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PubMedDate not supplied

Descriptive epidemiology of acute respiratory infections among under five children in an urban slum area.

A study was conducted in Sunderpur, Varanasi to study the magnitude of the problem of acute Respiratory Infections among under five children in an urban slum and the clinical profile of it in order to understand the pattern of disease presentation for identifying methods of early diagnosis and timely intervention. 150 under five children were selected by stratified random sampling method and were observed for 52 weeks at weekly interval to record the illnesses. In total 661 episodes were observed in 5623 child-weeks of observation giving an episode rate of 6.11 per child per year. ARI accounted for 67% of all morbidities. Mean duration of all the episodes taken together was 8.15 + 5.44 days. Majority of the episodes (88.96%) were confined to the Upper Respiratory Tract only. Most commonly occurring clinical features were rhinorrhea, nasal stuffiness and cough. 61.4% of all the episodes terminated within seven days, and only 26.2% continued for two weeks.

Absenteeism↗
PubMedDate not supplied

Risk factors of acute respiratory infections in underfives of urban slum community.

To ascertain the risk factors of Acute Respiratory Infections (ARI) in children, a prospective study was conducted for a period of one year among 112 underfives in urban slum community of Calcutta. Incidence of ARI was found significantly higher in undernourished children of poor socio-economic class. Parental smoking habit and solid fuel use for cooking were recognised as important risk factors of ARI.

Acute Disease↗
PubMedDate not supplied

Extents of contamination of top milk and their determinants in an urban slum of Varanasi, India.

A community based study to examine the extent of contamination of supplementary milk feeds of 149 children aged 6-24 months was conducted in a semi urban slum of Varanasi, India. Out of 201 children, 149 top milk samples were collected directly from the feeding utensils into a sterile vial and subjected to bacteriological analysis. Overall, 53.7% of milk samples were contaminated by bacteria and among them 16.1% were potentially enteropathogenic in nature. The distribution of pathogens was E. coli (13.4%), Klebsiella spp (5.4%), Enterobacter spp. (5.4%), Pseudomonas aeruginosa (4.7%), Shigella spp. (2.7%) and others (22.1%). The rate of contamination was significantly higher (p < 0.001) in lower income group (73.4%), lower caste (69.6%) and in case of illiterate mothers (69.3%). Bivariate analysis indicated that wherever the afore mentioned parameters of hygiene were adverse, isolation rates increased multifoldely. Multiple logistic regression analysis indicated that the probability of a milk sample being positive for bacterial contamination was higher by 20 times when unclean utensils were used, by 3 times if mothers hands were dirty and by 2.8 time if the mothers were illiterate. The odds of contamination by pathogens was 25.7 times higher if the feeding utensils were dirty.

Animals↗
PubMed2001

[Prevalence of sub-clinical vitamin A deficiency and malnutrition in slum children in Maraicabo - Venezuela].

The present cross sectional study was carried out to estimate the prevalence of vitamin A deficiency among children by means of clinics and conjunctival impression cytology (CIC), and nutritional status by anthropometric indicators H//A, W//A, W//H. The study population included 157 children 2-6 y old, from urban and rural slums of Maracaibo, Venezuela, Conjunctival impression cytology was performed by ICEPO standard procedure. Z-score was applied to anthropometric data with reference values of NCHS-WHO. No evidence of clinical or ophthalmologic signs of vitamin A deficiency were detected. The prevalence of subclinical vitamin A deficiency, as detected by abnormal CIC, was 35.4%, being higher in rural children (48.3%). These prevalence values are higher than the criteria laid down by WHO/UNICEF to indicate a public health problem (> 20%). Mild or moderate protein-energy global malnutrition and stunting were detected in 36.1% and 44.6% of children, respectively. Abnormal CIC was indistinctly observed (approximately equal to 35%) as much in children with adequate nutrition as in malnourished ones. There was no significant difference in the distribution of the CIC results in relation to nutritional status. The findings indicate that CIC and Z-score of nutritional anthropometric data are useful to characterize the risk of vitamin A deficiency and of malnutrition in communities. Beside the implementation of an integral nutritional program which includes supplementation, food fortification and dietary diversification, improvement of socio-economic and sanitation conditions and also the educational level, with emphasis on nutritional and health education, are highly recommended.

Anthropometry↗
PubMed2002

Iron status of children aged 9-36 months in an urban slum Integrated Child Development Services project in Delhi.

OBJECTIVE: To assess the magnitude/severity and possible etiology of anemia and iron deficiency among children 9-36 months of age. METHODS: A population-based study on the prevalence, etiology of anemia and iron status in 545 children, 9-36 months of age, was conducted in an urban slum ICDS (Integrated Child Development Services) project in North-East Delhi. Hemoglobin and serum ferritin was estimated and information on socio-economic, demographic, parasitic infection/infestation and dietary intake was collected. RESULTS: Prevalence of anemia (using WHO cut-off values of Hb >11.0 g/dl) among children, 9-36 months of age, was 64%, of these 7.8% had severe anemia (Hb >7.0 g/dl). Using 10.0 g/dl as the Hb cut-off point 44% children less than 18 months of age in the present study population were anemic. On a sub-sample study, 88% children were estimated to be iron deficient, with serum ferritin concentration less than 12 microg/L. The peripheral smear red cell morphology showed 33.9% as microcytic-hypochromic and 37.1% as dimorphic. Dimorphic anemia was 55% in moderate anemia group. The energy and iron intakes were 56% and 45%, respectively of the Recommended Dietary Allowances (RDA). The parasitic infestation/infection was not related to the prevalence or severity of anemia. CONCLUSION: In Delhi, high prevalence of moderate to severe anemia and iron deficiency with vitamins folate and/or B12 among children under 3 years of age in an ICDS block in operation for 20 years is of concern. Dietary origin was the main cause of anemia in this age group.

Anemia, Iron-Deficiency↗
PubMedDate not supplied

Nutritional status of adolescent girls of a slum community of Varanasi.

In order to assess nutritional status of adolescent girls of a slum community of Varanasi and factors influencing them, this study was carried out on 70 girls belonging to the age group 13 to 18 years. The study subjects were selected from Sunderpur, an urban community of Varanasi, by adopting appropriate sampling methodology. The approach adopted for the study was a cross sectional one. The tools in the study were pre-designed and pre-tested schedule, weighing scale, steel anthoropometric rod and measuring tape. The techniques of the study included interview method, clinical examination and anthropometry. In all, 70.0% adolescent girls had BMI < 20%; 51.43% study subjects were suffering from Chronic Energy Deficiency (CED). Stunting (Height for age alpha 90%) was present in 10% of adolescent girls. Their average Weight, Height, MAC were 83.45%, 93.08% and 82.05% of the corresponding estimated reference values. Significant association of common parameters (viz., age, caste, income, type of family, working and literacy status) with nutritional status of study subjects was not observed in this study. However, lesser undernutrition in large families (> 6) indicated role of familial support in prevention of undernutrition in adolescent girls.

Adolescent↗
PubMed2002

Pathways to infant mortality in urban slums of Delhi, India: implications for improving the quality of community- and hospital-based programmes.

The study aimed at obtaining insights into the processes underlying infant deaths to help identify preventive interventions which may bring down infant mortality rates further. Verbal autopsies were performed on 162 deaths of liveborn infants that occurred in a birth cohort in two urban slums of Delhi, India, between February 1995 and August 1996. A structured verbal autopsy form was used for ascertaining the cause of death. The narratives of caretakers on seeking of care and treatment received for illness were reviewed to identify the actions and behaviours that might have contributed to death. Seeking of care was less common (57%) for illnesses that led to death in the first week of life than at later ages. The first-week deaths commonly (61%) occurred within 24 hours of recognition of illness which might have been too a short time for effective interventions by care providers. Only six of 45 neonates who had features of sepsis, pneumonia or meningitis, major congenital malformations, birth asphyxia, or prematurity were advised by primary care providers for hospitalization. Similarly, only 25 (41%) of 61 older infants who had severe malnutrition and sepsis or meningitis, diarrhoea or pneumonia, or other illnesses were referred to hospital. Parenteral antibiotics were prescribed less often than warranted. Only two of 16 neonates with serious bacterial infections and eight of 19 postneonates with features of sepsis or meningitis received parenteral antibiotics. Inappropriate healthcare practices were common among the practitioners of modern and indigenous systems of medicine and registered medical practitioners. Forty percent of the neonates and a little over half of the older infants, advised for hospitalization, were taken to hospital. Fifteen percent of the infants taken to hospital were refused admission. Of 21 hospitalized infants discharged alive, five (23%) died within 48 hours and 13 (62%) within a week of returning home. A major effort is required to improve skills of healthcare providers of the biomedical and indigenous systems of medicine in caring for neonates and infants. Development of home-based treatment regimens for young infants and objective criteria for their hospitalization and discharge should receive a high priority.

Age Factors↗
PubMed2002

Effect of deworming on nutritional status of ascaris infested slum children of Dhaka, Bangladesh.

This randomized double blind community trial was conducted on Ascaris infested children (n = 85) aged 2 to 12 years and was aimed to study the impact of deworming on nutritional status, in an urban slum of Dhaka, Bangladesh. The change of weight gain was significantly higher in children given anthelmintics than those given placebo (0.92 kg vs. 0.54 kg). A multiple linear regression model shows that after controlling sex, deworming and height were positively correlated while age and weight were negatively correlated with weight change.

Ascariasis↗
PubMed2003

The association of health-care use and hepatitis C virus infection in a random sample of urban slum community residents in southern India.

To determine whether health-care use was associated with prevalent hepatitis C virus (HCV) infection in Chennai, India, 1,947 adults from 30 slum communities were randomly selected to be interviewed about parenteral and sexual risks for HCV infection and to provide biological specimens for HCV and sexually transmitted infection (STI) testing. Prevalent HCV infection was detected in 2.4% of non-injection drug using (IDU) participants. Controlling for other associated factors, and excluding IDU, men who used informal health-care providers were five times as likely to be HCV infected as those who did not use informal providers (Adjusted Odds Ratio, AOR = 5.83; 95% confidence interval [CI]: 1.57, 21.6), a finding not detected in women. More research is needed to determine the extent to which HCV infection is associated with reuse of contaminated injection equipment in health-care settings in developing countries.

Adolescent↗
PubMed2003

Prevalence of tuberculosis infection among children in slums of Ahmedabad.

Children below 15 yrs. of age without BCG scar were chosen for the tuberculin testing. Total 210 children were tested in 30 selected clusters (7 children in each cluster). Median age of the surveyed children was 6.33. Prevalence of infection in children was found to be 30.4% as 64 children out of 210 showed positive result (had induration > or = 10mm in size). Average ARI in the 0-14 yrs of age group was 5.4%. Tuberculosis is still one of the commonest problems in the urban slums. It is important to evaluate the epidemiology of tuberculosis in the changing face of century.

Adolescent↗
PubMed2002

Nutritional status of the preschool children of the Klong Toey slum, Bangkok.

A cross-sectional study was conducted to examine the nutritional status of children (aged 1-5 years) who lived in the Klong Toey slum, Bangkok; the factors related to nutritional status were also determined. Anthropometric measurements were made for 232 children; socioeconomic background information was obtained by interviewing their mothers using a structured questionnaire. The prevalence of malnutrition among the study sample was 25.4% by weight-forage, 18.1% by height-for-age, and 6.9% by weight-for-height; the prevalence among pre-school children in Thailand and in the Bangkok metropolitan area by weight-for-age was reported to be 8.73% and 5.25% respectively. Potential related factors were examined: family characteristics, (mother's age, marital status, educational background, family size, family income, and mothers' occupation); children's characteristics (age, gender, birth order, immunization status, and history of illness); mothers' knowledge and perception of nutrition and mothers' food practice. Multiple logistic regression analysis was used to identify the association with the nutritional status of children by height-for-age. The results showed that family income (adjusted OR=0.9998; 95% CI: 0.9997-1.0000), maternal housewifery or unemployment (adjusted OR=6.5; 95% CI: 1.74-24.3), food practice (adjusted OR=0.7123; 95% CI: 0.5390-0.9414), and a maternal educational level lower than primary school (adjusted OR=10.1; 95% CI: 1.13-91.9) were associated with the nutritional status of children. This finding implies that although malnutrition is no longer considered to be a major health problem in Thailand, it remains a threat to the health of the urban poor in Bangkok. This finding should not be overlooked and countermeasures are indicated.

Adolescent↗
PubMedDate not supplied

[Risk of HIV infection: how women living in a slum perceive themselves in the chain of the virus transmission].

The number of notified cases of women with AIDS is increasing in Brazil. Based on this, the authors developed this qualitative study theoretically based on Cultural Anthropology. The ethnographic methodology was used to collect and to analyze data. The investigation had the purpose to identify the perception about the risk for HIV infection of the women living in a slum located in the city of São Paulo, Brazil, through interviews and participant observation of the context. Results showed that the women have some knowledge about AIDS, about the transmission of HIV and its preventive measures through sexual intercourse. The cultural data also showed that the women do not feel susceptible to the disease, although most of them are dependent on their partners' income to maintain themselves healthy as well as their families. This way of thinking and acting may be contributing to increase the cases of women with AIDS in Brazil.

Attitude to Health↗
PubMed2003

Characteristics of young foster children in the urban slums of Bangladesh.

AIM: To identify the reasons for the fostering of children, and to describe their feeding practices and assess their health and nutritional status. METHODS: Forty-six pairs of mothers and their young foster children (up to 24 mo of age) were interviewed in a cross-sectional study in the urban slums of Dhaka, Bangladesh. Another 82 pairs of mothers and their biological children of a similar age group were interviewed for comparison. RESULTS: Sixty-five percent of the children were fostered because of the death of their biological mothers. Eighty-three percent of the biological mothers died because of complications during delivery or the immediate postpartum period and the remainder died after the postpartum period of diseases unrelated to their pregnancies. More than half (52%) of the foster mothers were childless and a quarter (24%) fostered children for reasons of gender preference. Almost a quarter (24%) of the children were placed in foster homes because of extreme parental poverty. Divorce or separation of the biological parents accounted for only 7% of children fostered. Approximately 90% of the foster children were given animal and/or formula milk in their first month of life while all children in the comparison group were given breast milk. Among the foster children, 58% were given semisolid or solid food before completion of 4 mo compared with 14% in the comparison group. Significantly more children in the foster group suffered from diarrhoea and acute respiratory infection than in the comparison group. CONCLUSION: Maternal death, poverty and childlessness and child gender preference of foster mothers were important factors in fostering of children in the study group. Inappropriate feeding practices compounded by diseases may have contributed to the poor nutritional status of the foster children.

Anthropometry↗
PubMed1992

Maternal practices and risk factors for dehydration from diarrhoea in young children: a case-control study in central Thailand slums.

To determine factors related to dehydration from diarrhoea, we conducted a hospital-based, case-control study in children aged 24 months or younger who had acute watery diarrhoea and attended Chonburi Regional Hospital in central Thailand during November 1988 through May 1989. The study compared 48 cases who had moderate or severe dehydration with 48 controls who had no dehydration. Both cases and controls belonged to low socioeconomic families and were living in urban slum areas. They had adequate health care facilities and access to ORS packets. Overall, 56% of the mothers used ORS solution at home. None of the mothers knew how to administer ORS, i.e. the fluid was not given at the onset of diarrhoea to prevent dehydration, and they gave no more than 60 ml over a 24-hour period to their dehydrated children. They also did not use home fluids. Multivariate analysis of data showed two factors significantly associated with dehydration: children's dirty fingernails that indicated inadequate maternal hygiene-related behaviour (Odds Ratio 6.4; 95% Confidence Intervals 1.5-27.6, p < 0.01), and frequency of vomiting in the 24 hours before rehydration (Odds Ratio 1.3; 95% Confidence Intervals 1.1-1.6, p < 0.001). Cases and controls had similar aetiologic agents and nutritional status. Providing proper education to mothers about oral rehydration therapy with special emphasis on the volume of ORS to be given, along with guidance to improve their personal hygiene should be considered important interventions in reducing the risk of dehydration and deaths from diarrhoea in these children.

Case-Control Studies↗
PubMedDate not supplied

Study of leprosy among slum dwellers in Pune. Part-I. Prevalence.

While conducting a point prevalence total population survey in Ghorpuri slum in Pune, the overall prevalence or leprosy was 9.16 per thousand. The prevalence rate varied in different bastis with Madari basti having a very high prevalence rate of 17.31 per thousand and showing clustering. Prevalence was highest in age group 31-40 years, females, Muslims, Widower/widow, skilled workers, illiterates and primary school educated and the lower socio-economic groups. Joint families had the highest prevalence of leprosy (20.83/1,000) and also higher prevalence was seen in families with more than 7 members.

Adult↗
PubMedDate not supplied

Study of leprosy among slum dwellers in Pune. Part II--Disabilities.

While conducting a leprosy survey in an urban slum in Pune 45 cases of leprosy were detected in a population of 4915 and only 7 of these cases had some disability. Disability rate in the leprosy cases was 15.56 percent, and maximum number had Grade 2 disability of hands or feet. Disability was higher in the higher age groups, males, Hindus, widower/widows, unemployed and lower socio-economic classes. Majority of the cases had a very low Disability Index DI (2) between 0.10 to 0.69 which is heartening and proves the successful implementation of the National Leprosy Eradication Programme.

Persons with Disabilities↗
PubMed1992

A rapid survey on substance abuse disorders in the urban slums of New Delhi.

The results are presented of a rapid survey screening method of general population for identifying dependent and non dependent drug abusers, especially in vulnerable groups such as slum dwellers. The results showed that with the help of instrument with modified DSM III and interviewing only the heads of the households it was possible to get reliable estimates of dependence disorder in the community. This method can be of assistance to health planners for a quick assessment of the magnitude of the problem leading to better allocation of funds and developing services for the affected population. The method is an improvement on key informant technique and a full fledged survey.

Adolescent↗
PubMed2002

Intensified pulse polio immunisation coverage in slums of a metropolitan city: an appraisal.

A study was conducted by house-to-house visit during 2nd and 3rd round of IPPI in Nov and Dec 2000 in two slums adjacent to Medical College Kolkata. Total houses visited in these two rounds were 2836 and 611 children were immunised at home. Mothers of 503 children (who did not receive IPPI dose at booth on NIDs) were interviewed. For rest 104 children, mothers were not available during the time of visit. The result showed that infants were the largest group (30.6%) to receive vaccine at home. Majority (84.1%) was permanent residents of the locality. Only 4.2% were Bengali-speaking Hindus while most other were Hindi or Urdu speaking Muslims. "Health workers will bring vaccine at door steps" was the reason of non-attendance at booth by 30.2% parents. No routine immunisation was received by 14.9% children. The source of information regarding IPPI was, 45.4% from medical students, 28.5% from health workers, 15.1% from TV, 5.6% from relatives and neighbours, 3.6% from miking and 1.8% from newspapers respectively.

Age Distribution↗