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PubMed1998

The orphans of Eritrea: are orphanages part of the problem or part of the solution?

OBJECTIVE: This study compared the mental health and cognitive development of 9- to 12-year-old Eritrean war orphans living in two orphanages that differed qualitatively in patterns of staff interaction and styles of child care management. METHOD: The directors and several child care workers at each institution were asked to complete staff organization and child management questionnaires. The psychological state of 40 orphans at each institution was evaluated by comparing their behavioral symptoms and performance on cognitive measures. RESULTS: Orphans who lived in a setting where the entire staff participated in decisions affecting the children, and where the children were encouraged to become self-reliant through personal interactions with staff members, showed significantly fewer behavioral symptoms of emotional distress than orphans who lived in a setting where the director made decisions, daily routines were determined by explicit rules and schedules, and interactions between staff members and the children were impersonal. CONCLUSIONS: When orphanages are the only means of survival for war orphans, a group setting where the staff shares in the responsibilities of child management, is sensitive to the individuality of the children, and establishes stable personal ties with the children serves the emotional needs and psychological development of the orphans more effectively than a group setting that attempts to create a secure environment through an authoritative style of management with explicit rules and well-defined schedules.

Adaptation, Psychological↗

PubMed2000

Prevalence of enterobiasis and its incidence after blanket chemotherapy in a male orphanage.

A prospective observational study was conducted in a male orphanage to find out the prevalence of enterobiasis and its incidence after blanket chemotherapy using mebendazole. We found that the prevalence of enterobiasis was 28.9%. The incidence density of enterobiasis after blanket chemotherapy was 379.82 per 1,000 person-years which was quite high. We suggest that blanket chemotherapy should be repeated at every 6 months interval to control enterobiasis in orphanages.

Adolescent↗

PubMed2002

Measles outbreak in an orphanage, Bangkok, Thailand, September-October 2000.

In Thailand, the morbidity rate of measles has declined since measles vaccination was included in the National Immunization Programme. A measles outbreak affected 41 infants in an orphanage in Bangkok during September-October 2000 prompted an investigation to study the epidemiological distribution, assess vaccine coverage and vaccine effectiveness. The attack rate was 66 per cent, among infants aged 6-12 months in two separate rooms. Sixty-three per cent of the 41 cases were less than 9 months old. Measles vaccine coverage among infants over 9 months was 45 per cent due to delay in immunization caused by mild illnesses of the infants and the vaccine effectiveness was 91 per cent (95%CI 42%-99%). Inefficiency of the surveillance system to early detect and respond to the outbreak was observed. A catch-up immunization program, close supervision for surveillance and immunization systems and an increase of measles vaccine coverage to more than 95 per cent in this and other orphanages in Thailand were recommended.

Cohort Studies↗

PubMed2005

Transmission of Enterocytozoon bieneusi genotype a in a Thai orphanage.

A cross-sectional study of Enterocytozoon bieneusi infection in children who lived in an orphanage in Bangkok, Thailand was conducted in April 2003. Two hundred ninety stool specimens were collected and examined under light microscopy after staining with gram-chromotrope. Confirmation of E. bieneusi was done using transmission electron microscopy. Of 290 samples, 12 (4.1%) were positive for E. bieneusi. Genotypic characterization of 10 E. bieneusi showed that all were genotype A, which might indicate the same source of infection. Multivariate analysis showed that orphans who were 12-23 months old, girls, and living in one particular house were independently associated with E. bieneusi infection. Our study suggests that E. bieneusi infection in this orphanage might be transmitted person to person.

Analysis of Variance↗

PubMed1997

[Evaluation of health conditions in orphanages in Poland].

The reported study was carried out in all orphanages controlled by the health conditions in these homes and inquiry form was evolved which made possible recording of deviations from the required state of hygiene and from the sanitary-technical requirements. In the realization of the study workers of the children and youths hygiene of the sanitary-epidemiological stations were participating. These workers supervised normally these homes in their areas. Out of 327 homes 93% were run by the state, 6% by the church and 1% by foundations; 30% of the homes were in rural areas, 45% in small towns, and 25% in province capitals. In 1995 these homes housed 16,471 inmates, 8,839 boys and 7,632 girls. On the basis of the obtained information it could be said that the health conditions varied greatly between these homes, and depended in a high degree on the care shown for the good of the inmates, and on the commitment of the staff. The poor sanitary-epidemiological conditions in certain homes were due to poor technical state of the buildings exploited during many years. Faulty were noted also due to negligence of the users of these homes. It is necessary to undertake current and remote future actions for improving these conditions of orphanages from the viewpoint of hygiene.

Adolescent↗

PubMed1983

Adoptions: follow-up from an orphanage in Bombay.

The practice of adoption, though long accepted as a social phenomenon, is only recently gaining popularity in India. Due to the paucity of adequate follow-ups, evaluation of these adopted children is incomplete. For the purpose of studying the well-being of these children after adoption, they were followed-up at the various places, i.e., orphanages, institutions, juvenile courts and adoption agencies, responsible for their care. One hundred sixty children, 63 boys and 97 girls, adopted from an orphanage in the vicinity of our hospital over a period of 13 years are included in this study. There were 104 local and 56 foreign adoptions. Due to sociocultural background in Indian adoptions, males were preferred; whereas the international adoptions mostly depended on human considerations without any specific preference for the sex of the child. On follow-up, all children except three were reported to be physically healthy and well-adjusted emotionally in the new family, and well accepted by the society. Although adoption is not the only solution for an abandoned child, it may open some avenues for the betterment of socially deserted and deprived children.

Adoption↗

PubMed1989

Morbillivirus infection among seals (Phoca vitulina) during the 1988 epidemic in the Bay of Heligoland. II. Serogological investigations reflecting a previous phocine distemper epidemic in a seal orphanage.

Of 57 seals hospitalized in the Norddeich Orphanage, 37 (65%) had died until 22nd of August, 1988, when the first collection of blood samples from the survivors commenced. All the sera including those obtained at a later date from the remaining animals had invariably higher neutralizing antibody titres against a phocine distemper virus (PDV) isolate than against canine distemper virus (CDV). The difference of mean titres was calculated to be more than 1.5 x log10 serum dilution. Peak titres demonstrated by a direct neutralization peroxidase-linked antibody (NPLA) assay reached 1/90,000. Attempts to isolate PDV in seal kidney cell cultures from heparinized blood samples collected from convalescent animals were not successful. From the increase in antibody titre following the last fatal case it was concluded that the devastating epidemic sweeping through the Norddeich Orphanage was primarily due to phocine distemper.

Animals↗

PubMed1992

Prevalence of hepatitis B and C and HIV antibodies in children in a Romanian orphanage.

Two hundred and fifteen children in an orphanage in Romania were examined for serum markers of present or past hepatitis B and C virus and HIV infection. In total, 183 children (85.1%) had at least one marker (HBsAg, anti-HBs or anti-HBc) of hepatitis B virus infection. An HBsAg carrier state was diagnosed in 38 (20.8%) of the infected children. Among the carriers 24.3% were HBeAg carriers, 51.4% had anti-HBe and 24.3% had neither HBe antigen nor antibody. Nine children (4.2%) had antibodies to hepatitis C virus. All sera were negative in tests for HIV antibodies. False-positive reactions represented a considerable problem with these sera. Six percent of the sera gave false-positive reactions in indirect ELISA tests for hepatitis C and HIV. Sera giving false-positive reactions had rather high serum IgG levels. The results of this study indicate that these children have been heavily exposed to hepatitis B virus and to a certain degree to hepatitis C virus, while there were no cases of HIV infection in this orphanage.

Child↗

PubMed1980

Chemotherapeutic control of Enterobius vermicularis infection in orphanages.

To observe the effect of egg-free state in an institute on the endemicity of Enterobius vermicularis, the theoretical condition was made by repeated chemotherapy. Mebendazole or pyrantel pamoate were administered to all orphans and their staffs concomitantly for four times, each 20-day interval. In two low endemic orphanages, in which mean egg positive rates were 18 % and 39 % respectively, the pinworm infection was controlled up to 6~7 months period. And other two highly endemic orphanages, with 70% and 55% of egg positive rates, were controlled up to 90th day after the first treatment. After then up to 7 months, the reinfection occurred, but the endemicity was brought down to about 20 % of egg positivity.

Journal Article↗

PubMed1991

[Prevalence of Enterobius vermicularis infection and preventive effects of mass treatment among children in rural and urban areas, and children in orphanages].

An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1,262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11.9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2-32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4-5 days interval were higher (70.8%) than those from single anal swabs (50.0-59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%). 5. A total of 2,609 (male: female = 1:12.4) worms were collected from 17 egg-positive cases treated with anthelmintics. The mean number of worms per child was 153 (range: 4-824).(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

PubMed1981

Prevalence and treatment of intestinal helminthic infections among children in orphanages in Jakarta, Indonesia.

A survey was carried out in three orphanages in Jakarta for intestinal helminthic infections. Stool samples and anal swabs of 158 children were examined. The prevalences of intestinal helminthic infections in the Putra Utama, Muslimin and Van der Steur orphanages were respectively as follows: a lumbricoides 70.0%, 76.6% and 50.8%, T. trichiura 78.0% 93.6% and 70.5%, hookworm 20.0%, 12.7% and 3.2% and E. vermicularis 34.0% 29.8%, 59.0%. Treatment with Trivexan (100 mg of pyrantel pamoate and 150 mg of mebendazole), one tablet as a single daily dose for 3 consecutive days resulted in cure rates for A. lumbricoides 96.0%, 100% for T. trichiura 78.0%, 80.9% and 86.9% for hookworm 98.0%, 100% and 100% and for E. vermicularis 82.3% 92.9% and 97.2%. No side effects were observed, except in one child who complained of nausea.

Adolescent↗

PubMed2006

Fetal alcohol spectrum disorders in children residing in Russian orphanages: a phenotypic survey.

BACKGROUND: Alcohol use in Russia is among the highest in the world. Over 600,000 children reside in institutional care in Russia, most of them in baby homes and orphanages. The actual prevalence of fetal alcohol spectrum disorders (FASD) among these children is unknown. Therefore, we performed a systematic survey of phenotypic features associated with prenatal alcohol exposure among institutionalized Russian children and related these findings to their growth, development, medical, and social histories. METHODS: Phenotypic screening was conducted of all 234 baby home residents in the Murmansk region of Russia (mean age 21+12.6 months). Phenotypic expression scores were devised based on facial dysmorphology and other readily observable physical findings. Growth measurements from birth, time of placement in the baby home, and at present were analyzed. In addition, the charts of 64% of the children were randomly selected for retrospective review. Information collected included maternal, medical, developmental, and social histories. RESULTS: Thirteen percent of children had facial phenotype scores highly compatible with prenatal alcohol exposure and 45% had intermediate facial phenotype scores. These scores correlated with maternal gravidity and age. At least 40% of mothers in whom history was available ingested alcohol during pregnancy; some also used illicit drugs and tobacco. Z scores for growth measurements corresponded to phenotypic score, as did the degree of developmental delay. Children with no or mild delay had significantly lower phenotypic scores than those with moderate or severe delay (p = 0.04); more than 70% of children with high phenotypic scores were moderately or severely delayed. CONCLUSIONS: More than half of residents of the baby homes in Murmansk, Russia, have intermediate (45%) or high (13%) phenotypic expression scores suggesting prenatal exposure to alcohol. Despite good physical care, stable daily routine, availability of well-trained specialists, and access to medical care, these vulnerable children show significant growth and developmental delays compared with their institutionalized peers.

Anthropometry↗

PubMedDate not supplied

Sulfur for scabies outbreaks in orphanages.

Scabies outbreaks occurred in two large orphanages in Chiang Mai, Thailand. Since we were concerned about the availability, safety, and cost of scabicides in Thailand, sulfur in petrolatum was our choice for mass treatment of the children. We studied the efficacy of sulfur in children 2 months to 6 years of age. After the treatment, 47% and 71% of the 102 patients were cured in 2 weeks and 4 weeks, respectively. Only three preschool children developed a mild facial irritation after the first application. This agent is a safe and cheap choice for mass therapy.

Child↗

PubMed2001

Nasopharyngeal colonization by Haemophilus influenzae in children living in an orphanage.

AIM: To study colonization and transmission of Haemophilus influenzae in a cohort of children <2 years old living in the unique epidemiologic conditions of a closed community of an orphanage. METHODS: Fifty-three children, ages 0 to 24 months, were followed for 1 year. All children >2 months were vaccinated against H. influenzae serotype b. Nasopharyngeal cultures were collected monthly or, in children <6 months of age, every 2 weeks. Antibiotic susceptibility, serotype, biotype and genotype (pulsed field gel electrophoresis) of each isolate were determined. As control, 39 H. influenzae isolates were recovered from various regions in France. RESULTS: The mean monthly rate of carriage was 45% ranging from 17 to 70%. Most isolates belonged to biotype II (62%), 4 isolates to serotype f (3.6%) and none to serotype b, and 60% of the 111 isolates produced beta-lactamase. A complete concordance was found among biotype, serotype, pulsotype and antimicrobial susceptibility. On average children were sequentially colonized by 3 different isolates. The mean duration of carriage for a given isolate was approximately 1.4 months. In younger children the mean age of primary colonization was 2 months. Contrasting with the high genetic heterogeneity of 39 control isolates, most isolates (82%) belonged to only 5 pulsotypes. Three main H. influenzae clones rapidly spread in the community and colonized children in waves. CONCLUSION: During early life nasopharyngeal colonization by H. influenzae is a dynamic phenomenon with sequential carriage of various clones spreading in the community.

Carrier State↗

PubMed1998

Prospective study of the incidence of diarrheal disease and Helicobacter pylori infection among children in an orphanage in Thailand.

To evaluate the hypothesis that gastric infection with Helicobacter pylori increases risk for diarrheal disease in children, we conducted a yearlong prospective study among 160 orphanage children < 5 years of age in Nonthaburi, Thailand. Serum samples collected at six-month intervals were examined by ELISA for antibodies to H. pylori, and children were followed daily for the development of diarrhea. Seven percent of children were seropositive on enrollment, 59% were seronegative, and 34% were indeterminate. Among the seronegative children, seroconversion occurred at a rate of 7% per six months. Forty-six percent of children developed 214 total episodes of diarrhea. By age group, children < 18 months, 18-24 months and > 24 months of age experienced 2.6, 1.1, and 0.2 mean diarrhea episodes per six months. The incidence of diarrhea was not significantly different between children by H. pylori serostatus. We conclude that H. pylori infection was not associated with an increased risk of diarrheal disease.

Antibodies, Bacterial↗

PubMed2003

Intestinal parasitic infestations among children in an orphanage in Pathum Thani province.

Infection caused by intestinal parasites is still a common health problem especially in children from developing countries. Orphans are a group of underprivileged population in society. To evaluate the intestinal parasitic infections in children in an orphanage in Pathum Thani province, Thailand, stool samples were collected during a cross-sectional study in April 2001. Examination for intestinal parasites were performed by using simple smear, formalin-ether concentration, Boeck and Drbohlav's Locke-Egg-Serum (LES) medium culture and special staining (modified acid-fast and modified trichrome) techniques. A total of 106 pre-school orphans (60 males and 46 females), aged 10.0-82.0 months, were recruited for the study. There were 86 individuals (81.1%), 45 males and 41 females, infected with at least one parasite. Interestingly, most of the parasites identified were protozoa. Blastocystis hominis was found at the highest prevalence (45.2%). The infections caused by Giardia lamblia was 37.7 per cent and Entamoeba histolytica was 3.7 per cent. Other non-pathogenic protozoa found were Trichomonas hominis (39.6%), Entamoeba coli (18.8%), and Endolimax nana (3.7%). The only one case of helminth parasite detected was Strongyloides stercoralis (0.9%). The sensitivity for detection of B. hominis and T. hominis was increased by the LES culture technique. No history of diarrhea symptoms were recorded among these orphans. However, during the investigation, stools of all infected cases were noted for six characteristics including formed, soft, loose, mucous, loose-watery and watery. The present study emphasized the problems of protozoan infections among these orphans. Health educations as well as routine surveillance is necessary in order to control the infections.

Child↗

PubMed2005

[Transmission of Haemophilus influenzae type b strains among children attending day-care centers and orphanages].

Goal of the work was to evaluate the differences level among H. influenzae strains of b serotype isolated from children attending day-care centres and orphanages and among strains isolated from invasive infections. In the work PFGE in Hib strains transmission examination and for epidemiological studies among three sources of invasive infection was applied. Among 35 Hib strains tested and control strain 8 different pulsotyped were found. Among 21 strains colonising the nasopharynx of healthy children, and among 13 Hib strains isolated from cerebrospinal fluid, 6 and 1 pulsotypes were found, respectively. Results obtained show that healthy children might be colonizing with genotypes characteristic for Hib strains isolated from invasive infections. In this view wider Hib vaccination seems be expected, as Hib circulation is common.

Carrier State↗

PubMed1995

The Solomuna Orphanage: a historical survey.

The social-emotional status and behavioral symptoms of Eritrean war orphans were compared before and after a major social reorganization of the institution had been implemented. The comparison was based on direct clinical observations and behavior checklist questionnaires. Two years after the orphanage was restructured, the emotional state of the orphans had improved dramatically. The findings suggest that even when financial and technical resources are severely limited, it is possible to provide humane group care for severely traumatized orphans by applying basic clinical principles of child development.

Child↗