substantial childhood morbidity and mortality are to be reduced.     

Combination and adaptation of two tools to assess parental feeding practices in pre-school children

ObjectiveTo test a combined version of the Child Feeding Questionnaire and the expanded concept of parental control (“covert” and “overt”) among Portuguese preschool children.MethodsThe final questionnaire comprised 38 items and 9 subscales. The translated questionnaire was self-administered to 854 mothers of 4 year-old children from the Generation XXI birth cohort. Maternal and children's weight and height and socio-demographic characteristics were measured. The global goodness of fit was evaluated by confirmatory factor analysis. Cronbach's alpha was used to measure the reliability of subscales. Construct validity was tested for different dimensions.ResultsA 9-factor model was obtained, after excluding five “restriction” items and 1 “overt control” item, with a global goodness of fit (CFI = 0.961, TLI = 0.973, RMSEA = 0.057). Cronbach's alpha ranged from 0.684 to 0.889. Children's body mass index (BMI) was significantly and positively related with “perceived parental weight”, “perceived child's weight” and “concern about child's weight”, and inversely related with “pressure to eat”, supporting the theoretical hypothesis. Maternal BMI was positively related with “perceived parental weight”.ConclusionsOur study confirmed the usefulness of this questionnaire for Portuguese preschool children, and supports the need of reformulating the restriction dimension and keeping separately the overt and covert control dimensions.     

A study on some diarrhoea related practices in urban Mirzapur

In an operational research on the improvement of sanitation and water supply by an Indo-Dutch project at Mirzapur, UP, diarrhoeal morbidity was taken as an intermediate outcome variable for measuring the impact of the proposed intervention. In this study 350-410 under-five children were selected from 200 urban families of 3 slums and surveyed during 3 different seasons for 2 weekly recall of morbidity, treatment and feeding practices during diarrhoea. The prevalence of diarrhoea varied between 8.7% to 33%. Breast feeding was not restricted while other forms of feeding was continued in 57.1% to 66.3% of cases. Use of ORT increased significantly from 0% to 39.62% possibly as a result of health education. Reorientation of private practitioners to avoid use of unnecessary drug is suggested.     

A study of infant feeding practices in an urban Indian community

Thirty mothers, attending either a paediatric clinic at a Government hospital or a private paediatrician's surgery, both in Tirupati, Andhra Pradesh, South East India, were questioned about their infant feeding practices. A sample of milk from their child's bottle was requested and subsequently analysed for the presence of dilution. Over-dilution, defined as less than 75% of the standard concentration, was found to be common (P<.05). No significant correlations were found between the incidence of over-dilution and either family income or educational status of the mothers due to the small sample size. The study suggests the need for practical education on the reconstitution of milk feeds.     

A study on the epidemiology of brucellosis in Punjab (India) using Survey Toolbox

A random survey was conducted to study the epidemiology of brucellosis in Punjab (India), using the 'Survey Toolbox' sampling software. A two-stage sampling procedure was adopted: in the first stage, villages were selected, and in the second the selection of animals was made. In all, 52 villages were selected randomly from a sampling frame of all the villages of Punjab. The total number of animals in these villages was 18,644, out of which 973 animals (approximately 5%) belonging to various owners were randomly selected. Serum samples collected from the animals were screened for Brucella antibodies by an avidinbiotin enzyme-linked immunosorbent assay, which showed the apparent overall prevalence of brucellosis to be 12.09% (true prevalence, 11.23%). The prevalence varied from a low of 0% to a high of 24.3% in various districts. Higher variance (0.08) was noted within villages than between different villages (0.03). The prevalence rates among buffaloes and cattle were 13.4% and 9.9%, respectively. The seroprevalence of brucellosis was found to be significantly higher (chi square = 24.50, p < 0.001) in animals with a history of abortion (33.87%) than in those without such a history (11.63%).