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Biomedical subjects

V Curtis

Publications and source records attributed to V Curtis.

26 records · Page 2Linked to original sources

Child defecation behaviour, stool disposal practices, and childhood diarrhoea in Burkina Faso: results from a case-control study.

OBJECTIVE: To investigate the association between where young children defecate, where stools are disposed of, and the presence of human stools on the ground in the compound and the rate of hospital admission with diarrhoea. DESIGN: This was a case-control study with two control groups. SETTING: The study took place in Bobo-Dioulasso, the second city of Burkina Faso in West Africa. PARTICIPANTS: Three groups of children aged 36 months and under, and living in Bobo-Dioulasso were studied. Cases were 757 children admitted to hospital with symptoms of diarrhoea or dysentery. The first control group comprised 757 neighbourhood control children approximately matched on age and date of recruitment, and the second, 631 children admitted to the same hospital without symptoms of diarrhoea or dysentery. MAIN RESULTS: There was no evidence of any association between where the child was reported to defecate and hospital admission with diarrhoea or dysentery (odds ratio = 1.10; 95% confidence interval (CI) 0.78, 1.57, cases v neighbourhood controls; odds ratio = 0.84; 95% CI 0.60, 1.18, cases v hospital controls). There was evidence of an association between where the mother reported disposing of the child's stools and hospital admission with diarrhoea or dysentery (odds ratio = 1.50; 95% CI 1.09, 2.06, cases v neighbourhood controls; odds ratio = 1.31; 95% CI 0.96, 1.79, cases v hospital controls). Human stools were more frequently observed in the yards of cases than controls (odds ratio = 1.38; 95% CI 0.98, 1.95, cases compared with neighbourhood controls; odds ratio = 1.33; 95% CI 0.96, 1.84, cases compared with hospital controls). CONCLUSIONS: The findings suggest that it is not where the child defecates that matters but how the mother then deals with the child's stools.

Age Distribution↗

[Acute respiratory infections in pediatric hospital at Bobo-Dioulasso (Burkina Faso)].

BACKGROUND: Acute lower respiratory tract infections are the primary cause of morbidity in developing countries. POPULATION AND METHODS: Six hundred and sixty seven children (379 boys, 288 girls, aged 0-30 months) admitted for lower respiratory tract infections from January 1990 to March 1991 were included in the study. Immediate medical history was collected from the mother. The weight, height, temperature and clinical manifestations, plus the results of chest X-rays, parasitologic and bacteriological examination of stools, and blood smear for malaria were recorded for each patient. Sero-immunologic study for HIV infection of 473 of the patients aged 12-36 months and their mothers also took part in a sero-immunological study for HIV infection. RESULTS: Lower respiratory tract infections were the second major cause of admission (16.8%) after malaria (28.7%). Infections peaked between 6 and 11 months of age (29.5%). The main diseases were pneumonia and bronchial pneumonia (54%) followed by bronchiolitis (21.7%). Almost half the patients were admitted during the hot, dry season. Two hundred and eighty seven patients (43.4%) were referred only after they had been suffering from the disease for 3 to 9 days, partly explaining the high level of mortality. One hundred and twenty one patients (20.9%) died; the main cause of death was staphylococcal pneumonia (57.9%), followed by pneumonia and bronchial pneumonia (29.3%). Some criteria for severity could be identified, based on pulmonary signs and symptoms and associated manifestations (dehydration, malnutrition, convulsions, anemia). Twenty two patients were positive for HIV-1 infection. CONCLUSIONS: This study confirms that acute lower respiratory tract infections remain a public health problem. Early diagnosis and treatment are necessary to reduce mortality.

Acquired Immunodeficiency Syndrome↗

[Diarrheic diseases in children. Rationalization of fecal test].

The level of diarrheic diseases among children in Burkina Faso is very high. The identification of aetiologic agents of diarrhoea in hospitalized children (0-36 months) is one of the objectives of the study. All children less than 37 months old admitted to the Pediatric Unit of the National Hospital Souro Sanou of Bobo-Dioulasso between January 1990 and March 1991, were investigated by a standardized clinical examination, and in addition, we do an analysis of a rectal swab at admission and a stool to identify aetiologic enteric agents. As a conclusion to the study: an agent was isolated in 56% of the children with diarrhoea, and in 40% of the children without diarrhoea; some germs (such Salmonella, Shigella, Entamoeba) are found in children both with and without diarrhoea; also, the total of these examinations comes to 20 US $ per episode, or 100 US $ per children/year in Burkina Faso where the number of bouts reaches 5 times per year per infant who is less than 5 years old. Stool samples are not beneficial for children with diarrhoea, neither for the diagnosis nor for the treatment. There fore these types of routine exams should not be used in Sub-Saharan Africa.

Burkina Faso↗

Prolonged breast-feeding: no association with increased risk of clinical malnutrition in young children in Burkina Faso.

Reported are our findings from a case-control study of the association between prolonged breast-feeding and clinical malnutrition in an urban setting in West Africa. The cases were children aged 12-36 months who had been hospitalized with a diagnosis of clinical malnutrition. Children of a similar age who lived in neighbouring courtyards were recruited as controls. For 152 case-control pairs in which both children were receiving solid foods, non-breast-feeding was associated with an increased risk of clinical malnutrition (crude odds ratio = 2.37; 95% confidence interval = 1.24, 4.55). This association remained statistically significant after controlling for various potentially confounding variables (P = 0.03). Our findings suggest that either prolonged breast-feeding may offer substantial protection against clinical malnutrition in the study population or malnutrition leads mothers to stop breast-feeding. These results are inconsistent with those of a number of workers who have reported that prolonged breast-feeding is associated with an increased risk of malnutrition. This inconsistency might have arisen because of differences in the definition of malnutrition used or because of variations in the quantity and quality of weaning foods available in different settings. We found no evidence to support the hypothesis that prolonged breast-feeding may be detrimental to children.

Breast Feeding↗

Structured observations of hygiene behaviours in Burkina Faso: validity, variability, and utility.

The use of observation techniques has been promoted for the study of hygiene practices; however, questions still remain about the validity and repeatability of such techniques. In this article we compare data on hygiene behaviours obtained from questionnaires with data obtained using a structured observation approach and examine the repeatability of structured observations of behaviours and spot observations of environmental conditions. Poor agreement between questionnaire responses and observations was found for child defecation and stool disposal practices (kappa statistic: 0.25 and 0.28, respectively). There was evidence of over-reporting of "good" behaviours (P < 0.0001). Repeated observations of child defecation and stool disposal behaviours showed better agreement (kappa statistic: 0.76 and 0.62, respectively) based on small sample sizes. These findings suggest that our questionnaire data are less valid than data obtained by direct observation. However, different approaches to questioning may be less prone to over-reporting of "good" behaviours than our approach. Further research into the validity of different forms of question is warranted. Behaviours and conditions related to hygiene vary. Observations may be useful in determining the frequency of different behaviours/conditions in the community. However, individual practices may be too variable to assign individuals to exposed and non-exposed groups for the purpose of identifying links with health outcomes. Further studies on the variability of behaviours and the repeatability of observations are therefore needed.

Adult↗

[Perinatal mortality in Burkina Faso: risk factors in an urban environment of Bobo-Dioulasso].

A total of 96 mothers of stillborn babies (cases) and 402 mothers of live-born babies (controls) were studied between the 1st November 1988 and the 31st July 1989 in an attempt to identify the risk factors for the high number of stillbirths in the Maternity wing of the Hôpital National Sourô SANON in Bobo-Dioulasso, Burkina Faso. From a stratified analysis, eight risk factors emerged as significant predictors of mortality: mother older than 35 years, high parity (five or more), previous history of stillbirth, lack of medical supervision of pregnancy, interval between last consultation and birth longer than 30 days, complications during delivery and birth weight less than 2,500 g. Polygamy was associated with a 51% reduction in the risk of stillbirth. The problem of selection bias which affects the validity of hospital based case-control studies is discussed. Techniques for reducing selection bias in hospital based case-control studies are proposed. Improvements in antenatal care in Bobo-Dioulasso are suggested.

Birth Intervals↗