Alimentación en población infantil inmigrante recién llegada / Infant feeding in recent immigrant population

Introducción. El exceso o defecto de nutrientes se ha relacionado con problemas de salud. El objetivo de este estudio es conocer los hábitos alimentarios de los inmigrantes a su llegada y su relación con variables sociodemográficas y patologías asociadas. Material y métodos. Estudio descriptivo observacional transversal. Población: niños inmigrantes con edad entre 6 meses y 15 años. Variables: edad, sexo y país de procedencia. En los menores de 24 meses introducción de los alimentos según la OMS y la ESPGHAN. En toda la población: raciones de cereales/farináceos, frutas, verduras, lácteos, proteínas, legumbres, aceites/grasas, bollería, dulces y golosinas, bebidas refrescantes, aperitivos salados, frutos secos, cacao, té y café. Presencia o no de: talla baja, obesidad y caries. Resultados. En los menores de 24 meses de edad se encontraron porcentajes elevados de introducción incorrecta de ciertos alimentos (36,7% leche de vaca). En la población estudiada se observan raciones insuficientes de alimentos (28,4% en verduras), excesos (47,2% en embutidos) y dieta incorrecta en el 32,6%. Se encontró significación estadística entre procedencia y déficit de alimentos (lácteos el 39,10% de los indopakistaníes) o excesos (embutidos en el 71,8% de los de Caribe). En la valoración de la dieta: correcta en el 57,1% de los magrebíes o incorrecta del 48,1% de los indopakistaníes y 43,1% en los de Europa del Este. Conclusiones. Se han de tener en cuenta las prácticas alimentarias inadecuadas encontradas y la asociación a ciertas procedencias por al riesgo que pueden suponer para la salud infantil y adulta. Su abordaje requiere recursos para acciones preventivas y educativas específicas (AU)

Introduction. The excess or deficiency of nutrients have related health problems. The aim of this study is to describe the eating habits of immigrants on their arrival and their relationship with socio-demographic variables and pathologies associated. Methods. A descriptive, observational transversal study. Population: immigrants between 6 months and 15 years. Variables: age, sex and country of origin. Children under 24 months food supply introduction according to WHO and ESPGHAN. In the entire population: cereal/farinaceous rations, fruits, vegetables, milk, protein, legumes, oils and fats, pastry, sweets and candy, soft drinks, salty snacks, nuts, cocoa, tea and coffee. Presence or not: low share, obesity and caries. Results. In children under 24 months were found significant percentages in incorrect introduction of certain foods (36.7% milk cow). In the studied population: inadequate basic foodstuffs (28.4% in vegetables), not needed developed food excesses (47.2% in sausages) and incorrect diet in 32.6%. Found statistical significance between origin and deficit of foods (milk 39.1% of Indo-Pakistanis) or excess (sausages 71.8% of the Caribbean). In the dietary's assessment: correct 57.1% of Maghrebi or incorrect 48.1% of Pakistani Indus and 43.1% in the Eastern Europe. Conclusions. Inadequate habits of nutrition and their association to certain regions must be taken into account because of the risk on childhood and adult health. Resources to specific preventive and educational actions are needed (AU)

[Infant feeding in recent immigrant population]. / Alimentación en población infantil inmigrante recién llegada.

INTRODUCTION: The excess or deficiency of nutrients have related health problems. The aim of this study is to describe the eating habits of immigrants on their arrival and their relationship with socio-demographic variables and pathologies associated. METHODS: A descriptive, observational transversal study. POPULATION: immigrants between 6 months and 15 years. VARIABLES: age, sex and country of origin. Children under 24 months food supply introduction according to WHO and ESPGHAN. In the entire population: cereal/farinaceous rations, fruits, vegetables, milk, protein, legumes, oils and fats, pastry, sweets and candy, soft drinks, salty snacks, nuts, cocoa, tea and coffee. Presence or not: low share, obesity and caries. RESULTS: In children under 24 months were found significant percentages in incorrect introduction of certain foods (36.7% milk cow). In the studied population: inadequate basic foodstuffs (28.4% in vegetables), not needed developed food excesses (47.2% in sausages) and incorrect diet in 32.6%. Found statistical significance between origin and deficit of foods (milk 39.1% of Indo-Pakistanis) or excess (sausages 71.8% of the Caribbean). In the dietary's assessment: correct 57.1% of Maghrebi or incorrect 48.1% of Pakistani Indus and 43.1% in the Eastern Europe. CONCLUSIONS: Inadequate habits of nutrition and their association to certain regions must be taken into account because of the risk on childhood and adult health. Resources to specific preventive and educational actions are needed.

Indicación de la determinación de los anticuerpos para los virus de la hepatitis C y de la hepatitis A en los protocolos de atención a los niños inmigrantes / Indication of determination of antibodies against hepatitis C and A viruses in the protocol for the care of young immigrants

ObjetivoValorar la determinación sistemática de los anticuerpos para el virus de la hepatitis C (Ac. VHC) y para el virus de la hepatitis A (Ac. VHA) dentro de los protocolo de atención a niños inmigrantes (PANI).MétodosEstudio descriptivo, transversal y multicéntrico. Se determinaron los Ac. VHC y Ac.VHA, en niños de 6 meses a 15 años procedentes de países de baja renta que habían inmigrado hacía menos de 12 meses. Se registró la edad, el sexo y el país de origen. Se ha comparado el coste de la vacunación (con vacuna HA y vacuna HA-HB, precio de sanidad pública y precio de venta al público) a todos los niños inmigrantes sin cribado, con el coste de la vacunación sólo a los no inmunes.ResultadosSe determinaron los Ac. VHC a 1055 niños/as, un caso resultó positivo: 0,09% (IC95%: 0–0,53%). Se determinaron los Ac. VHA a 992 niños/as, y fueron positivos el 38% (IC 95%: 35,0–41,1); en los de América Central y del Sur (n=352) el 34,9%; del Magreb (n=246) el 44,7%; de Indo-Pakistán (n=162) el 58,6%. Según el país de procedencia, la edad y el precio de la vacuna utilizada, es eficiente la determinación de los Ac. VHA previamente a la vacunación para el VHA.ConclusionesLa baja prevalencia de Ac. VHC en población infantil inmigrada no justifica su determinación sistemática. Valorar la determinación de los Ac. VHA en cada niño inmigrante en particular puede aumentar la eficiencia de los PANI (AU)

ObjectivesTo evaluate systematic determination of antibodies against hepatitis C virus (HCV) and hepatitis A virus (HAV) within the protocols for the care of young immigrants (PCYI).MethodsWe performed a descriptive, cross-sectional, multicenter study. Antibodies against HCV and HAV were determined in children aged from 6 months to 15 years from low-income countries who had immigrated to Spain less than 12 months previously. Age, sex and country of origin were registered. The cost of vaccinating all immigrant children (with the HA vaccine and HA-HB vaccine, public health price and retail price) without screening was compared with that of vaccinating non-immune children only.ResultsHCV antibodies were determined in 1055 children and only one was positive [0.09% (95% CI: 0–0.53%)]. HAV antibodies were determined in 992 children and, overall, 38% were positive (95% CI: 35.0–41.1). Distribution by country of origin was as follows: Central and South America (n=352) 34.9%, Maghreb (n=246) 44.7%, and India, Pakistan and Bangladesh (n=162) 58.6%. According to the children's age, country of origin, and the price of the vaccine used, HAV antibody determination in young immigrants before HAV vaccination is efficient.ConclusionsBecause of the low prevalence of HCV antibodies in the pediatric immigrant population, systematic determination is not warranted. Evaluating HAV antibodies in each immigrant child could increase the efficiency of PCYI (AU)

[Indication of determination of antibodies against hepatitis C and A viruses in the protocol for the care of young immigrants]. / Indicación de la determinación de los anticuerpos para los virus de la hepatitis C y de la hepatitis A en los protocolos de atención a los niños inmigrantes.

OBJECTIVES: To evaluate systematic determination of antibodies against hepatitis C virus (HCV) and hepatitis A virus (HAV) within the protocols for the care of young immigrants (PCYI). METHODS: We performed a descriptive, cross-sectional, multicenter study. Antibodies against HCV and HAV were determined in children aged from 6 months to 15 years from low-income countries who had immigrated to Spain less than 12 months previously. Age, sex and country of origin were registered. The cost of vaccinating all immigrant children (with the HA vaccine and HA-HB vaccine, public health price and retail price) without screening was compared with that of vaccinating non-immune children only. RESULTS: HCV antibodies were determined in 1055 children and only one was positive [0.09% (95% CI: 0-0.53%)]. HAV antibodies were determined in 992 children and, overall, 38% were positive (95% CI: 35.0-41.1). Distribution by country of origin was as follows: Central and South America (n=352) 34.9%, Maghreb (n=246) 44.7%, and India, Pakistan and Bangladesh (n=162) 58.6%. According to the children's age, country of origin, and the price of the vaccine used, HAV antibody determination in young immigrants before HAV vaccination is efficient. CONCLUSIONS: Because of the low prevalence of HCV antibodies in the pediatric immigrant population, systematic determination is not warranted. Evaluating HAV antibodies in each immigrant child could increase the efficiency of PCYI.

Valoración del estado vacunal de la población pediátrica inmigrante a su llegada a una área básica de salud de Barcelona y a los 12 meses / Evaluation of vaccination status of immigrant children on their first visit to a primary health area of Barcelona and 12 months later

Objetivos. Evaluar el estado de las vacunaciones de los inmigrantes recién llegados en la primera visita y a los 12 meses. Método. Estudio transversal con 2 cortes, retrospectivo y descriptivo. Mediante muestreo aleatorio simple se seleccionaron 180 historias clínicas, de un total de 338, de la población pediátrica inmigrante. Se estudiaron las siguientes variables: fecha de nacimiento, sexo, país de procedencia y fecha de primera visita, tipo y dosis de vacunas administradas. Para evaluar el estado vacunal se utilizó: Expanded Program on Immunization (EPI) OMS 1974 y protocolo de atención al niño inmigrante (PAI). Resultados. A la llegada resultó correctamente vacunado, según EPI, el 61,2% (intervalo de confianza [IC] del 95%, 51,2-71,1). Resultaron bien vacunados, según PAI a la llegada: triple vírica el 7,8% (IC del 95%, 3,9-11,7); tétanos, difteria el 45,0% (IC del 95%, 37,7-52,3); Pertusis el 45,0% (IC del 95%, 37,7-52,3); poliomielitis el 51,1% (IC del 95%, 43,8-58,4); Haemophilus el 3,9% (IC del 95%, 1,1-6,7); meningitis C el 1,7% (IC del 95%, 0,6-4,8); hepatitis A y B el 0,6% (IC del 95%, 0,1-3,1). A los 12 meses: triple vírica el 92,8% (IC del 95%, 88,7-96,8); tétanos, difteria y poliomielitis el 95,6% (IC del 95%, 92,2-98,8); Pertusis el 61,7% (IC del 95%, 54,6-68,8); Haemophilus el 21,1% (IC del 95%, 15,1-27,1); meningitis C el 95% (IC del 95%, 91,5-98,4), y hepatitis A y B el 61,7% (IC del 95%, 54,6-68,8). Conclusiones. Hay un alto porcentaje de niños que no cumplen el EPI 1974 originario. Según PAI a la llegada las coberturas eran muy bajas. A los 12 meses de la primera visita, las dosis registradas evidencian estados óptimos, excepto en el caso de las hepatitis A y B en el que es necesario su mejora

Objectives. To evaluate vaccination status in recently arrived immigrant children in the first medical visit and 12 months later. Method. We performed a cross-sectional study with two cross-sections: retrospective and descriptive. Of a total of 338 clinical histories among the immigrant population, simple random sampling was used to select 180 clinical histories. The following variables were studied: date of birth, gender, country of origin, date of the first medical visit, and type and dose of the vaccines administered. To evaluate vaccination status, the Expanded Program on Immunization (EPI) of the World Health Organization (WHO), 1974, and the protocol for the care of the immigrant child (PCIC) were used. Results. According to the EPI, 61.2% (95% CI: 51.2-71.1) of the immigrant children were correctly immunized on arrival. According to the PCIC, correct vaccination on arrival in Spain was as follows: measles-mumps-rubella (MMR): 7.8% (95% CI: 3.9-11.7); tetanus, diphtheria: 45.0% (95% CI: 37.7-52.3); pertussis: 45.0% (95% CI: 37.7-52.3); polio: 51.1% (95% CI: 43.8-58.4); Haemophilus: 3.9% (95% CI; 1.1-6.7); meningitis C: 1.7% (95% CI: 0.6-4.8), hepatitis A and B: 0.6% (95% CI: 0.1-3.1). Correct vaccination at 12 months was as follows: MMR: 92.8% (95% CI: 88.7-96.8); tetanus, diphtheria and polio: 95.6% (95% CI: 92.2-98.8); pertussis: 61.7% (95% CI: 54.6-68.8); Haemophilus: 21.1% (95% CI: 15.2-27.1); meningitis C: 95% (95% CI: 91.5-98.4); and hepatitis A and B 61.7% (95% CI: 54.6-68.8). Conclusions. A high percentage of the children had not received one or more of the vaccines included in the WHO's 1974 EPI. According to the PCIC, vaccination coverage on arrival was very low. Twelve months after the first medical visit, the doses registered were optimal, except in the case of hepatitis A and B. Vaccination against hepatitis A and B should be increased

Valoración de la carga asistencial del personal de enfermería en función de los nuevos usuarios de los servicios de pediatría / Evaluation of nursing workload generated by the immigrant pediatric population in primary care

Objetivo. Determinar las cargas asistenciales para el personal de enfermería generadas por la inmigración infantil y el seguimiento del Protocolo de Atención al Inmigrante (PAI) en la edad pediátrica, en relación con la atención a los niños autóctonos. Método. Niños de 6 meses a 15 años de edad llegados de países de baja renta, así como los nacidos en España que permanecieron más de 2 años en el país de sus padres y que fueron visitados entre el 31 de mayo de 2001 al 31 de mayo de 2002; se seleccionaron 74 de un total de 136. El número de niños autóctonos del mismo sexo y edad que los recién llegados fue de 74. Se utilizó una técnica de muestreo aleatorio. Resultados. El número de visitas en el grupo de inmigrantes fue de 454, con una mediana de 6 (mínimo, 2; máximo, 15). Destacan las 292 visitas relacionadas con la aplicación del PAI, 129 en los niños autóctonos, con una mediana de 2 (mínimo, 0; máximo, 8). Las actividades realizadas con los niños inmigrantes relacionadas con el PAI fueron 614, con una mediana de 8 (mínimo, 2; máximo, 19). En los autóctonos el número de actividades fue de 101, con una mediana de 1 (mínimo, 0; máximo, 6). Se llevaron a cabo 115 captaciones en los niños inmigrantes, con una mediana de 1, y 23 en los autóctonos (mediana, 0). Conclusiones. Hay una gran diferencia en el número de visitas y actividades entre los niños inmigrantes y los autóctonos. Las visitas y las actividades derivadas de la aplicación del PAI, que ha de realizarse sólo en inmigrantes, aumenta la carga asistencial global. Esta diferencia en las cargas asistenciales es el trabajo necesario para igualar ambos grupos en el nivel de salud. También hay mucha diferencia en el número de captaciones y el de actividades de recaptación entre niños inmigrantes y autóctonos

Objective. To determine the nursing workload generated by childhood immigration and by the Immigrant Healthcare Protocol (IHP) in pediatric patients in comparison with that generated by the autochthonous pediatric population. Method. Children aged between 6 months and 15 years from low-income countries as well as children born in Spain and resident in their parents' country of origin for more than 2 years who were attended between 31 May 2001 and 31 May 2002 were included. Of 136 children, 74 were selected. Autochthonous children of the same age and sex as immigrant children (n = 74) were also included. A randomized sampling technique was used. Results. There were 454 consultations in the immigrant group with a median of 6 visits (minimum, 2; maximum, 15). Noteworthy was the number of consultations exclusively related to the application of the IHP (292). There were 129 consultations in the autochthonous group with a median of 2 (minimum, 0; maximum, 8). There were 614 IHP-related activities in immigrant children with a median of 8 (minimum, 2; maximum, 19) while in autochthonous children there were 101 activities with a median of 1 (minimum, 0; maximum, 6). There were 115 missed appointments in immigrants (median, 1) and 23 in autochthonous children (median, 0). Conclusions. There was a marked difference between immigrant and autochthonous children in the number of consultations and activities. IHP-related consultations and activities, performed only in immigrant children, increased the overall workload. This difference is required to reduce inequalities in health between the two groups. A marked difference was also found in the number of missed appointments and in the number of activities related to rescheduling missed appointments between immigrant and autochthonous children