Bedouin Children Research Articles

Prevalence of Pharyngeal Carriage of Kingella kingae in Young Children and Risk Factors for Colonization

The carriage rate of Kingella kingae among Jewish and Bedouin children living in southern Israel paralleled the age-related incidence of invasive infections. Age 6-29 months was a significant risk factor for K. kingae colonization in both ethnic groups; day-care attendance was a risk factor in Jewish children, whereas living in a shanty town was negatively associated with carriage in Bedouins.

Varied Clinical Presentations of Seven Patients With Mutations inCYP11A1Encoding the Cholesterol Side-Chain Cleavage Enzyme, P450scc

The cholesterol side-chain cleavage enzyme P450scc, encoded by CYP11A1, converts cholesterol to pregnenolone to initiate steroidogenesis. P450scc deficiency can disrupt adrenal and gonadal steroidogenesis, resembling congenital lipoid adrenal hyperplasia clinically and hormonally; only 12 such patients have been reported previously. We sought to expand clinical and genetic experience with P450scc deficiency. We sequenced candidate genes in 7 children with adrenal insufficiency who lacked disordered sexual development. P450scc missense mutations were recreated in the F2 vector, which expresses the fusion protein P450scc-Ferredoxin Reductase-Ferredoxin. COS-1 cells were transfected, production of pregnenolone was assayed, and apparent kinetic parameters were calculated. Previously described P450scc mutants were assayed in parallel. Four of five Bedouin children in one kindred were compound heterozygotes for mutations c.694C>T (Arg232Stop) and c.644T>C (Phe215Ser). Single-nucleotide polymorphism analysis confirmed segregation of these mutations. The fifth kindred member and another Bedouin patient presented in infancy and were homozygous for Arg232Stop. A patient from Fiji presenting in infancy was homozygous for c.358T>C (Arg120Stop). All mutations are novel. As assayed in the F2 fusion protein, P450scc Phe215Ser retained 2.5% of wild-type activity; previously described mutants Leu141Trp and Ala269Val had 2.6% and 12% of wild-type activity, respectively, and Val415Glu and c.835delA lacked detectable activity. Although P450scc is required to produce placental progesterone required to maintain pregnancy, severe mutations in P450scc are compatible with term gestation; milder P450scc mutations may present later without disordered sexual development. Enlarged adrenals usually distinguish steroidogenic acute regulatory protein deficiency from P450scc deficiency, but only DNA sequencing is definitive.

Influence of age, social patterns and nasopharyngeal carriage on antibodies to three conserved pneumococcal surface proteins (PhtD, PcpA and PrtA) in healthy young children

The acquisition of specific antibodies is paramount to protect children against pneumococcal diseases, and a better understanding of how age, ethnicity and/or Streptococcus pneumoniae (Spn) nasopharyngeal carriage influence the acquisition of antibodies to pneumococcal surface proteins (PSP) is important for the development of novel serodiagnostic and immunisation strategies. IgG antibody titres against three conserved PSP (PhtD, PcpA and PrtA) in the sera of 451 healthy children aged 1 to 24 months from Israel [Jewish (50.1 %) and Bedouin (49.9 %)] were measured by enzyme-linked immunosorbent assay (ELISA), while nasopharyngeal swabs from these children were assessed for the presence of Spn. Globally, anti-PhtD and anti-PrtA geometric mean concentrations (GMC; EU/ml) were high at <2.5 months of age [PhtD: 35.3, 95 % confidence interval (CI) 30.6-40.6; PrtA: 71.2, 95 % CI 60-84.5], was lower at 5-7 months of age (PhtD: 10, 95 % CI 8-12.4; PrtA: 17.9, 95 % CI 14.4-22.1) and only increased after 11 months of age. In contrast, an increase in anti-PcpA was observed at 5-7 months of age. Anti-PcpA and anti-PrtA, but not anti-PhtD, were significantly higher in Bedouin children (PcpA: 361.6 vs. 226.3, p = 0.02; PrtA: 67.2 vs. 29.5, p < 0.001) in whom Spn nasopharyngeal carriage was identified earlier (60 % vs. 38 % of carriers <6 months of age, p = 0.002). Spn carriage was associated with significantly higher anti-PSP concentrations in carriers than in non-carriers (p < 0.001 for each PSP). Thus, age, ethnicity and, essentially, nasopharyngeal carriage exert distinct cumulative influences on infant responses to PSP. These specific characteristics are worthwhile to include in the evaluation of pneumococcal seroresponses and the development of new PSP-based vaccines.

Clonal Distribution of Common Pneumococcal Serotypes Not Included in the 7-Valent Conjugate Vaccine (PCV7): Marked Differences between Two Ethnic Populations in Southern Israel

This study aimed to compare the clonal distribution of common pneumococcal strains not included in the 7-valent pneumococcal conjugate vaccine (PCV7) that were isolated from cases of acute otitis media (AOM) and invasive pneumococcal disease (IPD) in two distinct ethnic populations in southern Israel during the decade (1999 to 2008) preceding PCV7 implementation. Isolates recovered from Jewish and Bedouin children <5 years old were characterized by antibiotic resistance and molecular epidemiology using pulsed-field gel electrophoresis and multilocus sequence typing. Of 5,236 AOM and 425 IPD isolates, 43% and 57% were from Jewish and Bedouin children, respectively. PCV7 accounted for 54% and 45% of the AOM and IPD episodes, respectively. Eleven major non-PCV7 serotypes (1, 3, 5, 6A, 7F, 12F, 15B/C, 19A, 21, 33F, and 35B) constituted 31% and 42% of the AOM and IPD episodes, respectively. The clonal distributions of the 11 non-PCV7 serotypes and their antibiotic susceptibilities were significantly different among the two ethnic populations in both the AOM and IPD groups. About half of the AOM and IPD cases resulted from non-PCV7 pneumococci, even before PCV7 implementation. The significant differences between the two ethnic populations suggest that lifestyle and microenvironment are major determinants in the clonal distribution of disease-causing pneumococci. Post-PCV7 surveillance is important in understanding non-PCV7 clonal expansion in the two distinct populations.

Cultural differences and students’ spontaneous models of the water cycle: a case study of Jewish and Bedouin children in Israel

The present research aims at pinpointing differences in spontaneous and non-spontaneous mental models of water cycle conceptions of two 4th grade student groups: the Jewish residents of a small provincial town and a group of students from an indigenous Bedouin community. Students’ conceptions were elicited using the Repertory Grid technique as well by being asked to draw “what happens to water in nature?” In later interviews, in addition to answering specially designed open-ended interview questions, the students were also requested to elaborate on their drawings and responses to the Repertory Grid technique. The Bedouin students were found to have richer mental models of water cycle phenomena; their models included more components of the water cycle and were more authentic and connected to other natural phenomena. On the other hand, Bedouin students also employed theological explanations to make sense of water cycle phenomena. These findings, as well as methodological issues relating to spontaneous and non-spontaneous models elicitation are discussed and implications for instruction are offered.

Indigenous knowledge and science in a globalized age

This forum explores and expands on Ben-Zvi Assaraf, Eshach, Orion, and Alamour’s article titled “Cultural Differences and Students’ Spontaneous Models of the Water Cycle: A Case Study of Jewish and Bedouin Children in Israel” by examining how indigenous knowledge is appropriated in science classrooms; how students from indigenous students’ experiences are more complex than many non-indigenous students; and how science and globalization complicates the preservation of indigenous knowledge. In this forum we suggest that research on indigenous knowledge be examined through the lens of the locally situated contexts and the extent to which globalization hinders this kind of knowledge in the name of value neutral scientific knowledge. We finally suggest that research in indigenous communities has to be more intentional and respectful, and teachers need to rethink how useful and meaningful science learning can be for indigenous students.

Rethinking historical and cultural source of spontaneous mental models of water cycle: in the perspective of South Korea

This review explores Ben-Zvi Assaraf, Eshach, Orion, and Alamour’s paper titled “Cultural Differences and Students’ Spontaneous Models of the Water Cycle: A Case Study of Jewish and Bedouin Children in Israel” by examining how the authors use the concept of spontaneous mental models to explain cultural knowledge source of Bedouin children’s mental model of water compared to Jewish children’s mental model of water in nature. My response to Ben-Zvi Assaraf et al.’s work expands upon their explanations of the Bedouin children’s cultural knowledge source. Bedouin children’s mental model is based on their culture, religion, place of living and everyday life practices related to water. I suggest a different knowledge source for spontaneous mental model of water in nature based on unique history and traditions of South Korea where people think of water in nature in different ways. This forum also addresses how western science dominates South Korean science curriculum and ways of assessing students’ conceptual understanding of scientific concepts. Additionally I argue that western science curriculum models could diminish Korean students’ understanding of natural world which are based on Korean cultural ways of thinking about the natural world. Finally, I also suggest two different ways of considering this unique knowledge source for a more culturally relevant teaching Earth system education.

P2-373 A cluster randomised controlled clinical trial to assess the efficacy of multiple micronutrient supplementations (iron, vitamins A, C, folic acid and zinc) to improve the nutritional and health indicators in Jewish and Bedouin infants in southern Israel

BackgroundThe immediate and long-term effects of nutritional deficiencies are increased incidence and severity of acute conditions, impaired rates of growth, and retarded cognitive development. An efficacy intervention trial using novel...

Ethnic and Gender Inequities in the Evaluation of Referred Short Children

Aims: To examine ethnicity and gender differences in the evaluation of referred children with short stature and to investigate adherence of the primary care evaluation to published guidelines. Methods: Cross-sectional study in a referral center. 371 short patients aged 2–18 years were included. Outcome measures were patient’s growth characteristics, final diagnosis, and prevalence of pre-referral patient data. Results: The study population was composed of 239 Bedouin children and 132 Jewish children (p < 0.0001). More males (61%) than females were evaluated (p < 0.0001). There were no significant differences between males and females in age and growth parameters at the time of referral. Bedouins, males and females, were significantly shorter than their Jewish counterparts at the time of referral: height SD –2.44 ± 0.73 and –2.62 ± 1.05 versus –2.13 ± 0.55 and –2.21 ± 0.57, respectively (p < 0.05). There were no significant ethnic or gender differences in the final diagnosis. Significant deficiencies in the primary care evaluation of referred short children were found. Conclusions: We demonstrated novel ethnic- and gender-based inequities in the evaluation of referred short children. We found that the current evaluation of short stature in our area does not comply with existing guidelines.

Distribution, dynamics and antibiotic resistance patterns of Streptococcus pneumoniae serotypes causing acute otitis media in children in southern Israel during the 10 year-period before the introduction of the 7-valent pneumococcal conjugate vaccine

Objectives To determine the dynamics of serotype prevalence, potential coverage by pneumococcal conjugate vaccines (PCV) and antibiotic resistance patterns of Streptococcus pneumoniae causing acute otitis media (AOM) in children in southern Israel before PCV7 introduction in the routine immunization program in Israel. Methods All S. pneumoniae isolates from middle ear fluid from children with AOM during 1999–2008 were included. Prospectively collected demographic data on S. pneumoniae serotypes and antibiotic resistance patterns were analyzed. Results A total of 14,911 tympanocenteses yielded 5281(35%) S. pneumoniae. Proportion of S. pneumoniae-AOM did not vary significantly (overall 35%; 33% in 2007; 38% in 2002 and 2003). The most frequent serotypes were 19F, 14, 23F and 19A; in both Jewish and Bedouin children; serotypes 6A and 19A contributed 6% and 10%, respectively, of all S. pneumoniae isolates. Serotypes included in PCV7, PCV10 and PCV13 represented 60%, 64%, 85% in Jewish children vs. 49%, 55% and 74%, respectively, in Bedouin children ( P < 0.001). Nonsusceptibility to TMP/SMX decreased significantly, in parallel with a significant increase in the nonsusceptibility to erythromycin, clindamycin and in multidrug resistant (MDR) isolates. No changes were recorded in the proportion of S. pneumoniae isolates with penicillin MIC ≥ 1.0 μg/ml. The proportion of penicillin- and erythromycin-nonsusceptible and of MDR serotype 6A and 19A isolates increased significantly in Bedouin children. Conclusions 1) No significant changes were recorded in the yearly proportions of serotypes 23F, 19F, 19A, 14 and 6A in both ethnic populations; 2) Potential coverage of the 3 PCVs was higher in Jewish children than in Bedouin children; 3) The relatively high coverage of macrolides- and multidrug-resistant S. pneumoniae by PCV13 and lack of increase in penicillin, erythromycin and multidrug nonsusceptibility among non-PCV13 isolates is encouraging.

Differential Circulation of Streptococcus pneumoniae Serotype 6C Clones in Two Israeli Pediatric Populations

We genotyped Streptococcus pneumoniae serotype 6C (Sp6C) isolates collected from Jewish and Bedouin children in southern Israel during the decade before vaccination. Sp6C constituted 8.2% of the presumed Sp6A isolates. All of the Sp6C clonal clusters were associated with serogroup 6, mainly Sp6A. Different clonal distributions were found in the two subpopulations.

Cultural and ecological contexts of violent punishment and restraint of Negev Bedouin children: from understandings to interventions

AbstractOver recent decades we have become increasingly sensitised to the importance of considering the cultural and ecological contexts of child abuse. This paper illustrates the necessity for but also the complexity of doing so in practice, through reflection on some of the dilemmas faced by social work professionals encountering physical punishment and restraint of children among the Negev Bedouin. We describe several cases and reflect on two central challenges. First, we point to a significant grey area remaining between consensually unacceptable and consensually acceptable practices, and show how the evaluation of worrying incidents of this kind requires careful reading of the complex interplay of a variety of cultural and contextual factors which are sometimes not easily resolved. Second, we highlight the need for cultural competence not just in understanding but in intervening since cultural differences continue to be important—sometimes critically so—in the ways in which social work interventions are understood by and affect clients and communities. We offer a schema for intervention, distilled from decades of experience working in the Bedouin setting, which describes the kind of decision‐making processes a social worker might follow in this context. This is intended to guide practitioners, but also to be used more interactively and further evolved in discussion with parents and members of the Bedouin community on the one hand, and those shaping state child care policies and procedures on the other. Thus, our schema is a kind of boundary object—a shared instrument for assessment and dialogue in which both Bedouin and professional cultures can negotiate and renegotiate their caring for children at the interface between their different but intersecting worlds. Copyright © 2010 John Wiley &amp; Sons, Ltd.

Punishment and child harm

Child Abuse ReviewVolume 19, Issue 4 p. 225-228 EditorialFree Access Punishment and child harm ‘You Don't Build a Family through a Stick’ (Traditional Zulu saying) Margaret A. Lynch, Margaret A. Lynch Community Paediatrics, Guy's, King's and St. Thomas' School of Medicine, London, EnglandSearch for more papers by this authorKenny Ross, Kenny Ross Greater Manchester West Mental Health NHS Foundation Trust, ManchesterSearch for more papers by this author Margaret A. Lynch, Margaret A. Lynch Community Paediatrics, Guy's, King's and St. Thomas' School of Medicine, London, EnglandSearch for more papers by this authorKenny Ross, Kenny Ross Greater Manchester West Mental Health NHS Foundation Trust, ManchesterSearch for more papers by this author First published: 21 July 2010 https://doi.org/10.1002/car.1141AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References Cashmore J. 2010. Book review of Physical Punishment in Childhood: the Rights of the child. Child Abuse Review 19: 299– 302. DOI: 10.1002/car.1132 Department for Children, Schools and Families. 2008. The Children Act 1989 Guidance and Regulations, Volume 1, Court Orders. The Stationery Office: London. Department for Children, Schools and Families. 2009. Being a Parent in the Real World. DCSF Publications: Nottingham. Department for Children, Schools and Families. 2010. Working Together. DCFS Publications: Nottingham. Garb G, Goren T. 2010. Cultural and ecological contexts of violent punishment and restraint of Negev Bedouin children: From understandings to interventions. Child Abuse Review 19: 273– 290. DOI: 10.1002/car.1127 Lynch MA, Saralidze L, Goguadze N, Zolotor A. 2008. National Study on Violence Against Children in Georgia. UNICEF: Tbilisi. Masson JM. 2010. (Mis)understandings of Significant Harm. Child Abuse Review 19: 291– 298. DOI: 10.1002/car. 1129 Multi Indicator Cluster Survey. 2005. Available: http://www.childinfo.org [24 May 2010] Mweru M. 2010. Why are Kenyan Teachers Still Using Corporal Punishment Eight Years after a Ban on Corporal Punishment? Chid Abuse Review 19: 248– 258. DOI: 10.1002/car.1121 Pinheiro PS. 2006. World Report on Violence Against Children. United Nations: Geneva, Switzerland. Rae H, Murray G. 2010. Health Care Workers' Knowledge of Current Child Protection Legislation and Child Discipline Practices. Child Abuse Review 19: 259– 272. DOI: 10.1002/car.1126 Runyan DK, Shankar V, Hassan F, Hunter WM, Jain D, Paula CS, et al. International variations in harsh child discipline. Pediatrics. In press. Singleton R. 2010. Physical Punishment: Improving Consistency and Protection – an independent report by Sir Roger Singleton, Chief Adviser on the Safety of Children. DCFS. Available: http://publications.dcsf.gov.uk/default.aspx?PageFunction=productdetails&PageMode=publications&ProductId=DCSF-00282-2010 [24 May 2010]. Zolotor A J, Theodore A D, Chang JJ, Berkoff MC, Runyan DK. (2008). Speak softly–and forget the stick. Corporal punishment and child physical abuse. American Journal of Preventive Medicine, 35(4), 364– 369. Zolotor A J, Puzia ME. 2010. Bans against corporal punishment: a systematic review of the laws, changes in attitudes and behaviours. Child Abuse Review 19: 229– 247 DOI: 10.1002/car.1131 Volume19, Issue4Special Issue: Punishment and Child HarmJuly/August 2010Pages 225-228 ReferencesRelatedInformation

Assessment of cognitive and adaptive behaviour among individuals with congenital insensitivity to pain and anhidrosis

Individuals with congenital insensitivity to pain with anhidrosis (CIPA) are reported to have mental retardation* but to our knowledge no detailed study on the subject has ever been published. The present study assessed and documented cognitive and adaptive behaviour among Arab Bedouin children with CIPA. Twenty-three Arab Bedouin children (12 females, 11 males) with CIPA aged between 3 and 17 years (mean 9 y 7 mo, SD 4 y 2 mo) were assessed. They were compared with 19 healthy siblings of the affected children aged between 5 and 13 years (mean 8 y 11 mo, SD 2 y 10 m). All of the children in the comparison group, but only half of the CIPA group, were attending school. The children were evaluated using a standardized, non-verbal intelligence test, the Leiter International Performance Scale--Revised, and an adaptive behaviour questionnaire, the Vineland Adaptive Behaviour Scales, 2nd edition. Based on scores on the intelligence test and the adaptive behaviour scale, children with CIPA functioned in the mental retardation range (mean IQ scores: CIPA group 53.8, comparison group 83.32 [p<0.001]; adaptive behaviour: CIPA group 68.1, comparison group 104.88 [p<0.001]). IQ was significantly higher among the children with CIPA aged up to 7 years 11 months than among the older children 73.83 vs 45.21 (p<0.001). As a group, the younger children with CIPA may be functioning above the mental retardation range. We propose that early intervention addressing these children's needs and developing an appropriate educational system, might improve their outcome.

Increasing Importance of Multidrug-Resistant Serotype 6A Streptococcus pneumoniae Clones in Acute Otitis Media in Southern Israel

The major aim of this study was to establish the molecular epidemiology dynamics of Streptococcus pneumoniae serotype 6A in acute otitis media, before the introduction of the 7-valent pneumococcal conjugate vaccine. Acute otitis media in Jewish and Bedouin children <5 years old undergoing tympanocentesis during 1999 to 2006, were studied. Serotype 6A was identified by the Quellung reaction and by polymerase chain reaction (PCR) of the wciN gene, to differentiate between 6A and 6C. Antibiogram and molecular typing by pulsed field gel electrophoresis were performed on all 6A isolates. Multilocus sequence typing was performed on representative isolates of each clone. The 7-valent conjugate vaccine had not yet been licensed in Israel during the study period. Serotype 6A constituted 5.8% (254/4408) of all pneumococcal acute otitis media episodes. The yearly proportion of serotype 6A among the Jewish children showed no distinct trend, whereas among the Bedouin children serotype 6A exhibited a significant increase, from 3.0% in 1999 to 7.6% in 2006. Among the Jewish children a single penicillin-nonsusceptible and erythromycin-resistant clone, ST-473, constituted 73.6% of the strains and dominated throughout the study period. Among the Bedouin children, the proportions of the most common, penicillin-nonsusceptible clone, ST-1988, gradually decreased, from 44.1% in 1999 to 2000 to 21.4% in 2005 to 2006, concurrently with the expansion of a multidrug-resistant clone, ST-457, from 5.9% in 1999 to 2000 to 28.6% in 2005 to 2006. The expansion of multidrug-resistant serotype 6A clone occurred before the introduction of the vaccine. Continued surveillance following vaccine introduction is warranted to further investigate its efficacy on vaccine-related serotypes.

Beta lactam allergy in children from two ethnically different populations

The effects of ethnicity on beta lactam allergy have not been reported. The Negev Desert in Southern Israel is inhabited by two ethnically distinct populations: Jews and Bedouin Muslims. Approximately 60% of the pediatric population of the area is Jewish. Whereas most Jews live in Westernized urban centers, Bedouins are in the process of transition from semi-nomadic conditions to a sedentary lifestyle and the majority of them now live in towns and villages. We sought to determine the rate and characteristics of physician-reported beta lactam allergy in Jewish and Bedouin children. The medical records of all children registered in five primary community clinics were reviewed and screened for allergy to beta lactam antibiotics. A total of 26,655 medical records were reviewed: of 11,069 Jewish children and 15,586 Bedouin children. Beta lactam allergy was registered in 344 records (1.3%), and was more frequent in Jewish (n= 226, 2.1%) than in Bedouin children (n= 118, 0.8%, P < 0.0001). Beta lactam allergy was more common in boys in both populations (P < 0.01). The clinical features of the reaction that led to the diagnosis of beta lactam allergy were not significantly different between the two ethnic populations, although the specific antibiotics prescribed and the diagnoses for which they were prescribed were different in the two ethnic populations. We concluded in this study that pediatric beta lactam allergy was registered more frequently in Jewish than in Bedouin children, and in boys more than in girls.

Carriage of Community-Associated Methicillin-Resistant Staphylococcus aureus in a Cohort of Infants in Southern Israel: Risk Factors and Molecular Features

There are few data about the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among children in Israel. This study was intended to identify risk factors for CA-MRSA colonization in healthy infants, to characterize the molecular features of colonizing organisms, and to determine whether they are responsible for health care-associated (HA) infections. Nasal cultures and demographic details were collected from a cohort of healthy infants at 5 visits between the ages of 2 and 12 months. Clinical characteristics of pediatric MRSA bloodstream infections (2001 to 2006) and wound cultures collected over 6 months were also studied. Clonal structure was evaluated by multilocus sequence typing. Isolates were studied for the staphylococcal cassette chromosome mec (SCCmec) type and for the presence of Panton-Valentine leukocidin (PVL) genes. MRSA was cultured at least once from 45 of 659 infants (346 Jewish and 313 Bedouin infants). Forty of 45 (89%) isolates were from Bedouin infants. Twenty-nine of 45 (64.4%) belonged to a new clonal complex, designated CC913, that carries SCCmec IV but not the PVL genes. CC913 was also isolated from 9/14 blood cultures and 7/8 wounds. All CC913 infections occurred in Bedouin children, and all but two were HA. In conclusion, Bedouin origin was the main risk factor for carriage of CA-MRSA. CC913 was dominant both in healthy carriers and as a cause of pediatric HA-MRSA bloodstream infections.

Risk factors for the initial symptomatic giardia infection in a cohort of young Arab-Bedouin children

Giardiasis is a common protozoan infection with clinical manifestations in children ranging from asymptomatic carriage to persistent diarrhoea with malabsorption. It can lead to growth and developmental retardation. The study evaluated risk factors for the initial symptomatic giardiasis (SG) episode among Arab-Bedouin children in Israel. A community-based, prospective cohort study was conducted in Rahat, a Bedouin township in southern Israel. Infants (n=238) were followed by weekly visits from birth to age 18 months. Giardia infection was identified by antigen detection in faecal specimens. Approximately 26% of children experienced one or more SG episode. Mean (SD) age for first SG episode was 12.3 (3.3) months, with 95% of episodes occurring in children >6 months of age. Risk for the first SG in children >6 months of age was associated with it being spring or summer [odds ratio (OR) 6.16, p<0.001], exposure to livestock (OR 4.89, p=0.002) and prior infection with entero-aggregative Escherichia coli (EAEC) (OR 1.12 for each additional percentage in stool prevalence, p=0.02). Weight-for-age Z-scores at age 6 months were inversely related to SG risk (OR 0.62 for each unit increase in Z-score, p=0.029). Giardiasis is an important cause of diarrhoea in Bedouin children. Increased risk of SG in spring/summer might be linked to environmental conditions or seasonal dietary practices which increase virulence or transmission. SG in those exposed to livestock suggests that there are zoonotic risk factors or that hygiene is a causal factor. The association between EAEC infection and SG warrants further investigation.

High Prevalence Rates of Anemia, Vitamin A Deficiency and Stunting Imperil the Health Status of Bedouin Schoolchildren in North Badia, Jordan

Aims: This survey aimed to identify nutritional deficits affecting Bedouin children as they enter school age and illustrate their families’ dietary consumption patterns. Methods: 560 healthy schoolchildren aged 5.5–10 years from 8 Badia hamlets were nutritionally investigated by applying anthropometric, laboratory and dietary assessment methods. Results: Mean and median serum retinol concentrations (SRCs) were 228 and 218 μg/l, respectively. Mean prevalence of nutritional deficits among children were stunting (23.4%), anemia (57.5%), vitamin A deficiency (29.5%), iron deficiency (28.4%), and vitamin E deficiency (17.1%). Including those with borderline values, the proportion of children vulnerable to VAD threats reached 90%. Compared to normal subjects, anemic children had lower SRC (207 vs. 233 μg/l; p < 0.001) and ferritin (9.6 vs. 11.3 μg/l; p < 0.001) levels; stunted children had lower serum vitamin E (6.5 vs. 7.3 mg/l; p < 0.001) and ferritin (10.3 vs. 11.1 μg/l; p < 0.001) levels; vitamin A-deficient children had lower hemoglobin (11.3 vs. 11.8 g/dl; p < 0.001), serum vitamin E (6.69 vs. 7.23 mg/l; p < 0.01), and serum ferritin (10.4 vs. 11.2 μg/l; p < 0.001) levels, and vitamin E-deficient subjects had lower SRC levels (206 vs. 232 μg/l; p < 0.001). Except for hemoglobin status, no significant differences between genders were detected. SRC correlated strongly with hemoglobin, vitamin E, BMI and serum ferritin. The frequency of consumption of meat and fats seemed to be among the determinants of SRC and hemoglobin values. Conclusion: Urbanization has brought Bedouins towards poverty and undernutrition, with older children suffering more severe consequences in comparison with preschool-age children. This multifaceted nutritional problem requires implementation of multicomponent interventions.

Is Transition from Nomadic to Sedentary Lifestyle an Important Social Determinant of Child Health?

ISEE-0680 Background and Objectives: Nomadic communities – one of the types of underprivileged populations – still lags the furthest behind in every field of progress. We were able to monitor changes in the health status of Bedouin children over a 25 year period of transition from a semi-nomadic life style to sedentarism in desert area of southern Israel. Methods: Systematic review of articles published on the health of Bedouin children in the Negev as well as summarizing data routinely collected by the Israeli Central Bureau of Statistics and the Regional Medical Office of the Ministry of Health. Results: Among the Bedouin Arab population of the Negev Infant Mortality Rates have decreased from 30.9 per 1000 live births in 1979 to 8.5 per 1000 in 2008. A striking decrease in vaccine-preventable infectious diseases in the Bedouin population was found. The data show marked decrease in the proportion of Bedouin children who born with low birth weight from 15% in 1980–1981 to 8.9% in 2006. In 1986 the proportion of 1 year old children with short stature was 38.2% but this decreased to 19% in 1999. In 2006, 17.5% of Bedouin women were exclusively breast-feeding their infants at 6 months of age while another 61.4% were still breast-feeding with supplements. All theses changes were temporally associated with the transition of over 60% of Bedouin the population from a semi-nomadic life style to permanent settlements which was started in 1978 and is continuing up to the present. Conclusions: The results have implications for the inclusion of transition from nomadism to a sedentary existence as social determinant of health which leads to improving in child health.