331
specific problems which could be encountered during their practice (Table). Traditional management of the problems included referral to a traditional healer. Some of the remedies mentioned included hot water, herbs, sacrifices, and physical manipulation. Those who said they would refer to hospital did so only after their traditional managementhad failed.
References Akungua, G. I., Akpovi, S. U. & Ogbeide, 0. (1981). Maternal and child health care in rural areas: the role of traditional birth attendants in Bendel State of Nigeria. Journal of Tropical Pediatrics, 27,210-214. Laventhel, M. N,., Jones, F. Q. & Mohetiskey, V. (1974). Acute renal falure in Zambian women using traditional herbal medicine. Journal of Tropical Medicine and Hygiene, 77, 87-96. Mbilu, J. N. K., Arkutu, A., Mandara, M. I’. & Takulia, H. S. (1981). Traditional birth attendants in Miono Insion, Bagamoyo District. Dar esSalaam MedicalJournal, f&99-105. Mwaikambo, E. D. & Do Amsi, D. M. (1987). Attendant at birth as a risk factor in child survival. Tanzanian Medical
Discussion and Recommendations
In this study no male TBA was identified, unlike the situation reported in Nigeria by AKUNGUA et al. (1981). Some of the tools and techniques used by TBAs could cause some risk to the health of the neonate. The TBAs’ role in the care of pregnancy complications, and their referral pattern, emphasize the need to educate the TBAs to use better facilities and to be more ready to refer their patients to modern medical facilities.
3ournal,4,15-18. Received 21 Feburary 1991; revised 29July 1991; accepted for publication 9 August 1991
TRANSACTIONSOF THE ROYAL SOCIETYOFTROPICAL MEDICINEAND HYGIENE (1992) 86,331-332
(lengths >mean -lSD), matched with every fourth stunted child for age (*3 months) and sex. Further de-tails of sample selection have been reported by WALKER et al. (1990). On enrolment, details of toilet and water facilities and crowding in the home were recorded. Stool sampleswere collected 4-6 months after the beginning of the study from 90% of the children. Faecal examinations were made on duplicate 1 g subsamples using Ritchie’s formalin-ether concentration technique. The number of eggs per gram (epg) was used as a measure of helminth infection intensity. Morbidity histories were recorded weekly for all the stunted children and 21 of the nonstunted children. Symptoms recorded included apathy, fever, anorexia, coughing, rapid or difficult breathing, vomiting, and diarrhoea. These data will be reported in detail elsewhere. Weight and length were measured
1Short Report 1 Stunting, intestinal parasitism the home environment
and
S. P. Walker”, R. D. Robinsonz, C. A. Powell’ and S. Grantham-McGregor1 ITropical M. Metabolism Research Unit and 2Department of Zoology, University of the West Indies, Kingston 7, Jamaica
Stunting or low height-for-age is extremely prevalent in developing countries (KELLER & FILLMORE, 1983). The contribution of intestinal parasitic infections to the aetiology of stunting remains unclear, as does the inTable
1. Prevalence
of intestinal
parasitic
Stunted (n=ZZZ) Trichuris trichiura Ascaris lumbricoides Giardia lamblia Other protozoaa Double infections Triple infections “Entamoeba coli and/or Endolimax
24 (21.4%) 13 (11.6%) 4 (3.6%) 11 (9.8%) 14 (12.5%) 3 (2.7%)
infection
by stunting
Numbers of children infected Non-stunted Wasted
Non-wasted
jn=31)
(n=64)
(n=79)
6 (19.4%) 4 (12.9%) 1 (3.2%) 4 (12.9%) 4 (12.9%) 0 -
12 (18.7%) 10 (15.6%) 1 (1.6%) 6 (9.4%) 7 (10.9%) 2 (3.1%)
18 (22.3%) 7 (8.9%) 4 (5.1%) 9 (11.4%) 11 (13.9%) 1 (1.3%)
nana.
fluence of host nutritional status on the dynamics of intestinal parasite populations (BUNDY & GOLDEN, 1987). Any relationship is probably confounded by environmental factors associated with poverty. This study formed part of an investigation into the effects of nutritional supplementation and psychosocial stimulation on the growth, development and morbidity of stunted et children aged 9 to 24 months (GRANTHAM-MCGREGOR al., 1991). We report here relationships among stunting, intestinal parasitism, and environmental variables, and the relationship between morbidity symptoms and intestinal parasitism. Children were recruited by house-to-house survey of most of the poor areasof Kingston, Jamaica.Two groups were selected: 129 stunted children with lengths below the mean minus 2 standard deviations (SD) of the National Center for Health Statistics (NCHS) reference value (HAMILL et al., 1977) and 32 non-stunted children *Author for correspondence.
or wasting group
Table 2. Spearman’s rank correlations of intensity (eggs/g) of
Trichuris trichiura and Ascaris Jumbricoides infections with age, environmental variables and morbidity (II= 143)
Age Toilet rating Water rating Crowding (persons/room) No. of children
specific problems which could be encountered during their practice (Table). Traditional management of the problems included referral to a traditional healer. Some of the remedies mentioned included hot water, herbs, sacrifices, and physical manipulation. Those who said they would refer to hospital did so only after their traditional managementhad failed.
References Akungua, G. I., Akpovi, S. U. & Ogbeide, 0. (1981). Maternal and child health care in rural areas: the role of traditional birth attendants in Bendel State of Nigeria. Journal of Tropical Pediatrics, 27,210-214. Laventhel, M. N,., Jones, F. Q. & Mohetiskey, V. (1974). Acute renal falure in Zambian women using traditional herbal medicine. Journal of Tropical Medicine and Hygiene, 77, 87-96. Mbilu, J. N. K., Arkutu, A., Mandara, M. I’. & Takulia, H. S. (1981). Traditional birth attendants in Miono Insion, Bagamoyo District. Dar esSalaam MedicalJournal, f&99-105. Mwaikambo, E. D. & Do Amsi, D. M. (1987). Attendant at birth as a risk factor in child survival. Tanzanian Medical
Discussion and Recommendations
In this study no male TBA was identified, unlike the situation reported in Nigeria by AKUNGUA et al. (1981). Some of the tools and techniques used by TBAs could cause some risk to the health of the neonate. The TBAs’ role in the care of pregnancy complications, and their referral pattern, emphasize the need to educate the TBAs to use better facilities and to be more ready to refer their patients to modern medical facilities.
3ournal,4,15-18. Received 21 Feburary 1991; revised 29July 1991; accepted for publication 9 August 1991
TRANSACTIONSOF THE ROYAL SOCIETYOFTROPICAL MEDICINEAND HYGIENE (1992) 86,331-332
(lengths >mean -lSD), matched with every fourth stunted child for age (*3 months) and sex. Further de-tails of sample selection have been reported by WALKER et al. (1990). On enrolment, details of toilet and water facilities and crowding in the home were recorded. Stool sampleswere collected 4-6 months after the beginning of the study from 90% of the children. Faecal examinations were made on duplicate 1 g subsamples using Ritchie’s formalin-ether concentration technique. The number of eggs per gram (epg) was used as a measure of helminth infection intensity. Morbidity histories were recorded weekly for all the stunted children and 21 of the nonstunted children. Symptoms recorded included apathy, fever, anorexia, coughing, rapid or difficult breathing, vomiting, and diarrhoea. These data will be reported in detail elsewhere. Weight and length were measured
1Short Report 1 Stunting, intestinal parasitism the home environment
and
S. P. Walker”, R. D. Robinsonz, C. A. Powell’ and S. Grantham-McGregor1 ITropical M. Metabolism Research Unit and 2Department of Zoology, University of the West Indies, Kingston 7, Jamaica
Stunting or low height-for-age is extremely prevalent in developing countries (KELLER & FILLMORE, 1983). The contribution of intestinal parasitic infections to the aetiology of stunting remains unclear, as does the inTable
1. Prevalence
of intestinal
parasitic
Stunted (n=ZZZ) Trichuris trichiura Ascaris lumbricoides Giardia lamblia Other protozoaa Double infections Triple infections “Entamoeba coli and/or Endolimax
24 (21.4%) 13 (11.6%) 4 (3.6%) 11 (9.8%) 14 (12.5%) 3 (2.7%)
infection
by stunting
Numbers of children infected Non-stunted Wasted
Non-wasted
jn=31)
(n=64)
(n=79)
6 (19.4%) 4 (12.9%) 1 (3.2%) 4 (12.9%) 4 (12.9%) 0 -
12 (18.7%) 10 (15.6%) 1 (1.6%) 6 (9.4%) 7 (10.9%) 2 (3.1%)
18 (22.3%) 7 (8.9%) 4 (5.1%) 9 (11.4%) 11 (13.9%) 1 (1.3%)
nana.
fluence of host nutritional status on the dynamics of intestinal parasite populations (BUNDY & GOLDEN, 1987). Any relationship is probably confounded by environmental factors associated with poverty. This study formed part of an investigation into the effects of nutritional supplementation and psychosocial stimulation on the growth, development and morbidity of stunted et children aged 9 to 24 months (GRANTHAM-MCGREGOR al., 1991). We report here relationships among stunting, intestinal parasitism, and environmental variables, and the relationship between morbidity symptoms and intestinal parasitism. Children were recruited by house-to-house survey of most of the poor areasof Kingston, Jamaica.Two groups were selected: 129 stunted children with lengths below the mean minus 2 standard deviations (SD) of the National Center for Health Statistics (NCHS) reference value (HAMILL et al., 1977) and 32 non-stunted children *Author for correspondence.
or wasting group
Table 2. Spearman’s rank correlations of intensity (eggs/g) of
Trichuris trichiura and Ascaris Jumbricoides infections with age, environmental variables and morbidity (II= 143)
Age Toilet rating Water rating Crowding (persons/room) No. of children
