Prevalence and correlates of acute respiratory infections in children less than two years of age.

OBJECTIVES: To study acute respiratory infections of children less than 2 years of age in Riyadh City and their sociodemographic and anthropometric correlates. METHODS: Study subjects included 250 mothers selected by systematic random sampling from mothers attending 5 Primary Health Care Centers selected by simple random sampling from the 5 geographical zones (one from each zone) in Riyadh during a one month period. Data was collected via a structured pilot tested modified questionnaire filled in by trained research assistants who interviewed mothers regarding acute respiratory infections during the past 2 weeks in their children aged less than 2 years. Heights and weights of both children and mothers were measured and the necessary sociodemographic characteristics of the mothers, and children were collected by the research assistants in addition to mothers' practices concerning their child's acute respiratory infections. RESULTS: The prevalence of acute respiratory infection in children was 24%, mostly in children whose mothers are less educated, aged 35 years or more, married at age 25 years or more and whose relatives take care of their children while working outside the home. The children affected were mostly 7 - 12 months of age, lighter in weight, not vaccinated, with no follow up cards and not weighed during the last 4 months. About 3 quarters of the mothers consulted somebody about acute respiratory infections, mostly at modern health facilities particularly government Primary Health Care Centers. Tachypnea, or diarrhea or both were the most important symptoms urging mothers to seek medical advice. Working mothers whose children are taken care of by relatives is the only significant predictor of acute respiratory infections, and children with a follow up card is the only significant predictor for consulting somebody about acute respiratory infections. CONCLUSION: Intervention strategies to control acute respiratory infections in children less than 2 years of age should target working mothers, less educated mothers, malnourished unvaccinated children and encourage periodic follow up visits for children.

Knowledge of nutrition and coronary heart disease in Riyadh, Saudi Arabia.

The purpose of this study was to determine the level of knowledge among adults in Riyadh City, Saudi Arabia, concerning dietary fat and the risk of coronary heart disease. We assessed the overall knowledge levels among 393 adults who were waiting to see their physicians at Primary Health Care Centers (PHCCs). Since the overall knowledge levels were high, we conclude that health education should concentrate on clarifying areas of misunderstanding shown by this study. Further, the importance of addressing perceived barriers is discussed.

Malnutrition among hospitalized patients in King Khalid University Hospital, Riyadh.

The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM) of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9%) of medical cases were found to be obese compared to surgical cases (19.7%). If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.

Food habits during pregnancy among Saudi women.

The food habits during pregnancy were studied in Saudi women. The general plan of the study was to interview pregnant women about food cravings and avoidances during pregnancy. A systematic random sample of 321 pregnant women was chosen from three different primary health care centers in Riyadh, Kingdom of Saudi Arabia. An interview questionnaire was used to collect data related to dietary habits during pregnancy and puerperium. The percentages of women with dietary cravings, pica and aversions were 38%, 8.8% and 66.4%, respectively. Saudi women craved for milk, salty and sour foods, sweets and dates. The avoidances included spicy foods and beverages. The study showed no relations between the literacy level and the food habits during pregnancy.

PIP: During November-December 1991 in Saudi Arabia, interviews were conducted with 321 pregnant women (mean age, 27.2 years) attending three primary health care centers in Riyadh to determine their dietary practices and aversions during pregnancy. 38% craved and ate special foods (salty, sour foods, sweets, dates, milk, eggs, and meats). 33% of women during lactation ate special foods. During pregnancy 8.8% had pica cravings (the compulsion to consume non-food items) such as clay, ice, plaster, and paper. 66.4% of the women avoided milk, dates, beverages, and fungreek foods. 34.9% avoided tea, coffee, and cola beverages. 20.9% avoided meat. 33.6% listed no particular avoidances. Reasons given for avoiding foods were: unpleasant smell (9.4%), vomiting (28%), diarrhea (2.5%), undesirable effect on fetus (7.8%), heartburn (18.7%), and no particular reason (33.6%). Mother's age, mother's education, or husband's education were not associated with any of the food habits during pregnancy. Given the importance of nutritional value and composition of foods consumed during pregnancy and lactation, health workers should use these findings to provide appropriate nutrition counseling and education.

A pilot epidemiologic study of diabetes mellitus in the Sudan.

Records of 523 consecutive diabetic patients attending a diabetic clinic in Wad Madeni, Central Region, Sudan, were reviewed to determine epidemiologic features and the relation between their diabetes and nutritional state. The male to female ratio was 0.97:1. The age at diagnosis ranged between 0-61 years with a mean age of 51.7 +/- 11.9 years for males and 49.4 +/- 11.4 for females. Obesity was a feature, in that 47.4% of females and 30% of males were determined to be in excess of normal body mass index (BMI) standards. A family history of diabetes was present in 67% of cases. Hypertension was present in 38% of cases; it was slightly more common among females than males (52% vs 48%), respectively. Insulin was employed for control of diabetes in 75% of cases, and oral hypoglycaemics in 20%. The remainder were on diet therapy alone. Thirty-four percent of the patients are rural dwellers that should be saved from disabling and even fatal complications of the disease in combination with malnutrition and infectious diseases that hasten death in rural areas. It is hoped that the interest of those concerned regarding public health implications of the findings in this study will be stimulated.

Selenium in malnourished Sudanese children: status and interaction with clinical features.

Plasma selenium (Se), haemoglobin (Hb) and packed cell volume (PCV) were measured in 53 malnourished Sudanese children, age 6-36 months, and 11 children who had tuberculosis. Twelve healthy well-nourished children served as controls. The mean (+/- SD) plasma Se (mg/kg) was 0.05 (0.036), 0.070 (0.040), 0.063 (0.015), 0.73 (0.012), 0.082 (0.014) in children with kwashiorkor/marasmic kwashiorkor (oedematous group), marasmus, tuberculosis and healthy controls. The mean Se level in the various groups showed a significant difference (p < 0.002). Whereas the oedematous group differed significantly from the rest, there was no difference between the means of the marasmic, underweight, tuberculosis patients and controls. The mean plasma albumin (+/- SD) in oedematous group was 19.6 (6.6) g/l and ranged between 22.6 (5.0) and 33.1 (3.0) in the other groups. A significant positive correlation was found between plasma Se level, albumin, Hb and PCV (respectively, r = 0.46, p < 0.0001; r = 0.37, p < 0.001; r = 0.36, p < 0.002).

The problems and challenges in growth monitoring.

Growth monitoring is the apparently simple act of regularly assessing physical growth to watch over changes in health and nutrition in a child and take appropriate actions to improve them. Several challenging issues need more in depth study to clarify the confusion that surrounds growth monitoring (GM) at present. This review seeks to clarify certain issues including production of scales and equipment-attendance at weighing clinics, interpretation of growth chart and inability to intervene. Moreover, the review specifically discusses the problems of growth monitoring in developing countries with reference to Africa.

PIP: Growth monitoring is one of the few technologies which has been uniformly accepted by proponents of selective primary health care (PHC) as well as by those who favor the Alma Ata comprehensive model of PHC. Growth monitoring consists of regularly assessing physical growth to watch over changes in a child's health and nutrition, and to take appropriate actions when needed to improve them. Growth monitoring programs have, however, many difficulties related to program scales and charts, recording and interpreting growth data, taking effective action, and problems encountered by mothers such as the need for regular attendance. This review tries to clarify these issues and discusses the problems of growth monitoring in developing countries with reference to Africa. The author believes that these problems should not drive us to reject growth monitoring, but instead encourage the development of better training and more functional, service-oriented research.

Plasma lipids and prolactin in patients with breast cancer.

In a comparative study of pre- and postmenopausal women with benign and malignant breast disease, a number of differences were observed in circulating plasma prolactin and lipid concentrations. Plasma lipids, phospholipids, triglycerides, cholesterol and free fatty acids were all higher in blood obtained from breast cancer patients prior to surgery. HDL-Cholesterol levels were significantly lower in these patients. These differences remained when the patient groups were sub-divided according to menopausal status. Plasma prolactin concentrations were also found to be higher in cancer compared with non-cancer patients, this effect being more marked in premenopausal than in postmenopausal patients. Premenopausal patients with invasive or poorly differentiated disease had significantly higher prolactin levels than those with non-invasive disease. No correlations were found between plasma prolactin and any of the lipid fractions.