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At least 19 recordsLinked to original sources
PubMed1991

Comparison of two growth charts in Lesotho: health workers' ability to understand and use them for action.

BACKGROUND: Two growth monitoring charts widely used for growth monitoring in Africa (the Road-to-Health (RTH) and the Growth Surveillance (GS] were compared in order to assist the Government of Lesotho to decide on an appropriate national growth chart. METHODS: Thirty-four health workers were taught and tested on the RTH during a first week of training and on the GS during a second week (the RTH-GS group), while the order was reversed for another 25 trainees (the GS-RTH group). The health workers were trained and tested on their ability not only to use and interpret the two charts, but also to make the right decisions about specific actions to be taken when growth faltering occurs. RESULTS: There was no difference between scores to the RTH and GS charts after one week of training. After the second week of training, the scores to the RTH chart improved and became better than those to the GS chart. The scores to the GS test did not increase with previous knowledge of the RTH chart. CONCLUSIONS: For this reason and others discussed in the paper, the RTH chart was recommended for nationwide use in Lesotho. The adoption of this recommendation was facilitated by the close involvement in this research of public and private agencies responsible for growth monitoring in Lesotho.

Allied Health Personnel↗
PubMed1990

The effective case management of childhood diarrhoea with oral rehydration therapy in the Kingdom of Lesotho.

In Lesotho prior to 1986, diarrhoea was the leading cause of hospital mortality in children less than 5 years of age. At the Queen Elizabeth II Hospital, diarrhoea-related admissions as a proportion of all admissions in children less than 5 years of age declined from 23% in the year prior to the opening of the Oral Rehydration Therapy Unit (ORTU) to 13% in the first nine months of 1987 (p less than 0.05). In addition, the case-fatality ratio of children treated in the ORTU declined from 1.4% in the first quarter of 1986 to zero in the second and third quarters of 1987 (p less than 0.05). In a case-control study conducted to identify reasons for children failing ORTU treatment, factors associated with an increased risk of hospitalization included male gender (odds ratio [OR] = 4.9; 95% confidence limits [CL] = 2.0, 11.9), fever greater than or equal to 38.5 degrees C (OR = 2.0; CL = 1.2, 3.3), undernutrition (OR = 3.2; CL = 1.1, 9.4), and moderate dehydration (OR = 2.3; CL = 1.2, 4.4) or severe dehydration. (OR = 12.1; CL = 3.8, 38.5). Breastfed children less than 2 years of age were at decreased risk of hospitalization (OR = 0.4; CL = 0.2, 0.7). At this major hospital in Lesotho, the standardization of outpatient treatment for diarrhoea with oral rehydration salts (ORS) in the context of an ORTU resulted in a marked decrease in diarrhoea-associated hospitalization and deaths in children less than 5 years of age.

Case-Control Studies↗
PubMed1992

The mediating effect of maternal nutrition knowledge on the association between maternal schooling and child nutritional status in Lesotho.

The present study tested whether maternal nutrition knowledge was a mediating factor in the association between maternal schooling and child nutritional status, and whether the mechanism involved differed according to socioeconomic status. The data were collected in Lesotho on 921 mother-child pairs and included scores from a nutrition knowledge test, socioeconomic and demographic information, and the child's anthropometric data. A wealth factor derived from a factor analysis was used to stratify the sample into two socioeconomic groups. Two-stage least-squares estimation was used to test the mediating role of nutrition knowledge between maternal schooling and child weight-for-age. Results showed that both the importance of maternal schooling and the mechanism by which it affects the child's weight-for-age are contingent upon the family's socioeconomic status. While maternal schooling was positively associated with weight-for-age for both wealthier and poorer households, the size of the effect was much larger for the latter group. The effect of maternal schooling on weight-for-age was mediated by the mother's nutrition knowledge only among wealthier households. These results imply that, in Lesotho, nutrition education for mothers could contribute to improving children's growth, but only in households that have access to a minimum level of resources. For poorer households, nutrition education would not be sufficient.

Adult↗
PubMed1976

Cross-sectional-type weight reference values for village children under five years in Lesotho.

Cross-sectional-type reference values for weight attained are described for village children under five years in rural Lesotho (formerly Basutoland). Weight measurements derive from observations on 1317 children attending an Under-Fives clinic; it is estimated that 60-70% of the children under five in the catchment area were represented. 4585 weighings on boys and 4826 weighings for girls are included in the analysis. Figures of weight-for-age of boys and girls are given separately as centile distributions suitable for use on Growth Charts. Lesotho 50 centile approximates to 3 centile of British children and slightly exceeds 80% Harvard standard. Weight attained for age is similar, in both sexes, to reports from other less-priviledged urban and rural areas, emphasizing the relative importance of environmental as compared to genetic influences in determining weight-for-age in early childhood. It is suggested that the construction of locally-derived growth reference values is both appropriate and practicable.

Age Factors↗
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↗
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↗
PubMed1990

Comparison of mothers' understanding of two child growth charts in Lesotho.

Reported are the results of a study that compared mothers' understanding of two growth monitoring charts in Lesotho, which was carried out to assist the government in selecting a national growth chart. The study was conducted over 4 months in nine primary health care (PHC) clinics, where 1221 mothers were enrolled. Mothers were assigned to one of the following chart groups: "road-to-health" (RTH), "growth surveillance" (GS), or no chart (controls). Mothers in the first two groups received instruction on their respective chart during monthly growth monitoring sessions and were tested on their knowledge of this chart before and after the follow-up period. The mothers in the control group were tested on the RTH and GS charts at the beginning and at the end of the study. The results indicated that mothers who received training on either chart markedly improved their understanding compared with the control group and that the RTH group understood their chart better than the GS group did theirs.

Audiovisual Aids↗
PubMed1991

A study of the association between improved sanitation facilities and children's height in Lesotho.

The impact of improved sanitation on the anthropometric status of children under 5 years in Lesotho was investigated using children recruited into a case-control study of diarrhoea morbidity. The children's height-for-age Z-scores were used as an indicator of chronic undernutrition. Classifying children as 'stunted' or 'adequately nourished' revealed some evidence of an association between latrine ownership and attained height. After allowing for confounding variables, the odds of stunting were 18 per cent lower among children in households with latrines (95 per cent confidence interval, 36 per cent lower to 3 per cent higher). More powerful analyses, using height-for-age as a continuous outcome variable, revealed that the mean height-for-age Z-score of children from households with a latrine was 0.27 standard deviations higher than that of children from households without a latrine (95 per cent c.i. = 0.12 to 0.42). These results suggest that the anthropometric status of children may be as responsive to improvements in sanitation facilities as diarrhoea morbidity in some settings.

Analysis of Variance↗
PubMed1976

Serological studies on human plague in Southern Africa. Part II. A bubonic/pneumonic plague epidemic in Lesotho.

A description is given of an outbreak of human plague in Lesotho in 1968 which was preceded by, and merged with, a typhoid epidemic. This circumstance was responsible for a diagnosis of typhoid fever being made in the earliest plague cases, especially as the clinical presentation was similar to that of the typhoid patients. Consequently, the plague epidemic ran its natural course and with the onset of winter the pneumonic form appeared. Serological follow-up studies of recovered patients were carried out up to 4 years after the outbreak.

Adolescent↗
PubMed1978

The occurrence of zearalanone in raw and fermented products from Swaziland and Lesotho.

Numerous reports of epizootics dur to zearalanone, and the subsequent experimental work upon it have implicated this oestrogenic mycotoxin as an important pathologic agent for the uterus and vagina. The finding of zearalanone in fermented products in an area in Southern Africa where human cervical cancer is prevalent may be related to this disease.

Beer↗
PubMed1976

Biochemical gene markers in the gerbil Tatera brantsii from Lesotho.

Several geographically separated populations of the gerbil Tatera brantsii were investigated with protein and enzyme gene markers. Genetic variation was found in the following systems: serum albumin, 6-PGD, haemoglobin, esterase, IDA and GPI. No variation was found in the SDH and LDH systems. There appeared to be only slight differences in gene frequencies between populations. No real seasonal variation in any of the frequencies could be established.

Animals↗
PubMed1978

Seasonal variations in weight of children attending an under-fives clinic in Lesotho.

The incidence of weight loss between successive visits, prevalence of under centile 3 weight-for-age and over centile 97, showed a marked bimodal annual variation for 1243 children attending an under-fives clinic. 9949 weighings on 661 boys and 682 girls over a five year period, contributed to the database. Season of birth also significantly influenced the centile distributions of weight-attained-for-age. Children over 1 1/2 years old showed considerably higher rates of weight loss (about 1 in 5 children attending in their fifth year of life), than children younger than the mean age of weaning. The rates of weight loss, together with seasonal variation, was considerably higher for a group of 'Regular Attenders' to the clinic, than for a group of 'Low Attenders'. Seasonal influences on growth need to be taken into accounts in evaluating the quality of care and outcome produced by under-fives clinics.

Body Weight↗
PubMed1979

Highland and lowland populations of Lesotho.

It has not been possible to demonstrate significant sero-genetic differences between lowland and highland Sotho populations; the differences which do exist may well be attributable to random genetic drift. The study shows that the Sotho have received an appreciable genetic contribution from the San they have absorbed but their sero-genetic profile remains eminently Negro. A low frequency of the PTC non-taster allele was found (t = 0.142 +/- 0.029) as was the overall frequency for colour blindness (cb = 0.013 +/- 0.009).

Alleles↗