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PubMed1989

Use of body mass index for assessing the growth status of infants.

Growth status of infants measured by weight and height was assessed from birth to 12 months in a randomly selected community from the urban slums of Hyderabad City. Mean birth weight was 2.82 kg. Weight/height indicator of body mass index (BMI) showed a progressive increase till 4th month, followed by more or less a constant figure with a mean value of 1.50 in longitudinal, semi-longitudinal and cross sectional data till one year. Critical limit for BMI at birth for given weight of 2.5 kg was 1.20 and subsequently increased to 1.35. BMI was well correlated with weight and weight for height (%) and least correlated with height. Children with height of 90% or above and birth weight of above 2.5 kg were observed with better growth and better maintenance of weight for height (%) and BMI till 6 months.

Body Mass Index↗
PubMed1989

Care of the newborn by traditional birth attendants.

The study was carried out in a slum cum resettlement colony (Area-I) and four villages (Area-II) of Delhi. Management of the newborn by the 25 functioning Traditional Birth Attendants (TBA's) who conducted 83.64% deliveries in Area-I and 16.22% in Area-II was studied. Majority of TBA's did not have the concept of washing hands before conducting per vaginum (P/V) examinations or deliveries. Most of the TBA's, i.e., 21 out of 25 used a razor blade to cut the umbilical cord of which 9 used a fresh blade. No TBA left the cord untied. Vigorous patting in upright and also after holding the baby upside down was the commonest (68%) method of neonatal resuscitation. All TBA's massaged and bathed the baby everyday. Majority of the TBA's (18 out of 25) referred the baby to a health agency for immunization though they did not know the exact schedule.

Delivery, Obstetric↗
PubMed1989

Magnitude of faecal contamination of rural community well waters in Nigeria and its relationship to well and water properties.

The possible relationship between high numbers of fecal coliforms (FCs), fecal streptococci (FS), standard plate count (SPCs) and well characteristics viz: well depth, water column, temperature, pH and non-filterable residue in 25 rural community wells in the Port Harcourt region, Nigeria, was studied. Zonal differences in residue level, well depth and fecal indicator bacteria were observed; these parameters were lowest in an area of high population density (slum) reclaimed from and adjacent to mangrove forests. Although some wells were covered and/or walled to protect them from surface runoff contamination, FCs and FS were recovered from all, except three, in numbers (log10 per 100 mL) ranging respectively from 0.40-3.79 and 0.70-3.44. The FC:FS ratio was less than 1.0 in 8 and greater than 1.0 in 14 samples. Well depth correlated with FCs (p = 0.01; r = 0.5684), FS (p = 0.001; r = 0.6423), pH (p = 0.0001; r = 0.5981); FCs and FS correlated significantly (p = 0.01; r = 0.4948). SPCs did not correlate significantly with FCs, FS and the well and water characteristics. Simultaneous analysis of samples by the Membrane-filtration (MF) and Most Probable Number (MPN) methods recovered mean FC counts in the decreasing sequence: Standard-MPN----Anaerobic----Aerobic MF----Direct-MPN. The underground water table is most probably contaminated via large numbers of soakaway pits and similar conveniences. Downward movement of contaminant from the shallow conveniences into deeper water tables may explain the well depth: indicator bacteria correlation.

Analysis of Variance↗
PubMed1989

Albendazole in the treatment of goehelminth infections in children.

Children with mixed helminthic infections between the ages of 2 and 14 years, from a slum area, were treated with two regimes of albendazole. A majority of children had moderate to heavy infections with Trichuris trichiura (greater than 70%) and Ascaris lumbricoides (greater than 84%). Children treated with a single 400 mg dose of albendazole showed a very good response in ascariasis with 100% cure rate irrespective of the severity of infection. In Trichuriasis (n = 40), a cure rate of 50% was observed in mild infections, but only a reduction in the egg counts of 60% and 57% respectively were observed in moderate and heavy infections. Only 10 patients with Necator americanus infections were treated with the single dose, and the cure rate in mild infections was satisfactory (86%), with an overall egg reduction rate of 95%. In 47 children included in the multiple dose regime (200 mg daily x 3 days), the cure rates in trichuriasis were, 82%, 66%, and 37% respectively in mild, moderate, and heavy infections. The egg reduction rate was 98% in all degrees of infection in trichuriasis. The cure rate in ascariasis, with the multiple dose regime was similar to that of the single dose, with 100% egg reduction, irrespective of the severity of infection.

Adolescent↗
PubMed1989

Nutritional interventions through primary health care: impact of the ICDS projects in India.

In 1975 the Government of India initiated an integrated approach for the delivery of health care as well as nutrition and education services for deprived populations at the village level and in urban slums through centres, each of which was run by a local part-time female worker (anganwadi) who was paid an honorarium and had a helper. This national programme, known as the Integrated Child Development Services (ICDS), began with 33 projects but, by March 1986, had expanded to 1611 projects covering 23% of the country's population and representing about 50% of the population in the socioeconomically backward areas. The ICDS can therefore be considered to function as a primary health care programme for preschool children (under 6 years old), pregnant women, and lactating mothers. The present study investigated the impact on the nutritional status of the target population after 3-5 years and after 8 years of ICDS interventions, compared with the nutritional status of non-ICDS (control) groups. The results showed that the ICDS nutrition intervention programmes achieved better coverage of the target population and led to a significant decline in malnutrition among preschool children in the ICDS population, compared with the non-ICDS groups that received nutrition, health care and education through separate programmes. This example may lead other developing countries to introduce integrated programmes with certain modifications to suit local conditions. International agencies and national governments should strive to bring about the integration of nutritional services with primary health care and development programmes for children because of the good results in terms of child survival and child development.

Anthropometry↗
PubMedDate not supplied

Prevalence of ascariasis and ancylostomiasis in families: a collaborative inquiry.

A collaborative survey was carried out to estimate the prevalence of ascariasis and ancylostomiasis in random samples of 200 families in each of 3 different communities: a city slum (CS), an industrial township (IT), a farming village community (FVC). Stool examination was done by Kato's qualitative thick smear method. Ascariasis was prevalent in all the three communities; the percentage of families with multiple members infected varied from 50 to 91 per cent; the percentage of members infected within such a family varied from 48 to 74 per cent; the infection was highly prevalent (41-78%) in all age groups excepts adults in the IT. From 8 to 11 per cent of persons with ascariasis were negative on stool examination but passed worms after medication. Ancylostomiasis was arevelent mainly in the FVC and to a less extent in the IT; the percentage of families with multiple members infected was 83 per cent in the FVC and 17 per cent in the IT; the percentage of members infected within such a family was 54 per cent in the FVC and 58 per cent in the IT. All the persons surveyed received a single 10 mg/kg dose of pyrantel pamoate (Combantrin*, Pfizer) which was well tolerated.

Ancylostomiasis↗
PubMed1989

Epidemiological study of enteric coronavirus excretion by an enzyme-linked immunosorbent assay.

The enzyme-linked immunosorbent assay with a blocking test was used to determine the prevalence of enteric coronavirus excretion among the population of Bangkok and Khon Kaen province. The results indicated that coronaviruses were present in fecal samples from both children and adults with or without diarrhea. It is interesting that the viruses were more frequently observed in the apparently healthy individuals in Bangkok than in the patients with diarrhea whereas the excretion rates were approximately alike in both groups in Khon Kaen province. Among children aged less than 5 years (with or without diarrhea) the viruses were more frequently observed in stools from young children (1-5 years old) than from the newborn (less than 1-year-old) particularly those living in the Bang Khen slum area and in the rural Khon Kaen community. The rate of coronavirus excretion did not increase with age and some apparently healthy individuals continued to excrete the viruses for several months. The results also suggested that chronic parasitic infection associated with low socioeconomic status might influence the excretion of enteric coronaviruses in the feces.

Adolescent↗
PubMed1988

Acceptability of the modified mucus method: study of the psychosocial factors affecting acceptance.

A three-phase study designed to study the acceptability and use-effectiveness of the modified mucus method covered a sample of 2,601 poor rural migrant women living in eight low-income areas--villages and resettlement slum colonies. In phase I, the women were exposed to NFP awareness, i.e., the modified mucus method, and 61.6% of the women accepted the method, and agreed to learn and use it. The learning phase is three cycles. Of these acceptors, 83.7% were fertile. A large percentage of the acceptors are Hindus. The low acceptance by the Sikhs was who were non pregnant, menstruating cohabiting. 15.3% were nonmenstruating owing to pregnancy or breast feeding; 0.9% were menstruating, but not cohabitating; 35.4% of the women were not interested in learning or using the method. A comparative study of the acceptance and nonacceptance for the selected sociodemographic and family planning variables is analysed. The acceptors of NFP differed significantly from the acceptors of sterilization and IUD in their occupation, educational levels, duration of marriage, number of living children, number of living sons, knowledge of family planning, and previous use of family planning.

Cervix Mucus↗
PubMed1988

Assessing supplementary feeding programmes in selected Balwadies.

The aim of the study was to investigate whether feeding programmes achieve their goal of improving nutritional status of target groups when such groups live in environmental conditions that constantly pose risk of infections and infestations. Two major areas from Pune city were selected: one comprised mostly slum dwellers, living in poor environmental conditions (LSE) and the other with better-off families living in good environmental conditions (MSE). From each of the two areas two Balwadies (kindergartens) were selected: one was implementing a feeding programme (LSE(F) and MSE(F)) and the other was not (LSE(NF) and MSE(NF]. A total of 273 newly admitted pre-school children from these Balwadies were selected and anthropometric measurements were made three times during the study period of 7 months. Food items distributed in the school were weighted and analysed for energy and protein values. Assessment of nutritional status by the Gomez classification showed that in both areas, moderately and severely malnourished children receiving the supplement showed significant improvement (P less than 0.05) as compared to those not receiving the supplement, but the extent of improvement differed. The impact of the food supplement in LSE was less than that in MSE suggesting that poor environmental conditions were a major interfering factor and cannot be overlooked.

Anthropometry↗
PubMed1988

An observation of the dynamics of intestinal helminth infections in two isolated communities in south-western Nigeria.

School pupils aged 8-12 years with triple infections of Ascaris lumbricoides, Trichuris trichiura and hookworms at Iwaya, a large urban slum in Lagos State and Iworoko/Igbemo, a rural farming community in Ondo State, Nigeria, were given single dose treatment of levamisole (40 mg.). Subsequent worm accumulation was studied by egg counts per gram of faeces on the 2nd week, 3rd, 5th, 9th and 12th months after treatment. Worm infection rates and load were heavier at Iwaya. The rates of worm recruitment were also higher at Iwaya. The differences observed between Iwaya and Iworoko/Igbemo communities were due to the huge population concentration in the former, low level of hygiene, poor drainage and complete absence of municipal facilities.

Ascariasis↗
PubMed1987

An urban nutrition education and rehabilitation centre: a description of the programme and change in nutritional status of children who were enrolled.

We report on a community-based day care nutrition rehabilitation and education centre which was established by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) in a slum in Dhaka, Bangladesh. Between March-December, 1985 approximately 10 children aged 1 to 5 years with a percent weight for height (% wt/ht) of 60 to 85 were enrolled in each of 9 sessions which were 3 to 5 weeks long. The children were fed 3 meals and 2 snacks daily made from locally available inexpensive foods. A nutrition education programme, developed with input from several feeding centres in Dhaka, included daily lessons, participatory cooking and personal hygiene sessions. Of the 85 children entering the programme, 82 (95%) completed 3 or more weeks. Relative to baseline, a median increase of 8.7% wt/ht was observed at 5 weeks (p less than 0.001), with the greatest improvement occurring in those children presenting with the lowest weights. Median increases of 7.2 and 7.4% wt/ht were noted 6 and 10 months after admission, respectively. Gender and minor illness did not have a significant impact on change in nutritional status. Poor performance of mothers in assigned chores was associated with inferior improvement in nutritional status 5 weeks but not 6 months post-admission. These results suggest that the intervention implemented by the centre may have been effective in improving nutritional status and that more rigorous evaluation of participants in relation to suitably matched concurrent controls should be performed.

Bangladesh↗
PubMed1987

Chronic ocular lesions in Bhopal gas tragedy.

A comprehensive eye checkup programme was carried out in 1140 cases of affected community to evaluate the exposure response and exposure effect with Methyl Isocynate on human eyes. The final evaluation of these cases was made with standard control group of same socioeconomic status in a non-gas affected slum area of Bhopal. The main chronic lesions noticed were chronic conjunctivitis, refractive changes, deficiency of tear secretion and persistent corneal opacities of various forms.

Accidents, Occupational↗
PubMed1986

Immunological response to measles vaccination in poor communities.

Cell-mediated immune response, antibody titres and morbidity were measured among children residing in a slum area following measles vaccination. Effect of malnutrition on the development of protective levels of antibody titres was also investigated. Of the vaccinated children 87 per cent had antibody titres above 1:8 and nutritional status had no influence on this. Cell-mediated immune response was similar before and after vaccination. However, morbidity due to other infections was less in vaccinated children compared to the controls and could be due to stimulation of non-specific host resistance mechanisms.

Antibodies, Viral↗
PubMed1986

Infectious hepatitis in urban India.

The paper is about infectious hepatitis in urban India. The discussion is on two case studies: one of Madras, and the other of Madurai: two major cities in the State of Tamilnadu, South India. The Madras study is on the temporal and spatial analysis of the distribution and diffusion of hepatitis during 1971-1978. The Madras study also relates age to incidence, the major conclusion being that children are more susceptible to hepatitis than elders. The diffusion of hepatitis is said to occur in a wave - like form, covering newer areas and intensifying in time in core areas. The Madurai study is about the epidemic of hepatitis during January-October of 1981. Relating incidence with share of slum population, and number of borewells in city localities, the study yields a positive relation between them with a correlation coefficient value of .7424 and .7812, respectively. General lack of environmental quality and use of contaminated water for domestic purposes appear to be causes of high incidence of infectious hepatitis.

Adolescent↗
PubMed1978

Protein energy malnutrition and nutritional anaemia in preschool children in rural KwaZulu.

The prevalence of protein energy malnutrition (PEM) and nutritional anaemia was investigated in 392 black children, aged 13--60 months, living in a poor rural area. Breast feeding was practised extensively in the population (median duration 14 months). The overall prevalence of PEM was 16,4%, but severe PEM occurred in only 2,7% of the children. Anaemia was present in 6,7% of children, and was almost invariably associated with iron deficiency. Biochemical evidence of iron, folate and vitamin B12 deficiency was detected in 36%, 14,8%, and 0,3% of children respectively. Anaemia was almost confined to the 1-year-old group, but biochemical evidence of iron deficiency, while highest in this age group, continued into the 2-4-year age group. No relationship was found between ecological factors such as income, educational status, etc. and any of the anthropometric, biochemical or haematological variables. The prevalence of PEM and anaemia in these poor rural children is lower than that of a comparable group of underprivileged urban children, thus emphasizing that city slum conditions are producing considerable nutritional problems in their wake. It is of importance to investigate further why some children who are severely deprived in many ways do not necessarily manifest a proportional degree of nutritional deprivation.

Black or African American↗
PubMed1971

Aedes aegypti (L.) and Aedes albopictus (Skuse) in Singapore City. 1. Distribution and density.

The distribution and density of Ae. aegypti and Ae. albopictus in Singapore were assessed from extensive larval surveys carried out from 1966 to 1968 to evaluate their respective roles in the epidemiology of dengue haemorrhagic fever and to study their ecology in the urban areas. Ten urban areas where the majority of dengue haemorrhagic fever cases occurred were surveyed.The results showed that both species were common in the city, with Ae. aegypti being the dominant species. The distribution of Ae. aegypti was more uniform and related to the prevailing housing types and conditions. Its premise index was highest in slum houses, intermediate in shop houses, and lowest in multistorey flats. Ae. albopictus, on the other hand, did not seem to be related to the prevailing housing type in its distribution but tended to be more widespread in areas with open spaces.The larval density index (the average number of larvae per housing unit) was higher for Ae. aegypti than for Ae. albopictus, in agreement with the relative densities shown by their premise indices. The larval density index correlated well with the premise index and correlated best with the infested-receptacle index. For practical purposes, the most suitable, convenient, and reliable measure of density of Ae. aegypti population seems to be the infested-receptacle index.An attempt was made to estimate the rate of dispersal of Ae. aegypti from a stable population to an adjacent area of multistorey flats. The rate of dispersal, estimated from the premise index and the larval density index, was approximately 2% per year of the "donor" population.

Aedes↗
PubMed1971

Aedes aegypti (L.) and Aedes albopictus (Skuse) in Singapore City. 2. Larval habitats.

Detailed information on the breeding habitats of Ae. aegypti and Ae. albopictus is necessary when planning programmes for their control. The larval habitats of the two species in 10 city areas were counted and classified according to type, frequency of occurrence, location, and function. Of all the breeding habitats recorded 95% were domestic containers. The most common Ae. aegypti breeding habitats were ant traps, earthenware jars, bowls, tanks, tin cans, and drums, ant traps being the most common indoors and earthenware jars the most common out doors. Breeding habitats for Ae. albopictus were commonly found in earthen ware jars, tin cans, ant traps, rubber tires, bowls, and drums; ant traps were the most common indoor habitat and tin cans were most common outdoors.The majority of Ae. aegypti breeding habitats were found indoors, while only half of all the Ae. albopictus breeding habitats were indoors. The indoor and outdoor distribution of breeding habitats of both species was not related to the type of housing in the area.The distribution of the type of breeding habitats, however, was related to the type of housing in the area. Ant traps were common to all areas, but water-storage containers and unused containers were common in slum-house and shop-house areas. Flats, however, had more containers used for keeping plants and flowers.The most common breeding habitats of Ae. aegypti and Ae. albopictus are discussed in relation to the habits of the people. It is concluded that control of the two species will depend largely on a change in such habits, either through public health education or by some form of law enforcement.

Aedes↗
PubMed1977

Social and economic factors in malnourished children around Lusaka, Zambia.

Three hundred and sixty malnourished children were admitted to one of the units of the Children's Hospital, UTH, Lusaka, in 1975. They were studied in an effort to determine the effects of various social, economic and feeding habits in the evolution of PCM. Malnutrition was found in 9.1% of the total admissions and was associated with a high immediate mortality (26.6%). The majority of children were in the 7 months to 24 months age-group. The majority of families were unitary and small, with a high level of illiteracy and from the slums of Lusaka. Breast feeding was a general rule in spite of the urban status of most families. The study showed that the major factors which contributed to malnutrition were poverty and faulty weaning foods. Results were compared with other studies in Africa and India. Incidence of malnutrition can be reduced by increasing the economic level of the community and improving basic health services.

Age Factors↗