Association of serum selenium with thyroxin in severely iodine-deficient young children from the Amhara region of Ethiopia.

BACKGROUND/OBJECTIVES: Selenium (Se) as part of glutathione peroxidase and iodothyronine deiodinase enzymes influences thyroid metabolism. This study investigated the association of serum Se levels with thyroid metabolism of severely iodine-deficient young children from the Amhara region of Ethiopia. SUBJECTS/METHODS: In a cross-sectional study, Se, thyroid-stimulating hormone, total thyroxin, total triiodothyronine and thyroglobulin in serum of children (N=628) 54-60 months of age from the Amhara region, Ethiopia, were analyzed. In addition, iodine in urine and household salt was analyzed, and the presence of goiter was assessed. RESULTS: The median serum Se concentration was 61.4 µg/l (10.7-290.9 µg/l). Selenium deficiency (serum Se <70 µg/l) was detected in 57.8% (N=349) of the children. The median urinary iodine concentration (UIC) was 9.8 µg/l. The majority (86.6%, N=449) of children had UIC below the recommended value (100 µg/l). In addition, 59.8% (N=310) of children were severely iodine deficient (UIC<20 µg/l). Only 12.7% of salt samples had iodine. Goiter was present in 44.6% (N=280) of the children. Selenium-deficient children had higher serum thyroxin (T4) than children with normal serum Se concentration (P<0.001). CONCLUSIONS: Serum Se was negatively associated with T4 level in young children from the Amhara region of Ethiopia and may endanger the effectiveness of the salt iodization program.

A problem-solving approach to nutrition education with Filipino mothers.

The study examined Filipino mothers' problem solving on issues related to child feeding, using a dyadic, peer-help approach. The participants were mothers of children under 6 yr of age from a village in the southern Philippines, where malnutrition among children is prevalent. Mothers were paired with a mutual friend (each nominated the other as a best friend) or a unilateral friend (only one nominated the other as a best friend) to discuss a feeding problem to which they initially gave similar solutions (agreed) and one to which they gave different solutions (disagreed). In the final step, they were asked to give privately the solutions they considered best for the problem. The number and quality of these final-step solutions were analyzed as a function of the friend relation, the level of initial agreement with their friend partner, and the source of the solution. Results indicated that the quantity and quality of solutions increased from before to after the dyadic discussion, especially among mothers paired with a mutual friend with whom they agreed. Most of their final-step solutions came from ones they themselves had generated during the discussion, not ones their friend partner had proposed. There was also evidence that high quality solutions were generated by mothers paired with a disagreeing unilateral friend. Implications for nutrition education concern the benefits of a peer-help, dyadic problem-solving approach, taking into account the role of a friend in facilitating a mother's production of new solutions to child feeding problems. The procedure may be used by health promoters who want to build capacities and self-reliance through collective problem solving.

Nutrition, maternal responsiveness and mental development of Ethiopian children.

Forty children between the ages of 16 and 42 months and their mothers, living in an Ethiopian rural village, participated in the study. The objective was to determine the mental development of the children using the Bayley Scale of Mental Development, and to examine its relation to nutritional status and mother-child interaction. Forty-eight percent of the children were mildly or moderately malnourished; 7.5% severely so. The child's weight for age was significantly related to the child's scores on the Bayley scale. Mother-child interaction was assessed through a 30-60 min observation of the pair in a naturalistic setting around the home. The number of verbal, gestural and motor actions spontaneously initiated by the mother and child, as well as responses made by each to the others' behavior were recorded and coded separately. The rate of a mother's verbal responses to the child positively predicted the child's verbal score. In contrast, the mother's spontaneously initiated motor actions toward the child correlated negatively with the child's performance score. The mother's responsiveness was unrelated to the child's nutritional status, age or sex, but was best predicted by a fussing/crying child and by her expectations about the ages when specific social-cognitive abilities would be acquired by a child.

Determinants of mental illness in a rural Ethiopian adult population.

A cross-sectional survey was conducted on 2000 adult Ethiopians living in rural communities to determine firstly the prevalence of mental illness and secondly its association with stress and demographic variables. The Self-Reporting Questionnaire developed by WHO experts was used as the measure of mental illness. A modified version of the Holmes-Rahe Social Readjustment Scale was the measure of stress. Respondents were interviewed in their homes. Those experiencing 11 or more of the 20 neurotic symptoms and 3 or more of the 4 psychotic symptoms were considered mentally ill. Despite the use of high cut-off points for identifying potential cases, the prevalence of mental illness was 17.2%--neurotic 11.2% and psychotic 6.0%. This is higher than earlier reports for Ethiopia, but comparable to rates found in other African countries. Mental illness scores were most strongly associated with stress in that the odds of experiencing 6 or more stressful life events in the past year were 2.7 times greater for neurotics and 2.1 times greater for psychotics. In addition, neuroses and psychoses were significantly associated with a family history of mental illness and with being divorced, separated or widowed. Neurosis alone was also associated with chronic illness, females, those between the ages of 35 and 44, and illiteracy. These findings were discussed in terms of their relevance for identifying high stress groups and thus for preventing mental illness through community activities.