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Biomedical subjects

H W Voorhoeve

Publications and source records attributed to H W Voorhoeve.

At least 19 recordsLinked to original sources

Physical growth of children under five years of age in Nchelenge, Zambia: results from a district survey.

This study focuses on the physical growth of children aged 0-60 months in Nchelenge District, northeast Zambia. By means of a two-stage clustered and random sampling method, 193 households were selected. Weight, height, and mid-upper-arm circumference (MUAC) of children 0-60 months were measured. Underweight, stunting, and wasting were defined as weight for age, height for age, and weight for height (W/H), respectively, < or = 2 z scores below the median of the National Center for Health Statistics (NCHS) reference population. Among 250 children, prevalence rates of 30% underweight, 69.2% stunting, and 4.4% wasting were found, with the highest rates at age 12- < 24 months. Prevalence of stunting, underweight, and wasting in children aged 0- < 6 months and 6- < 12 months suggested that a substantial proportion of infants were premature and/or small for gestational age. The literature suggests that prematurity and intrauterine growth retardation may be quite common in Africa, and this may have important implications for the interpretation of growth data and under nutrition rates. Use of the MUAC < 125 mm as an indicator of wasting resulted in higher estimates of wasting compared to W/H < or = -2 z scores, and seemed unsuitable as a screening test for wasting in this Zambian population.

Aging

Absolute values or Z scores of mid-upper arm circumference to identify wasting? Evaluation in a community as well as a clinical sample of under fives from Nchelenge, Zambia.

The purpose of the study was to compare the use of absolute cut off values of the mid-upper arm circumference (MUAC) with age- and sex-adjusted z scores of the MUAC in the identification of acute undernutrition (wasting) in children up to 60 months of age. In Nchelenge, northern Zambia, 275 children from the community, selected by a two-stage cluster sampling procedure, and 105 hospitalized children with protein energy malnutrition (PEM) individually matched for age, sex, village and under-five clinic attendance with 104 controls, were clinically and anthropometrically (weight, height, MUAC) examined. zScores for weight for height and MUAC were calculated and PEM was classified according to a modified Wellcome scheme. For community prevalence rates of wasting in various age groups, MUAC < or = -4 z scores more closely paralleled W/H < or = -2 z scores than MUAC <125 mm. To identify individual children with wasting, MUAC < or = -2 z scores gave a better sensitivity than MUAC <125 mm. In hospitalized PEM children, z scores appeared to offer no advantages over absolute MUAC values in identifying the presence of wasting. Applicability of the MUAC and optimal cut off values may differ according to the setting in which the MUAC is to be applied.

Anthropometry

Differences in physical growth of Aymara and Quechua children living at high altitude in Peru.

Physical growth of Amerindian children living in two Aymara and three Quechua peasant communities in the Andean highlands of southern Peru (altitude 3,810-3,840 m) was studied, taking into account differences in the microclimate, agronomic situation, and sociodemographic variables. Anthropometric measurements were taken in 395 children aged under 14 years of age in a sample of 151 families in these communities, who were surveyed for sociodemographic variables as well. Data on the land system were available for 77 families. In comparison with reference populations from the United States (NCHS) and The Netherlands, stature, weight, head circumference, and midupper arm circumference (but not weight for stature) in the sample children were reduced. Growth retardation increased after the age of 1 year. Stature and weight in the present sample were very similar compared with previously published data on growth of rural Aymara children living near Lake Titicaca in Bolivia. Head circumference, midupper arm circumference, and weight for stature were significantly larger in Aymara children compared with Quechua children. Land was significantly more fragmented in Aymara compared with Quechua families, but amount of land owned was not different. Perinatal and infant mortality was elevated in Aymara vs. Quechua communities. Most families in Aymara communities used protected drinking water. One Quechua community had a severe microclimate, grim economic outlook, and weak social cohesion. Children in this community showed significant reductions in weight and midupper arm circumference compared with their peers in the other communities. We conclude that (presumably nutritionally mediated) intervillage and Aymara-Quechua differences in childhood physical growth existed in this rural high-altitude population in Peru and were associated with microclimate and the village economy, sociodemographic factors, and differences in the land system.

Adolescent

Growth of under five-year-old children in Kyeni, Kenya.

During a three-months period a cross-sectional study of the measurements of head circumference, mid-upper-arm circumference (MUAC) and weight was performed in 515 under five-year-old children in Kyeni, Kenya. Growth of Kyeni children seems to develop according to international standards for weight-for-age, MUAC-for-age and head circumference and for all parameters the average remains above minus 2 SD of the standard. Despite the presence of anthropometric malnutrition and downward trend in weight-for-age, MUAC-for-age and to a lesser degree the head circumference-for-age, the average growth of the Kyeni children in Kenya is within normal limits of international references.

Age Factors

Obstetrics and childbirth at the Aitape Health Centre, Papua New Guinea.

Routinely collected obstetric data at the Aitape Health Centre, Papua New Guinea over the years 1986, 1988 and 1989 were analyzed and compared with figures from western New Guinea of about thirty years ago and with those of rural African hospitals. Data from 924 deliveries were analyzed. 30% were born before arrival (BBA). The number of abnormal deliveries was high. This was in part due to the high frequency of twin births (4.5%). Among the BBAs puerperal sepsis and stillbirth were significantly higher than among those who delivered in the health centre. The stillbirth frequency was 3.4%. The sex ratio male:female at birth was 120.9. The large number of retained placentae with manual removal (5.2%) was related to high parity; 33.5% of the women delivering at the health centre were para-4 or more. 20% of male and 24% of female newborns had low birthweight (less than 2500g).

Birth Weight

Tuberculosis in children: treatment evaluation and results in a 5 year cohort of children with tuberculosis in Turiani Hospital, Tanzania.

Between January 1983 and January 1988, a total of 146 children started TB treatment in Turiani Hospital, Tanzania. During the treatment period 16 children died and another 16 have been transferred out. From the remaining 114, 84 could be traced and were visited at home. Out of this group, 85% were found to be in good clinical condition, and 1% was in bad shape. Death had occurred in 7% after finishing their treatment. Medical records of all children were analysed. Tuberculin sensitivity testing has been carried out in 53 children from the follow-up group. The indications for treatment and the results of the follow-up study are discussed.

Adolescent

Community health care and hospital attendance: a case study in rural Ghana.

This study assesses the influence of coverage with a network of PHC clinics as well as private clinics in Dormaa District, Ghana on, hospital attendance. This influence is measured by analysing hospital attendance among inhabitants during 6 months in 1984 and 1986. Several conditioning factors are analysed: the type of modern health care present in the community and the experience of the community health worker (CHW); the distance between community and hospital; the time factor (1984 and 1986); the sex and age of the attendants; the diagnosis made at the hospital. It appears that fewer people attend the hospital if a community participates in the PHC programme and if the CHW is experienced. When people from these communities attend the hospital they do so less unnecessarily than those from other communities. Simple analysis of routine hospital data may contribute to any PHC assessment programme set up around the hospital.

Community Health Services