Ongoing deterioration of the nutritional status of Palestinian preschool children in Gaza under the Israeli siege.

This cross-sectional, community-based, household survey was carried out in Gaza City, Palestine during the first half of 2009 to study the nutritional status of Palestinian preschool children aged 2-5 years under blockade. The response rate was 95.2% from a total sample of 770. The majority (94.4%) of households faced difficulties accessing food, the main cause was the siege and the shortage of food products; and the majority (85.5%) were food insecure households. Just over 50% of the preschoolers were anaemic, 26.8% of those who had a stool test had parasitic infections, and 15.0 were stunted. Food insecurity was the first predictor of stunting andd underweight, and malnutrition indicators indicate the worst situation in the Gaza Strip for several decades.

Ongoing deterioration of the nutritional status of Palestinian preschool children in Gaza under the Israeli siege

This cross-sectional, community-based, household survey was carried out in Gaza City, Palestine during the first half of 2009 to study the nutritional status of Palestinian preschool children aged 2-5 years under blockade. The response rate was 95.2% from a total sample of 770. The majority [94.4%] of households faced difficulties accessing food, the main cause was the siege and the shortage of food products; and the majority [85.5%] were food insecure households. Just over 50% of the preschoolers were anaemic, 26.8% of those who had a stool test had parasitic infections, and 15.0 were stunted. Food insecurity was the first predictor of stunting and underweight, and malnutrition indicators indicate the worst situation in the Gaza Strip for several decades

Morbidity and mortality of low-birth-weight infants in Egypt.

Low birth weight is one of the major determinants of neonatal survival and postneonatal morbidity. This study assessed the morbidity and mortality of low-birth-weight (LBW) infants during the first 3 months. Data were collected for 6701 live births. All singleton liveborn LBW infants as well as a comparison group of normal-birth-weight (NBW) infants were followed up for 3 months. Data were collected on weight, morbidity and mortality using a structured questionnaire. Admission to neonatal intensive care unit and mortality were more frequent in LBW (31.6%, 2.0%) than NBW infants (2.0%, 0.2%). They also had increased risk of neonatal jaundice at 1 month, an increased risk of growth retardation and a much higher risk of mortality.

Morbidity and mortality of low-birth-weight infants in Egypt

Low birth weight is one of the major determinants of neonatal survival and postneonatal morbidity. This study assessed the morbidity and mortality of low-birth-weight [LBW] infants during the first 3 months. Data were collected for 6701 live births. All singleton liveborn LBW infants as well as a comparison group of normal-birth-weight [NBW] infants were followed up for 3 months. Data were collected on weight, morbidity and mortality using a structured questionnaire. Admission to neonatal intensive care unit and mortality were more frequent in LBW [31.6%, 2.0%] than NBW infants [2.0%, 0.2%]. They also had increased risk of neonatal jaundice at 1 month, an increased risk of growth retardation and a much higher risk of mortality

Construction of a local standard symphysis fundal height curves for monitoring intrauterine fetal growth.

The aim of the present study was to construct standard symphysis fundal height percentile curves to be used as a reference chart in monitoring fetal growth. The construction was based on 1185 observations (symphysis fundal height measured to the nearest 0.5 cm by a malleable elastic tape) obtained from follow up of 105 cases of healthy pregnant women who were: sure of date of their last menstrual period, confirmed by early dating scan "before 20th gestational week", experienced a very strict normal course of pregnancy, giving birth to normal term newborn with appropriate weight for gestational age and sex. The selection of the study sample went through several screening levels starting by 4088 cases and ending by 105 cases. The measurements were taken biweekly from the 18th week of gestation to delivery "37-42 weeks of gestation." Tenth, 25th, 50th, 75th, 90th and 95th percentiles were calculated and represented graphically. Mean, mean-1 SD, mean-2 SD, mean +1 SD, mean + 2 SD were also calculated and represented graphically. The curve of best fit was determined by polynominal regression. The resulted percentile curves and mean values were found to be comparable to those in both developed and developing countries. It was recommended to incorporate the reference charts of symphysis fundal height into the maternity services after using it in routine antenatal examination for large number of cases and establishing its sensitivity and specificity.

Screening of high risk pregnancy among mothers attending MCH centers in Alexandria.

A cross-sectional study was carried out on a sample of 900 pregnant women attending MCH centers in Alexandria to determine the incidence of high risk pregnancy and to demonstrate the common risk factors among them. The simplified scoring system developed by Morrison and Olsen (1979) was used. Mothers with scores 0-2 were considered at low risk those with score 3 and more were categorised as high risk. Results revealed that high risk women constituted 27.78% of the sample. Twenty three risk factors were identified among all pregnant women screened. The most frequently encountered were anaemia (37.33%), age 35+ (15.66%), parity 5+ (16.66%), previous gynecological surgery (8.88%) and history of previous stillbirth or neonatal death (6.11%). The mean number of risk factors in the low risk group was 0.95 compared to 3.03 in the high risk group. Stepwise regression analysis indicated that the reproductive history score was the best one variable predictor of total risk score explaining about 74% of the variation in the total score while the present history score explained a further 16% of the variation and the associated conditions score explained 9% only of the variation. The use of scoring technique is recommended to be used in identification of high risk pregnant women in MCH centers.

PIP: Data on 900 pregnant women attending 4 maternal and child health (MCH) centers in Alexandria, Egypt between June-August 1989 were analyzed to screen for high risk pregnancies and identify common risk factors among these pregnancies. The Morrison and Olsen scoring system revealed high or extreme risk pregnancy in 27.78% of the women. Women in the low risk group had a mean of 0.95 risk factors. Women in the high risk group had a mode of 2 risk factors and a mean of 3.03. The most frequent combination of 3 risk factors were maternal age of at least 35, parity =or 5, and anemia. Total scores ranged form 0 to 14. Among women of the high risk group, 49.6% received scores of 3-4, 28% of 5-6, and 22.3% of =or 7. The mean total risk score for the low risk group was 1.03 compared with 5.25 for the high risk group. The most common risk factors in order of frequency were anemia (37.33%), parity =or 5 (16.66%), maternal age of at least 35 (15.66%), previous gynecologic surgery (8.88%), and history of stillbirth or neonatal mortality (6.11%). All of these risk factors except anemia occurred significantly more often in the high risk group than in the low risk group. Reproductive history accounted for 74% of the variation in the total risk score. Present pregnancy score and associated conditions accounted for 16% and 9% respectively. It is suggested that health workers use a scoring system to screen pregnant women attending antenatal clinics. They should also learn how to identify and manage high risk pregnancies. Trained personnel should design and distribute uniform records for assessment of high risk pregnancy to all primary health care units with antenatal services. Each MCH center should register perinatal deaths so health workers can use the data to make antenatal diagnoses and determine care.

Growth and nutritional status of preschool children attending the well-baby clinics.

This study aimed at the assessment of growth and nutritional status of preschool children by comparing it with internationally recognized growth standards, using the anthropometric indices of nutritional status. A cross-sectional study was carried out upon a sample of children (N = 660) aged 0-71 months who attended the well-baby clinics in the MCH centres in Alexandria. Individual measurements of weight and height were done for each child. Anthropometric indices of weight and height were calculated. These indices were related to the US National Centre of Health Statistics (NCHS) reference population by standard deviation scores (Z-scores). The growth pattern of children was different from that of western reference populations, while it resembled that of most developing countries. Of all children, 10.5% suffered from malnutrition (weight for age less than 2 S.D. of the reference median), 14.1% were stunted, and 5.5% were wasted. Parents of all children were interviewed, and analysis of specific social risk factors associated with poor attained size was done using stepwise multiple regression analysis. Few of such factors reached statistically significant association such as sex, infant feeding pattern, birth order and parental consanguinity.