Infant feeding practices and the decline of breast feeding in Saudi Arabia.

PIP: Socioeconomic change in Saudi Arabia over the last two to three decades has introduced many foreign ideas into the country, many of which have influenced the Saudi people and changed long-established habits. The present level of breast feeding remains much higher in Saudi Arabia than in some other developing countries, but there is nonetheless a trend toward bottle feeding both in urban and rural areas. The increasing tendency to feed by bottle, especially among illiterate mothers and under bad hygienic conditions, must be stopped. Most of these mothers can successfully breastfeed their babies. A lack of breast milk and pregnancy have been stated as the reasons for giving artificial feeds by the majority of mothers in most studies from Saudi Arabia, although high purchasing capacity, easy availability, excessive advertisements, and acceptance of the promotion of artificial feeds may also be reasons for the increasing tendency to bottle feed. Widespread ignorance of modern research on breast feeding by the medical profession and nurses also drives many health personnel to either encourage or ignore the trend. The use of raw milk for infant feeding is a common practice in certain areas where brucellosis is endemic. Poor supplementation with solid food is a common problem in developing countries and is a major cause of malnutrition, since supplementation hastens the discontinuation of breast feeding. Supplementation and the allowance of fluids other than breast milk must be discouraged from the beginning.^ieng

Factors associated with growth faltering in children from rural Saudi Arabia.

Recent studies on the growth of children in Saudi Arabia have revealed that children under two years of age suffer from faltering growth when compared with the American reference population. The present study aims to identify parental and child characteristics associated with faltering growth among the children in a rural area of Saudi Arabia. A cross-sectional study of all women with a child less than three years of age in a rural community in NorthWestern part of Saudi Arabia was undertaken. Anthropometric measurements, socio-demographic and fertility variables were collected using a structured questionnaire. The indicators of growth were derived from the data and univariate and logistic models fitted to determine potential risk factors. There were 332 children, sex ratio 1.35 and 94.3% were less than 2 years of age. A low frequency (1.5%) had low weight for height, 11.4% low weight for age and 36.1% low height for age when compared with the American NCHS reference population. Multiple logistic regression suggested birth space > 2 years (OR = 0.44, 95% CI = 0.25 - 0.77), father's with primary or intermediate education (OR = 0.45, 95% CI = 0.25-0.90), birth weight > 2500 gms. (OR = 0.8, 95% CI = 0.03-0.75), male birth (OR = 2.60, 95%. CI = 1.54-4.59) were variables statistically and independently associated with faltering growth. The pattern of growth of children under 2 years deviated negatively from their NCHS-WHO reference. This is similar to the previous findings from urban communities in Saudi Arabia. This growth faltering could be attributed partly to the inadequacy of the reference to compare growth pattern of children in all geographical areas, of the world. While the effects of different dietary habits may not be ruled out, it may be important to develop a different anthropometrics and nutrients growth chart that could be more appropriate to compare variation of infant growth in all nations of the world.

The effect of sociodemographic variables on child-spacing in rural Saudi Arabia.

Adequate child-spacing is considered a positive factor in the health of mothers and their children. A house-to-house survey of 332 women in Al-Oyaynah village, Saudi Arabia was carried out in April and May of 1995 to determine the existing practice of child-spacing and factors influencing it. The variables examined included age of the mother, age at marriage, education, income, parity, type of infant-feeding and birth order. The age of the mother, age at marriage and education were significantly associated with the length of the birth interval. The current age of mother and her parity were found to be the only significant predictor variables of birth interval.

Relapse among substance-abuse patients in Riyadh, Saudi Arabia.

Substance abuse is a recently acknowledged problem in Saudi Arabia. Sociodemographic correlates of substance abuse and relapse rates of a sample of inpatients at Al-Amal Hospital in Riyadh in 1998 were studied. The mean age of patients was 29.5 years with a mean duration of abuse of 9.5 years. Age, unemployment, peer pressure and family and social stresses were factors that showed statistically significant associations with repeat admissions. The most significant predictors of a patient's relapse were unemployment and social stresses. More nation-wide studies are needed to document factors leading to the initiation and continuation of substance abuse and to help treatment and rehabilitative measures.

Influence of mothers' characteristics on their perceptions and use of the growth chart.

Although growth charts are recommended for monitoring children, recent reports indicate poor use by mothers. We investigated maternal knowledge and perceptions of growth charts and identified characteristics affecting use. At outpatient paediatric clinics of a Riyadh hospital, 305 mothers with children under age 5 were interviewed by questionnaire during May-June 2001. Overall awareness of growth charts was 35.8% and ever-use was 8.6%. Education, parity and number of living children were significantly associated with knowledge. Among mothers who ever used growth charts (8.7%), only 10% reported doctors recommended changes in health care because of them. Overall, 71% wanted to monitor their child's growth, but 20% did not know how. Increased health education in all health care delivery systems is needed.

Primary health care physicians' views on periodic health evaluation in Saudi Arabia.

The attitude and beliefs of primary health care physicians regarding periodic health evaluation is critical to determining the most effective and acceptable means for delivering recommended clinical preventive services. We aimed to evaluate the views of primary health care physicians in Saudi Arabia on periodic health evaluation. A self-administered and pre-tested questionnaire was sent to 1235 physicians randomly selected throughout the country. About 90% of the physicians would recommend periodic health evaluations to all or some clients while 10% would not. Almost all (95%) of the physicians were aware of the benefits and costs of periodic health examinations, and were willing to carry it out. Their enthusiasm for performing many items during examinations should be encouraged.

Infant mortality in the rural Riyadh region of Saudi Arabia.

A prospective study of a cohort of infants born in 1987 was carried out until they were one year old. Five villages were selected at random. All the babies born in 1987 in these villages were identified by a group of trained nurses. These nurses collected morbidity and mortality data on these children each time the events occurred using a structured data collection form. Data were analysed using relevant demographic and statistical techniques. A total of 4,963 babies was born during the period of study. The neonatal mortality rate was 21.4 per 1,000 live births and the infant mortality rate was 53.8 per 1,000. The postneonatal death rate was 32.5 per 1,000 live births. The causes of infant deaths as presumed from reported signs of last illness were gastroenteritis, respiratory problems, preterm birth complications and congenital abnormalities. It was concluded that there is a decline in the infant mortality rate compared with previous estimated rates, but the high levels of neonatal death rates call for improved antenatal and obstetric health services. The high postneonatal death rate indicates the potential for a further reduction.

PIP: Recent national studies in Saudi Arabia estimated the rate of infant mortality to be 52 infant deaths per 1000 live births in 1985 and 30/1000 in 1989. All 4963 babies born during 1987 in five randomly selected villages were followed for 1 year by a group of trained nurses who collected morbidity and mortality data on the children each time the events occurred using a structured data collection form. Data were then analyzed by cross-tabulating the data on the last illness with the age and sex distribution of infant deaths. The neonatal mortality rate was 21.4 per 1000 live births, the infant mortality rate was 53.8/1000, and the post-neonatal death rate was 32.5/1000. Causes of infant death as presumed from reported signs of last illness were gastroenteritis, respiratory problems, preterm birth complications, and congenital abnormalities. Improved antenatal and obstetric health services are needed to reduce the rates of infant and neonatal mortality.

Infant mortality in rural Riyadh region of Saudi Arabia.

OBJECTIVE: The purpose of this study was to estimate the level of infant mortality in the rural area of Saudi Arabia central region. SETTING: Rural villages in the Riyadh area. DESIGN: A prospective study of a cohort of infants born in 1987 until they were one year old. METHODS: Five random villages were selected by simple random method. All the babies born in these villages were identified by a group of trained nurses. These nurses collected morbidity and mortality data on these children each time the events occurred using a structured data collection form. Data were analyzed using relevant demographic and statistical techniques. RESULTS: A total of 4,960 babies were born during the period of study. The neonatal mortality rate was 21.4 per 1000 live births and infant mortality rate was 53.8 per 1000. The post neonatal death rate was 32.5 per 1000 live births. The causes of infant deaths as presumed from reported signs of last illness were gastroenteritis, respiratory problems, preterm birth complications and congenital abnormalities. CONCLUSION: There is a decline in infant mortality rate compared with previous estimated rates. But the high levels of neonatal death rates calls for improved antenatal and obstetric health services. The high post neonatal death rate indicates the potential for a further reduction.

Accidental poisoning with household detergents.

UNLABELLED: Caustic substances and home detergent poisoning remain a threat to the health of young children. The aim of the present work was to estimate the occurrence of household poisoning due to detergents and to study some demographic and behavioral correlates. MATERIAL AND METHODS: Through systematic random sampling technique one tenth of all women attending pediatric and family medicine clinics in King Khalid University Hospital over two months were selected and interviewed to complete questionnaire. They were asked about history of poisoning due to detergents in their family in addition to their demographic-and practice regarding storage, use and disposal of detergents. RESULTS: The sample amounted to 318 mothers with mean age 34.2+/-7 13 years. 55(17 3%) reported history of poisoning due to detergents in their families Housewife mothers mothers with ?5 children, not reading detergents' labels, using detergents' containers for food and mixing different detergents; all were significantly associated (P<0.05) with higher rates of detergents poisoning in families (24.6%, 25.3%, 30.6%, 35.7% and 50%, respectively). RECOMMENDATIONS: health education programs concentrating with storage, use and hazards of detergents are recommended for mothers.

Relapse among substance-abuse patients in Riyadh, Saudi Arabia

Substance abuse is a recently acknowledged problem in Saudi Arabia. Sociodemographic correlates of substance abuse and relapse rates of a sample of inpatients at Al-Amal Hospital in Riyadh in 1998 were studied. The mean age of patients was 29.5 years with a mean duration of abuse of 9.5 years. Age, unemployment, peer pressure and family and social stresses were factors that showed statistically significant associations with repeat admissions. The most significant predictors of a patient's relapse were unemployment and social stresses. More nation-wide studies are needed to document factors leading to the initiation and continuation of substance abuse and to help treatment and rehabilitative measures

The effect of sociodemographic variables on child-spacing in rural Saudi Arabia

Adequate child-spacing is considered a positive factor in the health of mothers and their children. A house-to-house survey of 332 women in Al-Oyaynah village, Saudi Arabia was carried out in April and May of 1995 to determine the existing practice of child-spacing and factors influencing it. The variables examined included age of the mother, age at marriage, education, income, parity, type of infant-feeding and birth order. The age of the mother, age at marriage and education were significantly associated with the length of the birth interval. The current age of mother and her parity were found to be the only significant predictor variables of birth interval

Influence of mothers' characteristics on their perceptions and use of the growth chart

Although growth charts are recommended for monitoring children, recent reports indicate poor use by mothers. We investigated maternal knowledge and perceptions of growth charts and identified characteristics affecting use. At outpatient paediatric clinics of a Riyadh hospital, 305 mothers with children under age 5 were interviewed by questionnaire during May-June 2001. Overall awareness of growth charts was 35.8% and ever-use was 8.6%. Education, parity and number of living children were significantly associated with knowledge. Among mothers who ever used growth charts [8.7%], only 10% reported doctors recommended changes in health care because of them. Overall, 71% wanted to monitor their child's growth, but 20% did not know how. Increased health education in all health care delivery systems is needed