Prevalence of specific IGM due to toxoplasma, rubella, CMV and c.trachomatis infections during pregnancy.

One hundred and seventy five apparently normal asymptomatic pregnant women were studied prospectively and 247 women with different complications of pregnancy were screened at the time of delivery for infections like Chlamydia trachomatis, Toxoplasma, Rubella and cytomegalovirus (CMV). One hundred and forty two women with normal outcome of pregnancy served as controls. Specific IgM due to these agents were determined in the sera using commercial diagnostic kits. Results of the study showed that chlamydial infection was the most prevalent (29.8%) followed by Toxoplasmosis (13.1), Rubella (6.5%) and CMV (5.8%). Adverse outcome was seen among those seropositive for Chlamydia, Toxoplasmosis and Rubella. CMV showed no association with adverse outcome of pregnancy. Since Chlamydia and Toxoplasmosis are amenable to treatment with antibiotics, screening for these infections and appropriate treatment would improve outcome of pregnancy.

Nutritional status, psychosocial development and the home environment of Indian rural children.

OBJECTIVE: To assess the psychosocial development of well nourished and malnourished children aged 0-6 years and to identify the microenvironmental factors influencing their growth and development. DESIGN: Multicentric cross-sectional. SETTING: Rural Communities. SUBJECTS: Total of 3668 children of whom 2212 were well nourished and 1456 were malnourished. METHODS: Weight for age index to assess nutritional status. Cut-off < 75% NCHS standards used based on Gomez grades II and III being malnourished and Normal and grade I being well nourished. ICMR Developmental Screening Test to assess psychosocial development and modified WHO parental interview schedule to assess family and micro-environmental factors. RESULTS: Malnourished children attained developmental milestones at a later age. Developmental delay among the malnourished was especially observed in areas like vision and fine motor, language and comprehension and personal social. The delay was to the extent of 7-11 months in these areas in different age groups. Paternal involvement with child care especially, father spending time, telling stories and taking child for outing was found to be important for positive psychosocial development. Other significant factors included parents teaching child, small family size and paternal occupation. Child's appetite, absence of health problems, parental age and family having own house and electricity were the factors significantly related to better nutritional status of children. CONCLUSION: Factors identified in the study are important for the development of relevant intervention at the home level. Appropriate multifaceted community based programmes such as the ICDS are also required for stimulating growth and development of backward rural children.

Screening test battery for assessment of psychosocial development.

A multicentric cross-sectional collaborative study was undertaken in 3 centres in India with the main aim of developing simple and reliable indicators for the early detection of developmental disabilities in children under 6 years of age and to compare the age of attainment of developmental milestones in children in the three regions. The study provided a simple low-cost and culture-appropriate psychosocial developmental screening test battery which can be used with ease by trained public health grass-roots functionaries. This instrument was standardized on a large rural, tribal and urban sample comprising more than 13,000 children from 3 regions in India. The procedure for sampling, selection of items and methodology for standardization of the instrument in the Hyderabad region detailed in this paper were replicated in other centres as well. Quality control of data was ensured through inter-rater and test-retest measures of reliability. During pre-testing, 66 culture-appropriate milestones were selected finally from a larger item pool. The 50th centile age reference values of the Hyderabad study children and those obtained by other 2 centres were comparable.