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PubMed2002

Psychiatric disorders in children with intellectual disability.

We investigated psychiatric disorders in intellectually disabled children; the prevalence rate and types of psychiatric disorders, and the association of psychiatric disorders with sex, residence type, level of disability, and epilepsy were examined. The population comprised 155 intellectually disabled children. Medical information was obtained from case files, which indicated that a psychiatric disorder had previously been diagnosed for 11% of patients. A careful re-examination of the case files revealed a psychiatric disorder for 33%. The criteria of a psychiatric ICD-10 diagnosis were fulfilled by 23%, and a further 10% had an unspecified mental disorder. The most common diagnoses were pervasive developmental disorders and hyperkinetic disorders. The former were less common among children with mild intellectual disability. In conclusion, about one-third of children with intellectual disability have a psychiatric disorder which needs to be taken into account in treatment.

Adolescent↗
PubMed2003

Suicidal ideation and behavior in children's homes.

The aim of this cross-sectional study is to report the self-destructive and suicidal behavior of 98 children and adolescents in child welfare institutions. The children were evaluated using the Child Behavior Checklist (CBCL), the Children's Global Assessment Scale (CGAS) and questionnaires about suicidal and violent behavior, filled in by the child's key worker. Thirty-two per cent of the sample had presented suicidal thoughts, threats or suicide attempts during the previous 6 months. Suicidality was associated with low general functioning level (CGAS<61), self-mutilating behavior and violence. Furthermore, suicidal children had significantly higher CBCL total, externalizing, internalizing, anxious-depressive and aggressive scores. Children with suicide attempts (8% of the sample) had a significantly higher number of different types of traumatic experiences before the placement and higher somatization syndrome scores compared to children with suicidal ideation or non-suicidal children.

Adolescent↗
PubMed1969

Human immunity to the meningococcus. II. Development of natural immunity.

Results of the present study suggest that natural immunity to meningococcal disease is initiated, reinforced, and broadened by intermittent carriage of different strains of meningococci throughout life. In young adults, carriage of meningococci in the nasopharynx is an efficient process of immune sensitization. 92% of carriers of serogroup B, C, or Bo meningococci were found to develop increased titers of serum bactericidal activity to their own meningococcal isolate, and 87% developed bactericidal activity to heterologous strains of pathogenic meningococci. The rise in bactericidal titer occurred within 2 wk of onset of the carrier state, and was accompanied by an increase in titer of specific IgG, IgM, and IgA antibodies to meningococci. In early childhood, when few children have antibodies to pathogenic meningococci, active immunization seems to occur as a result of carriage of atypical, nonpathogenic strains. Immunity to systemic meningococcal infection among infants in the neonatal period is associated with the passive transfer of IgG antibodies from mother to fetus. The antigenic determinants which initiate the immune response to meningococci include the group-specific C polysaccharide, cross-reactive antigens, and type-specific antigens.

Adolescent↗
PubMed2000

Role of health communications in Russia's diphtheria immunization program.

As part of a broader program in health communication assistance, project staff from Basic Support for Institutionalizing Child Survival worked with staff from Russia's oblast (regional) public health agencies to design and implement communication activities supporting local diphtheria immunization efforts. Because aggressive community outreach efforts and strong administrative sanctions had already achieved impressive adult coverage rates for first doses of diphtheria toxoid vaccine, communication interventions emphasized the need for second and third doses. Outcomes were assessed through vaccination coverage data and more qualitative measures. In one project site, the increase in adult coverage (two or more doses) was very modest. In a second site, with a stronger communications component, coverage increased significantly (from 20% to 80%). Although it is not possible to disentangle completely the effects of communications from other aspects of oblast immunization programs, these and other outcome data suggest that health communications can play an important role in Russia's ongoing mass immunization efforts.

Adult↗
PubMed1993

The epidemic of human immunodeficiency virus infection in Romanian children.

Between June 1989 and May 1991, 29,020 subjects were tested for anti-human immunodeficiency virus (HIV) antibodies; 1079 were seropositive. A big discrepancy existed between the high seroprevalence in the group 0-3 yr of age, 11.22%, and that of 0.43% in the adult population. Moreover, only a small percentage of the pediatric cases (4%) resulted from maternal infection. These observations indicate viral spread by horizontal transmission. Blood, blood products, and reusable unsterilized needles and syringes were probably the main route by which HIV spread in the infant population in medical institutions. The initial source of HIV infection in Romania remains to be determined.

Adolescent↗
PubMed1979

The pattern of severe protein-calorie malnutrition in Sudanese children attending a large hospital in The Sudan.

One hundred fifty patients suffering from severe protein-calorie malnutrition, admitted in 1 month to the Pediatric wards of Wad Medani Hospital, Sudan, were classified according to the Wellcome classification. Marasmus was the prevailing type. It was common in the 2nd year of life, while kwashiorkor occurred mainly under the age of 12 months. Anthropometric measurements showed that kwashiorkor was an acute disease while marasmus and marasmic kwashiorkor were more chronic. The triceps skinfold was unexpectedly low in kwashiorkor. Of the simple measurements and ratios used for assessing the nutritional status, the head/chest ratio applied ot children over 1 year was not found to be reliable and the weight for head circumference correlated poorly with deficits in other variables. Non of the major clinical features was found to be pathognomonic of any type of severe protein-calorie malnutrition. Megaloblastic anemia was common.

Age Factors↗
PubMed1980

Double blind study of milk lactose intolerance in a group of rural and urban children.

Two-hundred forty rural and 101 urban children were studied in a double blind fashion to determine their clinical response to three types of milk. Each participant received in three different days, 250 ml of lactose free milk, regular milk, and lactose enriched milk. In the urban girls a control period in which no milk was given was included. In both study groups, lactose free milk was highly significantly better tolerated than the others. However, the frequency of subjects asymptomatic after its ingestion was much lower, particularly in the rural group, to that found previously in a group of adults of high socioeconomic status. It is thought that in the rural children, part of this phenomenon can be explained by intercurrent gastrointestinal infections. There also appears to be a "background" of gastrointestinal symptoms present in the children, which wrongly classifies them as symptomatic to milk ingestion. It is concluded that probably no less than 15% of children have gastrointestinal complaints after the ingestion of 250 ml of regular milk and that lactose hydrolyzed milk is highly significantly better tolerated than the others.

Adolescent↗
PubMed2002

Evaluation of the Quality Assurance Project and BASICS Joint Project in Niger.

OBJECTIVE: The 1998 evaluation sought to assess the Quality Assurance Project (QAP) in Niger since 1993 and the degree of quality assurance institutionalization in the Tahoua Department, and to summarize lessons from introducing the Integrated Management of Childhood Illness (IMCI) guidelines in a quality management (QM) environment. DESIGN: This evaluation collected data from interviews with staff and managers, from focus groups conducted in the communities, and from medical records. The data were then compared with three sources of evaluation criteria. A pre-project assessment provided a baseline across certain impact indicators for tracking progress. Other measures were derived from the objectives and indicators from the QAP/Tahoua project plan, the joint QAP/BASICS (Basic Support for Institutionalizing Child Survival Project) project plan, and from an additional US Agency for International Development (USAID) objective that the joint project be a model for West Africa. SETTING: The evaluation took place in the two departments of Niger in which the joint project was carried out: Tahoua and Dosso. The QA Project launched a pilot program in Niger in 1993 to strengthen newly decentralized regional and district management, and to improve the quality of primary health care in Tahoua. The principal QA Project approach was QM. The BASICS Project became active in Niger in 1995, helping to improve child health services. In 1997, the projects merged in Niger to form the joint QAP/BASICS Project. The Ministry of Public Health (MPH) planned to implement IMCI in 1998, and wished to determine whether QM facilitated the introduction of IMCI. RESULTS: The evaluation team found that QM had been effectively implemented in Tahoua and that there were related improvements in health program indicators. The team also found that the joint project had met most of its objectives and that QM facilitated the introduction of IMCI. A follow-up evaluation 2 years later found continued practice of QM by Nigerien health care providers. CONCLUSION: Several factors contributed to the success of the Tahoua QA program and the joint project: teamwork, focus on patients, clarity of roles through standards, and synergy between the QA Project and the BASICS Project.

Child Health Services↗
PubMed1998

Malnutrition of children in the Democratic People's Republic of North Korea.

Natural disasters have caused extensive damage to crops and to infrastructure in the Democratic People's Republic of North Korea (DPRK). The international community has responded by providing emergency food aid. To improve understanding of the magnitude of food deficiency in the DPRK. The World Food Programme (WFP) conducted a nutritional assessment survey in August 1997. The survey measured the height and weight of a total of 3984 children <7 y of age in 40 government-selected institutions. Additional information was obtained on institutional access to food and on the care, treatment and parental support of a subsample of severely malnourished and nonmalnourished children. The prevalence of acute malnutrition (wasting), based on weight-for-height Z-score < -2, varied from 0 to 32.7% among institutions, and the prevalence of chronic malnutrition (stunting), based on height-for-age < -2 Z-score varied from 0.6 to 74.1%. The findings from this survey indicate the presence of areas with severe acute or chronic malnutrition in the DPRK.

Body Height↗