ABSTRACT
The study was conducted to examine the association between the indicators of malnutrition and disability of children as reported by caregivers. The Ten Questions Plus questionnaire was administered to caregivers of 1,902 children aged 1-9 years, during August 2007–March 2008, in rural Nepal. Height and weight of chil- dren were also measured. The main outcome was a positive response to one or more questions. In total, 514 (27%) children had a positive response to at least one question. Moderate stunting [odds ratio (OR)=1.47, 95% confidence interval (CI) 1.02-2.12) and severe (OR=2.39, 95% CI 1.60-3.57) stunting were independently associated with reported delay in sitting, standing, or walking. Severe stunting was also associated with report of delayed learning compared to other children of similar age (OR=2.01, 95% CI 1.27-3.20). Parental report of disability was quite prevalent in this setting, with over a quarter of the sample screening positive. Chronic malnutrition may be associated with delayed motor and mental development.
ABSTRACT
A population-based prevalence survey of ocular disease was conducted in the Lower Shire Valley of Malawi in 1983. A total of 5;436 children less than 6 years of age and 1;664 persons greater than or equal to 6 years were examined. The prevalence of inflammatory trachoma peaked in the 1-2-year-old age group at 48.7 percent and declined rapidly with age to less than 5 percent by age 15. The prevalence of cicatricial trachoma was low in young children and climbed gradually with age to greater than 40 percent among those greater than or equal to 50 years. Risk factors for infLammatory disease in young children included low socioeconomic status of the family; long walking distance to the household's primary source of water; absence of a latrine in the family compound; and presence of trachoma among siblings. Indices of crowding practices were not associated with inflammatory disease. An apparent inverse association of facewashing and inflammatory trachoma in children did not hold up when adjusted for other risk factors
Subject(s)
Socioeconomic FactorsABSTRACT
A variety of grading schemes have been proposed for the clinical classification of inflammatory trachoma. During a population based study of ocular disease conducted in southern Malawi we tested a simplified version of the current WHO grading scheme. Intraobserver agreement statistics were less than satisfactory for three of four graders. Interobserver agreement when compared against either a well experienced standard ophthalmologist or a consensus grade improved over time for two of the three graders. However; initial agreement for all three graders was only fair to moderate. Previous studies of trachoma grading schemes support these unsatisfactory results. A new system of classification is needed that is both accurate and reliable in a field setting
Subject(s)
TrachomaABSTRACT
A case-control study of breast-feeding and weaning patterns associated with xerophthalmia was conducted among children aged 24-71 mo in Southern Malawi in 1983. One hundred fifty-two children with active xerophthalmia were compared to 151 clinically normal children matched on age (+/- 12 mo); sex; and village of residence. All children were initially breast-fed; however; children with xerophthalmia began weaning onto porridge (p = 0.05) and ceased breast-feeding earlier (p less than 0.01 for 24-47 mo olds); had a shorter weaning interval (p less than 0.005); and were fully weaned from the breast for a longer duration (p less than 0.025) than the controls. The association between earlier cessation of breast-feeding and subsequent xerophthalmia was strongest during the immediate post- weaning years. These findings imply a protective role for breast- feeding against xerophthalmia in early childhood