Practices in child growth monitoring in the countries of the Eastern Mediterranean Region.

Growth reference charts are among the most sensitive and valuable tools for assessing the health and development of children. A questionnaire survey was answered by 16 of the 21 ministries of health in the Eastern Mediterranean Region countries (EMR) about their use of growth charts for children under 5 years. Most of the countries (13/16) used the NCHS/WHO charts and weight-for-age was the most commonly used. Charts for height-for-age and head circumference-for-age were less commonly used. Problems in the use of charts were identified. The introduction of the new WHO Child Growth Standards, based on exclusively breastfed babies, is a unique opportunity to support growth monitoring and optimal feeding practices in EMR.

Evaluation of tissue ascorbic acid status in different hormonal states of female rat.

The distribution pattern of ascorbic acid in the endocrine organs and/or tissues was investigated during various sexual states of female rats to demonstrate a correlation between ascorbic acid concentration and sex hormone activity. The concentration of ascorbic acid was estimated in the plasma, liver, pancreas, thyroid, ovary, adrenal and pituitary of contraceptive steroid treated, bilaterally ovariectomized, sham-operated and normal control animals at four different phases of estrous cycle to delineate a relationship between the level of ascorbic acid in different organs/tissues at various sex hormonal states. Statistically significant changes were observed in the concentration of ascorbic acid in different endocrine organs/tissues following contraceptive steroid treatment, ovariectomy and during the estrous phases. Our results suggest that the concentration of ascorbic acid in the endocrine organs and/or tissues varies during different sexual states of rat.

Iron deficiency anaemia--an old enemy.

Anaemia has remained a widespread public health problem in countries of the Eastern Mediterranean Region. Prevalence figures vary from a low of 17% to a high of over 70% among preschool children; from 14% to 42% among adolescents and from 11% to over 40% among women of childbearing age. Although the prevalence of anaemia has often been used as a proxy indicator for iron deficiency anaemia, this approach is not valid in settings where the etiology of anaemia is complex or unknown or where other micronutrient deficiencies of folate, vitamin B12 and vitamin A can co-exist. An integrated, multifactorial and multisectoral approach has to be adopted comprising targeted interventions to provide iron supplements to especially vulnerable segments of the population, in particular pregnant women; food-based approaches to increase iron intake through food fortification and dietary diversification; and other measures combined with iron interventions where other causes of anaemia are prevalent.

Caring for the elderly: a report on the status of care for the elderly in the Eastern Mediterranean Region.

To update our understanding of the status of elderly health care within the context of the Eastern Mediterranean Regional Office's Strategy Paper on Elderly Care (1995), a short questionnaire was sent to all Member States of the Region, except Afghanistan and Somalia. The questionnaire sought information on the proportion of the elderly in the population, the status of health care and the level of economic, social, cultural and physical assistance available to the elderly. Of the 21 countries in the survey, 18 (86%) responded. The findings of the survey are discussed here under the headings of demography, national policies on elderly care, social benefits, health care, social and community services, economic burden and the role of the non-government sector.

Nutrition in humanitarian crises.

It is anticipated that humanitarian crisis situations will continue to occur in countries of the Eastern Mediterranean Region affecting large segments of vulnerable populations. Subsequently the magnitude and effectiveness of the humanitarian response, particularly for food and nutrition, must be based on best practices and sound information of affected populations. To bridge the burgeoning gap between the food and nutrition needs of affected populations and the available resources, four key areas need to be addressed by the humanitarian agencies: adequate knowledge and skills in public health nutrition; effective coordination between humanitarian organizations when conducting nutritional assessments and interventions; efficient and appropriate delivery of services; communication, awareness and advocacy. This paper discusses approaches to how these may be improved.

Humoral immune response in children with iron-deficiency anaemia.

The humoral immune response (as shown by plasma immunoglobulin concentrations and antibody response to diphtheria and tetanus toxoids) was evaluated in 14 children with iron-deficiency anaemia and in 24 normal controls. Mean concentrations of haemoglobin and serum iron and mean transferrin saturation were significantly lower in children with iron-deficiency anaemia than in controls. Serum immunoglobulin concentrations were within the normal range in both groups. Two weeks after immunisation with diphtheria and tetanus toxoids the concentrations of IgG increased significantly in both groups. Antibody titres in iron-deficient children were similar to those of controls before and after immunisation. The mean T-lymphocyte count was significantly lower in iron-deficient children than that in controls, but the mean B-lymphocyte counts were similar in the two groups. These observations suggest that humoral immunity in children is not affected by iron deficiency and that conventional immunisation programmes would be effective in children with iron-deficiency anaemia.

Conformational preferences of oligopeptides rich in alpha-aminoisobutyric acid. I. Observation of a 3(10)/alpha-helical transition upon sequence permutation.

The solution conformation of peptides rich in the alpha, alpha-dialkylated amino acid Aib has proven to be a subtle problem, not because of helix/coil transitions, but rather because of alpha-helical/3(10)-helical competition. A special series of peptides containing 75% Aib has been synthesized that feature identical amino acid composition but differing sequences; they are sequence permutation isomers. Nuclear magnetic resonance hydrogen-bonding studies reveal that there is a sequence permutation induced transition between the two alternative helical forms within this set. The implications for the design and conformational prediction of helical Aib-rich peptides are discussed.

Epidemic of diarrhea caused by Vibrio cholerae non-O1 that produced heat-stable toxin among Khmers in a camp in Thailand.

An epidemic of a cholera-like disease occurred among Khmers in a camp in Aranyaprathet, Thailand, in May 1990. Of 215 patients with diarrhea, Vibrio cholerae O1 was isolated from 25 (12%) and V. cholerae non-O1 was isolated from 15 (7%). Five of 15 (33%) non-O1 V. cholerae isolates hybridized with two different oligonucleotide probes previously used to detect V. cholerae non-O1 that produces a heat-stable toxin. This is the first description of an epidemic of diarrhea caused by V. cholerae non-O1 that produces heat-stable toxin.