Low Socioeconomic Regions Research Articles

Prevalence of Overweight and Obesity in Children and Adolescents in Eastern Turkey-Original Article

Objective: The aim of this study was to estimate the prevalence of overweight and obesity in school children in Eastern Turkey.Methods: This study included 9048 school children aged 6−18 years. The subjects were classified as overweight and obese, according to the International Obesity Task Force.Results: We found prevalence of overweight of 11.1% in the studied population. It was detected that 2.2% of the population in the study was obese; 2.1% of males and 2.3% of females. While the prevalence of obesity was extremely low before 9 ages and after 15, it reached to high values at puberty and just before pubertal period in boys. The prevalence of overweight was higher in girls and reached to peak point at pubertal ages. Generally, the prevalence of obesity and overweight was slightly higher in girls than in boys, although the boys were more obese in prepubertal ages.Conclusion: Overweight and obesity are concerns for children andadolescents in low socio−economic status regions as well.Conflict of interest:None declared.

Unrecorded consumption, quality of alcohol and health consequences

This contribution aims to examine systematically the evidence on the impact of the quality of unrecorded alcohol products on health consequences. Systematic computer assisted review of the literature. There are a number of pathways related to alcohol quality that may lead to acute or chronic health problems. The following constituents and contaminants of alcoholic beverages were identified as likely contributors to these problems: (i) toxic metals (e.g. lead) from contaminated water sources or unsuitable distillation equipment; (ii) volatile constituents, such as acetaldehyde or higher alcohols, which may be produced in significant amounts due to faults in production technology or microbiological spoilage; (iii) ethyl carbamate (urethane), a carcinogenic contaminant with major occurrence in certain fruit and sugarcane spirits; (iv) biologically active flavour compounds (e.g. coumarin in cosmetics used as non-beverage alcohol); (v) toxic compounds used to denature alcohol (e.g. methanol or diethyl phthalate). In addition, the often higher ethanol content may have detrimental health effects. These pathways should not be assumed as present for all subcategories of unrecorded alcohol, but are more relevant to certain types and geographic regions. A health impact of unrecorded alcohol over and above the effect of ethanol cannot be excluded. More research is urgently needed, especially with respect to liver disease and alcohol poisoning as endpoints. A feasible approach for new research on the effects of unrecorded alcohol could be based on a representative sample from low socioeconomic regions with high prevalence of unrecorded consumption.

Prevalence of multiresistant gram-negative organisms in a tertiary hospital in Mwanza, Tanzania

BackgroundAntimicrobial resistance is fast becoming a global concern with rapid increases in multidrug-resistant Gram negative organisms. The prevalence of extended spectrum beta-lactamase (ESBL)-producing clinical isolates increases the burden on implementing infectious disease management in low socio-economic regions. As incidence can vary widely between regions, this study was done to determine resistance patterns of Gram-negative organisms at Bugando Medical Center, a tertiary hospital in Mwanza, Tanzania.MethodsA total of 800 clinical samples (urine, wound swab, pus, blood, aspirate, sputum etc) were processed over a period of 6 months. Gram-negative bacteria were identified using conventional in-house biochemical tests and susceptibility to common antibiotics done using disc diffusion methods. The disc approximation method was used to identify ESBL producers.ResultsA total of 377 Gram-negative bacteria (GNB) recovered from 377 clinical specimens were analyzed of which 76.9% were Enterobacteriaceae. Among all GNB, 110/377 (29.2%) were found to be ESBL producers. Species specific ESBLs rate among Klebsiella pneumoniae, Escherichia coli, Acinetobacter spp, Proteus spp and other enterobacteria were 63.7%, 24.4%, 17.7%, 6.4% and 27.9% respectively. A statistically significant higher number of inpatients 100/283 (35.3%) compared to 10/94 (10.6%) of outpatients had ESBL-producing organisms (p = 0.000023). Rates of resistances to gentamicin, tetracycline, sulphamethaxazole/trimethoprim and ciprofloxacin were significantly higher among ESBLs isolates than non-ESBL isolates (p = 0.000001).ConclusionESBL producing organisms are common at BMC (Bugando Medical Center) and pose a challenge to antibiotic therapy. Successful implementation of a routine detection of ESBL production is essential in designing appropriate antibiotic prescribing policies and infection control intervention programmes.

Is there a hidden mortality after one-stage transanal endorectal pull-through for patients with Hirschsprung’s disease?

One-stage transanal pull-through (TAP) has become a standard definitive procedure for the treatment of Hirschsprung's disease (HD). Short-term results of this operation seem to be excellent, but long-term outcome is still obscure. We evaluated the morbidity and mortality of our patients with one-stage TAP, and we reviewed the literature. We performed a TAP without a colostomy in 21 patients with HD. The primary outcome measures are age, sex, complications during surgery, enterocolitis (EC) attacks after surgery, postoperative stooling problems and mortality. All patients were called over telephone, and their clinical and functional outcomes were obtained. Case series of TAP in the literature were also reviewed in terms of postoperative problems. Twenty-one patients with full thickness rectal biopsy-proven HD underwent one-stage TAP. Average follow-up was 28 months. One early postoperative EC and three more late attacks of EC were observed. All survived patients had normal bowel habits. Three patients had perianal excoriations, three patients soiling, seven cases required anal dilatations and four patients experienced a diarrhea after surgery. We have been informed that four patients died after discharge from hospital. Two of them were a sudden death (one patient had metabolic problems, the other might have had an EC attack). The cause of death of one patient with an associated Down syndrome was a severe pneumonia, and one other case died of a septic shock of unknown etiology. None of these patients had a diarrhea or abdominal distention, which could have been an evidence of an EC attack prior to their deaths. We observed similar fatal cases, when reviewed the published series in the literature. There might be a hidden mortality within the long-term period after TAP for HD. Therefore, we recommend a close follow-up for all patients with any associated health problem and those from low socioeconomic regions after one-stage pull-through.

Aedes aegypti (l.) population in an endemic area of dengue in Southeast Brazil

A Aedes aegypti population from an area of dengue transmission was studied to determine mosquito's frequency, spatial distribution, parity, its ovarian development and midgut contents. The study carried out in São José do Rio Preto country, São Paulo, SP, Brazil. Low and intermediate socioeconomic level regions were chosen to the study, which was carried out 1996 and 1997. Using a manual electric aspirator, captures were performed inside and outside the houses. Dissections were conducted to allow classify female mosquitoes according to their physiologic state. One hundred and eighty-eight males and 189 females were captured in both regions. A general index of 0.46 Ae. aegypti females per house was determined. Of the total sample, 82.4% of males and 87.3% of females were collected indoors. Greater proportions of females were found in the region of low socioeconomic level, and higher population density. One hundred and forty-eight female mosquitoes were analyzed: 27.0% were nulliparous and 10.1% parous. The rest were classified as Christophers and Mer's (C & M) phases III to V, 28.0% of which had red blood in their midgut. Of the total female population, 87.9% had bloodmeals. The mosquito species revealed a high degree of endophily. There was a higher proportion of nulliparous mosquitoes, although the majority of the females were classified as C & M's phases III to V. These results highlight both the great number of females who had had bloodmeals, and the lack of gonotrophic concordance.

PHYSICAL ACTIVITY LEVEL AND DAILY HEART RATE IN CHILDREN FROM LOW AND HIGH SOCIOECONOMIC REGIONS

1601 The present study aim was to investigate the physical activity patterns of children aged 10 to 15 years-old from low and high socioeconomic regions. Sample consisted of 47 children: 24 boys and 23 girls (age 11.4 ± 1.0 yr; body weight 34.9 ± 5.9 kg; body height: 145.2 ± 8.6cm), from Ilhabela, an island in a low socioeconomic region at São Paulo coast (LOW) and 18 children: 14 boys and 4 girls (age: 13.1 ± 0.81 yr. Body weight 54.2 ± 15.1 kg; Body height 166.5 ± 14.6 cm), from São Caetano do Sul, a city in a high socioeconomic region in São Paulo State (HIGH). Physical activity level was measured using continuos minute-by-minute heart rate (HR) monitoring (Sport Tester XL/Vantage NV). Each child was monitored from 9.3 to 10.3 hours per day for 3 consecutive days (2 weekdays and 1 weekenday). Only children with data for at least 450 minutes were included in the analyses. It was calculated the mean accumulated time (min) and mean % time at the HR thresholds of < 140 bpm, ≥ 140 and > 160 bpm. The children completed a 3-day record physical activity questionnaire (Bouchard's 1983) during 12-hr period. Descriptive statistics (mean and standard deviation) and time at the threshold (% mean) values were as follows: (Table)TableData showed that 94.4% and 94.2% of the children from the low and high socioeconomic status spent the day at HR levels lower than 140 bpm. Although there were no significant differences between the two regions, it was clear that those students were not involved enough in moderate and vigorous physical activity. These results support the necessity of intervention programs to increase the PA level of children.

RELATIONSHIP BETWEEN PHYSICAL FITNESS LEVEL AT PUBERTY AND AT YOUNG ADULT LIFE 138

The purpose of this study was to determine the relationship between the level of physical fitness at puberty period and at early adult life, among individuals from low socioeconomic region. With that aim, 49 girls (G) and 62 boys (B) from the public school system of a low socioeconomic region were followed longitudinally for about 10 years. At the beginning of the project, mean age were 10.67 (s: 2.02)and 11.65(s: 1.77)years-old, and at the end 19.84(s: 2.48) and 21.44(s:2.78)years for girls and boys, respectively. Measures of physical fitness included body height, weight, adiposity (seven skinfolds-SF), arm and leg girths, maximal oxygen uptake (˙VO2max) in ml/kg/min-1, long and vertical jump with and without(W) help of upper arms, handgrip(HG), velocity(50m-dash-VEL), and agility (shuttle-run - SR). The coefficients of correlation for each variable and sex were as follows:Table The variables at puberty that explained the adult values the most were: a- for girls: body weight, adiposity, and velocity, and b- for boys: body height, adiposity, handgrip, vertical jump (VJ). When data from both sexes were combined, the variables at puberty that best explain the adult scores were body weight, adiposity, agility, velocity, and handgrip. These results permit to conclude that the level of physical fitness at puberty has a significant(low to moderate) correlation with the young adult fitness profile among subjects from low socioeconomic regions.