Zinc supplementation: effects on the growth and morbidity of undernourished Jamaican children

OBJECTIVE: We investigated whether there was a growth or morbidity response to zinc supplementation. DESIGN: The study was randomized, placebo-controlled, and double-blind. SETTING: Children were recruited at clinics in Kingston, Jamaica, and supplemented at home. SUBJECTS: Children selected were singletons aged 6-24 months, and stunted (< -2.0 s.d. length for age, NCHS references). They were stratified by sex and age and randomly assigned to receive zinc supplement (n = 31) or placebo (n = 30). Four children were excluded because of hospitalization; all others had all measurements. Adequately nourished children (n = 24) were recruited from a well-baby clinic. INTERVENTIONS: The supplement provided 5 mg elemental zinc in a syrup daily for 12 weeks; the placebo comprised the syrup only. MAIN OUTCOME MEASURES: Caretakers were interviewed to obtain social background data, number of clinic visits and hospitalizations. Anthropometric measurements were done on enrolment, and after 6 weeks, 12 weeks and 12 months. Children's health was determined by weekly questionnaire to caretakers of the undernourished groups during the supplementation period. RESULTS: The supplemented and placebo groups were similar on enrolment. The adequately nourished children were from significantly better socio-economic circumstances. Mean initial hair zinc content was 5.5 +/- 4.8 mumol/g (supplemented group) and 6.7 +/1 12.1 mumol/g (placebo) (n.s.). Regression analyses showed that there were no significant effects of supplementation on length, height or head circumference, nor on the incidence of any morbidity symptom. Mean duration of the episodes was significantly shorter for skin rashes in the supplemented group compared with the control group (ANCOVA, P = 0.02), and longer for vomiting (P = 0.02). The incidence of hospitalization was significantly greater in the control group (Fisher's exact test, P = 0.02). CONCLUSIONS: Zinc supplementation reduced the hospitalizations which probably reflect severity of morbidity, but did not improve growth.(Au)

Menkes' kinky hair syndrome

We herein describe a case of Menke's syndrome in a Jamaican infant. The diagnosis was confirmed by low serum copper and ceruloplasmin levels. (AU)

The use of eggs in the assessment of selenium status of a community - abstract

Selenium (Se) deficiency appears to play a part in the development of oedematous malnutrition. It occurs in regions where soil Se availability is low. This is likely in wet, tropical limestone-based regions, such as in much of Jamaica. In high Se regions in Venezuela, Se status of the inhabitants and Se concentrations in the locally produced eggs were high. The present study explored the potential use of egg Se concentrations as a monitor for low Se areas in Jamaica. Six areas were selected, three of which were expected to be low Se areas. Homes were visited and free range hens' eggs, soil samples and hair samples were collected. Se concentrations of the sample were measured. For each area, the mean concentrations in ppm dry weight were: Glengoffe, Haynes, E. St. Thomas, Porus, Mavis Bank, Lluidas Vale; YOLK - 1.3, 2.1, 2.2, 1.8, 1.2, 1.6 respectively Total mean is 1.8; WHITE - 1.5, 3.0, 4.4, 2.4, 1.6, 2.1 Total mean is 2.7; SOIL - 0.7, 0.6, 1.1, 1.8, 0.4, 1.9 respectively Total mean is 1.2; HAIR - 0.5, 0.6, 0.6, 0.8, 0.5, 0.5 respectively Total mean is 0.6. In many of the soil samples, the values found were lower than the accepted normal range. However, in egg and hair samples, they were mostly within the normal (literature) range. There were no very low values. There was a linear correlation between egg white and egg yolk concentrations (n=101, r=0.84, p<0.001) and between egg yolk and soil concentration (n=102, r=0.20, p<0.05). Overall, however, egg Se concentration did not reflect closely either soil or hair Se concentration, and therefore is unlikely to be a useful index of Se status of a community (AU)

Some observations on the biting habits of S. incrustatum and S. Amazonicum complex in the Lethem area, Rupununi district, Guyana, South America

Two species complexes: S. incrustatum and S. amazonicum form the Lethem area, Rupununi district, Guyana have been observed to show simmilar biting habits to African species mainly the damnosum complex but unlike those in the Americas. The observations are significant since it indicated that these potential vectors of onchocerciasis, "River Blindness", have the capacity for optimum trasmission of microfilariae of Onchocerca volvulus in the Rupununi,Guyana (AU)

An evaluation of the use of change in hair root morphology in the assessment of protein-calorie malnutrition

A study was carried out to evaluate the use of changes in hair root morphology in the assessment of protein-calorie malnutrition (PCM) among a group of black West Indian children. The following five hair root characteristics were measured: percentage of anagen (the growing phase), percentage of telogen (the resting phase), percentage of atrophy, diameter of anagen bulbs, and shaft diameter. Significant differences in shaft diameter, percentage of anagen, and percentage of telogen were found only between well-nourished and severely malnourished children. Significant correlation coefficients were obtained between both bulb diameter and percentage of atrophy and muscle circumference. No significant differences in any of the hair root characteristics were obtained between children with nutritional marasmus and those with kwashiorkor. The method was found to be time-consuming; it can be said for differentiating well-nourished children only from those with severe PCM; and it is unsuitable for determining the prevalence of the three degrees of PCM. For these reasons, the method is not the field assessment of protein-calorie malnutrition.(AU)