Nutritional disorders among children below 5 years in a rural community

Summary 30.2 per cent of children examined had nutritional disorders and 80.3 per cent of these nutritional disorders were in the 6-months to 4-years age groups. Protein calorie malnutrition was found in 1.9 per cent of children. The common deficiency signs observed were pale conjunctiva (18.3 per cent), bleeding spongy gums (0.9 per cent) pigeon chest (0.9 per cent), Bitot’s spots (4.9 per cent); retarded growth and skin changes (1.9 per cent each). It was observed that the lower the social class, the higher was the incidence of nutritional disorders. The maximum number of cases (67.2 per cent) were seen in vegetarian families. 26.8 per cent cases had delayed milestones. Children of birth order III had the maximum incidence of nutritional disorders. 69.3 per cent of children were 15–30 pounds in weight and 64.3 per cent had a height of 18–30 inches. There was a highly positive correlation between height and weight of the children.     

Morbidity pattern in children below three years attending a rural health centre in Haryana

Morbidity pattern of children below three years attending a rural health centre was studied prospectively for one year. All children were first examined by a doctor and the diagnoses made were compiled and analysed. The common morbidity conditions found were pyoderma (23.65%), respiratory infection (21.18%), diarrhea (20.05%), unspecified fever (11.75%), ear infection (6.58%) and eye infection (5.46%). The maximum episodes of morbidity were recorded in summer season (39.22%) followed by rainy (31.36%) and winter season (30.16%).     

Immunisation status of children in BIMARU states

To assess the immunisation status of children in the states of Bihar, Madhaya Pradesh, Rajasthan and UP the evaluation covered BCG, DPT, OPV, Measles, Pulse Polio and Vitamin A. WHO 30 cluster survey methodology with certain modifications incorporating information on sex of the child, literacy of parents and distance of the village was used. Study covered 30 districts, 900 villages and 6300 children. About 48 per cent of children received all the vaccines (BCG, DPT, OPV, Measles) in these states as compared to 63 per cent at All India level. These states accounted for about 70 per cent of non-immunised children. The coverage levels were lower for children of illiterate mothers and in small, inaccessible and triple villages. The literacy of mother is the key to the success of the Universal Immunisation Programme (UIP). Information, Education and Communication (IEC) activities should specially be targeted to educate the moters in rural areas. The underserved areas of these four states should have special focus in the programme and hence the tribal, small and inaccessible villages in the coverage should be focused and targeted, immediate improvement in the coverage could also be achieved by better follow-up and reducing drop-out rate.     

Morbidity pattern among children below 5 years in an urban Sindhi community

Summary A morbidity study was carried out in 350 children below 5 years. Sindhi Colony, Raja Park on the eastern outskirts of Jaipur city was selected for study. The minimum number of children (14.3 per cent) was in the age group 48·60 months. 62.9 per cent of the children had one or more behavioural disorders. The leading problem was pico (47.1 per cent). Anajovity (78.0 pevrecehty of the children suffered from one or the other communicable disease. Acute respiratory infections (48.9 per cent). diarrhoea ond dvsentery (18.3 per cent), pneumoning (7.6 per cent) and worm infestation (6.2 per cent) were the leading causes of illness during the preceding twelve months. 27.1 per cent of children were found sick at the time of examination. From the S.M.S. Medical College, Jaipur-302004.     

Groin and scrotal swellings in children aged 5 years and below: a review of 535 cases

There is limited literature dedicated to the surgical problems of infants and childhood, especially diseases of the groin and scrotum, in the setting of sub-Saharan Africa. We do not know the morbidity and mortality rates associated with surgical conditions of the groin and scrotum in children of our sub-region. This study was carried out among children aged 5 years and below in a regional referral hospital in Kumasi, Ghana, to determine the surgical conditions of the groin and scrotum treated at elective surgery. Inguinal hernias constituted 74% of the children with groin and scrotal diseases; this was followed by hydroceles - 14.2%; then undescended testis - 10.5%; and inguinal lymphadenopathy - 0.7%. The rest were testicular abscess, seminoma and cystic lymphangioma, representing 0.2% each of groin and scrotal conditions treated in this hospital among this age group. The last three are rare conditions of the groin and scrotum as shown by our data. The recurrence rate after herniotomy was 0.7%. Orchidopexy was successfully performed in 89% of children with undescended testes; in 7.1% of cases, orchidectomy was carried out for rudimentary and small, dysplastic testes. Over 98% of the children with groin and scrotal surgical problems were treated on day-care basis. There were no recorded deaths in the series.     

Assessment of immunity status of primary school children against smallpox in a rural population of Bundelkhand

Summary An investigation on smallpox vaccination scars and smallpox pock-marks, covering 1,055 children in 11 primary schools of a Bundelkhand rural community, was carried out during April to November 1976 with the view of studying, amongst the primary school children, the group susceptible to smallpox in the area. Analysis revealed a vaccination scar-rate of 92.98 per cent and smallpox scar (podk-marks) rate of 2.56 per cent. About 6 per cent (5.78%) children were observed to be susceptible to the disease. A need for carrying out such scar-surveys in various pockets of the area has been emphasized. From the Department of Social and Preventive Medicine, M.L.B. Medical College, Jhansi, U.P. Paper presented at 7th Annual Conference of Indian Association of Preventive and Social Medicine, held at G.S.V.M. Medical College, Kanpur, during 4–6, January, 1977.     

Immunisation status of children in Germany: temporal trends and regional differences

In Germany, a low coverage with hepatitis B and measles vaccines and a considerable delay in administration of all recommended vaccines were previously apparent. Whether there have been improvements and whether there are regional differences within Germany is not known. Using representative nationwide telephone interviews on 2,701 children born 1996–2003, we assessed vaccination coverage for the first dose or full primary series (2/3 doses, depending on vaccine used) at 24 months of age. The proportions vaccinated with the first dose, full priming and full immunisation (2/3 doses plus booster in the 2nd year of life) until the end of the recommended age (3, 5 and 15 months, respectively, for diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b (Hib) and hepatitis B vaccines (DTPPolioHibHep), and 15 for the first measles, mumps and rubella dose (MMR) were used as indicators of compliance with national guidelines. Coverage for polio, Hib and hepatitis B vaccines increased, while coverage for the first MMR dose remained constantly low at about 70%. Vaccination coverage differed substantially among the German states and was highest for the new states. Compliance with national guidelines increased from 2.5% to 15% for the full primary DTPPolioHibHep series, from 16.2% to 44.7% for the first MMR dose and from 1.0% to 19.3% for the full immunisation with all recommended vaccines (DTPPolioHibHepMMR). Conclusion:Vaccination coverage at 24 months and compliance with national guidelines has improved for most vaccines in Germany. However, improving coverage for measles, mumps, rubella and eliminating the regional disparities remain a major challenge for the public health sector.This study is part of a project evaluating vaccine effectiveness against Haemophilus influenzae type b which is financially supported by Aventis Pasteur MSD and GlaxoSmithKline Biologicals.     

Culture appropriate indicators for monitoring growth and development of urban and rural children below 6 years.

In this cross sectional study, 2000 apparently normal children aged 0-6 years (1200 urban and 800 rural), were nutritionally and developmentally assessed and their environment scrutinized for possible risk factors. Measurement of mid upper arm circumference (MUAC) using standard techniques revealed malnutrition in 44% of the rural and 24% of the urban children especially in the 2-6 years of age group. Culture appropriate indicators of psycho-social development picked up gross delays in gross motor (GM), vision and fine motor (V&FM) and language skills. Self help, concept hearing (SHCH) skills were recorded as normal while social skills were advanced particularly in the 0-2 years old urban group. By the use of the family protocols, low socio-economic status, malnutrition and 9 other risks factors have been generated for the urban group. No risk factor could be identified for the rural group. Better income emerged as the only real protective factor for the sample showing a direct positive relationship with the 45 skills tested, especially in the 2-6 years age group. Nineteen developmental skills were identified as powerful predictors of development. A prototype home based screening record was constructed for monitoring of growth and development which can be even used by minimally trained primary care worker.     

Epidemiological aspects of nutritional anaemia in children below five years

Summary A survey of children from the rural and urban communities around Kanpur revealed that 12.7 per cent of children had anaemia. Clinically, the prevalence of anaemia was found to be high in the 6 months to 2 years age group, in familiess and in rural children. Children from families of low economic status; those who were top fed and had associated gastrointestinal or respiratory illness, were affected more often than others. The mean haemoglobin of urban children was more than that of the rural group. From the Departments of Social and Preventive Medicine, Medical Colleges, Agra and Kanpur, and the Unit of Statistics and Demography, Dept. of Gynaecology, S.N. Medical College, Agra.