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Biomedical subjects

C D Molteno

Publications and source records attributed to C D Molteno.

At least 19 recordsLinked to original sources
PubMed1991

Preschool development of coloured children in Cape Town.

Developmental screening was applied during infancy to a birth cohort of 1,000 coloured infants born consecutively in Cape Town. The developmental progress of a sample of 187 children randomly selected from the cohort was followed over a period of 5 years. The value of the use of developmental screening is questioned, since 4 of the children in the cohort with major handicap had been diagnosed before the first screening was carried out and a 5th child with deafness was not detected by the screening process. Developmental milestones were similar to those studies reported in the literature. At 12 months the development correlated best with family stability. Language development at 30 months was associated with mother's education and family stability and reflected a general lag in verbal skills. By 5 years there was a good correlation between development and social indicators, particularly income and mother's education.

Black or African American↗
PubMed1991

Growth of preschool coloured children in Cape Town.

The growth of a random sample of coloured children in Cape Town was studied from birth until 5 years. At birth they were relatively light and short for gestational age. Size at birth correlated with social class. A rapid postnatal weight gain rendered them relatively overweight between 3 and 6 months. Thereafter they became lighter and shorter than the NCHS reference values and this persisted throughout the preschool period. Genetic factors, reflected by parental growth, were found to predict growth during childhood, but they were more predictive of weight and head circumference than of length. From 12 months onwards, socio-economic factors played a significant role in determining growth even after the effects of the genetic factors had been taken into account.

Black People↗
PubMed1990

Causes of mental handicap in Cape Town.

A cross-cultural study of the cause of the mental handicap of greater than 1,000 children born in the Cape Town area between 1974 and 1986 was carried out. Acquired causes were noted to be more prevalent among the black ethnic group. This study showed that at least 80-100 additional cases of moderate-severe mental handicap can be expected in the Cape Town area each year. Attention is drawn to the expanded facilities that will be required to provide for the ongoing special needs of these children. Possible areas for prevention of mental handicap are discussed.

Adolescent↗
PubMed1989

Early childhood mortality in Cape Town.

Early childhood mortality in the City of Cape Town was investigated with particular reference to preventability. Deaths were considered preventable if they resulted from infections or other acquired diseases and accidents. Non-preventable deaths were those resulting from congenital disorders, neoplastic disease and other non-acquired conditions. Cot deaths formed a third group. Mothers in the preventable group had had more pregnancies than those in the non-preventable group, and the children who died were more likely to have been born prematurely than children in the non-preventable group. Children in the preventable group came from lower social class backgrounds than those in the non-preventable group and were more frequently from single-parent families who lived with extended family or with people who were not related to them. Their families were less likely to own their own homes than families of children in the non-preventable group. The children who died had more siblings, more of whom had died previously, than children in a control group. The cot death group did not differ from the preventable group, but did differ from the non-preventable group with regard to gestational age and paternal occupation. The study shows that preventable deaths were particularly associated with socio-economic disadvantage.

Black or African American↗
PubMed1989

Postneonatal mortality in the Matroosberg Divisional Council area of the Cape Western Health Region.

Postneonatal deaths in the Matroosberg Divisional Council area were studied with particular reference to social and nutritional factors. Adverse social circumstances were strongly associated with death during the first year of life. The children who died had fathers who were less educated and held lower rated jobs than fathers of children in a control group. They were less likely to have belonged to a nuclear family and were more likely to have had families with social problems. They were also more frequently bottle-fed, were more likely to have been underweight, and were less often fully immunised. The study illustrates the need for a GOBI-FFF intervention strategy in the area.

Black or African American↗
PubMed1989

A comparative study of postnatally-acquired cerebral palsy in Cape Town.

The importance of socio-economic conditions in the causation of postnatally-acquired cerebral palsy has not been stressed in previous studies. A comparative survey was undertaken in Cape Town, South Africa. Three ethnic groups were compared--white, coloured (mixed ancestry) and black. The percentage of postnatally-acquired cerebral palsy in these groups was 13.2, 24.0 and 36.1 per cent, respectively. These figures can be explained by the differing socio-economic conditions of each group, the white group belonging to the highest socio-economic stratum and the black group to the lowest. The main causes of postnatally-acquired cerebral palsy were cerebral infections (particularly meningitis), cerebral trauma and cerebrovascular accidents. The proportion in each group, the main causal factors, age at onset, types of cerebral palsy and intellectual status are similar to those of most previous studies.

Black or African American↗
PubMed1987

Low-birth-weight infants in the Cape Peninsula. A follow-up study at the age of 3 years.

A sample of coloured children from the Cape Town City Council area who had been of low birth weight, although a weight appropriate for gestational age, was examined at the age of approximately 3 years. The children were compared with a control group of similar social background who had been of normal birth weight. Growth parameters were compared with the National Center for Health Statistics centiles. The low-birth-weight infants had compensated well. Although they were lighter, shorter in stature and had lower intelligence quotient scores than their normal-birth-weight contemporaries, when corrected for prematurity the growth parameters and IQ did not differ significantly from those of the controls. Six per cent of the preterm infants had major and 15% minor handicaps. Infants with very low birth weights (less than 1500 g) had no more handicaps than those with low birth weights. Iron deficiency was detected in 18% of the children overall but all those who were anaemic were from the low-birth-weight groups. Between 1 and 3 years of age the low-birth-weight infants had more illnesses but no more hospital admissions than the controls.

Child Development↗
PubMed1985

Tuberculous meningitis in children in the Western Cape. Epidemiology and outcome.

The incidence of tuberculous meningitis in children was determined using hospital records as well as local authority notifications. One hundred and eighty-five cases occurred over a 3-year period. The age-specific incidence in the 0-14-year-old group was 7,5/100 000. In only 28 cases was the disease at an early stage when treatment was commenced. Young age and late-stage disease at presentation were associated with a poor outcome. The associated morbidity and mortality rates were high; the mortality rate was 24%, and nearly 50% of patients were left with a residual disability.

Adolescent↗
PubMed1984

Tactile aversion in infancy.

Twenty children referred for assessment of delay in gross motor development showed tactile aversion. This is a common cause of delay in motor development and may be misdiagnosed as cerebral palsy or as a global developmental retardation. In some infants feeding is a problem. Although the condition is self-limiting, many patients need orthopaedic treatment for abnormalities of foot posture when they start to walk.

Cerebral Palsy↗
PubMed1980

Cerebral palsy in Cape Town: A review of 389 coloured children.

Three hundred and eighty-nine Coloured cerebral palsied children were reviewed with regard to clinical type and its relationship to aetiological factors. There was no significant change in type or severity of case over two 6-year periods. Associated handicaps were also analysed, and the prevalence of these stresses the need for comprehensive assessment and treatment clinics so that multidisciplinary treatment can minimize the extent of the disabilities.

Adolescent↗
PubMed1979

The adoption of the 'at risk' baby.

The high incidence of cerebral palsy among adopted children in Cape Town has long been a cause for concern. Five such children from a recent series of 12, in which pre- and perinatal histories were known, were high-risk infants. All were thought to have been normal at the time of adoption. The need for expert medical examination before adoption is stressed, risks that adoptive parents must take are evaluated, and the psychological aspects of delaying adoption are also considered. Some suggestions are made for modifying the existing adoption procedures in this country.

Adoption↗
PubMed1978

Cerebral palsy in Cape Town: a comparative 12-year retrospective study.

Three hundred and thirty-one Coloured and 175 White children with cerebral palsy, born between 1964 and 1975, were compared as regards aetiology and changing incidence over two 6-year periods. The following were the main points which emerged: (i) there is an apparent decrease in the total number of White children with cerebral palsy born in the second 6-year period, but for reasons discussed, there is probably little or no true decrease; (ii) there is a significant increase in the total number of Coloured cerebral palsied children born in the second 6-year period, due mainly to an increase in cases of cerebral palsy of perinatal origin, particularly cases of perinatal asphyxia; (iii) there is a high incidence of acquired cerebral palsy in both racial groups, but this is significantly higher amont the Coloured; (iv) ther is no racial difference in the incidence of cerebral palsy in babies of low birth weight; (v) both racial groups have a fairly high incidence of cerebral palsy due to kernicterus. It is interesting to speculate whether improved obstetric and neonatal care and the resultant lowering of perinatal mortality produce more handicapped babies.

Age Factors↗
PubMed1976

Acid-base determinations in normal and asphyxiated term infants during the first 24 hours of life.

Vigorous term infants who are born normally initially have a moderate metabolic and respiratory acidosis which is corrected by the time the infant is 6 hours old. Asphyxiated infants consistently show a greater degree of acidosis, both metabolic and respiratory. Caesarean section results in higher pCO2 values, especially when 'diffusion apnoea' occurs. Indications for the correction of acidosis in asphyxia are proposed.

Acid-Base Equilibrium↗
PubMed1976

Infants of very low birthweight: a follow-up study.

The survival, growth and neurodevelopmental status of a group of non-White infants of very low birthweight, who were managed in the Neonatal Intensive Care Unit of Groote Schuur Hospital, is reported. The effect of certain high-risk perinatal factors on this status is assessed.

Birth Weight↗