Paediatric anaemia at Kamuzu Central Hospital

This retrospective study assessed the outcome of children admitted during a six week period to Kamuzu Central Hospital (KCH) with anaemia. 19% of admissions had a primary discharge diagnosis of anaemia and there was a 12% mortality. Children who died were more likely than those who did not to have other diagnoses that may have contributed to mortality. 72% had a diagnosis that included both anaemia and malaria, but malaria was only documented in 36%. Malaria may be oveJlodiagnosed in that 57% of cases with a diagnosis that included malaria had negative blood smears for malaria. More data is required to determine whether delays in obtaining blood for transfusion influence mortality

Evaluation of a peer counselling programme to sustain breastfeeding practice in Hong Kong

<p>Abstract</p> <p>Background</p> <p>Peer counselling is reported to increase breastfeeding rates. We evaluated an intervention consisting of mainly telephone contact peer counselling programme on breastfeeding duration and exclusivity.</p> <p>Methods</p> <p>Peer counsellors (PCs) were mothers who had successfully breastfed and had received formal training. Following a postnatal visit, they provided scheduled telephone consultations (Days 1, 4, 7, Weeks 2, 4, 8, and Month 4) to PC group mothers (n = 100) who continued breastfeeding their infants after discharge. Control group mothers (n = 100) received routine care.</p> <p>Results</p> <p>After adjusting for mothers' previous breastfeeding experiences, mothers' working status and breastfeeding problems, no statistical differences in mothers' feeding methods (exclusive, almost exclusive or predominant breastfeeding) were noted at the three follow-up times for intervention and control mothers respectively (Day 5: 37%/38%, 46%/53%, 57%/63%; Month 3: 10%/9%, 17%/23%, 20%/26%; Month 6: 2%/1%, 18%/18%, 18%/19%). All differences between the groups were not significant. Also, there was no evidence to suggest that PC intervention prolonged breastfeeding duration.</p> <p>Conclusion</p> <p>The lack of effect of our PC intervention may reflect the low baseline breastfeeding rate and low value placed on breastfeeding in our population, the type of PC intervention or group allocation biases.</p> <p>Trial registration</p> <p>ISRCTN93605280.</p

Incidence of rotavirus gastroenteritis by age in African, Asian and European children: Relevance for timing of rotavirus vaccination

© 2016 The Author(s). Published with license by Taylor & Francis. © GSK Biologicals SA.Variability in rotavirus gastroenteritis (RVGE) epidemiology can influence the optimal vaccination schedule. We evaluated regional trends in the age of RVGE episodes in low- to middle- versus high-income countries in three continents. We undertook a post-hoc analysis based on efficacy trials of a human rotavirus vaccine (HRV; Rotarix™, GSK Vaccines), in which 1348, 1641, and 5250 healthy infants received a placebo in Europe (NCT00140686), Africa (NCT00241644), and Asia (NCT00197210, NCT00329745). Incidence of any/severe RVGE by age at onset was evaluated by active surveillance over the first two years of life. Severity of RVGE episodes was assessed using the Vesikari-scale. The incidence of any RVGE in Africa was higher than in Europe during the first year of life (≤2.78% vs. ≤2.03% per month), but much lower during the second one (≤0.86% versus ≤2.00% per month). The incidence of severe RVGE in Africa was slightly lower than in Europe during the first year of life. Nevertheless, temporal profiles for the incidence of severe RVGE in Africa and Europe during the first (≤1.00% and ≤1.23% per month) and second (≤0.53% and ≤1.13% per month) years of life were similar to those of any RVGE. Any/severe RVGE incidences peaked at younger ages in Africa vs. Europe. In high-income Asian regions, severe RVGE incidence (≤0.31% per month) remained low during the study. The burden of any RVGE was higher earlier in life in children from low- to middle- compared with high-income countries. Differing rotavirus vaccine schedules are likely warranted to maximize protection in different settings

Intussusception trends in Hong Kong children

OBJECTIVES: To assess trends in intussusception and to validate the coding in Hong Kong's computerised discharge information system. DESIGN: Case notes were reviewed for all children under the age of 5 years who had a discharge diagnosis indicating intussusception or a procedure indicating reduction of intussusception during the 6-year period 1 July 1997 through 30 June 2003. RESULTS: Intussusception rates for infants under 1 year of age (108/100,000) and under 5 years of age (38/100,000) were slightly higher than previous estimates (78-100/100,000 and 27-32/100,000, respectively) that used passive discharge data alone. CONCLUSIONS: Hong Kong's passive computer data systems could be used to monitor rates of intussusception after the introduction of new rotavirus vaccines, provided readmissions, inter-hospital transfers, and hospital follow-ups for the same episode are taken into account.published_or_final_versio

Dietary characteristics of Hong Kong young children: Implications for nutrition education

Objectives: To examine the dietary pattern of Hong Kong young children and its implication for nutrition education. Methods: Dietary patterns of 316 children aged 6-7-years (121 overweight, 130 middle-weight and 65 low-weight children), were assessed by a standardised questionnaire and a 3-day dietary record. Results: Macronutrient composition (carbohydrates: 53%; proteins: 16% and fats: 31%) was similar in the three weight groups and in line with recommendations. Our subjects mainly consumed proteins from animal sources. Seventy-nine percent of the subjects reported routine snacking during school breaks and fat from snacks (22%) was higher than that reported in 1993 (15%). An inadequate vegetable (84 g/day) intake was observed. Absence of vegetables during lunch was reported by 22% of subjects and this was associated with eating out. Conclusion: Further nutrition education in young children in Hong Kong should focus on healthy choices of snacks, balancing animal and plant sources of proteins and adequate consumption of vegetables and fruits. The need for healthy school lunch and snack programmes should be emphasised.link_to_subscribed_fulltex

Meal glycaemic load of normal-weight and overweight Hong Kong children

Objective: To describe the pattern of meal glycaemic load of children in Hong Kong and to determine whether the meal glycaemic load is associated with childhood overweight. Method: Dietary records (3-day) of 316 Hong Kong children aged 6-7 years were collected. Glycaemic load was calculated from the estimated weight (WT), carbohydrate content (%CHO) and glycaemic index (GI) of each food taken using the equation: (% CHO × GI × WT/100). The meal glycaemic load was then the sum of the glycaemic loads of all food taken in each meal. Logistic regression analyses were used to compare the average meal glycaemic load (of breakfast, lunch and dinner) and other dietary parameters between overweight children and normal-weight children. Results: Breakfast, lunch, dinner and snacks provided, respectively, 17, 29, 29 and 25% of the total glycaemic load in a day. White rice (excluding congee (rice porridge) and glutinous rice) contributed almost half of the total glycaemic load. Adjusted logistic regression showed that the meal glycaemic load was not significantly associated with childhood overweight after adjusting for parental obesity, birth weight, sleeping duration, mean energy intake and paternal smoking. Conclusion: Meal glycaemic load calculated from current diet was not an independent factor associated with childhood overweight in children aged 6-7 years. Our data suggested that modifying the type of rice/staple consumed and choosing low-GI snacks could have a major influence on the total meal glycaemic load of young Hong Kong children. © 2006 Nature Publishing Group All rights reserved.link_to_subscribed_fulltex