Evaluation du développement psychomoteur de l'enfant congolais par l'échelle de Bayley pour le développement des enfants. Deuxième édition

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

Health and educational achievement of school-aged children: The impact of anaemia and iron status on learning

Background: Anaemia is a common blood disorder in children and is known to cause complications such as lethargy and stress on bodily organs. Children from disadvantaged communities often fail to achieve their age-related potential with iron deficiency anaemia stated as a risk factor through causing inattentiveness and learning problems. Limited evidence exists for the adverse effects of iron deficiency anaemia on the developing child's brain from South African studies. Aim: The objective of this study was to determine the local prevalence of anaemia and iron deficiency and to examine their association with psychomotor development and school performance in school-aged children. Setting: This study was conducted in a peri-urban disadvantaged community from KwaZulu-Natal, South Africa. Methods: Children aged 6 to 8 years from KwaZulu-Natal were enrolled (n = 184). Three parameters of assessment were used: clinical data, biochemical data (haemoglobin levels and iron studies) and school performance (interviews with caregivers, teachers and the children). Anaemia presence and iron deficiency were the hypothesised mediating variables through which growth, development and school performance were influenced. Results: A high point prevalence of anaemia (23.4%), iron deficiency anaemia (4.9%) and helminth infection (27.1%) was identified. Impaired cognitive assessment scores (20.7%) were prevalent in the children sampled. Behavioural problems (4.3%), poor memory function (4.3%) and impaired attention (1.1%) were of low prevalence. Anaemia and iron deficiency were both associated with impaired fine motor skills (p < 0.05). Anaemia was significantly associated with low cognitive scores (p = 0.01). Neither anaemia, iron status nor helminth infection significantly predicted school performance in the children sampled. Conclusions: The point prevalence of anaemia and iron deficiency among the sampled children was higher than the national prevalence. The sample size was however inadequate for drawing statistical conclusions about psychomotor development and school performance because of the low prevalence of the different outcomes that were examined. Practical challenges faced in conducting this investigation in rural South African schools were discussed

Breastfeeding Practices and Growth

Background: Breastfeeding is vital for the growth and development of infants and young children. Early initiation within the half hour of birth fosters optimal breastfeeding practice; promotes growth and development.Objective: To evaluate breastfeeding practices and the growth of infants. Method: This was a crosssectional survey at three immunisation clinics in Asaba metropolis of Delta state. Using a structured questionnaire; we assessed breastfeeding practice of attendees and the growth of babies and documented information on the socio demographic characteristics; breastfeeding practices; previous weights of infants' and their Anthropometric measurements.Results: There were 97 mother infant/ pairs. 49 males; 48 females; giving a male to female ratio of 1:1. 20.6% were neonates; 74.2% were less than 6 months while 25.8% were older. About 50% of the mothers initiated breastfeeding within an hour of delivery; 25% of mothers gave pre-lacteal feeds. 49.5% of babies were optimally breastfed; of these; 68.7% mothers had initiated breastfeeding within an hour of birth (p=0.001). Underweight and stunting was only seen among babies of mothers who did not practice optimal breastfeeding. It was observed that babies' weights were not documented routinely in the road to health chart of the immunization cards after the measurements were taken. This was a missed opportunity for counselling and health promotion.Conclusion: Early initiation of breastfeeding increases the probability of optimal breastfeeding practice and prevents infant malnutrition. Even though growth was assessed; the information was not utilized for feed back to the mothers at the well-baby clinics; growth monitoring and promotion was not supported at the well-baby clinics in the health centres

Birth Weight Recovery among very Low Birth Weight Infants Surviving to Discharge from Charlotte Maxeke Johannesburg Academic Hospital; Neonatal unit

Background. The recommended growth velocity (GV) of very low birth weight (VLBW) infants is 15 g/kg/day. Several factors have been associated with poor postnatal weight gain. Objective. To provide current information on the postnatal growth of VLBW infants at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).Methods. This was a longitudinal study of VLBW infants surviving to discharge from CMJAH neonatal unit from August to October 2013.Results. Sixty-nine infants were included in the study. The mean GV was 13.2 g/kg/day; the median weight loss was 7.69 and the median time for regaining birth weight was 16 days. Fifty-one infants (73.9) regained their birth weight at or before 21 days. There was a decrease in mean z-scores for weight (ZSWs) from -0.32 (standard deviation 1.25) at birth to -1.94 (1.35) at discharge. A multiple linear regression showed a negative association between ZSW at discharge and number of days nil per os without parenteral nutrition (PN). Antenatal steroids were associated with poor GV. There were no factors associated with regaining birth weight after 21 days on multiple logistic regression.Conclusion. This study showed a GV in VLBW infants approaching recommended standards. Number of days without PN and use of antenatal steroids were associated with poor postnatal growth

African indigenous knowledge and research

This paper seeks to heighten awareness about the need to include indigenous knowledge in the design and implementation of research; particularly disability research, in Africa. It affirms the suitability of the Afrocentric paradigm in African research and argues the necessity for an emancipatory and participatory type of research which values and includes indigenous knowledge and peoples. In the predominantly Western-oriented academic circles and investigations, the African voice is either sidelined or suppressed because indigenous knowledge and methods are often ignored or not taken seriously. This paper posits that to be meaningful and empowering, African-based research must, of necessity, include African thought and ideas from inception through completion to the implementation of policies arising from the research. In this way the work is both empowering and meaningful for context-specific lasting impact

Valeurs de reference de la puissance anaerobie alactique des bantous congolais de 8 a 20 ans

Evaluer les valeurs de reference de la force explosive et la puissance anaerobie alactique des melano-africains Bantous au cours de la croissance. Methodes : Sept cent quatre vingt (780) eleves negro-africains; bantous Congolais; ages de 8 a 20 ans; dont 390 garcons et 390 filles; ont ete soumis a deux tests de terrain d'evaluation de la force explosive et de la puissance anaerobie alactique des membres inferieurs ; il s'agissait des sauts; horizontal et vertical sans elan. Tous le sujets ne pratiquaient aucune activite physique et sportive de maniere reguliere; a l'exception des cours d'education physique. Pour apprecier le niveau de la croissance staturo-ponderale; les mesures anthropometriques prises. Les valeurs de la puissance anaerobie alactique ont ete exprimees en valeurs absolues (W); puis rapportees au poids corporel (W/kg). Resultats : Les valeurs moyennes de la puissance anaerobie alactique (PAmax) croissent en fonction de l'age civil; et elles sont toujours superieures chez les garcons par rapport aux filles; particulierement a partir de 14 ans (p0001). Par ailleurs la puissance musculaire anaerobie alactique (pAmax) varie en fonction de la longueur des segments corporels et du poids maigre. Nos resultats sont similaires a ceux des autres ethnies humaines. Les differences entre les sexes s'expliquent par la superiorite de la masse musculaire et de la longueur des segments corporels chez les garcons a la puberte; tandis que celles des differentes ethnies humaines sont d'ordre genetique. Conclusion : Nos resultats confirment que les sujets melanodermes ont des caracteristiques musculaires superieures aux autres ethnies humaines; notamment le metabolisme anaerobie alactique

The Use of the Road to Health Card in Monitoring Child Health

Objectives: The Road to Health Chart (RTHC) provides a simple; cheap; practical and convenient method of monitoring child health. The RTHC could assist with vaccine compliance and early identification of growth faltering; to improve general health. The purpose of the study was to assess whether the RTHCs were adequately completed and interpreted at primary; secondary and tertiary care levels in South Africa.Methods: The study was carried out at a primary; secondary and tertiary care centre. A questionnaire was administered to 100 subjects from each; seeking demographic information; whether the RTHC was brought along; and if not why it was not brought.Results: Most children were brought by their mothers. The RTHC was not brought to 48 of the consultations; of those; about 72 thought that bringing the RTHC along was not necessary. Health workers seldom asked to see the RTHC at the primary and secondary care settings; but 50 of them did so at Ga-Rankuwa Hospital (p = 0;002). In only 8 cases overall were the children below the 3rd percentile of weight-for-age. Approximately 20 had incomplete immunisations.Conclusions: Many parents believe that the RTHC is only required for Well-baby-clinic visits; not for consultations. The RTHC is not often asked for at consultations; the fact that this is more often done at the tertiary care centre may be that much of the service is supplied by paediatricians-in-training. Health workers should ask to see the RTHC; in order for mothers to understand the importance of the information. The study showed that the RTHC is not used to its full potential

Effect of Inutero Exposure to an Aqueous Extract of Hibicus Sabdariffa on Offspring's Postnatal Growth in Sprague-Dawley Rats

"In folk medicine; extracts of Hibiscus Sabdariffa (HS) are used in the treatment of several complaints including high blood pressure; liver diseases and fever. To the best of our knowledge; no documented evidence exists on the effect of inutero exposure to an aqueous extract of HS on postnatal growth. The purpose of the present study; therefore; was to investigate this. Three groups of pregnant rats were used for this study. Group C had tap water while groups A and B had 0.6g and 1.8g HS extract respectively in 100ml tap water to drink throughout pregnancy. All groups had normal rat chow ad libitum. On the day of birth; birth weights were recorded and two pups each from dams in groups A and B were substituted for 4 pups from dams in group C such that dams in group C had two pups each from groups A and B and at least two pups from its own litters to nurse. Thereafter; weights were recorded at 10days; 14days; 20days and 34 days postpartum. Results of the present study show a statistically significant (p0.05) growth reduction in groups A and B pups (exposed group) compared with group C (unexposed group) at 10 days through 20 days postpartum with no statistically significant growth reduction at 34 days postpartum. We conclude that inutero exposure to an aqueous extract of HS attenuates early postnatal growth in SD rats with a possible ""catch-up"" growth later in life."

Analyse situationnelle des services de pesee dans les etablissements sanitaires publics peripheriques de la ville d'Abidjan

Le service de pesee est une unite de la PMI enfant ou se deroule l'activite de surveillance de la croissance staturo-ponderale et du developpement psychomoteur de l'enfant des 0 a 5 ans. Notre etude qui a eu lieu dans 11 centres de sante publics disposant d'un service de pesee consiste dans ces unites a evaluer d'une part leur capacite fonctionnelle et d'autre part la qualite des activites qui y sont menees dans le but de contribuer a l'amelioration de la qualite de la surveillance de la croissance des enfants de O a 5ans. Nous avons realise une etude transversale qui a consistee a observer 400 pesees des enfants sains et a interroger 39 agents de sante des services de pesee dans 11 etablissements sanitaires publics peripheriques de la ville d'Abidjan. Au terme de nos travaux; l'etude a revele que: *Tous les services de pesee ne fonctionnent que la matinee. *72pour cent de ces services pratiquent une tarification de parallele. *55pour cent des structures ne disposent pas de vitamine A. *Peu de supports pedagogiques sont disponibles. *L'age moyen des prestataires est de 43;2 ans et ceux-ci sont domines par les femmes (90;7pour cent). *Seuls 2;8pour cent du personnel a beneficie d'un recyclage. *94;9pour cent des prestataires estiment ne pas avoir de supervision reguliere. *Seulement dans 14;8pour cent des cas; les prestataires tracent la courbe de poids et l'interpretent dans 8pour cent des cas. *87;8pour cent des enfants peses sont des nourrissons. *Dans l'ensemble la surveillance de la croissance des enfants n'est pas bien faite juisqu'elle ne permet pas en general de depister les cas de malnutritions frustres. Au regard de ces resultats plusieurs recommandations ont ete faites pour ameliorer la qualite de la surveillance de la croissance et du developpement psychomoteur des enfants. Dans le but de reduire la prevalence de la malnutrition