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
The clustering of xerophthalmia in villages and in households was assessed among preschool children surveyed in the Lower Shire Valley; Malawi; and in Aceh province; Indonesia. Trachoma clustering was similarly assessed among the same children in Malawi. Trachoma clustered much more than xerophthalmia among villages and among households. The impact of xerophthalmia clustering on sample size considerations for future surveys or interventions was similar in Malawi and Indonesia. Village clustering of xerophthalmia would necessitate a twofold increase in sample size. Household clustering in the absence of village clustering would have almost no impact on sample size. Village clustering of trachoma would necessitate a ninefold increase in sample size. Household clustering would increase sample size requirements by 26 percent
ABSTRACT
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