Vitamin D status in Sri Lankans living in Sri Lanka and Norway

Vitamin D deficiency is common in non-Western immigrant groups living in Western countries. A comparison of vitamin D status in individuals who have emigrated and individuals who remain in their country of origin is needed in order to provide information about the effect of moving to northern latitudes. A total of 196 participants aged 30-60 years in a cross-sectional population-based study in Kandy, Sri Lanka (latitude 7 degrees north) and 242 Sri Lankans aged 31-60 years participating in a cross-sectional population-based study in Oslo, Norway (latitude 60 degrees north) were included in the analysis. All serum samples were analysed for serum 25-hydroxyvitamin D (s-25(OH)D) in the same laboratory. Sri Lankans living in Norway had substantially lower s-25(OH)D (mean 31.5 nmol/l) compared with those living in Sri Lanka (mean 54.2 nmol/l), and the prevalence of s-25(OH)D < 25 nmol/l was 9.3 times higher (95 % CI 4.4, 19.6) in Norway compared with Sri Lanka. In Sri Lanka there was a clear seasonal variation with the lowest s-25(OH)D levels in August-September and the highest levels in November-December. We conclude that vitamin D status among Sri Lankans living in Kandy, Sri Lanka was considerably higher than that among Sri Lankans living in Oslo, Norway. The low vitamin D status commonly observed in non-Western immigrant groups living at northern latitudes should not be regarded as normal levels for these groups. However, also in Sri Lanka we found a profound seasonal variation with the lowest levels in August and September after the Monsoon.     

Menstrual Problems and Health Seeking in Sri Lanka

Menstruation is associated with some morbidity, although it is a normal physiological event. In this article, we draw on qualitative research conducted in Sri Lanka in 2006–2007, which included eight key informant interviews with healthcare providers, six focus group discussions with eight women in each, and five case studies. We describe and analyze women's perceptions of menstruation and menstrual problems, their help-seeking behaviors to reduce these health problems, and the consequences of them on their lives. The majority of women perceived menstruation as a physiological process and related problems to changes in hormone levels, pathological conditions of the uterus, and the side effects of contraceptive methods. Menstrual problems significantly affected their daily activities, mental well-being, social life, and sexual life, but few sought medical advice to resolve these problems. Implications of the findings included the need for health care providers and educators to provide accurate information on menstruation to girls and women to enable them to identify normal variation of menstruation and to take appropriate action regarding health care.     

Health and health services on plantations in Sri Lanka

Sri Lanka is an example of a country which has achieved impressiveimprovements in health status since Independence despite itslow income per head. However, the improvement has been uneven,with plantations consistently lagging behind. Most of the estateworkers in Sri Lanka are Indian Tamils who have traditionallybeen economically disadvantaged and politically isolated, apattern which began under the colonial pattern of recruitmentand management Poverty, overcrowding, poor water and sanitationand health services were all reflected in the low health statusof estate workers and their families. However, since nationalizationin 1975, there has been considerable investment on estates and,with the introduction of a uniform health policy designed tomeet the needs of estate workers, the health status of workersand their families has dramatically improved. Interventionshave included components on housing, water supply and sanitationas well as health and child care and have been planned withthe involvement of the workers. The components which have broughtabout the improvements were specificially designed to meet theneeds of plantation workers and developed within a structurequite different from that which applies in rural peasant areas.It is possible that a separate structure responsive to the specialproblems on estates is needed if Health for All is to be a realityin plantations.     

Vitamin A status of children in Sri Lanka.

A representative country-wide rural nutrition status survey determined the extent and distribution of vitamin A deficiency in Sri Lanka in children 6 through 71 months of age. Trained paramedical personnel recorded the presence or absence of selected ophthalmological signs and symptoms associated with vitamin A deficiency in 13,450 children. The results of the country-wide clinical survey indicate that a vitamin A deficiency problem of public health importance may exist in two of 15 health areas. Serum vitamin A levels were determined on 346 survey children from two of 15 health areas and compared with clinical findings for these areas. The lowest mean serum vitamin A, 26.3 microgram/100 ml, occurred in children with clinical eye findings. A high prevalence of clinical eye findings, 34%, and the low mean serum vitamin A value, 28.2 microgram/100 ml, were found in the group of chronically undernourished children--children who are less than 90% of their expected height for age. The survey results enabled planned redirection of the distribution of vitamin A capsules to preschool children in Sri Lanka to areas shown to have the highest prevalences of ophthalmological signs and symptoms and/or the highest prevalence of chronic undernutrition.     

Effects of Pollution on Health of Residents in an Industrial Area in Sri Lanka

The authors conducted a cross-sectional comparative prevalence study to evaluate the effect of pollution on individuals who lived in an industrial zone in Sri Lanka. In this study, 81 male and female children who were 1-12 yr of age and 158 adults (51 males, 107 females) in the industrial zone were matched with 73 children (32 males, 41 females) and 146 adults (58 males, 88 females), respectively, who lived in a nonindustrialized area and whose ages were similar to those of the exposed individuals. The authors used a pretested questionnaire and a detailed clinical examination, including peak expiratory flow rate measurements, to assess the prevalence of illness. Children in the industrial area were 2.3 times more likely to have unexplained episodic cough (95% confidence interval [Cl] = 0.98, 10.3) and 2.8 times more likely to have rhinitis (95% Cl = 1.1, 7.1). The adult population was 2.1 times more likely to have unexplained episodic cough (95% Cl = 1.13, 7.09), 3.7 times more likely to have unexplained headaches (95% Cl = 2.2, 6.3), and adults had a significantly greater reduction in expiratory flow (peak expiratory flow rate = 446 - 92x [industrial area] + 91 x [male] - 0.8x [years lived in the area]).     

Health status and care of the urban elderly]

In order to investigate the health and care of the urban elderly, self-administered anonymous questionnaires were sent to a sample randomly selected from the elderly 70 to 89 years of age, in 3 different areas (central, residential and suburban) in Wakabayashi-Ward in Sendai. Responses from 1,248 were returned by mail (response rate = 76.4%) and results were compared to the expected values estimated from the results of investigations conducted by the Ministry of Health and Welfare. 1) As for present addresses of the elderly, 94.2% were at home, 3.8% in hospitals, 0.7% in nursing homes, and 1.3% in other facilities. 2) Responses showed that 28.4% were suffering from hypertension, 5.6% from diabetes mellitus, 2.2% from strokes and liver diseases, with all of these percentages similar to the respective expected values. However, 12.7% were suffering from heart disease which was over twice the expected value. 3) Analysis of health habits showed that the percentages of the elderly who had "good sleep and rest", "nutritious meal", and "moderate exercise" were higher than expected. Only 2.3% did not practice good health habits, which was one sixth of the expected value. 4) As for meal habits of the elderly, 88.3% had three meals a day, and 33.7% made efforts to take less salty foods. 5) Dietary habits of the elderly indicated that 83.8% were frequent consumers of meat, fish and soybeans products, 62.3% vegetables, 51.0% sweet confectionery (significantly higher), 49.2% milk (significantly higher), 22.3% fried foods like tempura (significantly higher), and 22.3% salty vegetables (significantly lower).(ABSTRACT TRUNCATED AT 250 WORDS)     

社会经济特征、社会支持对城市社区老年人死亡态度的影响研究Symbol`@@

目的 分析城市社区老年人死亡态度的现状及其与社会经济特征、社会支持的关系,为社区老年人死亡教育干预工作提供依据。方法 采用两阶段随机抽样抽取成都市990名老年人进行调查,应用结构方程模型探讨社会经济特征、社会支持对社区老年人死亡态度的影响及作用路径。结果 67.58%的老年人对死亡持接受态度;在老年男女性的路径中,老年男性的家庭人均月收入（P=0.007,β=0.119）和原职业(PSymbol|@@0.001,β=0.180)对死亡态度有直接作用,而文化程度（P<0.001,β=0.127）对死亡态度产生间接作用;老年女性的原职业对死亡态度同时有直接效应（P=0.018,β=0.101）和间接效应（P=0.001,β=0.007）,其中家庭人均月收入（P=0.001,β=0.039）和文化程度(PSymbol|@@0.001,β=0.094)对死亡态度仅有间接作用。社会支持对不同性别老年人的死亡态度均有直接影响和中介作用。结论 城市社区大部分老年人的死亡态度较积极;社会经济特征、社会支持与其死亡态度相关且存在性别差异,提示社区死亡教育干预应重点关注社会经济特征、社会支持因素对老年人死亡态度的影响。     

Low folic acid status and its association with anaemia in urban adolescent girls and women of childbearing age in Sri Lanka

Folic acid deficiency is implicated in the aetiology of nutritional anaemia and adverse pregnancy outcomes for the fetus. Data on folic acid status among adolescent girls and non-pregnant, non-lactating young women are limited. We assessed folic acid status in a random sample of 552 subjects (277 adolescent girls aged 15-18.9 years and 275 women aged 19-30 years) living in Colombo, Sri Lanka. The association of low folic acid status with anaemia was evaluated. Socio-economic, food intake and anthropometric data were obtained. Hb, serum folic acid, vitamin B12 and ferritin and plasma homocysteine concentrations were measured. Forty-three per cent of subjects studied had low serum folic acid concentrations (<3 ng/ml) and 47 % had low Fe stores (serum ferritin <20 microg/l). Overall prevalence of anaemia was 12.9 %, and 43.9 % of anaemic subjects had both low folic acid status and depleted Fe stores (serum ferritin <12 microg/l). Both low folate status and depleted Fe stores were significantly associated with anaemia (odds ratio = 2.32; 95 % CI 1.34, 4.01 and odds ratio = 5.98; 95 % CI 3.36, 10.63, respectively). Serum folic acid concentration was associated (r = 0.108, P = 0.015) with folate intake as indicated by a computed folate index. Folate index was associated inversely with household size and positively with economic status and education level. In this study population low folic acid status, besides depleted Fe stores, was associated with anaemia. The high prevalence of low folic acid status observed highlights the need for nutrition education to improve intakes of folate, Fe and other micronutrients among adolescent girls and young women.     

宁夏城市职业人群健康状况及影响因素分析

目的了解宁夏回族自治区城市不同人群健康状况及影响因素。方法采用多阶段分层抽样方法,按照公务员、科研人员、企事业管理人员、教师、医生、体力劳动者6类职业人群随机抽取若干单位,对18~60岁职业人群进行健康状况问卷调查并进行评估。结果调查对象自测健康评定量表总分为(69.86±11.74)分,生理健康、心理健康、社会健康子量表得分分别为(74.14±12.45)、(64.15±15.65)和(70.74±14.48)分;50~60岁生理健康评定量表得分最低,18岁~年龄组心理和社会健康量表得分较低;6类职业中,企事业管理人员量表总分最高,为(72.52±11.39)分,体力劳动者最低,为(63.70±10.55)分,6类人群比较差异有统计学意义(F=268.14,P<0.05);受教育程度、家庭人均月收入、婚姻状况、职业是自测健康状况的影响因素。结论不同年龄、不同职业人群的自测健康状况差异较大。     

Health status of elderly population in rural area of Varanasi district

In order to assess the health problems of the elderly people and its relationship with advancement of age, a field based cross sectional study was carried out in two selected villages in the rural field practices area in Varanasi district. 88.8 % were found to suffer from one or more illness at the time of study. This resulted in the morbidity load of 1.93 illnesses per person. The morbidity was directly proportional to the age. The most common morbidity was arthritis with overall prevalence of 57.08% followed by cataract (48.33%), hypertension (11.25%). But the prevalence of old age related morbidities increased with advancing age (p<0.008). Compared to married people higher percentage of widow / widower (91.5%) suffered from old age related morbidities (p<0.01).     

Endemic goitre in Sri Lanka

This survey examined 59,158 children from 87 schools in 17 out of 24 districts in Sri Lanka for goitre. The overall prevalence rate was 18.8%: 23.2% for girls and 14.0% for boys. Prevalence in districts varied from 30.2% in Kalutara to 6.5% in Matale. It was higher in rural than urban areas, and in inland than coastal areas. The sex ratio of prevalence rates was directly related and the ratio of palpable to visible goitre was inversely related to the severity of the endemic. It is suggested that for a rapid epidemiological assessment when the latter ratio is less than four, it is indicative of endemicity for public health purposes and calls for intervention. The iodination of salt is both practical and feasible in Sri Lanka.     

Vitamin status, immunity and infections in an elderly population

The relations between vitamin status and immunological parameters or number of infections have been investigated in self-sufficient healthy individuals aged 60 and over. A total of 411 subjects agreed to participate, but 202 were discarded from the main statistical analysis since they could have had their immune or nutritional status modified by a recent infection, vaccination or drug consumption. Plasma concentrations of retinol, alpha-tocopherol, ascorbic acid and vitamin B6 were determined. Three indices of cellular immunity were measured: percentages of T-cell subsets, lymphoproliferative response to phytohaemaglutinin and delayed-type hypersensitivity to 7 ubiquitous antigens. A questionnaire about past infections was presented. Two results, supported by previous experimental observations, should be underlined. Vitamin B6 status was positively related to percentages of T-cell subsets: the lowest percentages of CD5 and CD4 cells were observed in the low B6 status group (50.6 and 32.6 per cent) and the highest percentages in the high B6 status group (62.0 and 41.0 per cent), with intermediate values in the medium group (57.6 and 39.5 per cent). Vitamin E status was negatively related to the number of past infections: subjects with a high alpha-tocopherol plasma concentration had fewer infections during the last 3 years (1.0) than those with a medium (2.2) or a low (2.3) concentration. In spite of these two observations, cellular immunity did not seem to be strongly related to vitamin status in the supposedly healthy population studied.     

Nutritional status and oxidative stress in an elderly Sardinian population

Weight loss and overweight/obesity-frequent consequences of malnutrition-may impair functional status and worsen concomitant morbidities in the elderly, often through changes in oxidative balance. In order to verify the relationships between these factors, a group of elderly people living on the island of Sardinia (Italy) underwent health and nutritional status assessment and oxidative balance evaluation. The elderly subjects had significantly higher d-ROMs test and body mass index (BMI) values than controls (d-ROMs 325.4 ± 66.3 vs. 295.4 vs 58-9 CARR U, p = 0.006; BMI 28.0 ± 4.6 vs. 21.7 ± 1.4 kg/m², p < 0.0001). The risk of malnutrition in the elderly subjects was evaluated with the Mini Nutritional Assessment (MNA), which showed that 32 of the 111 elderly subjects (28.8%) were at risk of malnutrition, of whom 11 (34%) were overweight and 10 (31-2%) obese. Oxidative stress was negatively and significantly correlated with nutritional status. Oxidative stress may precede malnutrition, even in the absence of weight loss. Routine evaluation of nutritional status and oxidative balance in the elderly may help identify an early risk of malnutrition so that treatment can be personalized.