Sinhala translation of child behaviour checklist: validity and reliability.

OBJECTIVE: To translate the child behaviour checklist (CBCL) into Sinhala and validate it for assessment of mental health status of children aged 5-10 years. DESIGN AND SETTING: Translation/back-translation method was used to translate the English CBCL into Sinhala. Each item in the Sinhala CBCL (CBCL-S) was rated by mental health professionals to determine semantics, content, and conceptual validity types. To ascertain criterion validity, total scores obtained for CBCL-S by administering it to parents or parent surrogates of 49 girls and 80 boys aged 5-10 years attending the specialist psychiatry clinics and 69 boys and 69 girls in the same age group from the community were compared with clinical diagnoses by a child psychiatrist. Receiver operator characteristic curves were drawn to obtain the cut-off points in CBCL-S for boys and girls separately. RESULTS: Semantics, content, and conceptual and criterion validity of CBCL-S were satisfactory. At the cut-off level of 39, CBCL-S had a sensitivity of 90% and a specificity of 88% for boys and a sensitivity of 89% and a specificity of 92% for girls. Internal consistency, test-retest reliability, and inter-interviewer reliability of CBCL-S were satisfactory. INTERPRETATION: CBCL-S is a valid and reliable instrument to measure mental health status of Sinhalese children aged 5-10 years in Sri Lanka.

Perimenopausal symptoms in Sri Lankan women.

OBJECTIVE: To determine the types of perimenopausal symptoms (PMS) associated with the natural menopause and to make a preliminary assessment of the influence of PMS on household work, employment duties and social life, since no published data are available regarding these aspects in Sri Lankan women. DESIGN: A cross-sectional descriptive study of 403 women after natural menopause chosen randomly from four selected groups. METHOD: A pre-tested coded questionnaire administered by trained women medical students to consenting menopausal women. RESULTS: An overwhelming majority of menopausal women (87.1%) had one or more PMS. The principal PMS reported were insomnia (57.8%), joint pains (55.8%), night sweats (55.6%), hot flushes (40.2%), irritability (35.3%) and headaches (33.3%). Of the 171 women employed outside the home, 38% noted some interference with employment duties. PMS causes much morbidity in Sri Lankan perimenopausal women.

Dietary cravings and aversions during pregnancy.

Although nausea and vomiting in early pregnancy has been studied in detail, there is little information available regarding dietary aversions and some cravings during pregnancy. To study the prevalence and factors associated with dietary aversions and cravings during pregnancy, a survey was carried out on 1000 randomly selected pregnant women attending antenatal clinics in a district in southern Sri Lanka. In this group 473 (47.3%) had pregnancy cravings for wide variety of foods: sour food 65%, unripe fruits 40%, meat and fish 47%, ripe fruits 30%, food from alms giving 26% and jam and bread fruit 22%. Ninety nine per cent of those who had pregnancy cravings had made special attempt to obtain the food of their choice and all of them had their cravings satisfied by eating the food of their choice. Pregnancy cravings was significantly higher in women who married after a love affair's than in those who had on 'arranged' marriage (p < 0.05), in women who were superstitious (believed in devil dancing and gods) than in those who were not (p < 0.05), and in women with a family income of less than Rs. 2,500 than in those with an income of more than Rs. 2,500 (p < 0.05).

Neonatal and post-neonatal mortality in the Galle district.

OBJECTIVE: To determine some factors associated with infant mortality. DESIGN: Descriptive study. SETTING: Galle district in Sri Lanka. SUBJECTS: 350 infant deaths of singleton births. MEASUREMENTS: Association between variables. RESULTS: Neonatal:post-neonatal death ratio was 3.2:1, and 62.3% (218) were early neonatal deaths. First day deaths comprised 28.6% (100); 67.8% (237) died at the Teaching Hospital. A high incidence (65.7%) of low birthweight (LBW) was noted. Mean birthweights of neonates and post-neonates were 1925 +/- 729 and 2520 +/- 620 gram respectively, and the difference between means was statistically significant (p < 0.001). LBW and related disorders were the major cause of death in 44% (154) of the total sample, and in 55.8% (149) of neonates. Infections were the commonest cause (55.8%) of death in post-neonates. Pediatric clinical assessment to differentiate small-for-dates (SFD) was not recorded in 90.3%. Statistically significant associations were found between the period of death (neonatal and post-neonatal) and the following variables: period of gestation (p < 0.001); birthweight (p < 0.001) and cause of death (p < 0.001). CONCLUSIONS: There was a high incidence of neonatal deaths and a high proportion of early neonatal deaths. About one-third of deaths occurred on the first day of life. Incidence of LBW was high. The major cause of death was LBW and related disorders in the total sample and in neonates. Assessment of SFD was not carried out in the vast majority of infants.

Risk factors contributing to acute diarrhoeal disease in children below five years.

Data regarding factors contributing to acute diarrhoea in children under five years in urban populations in Sri Lanka is meagre. Studies of diarrhoeal disease have been limited mainly to descriptive epidemiological investigations. A case control study on 200 families in the Galle Municipality was undertaken to identify some of the social, behavioural and environmental factors contributing to childhood diarrhoea. Twelve variables were studied by logistic regression, and the following variables were identified as conferring a significant risk of causing diarrhoeal disease in children below five years in an urban setting in Sri Lanka; (1) unavailability of pipe-borne water in the house (2) lack of water-seal latrine in the household (3) low level of mother's education and her lack of awareness regarding infectious nature and mode of spread of diarrhoea (4) not disposing of children's faeces in a latrine (5) improper disposal of garbage.

Albendazole in the treatment of goehelminth infections in children.

Children with mixed helminthic infections between the ages of 2 and 14 years, from a slum area, were treated with two regimes of albendazole. A majority of children had moderate to heavy infections with Trichuris trichiura (greater than 70%) and Ascaris lumbricoides (greater than 84%). Children treated with a single 400 mg dose of albendazole showed a very good response in ascariasis with 100% cure rate irrespective of the severity of infection. In Trichuriasis (n = 40), a cure rate of 50% was observed in mild infections, but only a reduction in the egg counts of 60% and 57% respectively were observed in moderate and heavy infections. Only 10 patients with Necator americanus infections were treated with the single dose, and the cure rate in mild infections was satisfactory (86%), with an overall egg reduction rate of 95%. In 47 children included in the multiple dose regime (200 mg daily x 3 days), the cure rates in trichuriasis were, 82%, 66%, and 37% respectively in mild, moderate, and heavy infections. The egg reduction rate was 98% in all degrees of infection in trichuriasis. The cure rate in ascariasis, with the multiple dose regime was similar to that of the single dose, with 100% egg reduction, irrespective of the severity of infection.