ABSTRACT
OBJECTIVES: International growth charts have been used in the past decades to identify atypical growth and diagnose the nutritional status of individuals. The aim of this study was to construct and compare growth patterns of normo-nourished children between 6-59 months from Afghanistan, Haiti, and the Democratic Republic of the Congo, to assess if it would be worth developing growth charts at a national level. METHODS: We used an international sample of 46 466 subjects (53.7% female; 46.3% male) from the aforementioned regions. To create the growth charts, we used different statistical methodologies: the Lambda-Mu-Sigma (LMS), LMSP, and LMST models, and regression models based on fractional polynomials. The LMSP models were the ones that fitted our data best and were therefore the ones used to make comparisons between countries using percentiles (3rd, 50th, and 97th). RESULTS: We found that Haitian children were both, taller and heavier than their Afghan and Congolese equals of the same ages. Moreover, differences were bigger in the highest percentiles (i.e., 97th percentile). These differences might be the result of the influence that genetics and diverse social and environmental contexts have on growth rates. CONCLUSIONS: Using the same international reference standards for all populations could result in the overestimation or underestimation of the proportion of malnourished children. In light of our results, we recommend the future development of national and regional growth charts to provide health workers with more precise tools to evaluate the nutritional status in the child population.
Subject(s)
Child Development , Afghanistan , Child , Child, Preschool , Congo , Haiti , Humans , InfantABSTRACT
Introducción: El sarcoma de Kaposi es una neoplasia oportunista asociada a la inmunodepresión causada por VIH, que se relaciona con la infección por VHH tipo 8. Objetivo: Describir la presentación del sarcoma de Kaposi en personas que viven con VIH en Guinea Ecuatorial. Métodos: Se realizó un estudio descriptivo de carácter retrospectivo para identificar la prevalencia y las características epidemiológicas y clínicas del sarcoma de Kaposi en las personas que viven con VIH que acuden a las unidades de referencia para el manejo de casos en Guinea Ecuatorial. Se revisaron las historias clínicas de una muestra aleatoria y representativa de 338 pacientes del grupo que ha recibido tratamiento en las unidades de referencia para enfermedades infecciosas de Bata, desde enero de 2007 a febrero de 2012. Resultados: Se identificaron 40 pacientes diagnosticados de sarcoma de Kaposi (prevalencia del 11, 83 por ciento). La mediana de la edad al diagnóstico de sarcoma de Kaposi fue de 43 años, siendo la ratio del sexo de 1/1. La media de linfocitos CD4 al diagnóstico fue de 166 (rango 21-375) y la frecuencia de afectación oral fue de 45 por ciento. En la mayoría de los pacientes (94,6 por ciento) la observación del sarcoma de Kaposi fue anterior al inicio del tratamiento antirretroviral. Las cifras de linfocitos T CD4/mm3 inferiores a 100 aparecían sobre todo en pacientes menores de 30 años, y esto era especialmente frecuente en el grupo de mujeres (OR 11, p <0,04, Ic 95 por ciento 0,8-148). Conclusiones: El sarcoma de Kaposi es una neoplasia prevalente en personas que viven con VIH seguidas en las unidades de referencia en Guinea Ecuatorial. En mujeres menores de 30 años podría existir un diagnóstico tardío(AU)
Introduction: Kaposi sarcoma is an opportunistic neoplasm associated to the immunosuppression caused by HIV and related to infection by HHV-8. Objective: Describe the presentation of Kaposi sarcoma in people living with HIV in Equatorial Guinea. Methods: A retrospective descriptive study was conducted to identify the prevalence and the clinical and epidemiological characteristics of Kaposi sarcoma in people living with HIV attending reference units for the management of cases in Equatorial Guinea. A review was carried out of the medical records of a random sample representative of 338 patients from the group receiving treatment at Bata reference unit for infectious diseases from January 2007 to February 2012. Results: A total 40 patients diagnosed with Kaposi sarcoma were identified (prevalence of 11,83 percent). Mean age at Kaposi sarcoma diagnosis was 43 years, with a 1/1 sex ratio. The mean CD4 lymphocyte count at diagnosis was 166 (range 21-375), whereas the frequency of oral damage was 45 percent. In most patients (94.6 percent) detection of Kaposi sarcoma was prior to the start of antiretroviral therapy. CD4 T lymphocyte levels / mm3 below 100 were mainly found in patients aged under 30 years, a fact particularly frequent among women (OR 11, p< 0.04, CI 95% 0.8-148). Conclusions: Kaposi sarcoma is a neoplasm prevailing in people living with HIV who attend reference units in Equatorial Guinea. Late diagnosis could exist among women aged under 30 years(AU)