Relationship between carotenoids and anaemia during acute uncomplicated Plasmodium falciparum malaria in children.

A clinic-based cohort study in Kampala, Uganda, was conducted to examine the relationship between severe malarial anaemia and plasma micronutrients. Plasma carotenoids, retinol, vitamin E, and four trace metal concentrations were measured at enrollment and seven days later in 273 children, aged 1-10 year(s), with acute, uncomplicated Plasmodium falciparum malaria. Concentrations of plasma provitamin A carotenoids (p < 0.0001), non-provitamin A carotenoids (p < 0.0001), retinol (p < 0.0001), all four trace elements (all p < 0.001), and vitamin E (p < 0.0001) rose significantly by day 7 among children without severe anaemia (haemoglobin 70 g/L). There was no change in provitamin A carotenoids (p = 0.24) among children with severe anaemia (haemoglobin <70 g/L), whereas non-provitaminAcarotenoids (p < 0.0001), retinol (p < 0.0001), and vitamin E (p = 0.011) increased. These observations also support the hypothesis that the use of provitamin A carotenoids increases during malaria infection.

Promoting breastfeeding within the CDD Programme in Uganda

Because Ugandans have a traditionally breastfeeding culture; this infant feeding mode had not been the subject of active intervention programmes or activities for a long time. Over the decades; however; untoward breastfeeding practices and experiences have been increasingly observed. Once a core of health workers received adequate training in contemporary breastfeeding management skills; the move to promote effective breastfeeding gained momentum; commencing in 1989. The Uganda CDD/ARI programme; having appreciated that breastfeeding is a key strategy in diarrhoeal disease control; has since 1991 intensified breastfeeding management education through a modular curriculum training programme. While stressing the need to promote exclusive breastfeeding for the first six months of extrauterine life; the Uganda CDD Case management Training Curriculum also emphasises the need for health workers to acquire and utilise satisfactory communication and supervsory skills. It is suggested that clinical support supervision should be an intergral part of any clinical mangement training programme