ABSTRACT
BACKGROUND :Approximately 200 million children globally fail to fulfil their development potential due to malnutrition, poor health, and unstimulating environments. Children in Kabale, Uganda, may be at particularly high risk as the rate of malnutrition in the region is likely to impact development. The study aimed to identify possible determinants influencing developmental milestones of breastfed and non-breastfed children aged 0-23 months. MATERIALS AND METHODSThe study was conducted at the young child clinic of Kabale hospital, among 250 children aged 0-23 months and their caregivers, for two months. The study adopted a comparative cross-sectional design, and systematic random sampling was used to select the respondents for the study. The socio-demographic characteristics, nutritional status, and feeding practices were assessed using structured pretested questionnaires. Developmental milestones of the children (communication, motor, fine motor, problem-solving, and social skills) were assessed using the modified ages and stages questionnaires. The data collected was tabulated, analysed statistically, and the results interpreted. RESULTS :Developmental scores were not associated with breastfeeding and minimum meal frequency. A milestone achievement of communication skills was associated with caregiver's education, caregiver's age and length-for-age. Gross motor scores were associated with the caregiver's age, weight-for-age, and length for age. Achievement of fine motor skills was associated with caregiver's education, caregiver's age, child's age, length for age, and children who met the minimum dietary diversity score. Problem-solving scores were associated with child's age, weight for age, length for age, and children who met the minimum dietary diversity. Personal social scores were associated with lower caregiver's age and normal weight for age Conclusion: Developmental scores were not associated with breastfeeding and minimum meal frequency. Development in early childhood was mainly associated with caregiver's age, caregiver's education, child's age, weight for age, length for age, and minimum dietary diversity score. Children under the care of younger caregivers and those who attained normal nutrition status had significantly more developed motor and social skills compared to children with older caregivers and undernourished children, respectively.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child Nutrition Disorders , Child Development , Anthropometry , Nutritional Status , Breast FeedingABSTRACT
Introduction: les pays à ressources limitées présentent un haut risque de retard dans les 4 domaines du développement et le taux d'un handicap dans un de ces domaines est très élevé. L'objectif de cette étude est de déterminer l'âge de développement psychomoteur de l'enfant congolais en utilisant l'échelle de Bayley 2ème édition (BSID II).Méthodes: étude descriptive, observationnelle réalisé auprès les nourrissons en bonne santé apparente de Kinshasa (Centre de Santé BOMOI, CH de Kingasani II) et de la cité d'Idiofa dans la province du Kwilu durant la période allant de Janvier 2010 à janvier 2012. Les variables d'intérêts étaient les caractéristiques sociodémographiques (âge, sexe, milieu d'habitation), l'Index de développement psychomoteur (PDI) et Index de développement mental (MDI) et l'échelle comportementale (BRS) évalués à l'aide de l'échelle de Bayley 2nde édition (BSID-II). Résultats: sur 366 nourrissons retenus, 51,9% étaient du sexe féminin (sex ratio 1H/1F). L'âge chronologique et développemental médian était de 16,8 et 17 mois respectivement. Les valeurs moyennes de PDI et MDI étaient de 104,0±17,4 et 100,5±15,0 respectivement. Le retard mental et moteur sévère noté chez ces nourrissons était respectivement de 4,9% et 4,1%. Dans toutes les composantes du développement psychomoteur, les nourrissons du milieu rural avaient significativement une médiane d´âge élevée (p<0,05).Conclusion: les enfants en milieu urbain sont en avance en ce qui concerne la motricité, le cognitif et ont aussi un comportement meilleur par rapport à ceux du milieu rural
Subject(s)
Child , Child Development , Democratic Republic of the Congo , Growth and Development , Musculoskeletal DevelopmentABSTRACT
Background: developmental problems or delays are preventable and others may be ameliorated by interventions. Developmental delay and factors associated with it therefore need to be identified in order for early and appropriate interventions to be instituted. This study therefore aimed to determine the prevalence of developmental delay among under-fives and identify the sociodemographic factors associated with the delay.Methods: Four hundred and fifteen Nigerian children, aged 6- 59 months were assessed for development using the Schedule of Growing Skills II tool. Developmental quotient below threshold point of 85% in a developmental domain was used to define developmental delay. Results: Of the 415 children assessed, 147 (35.4%) had delay in the various developmental domains. The highest prevalence was in the manipulative domain (25.8%) followed by visual (17.1%), cognitive skill (13.5%), hearing and language (6.3%), interactive social (5.8%), self-care social (4.4%) and speech and language (4.1%). Low maternal education was significantly associated with delay in locomotive domain (4.3%; OR=5.00; 95% CI=1.04-23.84), manipulative domain (32.4%; OR=1.89; Most 95% CI=1.21-2.95), visual domain (22.9%; OR=2.11; 95% CI=1.25-3.55), speech and language (6.4%; OR=3.03; 95% CI=1.05-8.75), interactive social (8%; OR=3.05; 95% CI=1.32-7.04), self-care social (6.9%; OR=3.30; 95% CI=1.15-9.43), cognitive (17.6%; OR=1.89; 95% CI= 1.07-3.35). Birth order and household size also had significant association with delay in various domains. There was no significant association between socioeconomic class and developmental delay in any of the domains.Conclusion: The study showed that developmental delay was relatively common among under-five children in North-West Nigeria; and has a strong association with some socio demographic factors. There is need to screen children for developmental delay for early intervention
Subject(s)
Child , Child Development , Early Intervention, Educational , Social Skills , Socioeconomic FactorsABSTRACT
introduction:The Participation in Activities of Daily Living (PADL) instrument was developed out of a need for a culturally appropriate tool to measure the impact of ill health on children's well-being. Objective: We sought to devise a psychometrically sound instrument to measure well-being through participation in daily activities for rural school-age children in Kenya. Method: The study was carried out at the Kenya Medical Research Institute/Centre for Geographic Medicine Research - Coast; in the Kilifi district of Coast Province. The process that was followed ensured an integration of community reported activity; use of a relevant vocabulary and a careful translation of concepts in the adaptation of an instrument used in other contexts. The reliability; validity and sensitivity of the PADL were evaluated in studies with clinical and community samples. Results: Factor analysis suggested five potential summary scores measuring levels of participation and attitude to participation (alphas 0.56-0.91). Variability in children's responses on participation was significantly associated with ill health and level of schooling. Conclusion: The format and content of the questionnaire items concerning participation in activities of daily living were appropriate for use with rural children. The precise nature of the activities needs to be determined in context; taking into account both the nature of the health experience and the expected structure of a child's day
Subject(s)
Activities of Daily Living , Child Development , Factor Analysis, StatisticalABSTRACT
Background: The study obtained information on key growth promotion and developmental household and community health practices in Community-Integrated Management of Childhood Illnesses (C-IMCI) and non-C-IMCI in local government areas (LGAs) in Osun State; Nigeria; to determine the differences that existed; between these LGAs. Method: A cross-sectional comparative study to compare Integrated Management of Childhood Illnesses (IMCI) key growth promotion and development health practices in two LGAs in Osun State was conducted using quantitative and qualitative techniques. Data analysis was done using Epi Info version 6.0 for the quantitative survey and a content analysis method for the qualitative survey. The subjects were mothers or caregivers of children 0-59 months of age; and their index children. Results: Findings revealed that the IMCI key growth and development health practices were generally better rated in the CIMCI-compliant LGA than in the non-CIMCI compliant LGA. Breastfeeding practice was widespread in both LGAs. However; the exclusive breastfeeding (EBF) rate among children under six months was higher in the compliant LGA (66.7) than in the non-compliant LGA (25). More caregivers (59.7) from the non-compliant LGA introduced complementary feeds earlier than six months. Growth monitoring activities revealed that there were more underweight children (19.1) in the non-compliant LGA. Community Resource Persons (CORPs) and health workers were the most popular sources of information on IMCI key practices in the compliant LGA; while in the non-compliant LGA the traditional healers; elders and; to a lesser extent; health workers provided information on these key practices. Conclusion: The IMCI strategy; if well implemented; is an effective and low-cost intervention that is useful in achieving optimal growth; development and survival of Nigerian children
Subject(s)
Child Development , Child, Preschool , Delivery of Health Care , NigeriaABSTRACT
BACKGROUND: Some authors demonstrate that exclusively breastfed infants have growth patterns comparable with the NCHS standards while others conclude that exclusively breastfed infants grow slower. These conflicting results informed the need for this study to aid the paediatricians and health workers to justify or condemn the recommendation of exclusive breastfeeding for six months. This was a prospective longitudinal study carried out to determine the growth pattern of exclusively breastfed infants in the first 6 months of life and compare them with the International, National Centre for Health Statistics (NCHS/WHO) reference and the Local, Janes' Elite Standards. METHODS:Using weight, length and occipito-frontal circumference as indices, 530 infants were recruited consecutively by convenience sampling over 17 months. Measurements were taken at birth, 2 weeks, 6 weeks, 2 months and subsequently monthly until the end of the 6th month.RESULTS: The exclusively breastfed infants doubled their birth weights at 3 months. The mean weight, OFC and length gains were maximal at 2 months, 2 weeks and 2 months respectively. The growth of exclusively breastfed infants compared favourably with the NCHS/WHO reference group and also compared favourably with the Janes' 'Elite' reference group. CONCLUSION:It is concluded that the growth in weight, length and OFC of exclusively breastfed infants appears adequate for the first 6 months of life
Subject(s)
Bottle Feeding , Breast Feeding , Child Development/physiology , Hospitals, Teaching , Infant Nutritional Physiological Phenomena , Nigeria , Prospective StudiesABSTRACT
Introduction: Periventricular leucomalacia (PVL) and intraventricular haemorrhage (IVH) are two most important antecedents of neuro-developmental outcome in very low birth weight infants.Study objective: To determine the incidence of PVL/IVH and it's associated perinatal factors among very low birth weight (VLBW) infants admitted at neonatal unit Muhimbili National Hospital.Material and methods: Prospective study with a nested case-control study was conducted at the neonatal unit from May to November 2000. Three hundred seventy two VLBW neonates were recruited to the study on admission to the neonatal unit and were followed up to the postnatal age of 4 weeks or death depending on which came first. All 372 neonates had initial cranial-ultrasound examination within 72 hours of life. Cranial-ultrasound was done on 179 and 151 neonates at the postnatal age of 2 weeks and 4 weeks respectively. Records of all 372 neonates were reviewed to determine the presence or absence of the various perinatal factors. These data were analysed as a nested case-control study whereby a case was defined as any VLBW who had been recruited in the follow up study and had diagnosis of either PVL or IVH or both by cranial ultrasound and those VLBW who had been recruited in the follow up study without a diagnosis of either PVL or IVH were taken as controls. Results: A total of 4539 neonates were admitted to the neonatal unit during the study period and among these 443 (9.8) were VLBW. Two hundred fifty seven (58) out the 443 VLBW neonates died before the postnatal age of 4 weeks. Among the 372 VLBW infants recruited in the study; PVL was seen in 121/372 (32.5) with an overall incidence rate of 0.125/infant week and IVH was seen in 230/372 (61.8) with an overall incidence rate of 0.247/ infant week. Most of the PVL and IVH occurred during the first 3 days of life. All neonates with grade IV IVH died before the postnatal age of 4 weeks. Forty-seven neonates (12.6) developed post-hemorrhagic hydrocephalus. Maternal hemoglobin and neonatal hemoglobin showed significant `association with PVL and IVH respectively.Conclusion:There is high incidence of VLBW; IVH and PVL. IVH grade IV carries a very high mortality. Routine cranial-ultrasound on all VLBW neonates along with clinical follow up for long-term neuro-developmental outcome is recommended
Subject(s)
Child Development , Infant , Infant, Very Low Birth Weight/growth & developmentABSTRACT
Cereal grains are the basis of weaning gruel in Kenya yet they run a high risk of mycotoxin contamination. Children could be at a higher risk of dietary mycotoxin exposure than the rest of the population.. This paper presents information on the association between nutritional state of children and dietary exposure to aflatoxins in Kisumu District. Weaning flour samples were collected randomly from 242 households in Kisumu District; Kenya. A questionnaire was used to collect information; from mothers whose flour were sampled; on the types of weaning foods; handling and storage. The nutritional status of the children in question was assessed and their weight and height measured. The flour samples were analyzed for aflatoxins by thin layer chromatography. Cultural studies of the flour were also done. Thirty one percent of the children were malnourished. The number of children who were wasting and were being fed on flour contaminated with mycotoxins was highly significant (P = 0.002). Seventy samples (29) were positive for aflatoxins (concentration range 2-82 ?g/kg); some exceeding the advisory limit
Subject(s)
Aflatoxins , Child Development , Cross-Sectional Studies , Kenya , Mycotoxins , Nutritional Status , WeaningABSTRACT
Les enfants tares; de parents separes; orphelins ou encore malnutris sont souvent juges a tort de retardes. Les reponses aux besoins des enfants doivent donc etre adaptes aux besoins physiques et psycho-sociaux. La croissance et le developpement sont de ce fait subordonnes a un bien-etre qui demande des soins adaptes et continus chaque fois que l'enfant en bonne sante est soumis a un risque ou maladie
Subject(s)
Child Development , Child WelfareABSTRACT
This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens
Subject(s)
Child Care , Child Day Care Centers/standards , Child Development , Nigeria , Pilot Projects , Quality Control , Reproducibility of Results , World Health OrganizationABSTRACT
This manual is designed to help health workers develop and utilize growth charts and to give effective nutrition education presentations to mothers
Subject(s)
Child Development , Nutritional Sciences , RecordsABSTRACT
During November 1990 to January 1991 a survey of the nutritional status of high income urban children in a sample of 18 pre-schools in Blantyre; Zomba; and Lilongwe was carried out. The results confirm that high income Malawian children have a similar growth pattern to the NCHS/WHO International Child Growth reference population (WHO 1984) which is based on a sample of healthy North American children. The consistently shorther stature of rural Malawian children is not a result of ethnic differences but reflect socio-economic and environmental factors which affect nutritional status
Subject(s)
Child , Child Development , Child Nutrition , Food Supply , Growth , Social EnvironmentABSTRACT
The study revealed that there were various factors contributing to low attendance; among them being mothers education and social status; distance health centres; laziness; long queues; shortage of scales and staff