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
Objective To study the BCG vaccination scars of under 5 year old children who were admitted to a tertiary care hospital Design Cross sectional descriptive study Setting Ward 3, Lady Ridgeway Hospital for Children (LRH) Method All children between 6 and 60 months of age, admitted to ward 3 LRH from October 15th to December 30th 2006, were included in the study. The interviewer-administered questionnaire and examination of the child for BCG scar were the methods used to collect the data. Results: Of 1010 patients admitted to ward 3 LRH during the study period, 923 were analysed. BCG vaccine had been given to all patients. Whilst 821 (89%) patients had the BCG scar, 102 (11%) did not have it. Among patients with the BCG scar, 20% had received BCG vaccine in non tertiary care hospitals, whereas in patients with absent BCG scar, this figure was 35% (p=0.003; p < 0.05). In the Child Health Development Record (CHDR), the BCG scar column had been marked in only 554 (64%). Among 102 patients with absent BCG scar, revaccination was not indicated in 20 (21%) because the BCG scar had been marked as positive in the CHDR. However, 96 had not been revaccinated. Common reasons for non revaccination were: unawareness of mothers regarding absent BCG scar (38.5%) and postponement of revaccination (24%). Conclusion There was a significant number of patients with absent BCG scars indicating need for larger scale studies.