Jamaican Children Research Articles

Fasting pancreatic glucagon in Jamaican children during malnutrition and subsequent recovery.

Fasting pancreatic glucagon was observed in Jamaican infants during malnutrition and subsequent recovery. Rehabilitation in two groups of children with isocaloric diets rich either in carbohydrate or fat produced no differences in the rate of weight gain. During malnutrition, plasma pancreatic glucagon concentration was 104 +/- 11 (n = 20) pg/ml (mean +/- S.E.) significantly lower than during recovery when the maximum value was 180 +/- 24 (n = 13) pg/ml during the later recovery phase. After clinical recovery glucagon levels declined to 127 +/- 13 (n = 15) pg/ml. Plasma insulin followed a similar pattern, increasing significantly during catch-up growth and declining after recovery. Slower rates of growth were associated with the simultaneous decline in the concentrations of both hormones after clinical recovery.

Post-natal decline of fetal haemoglobin in homozygous sickle cell disease: relationship to parenteral Hb F levels.

The decline of fetal haemoglobin (Hb F) from birth to 6 years has been compared in a cohort of 266 Jamaican children with homozygous sickle cel (SS) disease and in 243 matched controls with a normal haemoglobin (AA) genotype. Hb F levels were significantly higher in the SS cases from 1 month onward but, unlike the normal controls, no sex difference was apparent. The Hb F levels in SS disease were significantly correlated with parental Hb F levels, suggesting that genetic factors regulating adult Hb F levels are active at earlier stages in development. Furthermore, some of these genetic determinants of Hb F production may be linked to the beta-like globin gene complex and be in linkage disequilibrium with the beta s allele.

Early rise in the "pitted" red cell count as a guide to susceptibility to infection in childhood sickle cell anaemia.

"Pitted" red cell counts (pit counts) were performed serially during a period of 18 months in 130 Jamaican children with homozygous sickle cell (SS) disease aged 0-4 years. Raised pit counts, defined as 10% or more "pitted" red cells, were present in 23% of the children at age 12 months, in 42% at age 24 months, and in 52% at age 36 months. Radioactive colloid spleen scans showed no splenic uptake in 11 children with palpable spleens and raised pit counts. Eight episodes of severe bacterial infection occurred in 7 children, all of whom had raised pit counts before (n = 6) or at the time of infection (n = 1). Of the 52 children with pit counts followed from age 12 months or younger, all 4 who developed severe infections had raised pit counts at or before age 12 months. Pit counts are a guide to susceptibility to severe infections in SS children. Children whose pit counts rise before age 12 months are at greater risk of subsequent infection; this may be related to loss of splenic function before first encounter with the infecting organism.

Intracranial pressure during intubation and anesthesia in infants

REFERENCES 1. Whitten CF: Growth status in children with sickle cell anemia, Am J Dis Child 102:355, 1961. 2. Ashcroft MT, Serjeant GR, and Desai P: Heights, weights, and skeletal age of Jamaican adolescents~ with sickle cell anemia, Arch Dis Child '47:519, 1972. 3. Lowry MF, Desai P, Ashcroft MT, Serjeant BE, and Serjeant GR: Heights and weights of Jamaican children with homozygous sickle cell anemia, Human Biol 49:429, 1977. 4. Ashcroft MT, and Serjeant GR: Body habitus of Jamaican adults with sickle cell anemia. J Southern Med Assoc 65:579, 1972. 5 . Neel AF: Social and biological factors in child development, Psychol Rep 40:1143, 1977. 6. Diggs LW: in Abrahamson H, Bertles JF, and Wethers DL, editors: Sickle cell disease, St. Louis, 1973, The CV Mosby Company, p 218. 7. Hegyi T, Delphin ES, Bank A, et al: Sickle cell anemia in the newborn, Pediatrics 60:213, 1977. 8. Pearson HA, and O'Brien RT: Sickle cell testing programs, J PEDIATR 81:1201, 1972. 9. Kramer MS, Rooks Y, Johnston DT, and Pearson HA: Accuracy of cord blood screening for sickle hemoglobinopathies: Threeto five-year follow-up, JAMA 241:485, 1979. 10. Kramer MS, Rooks Y, and Pearson HA: Growth and development in children with sickle cell trait: A prospective study of matched pairs, N Engl J Med 299:686, 1978.

The relationship between hospitalisation, social background, severe protein energy malnutrition and mental development in young Jamaican children

The development levels, length of hospital stay, social and biological backgrounds of 18 young Jamaican children who had recently been hospitalised for severe PEM, and 21 adequately nourished child...

Glucose-6-phosphate dehydrogenase deficiency and neonatal jaundice in Jamaica.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency was detected in 16 (69.6%) of a group of 23 neonates who had unexplained moderate or severe jaundice. This proportion is significantly more than the 9.4% observed or the 22.2% expected in Jamaican neonates who are not moderately or severely jaundiced (P less than 0.003), and significantly more than the 12.6% observed or the 21.0% expected in older Jamaican children and adults (P less than 0.003). Phenobarbitone therapy and phototherapy reduced the need for exchange transfusion but this was necessary in eight patients. Two babies developed kernicterus and one died. On the other hand, only two of 21 neonates who were identified as G6PD deficient at birth subsequently became moderately or severely jaundiced, and this could be attributed to other causes in both cases. These findings indicate that apparently spontaneous neonatal jaundice is important in infants who have the G6PD A--enzyme. However, the jaundice is probably precipitated by unknown factors to which the G6PD deficient neonate is more susceptible than the infant who is not G6PD deficient. THere is also a slightly increased incidence of G6PD deficiency in neonates who develop jaundice because of ABO or Rh(D) iso-immune disease, infection or prematurity.

Position of the apex beat in childhood.

The position of the apex beat in relation to the midclavicular and nipples lines and the intercostal spaces was studied in 353 healthy Jamaican children from birth to 10 years. The traditional use of the midclavicular line as a reference point in relation to the apex beat is not an accurate index of normal heart size at all ages. For this purpose actual measurement of the apex beat, which ranges between 2.8 and and 5.4 cm from the midline, should be made. However, for a rough estimate of normal cardiac size the midclavicular line may be used. In contrast, the nipple line lies outside the apex beat at all ages; it should not be used in the clinical evaluation of normal cardiac size. From birth to age 3 years the apex beat is located in the 4th intercostal space and with increasing age gradually moves into the 5th space in most children.

Early deaths in Jamaican children with sickle cell disease.

In Jamaican children with homozygous sickle cell (SS) disease diagnosed at birth two-year survival was 87%, compared with 95% in children with sickle cell-haemoglobin C (CS) disease, and 99% in normal controls. Death among those with SS disease occurred most often between the ages of 6 and 12 months. Principal causes were acute splenic sequestration and pneumococcal infection. Neonatal diagnosis of haemoglobinopathies must be followed by close observation if mortality is to be reduced by early diagnosis and treatment of these complications.

The metacarpal index in Jamaican children and adults.

The metacarpal index was measured in radiographs of the hands of 615 male and 667 female Jamaicans aged over two years. The index increased with age from two years to adulthood, and was greater in females than in males, and greater in the left hand than the right hand. Means and standard deviations of the index for the left hand are presented as standards. An index of 9.6 for males and 10.1 for females over the age of 13 years is suggested as the upper limit of normal (three standard deviations above the mean). These standards are higher than those previously reported, and are probably applicable to other black populations outside Jamaica.

Radiological evaluation of the cardiac apex in Jamaican children

The position of the clinical apex beat projected on chest radiographs was compared to different points on the cardiac outline which have been regarded as the radiological apex. Good correlation was found between the clinical apex and the most lateral point of the left cardiac border, but not with the cardiophrenic angle or the lower end of the long diameter of the heart. The mid-clavicular line cannot be used to define the upper limit of the normal sized heart on radiographs as in clinical practice, because in many of the subjects the heart extended outside the mid-clavicular line.

Energy balance during recovery from malnutrition

This report presents an account of energy balance of young Jamaican children recovering from protein-energy malnutrition (PEM). This was done in three steps. Initially the true gross energy of a formula used in the treatment of PEM was determined by bomb calorimetry. Then its metabolizable energy content was determined in a group of nine children recovering from PEM. In a similar but different group of eight children total daily metabolizable energy intake (EI), average rate of weight gain (g/kg/day) (WG), and total daily energy expenditure (TDEE) were determined. TDEE was determined by indirect calorimetry using a heart rate counter and is based on the relationship of heart rate to oxygen consumption. In this group, the mean EI was 122.5 kcal, WG was 8.4 g, and TDEE was 92 kcal. The difference between EI and TDEE was 30.7 kcal/kg, or 3.3 kcal/g of weight gain. This difference is presumed to be the stored energy in new tissue and corresponds to a proposed new tissue composition of 31% fat and 14% protein. A regression curve comparison of WG versus EI showed that at zero weight gain EI was 85.5 kcal and each additional gain. The difference of 1.0 kcal between total energy cost and stored energy reflects the energy required to deposit new tissue. Gram weight gain required 4.4 kcal. The latter figure is felt to reflect the total energy cost of weight. From three independent measurements, an estimate of maintenance energy requirements was estimated to be about 82 kcal/kg/day.

Growth, behaviour, and educational achievement of Jamaican children with sickle-cell trait.

A longitudinal study of the mental and physical development of 200 children with normal haemoglobin and 21 with the sickle-cell trait was carried out in a small rural community in Jamaica. At about 2 and 10 years of age heights and weights showed no significant differences. At about 10 years of age classroom behaviour, sociability, and educational achievement were similar. The results suggest that the sickle-cell trait does not affect growth and mental development.

Vitamin-D deficiency rickets in Jamaican children.

Vitamin-D deficiency is not as rare in Jamaica as previously believed. 9 children with vitamin-D deficiency rickets have been seen at the University Hospital of the West Indies during the past 5 years. All were over 3 years of age at time of presentation. Both dietary deficiency of vitamin D and lack of exposure to sunlight seem to be important causes. Children living in rural Jamaica seem to be more susceptible to the disease than those living in a city, due perhaps to more prolonged breast feeding and lack of fortified milk feeds on weaning.

The Language Learning Aptitudes of Jamaican Children at the Beginning of Secondary School

Against the background of the creole-language situation in Jamaica, the present paper examines the need for a study of language aptitudes. Also examined are the relevance of S. B. Carroll's theory of language aptitudes in the Jamaican situation, and the implications that become evident out of a comparison of children's performance in language-aptitude and learning-potential tests. The findings suggest that performance in both types of test is strongly influenced by social-class factors. It is then further suggested that the communication style of creole-influenced speech is different from that required overtly or covertly in most types of test performance, and that this specific factor could be responsible for the results discussed.

Developmental And Social-Class Differences In Language

It has often been suggested that lower social-class children are poor in their lang­uage abilities, and are in this respect deprived or disadvantaged. A suggestion contrary to this is here put forward; it is shown, by a comparison of language usage in upper and lower-social-class Jamaican children, that the two social-class extremes have different styles (formats) of communication, but that the two styles (formats) are equal in their capabilities.

CECE Approaches To Pupil Assessment In Early Childhood Education

The main object of assessment in this con­text was to determine just how far the enriched curriculum provided for these Jamaican children was meeting their needs for adequate compensatory education. As a result one area of PECE research concentrated on obtaining measures of the achievement levels in initial and final pupil performance.

Prevalence and persistence of lactose malabsorption among young Jamaican children

Prevalence and persistence of lactose malabsorption among young Jamaican children

Serum and liver triglycerides in malnourished Jamaican children with fatty liver

Serum and liver triglycerides in malnourished Jamaican children with fatty liver

Thermal insulation in malnourished Jamaican children.

The Vγ4⁺ pulmonary subset of γδ T cells regulates innate airway responsiveness in the absence of αβ T cells. We now have examined the same subset in a model of allergic airway disease, OVA-sensitized and challenged mice that exhibit Th2 responses, pulmonary inflammation, and airway hyperreactivity (AHR). In sensitized mice, Vγ4⁺ cells preferentially increased in number following airway challenge. Depletion of Vγ4⁺ cells before the challenge substantially increased AHR in these mice, but had no effect on airway responsiveness in normal, nonchallenged mice. Depletion of Vγ1⁺ cells had no effect on AHR, and depletion of all TCR-δ⁺ cells was no more effective than depletion of Vγ4⁺ cells alone. Adoptively transferred pulmonary lymphocytes containing Vγ4⁺ cells inhibited AHR, but lost this ability when Vγ4⁺ cells were depleted, indicating that these cells actively suppress AHR. Eosinophilic infiltration of the lung and airways, or goblet cell hyperplasia, was not affected by depletion of Vγ4⁺ cells, although cytokine-producing αβ T cells in the lung increased. These findings establish Vγ4⁺ γδ T cells as negative regulators of AHR and show that their regulatory effect bypasses much of the allergic inflammatory response coincident with AHR.

The response of malnourished babies to cold.

1. Twelve malnourished Jamaican children, aged 4-16 months, were studied before and after treatment, to see whether malnutrition impaired their response to cold.2. When they were studied in the post-absorptive state and in a neutral thermal environment, they had a lower rate of oxygen consumption per kg body weight, a slower pulse rate, lower body temperatures, lower R.Q., and evidence of a smaller peripheral blood flow on admission to hospital than they did after recovery.3. The malnourished children failed to increase their heat production above resting levels at 25 degrees C, and their rectal temperature fell at a rate of 1 degrees C/hr in spite of a further decrease in peripheral circulation.4. When they had recovered they maintained their body temperature within the normal range on exposure to this temperature, while increasing their heat production by 20%. The thermogenesis was apparently of the non-shivering type.5. There was evidence of increased metabolic activity in the interscapular brown fat pad at 25 degrees C both on admission and before discharge. In the malnourished children this activity was not sufficient to produce a measurable increase in total oxygen consumption.6. Interscapular brown fat was examined at autopsy in thirteen malnourished and fifteen well nourished children aged 1-24 months. Lipid depletion was found in this tissue in the former but not in the latter. This may explain the impaired response of the malnourished child to cold.