ABSTRACT
Objectives: To assess awareness and knowledge of folic acid (FA), educate about importance of using of pre-conceptional FA, find out the common source of information about FA and identify some epidemiological characteristics of neural tube defects (NTDs) Setting: Teaching Hospital, Kandy Method: A case control study was carried out for 17 months from July 2002 of all newborns with NTDs delivered at General Hospital (GH) Kandy and newborns with NTDs transferred from other hospitals. An age and sex matched group of babies born at GH Kandy with no obvious abnormalities was selected as the control. To increase statistical confidence we took 3 controls for 1 case. A pre-tested questionnaire was administered to obtain data. While interviewing, we counselled all mothers about value of pre-conceptional FA usage. Results: During the study period 14,580 live births took place at GH Kandy and twenty of them had NTDs. The number of babies with NTDs transferred from other hospitals was 30. The control group comprised 150 mothers with normal babies. Fourteen (28%) of the affected group were able to identify folic acid tablet as a vitamin taken during pregnancy, in comparison to 87 (58%) of the control group. One (2%) from the affected group and 70 (46%) from the control group knew about the value of pre-conceptional FA. None of the affected mothers had used FA pre-conceptionally whereas 20 (13%) of the control group had used it. Four (8%) of the affected mothers identified preventing birth defects as the primary reason to take FA whereas 54 (26%) of the control group mothers believed that folic acid helped in preventing birth defects. Awareness of FA usage came mainly from midwives. Conclusions: Knowledge and use of FA in relation to pregnancy were grossly inadequate especially among mothers who had affected babies.
ABSTRACT
OBJECTIVES: To identify the causative bacteria in childhood acute respiratory infections (ARI) and to determine the usefulness of pus cell counts in differentiating between pathogenic and commensal bacteria, cultured from nasopharyngeal aspirates. DESIGN: Case control prospective study. SETTING: Outpatients' department and the paediatric unit at General Hospital, Colombo South. SUBJECTS: 200 children under 5 years with cough and difficulty in breathing for less than one week who had no history of antibiotic therapy for the current illness, and 50 healthy controls matched for age and sex. RESULTS: 56.5% of cases had bacterial infections. Branhamella catarrhalis (25%), Haemophilus influenzae (12.5%) and Streptococcus pneumoniae (10.5%) were the major pathogens identified. Pus cell counts were found to be significantly higher in cases than in controls (X2 58.28 df = 1 p < 0.001), and the pathogens were more often associated with pus cell counts of more than 10/field. CONCLUSIONS: 56.5% of children with ARI had bacterial infections. B catarrhalis seems to play a major role in childhood ARI. Examination of nasopharyngeal aspirates is a useful way to identify pathogens, provided microscopic examination for pus cells is performed together with culture.