The use of herbal teas and remedies in Jamaica

We investigated the prevalence of the use of herbs among adults and children in Jamaica in 1996. Two concurrent surveys were conducted in randomly selected urban and rural area; among the adults and among caretakers of young children. From over 90 percent of the selected households, all caretakers of children under 6 years and one randomly selected adult (18 years or older) were interviewed using structured questionnaires. The 457 adults reportedly used 156 types of herbs: a mean of 6ñ3 (mean ñ standard deviation) by the urban adults, and 10ñ6 by the rural adults (t-test, p < 0.001). Almost 100 percent of respondents had at some time used herbs for teas or for treating illnesses. The most common methods of preparation was by infusion or boiling in water, then adding sugar. Urban respondents, women and those who were employed were more likely to buy medicines than to use herbal remedies. One hundred and sixty-seven caretakers of 203 children under 6 years were interviewed. The mean number of herbs given to each child was between 2 and 3. The most common herbs were introduced within the first 6 months of life. Many caretakers factors were associated with herbal use. Public health implications include the potential toxicity of some herbs, the possibilty that herbal teas given to young children may displace more nutritious foods and delay presentation to health care facilities. The findings will allow policy makers to target those most likely to use herbal preparations or to give them to young children, and target herbs to be analyzed for toxic or beneficial properties.(Au)

The nutritional status of rural Jamaican school children

Three thousand, eight hundred and eighty-two (3,882) children in grades 2-5, attending 16 rural primary and all-age schools in central Jamaica were weighed and their weight-for-age standard deviation scores calculated using the World Health Organization/National Cancer for Health Statistics (WHO/NCHS) refernces. Heights were also measured in a random sample of the grade 5 children (n=793) and height-for-age and body mass index (BMI - kg/m2) calculated. Sixty-nine percent of the total sample were of normal weight-for-age, 2 percent were moderately undernourished (weight-for-age > -3 Z-score, <-2 Z-score), and a further 24 percent mildly undernourished (weight-for-age >-2 Z-score, <-1 Z-score). Few children were overweight. The frequency distribution of weight-for-age was similar in girls and boys. In the subsample of children in whom heights were measured, 25.8 percent were <-1 Z-score height-for-age, and of these 4.9 percent were <-2 Z-score. Compared with a survey conducted in a similar rural area in the 1960s, the children's mean weights for age group categories were 1.1 to 3.7 kg heavier. Children who were older than appropriate for their grade were more likely to be undernourished (Odds ratio 3.94, 95 percent CI 3.21,4.83), which suggests that undernourished children may be more likely to repeat a grade or start school later (AU)

Nutrition, anaemia, geohelminth infection and school achievement in rural Jamaican primary school children

OBJECTIVE: To determine whether nutritional status, anaemia and geohelminth infections were related to school achievement and attendance in Jamaican children. DESIGN: A cross-sectional study using a randomly selected sample. SUBJECTS: Eight hundred children aged 9-13 years randomly selected from those enrolled in grade 5 in 16 primary schools in rural Jamaica. RESULTS: The mean height for age of the children was -0.37 z-score +/-1.0 s.d. with 4.9 percent having the heights for age < -2 s.d. of the NCHS references. Anaemia (Hb < 11 g/dl) was present in 14.7 percent of the children, 38.3 percent were infected with Trichuris trichiura and 19.4 percent with Ascaris lumbricoides. Achievement levels on the Wide Range Achievement Test were low, with children performing at grade 3 level. In multilevel analyses, controlling for socioeconomic status, children with Trichuris infections had lower achievement levels than uninfected children in spelling, reading and arithmetic (P < 0.05). Children with Ascaris infections had lower scores in spelling and reading (P < 0.05) Height for age (P < 0.01) was positively associated with performance in arithmetic. Ascaris infection (P < 0.001) and anaemia (P < 0.01) predicted poorer school attendance. CONCLUSION: Despite mild levels, undernutrition and geohelminth infections were associated with achievement, suggesting that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children(AU)

School breakfast benefits children's nutritional status

There are very few well-designed studies in developing countries to evaluate the benefits of school feeding programmes. The aim of this study was to determine the effects of giving breakfast on rural childrens' nutritional status, breakfast history and amount of money they brought to school. We conducted a randomized controlled trial of providing breakfast to rural primary school children in grade 2 to 5 in 16 schools in Jamaica. 407 undernourished children (weight for age,-ISD NCHS references and 407 adequtely nourished children (weight for age>-ISD) matched for age gender and class were randomly assigned to either breakfast or placebo groups for one school year. Breakfast consisted of bread or spiced bun with cheese and 250 ml flavoured milk which supplied 590-720 kcal and 22.5 g protein per day. The placebo was a small piece of orange. The children heights and weight were measured before and after the intervention. Differences between categorical variables were examined by Chi-squared tests and effects of giving breakfasts were tested by multiple regression analyses. The children receiving breakfast gained significantly more in weight and body mass index (p<.001) and height (p<0.05) than those in the placebo group. Participation in the programme did not reduce the amount of money brought to school, or change their home breakfasts, suggesting no significant income transfer to the families. We subsequently trained teaches to identify undernourished children who could benefit from a school meal using a calibrated measuring stick. (AU)

Diets of Jamaican primary school children and access to school feeding programmes - abstract

There is little information on the diets of school children in Jamaica. We observed food consumption and participation in government school feeding programmes in 415 children in grades 2 and 5 in 16 primary schools in rural Jamaica. All items eaten by children at break and lunch were recorded on two days. During break, the majority of children consumed sweets, snacks or syrup drinks and 25 percent of the children had nothing to eat for lunch and 6 percent had a drink only. Mean intakes at lunch were: energy 366 kcals (SD180), protein 10.4 g (SD 7.6) and iron 1.5 mg (SD1.2). The mean energy intake was 17-20 percent of the daily requirement of this age group. Children who brought lunch to school had significantly higher intakes (p<0.05). Girls had higher intakes than boys, and intakes were positively associated with height-for-age (both p<0.05). Approximately 20 percent of the children participated in the school feeding programmes. Poorer children were more likely to participate in the bun and milk programme (Odds Ratio 2.1, 95 percent CI 1.3-3.5) but children with more money for food were more likely to take part in the more costly Cooked Meal Programme (Odds ratio 2.4, 95 percent CI1.3-4.6). Strategies are needed to improve diet selection in school children and ensure access to school feeding among the poorest groups (AU).

Does poor health nutrition affect school achievement in rural Jamaican children?

In recent years, increasing attention has been given to the effects of health and nutrition on schoolchildren's ability to learn. This study was conducted to determine whether nutritional status, anaemia and geohelminth infections were related to school achievement after controlling for a wide range of social variables. Eight hundred children were randomly selected from all those enrolled in grade 5 in 16 rural primary schools in Jamaica. School achievement was assessed by the Wide Range Achievement Test (WRAT). Children's weights and heights were converted to Z-scores using the NCHS references. Haemoglobin was measured using a haemoglobin photometer (Hemocue), and the presence and intensity (eggs per gram stool) of Trichuris trichura and Ascaris lumbricoides assessed by the Kato Thick Smear method. Socio-economic variables were assessed by questionnaire and observation, and school attendance obtained was from the class registers. The mean height-for-age of the children was -0.4 ñ 1.0 SD with 25.3 percent having heights <-ISD of the NCHS references. Fourteen point seven per cent (14.7 percent) of the children were anaemic (Hb < 1lg/dl), 38.3 percent were infected with Trichuris trichura and 19.4 percent with Ascaris lumbricoides. Height-for-age (p<0.001) was positively correlated with scores on the WRAT, and anaemia (p<0.05), Trichons and Ascaris infections (p<0.001) were associated with lower scores. In a multiple regression analysis, after controlling for attendance, sex, socio-economic status, possession of school books and uniform quality, the achievement of children with Trichuris infections was significantly worse than that of uninfected children in spelling, reading and the total WRAT score (p < 0.01). Height-for-age (p < 0.001) and anaemia (p < 0.05) contributed significantly to the variance in arithmetic. Despite the mild levels of undernutrition and the low intensity of the geohelminth infections, they were still associated with achievement. This suggests that efforts to increase school achievement levels in developing countries should include strategies to improve the health and nutritional status of children (AU)

Preliminary investigation into the effect of fulvine on rat and human chromosomes - abstract

Some pyrrolizidine alkaloids have been shown to have nuclear toxicity in vitro. Fulvine was therefore investigated for its effect on mitotic chromosomes in the rat and in man. In vitro studies were performed on rat fibroblasts and human and rat peripheral blood cultures. In vivo studies were performed by injecting mature rats subcutaneously with 0.08mg/gm body weight in fulvine. Control animals received the identical dilutant. Blood cultures were established 24 and 48 hours, and 8 days later. Nine children with histologically proven veno-occlusive disease (VOD) and eight controls were studied by 48-hour blood cultures, for changes in chromosome number and morphology. The in vitro studies were negative. In vivo studies in rats showed marked mitotic depression at 24 and 48 hours. On the seventh day, breaks, gaps exchanges and rearrangements were seen in 24 percent of cells. VOD was found in 5 rats. Of the children, three sibs, and two others showed similar abnormalities marked in the former and less so in the latter. These findings are very suggestive of induction of chromosome abnormalities by fulvine or by VOD. The frequency of these changes may be related to dosage levels, intervals between ingestion and examination, or to familial reactions to the drug (AU)