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1.
Port of Spain; Caribbean Epidemiology Centre; 1993. 29-30 p. tab.(CAREC surveillance report, 1993).
Monografia em Inglês | MedCarib | ID: med-16495
2.
Am J Clin Nutr ; 56(3): 504-10, Sept., 1992.
Artigo em Inglês | MedCarib | ID: med-13081

RESUMO

Children aged 9-24 months were recruited by a survey of poor areas of Kinston, Jamaica. Stunted children were randomly assigned to supplementation or not. Weekly morbidity histories were taken for 2 y. Separate multiple regressions on each symptom for weight or length gain in 2-mo intervals showed significant reductions in weight gain with coughing, apathy, anorexia, diarrhea, and fever, ranging from -2.1 to -16.8g/d ill. Apathy and diarrhea reduced gins in length (-0.26 and -0.20 mm/d ill). Significant reductions in linear growth with lower respiratory-tract infections (-0.16 mm/d ill) occurred only in nonsupplemented children. Growth over 4-mo intervals was reduced if diarrhea occurred in the first 2 mo of the interval but there were no long-term effects of apathy, fever, or anorexia. Some of the effects of morbidity on growth were therefore transient and morbidity on growth were therefore transient and morbidity is unlikely to be a major cause of growth retardation in this population.(AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Crescimento , Transtornos do Crescimento/dietoterapia , Morbidade , Peso Corporal , Depressão/complicações , Diarreia Infantil/complicações , Transtornos do Crescimento/etiologia , Jamaica , Distribuição Aleatória , Vômito/complicações
3.
West Indian med. j ; 39(4): 205-11, Dec. 1990.
Artigo em Inglês | MedCarib | ID: med-14272

RESUMO

To determine the epidemiology and risk factors of rotavirus in St. Lucia, 229 children in three valleys with varying levels of sanitation were studied for 2 years. A four-fold rise in complement fixation antibody to rotavirus antigen was used in paired samples as evidence of recent infection. Results showed that forty-eight per cent of infants experienced at least one infection during a two-year period, and 17 percent of children were reinfected. Infections occured within the first months of life and peaked between 6 and 23 months of age. The peak infection coincided with the dry season in each age group. Children breast-feeding had fewer infections. Although crowding within the home was significantly associated with repeated infection, the incidence of infection was not affected by the degree of sanitation. Other studies in the region, using recently developed techniques, concur with these findings which advance our understanding of the epidemiological importance of rotavirus in St. Lucia. Although these studies provide insights into the risk factors for rotavirus infections, other studies are required to determine whether investments should be focused on improved sanitation or immunization or both (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Diarreia Infantil/epidemiologia , Diarreia Infantil/transmissão , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/transmissão , Gastroenterite , Saneamento , Fatores de Risco , Fatores Socioeconômicos , Aleitamento Materno , Clima , Santa Lúcia
4.
Soc Sci Med ; 31(4): 455-60, 1990.
Artigo em Inglês | MedCarib | ID: med-12557

RESUMO

Calls for household surveys to provide information on service utilization in less developed countries raise questions regarding the accuracy and reliability of reporting. This paper compares reported to recorded health service utilization for diarrhoea and any other morbidity over a 2-week and 3-month period for information obtained from a household survey in Grenada, West Indies. A sensitivity analysis is used to derive minimum and maximum estimates of the accuracy of reported utilization. Over-reporting utilization was found to be between 33 and 62 percent for diarrhoea and 49 and 81 percent for any other morbidity. Under-reporting of all utilization was estimated to be between 47 and 65 percent. These results cast doubt on the utility of household surveys as a reliable source of information regarding service utilization. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Países em Desenvolvimento , Serviços de Saúde/estatística & dados numéricos , Diarreia Infantil/epidemiologia , Diarreia Infantil/terapia , Serviços de Saúde , Inquéritos Epidemiológicos , Aceitação pelo Paciente de Cuidados de Saúde , Sensibilidade e Especificidade , Granada
5.
Carib Med J ; 51(1-4): 9-12, 1990. tab
Artigo em Inglês | MedCarib | ID: med-4459

RESUMO

The case records of 1295 children admitted to the Gastroenteritis Unit, Port-of-Spain General Hospital were reviewed. Data on age, mode of referral, pre-admission treatment, in hospital management and outcome were analysed. Of the 192 cases referred, 169 were referred by general practitioners, 18 by health centres and 3 by paediatricians. The bulk of admissions (1165) were however, self-referrals. 82 (46 percent) of the cases referred by general practitioners had documented evidence of pre-admission treatment. Only 7 (8.5 percent) received the recommended treatment with rehydration salts. The rest (91.5 percent) were treated with antidiarrheals, antibiotics or antiemetics. Lack of effectiveness of drug therapy, use of ORF (oral rehydration fluid) and health education are emphasized. (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Diarreia Infantil , Hospitais Gerais , Trinidad e Tobago
6.
Acta Paediatr Scand ; 76(3): 474-7, May 1987.
Artigo em Inglês | MedCarib | ID: med-15865

RESUMO

During a 5-month period, 513 stool samples submitted to the enteric laboratory at the University Hospital of the West Indies were examined for Cryptosporidium. Oocysts were detected in 4.9 percent of all stools, 7.3 percent of diarrhoeal stools, 19.5 percent of stools from malnourished children and 23.7 percent of stools from malnourished children with diarrhoea. Cryptosporidium was the sole pathogen detected in all 25 positive stools, and was the second most frequent enteric isolate. All cases of cryptosporidiosis occurred in children less than 2.5 years of age. All 15 malnourished children were admitted to hospital where they presented with dehydration (87 percent), vomiting (93 percent), fever (100 percent) and diarrhoea which lasted an average of 15.3 days. Two of these children died. In contrast, dehydration (20 percent), vomiting (40 percent) and fever (50 percent) were less common and diarrhoea less protracted in well-nourished children, four of whom were admitted to hospital. This preliminary report suggests that cryptosporidial gastroenteritis presents with increased frequency and severity in malnourished compared with well-nourished Jamaican children.(AU)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Masculino , Feminino , Criptosporidiose/etiologia , Países em Desenvolvimento , Distúrbios Nutricionais/complicações , Criptosporidiose/epidemiologia , Diarreia Infantil/microbiologia , Fezes/microbiologia , Nutrição do Lactente , Jamaica , Prognóstico
7.
West Indian med. j ; 34(suppl): 48, 1985.
Artigo em Inglês | MedCarib | ID: med-6669

RESUMO

Overgrowth of the small intestine with bacteria has been implicated in the chronic diarrhoea associated with severe malnutrition. The hydrogen breath test has been introduced as a simple non-invasive technique to assess bacterial fermentation in the bowel. An increase in breath hydrogen in excess of 20 ppm within 60 minutes of the oral presentation of substrate is taken as evidence of small bowel overgrowth (SBO). The hydrogen breath test was used in 30 children admitted with severe protein energy malnutrition. Of the 19 children tested on admission and at intervals during recovery, 5 were positive on admission and a further 3 became positive at varying times after admission. Of these 8 with positive results, 5 were treated with metronidazole and all were negative on subsequent testing. Of the 3 children who were not treated one improved, but 2 had persistently positive breath hydrogen. Eleven (11) children had breath hydrogen measured at some time during recovery. In 6 the test was positive; all received metronidazole and became negative. In 2 children who had received metronidazole and were negative, the test became positive at a later date. Three children had a positive test with lactose specifically, one was treated with metronidazole and became negative. Therefore, of 30 children studied, 14 had a positive test at some time, which became negative in the 11 treated with metronidazole. We conclude that small bowel overgrowth as measured by the breath hydrogen test is a frequent accompaniment of severe malnutrition and responds to treatment with metronidazole (AU)


Assuntos
Humanos , Criança , Testes Respiratórios , Hidrogênio/diagnóstico , Intestino Delgado/microbiologia , Diarreia Infantil/etiologia , Metronidazol/administração & dosagem
8.
Les Colloques de l'INSERIM ; 121: 53-60, 1984. tab, gra
Artigo em Francês | MedCarib | ID: med-3622

RESUMO

The cancerous role of frequent infections, particularly intestinal ones, on the growth of the child, has already been noted by several authors. Therefore, with acute diarrhea, the convergence of factors as varied as anorexia, accrued loss of nutrients, or familiar dietary habits all alter the nutritional state of the child. On the other hand, it seems that the part played by each one of these factors varies according to the type of diarrhea. Therefore, it has been suggested that with acute rotavirus diarrhea, refusal of food was responsible for the reduction of food consumption, rather than dietary "taboos", and children who were breastfed had a higher energy consumption level then those who were not breastfed. Therefore, the objective of this work is to study the relations between energy consumption in Jamaican preschoolers and the presence of rotavirus diarrhea.(AU)


Assuntos
Humanos , Pré-Escolar , Diarreia Infantil , Infecções por Rotavirus , Transtornos da Nutrição Infantil , Jamaica , Anorexia/diagnóstico
11.
Lancet ; 1(8220): 600-1, Mar. 14, 1981.
Artigo em Inglês | MedCarib | ID: med-12602

RESUMO

Oral rehydration with sucrose-electrolyte solutions is now established as a safe and effective way to treat dehydrated children in hospital. In Jamaica, oral rehydration with World Health Organization approved packets of glucose-electrolyte salts supplied by the United Nations International Children's Emergency Fund has been successfully introduced in the main children's hospitals in Kingston. However, because of the difficulty of supplying packets to scattered urban and rural community clinics, mothers are advised by health personnel as well as on radio and television programmes to prepare various homemade sugar-salt solutions to treat children with diarrhoea at home. The composition of solutions prepared by mothers varies dangerously. To reduce errors, a double ended spoon has been designed to help mothers to make up solutions more accurately. The value of the spoon has been established under the most favourable conditions. To obtain the maximum rate of absorption of water and electrolytes in dehydrated children, the oral solution should approximate closely to the WHO recommended solution which contains glucose 110 mmol/l (sucrose 210 mmol/l), sodium 90mmol/l, potassium 20 mmol/l, chloride ions 80 mmol/l, and bicarbonate 30 mmol/l. We compared the composition of salt-sugar solutions prepared by Jamaican mothers according to current health education and those prepared by means of the double-ended spoon. (AU)


Assuntos
Humanos , Lactente , Hidratação , Eletrólitos/administração & dosagem , Diarreia Infantil/tratamento farmacológico , Glucose/administração & dosagem , Desidratação/tratamento farmacológico , Educação em Saúde , Assistência Domiciliar , Soluções , Jamaica
12.
Trans R Soc Trop Med Hyg ; 75(4): 507-13, 1981.
Artigo em Inglês | MedCarib | ID: med-14736

RESUMO

About 75 babies in each of three valleys were followed up for two years. The valleys had different levels of water supply and latrine facilities, whereas socio-economic conditions and feeding patterns were similar. Results show that the prevalence of diarrhoea and intestinal helmints reduced as sanitation improved. Ascaris and Tricuris infections dropped 30 and 50 percent respectively after water supplies and latrines were installed. The growth of children was significantly better in the improved areas. The possibility of malnutrition being secondary to illness, rather than primary, is included in the discussion (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Toaletes , Abastecimento de Água , Ascaríase/epidemiologia , Estatura , Peso Corporal , Diarreia Infantil/epidemiologia , Diarreia Infantil/etiologia , Helmintíase/etiologia , Enteropatias Parasitárias/etiologia , Distúrbios Nutricionais/etiologia , Saúde da População Rural , Tricuríase/epidemiologia , Santa Lúcia
14.
West Indian med. j ; 29(4): 213, 1980.
Artigo em Inglês | MedCarib | ID: med-7141

RESUMO

The indications and pathophysiological principles underlying the use of glucose electrolyte solutions for treating diarrhoea with dehydration are well understood. The exact composition for the Caribbean is disputed, because the WHO recommended solution which contains 90mmols/L of sodium was developed for cholera and may produce hypernatremia. To establish the value of this solution in Jamaican children, we studied 84 cases of diarrhoea in children aged 5 to 18 months attending Bustamante Children's Hospital, Kingston. The children were assessed clinically and body weight, blood samples, urine and stool samples were studied at 0, 6 and 24 hours. Treatment was with oral rehydration solution given at a rate of 200 mls per hour. Cases were divided at random into two groups, one given a solution containing 90 mmols Na, the other, 60 mmols of Na. In both groups, clinical and biochemical indices improved rapidly, weight increased, serum specific gravity fell and bicarbonates rose. In the high sodium group, 5 cases developed hypernatremia at 6 hours and persistence of hyponatremia was seen in a few cases in the low sodium group. In a second study, 25 children were given standard GE solution, but the potassium was increased from 20 to 35 mmols/1 and the cases divided randomly into high and normal potassium groups. The GEsol was given as 2 volumes of solution to 1 of water. In this study the high potassium group showed no cases of hypokalemia whereas 19 - 33 percent of the low potassium group had this problem at 24 hours. It was concluded that the standard oral rehydration fluid containing 90 mmols/1 of sodium, given as 2 volumes of water to 1 of water is safe and effective in the cases seen in Jamaica and that a higher potassium concentration of 35mmols/1 would be more effective in correcting hypokalaemia than the present 20 mmol/1 solution. This regime is now standard practise in both Bustamante Children's Hospital and at the University Hospital of the West Indies and has led to dramatic reductions in hospitalization rates, use of drip sets and of intravenous therapy (AU)


Assuntos
Humanos , Lactente , Hidratação , Diarreia Infantil/terapia , Jamaica
15.
Lancet ; 2(8093): 764-7, Oct 7 1978.
Artigo em Inglês | MedCarib | ID: med-14435

RESUMO

The cow is a ruminant, and cow's milk has evolved to promote bacterial growth in the upper small bowel; whereas human milk has evolved to discourage bacterial growth. Examinations of the constituents of the two milks shows that their differences can be accounted for in terms of this difference in function. Children who are fed a calf's diet tend to develop a rumen. This may lead to chronic diarrhoea and malnutrition and may be a factor in diarrhoea ascribed to cow's-milk-protein allergy and lactose intolerance (Summary)


Assuntos
Humanos , Lactente , 21003 , Feminino , Toxinas Bacterianas/efeitos adversos , Nutrição do Lactente , Intestino Delgado/microbiologia , /efeitos adversos , Leite Humano/fisiologia , Bovinos , Diarreia Infantil/etiologia , Hipersensibilidade Alimentar/etiologia , Transtornos da Nutrição do Lactente/etiologia , Intolerância à Lactose/etiologia , /análise , /fisiologia , Leite Humano/análise , Rúmen , Desmame
17.
In. Cruickshank, Robert; Standard, Kenneth L; Russell, Hugh B. L. Epidemiology and community health in warm climate countries. Edinburgh, Churchill Livingstone, 1976. p.38-49.
Monografia em Inglês | MedCarib | ID: med-10177
18.
Am J Clin Nutr ; 25: 564-71, June 1972.
Artigo em Inglês | MedCarib | ID: med-12101

RESUMO

Quantitative aerobic and anaerobic bacteriological studies of the upper and lower jejunum were performed in six malnourished children without diarrhea and in a group of five malnourished children with weanling diarrhea. A third group of children was tested after prolonged treatment in the hospital. All three groups of children had small numbers of mixed aerobic and anaerobic bacteria in the upper and lower intestine; only four children had a total bacterial count above 10[4]/g, and there was no correlation between the numbers or type of organinsms and the nutritional state of the child. Jejunal perfusion studies showed that the children with weanling diarrhea had a marked jejunal accumulation of fluid, i.e., net secretion, similar to that seen in cholera. Malnourished or treated children without diarrhea did not show this abnormality. Glucose promoted water absorption even in children with gastroenteritis who had reduced glucose absorption rates. No enterotoxin-producing organisms were isolated to account for these functional changes. Treating cases of weanling diarrhea with low concentrations of oral glucose should promote positive water and electrolyte balance, but this effect will be limited by the degree of glucose malabsorption in the individual child. (Summary)


Assuntos
Diarreia Infantil/microbiologia , Transtornos da Nutrição do Lactente/microbiologia , Jejuno/microbiologia , Aerobiose , Anaerobiose , Diarreia Infantil/tratamento farmacológico , Diarreia Infantil/etiologia , Diarreia Infantil/fisiopatologia , Gastroenterite/microbiologia , Glucose/metabolismo , Glucose/uso terapêutico , Transtornos da Nutrição do Lactente/complicações , Transtornos da Nutrição do Lactente/fisiopatologia , Transtornos da Nutrição do Lactente/terapia , Absorção Intestinal , Intubação Gastrointestinal , Jamaica , Jejuno/fisiopatologia , Jejuno/metabolismo , Síndromes de Malabsorção/complicações , Perfusão , Desmame , Sódio/metabolismo
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