ABSTRACT
The main source of data on birth weight in developing countries is statistics from health facilities, although most developing countries do not produce annual estimates of the incidence of low birth weight from these data. Such estimates would be subject to selection bias as the data are usually limited to babies born within health facilities, and therefore are representative of a subgroup that is markedly different from the overall population of neonates. Since 1990 the Demographic and Health Surveys programme has included questions on recalled birth weight and relative size at birth in 15 national surveys. In this article, we show that these cross-sectional surveys can provide a useful data source for making national estimates of mean birth weight and the incidence of low birth weight. The extent of misclassification of birth weight is, however, too large to use the data on relative size as birth as an indicator of low birth weight at the individual level.
Subject(s)
Birth Weight , Developing Countries , Fetal Growth Retardation , Infant, Low Birth Weight , Pregnancy Complications/epidemiology , Developing Countries/statistics & numerical data , Female , Health Surveys , Humans , Infant, Newborn , Infant, Very Low Birth Weight , International Cooperation , PregnancyABSTRACT
Las estadísticas de centros de atención de salud son la fuente principal de datos sobre el peso al nacer en los países en desarrollo, si bien en la mayor parte de esos países no se producen estimaciones anuales de la incidencia de bajo peso al nacer a partir de esos datos. Si se produjeran, las estimaciones serían propensas al sesgo de selección ya que los datos están limitados en general a los niños nacidos en centros de salud y, por lo tanto, representan un subgrupo decididamente diferente de la población general de neonatos. Desde 1990, el programa de Encuestas Demográficas y de Salud ha realizado 15 encuestas nacionales en las que se incluyeron preguntas sobre el peso y el tamaño relativo al nacer tal como los recordaban las madres. Este artículo muestra que las encuestas transversales pueden constituir una fuente útil de datos para estimar la media nacional de peso al nacer y la incidencia de bajo peso. Sin embargo, la clasificación errónea del peso al nacer es demasiado extensa para emplear los datos de tamaño relativo al nacer como indicador de bajo peso a escala individual
Subject(s)
Birth Weight , Infant, Low Birth Weight , Data Collection/trends , Developing CountriesABSTRACT
Las estadísticas de centros de atención de salud son la fuente principal de datos sobre el peso al nacer en los países en desarrollo, si bien en la mayor parte de esos países no se producen estimaciones anuales de la incidencia de bajo peso al nacer a partir de esos datos. Si se produjeran, las estimaciones serían propensas al sesgo de selección ya que los datos están limitados en general a los niños nacidos en centros de salud y, por lo tanto, representan un subgrupo decididamente diferente de la población general de neonatos. Desde 1990, el programa de Encuestas Demográficas y de Salud ha realizado 15 encuestas nacionales en las que se incluyeron preguntas sobre el peso y el tamaño relativo al nacer tal como los recordaban las madres. Este artículo muestra que las encuestas transversales pueden constituir una fuente útil de datos para estimar la media nacional de peso al nacer y la incidencia de bajo peso. Sin embargo, la clasificación errónea del peso al nacer es demasiado extensa para emplear los datos de tamaño relativo al nacer como indicador de bajo peso a escala individual
The professionals and patients involved in dental examinations are at risk for infection by various disease-causing bacteria, viruses, and fungi, such as those responsible for hepatitis, tuberculosis, herpes, and AIDS. It is known that aerosols and spatter containing pathogenic microorganisms can spread during an examination. Nevertheless, some dental clinics are designed to have multiple examination areas in the same room, with no physical barriers between them. The objective of this study was to verify the reach of spatter resulting from the use of a triple syringe and high-rotation turbine during five simulated exams in a collective clinic, bearing in mind that spattercan contain the patient's saliva and blood. To facilitate tracking of the spatter, aniline dye (pink, blue, yellow, green, and brown) was added to the water in the appropriate receptacle in each of the five units. The room, the equipment, and the patient's and operator's clothing were covered with white paper. A high concentration of spatter was observed on the chair, the operator, and the floor of each unit, and it also appeared on the chairs and trays of the surrounding units. The maximum distance reached by spatter was 1.82 m from a point on the chair corresponding to the position of the patient's mouth. During real simultaneous examinations, the surrounding chairs and their patients and operators, as well as the trays containing sterilized instruments, are within spatter range. Therefore, there is a real possibility of crossinfection, and physical barriers should be placed between the units. This study also confirmed the need for protection of the operator's face, body, hair, and arms, since these regions were heavily affected by spatter.
Subject(s)
Humans , Male , Female , Infant, Newborn , Birth Weight , Developing Countries , Infant, Low Birth Weight , Data Collection/trendsABSTRACT
The main source of data on birth weight in developing countries is statistics from health facilities, although most developing countries do not produce annual estimates of the incidence of low birth weight from these data. Such estimates would be subject to selection bias as the data are usually limited to babies born within health facilities, and therefore are representative of a subgroup that is markedly different from the overall population of neonates. Since 1990 the Demographic and Health Surveys programme has included questions on recalled birth weight and relative size at birth in 15 national surveys. In this article, we show that these cross-sectional surveys can provide a useful data source for making national estimates of mean birth weight and the incidence of low birth weight. The extent of misclassification of birth weight is, however, too large to use the data on relative size at birth as an indicator of low birth weight at the individual level.
PIP: Data from 15 surveys conducted in developing countries that included questions on birth weight were analyzed to determine whether birth weight data from cross-sectional surveys can be used to improve national estimates of mean birth weight and the incidence of low birth weight (LBW). The proportion of children weighed at birth ranged from 9% in Pakistan and Yemen to 91% in the Dominican Republic. Most women could recall the birth weight. Units of measurement to record birth weight included grams in seven surveys, kilograms carried to one decimal place in five surveys, kilograms carried to two decimal places in one survey, pounds and ounces in one survey, and pounds or kilograms in one survey. Among all surveys reporting in kilograms or grams, 33-50% of birth weights were recorded in multiples of 500 g. The sensitivity of the relative-size-at-birth indicator to identify LBW babies was very low in all surveys (mean, 29%), even though the positive predictive value (PPV) was at least 70% in most surveys. Thus, most infants reported as very small were indeed LBW, but only 29% of all LBW infants were identified. When one used both very small and small as indicators of LBW, sensitivity improved greatly (mean, 66%). Yet 45% (mean PPV) of the very small and small infants were of LBW. The incidence of LBW, when considering both numerical weight and size, ranged from 8.7% (Colombia) to 18.8% (Tanzania). Poor data quality probably accounted for the fact that data from Yemen were very different than those from the other surveys. These findings suggest that these surveys can be a useful data source for estimating mean birth weight nationwide and the incidence of LBW. Misclassification of birth weight is too common to use the data on relative size at birth as an indicator of LBW at the individual level.
