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At least 649 records · Page 36Linked to original sources
PubMed2000

Prognostic factors for persistent diarrhoea managed in a community setting.

Two hundred and five cases (mean age 13.4, SD 9.5) of persistent diarrhoea (PD) of 14-28 days duration, attending an urban slum clinic and treated according to standard WHO guidelines, were monitored at weekly intervals to obtain an estimate of treatment failure rates and to identify its clinical predictors. Vitamin and micronutrients (daily 2RDA) were additionally provided. Only 9 (8.2%) of 109 children with criteria for hospital care accepted in-patient care. Weight gain was considered inadequate if the daily increment between enrollment and day 7 of follow up was < 10 g at age 0-3 months, < 5 g at 4-6 months, and any weight loss for those older than 6 months. Recovery was considered delayed if diarrhoea ceased 7 days after enrollment. Overall, 28.3% cases had inadequate weight gain and 25.6% had delayed recovery. The non-breast milk calorie intake was 11.2% during infancy and 40.6% at later ages of the recommended intakes. In a logistic regression model, initial watery stool frequency greater than median (adjusted OR 2.30, p = 0.01), age < or = 6 months (adjusted OR 2.24, p = 0.04) and low consumption of micronutrient mixture (adjusted OR 2.62, p = 0.01) were associated with an increased risk of delayed recovery. In a Cox proportional hazards model for time to recovery from diarrhoea, low consumption of the micronutrient mixture and age < or = 6 months reduced the chances of recovery by 29% and 37% respectively. Low consumption of the prescribed micronutrient mixture (adjusted OR 2.21, p = 0.04), fever (adjusted OR 1.91, p = 0.05) and diarrhoea continuing beyond study day 7 (adjusted OR 2.29, p = 0.03) increased the risk of inadequate weight gain. Breast feeding status and animal milk consumption did not influence weight gain or recovery. Due to the low compliance for advised hospitalisation, approaches for care at community level itself need to be evolved. Focus should be on increasing the overall dietary intake and provision of generous but safe amount of micronutrients; our findings do not support need for routine elimination of animal milk. The efficacy of individual micronutrients needs evaluation in controlled trials.

Community Health Services↗
PubMed2004

The Indian picture puzzle test - a developmental test designed and standardised for Indian children.

OBJECTIVE: To construct a test used by community pediatricians and other professionals in the UK as a screening test for verbal and non-verbal development in children aged 2 to 4 years of age. METHODS: A multifaceted developmental test of cognitive skills was constructed, modeled on the Bus Puzde Test (Egan 1984) for its case of administration and appeal. Each stage in the design was piloted in Rajasthan in all socioeconomic groups. Stages include simple ethnic modification of the original test, development of more socioculturally appropriate scenes, a detailed statistical procedure of item analysis and reliability studies. The picture was converted into a wooden insert puzzle, called The Indan Picture Puzzle Test (IPPT) and standardized on a random sample of 616 children to construct the norms. RESULT: The IPPT assesses aspects of early language, picture interpretation, performance skills and conceptual development in children aged 2 to 5 years. Analysis of the standardized data highlighted the need for separate norms for each socioeconomic group. CONCLUSION: Verbal abilities were significantly different between advantaged and disadvantaged (slum and rural) groups though performance skills were comparable.

Aptitude Tests↗
PubMedDate not supplied

Intestinal helminth infections among school children in Visakhapatnam.

A study was carried out between 1993-1994 to determine the prevalence and intensity of intestinal helminth infections among 217 primary school children in Relliveedhi, a slum area in Visakhapatnam. The children were between 7 to 13 years of age and belonged to lower socio-economic status. Stool samples collected were processed by modified formalin-ethyl acetate sedimentation technique to determine ova counts (EPG). One hundred and seventy seven children were infected with one or more of the intestinal parasites viz. Ascaris lumbricoides, Trichuris trichiura and hookworm. The overall prevalence of infection was eighty two per cent. Ascaris lumbricoides was the most common infection with a prevalence of 75% followed by T. trichiura (66%) and hookworm (9%). All infected children received a single dose of albendazole (400 mg/child). Single stool samples were examined over a period of nine months to study reinfection dynamics.

Adolescent↗
PubMed2005

Socio-demographic co-relates of psychiatric disorders.

OBJECTIVE: To find out the magnitude of probable psychopathology in children and study association of psychopathology with demographic, developmental and social factors. METHODS: Childhood Psychopathology Measurement Schedule (CPMS) was used to measure the magnitude of probable psychopathology in 620 children from an urban slum of Miraj (Maharashtra). A second schedule recorded demographic, developmental and social factors. RESULTS: CPMS score > 10 was observed in 102 children (16.5%). It was significantly higher in children aged 7-10 years, in males, belonging to lower socioeconomic status, large families, being first born, having low birth weight (LBW); body mass index (BMI) less than 18.5. Low maternal education and alcohol abuse in father also had significant association with CPMS score > 10. CONCLUSION: Findings suggest a need to educate the community about psychological implications of LBW, large family size and overcrowding in children. Improving maternal education and controlling alcoholism could help in reducing childhood psychopathology.

Adolescent↗
PubMedDate not supplied

Vitamin A status of socio-economically backward children.

A comprehensive survey was carried out to asses the Vitamin A status of pre-school (0-6 yrs). and school age (6-12 yrs.) children of socio-economically backward families from slums of Bombay and its suburbs. The Vitamin A, protein, calories and iron from the rice and dal based diet was found to be below recommended dietary allowances (RDA). Among the 1956 children surveyed 20% of the children showed low (< 20 micrograms/dl) serum vitamin A levels. 4.8% of the children were suffering from one or the other signs of Vitamin A deficiency. Rose Bengal stain test (RBST) and conjuctival impression cytology (CIC) indicted the signs of mild conjuctival xerosis and of early epithelial changes which were correlated with serum vitamin A levels. Serum iron, PCV, Hb and RBC levels were below normal. The anthropometric measurements of these children were below 50th percentile of Indian Council of Medical Research (ICMR) standards. Due to lack of proper nutrition, the overall growth of children is either retarded or not upto the standard levels as was noted in majority of the children.

Age Distribution↗
PubMed2000

Anemia in children: early iron supplementation.

Iron deficiency anemia is the most wide spread micronutrient deficiency disorder in the world, being most prevalent in women and young children. The present study was conducted to find out the prevalence of anemia in children and its contributory factors with reference to early iron supplementation. It was a cross sectional study done on 137 children of age 1-2 years in urban slums of Meerut. Prevalence of anemia in the study group was 59.9%. The socio-economic status, mother's educational status, birth weight, sibling order, and type of weaning food did not show any significant relationship with the prevalence of anemia in these children, whereas, weaning time, nutritional status and early iron supplementation had a positive impact on it. Exclusive breast feeding upto 4 months followed by weaning, adequate nutritional status and early iron supplementation have a definite role in prevention of anemia in children.

Age Factors↗
PubMedDate not supplied

Acute paralytic poliomyelitis in Delhi (1975-1992).

Incidence of poliomyelitis in Delhi between 1975 and 1992, estimated from available data, shows a ladder-pattern type of decline from 15.65 in 1975 to 5.90 in 1992. The linear regression analysis shows a declining trend of incidence by 66.28% during the period. Huge increase of population with fast growing slums and resettlement colonies in Delhi was attributed to be responsible for partly counteracting different poliomyelitis control/eradication activities. The population representativeness of estimated incidence showed constant improvement during 1980 to 1991.

Humans↗
PubMedDate not supplied

Development and assessment of a screening test for detecting childhood disabilities.

The paper outlines the development and assessment of a screening test for broad-based identification of major disabilities in children under 6 years of age. The Disability Screening Schedule (DSS) has been developed which should act as a one time screen for all major disabilities viz. physical, motor, sensory and mental retardation. The DSS was developed after reviewing a number of existing screening instruments. It was pilot tested in 3 phases and suitably modified. Nineteen AWW received a short training and used the DSS to screen children with disabilities in their respective areas. It was field tested by administering it on 3560 children (0-6 years) drawn from nine urban slums of South Delhi. The workers used the DSS and identified 245 children as having an impairment/at risk conditions and 3315 children were reported as normal. The investigator cross checked 219 'impaired' and 536 'normal' children. On the basis of the review exercise, the DSS was validated and was found to have a sensitivity of 0.89 and a specificity of 0.98. The DSS is a short questionnaire, and the administration time is about 5 minutes.

Child↗
PubMed2004

Investigations on the biology, epidemiology, pathology and control of Tunga penetrans in Brazil: IV. Clinical and histopathology.

Tungiasis is a parasitic skin disease caused by the sand flea Tunga penetrans. This ectoparasitosis is endemic in South America, the Caribbean and sub-Saharan Africa, where it is an important but neglected health problem in resource-poor communities. As part of a study of tungiasis-related morbidity in a typical slum in Fortaleza, Brazil, we identified 86 individuals with tungiasis. Lesions were counted, classified according to the stage of development, and clinical pathology was documented. One hundred and nine lesions were biopsied and examined by histological sectioning. The patients had between 1 and 145 lesions (median 14.5), the majority occurring in clusters. In all, 77% of patients reported severe pain at the site of the lesion, and 52% had one or more nails lost or severely deformed. Intense inflammation and/or fissures hindered 45% of the patients from walking normally. Signs of superinfection were observed in 29%, and signs of generalized inflammation in 2% of patients. Clinical pathology was significantly related to the number of lesions, and the total number of parasites present correlated with the number of fleas occurring in clusters. Clinical pathology was frequently accompanied by a pathological alteration of the epidermis (predominantly hyperplasia, parakeratosis, hyperkeratosis, and spongiosis) and the dermis. Tungiasis causes a broad spectrum of clinical histopathological alterations, and is a serious health threat in a typical, impoverished community in northeast Brazil. The clinical pathology is closely related to the parasite burden of an individual and the clustering of embedded fleas at certain predilection sites.

Adolescent↗
PubMed2006

Safe sex versus safe love? Relationship context and condom use among male adolescents in the favelas of Recife, Brazil.

This study examined the influence of the relationship context where adolescent sexual activity takes place on contraceptive decisions. The data were collected in a specially designed survey carried out in May 2000 on 1,438 adolescent males aged 13-19 residing in favelas (urban slum areas) of Recife, Brazil. A logistic regression analysis of condom use at last sexual intercourse and a multinomial logit analysis of contraceptive method choice were performed for 678 sexually active adolescents. Educational attainment, degree of knowledge of HIV transmission and prevention, and condom use at first sexual intercourse were found to be significantly associated with current condom use. Regarding the relationship context, the analysis revealed that adolescent males in steady relationships were less likely to use condoms, less likely to regard themselves at risk of HIV infection, and more concerned about pregnancy prevention than adolescents in casual relationships. Differentials in condom use by type of relationship, however, did not result from a higher rejection of contraception by steady partners but from their higher likelihood to rely on other contraceptive methods. Results suggest that prevention campaigns need to take into account the intimate context where adolescents assess potential health risks, and to address the divergent symbolic meanings condoms may have in different types of relationships. If an increase of condom use among stable sexual partners is pursued, public health campaigns might need to romanticize condom use as a sign of love and trust and place more emphasis on the benefits of dual protection.

Adolescent↗
PubMed1981

Acceptability of the contraceptive vaginal ring by rural and urban population in two Latin American countries.

A study of the field acceptability of the Contraceptive Vaginal Ring (CVR) was carried out in rural, small town and urban slum clinics in four locations, two in Brazil and two in the Dominican Republic (D.R.) The CVR was offered as a new method in the clinics and described as similar to the pill but placed in the vagina for three weeks each month with a one-week rest interval. Follow-up surveys were carried out in the four locations at the end of the experimental period. Three, eight, nine and 12.5% of the total acceptors in each of the 4 locations chose the CVR. The acceptance rate fell after the first five months but recovered during the second year. The acceptance rate was much higher in three rual clinics where the nurses themselves used the ring. The follow-up surveys showed that the fact that the ring is placed and kept in the vagina without removal for a prolonged period was the most important attribute of the method and played a large role in women's reactions to it. Anticipated use-related problems were the most prominent reason given by pill users for not choosing the ring, however ease of use was named as the "most killed" characteristic by 55% of ring users. Women tended to remove the ring for intercours and washed it frequently, often with detergents, thus illustrating their concern with "cleanliness" of an object kept within a body cavity for long periods of time.

Brazil↗
PubMed1987

Traditional obstetrics; a Nigerian experience of a traditional birth attendant training program.

A survey was conducted of 150 Traditional Birth Attendants (TBA) living in the peri-urban slum area of Ibadan, Oyo State, Nigeria. The purpose was to determine demographic characteristics as well as knowledge about midwifery practices prior to introducing a training program. The participants in the survey had volunteered for a free, 3-week training program in modern obstetrics. Information was collected by questionnaire which was read to the participants. The findings show that: (1) useful service is being rendered by the TBAs; (2) there are areas where the introduction of simple methods of aseptic technique, changes in some nutritional practices and increased knowledge on the benefits of immunization may improve the outcome for mothers and infants living in traditional societies in Nigeria. The findings serve as a guide for the development of content of TBA training programs.

Delivery, Obstetric↗
PubMed1982

Kanagawa phenomenon and serotypic pattern of Vibrio parahaemolyticus strains isolated from various sources in Calcutta.

A total of 135 strains of Vibrio parahaemolyticus isolated during the period 1976-77 from human gastroenteritis cases and various categories of environmental sources, e.g., crustaceans, fish and different water samples (pond, stored, open well and tap water) were tested for their Kanagawa phenomenon and serotypic pattern. Amongst the 80 human isolates tested, 69 strains (86.3%) were Kanagawa phenomenon positive, and 60 strains (75.0%) were serologically typable--the dominant serotype being 05:K15. Of the 25 isolates from various water sources 10(40.0%) were Kanagawa phenomenon positive, and 17(68.0%) were serologically typable and 4 (23.5%) of them belonged to serotype 05:K15. All the 30 strains isolated from crustaceans and fish were Kanagawa phenomenon negative and 22 (73.3%) of them were serologically typable, belonging to heterogeneous serotypes. The results of this study also indicate the possible role of water in the transmission of V. parahaemolyticus infection in Calcutta slums.

Food Microbiology↗
PubMed1986

Soiled saris: a vector of disease transmission?

We examined the relationship between uses of the sari that are potential health hazards and episodes of diarrhoea in children younger than 6 years in 247 families living in 51 slums in Dhaka, Bangladesh. These misuses appeared to be common (median of three per observation period) and were largely unrecognized by the women as possible sources of disease transmission. There appeared to be a positive correlation between the number of misuses of the sari and episodes of childhood diarrhoea.

Animals↗
PubMed1988

Seroprevalence of Toxocara canis infection in tropical Venezuela.

An enzyme-linked immunosorbent assay (ELISA) was used to determine the seroprevalence of Toxocara canis infection in different socio-economic groups of the tropical population of Venezuela. The lack of definitive independent diagnostic criteria for toxocariasis required the establishment of operational upper limits of normality for Toxocara ELISA values, based upon their log-normalized distribution in a presumptive "non-toxocariasis" sub-population. Only 1.8% of urban subjects of medium-high socio-economic level were considered to be clearly positive in Toxocara ELISA, compared to 20.0% of urban slum dwellers, 25.6% rural subsistence farmers and 34.9% Amazon Indians. As the test was performed using excretory-secretory antigen, and under conditions of competitive inhibition by soluble extracts of non-homologous parasites, co-infection by common intestinal helminths, protozoa or other organisms did not give rise to false positive results. However, strong cross-reactivity with Onchocerca volvulus may have influenced the prevalence figure obtained for the Amazon Indians. These results indicate that T. canis is yet another parasite that is widely distributed in economically underprivileged tropical populations.

Adolescent↗
PubMedDate not supplied

A home nutritional rehabilitation programme in a Peruvian peri-urban shanty town (pueblo joven).

In a peri-urban shanty town located in Lima, Peru, a nutritional census of children 0-3 years old revealed a number of second and third degree malnourished children. In order to treat these children a home-based nutritional rehabilitation (HNR) programme was developed utilizing available community health staff. The programme focused on individual and group maternal education, home-based therapy such as oral rehydration solution for diarrhoea, periodic growth monitoring, and a strong trust relationship between mother and health professional. There was one death and four (7%) hospital admissions among the 54 HNR children. These morbidity and mortality rates were similar to those achieved by more traditional programmes in Bangladesh, India, and Guatemala. NHR can provide an inexpensive, reproducible method useful for the treatment of malnourished 'third world' children in peri-urban slums.

Body Height↗
PubMedDate not supplied

Diagnosis of Giardia duodenalis infection in Bangladeshi infants: faecal antigen capture ELISA.

An enzyme-linked immunosorbent assay (ELISA) to detect antigens of Giardia duodenalis in faeces was evaluated as a diagnostic tool by testing faecal samples collected during a cohort study of 229 infants living in an urban slum in Dhaka, Bangladesh. Faecal samples had been collected at enrollment, on a routine monthly basis, and repeatedly during episodes of diarrhoea and infection with Giardia, and a portion of all samples was frozen in saline. A direct smear of all had been examined by microscopy and again after concentrating cysts by ether sedimentation. A total of 2121 of the 4936 samples stored during the 22 months study were tested by the ELISA. After excluding non-specific binding, the sensitivity of the assay was 94.2% and the specificity was 98%. The presence of other parasites, including flagellated protozoa, was not linked to false positive ELISA results. There was a correlation between the number of Giardia cysts present and the ELISA optical density. Assuming that the ELISA is 100% sensitive, microscopy detected 92.4% of the infections detected by the ELISA.

Animals↗
PubMedDate not supplied

Estimation of hookworm intensity by anthelmintic expulsion in primary schoolchildren in south India.

A study was carried out between March 1990 and February 1991 to determine the prevalence and intensity of hookworm infection in 151 primary schoolchildren, aged 6-12 years, in Jalaripet, a slum area in South India predominantly inhabited by fishermen. Pre-treatment stool samples were processed by a modified formalin-ethyl acetate sedimentation technique to determine ova counts. All children were treated with pyrantel pamoate and post-chemotherapy stools were collected over 48 h to recover expelled worms. The overall prevalence of hookworm infection was 45% and the mean egg count was 192 eggs/g. The mean worm burden was 1.25 worms/child. The influence of host factors such as age and sex, environmental factors and behavioural factors on the intensity of egg output and worm burden was investigated.

Age Factors↗