Childhood and adolescent obesity: primary health care physicians' perspectives from Riyadh, Saudi Arabia

Background and Objectives: Primary health care [PHC] physicians are foremost to confront childhood and adolescent obesity.Our objective was to evaluate PHC Physicians perspectives for managing overweight/obesity in children and adolescents

Methods: PHC services from eight public hospitals in Riyadh participated. A self-administered tool maintaining anonymity evaluated facilitators and barriers for managing overweight/obese children and adolescent patients. Physicians who 'always' recommended weight management for an overweight / obese patient during past year, by involving patient, parents, and others were classified as having positive and appropriate practice

Results: Of the 58 respondents, 51.7% had appropriate practices. Lack of patient motivation [82.2%], and parental involvement [70.7%] were the major barriers. Physicians with appropriate practices differed in perspectives from those with less appropriate practices by attending continued education forums [p<0.026], referring patients to sub-specialty [p< 0.041], clinical knowledge [p<0.039], convinced on interventions [p<0.017], low concern for precipitating eating disorders [p<0.019], comfortable in examining obese patients [p<0.020], and considered patient's readiness for weight change [p<0.007]

Conclusion: Efforts are needed to equip PHC physicians in managing overweight and obesity in Saudi children and adolescents

Does malaria during pregnancy affect the newborn?

To investigate the effect of malarial infection during pregnancy on the newborn. A retrospective cohort study was conducted at The Aga Khan University Hospital [AKUH], Karachi, using in-patient hospital records over an 11-year period from 1988 to 1999. The incidence of preterm delivery, low birth weight [LBW] and intrauterine growth retardation [IUGR] in 29 pregnant women with malaria, was compared with that in 66 selected pregnant women without malaria, who delivered at the AKUH during the same time period. Pregnant women with malaria had a 3.1 times greater risk of preterm labor [p=0.14]. They were more likely to be anaemic compared to women without malaria [RR=2.9, 95% CI=1.6-5.4] and had a significantly lower mean haemoglobin level [p=0.0001]. Maternal malaria was significantly associated with LBW babies [p=0.001]. The mean birth weight of infants born to pregnant women with malaria was 461 g less [p=0.0005]. No significant association was, however, found between malarial infection during pregnancy and IUGR [p=0.33]. Malarial infection during pregnancy is associated with poor maternal and fetal outcome. It is significantly associated with maternal anaemia and LBW infants. Appropriate measures must, therefore, be taken to prevent malaria during pregnancy, especially in endemic areas