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PubMed1994

Infant feeding practices in Bombay slums.

A study was conducted in two slum areas in a Bombay suburb covering a total population of 4879. One hundred and fifty-three mothers having children below two years were interviewed. Ninety six per cent infants below the age of 4 months received breast milk, though exclusive breastfeeding was practised only in 37% infants. Timely complementary feeding rate was only 0.48. Twenty three per cent of mothers used bottle for administration of supplementary food or water. Only 15.7% of mothers used commercial milk formula and 8.5% used commercial weaning food.

Bottle Feeding↗
PubMed1996

Perinatal mortality in urban slums in Lucknow.

OBJECTIVES: To determine the perinatal mortality rate (PNMR) in the urban slums of Lucknow DESIGN: Cross-sectional survey. SETTING: Twenty five Anganwadi centres of urban Lucknow, with a population of 25,901. METHODS: Data was collected on birth and early neonatal deaths, gestational age of the neonate (determined at birth) and maternal variables like socio-economic status, maternal age, parity, and bad obstetrical history from January 1992 to March 1993. RESULTS: There were 966 births with a still-birth rate of 37.2 and PNMR of 59.0 per 1000. The relative risk of perinatal mortality with lower socio-economic status was 1.87, bad obstetrical history 2.18, and gestational age < 37 weeks 1.95. CONCLUSIONS: Further reduction in PNMR may be possible with focussed medical services to women of low socio-economic status having bad obstetrical history and those delivering before term.

Cross-Sectional Studies↗
PubMedDate not supplied

Perception about AIDS among residents of a Calcutta slum.

A study was carried out in a slum area of South Calcutta to assess the impact of the current mass education programme against AIDS. Two hundred and six residents, mainly of lower middle class, aged 18-60 years of both sexes were selected at random. They were interviewed to know their perception and sources of information about AIDS. Two-third of them had their own TV and radio, which they watched/heard for about three and half hours each day. Another 28% watched TV outside for about one and half hours a day. About 46% were daily readers and 20% occasional readers of newspapers. Fifty nine percent knew about persons vulnerable to get AIDS, but most of them associated it to promiscuity only. Avoiding it was the main means known to them for preventing AIDS. The role of condom in it was known to only 2.5% residents. The source of their knowledge was mainly TV, either alone or with other mass media (67%). Such knowledge was related to higher education. To make perception about AIDS more effective, it is suggested that local health and voluntary agencies should involve the community in the AIDS education programme along with the back-up of mass media. An apex agency solely responsible for AIDS education should be set up for each big city to co-ordinate the activities of local agencies.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Prevalence of malnutrition and intestinal parasites in preschool slum children in Lucknow.

OBJECTIVE: To assess the point prevalence of intestinal parasites and their association with nutritional parameters. SETTING: Anganwadi centers under the Integrated Child Development Scheme (ICDS) in Lucknow, North India. DESIGN: Cross-sectional survey. METHODS: By random draw, 32 out of 153 Anganwadi centers were selected. All eligible subjects registered with the Anganwadi worker were enrolled. These were 1061 children (48.3% girls and 51.7% boys) between the ages of 1.5 to 3.5 years. RESULTS: Of these, 67.6% were underweight (weight for age < -2 SD), 62.8% were stunted (height for age < -2 SD) and 26.5% were wasted (weight for height < -2 SD). Parasites were detected in 17.5% (95% CI 15.3%-19.9%) children by a single direct fecal smear examination. Of these, Ascaris lumbricoides was found in 124 (68.1%) and Giardia lamblia in 60 (32.9%). There was no association between weight or height and parasite positivity. The mean hemoglobin levels for children who were smear positive versus smear negative for ascaris or giardia were 9.1 g/dl and 9.6 g/dl, respectively (p < 0.0001). CONCLUSION: In the urban slums the point prevalence of intestinal parasites is 17.5% in the preschool children. Malnutrition and low hemoglobin levels are also widely prevalent. Urgent remedial steps are needed on community basis to improve their nutritional status and control parasitic infestation.

Animals↗
PubMed1997

Impact of nutrition education on health of the mother and newborn belonging to the poor urban slum community.

To find the nutritional knowledge among mothers of one child of the poor community and to relate status of education to the nutritional health of them and the newborn and to get a thorough knowledge on the impact of nutritional education, a comprehensive study was undertaken in an urban slum area. Nutritional grading was done through scoring system. There were 47 mothers (24.1%) out of 195 having normal nutritional grade and 37 mothers (19%) having severe nutritional grade. There were 80 mothers having 'no knowledge' on maternal nutrition. 'Adequate knowledge' was found in 31 cases. Mothers (n = 80) of 'no knowledge' delivered babies of average weight 2.3 kg whereas 'adequate knowledge' mothers gave birth to babies of average weight 2.9 kg.

Adult↗
PubMed1976

The black slum child and the problem of aggression.

The exposure to violence and life-threatening aggression from many sources caused black children from socioeconomically deprived areas to respond in certain adaptive ways. These usually are appropriate for the culture in which the child is raised. Although one response is a paranoidlike reaction, aggression is also displayed directly in an attempt at mastery of the overwhelming frustration and life-threatening aspects of the ghetto. The significance of aggression in the psychotherapeutic relationship, particularly between the white therapist and black child, is discussed, and there is a brief review of the psychoanalytic concept of aggression as it applies to the ghetto child. A case is presented exemplifying these points clinically in a typical black slum child.

Adolescent↗
PubMed1994

Effect of vitamin A supplementation on diarrhoea and acute respiratory tract infection in children. A double blind placebo controlled trial in a Calcutta slum community.

To determine the effect of a massive single oral dose of vitamin A (200,000 IU) supplementation on diarrhoea and acute respiratory infection (ARI), a double-blind placebo controlled trial involving 174 children under six years of age (excluding infants) was carried out in a Calcutta slum community. Ninety-one children received vitamin A supplementation (experimental group) and 83 children received a placebo (control group). All the children were followed up for six months by active fortnightly surveillance for occurrence of diarrhoea or ARI and their duration. There was no statistically significant difference in the incidence of diarrhoeal episodes or ARI. However, there was a significant difference (p < 0.05) in the average duration of diarrhoea per episode (2.1 vs. 3 days) between the experimental and control groups. Possible beneficial effects of a single oral dose of vitamin A supplementation on the incidence of diarrhoea and ARI could not be demonstrated in the present study.

Acute Disease↗
PubMed2002

Leptospirosis in children in Mumbai slums.

OBJECTIVE: There is limited data available on symptomatic leptospirosis in Indian children. We report an outbreak of leptospirosis that occurred in children living in slums following heavy rainfall and flooding. This hospital-based prospective study was conducted from July to August 2001. METHODS: Diagnosis of acute leptospirosis was suspected by following the Indian Leptospirosis Society working definition for leptospirosis. Diagnosis was confirmed by detecting anti-Leptospira antibodies, using either a Leptospira genus-specific latex agglutination assay or a dipstick assay or by a macroscopic slide agglutination test. RESULT: Thirty (32%) out of 93 children admitted had acute leptospirosis. Fever, bodyache, chills, abdominal pain, headache, vomiting, cough, hepatosplenomegaly, edema and crepitations were the common presenting signs and symptoms. Twenty - two children had anicteric leptospirosis and 8 had Weil disease. Response to penicillin treatment was good in all except in one child with Weil disease who died of renal failure within 3 hours of admission. CONCLUSION: Leptospirosis has emerged as an infectious disease in Mumbai. During monsoon, parents should ensure that their child does not have contact with the contaminated flood water.

Child↗
PubMed2004

Epidemiological study of measles in slum areas of Kolkata.

OBJECTIVE: An epidemiological study on measles was conducted among the under five children in slum areas of Kolkata to assess the incidence of measles. METHODS: 20 cluster sampling technique was followed and in each cluster 250 under five children were covered. Paramedical workers identified children of the target of age group who had history of measles in past one year and the medical officer confirmed the diagnosis following standard case definition. RESULTS: Incidence of measles was found as 5.76%. Incidence was equal in both the sex groups, but found more among infants. The incidence of measles gradually declined with the increase of age strengthening the view in favor of early immunization. Amongst the measles cases only 19.7% were immunized with measles vaccine. 100% of measles cases gave history of rash, 98.9% had history of fever, 82.8% reported that the rash started from face and progressed downwards to abdomen and leg. Cough, redness of eye and discoloration of skin were reported by 97.5%, 83.8% and 65.2% measles cases respectively. Only 16.9% and 8.6% children received Vitamin A oil before and after the illness respectively. 49% gave history of exposure to measles cases and 46.6% cases had measles within 2 weeks incubation period. CONCLUSION: The study highlighted the necessity of timely measles vaccine coverage, additional dose at a higher age and Vitamin A supplementation through IEC activities.

Age Distribution↗
PubMedDate not supplied

Measles immunisation coverage in urban slums.

A cross-sectional, community-based study was conducted in 32 slums of Udaipur city to assess the prevalence of missed opportunities for measles immunization, reason for their occurrence and potential impact of avoiding them on measles immunization coverage. Two hundred and sixty-five children, between the age of 9 and 24 months were enlisted for the study, using a practical cluster sampling method. Immunization status of the children, visits to health facilities after 9 months of age and reasons for non-immunization were noted. Missed opportunities for measles immunization was defined as any visit by an eligible child to a health facility, which did not result in his/her vaccination. Measles immunization coverage amongst the study population was 50.61%. The prevalence of missed opportunities for measles immunization was 14.3%. Not offering measles immunization at curative visits (86.9%) was the major reason for missing opportunities. Avoiding all missed opportunities could have increased the measles immunization coverage to 64.9%.

Child, Preschool↗
PubMed2001

Rapid assessment and delivery of Vitamin A to slum children by using National Immunization Day in Chandigarh.

This study was done with the objective to see the feasibility of using National Immunization Days (NIDs) for rapid assessment, and delivery of Vitamin A solution to about 27,600 children dwelling in 26 slums in Union Territory of Chandigarh. The assessment of Vitamin A deficiency (VAD) was done in a stratified random sample of 1304 children during third round of Intensified Pulse Polio Immunization (IPPI) and delivery of Vitamin A solution was done during fourth round of IPPI in 1999-2000 covering 27,642 children in the age group of 1-5 years. An additional team of two persons per centre delivered age specific doses of Vitamin A solution through 72 centres and operational problems were recorded. IPPI staff provided supervision and same tally sheets as of IPPI were used. The prevalence rate of VAD was 24.6%, with conjunctival xerosis, bitot's spot and corneal xerosis as 23.7%, 0.6% and 0.2% respectively. 27,275 (98.7%) children out of 27,642 were administered Vitamin A solution, with no major operational problem. Only five parents (0.01%) refused Vitamin A solution. No case of side effect or toxicity due to Vitamin-A was reported. The strategy to assess and deliver Vitamin A during NID's was found to be feasible and successful and could be a basis for launching similar initiatives in other areas of India and other countries where VAD is a public health problem.

Child, Preschool↗
PubMed2006

Spousal abuse against women and its consequences on reproductive health: a study in the urban slums in Bangladesh.

OBJECTIVES: Spousal violence is common and results in costly problems both for society and for the reproductive health of women. Despite the recognition that violence may be associated with serious consequences for women's reproductive health, our understanding of the relationship between the two remains limited. In this study, we assessed the association between spousal violence and women's reproductive health. METHODS: Data from an interviewer-administered questionnaire assessing socioeconomic, demographic, behavioral profiles, and spousal violence-related information was collected from 496 women. Subjects were chosen from eight randomly selected urban slums from four metropolitan cities. RESULTS: Spousal violence was significantly higher amongst the group of less educated women who had been in several marriages; indicating that the social and behavioral traits of women act as catalysts for spousal violence. Abusive husbands also had been married several times and were more likely to be addicted to alcohol or drugs. This demonstrates that the behavioral traits of husbands were also responsible for spousal violence. Spousal violence injuries adversely affect the health and well-being of women. More than three-quarters of physically violated women suffered injuries as a result of this violence. About 50% of these injuries were minor and about 10% serious. Sexual violence adversely affected women's health; more than 80% of sexually violated women complained of pelvic pain, more than 50% reported reproductive tract infections, and more than 50% reported symptoms of irritable bowel syndrome. Abused women suffered from gynecological problems at the time of pregnancy significantly more than non-abused women (p<0.05) and abused women suffered from reproductive tract infections significantly more than non-abused women (p<0.01). Abusive husbands suffered from sexually transmitted diseases (STD) significantly more than non-abusive husbands (p<0.05). Abused women used contraception significantly less than non-abused women (p<0.01). Logistic regression analysis suggested that spousal violence was the most important contributing factor for reproductive health problems in women. CONCLUSIONS: The findings of this study may enhance our understanding of the impact of spousal violence against women and their reproductive health and therefore highlight the importance of spousal violence prevention measures. Increasing the awareness and understanding of the relationship between violence against women and reproductive health could be achieved if lawyers, researchers, clinicians, practitioners, and government workers from multiple disciplines and agencies worked together.

Adult↗
PubMed1988

Epidemiological aspects of leptospirosis in a slum area in the city of Rio de Janeiro, Brazil. Search for leptospires and specific antibodies in rodents.

101 Rattus norvegicus and 3 Mus musculus were captured in an urban slum of Rio de Janeiro city and examined for leptospiral infection. Direct examination of urine, serology (microagglutination) and culture together gave a positivity rate of 39%. Separately direct examination and serology gave positivity rates of 13% and 36% respectively. Serogroup Icterohaemorrhagiae predominated in the serological tests. Leptospires were isolated from 24 of the 104 rodents (23%), but 4 cultures died. The remaining 20 were identified as members of the Icterohaemorrhagiae serogroup, and 5 were further identified as serovar copenhageni. Human leptospiral infection, mainly caused by Icterohaemorrhagiae, is endemic in Rio de Janeiro city, and rodents are a major source of the disease.

Agglutination Tests↗
PubMed1988

Age-related prevalence, intensity and frequency distribution of gastrointestinal helminth infection in urban slum children from Kuala Lumpur, Malaysia.

The gastrointestinal helminth infection status of 1574 children living in a slum area of Kuala Lumpur, Malaysia was assessed by quantitative coprology. Almost two-thirds were infected with Trichuris trichiura, 49.6% with Ascaris lumbricoides, and 5.3% with hookworm. Infection prevalence rose rapidly to a stable asymptote at 7 years of age, and the age-intensity profile was convex with maximal values in the 5-10 year age classes. This pattern was the same for males and females, but differed markedly between different ethnic groups. The frequency distributions of A. lumbricoides and T. trichiura were highly overdispersed (k values were 0.21 and 0.27, respectively), and age-dependent over the 0-8 year age classes. This suggests that the force of infection with these nematodes is lower in infants than in older children.

Adolescent↗
PubMedDate not supplied

Relationship between the degree of poverty and the IgE response to Ascaris infection in slum children.

We examined a group of urban slum children in Caracas, Venezuela, and demonstrated the relationship that exists between poverty, conditions of hygiene and the prevalence of helminth infection. Concordant with the high prevalence of helminth infection in these children, the total serum levels of immunoglobulin E (IgE) and blood eosinophilia were elevated and were directly related to the degree of poverty and lack of sanitary facilities. However, in contrast, the reverse pattern was observed for the specific allergic response to these parasites. Thus, the immediate hypersensitivity skin test reactivity to Ascaris antigens, and the serum levels of specific anti-Ascaris IgE antibody, were lowest in the poorest children, who had the highest prevalence of helminth infection and the highest total IgE levels. As allergic-type reactions may participate in protective mechanisms against helminths, these results suggest that poverty and poor sanitary conditions may, by influencing the IgE response, compromise the resistance of such children to parasitic infections.

Animals↗
PubMedDate not supplied

Strongyloides stercoralis in an urban slum community in Bangladesh: factors independently associated with infection.

Stool samples from 880 residents in an urban slum in Dhaka, Bangladesh, were collected on 3 occasions over one year, and examined for intestinal parasites. Information on many potential risk factors for infection was obtained by questionnaire from a respondent in each household studied. In a crude univariate analysis of the data, several of the factors were found to be significantly associated with Strongyloides stercoralis infection. Most of these factors were co-variate with one another, and with poverty generally. Using Mantel-Haenszel chi 2 tests to control for confounding effects of each variable individually, the following 4 factors remained independently associated with S. stercoralis infection: respondent's use of a community latrine rather than a private latrine, living in a house with an earth floor rather than a cement floor, being of Bihari ethnicity, and being 7-10 years of age. Implications of these results for the epidemiology and control of strongyloidiasis are briefly discussed.

Adolescent↗
PubMedDate not supplied

Nutritional status and the IgE response against Ascaris lumbricoides in children from a tropical slum.

Helminthic infection can stimulate the interleukin-4 (IL-4)-dependent polyclonal synthesis of immunoglobulin E (IgE) in children endemically exposed to these parasites. As such children are also frequently at nutritional risk, in this study we considered the possible influence of malnutrition on serum IL-4 levels and the IgE response in helminthic infection. We evaluated 85 Ascaris-infected children living in an urban slum area of Caracas, Venezuela, and found that the serum levels of IL-4 and total IgE were significantly higher in malnourished children than in their well nourished counterparts. In contrast, the specific anti-Ascaris IgE antibody response was significantly lower in the malnourished group. After anthelmintic treatment of the children, the total serum IgE and IL-4 levels decreased significantly in the well nourished group, while the specific anti-Ascaris IgE antibody response increased. No significant change was detected, however, in the malnourished group. Our results suggested that malnutrition potentiates the polyclonal stimulation of IgE synthesis induced by helminths. As specific IgE antibody has been implicated in the resistance to helminthic infection, and the polyclonal stimulus diminishes this response, these factors may increase the susceptibility of malnourished children to such parasites.

Animals↗
PubMed1988

Sensitisation by mycobacteria and the effects of BCG on children attending schools in the slums of Bombay.

Quadruple skin testing with new tuberculins was used to evaluate the effects of previously administered BCG Madras in children attending schools in the slums, or living in Kopri Leprosy Colony in Bombay. There were differences between schools both in the level of sensitisation of children without BCG scars and in the effects of BCG vaccination. Results obtained at one school resembled those obtained in a previous study in Agra, where BCG was thought to be ineffective. Results from the other schools and Kopri were more like those previously reported from Ahmednagar, where BCG was considered to be much more effective. Thus within the same city groups of children of the same social status may vary widely both in their contact with mycobacteria and in their capacity to benefit from BCG vaccination.

Adolescent↗