A comparison of the National Center for Health Statistics and new World Health Organization growth references for school-age children and adolescents with the use of data from 11 low-income countries.

BACKGROUND: In 2007 new World Health Organization (WHO) growth references for children aged 5-19 y were introduced to replace the National Center for Health Statistics (NCHS) references. OBJECTIVE: This study aimed to compare the prevalence of stunting, wasting, and thinness estimated by the NCHS and WHO growth references. DESIGN: NCHS and WHO height-for-age z scores were calculated with the use of cross-sectional data from 20,605 schoolchildren aged 5-17 y in 11 low-income countries. The differences in the percentage of stunted children were estimated for each year of age and sex. The z scores of body mass index-for-age and weight-for-height were calculated with the use of the WHO and NCHS references, respectively, to compare differences in the prevalence of thinness and wasting. RESULTS: No systematic differences in mean z scores of height-for-age were observed between the WHO and NCHS growth references. However, z scores of height-for-age varied by sex and age, particularly during early adolescence. In children for whom weight-for-height could be calculated, the estimated prevalence of thinness (WHO reference) was consistently higher than the prevalence of wasting (NCHS reference) by as much as 9% in girls and 18% in boys. CONCLUSIONS: In undernourished populations, the application of the WHO (2007) references may result in differences in the prevalence of stunting for each sex compared with results shown when the NCHS references are used as well as a higher estimated prevalence of thinness than of wasting. An awareness of these differences is important for comparative studies or the evaluation of programs. For school-age children and adolescents across all ranges of anthropometric status, the same growth references should be applied when such studies are undertaken.

When is deliberate killing of young children justified? Indigenous interpretations of infanticide in Bolivia.

In the Andes, as elsewhere, infanticide is a difficult challenge that remains largely undocumented and misunderstood. From January to March 2004 we used community-based vital event surveillance systems, discussions with health staff, ethnographic interviews, and focus group discussions among Aymara men and women from two geographically distinct sites in the Andes of Bolivia to provide insights into the practice of infanticide. We noted elevated mortality at both sites. In one location, suspected causes of infanticide were especially high for girls. We also observed that community members maintain beliefs that justify infanticide under certain circumstances. Among the Aymara, justification for infanticide was both biological (deformities and twinship) and social (illegitimate birth, family size and poverty). Communities generally did not condemn killing when reasons for doing so were biological, but the taking of life for social reasons was rarely justified. In this cultural context, strategies to address the challenge of infanticide should include education of community members about alternatives to infanticide. At a program level, planners and implementers should target ethnic groups with high levels of infanticide and train health care workers to detect and address multiple warning signs for infanticide (for example, domestic violence and child maltreatment) as well as proxies for infant neglect and abuse such as mother/infant separation and bottle use.

Investigacion de creencias comunes sobre cinco enfermedades en el altiplano boliviano: un ejemplo Carabuco / Common believes research about five deseases in the bolivian altiplano: Carabuco, an example

Una investigacion etnografica realizada con grupos focales aymaras en el Altiplano Norte boliviano, Provincia Camacho, sobre creencias y costumbres relacionadas con enfermedades relevantes a la mortalidad evitable: Diarrea en niños y adultos, Neumonia, Tuberculosis, Sepsis puerperal. Comparacion de terminos aymaras con terminos tecnicos castellanos en cuanto a la etiologia, semiologia prevencion y tratamiento de entidades nosologicas percibidas por la poblacion. Recomendaciones concretas de traduccion del castellano al aymara requeridas en la educacion para la salud que concientizan sobre connotaciones especificamente ligadas al contexto cultural