Results from the healthy active kids South Africa 2018 report card

Background. Healthy Active Kids South Africa (HAKSA) Report Cards were produced in 2007, 2010, 2014 and 2016. Objective. The 2018 Report Card aims to report on the latest available evidence relating to the physical activity (PA), nutrition and body composition of South African (SA) children and adolescents. Methods. A review was conducted using the following databases: PubMed; Africa Journals Online; and Africa-Wide (EBSCOhost). Articles published from January 2016 to September 2018 were included for review by the HAKSA scientific advisory group. Data were extracted, and a grade for each indicator was assigned based on the available evidence and the consensus of the scientific advisory group. This included 12 PA indicators, 6 nutrition indicators and 3 body composition indicators. Results. There was no evidence of a significant change in any of the indicators since the 2016 Report Card. Grades for certain indicators have been downgraded (from 2016) to bring these to the attention of relevant stakeholders and industry. These include food insecurity and grades that relate to the implementation of policy on PA and nutrition in the school environment, and on advertising and media relating to nutrition. Conclusion. Key priorities for action include: safe opportunities for physical activity; minimising the gap between policy and implementation (school culture and environment, and government strategies); and the double burden of over- and undernutrition, which relates to the continuing concern about food insecurity in SA. There is a need for further research, including surveillance, on all indicators, for future Report Cards

Enteral Feeding Practices in Preterm Infants in South Africa

Background. Optimal feeding regimens in babies weighing 1 000 g have not been established; and wide variations occur. In South Africa (SA) this situation is complicated by varied resource constraints.Objective. To determine the preterm enteral feeding practices of paediatricians in SA.Methods. We invited 288 paediatricians to participate in a cross-sectional web-based survey. Results. We received responses from 31.2 of the paediatricians; 43.6 were from the state sector and 56.4 from the private sector. Most participants worked in medium-sized neonatal units with 6 - 10 beds. The proportions commencing feeds within the first 24 hours were 24 in infants of 25 weeks' gestational age; 36 in infants 25 - 27 weeks; and 65 in infants 28 - 31 weeks. Feed volumes were routinely advanced daily in 47 of infants 25 weeks; 68 of infants 25 - 27 weeks; and 90 of infants 28 - 31 weeks. Forty-five per cent of infants 25 weeks received continuous intragastric feeds; while 50 of those in the 28 - 31 weeks group were on 3-hourly bolus feeds. The majority of the participants targeted full enteral feeds of 161 - 180 ml/kg/d; 66.7 had access to donor milk; and 77 used breastmilk fortifier.Conclusion. This is the first study to survey feeding practices in SA. The survey did not highlight differences in feeding practices among paediatricians. These data could be valuable in the design of local collaborative trials to determine optimal feeding strategies

Osmolality of Modified Enteral Tube Feeds for Adults in Hospitals Across the Western Cape Province

Objectives: The first aim of this study was to determine the incidence of use; reasons for use; and procedures/recipes followed in modifying enteral tube feeds (ETFs) for adults in state and private hospitals across the Western Cape Province (WCP); South Africa (baseline data). The second aim was to determine the osmolality of the modified ETFs used by these hospitals (osmolality data). Design: A descriptive cross-sectional study. Setting and subjects: The study was conducted in January/February 2007. The baseline data was collected by means of a coded questionnaire sent to all state and private hospitals in the WCP (n = 111); excluding all children's hospitals. The osmolality data was obtained by means of freeze-point depression of the modified ETF recipes obtained from the participating hospitals. Results: A total response rate of 94was obtained. Of the participating hospitals (n = 104); 48were state (n = 50) and 52were private hospitals (n = 54). Sixty-two per cent of hospitals (n = 64) made use of ETFs; with 25modifying their feeds (n = 16). Twelve recipes were obtained for the osmolality testing. Eight recipes (66) were significantly lower (p 0.001); two (16) were significantly higher (p 0.001) and two of the recipes did not differ from the standard enteral product. Eight recipes (66) had a significantly higher average osmolality (p 0.001) than that of body fluid. The concentrated ETF recipe (1.43 kcal/ml) had the highest osmolality (707 mOsm/kg/H20). Conclusions: Modular ETFs had lower average osmolality than those of the semi-modular and the standard enteral products; and of body fluid (300 mOsm/kg/H20)

Infant Feeding Tube as Urinary Tract Stent

Background: The infant feeding tube is a cheap and readily available device with many uses in the urinary tract. Many types of stents are available in the market but among other factors; cost and affordability limit their use in developing countries and remote areas. Aim: To document experience with infant feeding tubes as stents in the urinary tract. Methods: Data from the hospital records of patients who required stents at the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria were obtained from their case notes from May 2003 to May 2006. Information extracted from these case notes included: age and sex of patient; indications for stenting; stent-related complications and outcome of surgery. The data were analysed using Microsoft Excel Software. Results: Thirty-three patients who required stents within the period were included in the study. In nineteen patients (57.6) feeding tubes were used as urethral stents while in 14 (42.4) as ureteric stents. Operations requiring stents include: dismembered pyeloplasty 9.1 (3); ureteric re-implantation 24.3 (8); ureterolithotomy 9.1 (3); and urethroplasty 57.6 (19). The stents were left in situ for 2-3 weeks depending on the indication. Ureteric stents were left for 3 weeks while urethral stents were usually left for 2 weeks. However; where a significant complication was noted; the stent was removed. Complications noted in 4 patients (12.1) which were probably stent-related include: bladder spasm; infection and wound dehiscence. Conclusion: Infant feeding tubes can be used as suitable urinary tract stents where expensive stents are not available

Infant feeding tube as urinary tract stent

Background: The infant feeding tube is a cheap and readily available device with many uses in the urinary tract. Many types of stents are available in the market but among other factors; cost and affordability limit their use in developing countries and remote areas.Aim: To document experience with infant feeding tubes as stents in the urinary tract.Methods: Data from the hospital records of patients who required stents at the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria were obtained from their case notes from May 2003 to May 2006. Information extracted from these case notes included: age and sex of patient; indications for stenting; stent-related complications and outcome of surgery. The data were analysed using Microsoft Excel Software.Results: Thirty-three patients who required stents within the period were included in the study. In nineteen patients (57.6) feeding tubes were used as urethral stents while in 14 (42.4) as ureteric stents. Operations requiring stents include: dismembered pyeloplasty 9.1(3); ureteric re-implantation 24.3(8); ureterolithotomy 9.1(3); and urethroplasty 57.6(19). The stents were left in situ for 2-3 weeks depending on the indication. Ureteric stents were left for 3 weeks while urethral stents were usually left for 2 weeks. However; where a significant complication was noted; the stent was removed. Complications noted in 4 patients (12.1) which were probably stent-related include: bladder spasm; infection and wound dehiscence. Conclusion: Infant feeding tubes can be used as suitable urinary tract stents where expensive stents are not available

L'ascite chyleuse du nouveau-ne : a propos d'un cas

Les auteurs rapportent un cas d'ascite chyleuse chez un nouveau-ne de 3 semaines. L'evolution sous nutrition parenterale puis alimentation enterale elementaire excluant les triglycerides a chaine longue a ete malheureusement defavorable au 37eme jour de vie dans un tableau de choc septique. Une revue de la litterature a permis de souligner le caractere en regle idiopathique de l'ascite chyleuse du nouveau-ne; et la necessite d'une nutrition parenterale ou enterale comportant des triglycerides a chaine moyenne : seul gage d'une evolution habituellement favorable