Assessment of Physical Growth and Motor Development of Preterm Babies Based on Developmental Assessment Scale For Indian Infants (DASII)

2020 ◽  
Vol 34 (1-2) ◽  
pp. 11-14
Author(s):  
E. S. Akshara ◽  
Poorva Gohiya ◽  
Jyotsna Shrivastav
Keyword(s):  
Low Income ◽  
Motor Development ◽  
Head Circumference ◽  
Preterm Births ◽  
Physical Growth ◽  
Low Income Countries ◽  
Developmental Assessment ◽  
Preterm Babies ◽  
A Prospective Study

Background: The rate of preterm births ranges from 5% to 18% across 184 countries. Almost 12% births are preterm in low-income countries compared with 9% in high-income countries. Almost 1 million children die each year due to complications of preterm birth. Of those who survive, suffer from face developmental disabilities and undernourishment. Aims and Objectives: To assess the physical growth and its relation with the development of babies taken into study. Materials and Methods: A prospective study was conducted on 159 preterm babies of gestational age 32 to 36 weeks. All the treatments given during hospitalization, course of stay, and special procedures done were recorded. Baby’s weight, length, and head circumference were again noted at the time of discharge. Anthropometric measurements were done at every follow-up visit. Neurodevelopmental screening was performed at each follow-up. At the end of 12 months the risk factors contributing to the delayed development were analyzed. Results: 95.5% infants born as preterm had a length of more than 58 cm (– 3SD) and weight 5.6 kg at 1 year and 50% infants had a head circumference of more than 39 cm (– 3SD). Conclusion: Preterm babies when followed-up for 1 year of age did attain appropriate weight and length of their corrected age. Microcephaly was observed in 30% of babies at 1 year of age, of which 15.7% were found with developmental delay.

scholarly journals Presentation, surgery and 1-year outcomes of childhood cataract surgery in Tanzania

2020 ◽  
pp. bjophthalmol-2020-316042
Author(s):  
Furahini Godfrey Mndeme ◽  
Blandina Theophyl Mmbaga ◽  
Mchikirwa Msina ◽  
Judith Mwende ◽  
Sonia J Vaitha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Low Income ◽  
Visual Outcome ◽  
Low Income Countries ◽  
Similar Proportion ◽  
Poor Visual Outcome ◽  
A Prospective Study ◽  
Good Vision ◽  
Childhood Cataract

BackgroundRecent reports have suggested a significant change in the causes of blindness in children in low-income countries cataract becoming the leading cause. We aimed to investigate the presentations and surgical outcomes in children with cataract operated at different ages in Tanzania.MethodsWe conducted a prospective study of 228 children aged ≤192 months at three tertiary centres, 177 with bilateral cataracts and prospectively followed them for 1-year postsurgery. We collected demographic, surgical, preoperative and postoperative clinical characteristics using the standard childhood cataract surgical assessment questionnaire. Families were encouraged to return for follow-up by phone with travel reimbursement where necessary.ResultsPreoperatively, 76% bilateral children were blind in the better eye. 86% of children were followed up at 1 year and 54% bilateral children achieved visual acuity of 0.48 logMAR or better in the better eye and 5% were blind. 33% of unilateral children achieved visual acuity of 0.48 logMAR or better and 17% were blind. Preoperative blindness (adjusted OR (AOR) 14.65; 95% CI 2.21 to 97.20), preoperative nystagmus/strabismus (AOR 9.22; 95% CI 2.66 to 31.97) and aphakia (AOR, 5.32; 95% CI 1.05 to 26.97) predicted poor visual outcome in bilateral cases. 9% of 342 refracted eyes had initial postoperative cylinder of 1.5 D or more, as did a similar proportion (11%) of 315 eyes refracted 1 year after surgery. Acute fibrinous uveitis occurred in 41 (12%) eyes.ConclusionThree-quarters of children were blind preoperatively whereas over half had good vision 1-year postoperatively. Preoperative blindness, nystagmus/strabismus and aphakia predicted poor visual outcome, suggesting that cataract density determines density of amblyopia.

The 7th French Airborne Forward Surgical Team experience of surgical support to the population of a low-income country: a prospective study on 341 patients with short-term follow-up

2018 ◽  
Vol 164 (6) ◽  
pp. 423-427 ◽  
Author(s):  
Yvain Goudard ◽  
C Butin ◽  
C Carfantan ◽  
G Pauleau ◽  
E Soucanye de Landevoisin ◽  
...  
Keyword(s):  
Low Income ◽  
Elective Surgery ◽  
Surgical Care ◽  
Host Population ◽  
Surgical Team ◽  
Low Income Country ◽  
Operative Outcomes ◽  
Surgical Teams ◽  
A Prospective Study

BackgroundThe 7th Airborne Forward Surgical Team (FST) has deployed to Chad in 2015 and 2016, in support of French military forces. Humanitarian surgical care is known to represent a significant part of the surgical activity in such missions, but to date limited data have been published on the subject.MethodsAll surgical patients from a civilian host population treated by the FST during these missions have been prospectively included. Indications, operative outcomes and postoperative outcomes were evaluated.ResultsDuring this period, the FST operated on 358 patients. Humanitarian surgical care represented 95% of the activity. Most patients (92.7%) were operated for elective surgery. Emergencies and infectious diseases represented, respectively, 7.3% and 9.1% of cases. The mean length of stay (LOS) was three days (2–4), and the median follow-up was 30 days (22–34). Mortality rate was 0.6% and morbidity was 5.6%. Parietal surgery had no significant complication and had shorter LOS (p<0.001). Emergent surgeries were more complicated (p<0.01) and required more reoperations (p<0.05). Surgical infectious cases had longer LOS (p<0.01).ConclusionsHumanitarian surgical care can be provided without compromising the primary mission of the medical forces. Close surveillance and follow-up allowed favourable outcomes with low morbidity and mortality rates. Humanitarian care is responsible for a considerable portion of the workload in such deployed surgical teams. Accounting for humanitarian care is essential in the planning and training for such future medical operations.

A Randomized Clinical Trial of Home Intervention for Children With Failure to Thrive

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 807-814 ◽  
Author(s):  
Maureen M. Black ◽  
Howard Dubowitz ◽  
Jacqueline Hutcheson ◽  
Julie Berenson-Howard ◽  
Raymond H. Starr
Keyword(s):  
Low Income ◽  
Motor Development ◽  
Failure To Thrive ◽  
Home Visitors ◽  
Child Interaction ◽  
Home Intervention ◽  
Height For Age ◽  
Weight For Age

Objective. To evaluate the efficacy of a home-based intervention on the growth and development of children with nonorganic failure to thrive (NOFTT). Design. Randomized clinical trial. Participants. The NOFTT sample included 130 children (mean age, 12.7 months; SD, 6.4) recruited from urban pediatric primary care clinics serving low income families. All children were younger than 25 months with weight for age below the fifth percentile. Eligibility criteria included gestational age of at least 36 weeks, birth weight appropriate for gestational age, and no significant history of perinatal complications, congenital disorders, chronic illnesses, or developmental disabilities. Children were randomized into two groups: clinic plus home intervention (HI) (n = 64) or clinic only (n = 66). There were no group differences in children's age, gender, race, or growth parameters, or on any of the family back-ground variables. Most children were raised by single, African-American mothers who received public assistance. Eighty-nine percent of the families (116 of 130) completed the 1-year evaluation. Interventions. All children received services in a multidisciplinary growth and nutrition clinic. A community-based agency provided the home intervention. Families in the HI group were scheduled to receive weekly home visits for 1 year by lay home visitors, supervised by a community health nurse. The intervention provided maternal support and promoted parenting, child development, use of informal and formal resources, and parent advocacy. Measurements. Growth was measured by standard procedures and converted to z scores for weight for height and height for age to assess wasting and stunting. Cognitive and motor development were measured with the Bayley Scales of Infant Development, and language development was measured by the Receptive/Expressive Emergent Language Scale. Both scales were administered at recruitment and at the 12-month follow-up. Parent-child interaction was measured by observing mothers and children during feeding at recruitment and at the 12-month follow-up, and the quality of the home was measured by the Home Observation Measure of the Environment 18 months after recruitment. Analyses. Repeated-measures multivariate analyses of covariance were used to examine changes in children's growth and development and parent-child interaction. Analyses of covariance were used to examine the quality of the home. Independent variables were intervention status and age at recruitment (1.0 to 12.0 vs 12.1 to 24.9 months). Maternal education was a covariate in all analyses. When changes in developmental status and parentchild interaction were examined, weight for height and height for age at recruitment were included as covariates. Results. Children's weight for age, weight for height, and height for age improved significantly during the 12-month study period, regardless of intervention status. Children in the HI group had better receptive language over time and more child-oriented home environments than children in the clinic-only group. The impact of intervention status on cognitive development varied as a function of children's ages at recruitment, with younger children showing beneficial effects of home intervention. There were no changes in motor development associated with intervention status. During the study period, children gained skills in interactive competence during feeding, and their parents became more controlling during feeding, but differences were not associated with intervention status. Conclusions. Findings support a cautious optimism regarding home intervention during the first year of life provided by trained lay home visitors. Early home intervention can promote a nurturant home environment effectively and can reduce the developmental delays often experienced by low income, urban infants with NOFTT. Subsequent investigations of home intervention should consider alternative options for toddlers with NOFTT.

scholarly journals A Garden-Based Intervention to Improve Dietary Diversity in Kenyan School Children: Results from a Natural Experiment

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 810-810 ◽  
Author(s):  
Sara Benjamin-Neelon ◽  
Tiange Liu ◽  
Eve S Puffer ◽  
Liz Turner ◽  
Daniel Zaltz ◽  
...  
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Primary Schools ◽  
Dietary Diversity ◽  
Food Group ◽  
Low Income Countries ◽  
Severe Drought ◽  
School Gardens ◽  
Post Intervention

Abstract Objectives School gardens may improve child diet, but little is known about their effectiveness in rural areas in low-income countries. We evaluated the ability of school gardens to improve child diet in rural Kenya. We hypothesized that children in intervention schools would improve their dietary diversity and specifically their produce intake. Methods An non-government organization installed gardens in 2 primary schools. We selected 2 geographically proximal additional schools as comparisons. We conducted baseline assessments in 2013, prior to garden installation, and follow-up assessments a year later in 2014 in all 4 schools. We measured child dietary intake via a single 24-hour recall. We calculated dietary diversity using the women's dietary diversity score (WDDS) (continuous) and also examined each of the 10 food group components defined as adequate ≥15 g (binary). We conducted marginal linear or logistic regression models using a generalized estimating equation and included an exposure x time interaction to assess differences in outcomes between intervention and comparison schools from baseline to follow up. We controlled for child age, gender, and orphan status. Results We assessed 855 children (n = 438 intervention; n = 417 comparison) at baseline and 688 children (n = 383 intervention; n = 305 comparison) at follow up. Children in intervention schools were 51.8% male, compared to 56.5% in comparison schools. Mean (standard deviation) age was 11.6 (2.1) years in intervention and 11.8 (2.3) years in comparison schools. All children's WDDS worsened post-intervention. In adjusted difference in difference analyses, WDDS did not differ in intervention vs. comparison schools pre- to post-intervention (β 0.04, CI −0.19, 0.27). However, we observed less of a decrease in meeting adequate intake for pulses (OR 2.18, CI 1.18, 4.01) and other fruits (OR 1.55, CI 1.00, 2.40) in intervention versus comparison schools. Conversely, children in comparison schools had less of a decrease in meat, poultry, and fish compared to children in intervention schools (OR 0.67, CI 0.45, 0.99). Conclusions Children's WDDS worsened in all 4 schools, likely due to a severe drought that affected the region in 2014. We observed some differences in intervention vs. comparison children, but cannot attribute these improvements to school gardens. Funding Sources Duke Global Health Institute.

scholarly journals Time trends and sociodemographic determinants of preterm births in pregnancy cohorts in Matlab, Bangladesh, 1990–2014

2019 ◽  
Vol 4 (4) ◽  
pp. e001462 ◽  
Author(s):  
Anisur Rahman ◽  
Monjur Rahman ◽  
Jesmin Pervin ◽  
Abdur Razzaque ◽  
Shaki Aktar ◽  
...  
Keyword(s):  
Seasonal Variation ◽  
Preterm Birth ◽  
Low Income ◽  
Time Trends ◽  
Maternal Education ◽  
Preterm Births ◽  
Population Based ◽  
Low Income Countries ◽  
Sociodemographic Determinants ◽  
Gestational Age At Birth

IntroductionPreterm birth is the major cause of under-five mortality. Population-based data on determinants and proportions of children born preterm are limited, especially from low-income countries. This study aimed at assessing time trends and social, reproductive and environmental determinants of preterm births based on a population-based pregnancy cohort over 25 years in rural Bangladesh.MethodsIn this cohort study in Matlab, a rural area in Bangladesh, we used data from the Health and Demographic Surveillance System from 1990 to 2014. Gestational age at birth was based on the reported last menstrual period and verified by ultrasound assessments. Preterm birth proportions were assessed within strata of social and reproductive characteristics, and time series analysis was performed with decomposition for trend and seasonality. We also determined the prevented fractions of preterm birth reduction associated with social and demographic changes during the follow-up period.ResultsAnalyses were based on 63 063 live births. Preterm birth decreased from 29% (95% CI 28.6 to 30.1) in 1990–1994 to 11% (95% CI 10.5 to 11.6) in 2010–2014. Low education, older age and multi-parity were associated with higher proportions of preterm births across the study period. Preterm births had a marked seasonal variation. A rapid increase in women’s educational level and decrease in parity were associated with the decline in preterm births, and 27% of the reduction observed from 1990 to 2014 could be attributed to these educational and reproductive changes.ConclusionThe reduction in preterm birth was to a large extent associated with the sociodemographic transition, especially changes in maternal education and parity. The persistent seasonal variation in the proportion of preterm birth may reflect the environmental stressors for pregnant women across the study period. Continued investments in girls’ education and family planning programmes may contribute to further reduction of preterm births in Bangladesh.

Physical growth of Jamaican school children who were severely malnourished before 2 years of age

1975 ◽  
Vol 7 (4) ◽  
pp. 445-462 ◽  
Author(s):  
Stephen A. Richardson
Keyword(s):  
School Children ◽  
Head Circumference ◽  
Age Groups ◽  
Physical Growth ◽  
Severe Malnutrition ◽  
Growth Standards ◽  
Catch Up ◽  
Index Cases

SummaryA study is reported of physical growth of Jamaican schoolboys who had been admitted to hospital with severe malnutrition during infancy (index cases). Height, weight and head circumference of the index cases was compared with that of male siblings close in age (siblings), with unrelated classmates or neighbours matched for sex and age (comparisons) and with Jamaican or US growth standards. Index boys were significantly smaller in height and head circumference than comparisons and significantly smaller than sibs only in head circumference. Sibs were intermediate in stature to the index and comparison boys. When the boys were divided into three age groups there was evidence of complete catch-up in height and weight after 7 years of age, but catch-up was incomplete for head circumference in the oldest group. No significant differences in stature at follow-up of the index boys were found in relation to age when admitted to hospital.

scholarly journals Prevalence of Soil-Transmitted Helminthiases and Schistosomiasis in Preschool Age Children in Mwea Division, Kirinyaga South District, Kirinyaga County, and Their Potential Effect on Physical Growth

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Stephen Sifuna Wefwafwa Sakari ◽  
Amos K. Mbugua ◽  
Gerald M. Mkoji
Keyword(s):  
Low Income ◽  
Intestinal Parasites ◽  
Preschool Age ◽  
Physical Growth ◽  
Low Income Countries ◽  
Intestinal Helminth ◽  
Parasitic Infections ◽  
Anthropometric Indices ◽  
Intestinal Parasitic Infections ◽  
Preschool Age Children

Intestinal parasitic infections can significantly contribute to the burden of disease, may cause nutritional and energetic stress, and negatively impact the quality of life in low income countries of the world. This cross-sectional study done in Mwea irrigation scheme, in Kirinyaga, central Kenya, assessed the public health significance of soil-transmitted helminthiases (STH), schistosomiasis, and other intestinal parasitic infections, among 361 preschool age children (PSAC) through fecal examination, by measuring anthropometric indices, and through their parents/guardians, by obtaining sociodemographic information. Both intestinal helminth and protozoan infections were detected, and, among the soil-transmitted helminth parasites, there were Ascaris lumbricoides (prevalence, 3%), Ancylostoma duodenale (<1%), and Trichuris trichiura (<1%). Other intestinal helminths were Hymenolepis nana (prevalence, 3.6%) and Enterobius vermicularis (<1%). Schistosoma mansoni occurred at a prevalence of 5.5%. Interestingly, the protozoan, Giardia lamblia (prevalence, 14.7%), was the most common among the PSAC. Other protozoans were Entamoeba coli (3.9%) and Entamoeba histolytica (<1). Anthropometric indices showed evidence of malnutrition. Intestinal parasites were associated with hand washing behavior, family size, water purification, and home location. These findings suggest that G. lamblia infection and malnutrition may be significant causes of ill health among the PSAC in Mwea, and, therefore, an intervention plan is needed.

scholarly journals Favorable Outcome in CLL Patients Not Treated Despite Presenting Iwcll Criteria: A Retrospective Analysis of the Brazilian CLL Group

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 12-12
Author(s):  
Fernanda de Morais Marques ◽  
Verena Pfister ◽  
Flavia Parra ◽  
Mihoko Yamamoto ◽  
Rodrigo Santucci Silva ◽  
...  
Keyword(s):  
Low Income ◽  
Conflicts Of Interest ◽  
International Workshop ◽  
Clinical Manifestations ◽  
Lymphocytic Leukemia ◽  
Public Hospitals ◽  
Low Income Countries ◽  
Treatment Indication ◽  
Treatment Indications

Introduction: Some patients with CLL will require treatment at diagnosis, but many other will remain untreated under observation for several years. In 2008, the International Workshop on Chronic Lymphocytic Leukemia(IWCLL) defined the criteria for treatment indications, which have been widely used in daily practice and in clinical trials. We have observed that many patients tolerate several of these clinical manifestations without treatment need, especially in public hospitals were resources and treatment options are scarce. We identified 5 reference centers for CLL that share the same profile of being more conservative in indicating treatment for CLL patients. We decided to analyze if more conservative local criteria for treatment indication impacts on patients' outcomes. Objective: To describe the outcomes of a series of CLL patients treated according to locally defined more conservative criteria for initiating treatment. Methods: The Brazilian Registry of CLL was started in 2004 as a prospective observational data collection tool. Inclusion criteria for enrollment followed the IWCLL guidelines. We retrospectively evaluated all patients with CLL in the Brazilian Registry of CLL who were followed between January 2013 and April 2020 at the 5 reference centers (3 public and 2 private). The following local criteria were used for treatment indications to all patients included: 1) persistent and progressive symptomatic cytopenias (no predefined minimum levels), 2) Massive or symptomatic lymphadenopathy, 3) Massive or symptomatic splenomegaly, 4) Disease-related symptoms, only if persistent and if other causes were excluded, and 5) Autoimmune complications including anemia or thrombocytopenia non-responsive to steroids. Progressive lymphocytosis and extranodal manifestations were not considered for treatment indication. Results: A total of 581 patients were followed during the observation period of 7 years (median follow-up was 40 months (range: 3-86). Median age was 65 years (range: 32-98) and most patients were male (57%). Binet stage was A in 67%, B in 14% and C in 19% of cases. FISH, performed in only 199 patients (34%), was normal in 47%, and showed del13q in 22%, trisomy 12 in 17%, del11q in 8% and del17p in 7%. According to IWCLL criteria, 257 (44%) presented indication for treatment over the time: 140 (55%) at diagnosis and 117 (45%) during follow-up. Based on the local criteria, 148 (25%) patients met criteria for indication of treatment. Therefore, 109 patients with IWCLL indication were not treated to date according to the local criteria. The IWCLL indications for these untreated patients were: cytopenias in 50 patients (48%), constitutional symptoms in 37 patients (35%), progressive lymphocytosis in 9 (9%), and lymphadenopathy or splenomegaly in 8 (8%). The median observation time for these untreated patients from the time of indication of treatment by IWCLL until the analysis was closed was 39 months, ranging from 3 to 86 months. Of the 109 untreated patients, 12 (13%) died during follow-up: 4 from infections probably unrelated to CLL (all patients were elderly, Binet A, non-neutropenic and non-hypoglobulinemic), 2 from cardiac causes, 1 from a car accident and 5 of unknown causes (lost follow-up after at least 2 years). No deaths were attributable to LLC. Overall survival at 4 years was 90% for the patients who were treated versus 89% for the patients who were not treated (P=0.85). Conclusion: Our data suggest that it is feasible and safe to adopt more conservative criteria to indicate treatment in a CLL patient. A more restrict approach may not only reflect in a significant financial impact to the health care system but also avoid premature exposition to prolonged and/or potentially toxic treatments. This finding might be of special interest to low-income countries. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Ten Years Retrospective Study of Hysterectomy in Goba Referral Hospital, Bale Zone, South East Ethiopia, Magnitude Indications and Outcomes

2020 ◽  
Author(s):  
Aklilu Getachew ◽  
Takele Mengistu ◽  
Yaregal Asres
Keyword(s):  
Retrospective Study ◽  
Antenatal Care ◽  
Low Income ◽  
Uterine Rupture ◽  
Female Genital Tract ◽  
Referral Hospital ◽  
Low Income Countries ◽  
Categorical Variables ◽  
P Value

Abstract Background: Hysterectomy is one of the major surgeries performed in clinical practice for commonly encountered diseases of the female genital tract worldwide. Even if Hysterectomy is widely performed surgery in both developed and low income countries little is known about is epidemiology in rural part of develop countries. Especially in developing countries like Ethiopia representative reliable statistics are rarely available on this important aspect of women’s health mainly on its prevalence, indication and outcome. So the aim of this study was to assess the magnitude indication and outcome of hysterectomy in Goba Referral Hospital from January 1, 2008 to January1, 2018. Methods: institutional based retrospective study was conducted in Goba Referral Hospital. Self-administered structured checklists were used to collect the data. The data were entered into Epi data version 3.1 and analyzed by SPSS version 20. Continuous and categorical variables were summarized by tables, graph and descriptive statistics. Logistic regression was used to determine association between predictors and Hysterectomy prevalence. P-value <0.05 was -considered as statistically significant. Results: a total of 200 hysterectomies were done for obstetrics and gynecology indications, of which the commonest, 47% (n=94), indication was uterine rupture. From the total of 116 women, who had no antenatal care follow up, 40% (n=47) had uterine rupture. This study also indicated that, most of uterine rupture cases 80% (n=76) were living far away from the hospital (> 50km from the hospital) 94.6% (n-89) were multiparous. This study has also indicated that from the total of 20 discharged dead, 90% (n=18)) were came from a distance of >100km far from the hospital and 95% (n=19) were those who didn’t attend antenatal care. Conclusions: the higher rate of uterine rupture was seen in those who were multi Para, far from Hospitals and those who have no ANC follow up. Large scale study for the identification of determinant factors for evidence based intervention will be very important.

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