Preschool development of coloured children in Cape Town.

Developmental screening was applied during infancy to a birth cohort of 1,000 coloured infants born consecutively in Cape Town. The developmental progress of a sample of 187 children randomly selected from the cohort was followed over a period of 5 years. The value of the use of developmental screening is questioned, since 4 of the children in the cohort with major handicap had been diagnosed before the first screening was carried out and a 5th child with deafness was not detected by the screening process. Developmental milestones were similar to those studies reported in the literature. At 12 months the development correlated best with family stability. Language development at 30 months was associated with mother's education and family stability and reflected a general lag in verbal skills. By 5 years there was a good correlation between development and social indicators, particularly income and mother's education.

Growth of preschool coloured children in Cape Town.

The growth of a random sample of coloured children in Cape Town was studied from birth until 5 years. At birth they were relatively light and short for gestational age. Size at birth correlated with social class. A rapid postnatal weight gain rendered them relatively overweight between 3 and 6 months. Thereafter they became lighter and shorter than the NCHS reference values and this persisted throughout the preschool period. Genetic factors, reflected by parental growth, were found to predict growth during childhood, but they were more predictive of weight and head circumference than of length. From 12 months onwards, socio-economic factors played a significant role in determining growth even after the effects of the genetic factors had been taken into account.

Postneonatal mortality in the Matroosberg Divisional Council area of the Cape Western Health Region.

Postneonatal deaths in the Matroosberg Divisional Council area were studied with particular reference to social and nutritional factors. Adverse social circumstances were strongly associated with death during the first year of life. The children who died had fathers who were less educated and held lower rated jobs than fathers of children in a control group. They were less likely to have belonged to a nuclear family and were more likely to have had families with social problems. They were also more frequently bottle-fed, were more likely to have been underweight, and were less often fully immunised. The study illustrates the need for a GOBI-FFF intervention strategy in the area.

Early childhood mortality in Cape Town.

Early childhood mortality in the City of Cape Town was investigated with particular reference to preventability. Deaths were considered preventable if they resulted from infections or other acquired diseases and accidents. Non-preventable deaths were those resulting from congenital disorders, neoplastic disease and other non-acquired conditions. Cot deaths formed a third group. Mothers in the preventable group had had more pregnancies than those in the non-preventable group, and the children who died were more likely to have been born prematurely than children in the non-preventable group. Children in the preventable group came from lower social class backgrounds than those in the non-preventable group and were more frequently from single-parent families who lived with extended family or with people who were not related to them. Their families were less likely to own their own homes than families of children in the non-preventable group. The children who died had more siblings, more of whom had died previously, than children in a control group. The cot death group did not differ from the preventable group, but did differ from the non-preventable group with regard to gestational age and paternal occupation. The study shows that preventable deaths were particularly associated with socio-economic disadvantage.

A comparative study of postnatally-acquired cerebral palsy in Cape Town.

The importance of socio-economic conditions in the causation of postnatally-acquired cerebral palsy has not been stressed in previous studies. A comparative survey was undertaken in Cape Town, South Africa. Three ethnic groups were compared--white, coloured (mixed ancestry) and black. The percentage of postnatally-acquired cerebral palsy in these groups was 13.2, 24.0 and 36.1 per cent, respectively. These figures can be explained by the differing socio-economic conditions of each group, the white group belonging to the highest socio-economic stratum and the black group to the lowest. The main causes of postnatally-acquired cerebral palsy were cerebral infections (particularly meningitis), cerebral trauma and cerebrovascular accidents. The proportion in each group, the main causal factors, age at onset, types of cerebral palsy and intellectual status are similar to those of most previous studies.