A study of the physical growth of malnourished children during recovery in a rural hospital, the first six months following their discharge and a comparison with an urban hospital

Protein-energy malnutrition (PEM) is a major public health problem with high rates of mortality and morbidity in the young child. Although there have been several studies on the long term physical sequelae of malnutrition in early life, there is little information on the physical growth of previously malnourished children in the immediate period after hospital discharge. The aim of this study was to determine the changes in body weight and length of children in the first 6 months following their discharge from hospital after treatment for malnutrition, and to evaluate how these changes were affected by nutritional status at the time of discharge, dietary intake and frequency of infection. 41 children aged 6-22 months were selected from patients admitted to the paediatric ward of the Spanish Town Hospital, 21 children (aged 5-23 months) were traced and followed up for periods of 3-8 months (Spanish Town Hospital index study group). The remaining 20 who could not be traced for follow up formed Spanish Town group B. The comparison group comprised 21 children from the ward at TMRU, selected retrospectively and matched according to age and sex. Information concerning these children was obtained from Tropical Metabolism Research Unit (TMRU) records, Spanish Town Hospital, a rural hospital, serves not only a smal town but more remote areas. For all 4 syndromes of PEM combined, the Spanish Town groups and the comparison group had mean deficits of 40 percent in weight for age, 20 percent in weight for length and 10 percent in length for age. During treatment in the Spanish Town Hospital the use of high energy feeds was inconsistent. On discharge, the comparison group (median length of stay in hospital = 47 days) and B group (median length of stay in hospital = 19.5 days) were 83 percent weight/length. The comparison group had significant higher mean rate of weight gain in hospital than the index group. During follow up, 60 percent of the index group gained weight steadily and repleted wasting. Differences between the index and comparison groups in weight/age and length/age were not significant. Faltering and weight loss were seen in the comparison group. Dietary information revealed improvement in some infant feeding practices, e.g. infrequent use of condensed milk was noticeable. The traditional diet of porridge with small portions of solid food, though bulky, could maintain adequate growth. The role of infections in affecting the nutritional status of the index group could not be determined from the study (Summary)

An evaluation of methods to screen for anaemia at the point of delivery in primary health care systems

Screening methods for anaemia were selected for testing on the grounds of cheapness, simplicity, sturdiness, independence on mains electricity or batteries and accuracy. The methods evaluated were the Copper Sulphate, Dare Haemoglobinometer, Lovibond Comparator, A.O. Spencer Haemoglobinometer and the Tallqvist Method. A new device, the Carib Haemoglobin Comparator, was developed. The Dare and Lovibond instruments were found to be inaccurate in the laboratory. The remainder were tested by primary health care workers in clinics in Jamaica. The Carib Haemoglobin Comparator and Copper Sulphate Method were found to fulfil the criteria

An evaluation of methods to screen for anaemia at the point of delivery in primary health care systems

Screening methods for anaemia were selected for testing on the grounds of cheapness, simplicity, sturdiness, independence on mains electricity or batteries and accuracy. The methods evaluated were the Copper Sulphate, Dare Haemoglobinometer, Lovibond Comparator, A.O. Spencer Haemoglobinometer and the Tallqvist Method. A new device, the Carib Haemoglobin Comparator, was developed. The Dare and Lovibond instruments were found to be inaccurate in the laboratory. The remainder were tested by primary health care workers in clinics in Jamaica. The Carib Haemoglobin Comparator and Copper Sulphate Method were found to fulfil the criteria