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PubMed1989

Measles prevention and control in emergency settings.

Outbreaks of measles continue to be a common occurrence among refugee and famine-affected children in emergency relief camps. Extremely high measles-associated mortality rates have been reported from refugee camps--where undernutrition is common--in several countries over the past 10 years. Mortality from measles is, however, preventable, and immunization against the disease is a high priority in emergency relief programmes, second only in importance to the provision of adequate food rations. All children aged 6 months to 5 years should be immunized with measles vaccine as soon as they enter an organized camp or settlement. Should supplies of measles vaccine be inadequate, children in feeding centres, or those otherwise identified as undernourished, are the top priority for immunization. The occurrence of measles in a camp is not a contraindication to conducting an immunization campaign. Strong coordination by a designated lead agency is needed if such campaigns are to be successful; however, cooperation with the local expanded programme on immunization is essential to ensure that existing cold chain equipment, training protocols, and management manuals are used. If additional equipment is necessary, a complete immunization kit developed by the Office of the United Nations High Commissioner for Refugees, the World Health Organization, and Oxfam can be procured from Oxfam headquarters in the United Kingdom. Vitamin A supplements should be given routinely at the time of measles immunization in situations where malnutrition is severe. Mortality and morbidity in children with clinical measles can be reduced by administering high doses of vitamin A.

Child, Preschool↗
PubMed1988

Outbreaks of smallpox due to variolation in China, 1962-1965.

In 1985, previously unknown outbreaks of smallpox were uncovered which had occurred in Shanxi Province and Nei Monggol Autonomous Region in northern China during 1962-1965, several years after smallpox transmission was thought to have been interrupted. During field investigation, the authors learned that most of the cases were known to local health officials but had not been officially reported to national authorities. All were among persons who had been variolated or were their close contacts. Variolation is an ancient method of protection against naturally acquired smallpox that was officially proscribed in the early 1950s but was renewed in remote areas when smallpox vaccination activities were interrupted during the three-year famine of 1959-1962, following the "great leap forward" program of 1958. It was found that the variolators in Shanxi Province and Nei Monggol Autonomous Region inoculated persons with the use of powdered smallpox scabs mixed with human milk, and that they obtained fresh supplies of scabs every 6-12 months by variolating relatives and friends. The health authorities responded by capturing the variolators, confiscating their variolation material and equipment, and vaccinating the population. The last known cases occurred in 1965, and the practice of variolation is now believed to be extinct.

Adolescent↗
PubMed1986

[Psychosomatic aspects of protein-calorie malnutrition in early childhood in a tropical environment. Facts and hypotheses].

After a brief look at the clinical descriptions of marasmus and kwashiorkor, and a summary of the physiopathological concepts of these protein calorie malnutritions (PCM), the author looks at arguments which suggest there is a change in the mother-child relationship at the onset of PCM, excluding, however, those malnutritions which appear in conditions of famine or catastrophe. These arguments are drawn principally from studies done in Africa, and are based on clinical, sociological, and ethnopsychiatric data. The contributing factor of maternal depression and that of relational characteristics of the child are considered, and an analysis is made of how these factors might converge at the onset of PCM. The author attempts to demonstrate the important role of a psychomotor retardation in the tableau of psychological troubles which present themselves during the course of Kwashiorkor. The role and importance of weaning, of the separation and the psychomotor retardation in the genesis of the "situation of malnutrition" are discussed. Finally, a parallel is established between PCM and early psychosomatic syndromes observed in the west, principally the anorexias and insomnias during the first year of life. The point in common between these situations and PCM is perhaps the onset of conditions having an upsetting and distorting effect on the mother-child relationship. The family and the entourage use certain collective representations in Africa ("Nit-KuBon", "Tjid-a-Paxer") to try and explain the onset of PCM. The description of these traditional representations is utilized as a materialization, by the mother and the social group, of an alteration of the mother-child relationship, and can be compared to representations which play the same role in the west.

Africa↗
PubMedDate not supplied

Obesity.

Obesity is not a single disease, but a variety of conditions resulting from different mechanisms and associated with various types and degrees of risks. To determine who should lose weight, how much weight should be lost, and how to undertake weight loss, the following types of information are needed: personal-demographic data, developmental patterns, family history, energy balance, body composition/fat distribution, psychological/behavioral measures, endocrine/metabolic measures, complications and associated conditions. Weight reduction should be undertaken by women with morbid obesity, with complications secondary to the obesity, with a strong family history of conditions associated with obesity, or with increased abdomen:hip ratios. In contrast, women who have excess weight localized in the hips and thighs and no personal or family history of associated conditions may not benefit from dietary restriction. Low calorie diets result in adaptive changes, "designed" to prolong survival in the face of famine. These include changes in water balance, metabolic rate, and appetite. Metabolic rate declines, allowing the individual to burn fewer and fewer calories. Each time a woman diets she tends to lose weight less rapidly than the time before. "Restrained eating" predisposes binge eating. Indeed, bulimia rarely occurs in the absence of prior caloric restrictions. Current medical definitions of obesity do not consider these nuances. Existing definitions "over-diagnose" obesity in women, in general, and in older women and nonwhite women, in particular. For example, by existing standards, more than 60 percent of black women more than 45 years of age are considered obese. In contrast, the health risks of similar degrees of obesity are substantially greater for men than for women. Part of the problems lies in the fact that many women have pear-shaped fat distribution,a pattern which is not associated with increased health risks.Current cultural definitions of obesity for women distort the picture even further. In the past 20 years,there has been a progressive decline in the weight-for height of such "culture models" as Playboy centerfold subjects and Miss America contestants. Attempting to achieve such low weights predisposes women to an endless cycle of dieting and regaining, and contributes to the growing problems of eating disorders, including anorexia nervosa and bulimia.

Diet, Reducing↗
PubMed1988

The National Schistosomiasis Control Programme in Mali, objectives, organization, results.

Schistosomiasis control started regionally, in the Bandiagara district, and as a component of a dam-building project in 1978. In 1982 a national programme was created. Control was divided into three phases: Preparation, intervention and maintenance. Districts qualifyed for schistosomiasis control activities, when the prevalence for either Schistosoma haematobium or Schistosoma mansoni exceeded 20% and/or the prevalence of persons with intensive infections for either parasite exceeded 5%. Intensive infection was defined as the excretion of more than 50 eggs per 10 ml of urine or the excretion of more than 100 eggs per one gram of stool. Preparation consisted of sample surveys to identify districts that needed to be included in control operations and the training of local health personnel. Interventions were primarily mass chemotherapy, using a single dose of praziquantel (40 mg/kg), sanitation and health education. The application was still being investigated for its cost benefit. Maintenance was to be achieved through the treatment of cases at fixed centres of the basic health services. Until 1987, control activities were carried out almost entirely through a central team based in the Institut National de Recherche en Santé Publique at Bamako in a vertical fashion. The full integration into the basic health services was retarded due to the drought and famine of the years 1983 to 1985 and other factors. The programme had been active in 136 villages located in the district of Bandiagara, the Office du Niger irrigation area, the Haute Vallée Baguineda irrigation area and the Sélingué dam zone.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1987

Threads of cultural nutrition: arts and humanities.

Cultural nutrition encompasses a wide sweep of food-related themes within three major categories: arts and humanities, social sciences, and biological-natural sciences. The paper, first of three, considers the arts and humanities. Topics include food and diet expressed through art, film, music, and dance. The essay then examines food and diet in representative works of literature, both ancient and modern. The place of food and diet within folklore, mythology, and religion is treated, with consideration of symbolic roles played by food throughout the human life cycle, especially with birth and infancy, coming-of-age, marriage, and death. Religion, a major theme in cultural nutrition, is explored and the food-dietary patterns of Jews, Christians, Moslems, Hindus, and Shintos are treated. Ethics and philosophy are examined as both relate to programs of international food relief and vegetarianism. The essay concludes with a review of work by historians, especially themes of famine and approaches taken to refeed populations during combat and hostilities.

Culture↗
PubMed1986

New technology and its role in enhancing global food production.

The transfer in the past 3 decades of modern agricultural technology to countries of the Third World has led to a steady improvement in global food production. The results have not been evenly distributed, however, and serious problems remain. Modern biotechnology may contribute to solving some of the problems of high input costs and may also contribute to decreasing the risks associated with agriculture in developing economies. Several problems must be overcome, however. Among these are finding ways to bring the advanced technological capabilities of private companies, both large and small, to the international agricultural research network where commercial incentives are not strong or are inappropriate. Also, unless and until severe countervailing forces, such as population growth rates and deterioration of the environment, are brought under control the spread of new agricultural technology will be of little consequence in the most difficult famine-prone situations.

Agriculture↗
PubMedDate not supplied

[Nutrition in Africa].

A certain number of countries in Africa south of the Sahara are suffering from severe food shortages and famine which have called the attention of the international public opinion. A review of the situation clearly shows that, not only the availability of food depends upon agricultural production and its various conditioning factors (soil, climate, fertility, agricultural technology, storage facilities, etc.), but that such socio-economic factors as population, migration, supplies to urban centres, transport, unemployment, inflation and debt also have a strong influence. With some variations in intensity, these factors and conditions are the same everywhere. It may therefore be said at the present time that political disorders and a poor understanding of nutritional problems are more often than not responsible for tragic situations.

Africa↗
PubMed1970

Fetal nutrition.

The extensive literature on nutrition in pregnancy is reviewed with special reference to international experience, including observations on nutritional trials in pregnancy, pregnancy during famines caused by war, and studies of birth-weight in relation to pregnancy interval, parity and multiple pregnancies. Recent research on the significance of fetal nutrition suggests that "small-for-dates" infants, i.e., those that are developmentally retarded in utero, suffer long-term developmental sequelae. A high world-wide incidence of small-for-dates births was reported by the World Health Organization in 1960.Although a definite correlation has been found between socio-economic status and birth-weight, it is not known to what extent the smaller birth-weights observed in the lower socio-economic groups can be improved by specific nutritional measures. In addition to the general advice given on maternal nutrition and family-planning, further studies are needed to determine the precise means of achieving improvement in fetal nutrition and a better outcome of pregnancy.

Anthropometry↗
PubMed1980

Obesity and the development of the diffuse neuroendocrine system.

The diffuse neuroendocrine system may play a critical role in the events of both adaptation for impending famine and of arousal from the opioid-induced conservation state. This may occur by means of the opioid and anti-opioid peptides of APUD cells acting in conjunction with shifts in biogenic amine uptake and release.

APUD Cells↗
PubMed1984

The impact of oedema on anthropometric measurements in nutritional surveys: a case study from Zaire.

Six surveys for protein-energy malnutrition were carried out in sequence in Bas-Zaire beginning at the end of 1978 at the estimated height of the famine and continuing throughout the recovery period. Utilizing a stratified multi-stage sampling technique, over 1000 children aged 6 months to 6 years were measured anthropometrically and examined for the presence or absence of bilateral pedal oedema in each survey. The proportions of children who were less than 80% of the reference median weight-for-height and who had oedema decreased, respectively, from 12.8% and 14.4% initially to 2.1% and 1.8% in the final survey. The proportion of oedematous children who were found to be not less than 80% of the reference median weight-for-height was high, varying from 71.7 +/- 7.0% to 94.4 +/- 10.6%. The importance of these findings for the interpretation of anthropometric data from nutritional surveys in developing countries is discussed.

Anthropometry↗
PubMed1982

Vitamin deficiencies during the Spanish Civil War in Madrid: a reminiscence.

During the second winter of the war (1937-38) most of the patients showed a picture of classic pellagra, with a number of neurological disorders which in same cases appeared with no other manifestations of Pellagra. The clinical picture was dominated by the appearance of famine edema, with less manifestations of specific vitamin deficiencies, with neurological manifestations called similar to those "burning feet" syndrome and described by us as Paresthetic and Paresthetic-causalgic syndrome. The prominent features were: acroparesthesia, dysestesia dolorosa, sensation of cold, sensation of wetness, hyperpathia and causalgic pain. Treatment with nicotinic acid was very effective for the classical manifestations of Pellagra (dermatitis, diarrhea and dementia), but had no significant effect on the neurological manifestations. No effect of vitamin B1 was observed, but some improvement following the administration of autoclaved brewers yeast. It was concluded that the neurological manifestations often associated with the classical picture of Pellagra are not due to nicotinic acid deficiency, but to the deficiency of some component of the vitamin B complex which was neither vitamin B1, nor vitamin B2.

Avitaminosis↗
PubMed1983

Absence of detrimental changes of cognitive parameters during fasting.

During the first 10 d of a total fast the changes in a series of cognitive parameters: short-term memory, long-term memory, speed of information processing, vigilance, and mental control were tested in 14 obese inpatients and compared with a control group. Ten days of fasting induced no detrimental changes. An improvement in the subtest 'Repetition of digits' was interpreted as improved motivation as a consequence of successful weight reduction. In contrast to the experience of normal weight people during famine periods, obese patients seem to tolerate short-term fasting periods without negative intellectual effects.

Adult↗
PubMed1981

[Nutrition of man and animals (author's transl)].

Information on daily nutrient requirements is more complete for farm animals than for horses, pets and man. Very little is known, particularly in man, horses and pets of the relationship between nutrition and longevity. Therefore, a slightly higher intake of essential nutrients would appear to be preferable, the more so as the body can readily remove any surpluses. This also holds true for man and animals in suboptimum living conditions. Inadequate information on this relationship in man as well as the current concern of the consumer regarding the safety of his food are the reasons for which animal production should be very cautious regarding the use of additives and drugs. Investigations on the effects of nutrition on longevity and resistance, immunity, food-intake regulation and other complicated problems should be directed towards understanding and require thorough and extensive preliminary studies covering all species of animal, including man. Animal husbandry as a whole contributes materially to world food production because of its use of many feeds which are unacceptable to or cannot be utilized by man. Further possibilities of increasing the conversion of feed into food are presented. However, ensuring an optimum world food supply to defeat famine not only involves the technical problems referred to but also has several economic and sociological aspects and requires united international efforts.

Animal Feed↗
PubMedDate not supplied

[Was the regression of leprosy also a function of the economic development in the XIV century? (author's transl)].

During century of expansion, the bread was regularly more costly and the labour cheapness for surpopulation. During the XIVth century, the weather was too rainy and more cold, the corn harvest was too much deficient, the mortality increased; ground no fertile was deserted: dearth and famine consecutive. The rats followed peasantry and giving the pest, from which depopulation increased. The wages growed to twice as much while the bread was reduced. Life come better and the leprosy was coming to reduce.

Europe↗
PubMed1995

Racial difference in body core temperature between Pima Indian and Caucasian men.

A low body temperature is associated with a low metabolic rate for a given body size and body composition. These two traits might have been assets in the history of a population subjected to cycles of feast and famine, but became part of an obesity-prone syndrome in our westernized society characterized by plenty of food and a sedentary lifestyle. We tested whether Pima Indians have lower body temperatures than Caucasians, a trait which might partly explain the high prevalence of obesity in this population. Twenty-five Pima Indian (28 +/- 6 yrs, 87.8 +/- 22.8 kg, 29 +/- 9% body fat) and 25 Caucasian (30 +/- 5 yrs, 80.7 +/- 18.4 kg, 22 +/- 11% body fat) men had body core temperatures measured by telemetry for 24 h while in a respiratory chamber. Mean daily body core temperature was 36.93 +/- 0.12 and 36.90 +/- 0.22 degrees C in Pima Indians and Caucasians, respectively. Since body core temperature during sleep (SLBCT) correlated with percentage body fat, a subset of 10 Pima Indians and 10 Caucasians were pair-matched for body weight and percentage body fat. In this group, SLBCT was lower in Pima Indians than in Caucasians (36.45 +/- 0.10 vs 36.65 +/- 0.27 degrees C; P < 0.01) and, ethnic group accounted for 20% of the variance in SLBCT (P < 0.01). Surprisingly, the lower SLBCT was not associated with a low metabolic rate and therefore does not seem to play a role in the etiology of obesity in Pima Indians.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1994

Re-thinking the "human factor" in malaria mortality: the case of Punjab, 1868-1940.

Recurrent, severe malaria epidemics dominated 19th century colonial Punjab's demographic history. Regression analysis supports Sir Rickard Christophers' 1911 findings that acute hunger (as reflected in foodgrain prices) was an important factor underlying these epidemics between 1868 and 1908. In the ensuing three decades, autumn malaria mortality fell dramatically to less than one-third the earlier levels though malaria transmission and infection rates across the province appear to have remained unchanged, a decline more likely attributable to decline in famine than to either medical or entomological factors.

Disease Outbreaks↗
PubMedDate not supplied

[An outbreak of Heliotrope food poisoning, Tadjikistan, November 1992-March 1993].

The seeds and roots of Heliotropium lasocarpium, contain a pyrrolizidine alkaloid which causes toxic liver injury and veno-occlusive disease (VOD), characterised by an occlusive lesion of the centrolobular veins of the liver, when consumed by humans. The Farkhar region of Southern Tadjikistan, was blockaded from May to November 1992. This led to a famine and a delay of two months in the wheat harvest. Heliotropium lasocarpium had time to grow in the fields and their seeds were therefore collected with the wheat. The contaminated wheat was distributed to the population, who milled it and made bread. The first case of liver toxicity was six weeks after the first consumption of the contaminated bread. By March 1993, 3,906 cases had been recorded (attack rate = 4%). The attack rate were 0.4%, 5.4%, 4.0%, 2.8% and 1.5% for the less than 1 year, 1-14 years, 15-30 years, 31-50 years and over 50 years age groups respectively. The overall case fatality ratio (CFR) was 1.3% and increased with age from 0 to 5.9% in the same age groups. Two of the ten collective farms represented 83.3% of the cases attack rate of 16.9% and 23.6%. Four stages of illness were defined. Stage I corresponds to abdominal pain, nausea or vomiting, and asthenia. All stage I patients (55.5%) recovered rapidly. Stage II is an association of Stage I and hepatomegalia (29.9%). Stage III includes ascites in addition to these symptoms (13.7%) and stage IV alteration of consciousness (0.9%). The last case was reported on March 4th 1993.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗