6 research outputs found
Comparison of a possession score and a poverty index in predicting anaemia and undernutrition in pre-school children and women of reproductive age in rural and urban Côte d'Ivoire
Abstract Objective To determine whether a possession score or a poverty index best predicts undernutrition and anaemia in women of reproductive age (15-49 years; WRA) and children aged 6-59 months living in Côte d'Ivoire. Design Anthropometric measurements were converted to Z-scores to assess stunting, wasting and underweight in children, and converted to BMI in WRA. A venous blood sample was drawn, and Hb concentration and Plasmodium spp. infection were determined. A possession score was generated with categories of zero to four possessions. A five-point (quintile) poverty index using household assets was created using principal component analysis. These socio-economic measures were compared for their ability to predict anaemia and malnutrition. Setting Data were from a nationally representative survey conducted in Côte d'Ivoire in 2007. Subjects A sample of 768 WRA and 717 children aged 6-59 months was analysed. Results Overall, 74·9 % of children and 50·2 % of WRA were anaemic; 39·5 % of the children were stunted, 28·1 % underweight and 12·8 % wasted, while 7·4 % of WRA had BMI < 18·5 kg/m2. In general, there were more stunted and underweight children and thin WRA in rural areas. The poverty index showed a stronger relationship with nutritional status than the possession score; mean Hb difference between the poorest and wealthiest quintiles in children and WRA was 8·2 g/l and 6·5 g/l, respectively (13·9 % and 19·8 % difference in anaemia, respectively; P < 0·001), and Z-scores and BMI were significantly better in the wealthiest quintile (P < 0·001). Conclusions The poverty index was generally a better predictor of undernutrition in WRA and pre-school children than the possession scor
Prevalence and public health relevance of micronutrient deficiencies and undernutrition in pre-school children and women of reproductive age in Côte d'Ivoire, West Africa
Abstract Objective To provide nationally representative data on the prevalence of anaemia, vitamin A and Fe deficiencies among pre-school age children (pre-SAC) and non-pregnant women of reproductive age (WRA), and on vitamin B12 and folate deficiencies in WRA, and the influence of inflammation on their interpretation. Design A cross-sectional survey to measure anthropometry, malaria parasitaemia and micronutrient status. Specifically, blood samples were analysed for Hb, plasma ferritin, soluble transferrin receptors, C-reactive protein, α1-acid glycoprotein, retinol-binding protein, vitamin B12 and folate. Setting Côte d'Ivoire in 2007. Subjects Nine hundred and twenty-eight WRA and 879 pre-SAC. Results In WRA, prevalence of Plasmodium parasitaemia (5 %) was low, but inflammation (34 %) was higher. Anaemia was a severe public health problem and prevalence differed by residency and eco-region. Inflammation-adjusted Fe deficiency was highest in urban areas (20 %). Nationally, folate deficiency was 86 %, higher in urban areas and varied by eco-region. Prevalence of vitamin B12 deficiency was low but higher in the rural areas and the north. Inflammation-adjusted vitamin A deficiency was very low (1 %). In pre-SAC, prevalence of inflammation (67 %) and Plasmodium parasites (25 %) was high; the latter was associated with poverty, rural residency and higher ferritin concentrations. Anaemia was classified as a severe public health problem (72 %), and was higher in rural areas (76 %) and the north (87 %). A quarter of pre-SAC suffered from vitamin A deficiency (inflammation-adjusted) and prevalence of undernutrition was high. Conclusions Prevalence of inflammation, Plasmodium parasitaemia and micronutrient deficiencies were high in Côte d'Ivoire, particularly in pre-SAC. Nutritional interventions should be accompanied by strategies to reduce exposure to infection
Quality of normal delivery care in Côte d'Ivoire
The aim of this study was to assess the quality of normal delivery care
in Côte d'Ivoire. A total of 229 women were included in a
cross-sectional study conducted in four urban maternity wards between
2002 and 2003. Observation checklists and exit-interviews were used to
examine various dimensions of care. The results showed that the overall
quality of care was poor, despite most women giving birth with a
professional midwife. A vaginal examination was performed
systematically at admission but blood pressure was measured in less
than half of the women. The partograph was completed during labour in
only 5% of cases. Episiotomy and uterine revision rates were high at
24% and 32%, respectively. There was a lack of universal hygiene
precautions and women received little support during labour. Our
results question the quality of labour, delivery and post-partum care
by skilled attendants in Côte d'Ivoire.Qualité du service de l'accouchement normal en Côte-d'Ivoire
Cette étude avait pour but d'évaluer la qualité du
service de l'accouchement normal en Côte-d'Ivoire. Au total, 229
femmes ont fait partie de cette étude transversale qui a
été menée dans quatre salles d'accouchement urbaines
entre 2002 et 2003. On s'est servi des listes de contrôle de
l'observation et les interviews de sortie pour examiner des dimensions
différentes du service. Les résultats ont montré que
dans l'ensemble la qualité du service est médiocre,
malgré le fait que la plupart des femmes accouchent avec
l'assistance d'une sage-femme professionnelle. On a effectué
systématiquement un examen vaginal au moment de l'admission mais
nous n'avons mesuré la pression artérielle que chez moins
d'une moitié des femmes. La partagraphe n'a été
complétée pendant le travail que chez 5% des cas. Et les taux
de l'épisiotomie et de la révision de l'utérin
étaient élevés, s'élevant jusqu'à 24% et 32%,
respecitvement. On a remarqué un manque de précautions
d'hygiène universelle et les femmes n'ont reçu que très
peu de soutien pendant le travail. Nos résultats mettent en
question la qualité des services du travail et du soin du
post-partum par les auxillaires habiletés en Côte d'Ivoire