Efficacy of albendazole against the whipworm Trichuris trichiura - a randomised, controlled trial

Objectives and design. To test the efficacy of albendazole against the whipworm Trichuris trichiura for  school-based deworming in the south-western Cape, South Africa. Children infected with Trichuris were  randomised to 3 doses of albendazole (400; 800 or 1 200 mg), each repeated 4 times. The boy I girl ratio was 1. A group not infected With worms was treated with placebo, creating a negative control. Subjects and setting. Pupils at a primary school serving a wineproducing area approximately 90 km east of Cape Town.Outcome measures. Trichuris cure rates and reduction in the number of eggs/gin faeces, as well as the  infection dynamics of Trichuris and Ascaris during treatment with placebo.Results. Albendazole treatment was associated with Trichuris cure rates of 23% (400 mg), 56% (800  mg) and 67% (1 200 mg) after the final treatment. The corresponding reductions in the number of eggs/g of faeces were 96.8%, 99.3% and 99.7%. Environmental pollution by human faeces was confirmed because worm egg-negative children in the placebo group became egg-positive while the study was in progress.Conclusion. The 400 mg stat dose had a low Trichuris cure rate. To repeat the dose on 2 or 3 days would  increase cost, reduce compliance and complicate management. Albendazole cannot be used in deworming programmes in South Africa because it is a Schedule 4 prescription medicine. De-scheduling is needed urgently, particularly because of high efficacy against hookworm in KwaZulu-Natal and  neighbouring countries

The nutrition situation in South Africa: demographic, socio-economic and health indicators

Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected] Voedin

Is prophylactic vitamin A supplementation justified in areas where liver is frequently eaten?

Geneeskunde en GesondheidswetenskappeMenslike VoedingPlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Frequent consumption of liver protects against vitamin A deficiency in a socio-economically deprived community: Time to reappraise the vitamin A supplementation policy for South Africa's diverse population

Geneeskunde en GesondheidswetenskappeMenslike VoedingPlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Full term, peri-urban South African infants under six months of age are at risk for early-onset anemia.

Objective: There is a paucity of data on the micronutrient status of low-income, lactating South African women and their infants under 6 months of age. The aim of this study was to elucidate the level of anaemia and vitamin A deficiency (VAD) in peri-urban breast-feeding women and their young infants. Design: Cross-sectional study including anthropometric, biochemical and infant feeding data. Setting: Peri-urban settlement in Cape Town, South Africa. Subjects: Breast-feeding women (n = 113) and their infants (aged 1–6 months) attending a peri-urban clinic. Results: Mean (standard deviation (SD)) haemoglobin (Hb) of the lactating mothers was 12.4 (1.3) gdl−1, with 32% found to be anaemic (Hb \u3c 12 g dl−1). Maternal serum retinol was 49.8 (SD 13.3) μg dl−1, with 4.5% VAD. Using breast milk, mean (SD) retinol concentration was found to be 70.6 (24.6) μg dl−1 and 15.7 (8.3) μg/g milk fat, with 13% below the cut-off level of \u3c8μg/g fat. There was no correlation found between breast milk retinol and infant serum retinol. Z-scores (SD) of height-for-age, weight-for-age and weight-for-height were –0.69 (0.81), 0.89 (1.01) and 1.78 (0.83), respectively. Mean (SD) infant Hb was 10.9 (1.1) g dl−1, with the prevalence of anaemia being 50%, 33% and 12% using Hb cut-offs below 11 g dl−1, 10.5 g dl−1 and 9.5 g dl−1, respectively. Mean (SD) infant serum retinol was 26.9 (7.2) μg dl−1, with 10% being VAD. None of the infants was exclusively breast-fed, 22% were predominantly breast-fed and 787percnt; received complementary (mixed) breast-feeding. Thirty-two per cent of infants received weaning foods at an exceptionally young age (≤1 month old). Conclusion: A high rate of anaemia is present in lactating women residing in resource-poor settings. Moreover, their seemingly healthy infants under 6 months of age are at an elevated risk of developing early-onset anaemia and at lower risk of VAD

The importance of breakfast in meeting nutritional requirements of South African children � a review

GesondheidswetenskappeMenslike VoedingPlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Socio-demographic factors and anthropometric status of 0-71-month-old children and their caregivers in rural districts of the Eastern Cape and KwaZulu-Natal provinces of South Africa

Objectives: To determine the nutritional status of 0- to 71-month-old children and their caregivers, as well as their socio-demographics, in two provinces in South Africa. Design: Cross-sectional baseline survey. Setting: OR Tambo and Alfred Nzo districts in the Eastern Cape (EC), and Umkhanyakude and Zululand (Nongoma and Pongola subdistricts) in KwaZulu-Natal (KZN), South Africa. Subjects: 0- to 71-month-old children and their caregivers (EC 1 794; KZN 1 988). Methods: Questionnaire and anthropometric survey. Results: The prevalence of childhood malnutrition doubled from the first to second year of life and reached high levels in the EC and Nongoma (KZN). Many caregivers were either overweight or obese (EC 55%; KZN 45%). Initiation of breast-feeding was universal. For infants younger than six months, more than 80% were breast-feeding, and 50% received bottle feeds in addition to breast milk in the EC. Breast-feeding was similar in the two provinces up to the age of 18 months, but differed for 18- to 24-month-old children (EC 50%; KZN 33%). Animal products and yellow/orange-fleshed vegetables were not consumed regularly by children aged two to five years. Immunisation coverage up until 10 weeks was approximately 90%; measles immunisation coverage at 18 months was 40 to 43%. Toilet facilities (31 to 96%), tap water (9 to 38%), electricity (8 to 51%), single mothers (29 to 68%) and unemployed husbands (19 to 55%) varied among provinces. Many households relied on grants for income. In Umkhanyakude, 37% of the caregivers had no formal education. Conclusions: Childhood malnutrition and maternal overweight/obesity co-existed. A large proportion of the study population did not have access to basic services. Differences were observed within and between provinces. Nutrition programmes should be flexible, taking into consideration local conditions. SAJCN Vol. 21 (3) 2008: pp. 117-12

Commentaries on "Informatics and medicine: from molecules to populations"

OBJECTIVE: To discuss interdisciplinary research and education in the context of informatics and medicine by commenting on the paper of Kuhn et al. "Informatics and Medicine: From Molecules to Populations". METHOD: Inviting an international group of experts in biomedical and health informatics and related disciplines to comment on this paper. RESULTS AND CONCLUSIONS: The commentaries include a wide range of reasoned arguments and original position statements which, while strongly endorsing the educational needs identified by Kuhn et al., also point out fundamental challenges that are very specific to the unusual combination of scientific, technological, personal and social problems characterizing biomedical informatics. They point to the ultimate objectives of managing difficult human health problems, which are unlikely to yield to technological solutions alone. The psychological, societal, and environmental components of health and disease are emphasized by several of the commentators, setting the stage for further debate and constructive suggestions