Prevalence of respiratory illnesses of school children in the industrial, urban and rural areas of Singapore.

An epidemiological survey of 3216 primary school children living in the industrial, urban and rural areas of Singapore revealed a high prevalence of various respiratory symptoms and illnesses, with 13.1% cough, 8.2% wheezy chest, 25.9% blocked/running nose, 4.3% sinusitis, 7.8% asthmatic attacks and 4.1% bronchitis/pneumonia. Differences in the prevalence of respiratory illnesses and lung function tests were observed among children in the three areas, but this could not be accounted for by the varying air pollution levels which have been maintained below the long-term standards set up by WHO. It was probably responsible for the differences noted.

Emotional and social effects of congenital heart disease in Singapore.

A cohort of patients with congenital heart disease (n = 29) who had undergone corrective cardiac surgery was studied and compared with normal controls. The mean age of cardiac patients was 10.3 years with a range of 6 years to 16 years. Their emotional maladjustment as measured on a behavioural checklist was significantly higher (P less than 0.01) than controls, and their social adjustment was also similarly less satisfactory (P less than 0.05). Regression analysis indicated that emotional maladjustment in the child was related to maternal maladjustment (P less than 0.01), maternal guilt (P less than 0.01) and maternal anxiety (P less than 0.05). Social maladjustment in the child was significantly related to maternal guilt (P less than 0.05) and pampering (P less than 0.02). It was considered that the child with heart disease was perceived and 'labelled' by the mother as abnormal even after surgery and was therefore the object and focus of maternal guilt and anxiety. Hence, the child's emotional and social maladjustment is probably the result of maternal factors rather than the physical handicaps of the illness.

Dermatoglyphs in children with mitral valve prolapse.

The dermatoglyphs of 50 Singapore school children with mitral valve prolapse (MVP) were studied, with special reference to the frequency of digital arches. The MVP was diagnosed clinically and substantiated by two dimensional echocardiography. In the study there were 35 Chinese and 15 Malay children, with ages ranging from 6 to 19 years. Four Chinese children had one or more arches on the digits but none of the Malay children was found to have arches. It was shown that the frequency of arches on the digits was not significantly higher than that among 50 controls (who were shown not to have MVP on two dimensional echocardiography) or when compared with the frequency of arches among the Chinese and Malay population in Singapore (2.0% and 2.9% respectively). No other dermatoglyphic abnormalities (including atd angle) were found.

Idiopathic scoliosis. Prevalence and ethnic distribution in Singapore schoolchildren.

Routine examination for spinal deformity as part of a school health screening programme was introduced in Singapore in 1981. The three different ethnic groups included in the study provided figures for the prevalence of idiopathic scoliosis in an Asian population. A three-tier system of examination was used and a total of 110744 children in three age groups were studied. In those aged 6 to 7 years the prevalence was 0.12%. The prevalence in those aged 11 to 12 years was 1.7% for girls and 0.4% for boys, a ratio of 3.2 to 1. In girls aged 16 to 17 years the prevalence was 3.1%. In the latter two age groups there was a significantly higher prevalence in Chinese girls as compared with Malay and Indian girls. The optimal age for school screening seemed to be 11 to 12 years, but repeated examinations may be worthwhile.

The prevalence of obesity in singapore primary school children.

The purpose of this study is to survey the prevalence of obesity in Singapore primary school children from 1976 to 1980. The number of children screened comprised of 221,988 in primary I and 218,104 in primary VI. The male to female ratio was 1.04:1. Obesity is defined as body weight above 120% of Harvard standard weight for height. The overall prevalence rate was 3.51% with a significantly higher rate in boys (3.95%) than in girls (3.06%), p less than 0.0001. This sex difference prevailed in both the primary I and primary VI group. Furthermore, primary VI students had a higher prevalence rate (4.29%) compared to the primary I students (2.75%) p less than 0.0001. The prevalence rates were rising over the years with a rate of 5.33% in 1980 compared to that in 1976 (1.80%). Our observations suggest that the problem of obesity is an increasing one. The tendency to become obese increases with age and boys are more prone to obesity.

Familial Wolff-Parkinson-White syndrome.

Familial occurrence of Wolff-Parkinson-White (WPW) syndrome is uncommon and to date only seven instances have been documented in the literature. We describe another unusual family in which the proband, his father and two of his five brothers (including one who died suddenly) showed WPW conduction. A younger sister showed evidence of Lown-Ganong-Levin (LGL) pre-excitation. This pedigree is consistent with autosomal dominant inheritance and supports the importance of testing asymptomatic family members of patients with WPW because it is a potentially life-threatening conduction disorder.

A three-year streptococcal survey among Singapore school children: Part II. Streptococcal infections.

The cumulative streptococcal pyoderma and pharyngitis rates of 491 children followed over a period of three years were 19.8 and 15.7% respectively. Streptococcal infections occurred more commonly in Malays, in children from families with monthly household incomes of less than $500/- and in those living in attap/zinc-roofed houses. During the three years, streptococcal pyoderma and pharyngitis rates varied from 1.6-5.3 and 0.4-4.3% respectively. Skin sores occurred most frequently on lower limbs. About one in six acquisitions of streptococci in throats was accompanied by clinical manifestations of respiratory infections. 90.9% of pyoderma cases responded to penicillin therapy. Penicillin was effective in eradicating group A streptococci from the throats of 84.6% of 136 children with previous positive cultures. The treatment schedule implemented for School C did not seem to reduce the streptococcal infection and carrier rates in that school to a great extent.

A three-year streptococcal survey among Singapore school children. Part I--Carriership of streptococci.

A prospective three years' survey, conducted on a total of 491 children attending four schools in Singapore showed that the throat carrier rates for beta-haemolytic and group A streptococci varied from 15-31 percent and 6.6-15.7 per cent respectively. Malays had the highest streptococcal throat carrier rates followed by Indians/Pakistanis and the Chinese. There was no significant difference in streptococcal throat carrier rates between the sexes. Children from lowest family income of less than $500/- and those living in attap/zinc houses had the highest streptococcal carriage rates. On the other hand, children from households where two or less than two persons shared a room had the lowest beta-haemolytic and group A streptococcal throat carrier rates. No marked variation in the incidences of streptococcal carriage rates was detected during the rainy and dry seasons. Twelve (2.4 percent) of the children haboured beta-haemolytic streptococci on their healthy skin. Ten (2 percent) of these children were colonized by group A streptococci. T5/11/12/27/44 was found to be the most predominant pattern during the period of study. Other common T patterns were T3/13/B3264, T8/25/Imp19 and T4/24/26/28/29/46. 19(17.3 percent) of the throat group A strains were M-typable and 11 M types were differentiated.