Anthropometric characteristics of hospitalised elderly women: a case-control study.

This study assessed the anthropometric status of 451 hospitalised female patients aged 70 or over, at their admission to hospital, in reference to 77 healthy women of the same age. The most frequent diseases were circulatory diseases (40.8%), mental disorders (29.9%), respiratory diseases (12.4%), endocrine and metabolic diseases (11.5%), osteomuscular diseases (8.4%), and traumatisms (6.9%). The differences were significantly high for mid-arm circumference (MAC), triceps skinfold thickness (TSF), weight, weight/height, and body mass index (BMI). The patients with cancers, blood diseases, mental disorders, respiratory disease, digestive diseases, or traumatisms had the lowest values. All the indicators correlated in a similarly negative way with age. The decreased TSF was more pronounced among subjects with respiratory diseases. Measurement of anthropometric indicators, TSF in particular, should be part of preventive measures aimed at reducing malnutrition and its consequences in a hospital setting.

Determinants of glycaemic control in type 2 diabetes African patients monitored by physicians from 1991 to 2004 in Cote d'Ivoire.

The aim of this study was to propose determinants of glycaemic control which are useful to adequately manage the healthcare of type 2 diabetes patients attending an out-patient clinic. A retrospective, descriptive research design was implemented at the Centre AntiDiabétique d'Abidjan in 2399 African patients. Glycaemic control was calculated from the average of at least 12 fasting plasma glucose levels measured during at least three years. Logistic and multiple linear regressions were performed at the limit of the glycaemia average of 6.7mmol/l (120mg/dl). The determinants of poor glycaemic control were: long duration of monitoring (odds ratio (OR)=1.66, then 2.68), annual frequency of visits outside the 2-3 per year interval (OR=3.25) and insulin treatment (OR=4.66) in 'non-obese men'; the aforementioned frequency of visits (OR=3.69) and insulin treatment (OR=3.72) in 'non-obese women'; the duration of monitoring reaching the 10-14 year interval (OR=3.48), the aforementioned frequency of visits (OR=2.51), insulin treatment (OR=26.16) and housewife status (OR=1.94) in 'obese women'. In 'obese men', insulin treatment was the sole determinant (r(2)=0.24). Healthcare parameters (treatment, frequency of visits, and duration of monitoring) seemed to be predominant as effective predictors of glycaemic control in our study context. These findings reveal the urgent need for both more concern and further research in diabetes management to improve the quality of care and tackle this health challenge.

Serum zinc and copper status in hospitalized vs. healthy elderly subjects.

OBJECTIVE: To assess serum zinc and copper concentrations of elderly hospitalized patients with a broad range of diseases and compare their levels to those of healthy community dwelling controls of similar age. METHODS: This case-control study compared serum zinc and copper levels of 668 hospitalized subjects, aged 70 or over, with 104 healthy controls of the same age and from the same geographical area. The study protocol, conducted by one physician on the day after the admission to the hospital, included a questionnaire on sociodemographic characteristics, a medical examination, and serum zinc and copper measured with flame atomic absorption spectrophotometry. Data were analysed using analysis of covariance, controlling for age and sex. RESULTS: The diseased subjects had markedly lower zinc concentrations than the control group. The frequency of low values (<0.70 mg/L) was high (20.2% vs. zero in controls, p < 0.001), and it differed among various disease categories: 35.7% for respiratory disease, 20%- 27% for cancer, infectious disease, trauma, blood diseases, and genitourinary diseases, and less than 20% for the other diseases. Low values for serum copper concentration (<0.80 mg/L) were rare in hospitalized subjects (1.4% vs. zero in controls). Whatever the disease category and number of diagnoses considered, the serum copper/zinc ratio was significantly (p < 0.001) higher in diseased than in healthy people. CONCLUSIONS: Elderly hospitalized patients are at elevated risk of low zinc but not copper values. The significantly lower values of serum zinc found in the hospitalized elderly compared to healthy elderly are likely to be related to disease rather than to aging per se. In addition to other classic anthropometric (BMI) and biological (serum proteins) nutritional parameters, copper/zinc ratio may be a useful marker of malnutrition.

[Assessment of iodine content of dietary salt in Abidjan (Côte d'Ivoire)]. / Evaluation de la teneur en iode du sel alimentaire à Abidjan (Côte d'Ivoire).

Côte d'Ivoire is one of the countries engaged in the strategy of universal salt iodization set up to prevent and control iodine deficiency disorders. However, no systematic monitoring of iodine content of salt has been performed up to now. Therefore, a survey was conducted on a random sample of 400 households in the Marcory district of Abidjan in order to study consumers' behaviour regarding the purchase and storage of salt, and to determine the iodine content of dietary salt. The proportioning of iodine was carried out by the titrimetric method. The salt consumed in the homes was bought at the market, the shop, the supermarket or was delivered at residence by a hawker in the proportions of 82.8%, 10.3%, 6.3%, and 0.8%, respectively. At the warehouse, the salt purchased was packaged into bags of 25 kg for 0.5% of homes. 1% of homes bought salt in tins. 9.5% of homes bought their salt in sachets. Most homes (89%) replenished their stock in bulk from the market. Laboratory analyses showed that all salt samples were iodised. The average content of iodine in salt was 52.74 ppm with a standard deviation of 32.56. We observed that in 23.3% of households the iodine content of salt was weak (< 30 ppm). Contents higher than the upper limit of normality (30-50 ppm) were found in 44.8% of cases. The level of iodine was adequate for 32% of households. The major risk to which the population is exposed is the outbreak of iodine-induced hyperthyroidism (IIH) despite the fact that the Abidjan area is not naturally deprived of iodine. The risk is even more significant in the goitre endemic zone of the western and northern areas of the country, because these regions receive the same salt as Abidjan. From this arises the need for setting up an effective system of controlling the iodine content in dietary salt to continuously adjust it, taking into consideration the minimum needs of the population.