Maternal-child health in Pelotas, Rio Grande do Sul State, Brazil: major conclusions from comparisons of the 1982, 1993, and 2004 birth cohorts / Saúde materno-infantil em Pelotas, Rio Grande do Sul, Brasil: principais conclusões das comparações de coortes de nascimento de 1982, 1993 e 2004

Important changes were observed in maternal characteristics, health care indicators, and child health during the 22 years covered by the three population-based birth cohort studies conducted in the city of Pelotas, Southern Brazil. Maternal education levels improved, cigarette smoking during pregnancy was reduced, and birth intervals became longer. Also, there were more single mothers, and maternal obesity increased. Coverage of antenatal and delivery care by professionals improved, but inductions and caesarean sections increased markedly, the latter accounting for 45 percent of deliveries in 2004. With regard to child health, the reductions in neonatal and infant mortality rates were modest, and the significant increase in preterm births - 14.7 percent of all births in 2004 - appears to have colluded with this stagnation. Other infant health indicators, such as immunization coverage and breastfeeding duration, showed improvements over the period. Regarding infant nutrition, malnourishment at age 12 months decreased, but the prevalence of overweight was higher in 2004. The existence of three population-based birth cohorts using comparable methodology allowed for the study of important secular trends in maternal and child health.

Foram observadas mudanças importantes nas características maternas, de assistência à saúde e de saúde infantil ao longo dos 22 anos cobertos pelas três coortes de base populacional na cidade de Pelotas, Rio Grande do Sul. Melhorou o nível de escolaridade materna, houve uma redução no tabagismo durante a gravidez e aumentou o espaçamento entre filhos. Além disso, havia mais mães solteiras e aumentou a obesidade materna. Melhoraram a cobertura pré-natal e assistência ao parto por profissionais, mas houve um aumento marcante nos partos induzidos e nas cesarianas, que representaram 45 por cento do total de partos em 2004. Com relação à saúde infantil, houve uma redução apenas modesta nas taxas de mortalidade neonatal e infantil, e o aumento significativo nos partos prematuros (14,7 por cento de todos os nascimentos em 2004) parece haver contribuído para essa estagnação. Outros indicadores de saúde infantil, como cobertura de imunização e duração do aleitamento materno, melhoraram durante o período. Em relação à nutrição infantil, a desnutrição aos 12 meses de idade diminuiu, mas a prevalência de sobrepeso foi maior em 2004. A existência de três coortes de nascimento de base populacional utilizando metodologias comparáveis permitiu o estudo de importantes tendências seculares na saúde materno-infantil.

Declining prevalence of rheumatic heart disease in rural schoolchildren in India: 2001-2002.

BACKGROUND: Rheumatic heart disease is still a major health problem in developing countries such as India and, for the health planners to allocate funds, the actual prevalence of the disease should be known. This study aimed to assess the prevalence of rheumatic heart disease in rural school children in India. METHODS AND RESULTS: A total of 229,829 children between 6 and 18 years of age were screened as part of a school health program. All children with a valvar heart disease detected by the screening doctor were referred to a tertiary care center for evaluation by a cardiologist. The presence of cardiac lesions was confirmed by color Doppler examination. All children with known congenital heart disease were excluded from this study. A total of 374 children were found to have heart disease. Of these, 157 children were found to have rheumatic heart disease, confirmed by echocardiogram. Thus, the current prevalence of rheumatic heart disease is 0.68 per 1000 children. CONCLUSIONS: In the largest school survey conducted to date in India, we report the prevalence of rheumatic heart disease to be 0.68 per 1000 children. Our study suggests that there may have been a dramatic decline in the prevalence of rheumatic heart disease in India.

Nutritional status of Libyan children in 2000 compared with 1979

This cross-sectional study examined the growth and nutritional status of Libyan preschool children and the socioeconomic status of their parents in 2000 and compared the results with those of a similar study conducted in 1979. The investigation involved 1614 healthy children of both sexes under 5 years of age in two regions of the Libyan Arab Jamahiriya. Simple random sampling and cluster sampling techniques were used to enlist participants. Body weight, height, and head and arm circumference of the children were recorded and mothers were interviewed about their child's health and the socioeconomic status of the family. Significant improvements in nutritional status since 1979 were found that could be attributable to factors such as socioeconomic development, longer breastfeeding, greater availability of high energy foods, supplementation with semi-solid or solid foods and heavy government subsidy of basic foods

Overweight and obesity among Saudi Arabian children and adolescents between 1994 and 2000

Overweight and obesity trends were investigated for schoolchildren and adolescents in Jeddah using data from 1994 and 2000. Individuals aged 10-20 years were selected using multistage stratified random sampling and direct measurements were made of body weight and height. Percentiles were calculated for body mass index [BMI], body weight and height for specific age and sex strata. For both sexes, BMI increased between 1994 and 2000 at the 50th percentile but higher still at the 85th and 95th percentiles. The increase in body weight and BMI were marked for all age groups; however boys showed the largest increase aged 10-16 years, whereas girls showed the lowest at 14-16 years. Public health intervention is crucial to prevent or reduce overweight and obesity among youth

Time trends and seasonal variations in hospital admissions for childhood asthma in Taiwan from 1990 to 1998.

The aim of the study was to determine the trends and seasonal variations in hospital admissions for childhood asthma in a tertiary medical center since 1990. Data were collected according to the age and sex of patients and obtained from hospital registries between 1990 and 1998. Children between 2 and 14 years of age admitted with the diagnosis of asthma, or asthmatic bronchitis (ICD-9 code 493) were included. Age-specific and sex-specific hospital admission rates for asthma were calculated for each calendar year. The asthma admission rates were defined as the number of asthma admissions divided by the total number of all pediatric admissions in a year. Seasonal admission rates were calculated in a similar fashion. In addition, the number of readmissions was also calculated during the study period with comparisons of sex and age differences. The asthma admission rates showed a significant upward trend throughout the period studied, particularly among the 2-4 years of age group (relative risk = 2.08; p = 0.0001). Seasonal admission rates revealed a statistically significant increase during the October-December period, peaking in November or December of each calendar year (relative risk = 1.84; p = 0.0001). There was a male predominance in both age categories during the 9-year period. Comparisons of readmissions for asthma (at least three admissions) disclosed that girls were far more likely to be readmitted than boys among the 5-14 years of age group (p = 0.01). Our results indicate 1) an increased prevalence and severity of childhood asthma in Taiwan; 2) boys and younger children aged 2-4 years with asthma had increased risks of admission for asthma (relative risks were 1.22 and 1.96, respectively) and 3) girls among the older children with asthma tend to present with greater severity than boys owing to higher relative risks of readmission for asthma.