Vitamin A deficiency in Latin America and the Caribbean: an overview.

Vitamin A deficiency (VAD) has been known to exist in Latin America and the Caribbean since the mid-1960s; however, except for pioneering work by the Institute of Nutrition of Central America and Panama/Pan American Health Organization on sugar fortification in Central America, there was little interest in controlling it because of the low frequency of clinical findings. More recently, implications of the effect of subclinical VAD on child health and survival has generated increased interest in assessing the problem and a greater commitment to controlling it. The information available by mid-1997 on the magnitude of VAD in countries of the Region was extensively reviewed. Internationally accepted methods and cutoff points for prevalence estimations were used to compile information from relevant dietary, biochemical, and clinical studies carried out between 1985 and 1997 in samples of at least 100 individuals. VAD in the Region of Latin America and the Caribbean is mostly subclinical. The national prevalence of subclinical VAD (serum retinol < 20 micrograms/dl) in children under 5 years of age ranges between 6% in Panama and 36% in El Salvador. The problem is severe in five countries, moderate in six, and mild in four. There are no recent data from Chile, Haiti, Paraguay, Uruguay, Venezuela, and the English-speaking Caribbean. The population affected amounts to about 14.5 million children under 5 years of age (25% of that age group). Schoolchildren and adult women may also have significant VAD. Actions currently implemented to control VAD include (a) universal or targeted supplementation, with sustained high coverage rates through national immunization days in some countries; (b) sugar fortification, which is well established in El Salvador, Guatemala, and Honduras (a significant effect has been documented in Guatemala and Honduras) and is under negotiation in Bolivia, Colombia, Costa Rica (to be resumed), Ecuador, Nicaragua, and Peru; and (c) limited dietary diversification activities.

Anthropometric assessment of nutritional status in pregnant women: a reference table of weight-for-height by week of pregnancy.

A reference table of weight-for-height by week of pregnancy has been devised on theoretical grounds, based on the premises that the average increment of weight during pregnancy is 20% of the prepregnant weight and that almost all the increment takes place linearly during the 2nd and 3rd trimesters of pregnancy. The table was tested with retrospective clinic and hospital data. The results show a good correlation between the weight-for-height at different stages of pregnancy as a percentage of the reference table and the birth weight of the offsprings. This reference table can be a useful tool to assess the nutritional status of pregnant women and, within limits, to "predict" the chances of delivering a low birth weight infant.

A survey of the anemia status of preschool age children and pregnant and lactating women in Jamaica.

An island-wide anemia survey was conducted in Jamaica on pregnant and lactating women and preschool age children. The results indicate that anemia is a serious public health problem in Jamaica. Of pregnant women, 61.6% had Hb levels below 11.0 g/dl. Of lactating women 58.7% had Hb levels below 12.0 g/dl. Of preschool age children 69.1% had Hb levels below 11.0 g/dl. Public health and fortification programs for the control of anemia have been implemented by the government and are currently being reviewed.

Malnutricion infantil en el Caribe. / Infant malnutrition in the Caribbean

Entre una cuarta parte y la mitad de los ninos de menos de cinco anos de edad en la comunidad media de habla inglesa del Caribe estan malnutridos. En este articulo se examina os que se puede hacer en el futuro mediante politicas nacionales y lo que los trabajadores de la nutricion deben hacer ahora para remediar esa situacion

Lactancia al pecho materno en Trinidad / Breast-feeding practices in Trinidad

Un estudio de las prácticas de lactancias al pecho materno en Trinidad indica que a pesar de sus evidentes ventajas, se abandonan al poco tiempo. A los cuatro meses del parto aproximadamente casi todos los lactantes dentro del grupo que se estudió habían dejado de recibir leche materna. Se comprobó la existencia de una asociación significativa entre el comienzo temprano de la lactancia con biberón (antes de la primera sesión de pecho materno) y la terminación temprana de la lactancia al pecho (AU)

The Gomez classification. Time for a change?

The Gomez classification of nutritional status is well known and widely used. However, it has a considerable number of drawbacks and it is questionable whether it should continue to be used. The history of the classification, its value, and its disadvantages are examined and an alternative classification based on more recent reference values of weight-for-age is proposed.

[Evaluation of a breast-feeding campaign in Trinidad]. / Evaluación de una campaña de lactancia materna en Trinidad.

PIP: The article evaluates a campaign to promote breast-feeding organized in Trinidad in 1974 by a private association of housewives. Advantages of breast-feeding were advertised in newspapers, television, and especially through the radio. A total of 418 women were interviewed for the first time after delivery at the hospital, and 4 months after that in their homes. The campaign reached 93% of the target population. There was a relationship between exposure to the campaign and knowledge of nutritional value of maternal milk, advantages of breast-feeding, and a relationship between knowledge of media messages and avoidance of the bottle before the infants were 2 months old.^ieng