Performance of the allometric power model in scaling from adult to paediatric antiretroviral dose in children at a Referral Hospital in Windhoek, Namibia

Background: World Health Organization (WHO) advocates use of weight bands in antiretroviral therapy (ART) guidelines. Allometric scaling could be a more reliable method because it uses a non-linear approach in relating dose to body weight. This study evaluates performance of the allometric ¾ power model in comparison to WHO weight band method in children receiving ART. Methods: Records of children receiving (ABC/3TC) + DTG were reviewed. Paediatric ABC/3TC dose was calculated from the adult dose using the allometric ¾ power model and compared to WHO weight band dose. Results: WHO weight band strategy grouped 50.6% of the children in the 25 kg category and therefore received the adult dose of ABC/3TC (600 mg/300 mg); only 1.1% received this dose with allometric scaling. Mean dose (3.8 tablets) for the WHO weight band dosing method was found to be significantly higher (p<0.0001) than for allometric scaling (1.5 tablets). Conclusions: WHO weight bands may result in the 25 kg weight category receiving a much higher dose leading to ADRs. Using allometric scaling, we recommend a weight band strategy that could improve paediatric ABC/3TC dosing

Correlation of optic nerve sheath diameter with height, weight, body mass index and age

Abstract: The study was conducted to determine the relationship or association between optic nerve sheath diameter and age, weight, sex, height, and Body mass index (BMI) in children of the South West Nigeria extraction. A cross-sectional study was carried out among 2-14-year-old children of the selected school in a suburban town in Southwest Nigeria. Approval was obtained from the institutional Human Research Ethics Research Committee, and consent was obtained from parents of the children. Where indicated, assent was obtained from the children. A pediatric ophthalmologist ascertained the normalcy of the eyes with visual acuity, refraction and fundoscopy. Height and weight were measured according to standard protocol and BMI was calculated from weight and height. The scanning was done by a radiologist with 4-12MHz Linear transducer on a gently closed upper eyelid with a B-mode ultrasound machine (Clear Vue 550 Phillips Model). No sedation was involved. The mean ONSD for the right eye was 0.54±0.07cm (5.4mm), while the left eye was 0.56±0.07cm (5.6mm). The optic nerve sheath diameter was longer in the left eye for all subjects, and this may be due to the fact that females have shorter diameter in the right eyes. ONSD did not correlate with height, weight and BMI. The mean ONSD is affected by sex in the right eye. This may be indicative of a relatively lower intraocular pressure in the right eyes of the girls. Therefore, in the use of the optic nerve sheath diameter as surrogate for intraocular pressure, it is preferable to use the left eye in which there is no sex difference

A systematic review and meta-analysis of the accuracy of weight estimation systems used in paediatric emergency care in developing countries

Introduction :When weight cannot be measured during the management of medical emergencies in children, a convenient, quick and accurate method of weight estimation is required, as many drug doses and other interventions are based on body weight. Many weight estimation methodologies in current use have been shown to be inaccurate, especially in low- and middle-income countries with a high prevalence of underweight children. This meta-analysis evaluated the accuracy of weight estimation systems in children from studies from low- and middle-income countries. Methods : Articles from low- and middle-income countries were screened for inclusion to evaluate and compare the accuracy of existing systems and the newer dual length- and habitus-based methods, using standard meta-analysis techniques. Results:The 2D systems and parental estimates performed best overall. The PAWPER tape, parental estimates, the Wozniak method and the Mercy method were the most accurate systems with percentage of weight estimates within 10% of actual weight (PW10) accuracies of 86.9%, 80.4%, 72.1% and 71.4% respectively. The Broselow tape (PW10 47.1%) achieved a moderate accuracy and age-based estimates a very low accuracy (PW10 11.8­47.5%). Conclusions:The PAWPER tape, the Wozniak method and the Mercy method achieved an acceptable level of accuracy in studies from low- and middle-income countries and should preferentially be used and further advanced for clinical emergency medicine practice. Parental estimates may be considered if the regular caregiver of the child is present and a recent measured weight is known. The Broselow tape and age-based formulas should be abandoned in low- and middle-income country populations as they are potentially dangerously inaccurate

Body weight, eating practices and nutritional knowledge amongst university nursing students, Eastern Cape, South Africa

Background: Health care workers need to be equipped to deal with the increasing obesity and obesity-related morbidity occurring in developing countries. Objectives: To assess weight status; eating practices and nutritional knowledge amongst nursing students at the University of Fort Hare; Eastern Cape. Method: A cross-sectional descriptive survey was conducted on 161 undergraduate (51 male and 110 female) students of the Department of Nursing Sciences at the University of Fort Hare. Body mass index; waist and hip circumferences and waist hip ratio were determined. Nutritional knowledge and eating practices were investigated by structured intervieweradministered questionnaires. Results: Statically; 49.7were overweight or obese (58.2of the females; 31.4of the males) and 65.2had waist circumferences putting them at risk for non-communicable diseases. Most did not meet the recommendations for intakes from the vegetable group (97.5ate 3 servings per day); the fruit group (42.2ate 2 servings per day); and the dairy group (92.6ate 2 servings per day); whilst 78.3ate ?4 serving per day of sugar or sweets. Most consumed margarine; oil or fat (68.3); sugar (59.0) and bread (55.9) daily; but few reported daily intakes of vegetables (12.4); fruit (23.6); fruit juice (21.2) and milk (15.6). Fewer than 50knew the recommended intakes for vegetables; fruit; dairy; starchy foods and meat or meat alternatives. Conclusions: These nursing students had a high prevalence of overweight and obesity; poor eating habits and inadequate knowledge on key nutrition issues; which may impact negatively on their efficacy as future health ambassadors to the public

Accuracy of Reporting Food Energy Intake: Influence of Ethnicity and Body Weight Status in South African Women

The current study sought to identify characteristics that may be associated with the misreporting of food energy intake (EI) in urban South African women. A total of 198 women (61 black; 76 of mixed ancestry; 61 white) completed a quantified food frequency questionnaire; from which daily energy and macronutrient intake were calculated. Body composition (body mass index [BMI]; percentage of body fat); body image (Feel-Ideal Difference index and Body Shape questions) and socio-economic status (SES) (household density and asset index) were also measured. Food EI in relation to estimated basal metabolic rate ratio that was less than 1.05 represented under-reporting; whereas a ratio greater than 2.28 represented over-reporting. Results suggested that 26of the participants under-reported; 64adequately reported and 10over-reported. Participants who under-reported had a higher BMI (p 0.01) and higher percentage of body fat (p 0.05) than those who adequately and over-reported. The majority of under-reporters were black (38) versus 21under-reporters of mixed ancestry and 20white under-reporters (p 0.01). Eighty-three per cent of black under-reporters were obese. On the other hand; a majority (63) of overweight women of mixed ancestry and a majority (50) of white normal-weight women under-reported their food EI. Under-reporters reported a lower intake of dietary fat (p 0.01) and a higher intake of dietary protein (p 0.01) than adequate or over-reporters. Food EI reporting was not influenced by SES or body image. In conclusion; results suggest that food EI reporting is influenced by body size; and may be ethnic-specific in South African women

Height as a Surrogate for Bodyweight for Estimating the Dosage of Praziquantel and Artesunate in theTreatment of Urinary Schistosomiasis in School-Age Children

World Health Organization recommends mass treatment of all school children in areas where the prevalence of schistosomiasis is greater than 50. Praziquantel and artesunate are reported to display broad-spectrum antischistosomal activities. Since the susceptibilities of the different stages of schistosomes to the two drugs are distinctively different; it has been established that the use of these two drugs in combination will be beneficial for the treatment of urinary schistosomiasis. Dosage is determined by weight; which can be difficult to determine in field conditions. The use of calibrated height meter with height-based dosage calibration will make the work less cumbersome in field settings. Data on age; weight; and height from 264 school children who were screened and found to be infected with Schistosoma haematobium; diagnosed by the presence of the ova in their urine; were used to predict an alternative to bodyweight and thus the dosage of praziquantel and artesunate required to treat this disease. A very strong positive correlation (r = 0.8) was obtained for the height of treated children measured against weight while a moderately positive correlation coefficient (r = 0.6) was obtained for weight against age measurements; depicting that height can be used in lieu of weight for correct dose determination. A height meter calibrated with the equivalent number of tablets of praziquantel and artesunate could thus be used as a simple measurement to determine the dosage of praziquantel and artesunate needed to treat children in the field. This calibrated height will expedite treating large population of children in mass treatment campaigns in an endemic community

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

Biometrie ultrasonore et estimation du poids du foetus togolais : a propos de 512 gestantes au C.H.U. de Lome

Les conditions socio-economiques; le facteur racial et la meconnaissance frequente de la date des dernieres regles dans nos milieux ont motive a etablir les courbes biometriques echographiques chez 512 foetus togolais. 1831 mesures biometriques des 6 parametres classiques (LCC; DBP; DOF; CT; CA; LF) ont ete realisees. D'une facon generale; ces courbes sont identiques a celles produites en Europe ou en Amerique avec toutefois des valeurs relativement inferieures; ce qui permet d'etablir un age gestationnel precis. L'estimation du poids foetal a partir des DBP; CA et LF donne des valeurs inferieures aux valeurs europeennes et americaines; mais elles sont superposables avec celles des auteurs africains

Association between weight for age and mid-upper arm circumference measurement: findings from Malawi

Anthropometric methods involving measurement of weight-for-height; height-for-age; weight-for-age; and mid-upper arm circumference have been extensively researched to identify an appropriate method of monitoring infant and child growth. Many countries have adopted weight for age as the main practical method. The Malawi Ministry of Health introduced weight for age based upon WHO recommended standards as a growth indicator in 1973. There are; however; difficulties in making the practice widely used at community level. In the present study; confined to the four urban areas of Malawi; a comparison was made between the weight-for-age (W/A) and mid-upper arm circumference (MUAC) measurements. A very good correlation was observed between the two methods of screening for identification of undernourished children from 4 months of age onwards. Correct use of MUAC was found to be as effective as W/A in detecting undernutrition. Author.90.Z1-542-363-300901107