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PubMed1981

Diabetic retinopathy in Lesotho.

Diabetic retinopathy was found in 47.8% of 153 consecutive diabetic clinic patients examined in Maseru, Lesotho. Background retinopathy was present in 78% of patients with retinopathy, compared with 22% with proliferative changes. While no difference in prevalence of diabetic retinopathy could be demonstrated between the sexes, an association between diabetic retinopathy and hypertension and peripheral neuropathy was observed. The prevalence and severity of diabetic retinopathy was significantly related to the duration of disease. The pitfalls inherent in comparing the results of the current study with other published reports are considered. Better epidemiological surveys are required to determine the true prevalence of diabetic retinopathy among different racial, ethnic, religious, and tribal groups in Africa.

Adolescent↗
PubMed1980

Survey of ophthalmic conditions in rural Lesotho.

The first survey of ocular problems in rural Lesotho was conducted by a visiting eye team and consisted of an examination of 1266 ophthalmic clinic patients at 15 representative sites throughout the country. The most common ocular conditions encountered were: conjunctivitis, refractive error, vernalis, senile cataract, glaucoma, corneal opacities and trauma. This disease pattern differs from most developing African nations for reasons of climate, geography and diet. The absence of disciform macular degeneration, narrow-angle glaucoma, and rarity of retinal detachment was noted. The educational impact of the survey, and its importance for future planning are suggested.

Adolescent↗
PubMed1986

Tuberculous peritonitis in Lesotho.

Tuberculous peritonitis, although a common cause of ascites in Africa, previously was rarely diagnosed in Lesotho. We evaluated prospectively 105 consecutive patients admitted with ascites: tuberculosis accounted for 42% of the cases. Clinical differentiation from other causes of ascites proved to be difficult: signs and symptoms commonly associated with this disease were non-specific and often absent. The majority of our patients were elderly, male and alcoholic. Mortality was 26% despite treatment, and was highest among the aged and those who abused alcohol.

Aged↗
PubMed1994

An analysis of home-based oral rehydration therapy in the Kingdom of Lesotho.

Mothers in developing countries are being successfully taught to give an oral rehydration solution (ORS) at home. The quantity of oral rehydration fluid that mothers administer to their child remains a critical question. Inadequate quantities render oral rehydration therapy (ORT) ineffective. The primary focus of our investigation was direct measurement of the quantity of fluid unsupervised mothers gave their children at home. This study validates a methodology that provides precise information on ORS administration in the home, information essential for evaluating the effectiveness of home-based therapy and for planning programmes to influence unsupervised mothers to correctly administer ORS to their sick children. This study, conducted in the Kingdom of Lesotho, assessed the impact on home care of the national control of diarrhoeal disease (CDD) programme. Direct observations in the home established each child's status and the quantity of fluid used 24 hr after children left the ORT unit where mothers were instructed to give ORS at home. Data were gathered on natural consequences that might discourage use of ORS, such as vomiting, increased frequency of watery stools and distaste for the solution. The health status of most of the 197 children followed improved. The average volume of ORS administered was 544 ml. A full liter was given by 21% of the mothers. Only 3% of the mothers gave no ORS. The average dose was 65 ml/kg. Younger children got about the same volume as older children; thus, they received a higher ml/kg dose. Mothers gave more ORS to children who had more symptoms of diarrhoeal disease at the time they were brought to the clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1986

Early postnatal growth of Basotho infants in the Mantsonyane area, Lesotho.

The records of 814 infants born in a rural hospital in Lesotho were analysed. It was calculated that on average Basotho infants regained their birthweight between 3 and 4 days of age and the average weight loss amounted to 3%. Compared with Caucasian infants, Basotho infants regained their birthweight sooner. Of 289 infants in whom the gestational age was assessed, small-for-dates infants showed an increased mean growth rate compared with pre-term and appropriate-for-dates full-term infants.

Birth Weight↗
PubMed1990

The effects on weight and attendance of a supplementary feeding programme operating in two under-5 clinics in Lesotho.

The routinely collected weight data of 2202 pre-school children who visited two under-5 clinics in Lesotho between 1978 and 1983 were used to calculate growth curves and to assess the effects of supplementary feeding. Up to the age of 5 months growth curves were above the NCHS reference. Growth started to decrease at the age of 3 months and stabilized at 11-13 months at the 10th percentile of the reference. The decrease of growth might have been due to environmental factors such as under-nutrition and disease. If this was the case, supplementary feeding might have had a positive impact on weight, but such an effect was not observed in this study. Supplementary feeding had, however, a positive effect on attendance rates and hence contributed to higher coverage of other under-5 clinic activities, such as immunization, health and nutrition education, and growth monitoring. Whether this positive effect warrants its extra cost remains open to question.

Ambulatory Care Facilities↗
PubMed1993

A diphtheria epidemic in Lesotho, 1989. Did vaccination increase the population's susceptibility?

We report a diphtheria outbreak which occurred in the 1st 6 months of 1989 in the Quthing district of Lesotho in Southern Africa. Sixty-eight clinical cases were identified in patients with ages ranging from 14 months to 51 years. The 10-15-year age group represented 38% of the cases and the 15-20-year age group another 26%. Age-adjusted incidence rates were higher in patients aged between 15 and 35 than in those aged 0-15 years (p < 0.001). The overall case fatality rate was 23%. Most deaths occurred in the age range 10-14 years, but the case fatality rate tended to be higher in the younger age groups. The epidemic raises the question of the influence of the ongoing vaccination programme, established since 1977, and the importance of naturally acquired immunity. It is suggested that the number of throat carriers, who in the absence of skin diphtheria would provide most of the population's immunity, decreases as an indirect consequence of vaccination, and that certain groups not immediately reached by vaccination become more susceptible to diphtheria. This outbreak also illustrates that a sporadic case of diphtheria in a partially immunized community warrants serious efforts to curb the spread of the disease.

Adolescent↗
PubMed1989

The risk of infection from Giardia lamblia due to drinking water supply, use of water, and latrines among preschool children in rural Lesotho.

Stool samples were collected from 267 rural, preschool children in four districts in Lesotho during October-November, 1984. Sixty-three children (23.6%) were tested positive for Giardia lamblia, the most commonly recovered parasite from stool samples. The use of low amounts of water for personal hygiene was associated significantly with having G. lamblia (OR = 2.42), but the use of traditional, non-improved drinking water sources (OR = 1.38) or lack of latrines (OR = 0.94) was not. Although G. lamblia may be primarily waterborne in developed countries, the amount of water that is used for personal and domestic hygiene may be more important than the quality of drinking water in developing countries. Other risk factors that were identified to be associated significantly with having or not having Giardia were child older than 24 months (OR = 6.79), mother less than 20 years of age (OR = 5.18), residing in Mohales Hoek district (OR = 2.33), and possessing several agricultural tools (OR = 0.70).

Adult↗
PubMed1992

Impact of a clinic-based growth monitoring programme on maternal nutrition knowledge in Lesotho.

An evaluation of the impact of a nationwide clinic-based growth monitoring (GM) programme was done in Lesotho to determine if clinic attendance was associated with improved maternal knowledge of weaning practices and diarrhoea. A total of 907 mothers from eight clinics were included in the study. Our results showed that mothers who had attended the clinics knew more about the appropriate timing for introducing animal protein-rich foods in the child's diet and about the use of oral rehydration salts for diarrhoea, than those who had not. The difference in knowledge between previous clinic attendants and new attendants was particularly marked among mothers with less than secondary schooling and mothers with young babies (less than 6 months). From observation in the clinics, we believe that group nutrition education, although it was not integrated with growth monitoring, was probably responsible for the positive association between clinic attendance and maternal knowledge. Prior clinic attendance was not specifically associated with improved knowledge about feeding during diarrhoea or the need to stop breastfeeding gradually. These need to be better incorporated into present clinic nutrition education. Whether improvements in growth monitoring would further significantly improve nutrition education remains to be seen.

Adult↗
PubMed1992

Growth charts only marginally improved maternal learning from nutrition education and growth monitoring in Lesotho.

A study done in Lesotho in 1985-1986 assessed whether growth charts increased the impact of nutrition education and growth monitoring on maternal learning about weaning practices and diarrhea. Seven hundred and seventy six mothers were given three monthly sessions of group nutrition education along with growth monitoring of children and individual counseling. Growth charts, which were taught to one of two groups, fostered learning but only on issues related to diarrhea and only among new clinic attendants, mothers with less than secondary schooling and mothers of malnourished children. These benefits, however, were small (differences less than 10%) compared with the overall impact of the nutrition education and growth monitoring intervention (increases between baseline and post-intervention were greater than 50% for some questions). Our findings suggest that well-designed clinic-based nutrition education and growth monitoring can have a significant impact on maternal nutrition knowledge. Teaching growth charts to mothers may not be necessary for obtaining such results in programs conducted under ideal conditions. More research is needed to determine under what circumstances, for what purposes and for whom growth charts may be beneficial.

Audiovisual Aids↗
PubMed1992

The complementary effect of latrines and increased water usage on the growth of infants in rural Lesotho.

The effects of water quantity and sanitation, alone and in combination with each other, on infant weight gain and length gain were examined. Data on 119 infants were collected from 20 villages in rural Lesotho between July 1984 and January 1985. The interactions between sanitation and increased water usage for weight gain (p = 0.007) and length gain (p = 0.006) were significant after potential confounding was controlled. The biggest growth effects were dependent on families possessing a latrine and increasing their use of water during the warm, wet season. Infants gained 1.031 kg (95% confidence interval (CI) 0.420 to 1.642) and 2.028 cm (95% CI 0.523 to 3.533) more when both positive factors were present, as compared with only having a latrine. Increasing water usage compared with not increasing water usage resulted in only 0.105 kg (95% CI -0.175 to 0.385) more weight gain and -0.309 cm (95% CI -1.005 to 0.387) more length in the absence of a latrine. Similarly, infants gained 1.106 kg (95% CI 0.484 to 1.728) and 2.076 cm (95% CI 0.559 to 3.593) more if both factors were operating than did infants whose families only increased their water usage. In the nonincreased water group, the difference in growth between having and not having a latrine was 0.180 kg (95% CI -0.093 to 0.453) and -0.261 cm (95% CI -0.951 to 0.429). Water supply programs should emphasize use of more water for personal hygiene, and sanitation programs should install toilet facilities where water usage is high or has been increased because of an educational program.

Bias↗
PubMed1989

Use of alcohol among high school students in Lesotho--a health promotion perspective.

A recently published article on alcohol use among young people in Lesotho highlighted an important public health issue--the changing pattern of alcohol consumption in many Third World countries. In this commentary I wish to consider some of the factors which might be contributing to this growing problem and some of the steps that need to be taken to address this issue. In particular I will focus on the role of the alcohol industry and the tactics used to create and develop new markets.

Adolescent↗
PubMed1986

A population study on rheumatoid arthritis in Lesotho, southern Africa.

Motivated by the results of a hospital study on rheumatoid arthritis (RA) in Lesotho (southern Africa) a survey of inflammatory polyarthritis (IP) and RA was undertaken in a sample of the rural population of that country. Contrary to expectations the prevalence of IP grades 2-4 (definite disease) was low (0.4%) and equal in both sexes, while probable and definite RA combined (American Rheumatism Association (ARA) criteria) occurred in 1.8% of both males and females. RA was slightly more severe than in other rural African Negro studies but less so when compared with the disease condition of the patients observed in the hospital study. Rheumatoid factor and particularly that directed against heterologous antigen occurred in 41% of the RA patients and in 16% of the controls. Two thirds of the definite cases and 29% of the combined probable and definite group showed radiological abnormalities.

Adult↗
PubMed2000

Sexually transmitted infections and HIV in a rural community in the Lesotho highlands.

OBJECTIVES: To conduct a knowledge, attitude, and practice (KAP) study and to determine the prevalence of sexually transmitted diseases (STDs), including HIV, in a community residing in remote, rural Lesotho. METHODS: In 1995 a cross sectional, community based epidemiological study was conducted on a population of 7500 people living in 89 villages. A total of 29 villages were randomly selected and a systematic sample of houses within villages was obtained. Questionnaires were administered to subjects after written consent was obtained. Determination of N gonococcus and C trachomatis infection was done on urine using ligase chain reaction (LCR) technology. Using blood specimens, syphilis was diagnosed by RPR and TPHA tests and HIV by a single ELISA and confirmed with a western blot. RESULTS: Questionnaires were administered to 277 women, 100 men, and 149 youths (12-15 years). Chlamydia was diagnosed in 28.4% of adults, gonorrhoea in 5.9%, syphilis in 11.3%, and HIV infection in 6.3%. All cases of HIV occurred along the main road (p = 0.001) and 72% of individuals with gonorrhoea were co-infected with chlamydia (p = 0.0001). 11.6% of women and 38.0% of men had had sex with a non-regular partner in the past 3 months and none had used condoms. CONCLUSION: A high prevalence of STDs and HIV infection was found in a population characterised by low levels of knowledge about STD/HIV, high risk sexual behaviour, and evidence of inappropriate health seeking behaviour for STDs.

Adolescent↗
PubMedDate not supplied

Health and safety in the Lesotho Highlands Dam and Tunnel Construction Program.

To review health and safety practices and to determine the occupational health status of dam workers in the Lesotho Highlands, a health and safety audit and a health study of 258 workers was undertaken. The workers were administered respiratory health questionnaires and underwent chest x-rays and lung function and audiometric testing. The audit revealed a low level of awareness of health and safety issues at all levels of management and a lack of occupational medicine and industrial hygiene systems. Noise-induced hearing loss occurred among 92% of the study subjects. Among the 158 dam construction workers, 5.4% had pneumoconiosis. With poorly developed laws and regulatory bodies, unsophisticated trade unions, and little client supervision, health and safety had a low priority in this construction project. Recommendations are made that are pertinent to health and safety management where international companies are operating in developing countries.

Cross-Sectional Studies↗
PubMed1985

"Mummies and babies" and friends and lovers in Lesotho.

This paper examines an institutionalized friendship among adolescent girls and young women in southern Africa. Lesotho's economy is based on migrant male labor which leaves the women dependent on male earnings or subsistence from the land, and also creates unstable marital relations. Young girls in the modern schools develop close relationships, called "mummy-baby," with slightly older girls. Sexual intimacy is an important aspect of these relationships. Mummy-baby relationships not only provide emotional support prior to marriage, but also a network of support for married and unmarried women in new towns or schools, either replacing or accompanying heterosexual bonds.

Adolescent↗