Child Health Surveillance Research Articles

Child health surveillance.

Child health surveillance.

Child health surveillance.

Child health surveillance.

Child health surveillance

Child health surveillance

Child health surveillance

Child health surveillance

Child health surveillance.

Child health surveillance.

The preschool medical: an evaluation of this examination and its role in child health surveillance.

Records of 244 preschool medicals were studied retrospectively. The value of the examination to the children, their parents and teachers, and the use of clinical medical officer time was considered. Fifty-seven per cent had previously undetected problems deemed to require follow-up. This number was subsequently corrected to 50% in the light of current practice. Fourteen per cent warranted referral to other professionals and 4.5% received treatment. The high number of vision defects noted suggests further study. Fifteen per cent of the parents wished to discuss concerns about their children with the clinical medical officer. Clinical medical officer practice varied, but showed the incidence of follow-up to be inversely proportional to the referral rate. The number of previously undetected problems recorded in the survey supports medical examination of all children at this age. However, review of criteria and further study is indicated to make the best use of resources.

General practitioner training in paediatrics in the Trent region.

A total of 259 postal questionnaires were sent to all final year vocational trainees and new principals in general practice in the Trent region to find out how much training in paediatrics they had had. Questionnaires were returned by 105 trainees and 139 principals (244; 94%). Overall 72% (175) had taken up a hospital post in paediatrics during training, but among the 138 doctors who were on or had completed a three year vocational training scheme the proportion was slightly higher (82%; 115) (p = 0.01). Among the 175 who had had a post in paediatrics 108 (62%) had been given teaching sessions every week, and for half of these doctors the sessions lasted over one hour a week. Seventy five (54%) of the 139 principals reported that in their training in a general practice they had received no teaching about child health and a fifth said that they had not attended a clinic for children; 47 (34%) had received no training on procedures for dealing with cases of child abuse. The doctors who had held posts as senior house officers in paediatrics were more likely to report that they had adequate skills in paediatrics than those who had not, but overall only 62 (44%) reported that they could run a preschool child health surveillance programme. Extra paediatric posts in hospital are needed, but in the mean time improvements can be made to the teaching content in hospital and in the general practice attachment and postgraduate training in paediatrics provided for all general practitioners.

The Health Surveillance of Children in Care — Are There Serious Problems?

The Health Surveillance of Children in Care — Are There Serious Problems?

Combined deficiency of iron and vitamin D in Asian toddlers.

One hundred and forty five Asian children born at Sorrento Maternity Hospital, Birmingham, were reviewed at the age of 22 months. A significant association of iron deficiency and poor vitamin D state was found. Two fifths of the children were anaemic, two fifths had a low plasma concentration of vitamin D, and one fifth had both features. This was more than simple overlap of the two deficiencies; the children with low plasma vitamin D concentrations had significantly lower concentrations of haemoglobin and serum iron. On the other hand, the deficiencies were not merely individual features of generally poor nutrition; growth and other measures of protein energy nutrition were slightly better in these children, and their plasma zinc concentration was no lower than in the children without deficiencies. It seems, therefore, that child health surveillance as currently practised--for example, growth monitoring, clinical signs, etc--will not detect these problems unless a haemoglobin determination is included. In view of the association of poor iron and vitamin D state combined prophylaxis is desirable. At present, strategies for preventing rickets in this country are not combined with attempts to detect or prevent iron deficiency. In our opinion they should be and the options are discussed.

Treatment with iron increases weight gain and psychomotor development.

Previous work at this hospital and elsewhere has shown that anaemia in toddlers is common and is associated with psychomotor delay. It seemed unclear, however, whether this association was cause and effect or merely due to the same underprivileged environment. A double blind randomised intervention study was, therefore, performed. After an initial assessment 97 children with anaemia (haemoglobin 8-11 g/dl) aged 17-19 months received either iron and vitamin C or vitamin C only (control group) for two months and were then reassessed. The children who received the iron had an increased rate of weight gain and more of them achieved the expected rate of development. While iron deficiency anaemia is unlikely to be the only factor in the slower development of children living in underprivileged circumstances, it can at least be easily identified and treated. Routine child health surveillance in such areas should include a haemoglobin determination.

Points: Health surveillance of preschool children

Points: Health surveillance of preschool children

Book Reviews

Book reviewed in this article:Malformations in Children from One to Seven Years: a Report from the Collaborative Perinatal Project By Ntinos C. Myrianthopoulos.Left, Right, Hand and Brain: the Right Shift Theory By Marion AnnettManual of Neonatal Care, 2nd Edn. Edited by John P. Cloherty and Ann R. Stark.Health: Child Health Surveillance Strasbourg:.

Health surveillance of preschool children.

Discussions with every general practice, health visitor, and clinical medical officer in Northumberland Health Authority led to agreement about the content of preschool health surveillance, the ages at which it should be done, and referral pathways after a failed screening test. Each primary health care team now undertakes to do a basic minimum set of screening tests, and each team decides who in the team will do each test. The screening system agreed on should enable time to become available for the equally important aspects of surveillance--namely, developmental guidance, health education, and assessment and follow up of problems. The discussions also led to agreement about how the health authority should evaluate the effect of the surveillance programme on the health of children.

Meaning and method in child health surveillance: discussion paper.

Meaning and method in child health surveillance: discussion paper.

The value of selective pre-school medicals in an inner city area

Two clinics in a deprived inner city area of London had developed different systems of child health surveillance. One (non-selective) offered medicals to all children, the other (selective) only to those children judged to be abnormal by the health visitors. The selective clinic found many more abnormalities and was a much more efficient use of the clinical medical officer's time.