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Biomedical subjects

G J Ebrahim

Publications and source records attributed to G J Ebrahim.

At least 91 records · Page 5Linked to original sources

Infant mortality and undernutrition in the squatter settlements of Karachi.

The socio-demographic and biological processes contributing to infant mortality and undernourishment were studied in five urban squatter settlements of Karachi. All those families who had experienced an infant death in the past 2 years (N = 106) were recruited into the study. Comparative children were selected by random numbers with geographical matching from families with at least one live infant and without a history of infant deaths in the past 2 years. The comparison children were weighed and those found underweight (27 per cent) were studied for the presence of risk factors. Forty-one per cent of all deaths were in the neonatal period, and in 47 per cent of cases deaths had occurred in infants with a birth order of 5 and above. Age, duration of breast feeding, birth interval, and the live/dead status of the previous sibling were significant biological variables accounting for 23 per cent of the variance for survival. Socio-economic status accounted for 22 per cent of the variance and health-seeking behaviour (antenatal care, immunization, etc.) for 28 per cent. Sixty-eight per cent of those underweight were more than 6 months old. Age, female sex, birth interval less than 24 months, duration of breast feeding, adolescent mother, alive/dead status of the previous child were significant influences accounting for 12 per cent of the variance. Socio-economic status and health seeking behaviour were also important determinants, but not to the same extent as in the case of infant death.

Adolescent↗

Strategies educated mothers use to ensure the health of their children.

Mothers attending the out-patients in a programme of primary health care in rural west Bengal were interviewed for obtaining personal, socio-economic, and health data. Anthropometric measurements were made on them and their accompanying children. Sixty-five of the mothers were educated (defined as primary level and above of education) and 136 were not. The uneducated group had experienced a greater rate of child loss at 130 per 1000 births compared to 58 per 1000 births in the educated group. They were shorter (mean height 1.487 +/- 0.0475 m) compared to the educated group (mean height 1.507 +/- 0.051 m; P less than 0.01). Their children had a higher proportion of growth deficiencies, significant for height-for-age (P less than 0.001). These differences persisted after controlling for socio-economic status. The strategies used by the educated mothers were significantly more appropriate than those of their non-educated counterparts with regard to pregnancy and childbirth, diarrhoea, immunization, family planning, and source of treatment in illness. The educated women also benefited more from the primary health care programme.

Adult↗

Neonatal mid-upper-arm circumference is a valid proxy for birth-weight.

A survey was carried out on a consecutive sample of 973 newborn babies representative for the city of Ouagadougou to assess the validity of neonatal mid-upper-arm-circumference (MUAC) as an indicator of birth-weight. The optimal cut-off point of neonatal MUAC to differentiate between low (less than 2500 g) and normal (greater than or equal to 2500 g) birth-weight babies was 9.5 cm. High values for sensitivity (91%) and specificity (83%) indicate an excellent validity. A newborn with a MUAC of less than 9.5 cm runs a 23 fold risk of being of low birth-weight (relative risk). The advantages of this simple, locally available and inexpensive indicator, which can be used by trained traditional birth attendants (TBA) and by the mothers themselves as a substitute for birth-weight, are discussed.

Anthropometry↗

Lessons for national health systems from small-scale projects: a case study from Tanzania.

A number of health projects have helped to establish the conceptual framework for Primary Health Care. Since the main difficulties in establishing Primary Health Care nationally arise with regard to planning, organization, and management, the replicability of such projects nationally is made easy if these difficulties are addressed at the level of the basic administrative unit in the country. In most countries it is the district. District level projects also give a more realistic account of the structures needed for planning, management, the logistics, lines of communication, intersectoral activities, and so on. This paper gives an account of a district level project in Tanzania and the lessons derived from it for the national health system relevant to Primary Health Care.

Community Health Services↗

Skin-to-skin contact as a method of body warmth for infants of low birth weight.

Skin-to-skin mother/infant contact as a means of warmth for newborns of low birth weight (less than or equal to 2500 g) was studied in 132 infants admitted consecutively during the cold season July/September at the Central Hospital in Maputo. The mean (+/- SD) birth weight was 1788 g (+/- 304 g) and the gestational age 34 weeks (+/- 2.7). Fifty-seven (43 per cent) infants were born outside the hospital and were referred. The ambient temperature ranged from less than 22 degrees C to 32 degrees C. Skin-to-skin contact as the principal means of warmth commenced in more than a third by age 3 days and in more than a half by age 5 days after periods of observation to exclude clinical problems. The infants were kept warm using conventional methods during observation. Re-admission to the intensive care unit was required in nine cases: four for diarrhoea; two for respiratory infection; two with jaundice; and one for poor suckling. Infants were discharged home at a mean (+/- SD) weight of 1864 g (+/- 227), and age 15.6 d (+/- 7.9). Skin-to-skin contact, either by itself or in combination with other methods of warmth, was reportedly followed at home by 67 per cent of the mothers who received home visits. No infant needed readmission for hypothermia either from the neonatal wards or after being discharged home. At follow-up, when body weight had reached greater than or equal to 2500 g, the outcome was graded as 'good' in 64; 'satisfactory' in 6; and 'poor' in 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Body Temperature↗