Protein energy malnutrition: current status.
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Biomedical subjects
Publications and source records attributed to N O Bwibo.
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One hundred children comprising of 57 males and 43 females aged between 8 and 24 months entered the study. 46 children had single and 54 children had multiple helminth infections. All children received albendazole 200 mg (10 ml) suspension as a single dose. Albendazole proved very effective and safe in the treatment of single and multiple helminth infections in children under 2 years of age, achieving cure rates of 100% in both Ascaris lumbricoides and Necator americanus respectively, 83% in Trichuris trichiura and 66% in Hymenolepis nana. Treatment of polyparasitism appears to be of benefit in improving nutritional status using haemoglobin concentrations as an index.
Sera of 95 mothers and 129 children from Nairobi, Kenya, collected in 1976, and of 466 adults and 193 children of Embu District, Kenya, collected in 1984 and 1985, were analyzed for the presence of human immunodeficiency virus type 1 (HIV-1) antibodies. Although no HIV-1 seropositivity was demonstrated by western blot analysis in both study groups, 7% of Nairobi mothers and 10% of adult females from Embu District had false positive results by enzyme immunoassay (EIA) compared with less than 1% seroreactivity rates observed in adult males and children. False positive results were not due to simian T lymphotropic virus type III (STLV-IIIAGM)/human T lymphotropic virus type IV (HTLV-IV) seropositivity. Sixty-one percent of the HIV-1 EIA reactive sera could not be explained by cytotoxic activity to lymphocytes bearing the HLA-DR4 or HLA-DQw3 phenotype. We conclude that false positive HIV EIA tests are frequently encountered in East Africa. Seroprevalence rates in rural Africa must be interpreted with caution due to the decreased specificity of HIV EIAs.
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Teenage pregnancies lower average birthweight. In the NBS, teenage mothers had significantly lower average birthweight of 2 920 +/- 553 g compared with 3 133 +/- 533 g among women in the general population. A high rate of LBW on the infants of the teenage mothers was the significant factor in lowering the average birthweight. In both NBS and the PMHS the incidence of LBW 18% and 15% respectively as well as the rate of preterm delivery of 24% and 23% respectively were high. In PMHS although the numbers were small, the incidence of LBW was high (13%) in the 14-year-olds and in the 15-year-olds it was 4.8% which was much lower than that for 17- and 18-year-olds. In a large series in Nigeria the incidence of LBW was 27% in mothers aged less than 15 years, 26% in mothers aged 15-19, 20% in those aged 20-24 and least (18%) in the 25-29 year age group. Many unfavourable socioeconomic circumstances and lack of adequate antenatal supervision contribute to these high rates. Some of the teenage mothers-particularly the very young, below 16 years-are physically immature and are still growing children themselves. Their nutrient intake is shared between their own growth needs and those of their foetuses. In the Nigerian study, administration of folic acid and iron together with antimalarials to pregnant mothers resulted in increased maternal height as well as foetal growth, thus stressing the importance of nutritional care for the teenage mothers.
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This paper reviews clinicopathological and hematological manifestations of sickle cell anemia as seen in Kenyan children in the first decade of life. The information is based on a study of 447 patients. The findings are similar to those that are well documented from America, West Africa, and other parts of Africa. However, local variations and complications such as malnutrition and topical infections that may affect prognosis are high-lighted.
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Children with sickle cell disease in Nairobi come from tribes living in malarial regions of Kenya. The clinical presentation and complications of this disease are described. The symptoms at onset are nonspecific but the typical features that follow are easy to recognize. Cardiac murmurs and persistently enlarged spleen in older children pose diagnostic challenges. Poor appetite and failure to thrive are common; so are school absenteeism due to crises and infection. The use of white blood cell counts to determine the presence of infection during crises is described.
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