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At least 19 recordsLinked to original sources
PubMed1991

Comparison of two growth charts in Lesotho: health workers' ability to understand and use them for action.

BACKGROUND: Two growth monitoring charts widely used for growth monitoring in Africa (the Road-to-Health (RTH) and the Growth Surveillance (GS] were compared in order to assist the Government of Lesotho to decide on an appropriate national growth chart. METHODS: Thirty-four health workers were taught and tested on the RTH during a first week of training and on the GS during a second week (the RTH-GS group), while the order was reversed for another 25 trainees (the GS-RTH group). The health workers were trained and tested on their ability not only to use and interpret the two charts, but also to make the right decisions about specific actions to be taken when growth faltering occurs. RESULTS: There was no difference between scores to the RTH and GS charts after one week of training. After the second week of training, the scores to the RTH chart improved and became better than those to the GS chart. The scores to the GS test did not increase with previous knowledge of the RTH chart. CONCLUSIONS: For this reason and others discussed in the paper, the RTH chart was recommended for nationwide use in Lesotho. The adoption of this recommendation was facilitated by the close involvement in this research of public and private agencies responsible for growth monitoring in Lesotho.

Allied Health Personnel↗
PubMed1989

The changing incidence of cancer of the oesophagus in Lesotho: real or improved diagnostic ability.

Cancer of the oesophagus has previously been reported as an exceedingly rare tumour in the Kingdom of Lesotho. This is in marked contrast to the extremely high incidence in the neighbouring South African homeland, Transkei. During 1984, gastroscopy was used as a diagnostic tool in determining a more accurate estimation of the true incidence of oesophageal cancer in Lesotho, and more specifically in the capital region of Maseru. The results of this study revealed that the incidence of this disease in Lesotho approaches that of the Transkei.

Adult↗
PubMed1990

The effective case management of childhood diarrhoea with oral rehydration therapy in the Kingdom of Lesotho.

In Lesotho prior to 1986, diarrhoea was the leading cause of hospital mortality in children less than 5 years of age. At the Queen Elizabeth II Hospital, diarrhoea-related admissions as a proportion of all admissions in children less than 5 years of age declined from 23% in the year prior to the opening of the Oral Rehydration Therapy Unit (ORTU) to 13% in the first nine months of 1987 (p less than 0.05). In addition, the case-fatality ratio of children treated in the ORTU declined from 1.4% in the first quarter of 1986 to zero in the second and third quarters of 1987 (p less than 0.05). In a case-control study conducted to identify reasons for children failing ORTU treatment, factors associated with an increased risk of hospitalization included male gender (odds ratio [OR] = 4.9; 95% confidence limits [CL] = 2.0, 11.9), fever greater than or equal to 38.5 degrees C (OR = 2.0; CL = 1.2, 3.3), undernutrition (OR = 3.2; CL = 1.1, 9.4), and moderate dehydration (OR = 2.3; CL = 1.2, 4.4) or severe dehydration. (OR = 12.1; CL = 3.8, 38.5). Breastfed children less than 2 years of age were at decreased risk of hospitalization (OR = 0.4; CL = 0.2, 0.7). At this major hospital in Lesotho, the standardization of outpatient treatment for diarrhoea with oral rehydration salts (ORS) in the context of an ORTU resulted in a marked decrease in diarrhoea-associated hospitalization and deaths in children less than 5 years of age.

Case-Control Studies↗
PubMed1992

The mediating effect of maternal nutrition knowledge on the association between maternal schooling and child nutritional status in Lesotho.

The present study tested whether maternal nutrition knowledge was a mediating factor in the association between maternal schooling and child nutritional status, and whether the mechanism involved differed according to socioeconomic status. The data were collected in Lesotho on 921 mother-child pairs and included scores from a nutrition knowledge test, socioeconomic and demographic information, and the child's anthropometric data. A wealth factor derived from a factor analysis was used to stratify the sample into two socioeconomic groups. Two-stage least-squares estimation was used to test the mediating role of nutrition knowledge between maternal schooling and child weight-for-age. Results showed that both the importance of maternal schooling and the mechanism by which it affects the child's weight-for-age are contingent upon the family's socioeconomic status. While maternal schooling was positively associated with weight-for-age for both wealthier and poorer households, the size of the effect was much larger for the latter group. The effect of maternal schooling on weight-for-age was mediated by the mother's nutrition knowledge only among wealthier households. These results imply that, in Lesotho, nutrition education for mothers could contribute to improving children's growth, but only in households that have access to a minimum level of resources. For poorer households, nutrition education would not be sufficient.

Adult↗
PubMed1989

Use of alcohol among high school students in Lesotho.

Data on alcohol consumption, attitudes to and knowledge of alcohol were collected by means of questionnaires from 1133 high school students aged 11-22 years in Lesotho. Additional data were obtained by means of classroom discussion and 13 in depth interviews. About half of the students (54% of the boys and 42% of the girls) had drunk alcohol at some point in their lives. Drinking was found to be related to age, sex, drinking of friends, family income, and drinking in the family. No indication of widespread alcohol abuse was found, but about half of the students (drinkers and non-drinkers) believed that moderate drinking is impossible and that the fun of drinking is to get drunk, indicating the possibility of alcohol abuse in the future. The results have implications for future research and for preventive work among youth and adults in Lesotho.

Adolescent↗
PubMed1990

Anxiety and depression in a village in Lesotho, Africa: a comparison with the United States.

Adults in a village in Lesotho, Africa, were interviewed to determine the community prevalence of major depression, panic disorder, and generalised anxiety disorder. The prevalence data were compared with data from a large epidemiological study in the United States utilising the same research instrument. There was a significantly higher prevalence of all three diagnoses in Lesotho as compared with the United States. As in the United States, women were at an increased risk for these disorders, although statistical significance was not demonstrated for depression. The majority of people (77%) who had experienced panic attacks said they had sought help for their symptoms, with the majority attending Western-trained doctors. The relationship between explanatory models and help-seeking behaviour was explored in people who had had panic attacks. Less than 40% of those with generalised anxiety disorder said they sought help.

Adult↗
PubMed1976

Cross-sectional-type weight reference values for village children under five years in Lesotho.

Cross-sectional-type reference values for weight attained are described for village children under five years in rural Lesotho (formerly Basutoland). Weight measurements derive from observations on 1317 children attending an Under-Fives clinic; it is estimated that 60-70% of the children under five in the catchment area were represented. 4585 weighings on boys and 4826 weighings for girls are included in the analysis. Figures of weight-for-age of boys and girls are given separately as centile distributions suitable for use on Growth Charts. Lesotho 50 centile approximates to 3 centile of British children and slightly exceeds 80% Harvard standard. Weight attained for age is similar, in both sexes, to reports from other less-priviledged urban and rural areas, emphasizing the relative importance of environmental as compared to genetic influences in determining weight-for-age in early childhood. It is suggested that the construction of locally-derived growth reference values is both appropriate and practicable.

Age Factors↗
PubMed1989

Shedding of coronavirus-like particles by children in Lesotho.

Stools from 266 children in four districts of Lesotho were examined for viruses by electron microscopy (EM) over a 5-week period. Eighty one (30.5%) of the children shed coronavirus-like particles (CVLPs). Shedding was not significantly associated with diarrhea. The proportion of children shedding these particles increased with increasing age. In one district, the prevalence of CVLP shedding (67.9%) was at least twice the prevalence in any of the other three districts. This was the only district to be sampled during the first week of the study. It was shown that the proportion of children shedding CVLPs declined during each of the 5 weeks of study. The stools of six children who shed CVLPs in the early summer of 1984-85 were negative by EM 5 months later. There was no association between the shedding of pathogenic bacteria or parasites and the presence or absence of CVLPs in the stool.

Age Factors↗
PubMed1986

Tuberculous peritonitis in Lesotho.

Tuberculous peritonitis, although a common cause of ascites in Africa, previously was rarely diagnosed in Lesotho. We evaluated prospectively 105 consecutive patients admitted with ascites: tuberculosis accounted for 42% of the cases. Clinical differentiation from other causes of ascites proved to be difficult: signs and symptoms commonly associated with this disease were non-specific and often absent. The majority of our patients were elderly, male and alcoholic. Mortality was 26% despite treatment, and was highest among the aged and those who abused alcohol.

Aged↗
PubMed1986

Early postnatal growth of Basotho infants in the Mantsonyane area, Lesotho.

The records of 814 infants born in a rural hospital in Lesotho were analysed. It was calculated that on average Basotho infants regained their birthweight between 3 and 4 days of age and the average weight loss amounted to 3%. Compared with Caucasian infants, Basotho infants regained their birthweight sooner. Of 289 infants in whom the gestational age was assessed, small-for-dates infants showed an increased mean growth rate compared with pre-term and appropriate-for-dates full-term infants.

Birth Weight↗
PubMed1990

The effects on weight and attendance of a supplementary feeding programme operating in two under-5 clinics in Lesotho.

The routinely collected weight data of 2202 pre-school children who visited two under-5 clinics in Lesotho between 1978 and 1983 were used to calculate growth curves and to assess the effects of supplementary feeding. Up to the age of 5 months growth curves were above the NCHS reference. Growth started to decrease at the age of 3 months and stabilized at 11-13 months at the 10th percentile of the reference. The decrease of growth might have been due to environmental factors such as under-nutrition and disease. If this was the case, supplementary feeding might have had a positive impact on weight, but such an effect was not observed in this study. Supplementary feeding had, however, a positive effect on attendance rates and hence contributed to higher coverage of other under-5 clinic activities, such as immunization, health and nutrition education, and growth monitoring. Whether this positive effect warrants its extra cost remains open to question.

Ambulatory Care Facilities↗
PubMed1989

The risk of infection from Giardia lamblia due to drinking water supply, use of water, and latrines among preschool children in rural Lesotho.

Stool samples were collected from 267 rural, preschool children in four districts in Lesotho during October-November, 1984. Sixty-three children (23.6%) were tested positive for Giardia lamblia, the most commonly recovered parasite from stool samples. The use of low amounts of water for personal hygiene was associated significantly with having G. lamblia (OR = 2.42), but the use of traditional, non-improved drinking water sources (OR = 1.38) or lack of latrines (OR = 0.94) was not. Although G. lamblia may be primarily waterborne in developed countries, the amount of water that is used for personal and domestic hygiene may be more important than the quality of drinking water in developing countries. Other risk factors that were identified to be associated significantly with having or not having Giardia were child older than 24 months (OR = 6.79), mother less than 20 years of age (OR = 5.18), residing in Mohales Hoek district (OR = 2.33), and possessing several agricultural tools (OR = 0.70).

Adult↗
PubMed1992

Impact of a clinic-based growth monitoring programme on maternal nutrition knowledge in Lesotho.

An evaluation of the impact of a nationwide clinic-based growth monitoring (GM) programme was done in Lesotho to determine if clinic attendance was associated with improved maternal knowledge of weaning practices and diarrhoea. A total of 907 mothers from eight clinics were included in the study. Our results showed that mothers who had attended the clinics knew more about the appropriate timing for introducing animal protein-rich foods in the child's diet and about the use of oral rehydration salts for diarrhoea, than those who had not. The difference in knowledge between previous clinic attendants and new attendants was particularly marked among mothers with less than secondary schooling and mothers with young babies (less than 6 months). From observation in the clinics, we believe that group nutrition education, although it was not integrated with growth monitoring, was probably responsible for the positive association between clinic attendance and maternal knowledge. Prior clinic attendance was not specifically associated with improved knowledge about feeding during diarrhoea or the need to stop breastfeeding gradually. These need to be better incorporated into present clinic nutrition education. Whether improvements in growth monitoring would further significantly improve nutrition education remains to be seen.

Adult↗
PubMed1992

Growth charts only marginally improved maternal learning from nutrition education and growth monitoring in Lesotho.

A study done in Lesotho in 1985-1986 assessed whether growth charts increased the impact of nutrition education and growth monitoring on maternal learning about weaning practices and diarrhea. Seven hundred and seventy six mothers were given three monthly sessions of group nutrition education along with growth monitoring of children and individual counseling. Growth charts, which were taught to one of two groups, fostered learning but only on issues related to diarrhea and only among new clinic attendants, mothers with less than secondary schooling and mothers of malnourished children. These benefits, however, were small (differences less than 10%) compared with the overall impact of the nutrition education and growth monitoring intervention (increases between baseline and post-intervention were greater than 50% for some questions). Our findings suggest that well-designed clinic-based nutrition education and growth monitoring can have a significant impact on maternal nutrition knowledge. Teaching growth charts to mothers may not be necessary for obtaining such results in programs conducted under ideal conditions. More research is needed to determine under what circumstances, for what purposes and for whom growth charts may be beneficial.

Audiovisual Aids↗
PubMed1992

The complementary effect of latrines and increased water usage on the growth of infants in rural Lesotho.

The effects of water quantity and sanitation, alone and in combination with each other, on infant weight gain and length gain were examined. Data on 119 infants were collected from 20 villages in rural Lesotho between July 1984 and January 1985. The interactions between sanitation and increased water usage for weight gain (p = 0.007) and length gain (p = 0.006) were significant after potential confounding was controlled. The biggest growth effects were dependent on families possessing a latrine and increasing their use of water during the warm, wet season. Infants gained 1.031 kg (95% confidence interval (CI) 0.420 to 1.642) and 2.028 cm (95% CI 0.523 to 3.533) more when both positive factors were present, as compared with only having a latrine. Increasing water usage compared with not increasing water usage resulted in only 0.105 kg (95% CI -0.175 to 0.385) more weight gain and -0.309 cm (95% CI -1.005 to 0.387) more length in the absence of a latrine. Similarly, infants gained 1.106 kg (95% CI 0.484 to 1.728) and 2.076 cm (95% CI 0.559 to 3.593) more if both factors were operating than did infants whose families only increased their water usage. In the nonincreased water group, the difference in growth between having and not having a latrine was 0.180 kg (95% CI -0.093 to 0.453) and -0.261 cm (95% CI -0.951 to 0.429). Water supply programs should emphasize use of more water for personal hygiene, and sanitation programs should install toilet facilities where water usage is high or has been increased because of an educational program.

Bias↗
PubMed1989

Use of alcohol among high school students in Lesotho--a health promotion perspective.

A recently published article on alcohol use among young people in Lesotho highlighted an important public health issue--the changing pattern of alcohol consumption in many Third World countries. In this commentary I wish to consider some of the factors which might be contributing to this growing problem and some of the steps that need to be taken to address this issue. In particular I will focus on the role of the alcohol industry and the tactics used to create and develop new markets.

Adolescent↗