Louw, GJ

Naidoo, SM

English

Louw, G J

Naidoo, S M

AJOL - African Journals Online

ORIGINAL ARTICLESdiabetic patients in Addis Ababa, Ethiopia, 1976 -1990. QJM 1992; 301: 389-399.8. Gill CV, Huddle KR, RoUe M. Mortality and outcome of insulin-dependent diabetes inSoweto, South Africa. Diabet Med 1995; R 546-550.9. Hanssen ICE Determinants of microvascular complications in diabetes: an ovenrie\v. In:Pickup j, Williams G, eds. Textbook of Diabetes. Oxford: Slackwell Scienti6c Pubtications, 1991:519-525.10. Lester FT. Clinical status of Ethiopian diabetic patients after 20 years of diabetes. Dinbet Med1991; 8: 272-276.11. Levitt NS, Bradshaw, 0 Zwarenstein MF, Bawa AA, Maphumolo S. Audit of public sectorprimary diabetes care in Cape Town, South Africa: high prevalence of complications,uncontrolled hyperglycaemia, and h}'P"rtenSion. Diabet Med 1997; 14: 1073-1077.12. World Health Organisation Expert Committee. Arterial Hypertension.. Report of a WHOExpert Committee. World Health Organ TecJI Rep $er 1978; No. 628.13. Kohner EM. The lesions and natural history of diabetic retinopathy. In: Pickup J, Williams G,eds. Textbook of Diabetes. Oxford: Blackwell Scientific Publications, 1991: 575-588.14. SAS Institute. SAS/STAT User's GlIidr. Release 6.03 00. Cary, NC: SAS Institute, 1988.15. Viberti GC, MarshallS, Beech R, rt al. Report on renal disease in diabetes. Diabrt Med 1996;13: suppl4, 6-12.16. Omar MAK, Asmal AC. Complications of early-onset insulin-dependent diabetes mellitus inblacks and Indians. 5 Afr Med J1984; 65: 75-78.17. Seedat YK. Race, environment and blood pressure: the South African experience. J Hyperl~151983; 1: 7-12.18. Omar MAK Asmal AC. Patterns of diabetes mellitus in young Africans and Indians in Natal.Trap Grogr Med 1984; 36: 113-138.19. Kalk Wj, Huddle KRL. RaaJ FJ. The age of onset and sex distribution of insulin-dependentdiabetes mellitus in Africans in South Africa. Postgrad Mrd J1993; 69: 552-556.20. LaPorte RE. Tajina N, Dorman IS, et al. Differences between Blacks and Whites in theepidemiology of insulin dependent diabetes mellitus in Allegheny county, Pennsylvania. AmJEpidrmioI1986; ID: 592-603.Accepted 9 September 2001.ovember 2001, VoL 91, 0: 11 SAMJS 1'1 (I \ I A l{ I I ( I I ItAN ASSESSMENT OF GROWTHIN HIGH AND LOW SOCIO-ECONOMIC STATUSSCHOOLCHILDREN IN SOUTHAFRICAG JLouw, S M Naidoo'We are guilty of many errors and many faults, but ourworst crime is abandoning the children, neglecting thefoundation of life. Many of the things we need can wait.The child cannot.• Right now is the time his bones are bein[formed, his blood is being made and his senses are beingdeveloped. To him we cannot answer "Tomorrow". Hisname is "Today".'(Gabriela Mistral, 1948, World Health Organisation, 1997The patterns of physical growth (height, weight, length oftrunk and limbs, circumference of trunk and limbs, and limbbreadths) and function (grip strength of both hands andneuromuscular reaction time) of Cape Coloured (specificallymixed origin) schoolchildren from urban and rural areas anecontrasting socio-economic status (SES) levels, were measurE LThe mixed longitudinal study accumulated data over morethan a decade, and included 929 male and 1 160 female pupi .;of high SES (HSES) in the Cape Town urban area, aged 5 - 20years, and 954 male and 1 030 female pupils of low SES (LSE .;)in rural areas of the Little Karoo, aged 5 - 19 years. Means fo:every anthropometric character were calculated and matchee:against age for each of the four groups, for comparativepurposes. Standard deviations were recorded for eachcharacter. Figs 1 - 16 show the means for each of theanthropometric characters, matched with age groups, for HSESand LSES boys and girls.The results reflect the importance of positive intervention inthe growth and development of the LSES children at differentperiods for the girls and boys, namely pre-pubertally in girls,particularly during the period of possible pre-pubertal growthspurt (8 - 10 years of age), and continuously and consistentlyfor the boys, from 5 to 19 years and onwards. Interventionshould take the form of improved diet, increased. exercise, andplenty of time spent outdoors in the sun.Department ofHuman Biology, University of Cape TownG J Louw, DVSc5 M Naidoo, BSc, ORIGINAL ARTICLES-- .// .,_,-.-,-;/- ... - ,.<.:-- ---, - " ",.- .. _--, .-----'.:Y'../':"" /-.'//,~"/ .. f'(~.".,/: '.'... ~"., ~~-;......- HSES males~/" - - HSES females,~ - - - LSES males-- LSES females201816.,.'....,1412--.- ...." .-'---',...---- .................1086-l--~c?--=-"",""o<:...-------------j- HSES malesI .;,:/ - - HSES females.1::;::. • - - LSES males- - LSES females800750700E.s 650.c15>c:.!!! 800.0~Q; 550a.a.::J5004SO400420181614121086l' 0HO" 01 )41, 01(0, )Age (yrs) Age (yrs)'ig. . Means of total body height (mm) for age (yrs). Fig. 4. Means of upper limb length (mm) for age (yrs).- ~/ V-t!----;.-,..,, ., ,_/ '''''.: ......... \:." ... ,// .,_.~.;;// I ,~.'./,'./ /,::.., - HSESmales','ff /--- HSES females0-';-' - - - LSES males~_._ .., .... - LSES females_._J'950900850E 800.s.c0. 750c:.!!!.0~ 700Q;~ 6500.J- HSESmales800 - - HSES females- - - LSES males550- - LSES females---:5004 6 8 10 12 14 16 18 20201816141210864Age (yrs) Age (yrs)19.. Means of body weight (kg) for age (yrs). Fig. 5. Means of lower limb length (mm) for age (yrs).20181614..../ ..'12Age (yrs)1086"-,-,,,,' - HSESmales~:.-.,..... - - HSES females+---7"'--------r-.:....:'--------------l~~ ~~~ =~s- ....;,.:,_#'..",Fig. 6. Means ofarm circumference (mm) for age (yrs).290270E 250.s'"() 230c:eCllE" 210euE< 1901701504- HSESmales3So1---7"~.,=-----------j-- HSES females_ - - LSES males- - LSES femalessv·.I, ::::::--/1.04SDi-- -f-=-='::--.::-:;;"'-=--;:------j3'Jor--_-,-_-,-_-,-_-._-.,__r--,--,----'4 6 8 10 12 14 16 18 20Age (yrs)! . 3. Means of trunk length (mm) for age (yrs).,4ODt---------:-~~=--------1ORIGINAL ARTICLES_._---// ...../_,.O&:'..~._J/' . .-e.._-..",.. .. ......." .". .. -./ .,:: -;•.r-/ "./."".J/ 4"/.;.~.' - HSESmales-/--/ .;/ HSES females,r •• - lSES males,...... .;,"".........~.95--.90 / ". ....-..-\!:'",,.-~85.;;.-- .....,r:. I,' ,....;,:~:" ,./ .' /.-.,.,' .... ,".-- .' ,., .... .L,/ .., .'I ... 1 ,._;, . .../.. , /75 " ./ ,.' "70./.., ,./",- .", ...' - HSES males. r/ - - HSES female.• - _ lSES males65 • lSES female, r,60 -410390370E.s 350$a>E 330'"'5(ij 310Ee" 290'1'iD2702502304 6 8 10 12 14 16 18 204 6 8 10 12 14 16 18 2CAge (yrs)Age (yrs)Fig. 7. Means of bi-acromial diameter (mm) for age (yrs).Fig. 10. Means ofbi-epicondylar breadth offemur (mm) for age (yl ,).1}2C181614121086- //.............-~~/_---r-, \\., /.. . ... .........,;. .-.... \, .y...-..!.._'I' "/ ,/./Y ',., / ,...,L ,. .'.// /.,/~.J// .,..-' - HSESmales. ... ..-,::.-' - - HSES femal.-,.;:;,...", • - - lSES males- .i i i i i i i i5004900850E 800.sa> 750"c:i!!S2E 700::>!!'u0; 850a>.r::(J600550\20181614121086~...~../., - HSESmales+----..::.:-=-r'-'----------------~ ~~~~~;:~es270250E.s 230$a>E'"'5 210]l'"'5~ 190iD1701504Age (yrs) Age (yrs)Fig. 8. Means of bi-iliocristal diameter for age (yrs). Fig. 11. Means ofchest circumference (mm) for age (yrs).Fig. 9. Means of bi-epicondylar breadth ofhumenls (mm) for age(yrs).2018161412I',--'I" I, ''''1086,-."". 'J' •• - ....... _ ..... -;=..-"••-'0'----,, - HSES males+~~'""""'~~ __~/~.-;o-~.'--._--.;::-=-.----____1- - HSES females•••_. ' • - - lSES males1715E.s'" 13'"a>c:"l\:s 11~c::i' 9'"1;;:;Q.~ 7.0::>(JJ534Age (yrs)Fig. 12. Means ofsubscapular skinfold thickness (mm) for age (yrs).2018161412Age (yrs)1086-/\,.. --:/ ........ ,\/~~.;.. :., _. I\--...'_........ I\.... _-'.1' ,,' -----' --.:."<.~"'/'->/ ':.- ,..-~ .', ,x::: / . ,.,/ ....... '--_ .... "",- HSESmales......_...., .. '- - HSES females" •• - lSES males-._'" -.4ovember 2001, Vol. 91, No. 11 SAMJ70E 65.s'"::>1;;60E::>.r::'0.r::55'5'"i!!.01;;50>."0c:0"a.'!' 45iD40ORIGINAl ARTICLES3+----,;-----,_...--_.,---_,------,.-=::::::;:::==~4035..30S- ,'c 252-.s::e;, ,.c:~1;jCo 15~10- HSESmales- - HSES females- - - LSES males-- LSES females04 6 8 10 12 14 16 18 20201816,. _.I './ \1412108641715- 13~-,E:<~ 110~97...JIL "-./ // .'_' ..' -' '.. - HSES males+--;;'F-'-"'-~-~/~~:'=-'-'-"'-=------~-- HSES females,._•• -.................... --- lSESmales- - LSES femalesAge (yrs) Age (yrs)'ig. 13. Means ofabdominal skinfold thickness (mm) for age (yrs). Fig. 15. Means of left-hand grip strength (units) for age (yrs).4035~/ .,......30725"/ ---,<u /, /, ' "~ ,~,-.-/7-' ,...~" ....15,. .~/'/'10...~...:-..d: ...-~.,A" / - HSESmales..., , - - HSES females5_......... ,"";,,-:....... • - - LSES males-'" - - LSES females0201816, , .....". "14" I."".121086- HSESmales+----: -1- - HSES females- - - LSES males- - LSES females290270Eg.. 250.~c:.2Uco 230~:0'5~ 2100Ee0..z 19017042018161210864Age (yrs):ig. 14. Means of right-hand grip strength (units) for age (yrs).Age (yrs)Fig. 16. Means of neuromuscular reaction time (mm) for age (yrs).Four patterns of growth and development emerge from thisanalysis, and the anthropometric characters falling into eachpattern are grouped accordingly,The majority of characters fell into the first pattern, namelytotal bOdy height, body weight, trunk length, upper extremitylength, lower extremity length, arm circumference, bi-acromialdiameter, bi-iliocristal diameter, bi-epicondylar width ofhumerus, bi-epicondylar width of femur, and chestcircumference. The rates of increase of the anthropometriccharacters, as reflected by the slopes of the graphs, are similarfor HSES and LSES males and females from age 5 until puberty,Where the values for the girls drop off rapidly as the growthplates of their bones close. The different values observed alongthe graph are a reflection of differing starting points at age 5for the HSES and LSES groups, and there is no 'catch-up'achieved at any time. The males have higher final valuebecause they continue growing postpubertaUy, into theirtwenties. For all four groups, only a small pre-pubertal growthspurt is visible.The second pattern of growth was similar for the variousskinfold thicknesses. The skinfold thicknesses, as a reflection of'fatness', fluctuate continuously, but a pre-pubertal peak isvisible in all groups. Although both HSES and LSES groupscommence at similar values at age 5, the HSES group risesrapidly, with females exceeding the males at all ages. BothHSES and LSES males show lower values after puberty sincetheir linear characters all continue to increase, and the LSESfemales overtake the HSES males at the time of puberty. Agirl's 'fatness' is an important trigger for menarche.The third pattem of development was for left and right grip••ORIGINAL ARTICLES 'strengths, which are virtually identical. The pattern for boys ismarkedly different from that of the girls in that there is adramatic increase in the strength just before puberty rightthrough to the mid-teens, after which the graphs plateau. Thevalues for the girls increase at the same rate as those of theboys, as reflected by similar slopes, but the girls reach theirmaximum strength at a younger age, shortly after puberty.The last pattern of development was shown byneuromuscular reaction time. The graphs for all four groups ofschoolchildren are similar in shape from 6 to 16 years in thatthere is a declining reaction time from 6 to 8 years, then a slowincrease from 8 to 12 years, after which the time decreasesagain until 16 years of age. The graphs demonstrate that HSESmales have the quickest reaction times, followed by the LSESmales. The girls of both groups show considerable fluctuation,but the LSES girls have the slowest reaction times of all groupsat all ages, and do not achieve a 'catch-up' period.The authors wish to thank the staff and students of thisDepartment for their assistance in collecting the data over theyears, and the staff and pupils of the schools visited for theirwonderful co-operation.ovember 2001, VoL 91, o. 11 SAMJSTLDE"-'T PAPER •.FACTORS INFLUENCING PEAKEXPIRATORY FLOW IN TEENAGEBOYSS N van Helden, E G Hoal-van Helden, P D van HeldenBackground. Peak expiratory flow (PEF) is a useful measure fpulmonary health status and is frequently utilised in asthm,management. Reduction in PEF is usually indicative of OIlS(of asthma symptoms. However, use can be made of PEFvalues only if normal values are known. The definition ofnormal range is always difficult and may vary betweenregions and be affected by a variety of factors.Objective. To establish PEF values for teenage boys in a CapTown suburb and examine factors that possibly influence tl" smeasurement.Setting. A high school for boys in the southern suburbs ofCape Town.Methods. Measurements of PEF were taken for 124 boys.Subjects were approximately 16 years old and apparentlyhealthy at the time of survey. Further details were providby means of a questionnaire.Results. PEF ranged from 350 to 760 1/min, with a mean(± standard deviation (SD» of 539 ± 681/min. Factorsexpected to influence PEF included height and mass, where isunexpected factors included sport intensity and academicgrade. A trend to reduced peak flow was already evident inboys who smoked and boys from homes where a parentsmoked. Regression analysis suggested peak flow differenct.sin our population compared with the standard reference.Conclusion. Interpretation of results obtained from peak-flO\:instruments should take into account additional knowledgconcerning the individual. Further surveys of the SouthAfrican population and of different groups should be done toestablish local standards and factors influencing PEE5 Afr Med J 2001; 91: 996-1()()().Scholar, Rondebosch Boys' High SchoolS N van HeldenMedical Research Council Centre for Molecular and Cellular Biology, DepartmentofMedical Biochemistry, 4niversity of Stellenboscll, W Cape.E G Hoal-van Helden, PhDP D van Helden, PhD

An assessment of growth in high and low socioeconomic status schoolchildren in South Africa

ORIGINAL ARTICLES diabetic patients in Addis Ababa, Ethiopia, 1976- 1990. Q]M 1992; 301: 389-399. 8. Gill GV, Huddle KR, Rolfe M. Mortality and outcome of insulin-dependent diabetes in Soweto, South Africa DiDbet M£d 1995; 1£ 546-550. 9. Hanssen KF. Determinants of microvascular complications in diabetes: an overview. ln: Pickup), Williams G, eds. Te:rtbook of Diabetes. Oxford: Blackwell Scientific Publications, 1991: 519-525. 10. Lester FT. Clinical status of Ethiopian diabetic patients after 20 years of diabetes. Diabet Med 1991; 8: 272-276. 11. Levitt 5, Bradshaw, D Zwarenstein MF, Bawa AA, Maphumolo S. Audit of public sector primary diabetes care in Cape Town, South Africa: high prevalence of complications, uncontrolled hyperglycaemia, and hypertension. DiDbet Med 1997; 14: 1073-1077. 12. World Health Organisation Expert Committee. Arterial Hypertension. Report of a WHO Expert Committee. World Health Organ Teclz Rep Ser 1978; No. 628. 13. Kohner EM. The lesions and natwal history of diabetic retinopathy. In: Pickup J, \<\rilliams G, eds. Textbook of Diabetes. Oxford: Blackwell Scientific Publications, 1991: 575-588. 14. SAS!nstitute. SAS/STAT User's Guide. Release 6.03 ed. Cary, NC: SAS Institute, 1988. 15. Viberti GC, Marshall 5, Beech R, eta/. Report on renal disease in diabetes. DiDbet Med 1996; 13: suppl4, &-12. 16. Omar MAK. Asmal AC. Complications of early-onset insulin-dependent diabetes mellitus in blacks and Indians. 5 Afr Med I 1984; 65: 73-78. 17. Seedat YK.. Race, environment and blood pressure: the South African experience. } Hypertens 1983; 1:7-12. 18. Omar MA.K, Asmal AC. Patterns of diabetes mellitus in young Africans and Indians in a tal. Trop Geogr Med 1984; 36: 113-138. 19. Kalk WJ, Huddle KRL, Raal FJ- The age of onset and sex distribution of insulin-dependent diabetes mellitus in Africans in South Africa. Postgrad Med I 1993; 69: 552-556. 20. laPorte RE, Tajina t, Dorman JS, rl a/. Differences between Blacks and Whites in the epidemiology of insulin dependent diabetes mellitus in Allegheny county, Pennsyh•ania. Am I Epidemiol 1986; 12.3: 592-603. Accepted 9 September 2001. ovember 2001, Vol. 91, To. 11 SAMJ S I' I <. I \ I .-\I{ II ( II • AN ASSESSMENT OF GROWTH IN HIGH AND LOW SOCIO-ECONOMIC STATUS SCHOOLCHILDREN IN SOUTH AFRICA G J Louw, S M Naidoo 'We are guilty. of many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot .• Right now is the time his bones are beinf formed, his blood is being made and his senses are being developed. To him we cannot answer "Tomorrow". His name is "Today".' (Gabriela Mistral, 1948, World Health Organisation, 1997 The patterns of physical growth (height, weight, length of trunk and limbs, circumference of trunk and limbs, and limb breadths) and function (grip strength of both hands and neuromuscular reaction time) of Cape Coloured (specifically mixed origin) schoolchildren from urban and rural areas an contrasting socio-economic status (SES) levels, were measurE I. The mixed longitudinal study accumulated data over more than a decade, and included 929 male and 1 160 female pupi ' of high SES (HSES) in the Cape Town urban area, aged 5 - 2C years, and 954 male and 1 030 female pupils of low SES (LSE ,) in rural areas of the Little Karoo, aged 5- 19 years. Means fo· every anthropometric character were calculated and matchec. against age for each of the four groups, for comparative purposes. Standard deviations were recorded for each character. Figs 1 - 16 show the means for each of the anthropometric characters, matched with age groups, for HSES and LSES boys and girls. The results reflect the importance of positive intervention in the growth and development of the LSES children at different periods for the girls and boys, namely pre-pubertally in girls, particularly during the period of possible pre-pubertal growth spurt (8 - 10 years of age), and continuously and consistently for the boys, from 5 to 19 years and onwards. Intervention should take the form of improved diet, increased exercise, and plenty of time spent outdoors in the sun. Department of Human Biology, University of Cape Town G J Louw, DVSc S M aidoo, BSc ORIGINAL ARTICLES H O 800 - / / __ .. -··· .. . /- _ .. ___ -~:,~ _.. . ..:::.:-:_. __ , . ...-~--· ./_, / . ' ,. . '"' ; _.· ~,/.· ' ~ ... - ' / ·-· ... ... ' ~ /;~· ...... - HSES males . " -- HSES females - - - LSES males 1( 0 1 ' a 1- 0 1 J 1 ) 750 700 E .§. 650 .r: c;, c: .91 800 .0 ~ :;; 550 a. a. ::::> 500 450 ~ /. .. ,. ....... /--.- ... ~ .- ·- -- ' ,. ,- -- ' ... . 7 /. •' _,.f ~/ ... :· ./" _.. ,.-,. ...... /_ / -' . , ,..:· ' HSES males "7, .;,.,; - - HSES females :,!::::-·· - - - LSES males - LSES females - - LSES females 400 6 8 10 12 14 16 18 20 4 6 8 10 12 14 16 18 20 Age (yrs) Age (yrs) :ig. Means of total body height (mm) for age (yrs). Fig. 4. Means of upper limb length (mm) for age (yrs). 950 ........... / I v /-----:·-"·" . . ' _/ ~~.· ......... \ :.-• ... ' // ,. -·~':!' 900 850 E 800 .§. .r: c;, 750 c: .91 /._ ... --···· · ? -.,.:.·---_... .. -;=-"- - -//~- ;- -- - -// I ' ~ ' ·· I ./ /,-: :: ..... - HSES males ·.· p /-• - HSES females . -,;-" - - - LSES males ~ ............. - LSES females .0 ~ 700 :;; 3 650 0 --' 800 550 /_;.:; / - HSESmales -1----.-/~..-~.~.::_-----------1- - HSES females r--'.(' . ~ ~ ~~~ =~. . -~ 500 6 8 10 12 14 16 18 20 4 6 8 10 12 14 16 18 20 Age (yrs) Age (yrs) Ig. Means of body weight (kg) for age (yrs). Fig. 5. Means of lower limb length (mm) for age (yrs). 290 270 E 250 .§. "' " 230 c: ! "' E " 210 e'G E < 190 - HSESmales - - HSES females 170 -1- --7'~-----:r..:..C:~-----------l~ ~ ~~~ =·s ---~~--""' 150 4 6 8 10 12 14 16 18 20 Age (yrs) Age (yrs) !g. 3. Means of tnmk length (mm) for age (yrs). Fig. 6. Means of arm circumference (mm) for age (yrs). ORIGINAL ARTICLES 410 390 / / .... ... 370 E .§. 350 ~ E 330 .. '5 '" 310 E e " 290 'l'iii 270 250 /_,."'···~·-£' .· . c..- -._, # -·--' . ·>~-/ .:= -"' ·." / .~-~· J., __// ;r /.:· ~- · - HSESmales -:/> ,y - HSES females /' • • - LSES males - . ~.:· ... ~.:: ;/., 230 4 8 10 12 14 16 18 20 Age (yrs) Fig. 7. Means of hi-acromial diameter (mm) for age (yrs). 270 250 E .§. 230 !i "' E.. '5 210 '" ]? u ~ 190 iii - HSESmales 170 -~-~~::o-~--------------1~ ~ ~~; ~:::~es 150 4 6 8 10 12 14 16 18 20 Age (yrs) Fig. 8. Means of bi-iliocristal diameter for age (yrs). 70 E 65 .§. "' :::J<; 60 E :::J .<:: 0 .<:: 55 '5 .. !!! .0 "' 50 >-"0 c 0 " Q. '!' 45 iii ./\ / .. ······ r,\ /: ~...:.·:.. _ -· I ' ...._·'- ..... , I \ of,·--·-"' --.:.-<. / . h .. /--. _,., :-- _, ~ _., , ><.:: / . , / .... · .. """ ____ .. _, - HSESmales .. ..... __ ..... , .. ' - - HSES females • • - LSES males ---"' --40 4 6 8 10 12 14 16 18 20 Age (yrs) Fig. 9. Means of bi-epicondylar breadth of humerus (mm) for age (yrs). ovember 2001, Vol. 91, o. 11 SAMJ 95 90 L --. .... ~ 1 /:,,, ,;;:·~,_ ,-~ 65 ~ I , •' . - . ,l>..: .. :~;' ' - / ... · // .... . ~ '· ..... ...... . -L / .·· _, I .·',. .-""" , . . 75 - ..;'· · · / /. , _.· / /'' / 70 . _, t'- ,.,. .. - .; - HSES males . r / - - HSES female. .., · •• - LSES males 65 • LSES female; n ' 60 -4 6 8 10 12 14 16 18 2C Age (yrs) Fig. 10. Means of bi-epicondylar breadth of femur (mm) for age (y1 J. 900 650 E 800 .§. "' 750 " c !!! .91 E 700 :::J f:! u 1ii 650 <D .<:: u 600 550 l - / L '-"' .. ·-:::.. /---- .... .- ' \ ,~ ....... ~.-- . \ ' ·~ -·.:.-· .. / / ,. _L/ / , / -"' / /.' ... ~· J" .···"" - HSESmales .. .-' ::;.; - - HSES tarnal• -...:.;,.· ...... - - - LSES males - -500 4 6 8 10 12 14 16 18 Age (yrs) Fig. 11. Means of chest circumference (mm) for age (yrs). 17 15 E .§. "' 13 "' "' c ~ = 11 "0 :§ c :;;: 9 "' "' :; c. ~ 7 .0 :::J en 5 3 4 6 8 I _,, I ' '"' ... -. ,... ,_,. / .,. ... ·----10 12 Age (yrs) __ , 14 , , ·' 16 , ..... \ I .'\ I 18 20 Fig. 12. Means of subscapular skinfold thickness (mm) for age (yrs). ORIGINAL ARTICLES 17 15 - 13 ·' " ~~ ~ 11 ~ ~ 9 7 5 ... \ " -;-~--, -/ ,.. \ \ / " , ,. _.1 , ........... __ , / \ I I A/ \ / /""'""" / __ ...... ""I - / .. ·- ·-~ I , - ...... .., - ..... /L '\...../ / ·~· I "' - HSESmales ..J • "' -·- ···- - HSES females 7·--·-···- .· • ·- LSES males ............ - - LSES females 3 4 6 8 10 12 14 16 18 20 Age (yrs) 'ig. 13. Means of abdominal skinfold thickness (mm) for age (yrs). 40 ~ 3S / , .... ... . 30 / 25 .· / ----..... 'V / .... ' ... " ~ ' ,, ___ "'7-' _, .. ..%- "' .. -15 . . ~::/·/· 10 --~ · ~---~--, " - HSESmales . -- HSES females 5 ...... .,.. ........ - • - LSES males - ·" -- LSES females 0 4 6 8 10 12 16 18 20 Age (yrs) ·ig. 14. Means of right-hand grip strength (units) for age (yrs). Four patterns of growth and development emerge from this analysis, and the anthropometric characters falling into each pattern are grouped accordingly. The majority of characters fell into th.e first pattern, namely total body height, body weight, trunk length, upper extremity length, lower extremity length, arm circumference, hi-acromial diameter, bi-iliocristal diameter, bi-epicondylar width of humerus, bi-epicondylar width of femur, and chest circumference. The rates of increase of the anthropometric characters, as reflected by the slopes of the graphs, are similar for HSES and LSES males and females from age 5 until puberty, Where the values for the girls drop off rapidly as the growth plates of their bones dose. The different values observed along the graph are a reflection of differing starting points at age 5 for the HsES and LSES groups, and there is no 'catch-up' 40 3S .,---/ ........ 30 / 25 _,. / ' .. . <U / .:- / _/ ' , "·- · 15 ./ • -·- '-·-~- " ' / .,., .· . .·/ 10 - ..... . ~ ~· , · ..:"'~ ..... · - HSESmales 5 ...-· - - HSES females /.';-<···;-· - - - LSES males _.( ......,. • - • LSES females / 0 ' 4 6 8 10 12 14 16 18 20 Age (yrs) Fig. 15. Means of left-hand grip strength (units) for age (yrs). 290 270 'E .s .. 250 ~ c: .2 u "' 230 !!!:. :; " "' ::l 210 E e :I .. z 190 170 - HSESmales +---:----------------!-- HSES females - - - LSES males - • LSES females ,. \ 4 6 8 10 12 14 16 18 20 Age (yrs) Fig. 16. Means of neuromuswlar reaction time (mm) for age (yrs). achieved at any time. The males have higher final values because they continue growing postpubertaUy, into their twenties. For all four groups, only a small pre-pubertal growth spurt i visible. The second pattern of growth was similar for the various skinfold thicknesses. The skinfold thickne es, as a reflection of 'fatness', fluctuate continuou ly, but a pre-pubertal peak is visible in all groups. Although both HSES and LSES groups commence at similar values at age 5, the HSES group rises rapidly, with females exceeding the males at all ages. Both HSES and LSES males show lower values after puberty since their linear characters all continue to increase, and the LSES females overtake the HSES males at the time of puberty. A girl's 'fatness' is an important trigger for menarche. The third pattem of development was for left and right grip ORIGINAL ARTICLES strengths, which are virtually identical. The pattern for boys is markedly different from that of the girls in that there is a dramatic increase in the strength just before puberty right through to the mid-teens, after which the graphs plateau. The values for the girls increase at the same rate as those of the boys, as reflected by similar slopes, but the girls reach their maximum strength at a younger age, shortly after puberty. The last pattern of development was shown by neuromuscular reaction time. The graphs for all four groups of schoolchildren are similar in shape from 6 to 16 years in that there is a declining reaction time from 6 to 8 years, then a slow increase from 8 to 12 years, after which the time decreases again until16 years of age. The graphs demonstrate that HSES males have the quickest reaction times, followed by the LSES males. The girls of both groups show considerable fluctuation, but the LSES girls have the slowest reaction times of all groups at all ages, and do not achieve a 'catch-up' period. The authors wish to thank the staff and students of this Department for their assistance in collecting the data over the years, and the staff and pupils of the schools visited for their wonderful co-operation. ovember 2001, Vol. 91, o. 11 SAMJ SlUDENTPA.PEI{ I. FACTORS INFLUENCING PEAK EXPIRATORY FLOW IN TEENAGE BOYS S N van Heiden, E G Hoal-van Heiden, P D van Heiden Background. Peak expiratory flow (PEF) is a useful measure f pulmonary health status and is frequently utilised in asthm, management. Reduction in PEF is usually indicative of OilS( of asthma symptoms. However, use can be made of PEF values only if normal values are known. The definition of normal range is always difficult and may vary between regions and be affected by a variety of factors. Objective. To establish PEF values for teenage boys in a Cap Town suburb and examine factors that possibly influence t1- s measurement. Setting. A high school for boys in the southern suburbs of CapeTown. Methods. Measurements of PEF were taken for 124 boys. Subjects were approximately 16 years old and apparently healthy at the time of survey. Further details were provid by means of a questionnaire. Results. PEF ranged from 350 to 760 l/min, with a mean (±standard deviation (SD)) of 539 ± 681/min. Factors expected to influence PEF included height and mass, where ,s unexpected factors included sport intensity and academic grade. A trend to reduced peak flow was already evident in boys who smoked and boys from homes where a parent smoked. Regression analysis suggested peak flow differenets in our population compared with the standard reference. Conclusion. Interpretation of results obtained from peak-flO\ .' instruments should take into account additional knowledge concerning the individual. Further surveys of the South African population and of different groups should be done to establish local standards and factors influencing PEF. 5 Afr M£d I 2001; 91: 996-1000. Sclwlar, Rondebosch Boys' High School S N van Heiden Medical Research Council Centre for Molew/ar and Cellular Biology, Departmntl of Medical Biochemistry, University of Stellenbosch, W Cape E G Hoal-van Heiden, PhD P D van Heiden, PhD 

An assessment of growth in high and low socioeconomic status school children in South Africa

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An assessment of growth in high and low socioeconomic status school children in South Africa

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