[Feeding status of 0～23-month-old infants in poor rural areas of Gansu Province from 2018 to 2019].

OBJECTIVE: To investigate the feeding status of infants and their feeder's feeding literacy in poor rural areas of Gansu Province. METHODS: From November 2018 to January 2019, a multi-stage cluster random sampling method was used to select 1200 infant and child families aged 0 to 23 months in 40 villages of Gansu Province. A standardized questionnaire from the Chinese Nutrition Society(CNS)was used to investigate the basic situation of infant and young children's families, the situation of breastfeeding and the addition of supplementary food, and parents feeding knowledge, attitude behavior(KAP). Using chi-square test, logistic regression and other method to statistically describe and infer the collected data. RESULTS: A total of 1193 infants and 1165 feeders were investigated. The exclusive breastfeeding rate of infants and young children under the age of 6 months was 39. 02%. The rate of continuous breastfeeding at 1 year old was 37. 40%, and the rate of continuous breastfeeding at 2 years old was 20. 88%, the difference between the two was significant(χ~2=13. 498, P<0. 01). The supplementary food supplement rate of infants and children over 6 months was 94. 37%, the highest supplementary supplement for cereals and potatoes(98. 01%), and the lowest percentage for beans and nuts(23. 51%), and the distribution of supplementary foods at different ages was significantly different(χ~2=52. 336, P<0. 01). The qualification rate of infants and young children's minimum dietary diversity was 64. 13%, the minimum eating frequency qualification rate was 70. 64%, the minimum acceptable dietary intake qualification rate was 42. 16%, and the qualification rates of various indicators were significantly different between different months(χ~2=85. 421, P<0. 01;χ~2=19. 66, P<0. 01; χ~2=17. 261, P<0. 01). The KAP score passing rate of infant caregivers was 37. 34%, and there was a statistical difference between the age of infants and young children, the education level and the sex of the caregiver(χ~2=9. 411, P<0. 05;χ~2=25. 901, P<0. 01;χ~2=3. 874, P<0. 05). Taking low-month-old infants and young children, low education and male caregivers as controls, infants and young children aged over 12 months, high school education and female caregivers were the protective factors of KAP scores(P<0. 05). CONCLUSION: The problems of infant breastfeeding and supplementary feeding in poor rural areas of Gansu Province were serious, and the knowledge and skills of raising people were scarce, which were related to the age of infants and young children, the education and the sex of raising people.

[Factors associated with taking Yingyangbao efficiently among infants and young children aged 6-24 months in poor rural areas of Hunan Province, China].

OBJECTIVE: To describe the status and identify factors associated withtaking Yingyangbao efficiently among infants and young children aged 6- 24 months in poor rural areas. METHODS: A total of 7481 rural infants and young children aged between6 and 24 months in 25 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by Probability-Proportional-to-Size Sampling( PPS), and designed questionnaires to collect infants and young children's information of personal, family and taking Yingyangbao. Non-conditional Logistic regression analysis was used to analyze the factors associated with taking Yingyangbao among infants and young children aged 6- 24 months. RESULTS: The findings indicated that 90. 4%( 6762 /7481) of infants and young children had got Yingyangbao, and 69. 2%( 4677 /6762) of infants and young children took Yingyangbao efficiently, 62. 5%( 4677 /7481) of all investigative infants and young children took Yingyangbao efficiently. The result of multivariate non-conditional logistic regression analysis showed that, compared with 6- 11 months, 12- 17 and18- 24 months were protective factors of infants and young children took Yingyangbao efficiently( OR = 0. 839, 95% CI 0. 735- 0. 959. OR = 0. 854, 95% CI 0. 748-0. 974). Compared with Han ethnic, Miao, Tujia, Dong and other minority ethnic were risk factors of infants and young children took Yingyangbao efficiently( OR = 1. 243, 95%CI 1. 07- 1. 443. OR = 2. 352, 95% CI 2. 008- 2. 755. OR = 1. 801, 95% CI 1. 453-2. 233. OR = 1. 675, 95% CI 1. 192- 2. 355). Compared with father with primary school education or below, father with senior high school education and educated to university level or above were protective factors of infants and young children took Yingyangbao efficiently( OR = 0. 774, 95% CI 0. 618- 0. 970. OR = 0. 570, 95% CI 0. 428-0. 760). Compared with famer father, worker or cadre father was risk factor of infants and young children took Yingyangbao efficiently( OR = 1. 279, 95% CI 1. 104- 1. 482). Compared with parents as caregivers, grandparents as caregivers was protective factor of infants and young children took Yingyangbao efficiently( OR = 0. 651, 95% CI 0. 581-0. 729). Compared with taking Yingyangbao with no adverse reaction, taking Yingyangbao with adverse reaction was risk factor of infants and young children took Yingyangbao efficiently( OR = 2. 759, 95% CI 2. 346- 3. 245). CONCLUSION: The rate of taking Yingyangbao efficiently among infants and young children in poor rural areas is low. The risk factors of infants and young children taking Yingyangbao efficiently include lower in age( months), of minority ethnic, of father with lower education, of father who is worker or cadre, of parents as caregiver, and of taking Yingyangbao with adverse reaction.

[Analysis the statue of growth and development of infants and young children aged 6- 23 months in poor rural areas of Hunan Province, China].

OBJECTIVE: To describe the statue of growth and development among infants and young children aged 6-23 months in poor rural areas of Hunan Province. METHODS: A total of 15 248 rural infants and young children aged 6-23 months in 54 poor counties of Wuling Mountains and Luoxiao Mountains in Hunan Province were selected by Probability-Proportional-to-Size Sampling( PPS) between 2009 and 2015. Participants' length and weight were tested, WHZ, WAZ, HAZ and BMI Z score were calculated according to The WHO Child Growth Standards, and describe the rate of wasting, underweight, stunting and low BMI, and the physical growth level of children were evaluated according to the WHO standards. RESULTS: The average weight of girls aged 6-23 months in poor rural areas of Hunan Province were 9. 17 kg, lower than boys which were 9. 79 kg. The average length of girls aged 6-23 months were 75. 53 cm, lower than boys which were 77. 19 cm. The average BMI of girls aged 6-23 months were15. 96, lower than boys which were 16. 40( P < 0. 05). The curve of weight-for-length Z scores and weight-for-age Z scores and length-for-age Z scores of infants and young children aged 6-23 months were lower than the WHO standards( P < 0. 05). The rate of wasting, underweight, stunting and low BMI of infants and young children aged 6-23 months were 3. 9%, 5. 1%, 7. 2% and 3. 9%, and boys were higher than girls in the rate of underweight and stunting, the rate of underweight and stunting were increased with the growth of age( P < 0. 05). CONCLUSION: The problem of growth and development of infants and young children aged 6-23 months in poor rural areas of Hunan Province are serious, and there are lower than the WHO standards. To improve the nutrition and health of infants and young children in poor rural areas, the ability of child health care and the feeding knowledge of caregivers are need to be improved.

[Child health environment in the context of relocating of camp site families to social housing]. / Salud ambiental infantil en el contexto de la reubicación de familias de campamentos a viviendas sociales.

INTRODUCTION: Housing interventions aimed at overcoming poverty can lead to changes in the health status of children by modifying risk factors in their physical and social environment OBJECTIVE: the aim was to identify children's environmental health factors to change with the relocation of families from slums to public housing. SUBJECTS AND METHOD: A cross-sectional study was conducted in children ages 2-8 years old of families relocated to public housing (n=115) who were compared to children residing in slums (n=88) in Santiago, Chile. Family socioeconomic characteristics, indoor environment and neighborhoods were collected. It was included respiratory symptoms, accidents and maternal-child care of children. χ2, Fisher and Mann-Whitney test were used to compare groups. RESULTS: There were differences in households related to pets keeping, presence of humidity/molds in homes, types of fuels, and perceived safety problems in neighborhoods (p<0.05). The families from slums reported higher tenancy of pets (73.8% v/s 32.2%%), humidity/molds in homes (43.,2% v/s 18.3%), use of wood for heating (39.8% v/s 0.0%), compared with families of public housing. Residents of public housing perceived more safety problems in neighborhood, and children have more asthma related symptoms and have lower diversity of accidents in home. CONCLUSION: Among the factors studied, indoor air quality and safety in neighborhoods could be linked to changes from the relocation of families. This reinforces the need to deepen the positive and negative influences of residential mobility of these groups focused on child welfare perspective.

[Occurrence of injuries among left-behind children from 27 poor rural areas in 12 provinces of China, 2016].

Objective: To understand the injuries among 16 459 left-behind children from 27 poor rural areas in 12 provinces of China, 2016. Methods: Data were collected from the survey of 'Health Service Needs Assessment' (HSNA) program on left-behind children, from poor rural areas in the middle and western parts of China. Factors including causes, types, locations, related activities, ways of treatment and outcomes among left-behind children with injuries in 2016, were described and analyzed by gender and age groups. Results: In 2016, per-person and person-time incidence rates of injuries were 8.88% and 11.21%, among the 16 459 left-behind children from 27 poor rural areas in 12 provinces of China, both higher in boys, than in girls. Most injuries were unintentional with its proportion higher in older children. The main types of injuries were seen as falls, blunt and sharp injuries, with burns and animal injuries more common in younger children. Injuries among left-behind children mainly took place at home, kindergarten/school, and on the highways/streets/roads, during playing. Most common ways of treatment would include at the emergency settings, self-treated, with older children more likely to treat by themselves. Most injuries were cured. Conclusions: In programs on prevention and control of injuries targeting the left-behind children in poor rural areas, special attention should be given to older boys, on falls and blunt/sharp injuries, at home or kindergarten/school. Education programs should pinpoint on self-rescue skills and guidance on kids by the parents, with behavioral norms and social support included. Related comprehensive prevention and control mechanism should be developed in families, schools and communities, with medical resources and insurance mechanism explored to serve these population and districts, including those left-behind children.

Screening HIV-infected adults in Malawi for anaemia: impact on eligibility for antiretroviral therapy.

Clinical staging determines antiretroviral therapy (ART) eligibility when CD4 count is not available. Haemoglobin (Hb) ≤8 g/dL is an indication for the treatment. We measured Hb in HIV-positive Malawian adults undergoing clinical assessment for ART eligibility and calculated the percentage of patients with CD4 ≤ 350 cells/µL deemed eligible for ART by clinical staging with and without Hb measurement, using the existing threshold and an alternative proposed after comparing Hb values to CD4 counts. Three hundred and thirty-eight patients had CD4 counts measured and 226 (67%) had CD4 ≤ 350 cells/µL. Thirty-six (16%) patients with low CD4 count were eligible for ART by clinical assessment alone, 48 (21%) when Hb was also measured with a threshold of ≤8 g/dL and 74 (34%) with a threshold of ≤10 g/dL. Measuring Hb alongside clinical assessment could increase the number of patients with CD4 ≤ 350 cells/µL starting ART by 33% using a threshold of Hb ≤ 8 g/dL or 114% with a threshold of ≤10g/dL.

A abordagem equitativa de gênero como uma estratégia de gestão para fixação de médicos em áreas vulneráveis / A gender equity approach as a management strategy for the settlement of physicians in vulnerable areas / El abordaje equitativo de género como una estrategia de gestión para la fijación de médicos en áreas vulnerables

Embora diversos programas governamentais tenham contribuído para aumentar expressivamente o número de médicos no Brasil, áreas distantes, vulneráveis e de difícil acesso continuam carentes de um quantitativo mínimo de profissionais, prejudicando o acesso à assistência e os indicadores de saúde da população. Estratégias governamentais, como incentivos financeiros especiais, têm conseguido atrair profissionais médicos para essas áreas remotas e com necessidades especiais; no entanto, a fixação desses profissionais não tem sido efetiva. Considerando a tendência de feminização da Medicina e a crescente influência familiar e econômica das mulheres nos processos decisórios da sociedade atual, neste ensaio teórico, propõe-se a utilização de abordagens contemporâneas direcionadas à equidade de gênero nos serviços de saúde para favorecer a fixação de profissionais médicos em regiões mais necessitadas.

Although several government programs have contributed to significantly increasing the number of physicians in Brazil, remote and vulnerable areas that are difficult to access continue to lack a minimum number of professionals, and this hampers access to health care services and the population's health indicators. Government strategies, such as special financial incentives, have been able to attract physicians to these remote areas with special needs; however, the settlement of these professionals has not been effective. In view of the trend toward the feminization of Medicine and the increasing family and economic influence of women in decision-making in current society, this theoretical essay suggests the use of contemporary approaches aimed at gender equity in health services in order to favor the settlement of medical professionals in regions most in need.

Aunque diversos programas gubernamentales hayan contribuido para aumentar expresivamente el número de médicos en Brasil, áreas distantes, vulnerables y de difícil acceso siguen carentes de una cantidad mínima de profesionales, perjudicando el acceso a la asistencia y los indicadores de salud de la población. Estrategias gubernamentales, tales como incentivos financieros especiales, han conseguido atraer a profesionales médicos para esas áreas remotas y con necesidades especiales; sin embargo, la fijación de esos profesionales no ha sido efectiva. Considerando la tendencia hacia la feminización de la Medicina y la creciente influencia familiar y económica de las mujeres en los procesos de decisión de la sociedad actual, en este ensayo teórico se propone la utilización de abordajes contemporáneos dirigidos a la equidad de género en los servicios de salud para favorecer la fijación de profesionales médicos en regiones más necesitadas.

Salud ambiental infantil en el contexto de la reubicación de familias de campamentos a viviendas sociales / Child health environment in the context of relocating of camp site families to social housing

Introducción: Intervenciones habitacionales destinadas a superar la pobreza pueden generar cambios en la situación de salud de la población infantil, modificando factores de riesgo en el entorno físico y social de niños y niñas. El objetivo fue identificar indicadores de salud ambiental infantil susceptibles de ser modificados con la reubicación de familias desde campamentos a vivienda social. Sujetos y método: Estudio transversal en niños de 2-8 años. Se comparó dos grupos de familias provenientes de campamentos. Un grupo fueron familias reubicadas en viviendas sociales entre 2001 y 2002 (n = 115). El otro grupo corresponde a niños cuyas familias permanecieron en campamentos (n = 88) de la zona poniente de Santiago. Se recolectó información sobre: características socioeconómicas, ambiente intradomiciliario y de barrios, y eventos en salud: síntomas respiratorios, accidentabilidad y cuidado materno infantil. Se emplearon pruebas de x², Fisher y Mann-Whitney para la comparación de los grupos. Resultados: Se identifican diferencias entre los grupos comparados en relación a la tenencia de mascotas, presencia de hongos/humedad en el hogar, tipo de combustibles utilizados y problemas de seguridad percibidos en los barrios (p<0,05). Las familias de campamentos reportan una mayor tenencia de mascotas (73,8% v/s 32,2%%), presencia de huellas de humedad/hongos en el hogar (43,2% v/s 18,3%), uso de leña (39,8% v/s 0,0%), en comparación con familias de viviendas sociales. Residentes de viviendas sociales perciben mayores problemas de seguridad en el barrio, mientras que los niños presentan mayor frecuencia de síntomas relacionados con asma y menor diversidad de accidentes en el hogar comparado con el grupo residente en campamentos. Conclusiones: Entre los factores estudiados, aquellos susceptibles de ser modificados con la reubicación de familias desde campamentos a vivienda social se vinculan a indicadores de calidad del aire interior y seguridad en los barrios. Lo anterior refuerza la necesidad de profundizar en las influencias positivas y negativas de la movilidad residencial de estos grupos, desde una perspectiva centrada en el bienestar infantil.

Introduction: Housing interventions aimed at overcoming poverty can lead to changes in the health status of children by modifying risk factors in their physical and social environment Objective: the aim was to identify children's environmental health factors to change with the relocation of families from slums to public housing. Subjects and method: A cross-sectional study was conducted in children ages 2-8 years old of families relocated to public housing (n=115) who were compared to children residing in slums (n=88) in Santiago, Chile. Family socioeconomic characteristics, indoor environment and neighborhoods were collected. It was included respiratory symptoms, accidents and maternal-child care of children. x², Fisher and Mann-Whitney test were used to compare groups. Results: There were differences in households related to pets keeping, presence of humidity/molds in homes, types of fuels, and perceived safety problems in neighborhoods (p<0.05). The families from slums reported higher tenancy of pets (73.8% v/s 32.2%%), humidity/molds in homes (43.,2% v/s 18.3%), use of wood for heating (39.8% v/s 0.0%), compared with families of public housing. Residents of public housing perceived more safety problems in neighborhood, and children have more asthma related symptoms and have lower diversity of accidents in home. Conclusion: Among the factors studied, indoor air quality and safety in neighborhoods could be linked to changes from the relocation of families. This reinforces the need to deepen the positive and negative influences of residential mobility of these groups focused on child welfare perspective.