The effect of teacher education on the prevalence of obesity in kindergarten children.

BACKGROUND: Childhood obesity is increasing worldwide and becoming an important health problem in both the children's current life and their later years. Providing kindergarten teachers with the knowledge should reduce the severity of obesity and prevent childhood obesity. OBJECTIVE: To monitor the prevalence of over-nutrition and obesity in kindergarten children for 3 years, and to evaluate the effects of teacher education on the prevalence of over-nutrition and obesity. MATERIAL AND METHOD: Kindergarten children from 7 schools in Bangkok were enrolled in this cohort study for 3 years (2005-2007). Three school groups were classified according to the number of informed teachers in the school. The children's weight and height were measured yearly using standard instruments. Nutritional status was assessed by% weight for height (%W/H), using the Thai Growth Reference, 1999. After the second measurement, all teachers were informed directly at the schools. The prevalence of over-nutrition and obesity was assessed and compared among the 3 years, and the 3 groups, using Chi-square (chi 2) test. RESULTS: In the year 2005, 1,232 kindergarten children from 7 schools were enrolled. The prevalence of over-nutrition and obesity was 33% and 17.4% in 2005; 32.8% and 17.2% in 2006; 28.8% and 15.3% in 2007. In the 3rd year the prevalence of over-nutrition decreased statistically significantly from the first 2 years. The prevalence of over-nutrition and obesity in 3 years decreased insignificantly in each group. This showed the positive effects of the teacher education. CONCLUSION: Teacher education has effects in reducing the prevalence of over-nutrition and obesity in the kindergarten children.

Trend study of autistic spectrum disorders at Queen Sirikit National Institute of Child Health.

BACKGROUND: Increases in the incidence and prevalence of autistic spectrum disorders have been reported recently in the United States and Europe, but there are only a few reports on the trend of this problem in Thailand. OBJECTIVES: To study trend in autistic spectrum disorder patients and to find the factors that correlate with the incidence of this disorder at Queen Sirikit National Institute of Child Health. MATERIAL AND METHOD: A hospital-based prospective trend study was conducted in patients aged less than 12 years old, who attended the Child and Adolescent Department, Queen Sirikit National Institute of Child Health, Bangkok, form January 1998 to December 2002. Autistic spectrum disorders were defined as autistic disorder pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger's disorder Related factors were recorded and analyzed Aged-adjusted incidence rate in both sexes and proportion rates of related factors were calculated by using the direct method Standard t-test and correlation coefficient were performed to test for statistically significant difference in the prevalence rate in each group. RESULTS: There were 610 new patients aged less than 12 years who displayed behavior consistent with autistic spectrum disorders. The increasing trend in the incidence of autistic spectrum disorder is observed (r = 0. 935, p = 0. 02). The incidence rate of autistic spectrum disorders among out patients less than 12 years has increased from 1.43 per 10, 000 in 1998 to 6.94 per 10, 000 in 2002. The correlation factors "an only one child in the family" is observed (r = 0.9, p = 0.038). CONCLUSION: During the 5 years of the study, a significant increase in the incidence of autistic spectrum disorders was observed at Queen Sirikit National Institute of Child Health. Increase in the incidence of ASD in this center cannot explain by any solid evidence from the present study.

Linear growth of prepubertal asthmatic Thai children receiving long-term inhaled corticosteroids.

BACKGROUND: Long-term inhaled corticosteroids are recommended in persistent asthma in children. The aim of this study was to determine the growth rate of asthmatic Thai children who received long-term inhaled corticosteroids. METHOD: This controlled clinical trial was carried out on 145 prepubertal asthmatic Thai children, 81 in the study group (the group who received long-term inhaled corticosteroids) and 64 in the control group. RESULTS: The mean age of the patients when the study began was 5.9 years in the study group and 4.7 years in the control group. The average dose of inhaled corticosteroids used was 300 microg/day. The average duration overtime of inhaled corticosteroid usage was 2 years (9 months-5 years). The study showed that inhaled corticosteroids (300 microg/day for 9-60 months) have no significant effects on growth rate. From linear regression analysis, the factors that influenced the growth rate of asthmatic patients were the severity of the asthma and the age of the patients when nasal corticosteroids were started. Insulin-like Growth Factor 1 (IGF 1) and Insulin-like Growth Factor Binding Protein 3 (IGFBP 3), were measured in 7 patients in the study group and 5 in the control group. All were normal, the height standard deviation score (Ht.SDS) was below average. CONCLUSIONS: The average dose of inhaled corticosteroids (300 microg/day for 9 months) has no significant effects on the growth rate of prepubertal asthmatic Thai children.