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H C Stetler

Publications and source records attributed to H C Stetler.

27 records · Page 2Linked to original sources

Results of nutritional status surveillance in El Salvador, 1975-77.

Nutritional status surveillance data based on the clinical diagnosis of malnutrition and on weight-for-age, as well as diarrhoeal disease data for preschool age children attending government health clinics in El Salvador are presented for a 3-year period (1975 - 77). Surveillance results indicated consistently higher rates of clinical malnutrition and weight-for-age deficit in rural children as compared with urban children, and higher malnutrition rates in children 1 - 4 years of age as compared with infants less than 1 year old. Consistent seasonal increases in malnutrition were observed that were most pronounced in older preschool children (1 - 4 years) in rural areas. Seasonal peaks in malnutrition consistently followed 1 - 2 months after the major seasonal peak in diarrhoea at the onset of the rainy season, suggesting that diarrhoea may play a role in the etiology of malnutrition. A secondary seasonal peak in diarrhoea in the cooler, dry season was most prominent in infants but was not related to increased malnutrition. These results indicate that nutritional and health status indicators formed from data collected regularly at health centres can demonstrate consistent age group, urban/rural, and seasonal differences in nutritional status that may be useful in identifying risk groups and in monitoring nutritional changes for planning and evaluation purposes.

Body Weight↗

Fetal risk associated with rubella vaccine.

Ninety-four susceptible women received either Cendehill or HPV-77 rubella vaccine. All gave birth to healthy infants. Seventeen susceptible women received the RA 27/3 vaccine. All their infants were free of abnormalities compatible with congenital rubella, as were 54 born to mothers of unknown immune status at the time of RA 27/3 vaccination and those later found to be immune. An additional susceptible woman received an unknown strain of vaccine; she also had a healthy infant. The risk of severe congenital malformations after rubella vaccination is low. In our 112 cases, the maximum risk was approximately 3%. Concern about the potential adverse effects of rubella vaccine on the fetus should not interfere with vaccination of women of childbearing age. However, since the actual risk may not be zero, women known to be pregnant should not be vaccinated, and conception should be avoided for three months after vaccination.

Adolescent↗

Anthropometric nutrition status and diarrhea prevalence in children in El Salvador.

Data are presented to quantify the relationship between nutritional status and diarrheal disease reported in a 1-week period in children in El Salvador. A strong association was observed between reported diarrhea and combined wasting (defined by low weight-for-height) and stunting (defined by low height-for-age). This association held for all age groups studied and was consistently observed in the seasons of low and high prevalence of malnutrition. There were also significant associations between reported diarrhea and wasting alone, low weight-for-age, and low arm circumference. No consistent association was observed between reported diarrhea and stunting or chronic undernutrition as defined by low height-for-age, suggesting that short stature is not, by itself, a risk factor for diarrhea. Previously defined seasonal patterns of malnutrition for El Salvador as a whole were confirmed and appear to affect some geographic subregions more severely than others. Definition of these regional and seasonal patterns of malnutrition and their association with diarrhea has implications for the targeting and timing of nutrition interventions.

Body Height↗

Nutritional status of preschool children in Togo, 1976-77.

Survey teams visited 163 rural villages and 41 urban quarters in Togo and collected data on weight, height, arm circumference, age, and pedal oedema from 6120 children aged 6-72 months. Haemoglobin levels were determined for one-fifth of the survey children. When 80% of the reference median weight-for-height was used as the cut-off point, the prevalence of acute undernutrition was 2.0%. When 90% of the reference median height-for-age was used as the cut-off point, the prevalence of chronic undernutrition was 19.1%. The prevalence of both types of undernutrition was significantly higher in the northern rural regions, with the lowest prevalence in the urban areas. The prevalence of anaemia was 58.6%, with the highest prevalence in the northern regions. Anthropometric data on socioeconomically privileged preschool children were collected and compared with those for the survey children and the reference population. The socioeconomically privileged preschool group of Togolese children had a nutritional status substantially better than that of the survey children and nearly equivalent to that of the American reference population. The survey method was economical in terms of money, time, and personnel. The methodology employed rapidly provided objective data on the extent and distribution of protein-energy undernutrition and anaemia in the preschool children of Togo.

Anemia↗

Fetal risk associated with rubella vaccine: an update.

One hundred nineteen women susceptible to rubella received RA27/3 vaccine, 94 received either Cendehill or HPV-77 vaccine, and one received a vaccine of unknown strain in the three months before or after their estimated date of conception. They gave birth to 216 living infants free of abnormalities compatible with the congenital rubella syndrome (CRS). The maximum theoretical risk for CRS for these infants was 1.7%. Four of these infants born to susceptible women had laboratory evidence of subclinical infection (three after receiving Cendehill or HPV-77 vaccines and one after receiving RA27/3 vaccine) but were normal at birth and at subsequent follow-up examinations. Rubella virus was isolated from the products of conception for only 3% (1 of 32) of cases involving susceptible women who received RA27/3 vaccine; the reported rate of virus isolation for Cendehill and HPV-77 vaccine is 20%. The available data indicate that if vaccination occurs within three months of conception, the risk is negligible. However, since the actual risk may not be zero, women known to be pregnant should not be vaccinated, and conception should be avoided for three months after vaccination.

Abortion, Induced↗

Streptococcal abscesses following diphtheria-tetanus toxoid-pertussis vaccination.

Abscesses developed in seven children who received diphtheria-tetanus toxoid-pertussis vaccine at a clinic in Indiana. Epidemiologic investigation revealed that all seven children had received vaccine from the same multidose vial and had been vaccinated by the same nurse at the office of one physician. Group A beta-hemolytic Streptococcus was isolated from abscesses in six of the seven children. No source was identified as the cause of this cluster of abscesses. Vaccine of the same lot number used elsewhere was not associated with the development of abscesses. It appears that the vaccine became contaminated during use.

Abscess↗

[Tuberculosis surveys in Guerrero and new estimates of the magnitude of tuberculosis infection in Mexico].

Tuberculosis infection surveys are carried out by tuberculin skin test (Mantoux) which is a simple, cheap, valid and reliable procedure for the estimation of prevalence and incidence rates. In 1987 a survey was undertaken in children of 6-7 years old who attended the elementary school and who were not vaccinated (BCG) in the region of Iguala, México. Out of 6,095 children of such age group, just 531 were not vaccinated, thus the prevalence figure was 2.5% (CL05 = 0.1%, 5.3%). On the basis of the findings by Izaguirre et al, 26 years ago, who reported that about 10% of the children of this age group were infected, it can be estimated that the annual risk of infection is about three newly infected each year per 1,000 population. It is necessary to provide better estimates of the whole tuberculosis incidence rate.

Adolescent↗