Plasma retinol level, vitamin A supplementation and acute respiratory infections in children of 1-5 years old in a developing country. Respiratory Diseases Working Group.

STUDY OBJECTIVE: To evaluate the relationship between vitamin A supplementation, plasma retinol level (PRL) and incidence, severity and duration of acute respiratory infect ions (ARI) in children 1-5 years old. DESIGN AND SETTING: A one year prospective randomized intervention study from June 1989 to May 1990 in Cikutra, a suburb of Bandung, Indonesia. SUBJECTS AND MEASUREMENTS: Out of almost 2000 children aged 12-54 months, 269 were selected by stratified randomization. Vitamin A (200,000 IU orally) was administered at 6-monthly intervals in a double blind, placebo controlled programme. Every 2 weeks, primary health care workers collected data on respiratory symptoms in the children, and every month a pediatrician examined the children. Venous blood samples were obtained at the start and at 3 and 6 months for plasma retinol levels (PRL). RESULTS: The mean PRL at the start of the study was 20 +/- 8 micrograms/dl; 8% of the children showed a deficient level of less than 10 micrograms/dl. The incidence or ARI was 6.7 +/- 3.5 episodes per child per year with a mean duration of 5.3 +/- 3.1 days per episode. In vitamin A supplemented children the duration of ARI was slightly shorter (5.2 +/- 3.1 versus 5.6 +/- 3.1 days, P < 0.01) but no effect on the incidence or severity of ARI was detected. Low, and especially deficient, PRL had improved after 3 months and even after 6 months, but this was unrelated to vitamin A supplementation. There was also no relationship between PRL and incidence, severity or duration of ARI. CONCLUSIONS: Only a slight relationship is found between vitamin A supplementation and ARI duration in under-fives.

Total serum IgE and eosinophil count in children with and without a history of asthma, wheezing, or atopy in an urban community in Indonesia. The Respiratory Disease Working Group.

AIM: The objectives of the study were to assess total serum IgE and eosinophil count in a random sample of 20% of the children between 12 and 54 months old in a suburban community of Bandung, Indonesia, and to investigate a possible relationship between these values and atopy, asthma or wheezing and parasite infestation. METHODS: Two hundred sixty-nine children were examined at the Integrated Primary Health Care Unit, and the parents or guardians were interviewed with the use of a standardized questionnaire. RESULTS: The overall median value of IgE was 436 IU/ml (range, 18 to 9707 IU/ml); almost 94% of the children showed an IgE value of more than 100 IU/ml, and 29% showed a value of more than 1000 IU/ml. The median value for eosinophils was 580/mm3 (range, 70 to 5090/mm3); only 31% of the children had less than 400 eosinophils/mm3. IgE levels and eosinophilia were not related to age but showed a significant, although not high, correlation with each other (p < 0.05). In about 36% of the children parasites were demonstrated in a single stool sample; in those subjects eosinophilia and IgE values tended to be greater, but the difference was not significant. About 7% of the children had asthma, and in those subjects the eosinophil counts and IgE levels were much more increased (p < 0.001 and p approximately 0.01, respectively). No difference was found in IgE or eosinophil count in relation to other forms of atopy in the child (milk-induced dermatitis, urticaria, eczema, rhinitis) or in relation to a history of asthma or atopy in other family members. Yet, the occurrence of asthma in the child was significantly related to a history of asthma in other family members. CONCLUSIONS: IgE values and eosinophilia are markedly increased in these children under 5 years of age in Bandung, Indonesia, and the highest values are found in the 7% with asthma.

Vitamin A and acute respiratory infections.

By questionnaire we studied the occurrence of acute respiratory infections (ARI) in 1961 children between 0 and 5 years old from a total of 3225 families in Cikutra, Bandung. In 38.7% of them 200.000 IU vitamin A supplement had been given at least once during the preceding year. Mild or moderate ARI occurred in 54.7% of the children during the previous month and in 87.9% during the previous year; severe ARI occurred in 5.5% during the previous month and in 16.8% during the previous year. Surprisingly slightly more ARI occurred in children with vitamin A supplementation. However, vitamin A had been distributed more to low income than high income families, and in the latter group significantly less children suffered from ARI (p less than 0.05; 44% versus 54 a 56%).

Risk factors in smoking habits of high school students.

Although the hazards of smoking is well known, the number of smokers among high school students is still high. There are many factors influencing these students to start smoking. This study was conducted to discover the size of the population of smokers among high school students is still high. There are many factors influencing these students to start smoking. This study was conducted to discover the size of the population of smokers among high school students, their smoking behaviour, and what factors might be associated as risk factors. Questionnaires were filled by 1627 respondents between 12 and 22 years of age of which 955 (58.7%) are boys and 672 (41.3%) are girls. Among all male respondents there were found 622 (86.2%) experimental smokers; among all the girls there were only 99 (13.7%) experimental smokers. From the total number of experimental smokers, 377 (95.2%) boys and 19 (4.8%) girls eventually became smokers. One hundred and seventeen (16.2%) students tried smoking before 13 years old, 65 of these students became smokers. This study found that socio-economic status, parents, friends, and siblings who smoked, and social environment, have significant influence on high school students' smoking habits. To prevent and lower the number of smokers among students in high schools, health and smoking education must be started in the schools as early as possible.