BackgroundThe nutritional status of school-aged children impacts their health, cognition, and subsequently their educational achievement. The school is an opportune setting to provide health and nu...

https://journals.sagepub.com/doi/pdf/10.1177/156482651003100303

The Nutritional Status of School-Aged Children: Why Should We Care?

The neglected tropical diseases (NTDs) are the most common infections of the world's poorest people living in Africa, Asia, and the Americas [1]. Occurring predominantly among people who live on less than US$2 per day or below the World Bank poverty figure of US$1.25 per day, the NTDs represent a group of chronic parasitic and related bacterial and viral infections that actually promote poverty because of their impact on child development, pregnancy outcome, and worker productivity [2]. The NTDs differ significantly in their prevalence and disease burden according to their geographic and regional presence. Such features for the NTDs in sub-Saharan Africa [3], China and East Asia [4], and the Americas [5]–[7], respectively, were reviewed previously. Here, we summarize current knowledge on the prevalence, distribution, and disease burden of the NTDs in India and South Asia, focusing on aspects particular to the region. The review of the literature was conducted using the online database PubMed from 2003 to 2010 with the Medical Subject Headings, the specific diseases listed in the World Health Organization's (WHO) first report on NTDs [8], and the geographic regions and countries of South Asia. Reference lists of identified articles and reviews were also hand searched as were WHO databases (http://www.who.int/), including the WHO's Weekly Epidemiological Record. Recently, a comprehensive review on the continuing challenge of infectious diseases in India was published [9]. However, this review focuses exclusively on NTDs, many of which, especially the helminthiases, were not emphasized previously [9].

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The neglected tropical diseases of India and South Asia: review of their prevalence, distribution, and control or elimination.

Background 
The plantation sector in Sri Lanka lags behind the rest of the country in terms of living conditions and health. In 1992, a sector-wide survey of children aged 3–12 years and women of reproductive age showed >90% prevalence of soil-transmitted helminth infections. Biannual mass de-worming targeting children aged 3–18 years started in 1994 and was continued until 2005. The present study was carried out to assess the status of infection four years after cessation of mass de-worming.
Methods/Findings 
A school-based cross-sectional survey was carried out. Faecal samples from approximately 20 children from each of 114 schools in five districts were examined using the modified Kato-Katz technique. Data regarding the school, the child's family and household sanitation were recorded after inspection of schools and households. Multivariate analysis was carried out using logistic regression, to identify risk factors for infection. Faecal samples were obtained from 1890 children. In 4/5 districts, >20% were infected with one or more helminth species. Overall combined prevalence was 29.0%; 11.6% had infections of moderate-heavy intensity. The commonest infection was Ascaris lumbricoides, present in all five districts, as was Trichuris trichiura. Hookworm was not detected in two districts. Multivariate analysis identified low altitude and maternal under-education as risk factors for all three infections. Poor household sanitation was identified as a risk factor for A. lumbricoides and hookworm, but not T. trichiura infections.
Conclusions/Significance 
The results indicate that regular mass de-worming of plantation sector children should be resumed along with more emphasis on better sanitation and health education. They show that even after 10 years of mass chemotherapy, prevalence can bounce back after cessation of preventive chemotherapy, if the initial force of transmission is strong and other long-term control measures are not concomitantly implemented.

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Soil-transmitted helminth infections among plantation sector schoolchildren in Sri Lanka: prevalence after ten years of preventive chemotherapy.

Malnutrition continues to be a major public health challenge especially in South Asian developing countries. The aim of the present review is to spotlight the magnitude of the prevalence of malnutrition and its dynamics in South Asian region and to suggest potential approaches for the prevention and control of this issue of public health significance. An extensive review of literature, covering malnutrition and its determinants, health and economic consequences and pragmatic preventive strategies was performed on computer based bibliographic databases (PubMed, Google Scholar, Scopus, Medline and Sciencedirect.com ) to retrieve abstracts and full texts for India, Pakistan, Bangladesh, Sri Lanka and Nepal. All relevant titles and abstracts were examined and evaluated for malnutrition and its prevalence in South Asia. The results revealed malnutrition to be a major public health problem and a potential cause of high disease burden and mortality in South Asia. Compelling evidence suggests malnutrition to be the leading cause of stunting, wasting and underweight with drastic economic consequences among vulnerable populations. Reduced cognitive performance and low productivity have also been associated with micronutrients malnutrition. Suboptimal breastfeeding, inadequate food supply, micronutrient deficiencies, low household income, poor health care system, increased healthcare costs, illiteracy, unhygienic and substandard living, inappropriate child's care and the caregiver, food insecurity and on top of that vicious cycle of poverty, have been recognized as principal indicators for growing malnutrition prevalence in South Asia. Global organizations, local governments, program managers, NGOs, academia, industry in particular and the society at large need to take up the challenge to completely confiscate malnutrition from the region for economic prosperity and a healthier future.

Malnutrition in South Asia—A Critical Reappraisal

This cross-sectional study included 20,084 students from urban schools (first to fourth-grade) in Pelotas, Rio Grande do Sul State, Brazil. Weight and height were measured, and nutritional status was classified according to the World Health Organization (height deficit) and International Obesity Task Force (overweight and obesity) criteria. The study also recorded the variables age, gender, type of school, and schooling (grade-for-age adequacy). Prevalence of height-for-age deficit was 3.5% (3.9% in boys and 3.1% in girls). Prevalence rates for overweight and obesity were 29.8% and 9.1%, respectively. Overweight and obesity were more frequent in private schools, while height-for-age deficit was more frequent in municipal or State schools. For both boys and girls, age was positively associated with underweight and inversely related to overweight and obesity. Inadequate schooling was associated with increased risk of height deficit and decreased risk of overweight and obesity. In conclusion, primary students' nutritional status depends not only on demographic and socioeconomic factors, but also on type of school.

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[Nutritional status of first to fourth-grade students of urban schools in Pelotas, Rio Grande do Sul State, Brazil].

Objective To assess health status of 9-10-year old school children in Sri Lanka. Design A cross-sectional, descriptive study. Schools were selected to obtain a sample representative at national and provincial levels and 20 children were randomly selected from Grade 5 classes in each school. Measurements Children were examined for Bitot's spots and goitre. Height, weight, and visual acuity were measured according to standard procedures. Haemoglobin level was measured using finger-prick blood and a HemoCue® meter. Geohelminth infections were quantified by faecal examination using the modified Kato-Katz technique. Height for age Z-scores (HAZ) and body mass index (BMI) were calculated as indicators of nutritional status. Results Two thousand five hundred and twenty eight children (1351 boys) from 144 schools (140 state schools and four private schools) were examined. Nationally, 15.5% of children were stunted (HAZ lower than - 2.0 SD); 52.6% were thin (BMI 85th centile); 12.1% were anaemic; 0.3% had Bitot's spots; 3% had a visible or palpable goitre; 4.6% were shortsighted; and 6.9% had one or more soil-transmitted nematode infection. Among children on whom anthropometry, haemoglobin and faecal examinations were all done, 64.6% (1332/2063) were thin, stunted, anaemic or infected with worms. A much higher proportion of children in the Northern and Eastern provinces had health problems when compared to the other provinces. Conclusions The majority of older primary schoolchildren in Sri Lanka are undernourished. Anaemia, vitamin A deficiency, iodine deficiency and soil-transmitted nematode infections affect a much smaller proportion of them. Key words: Anaemia, goitre, malnutrition, soil-transmitted nematode infection, vision DOI: 10.4038/cmj.v50i2.1567 Ceylon Medical Journal Vol.50(2) 2005 pp46-50

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Health status of primary schoolchildren in Sri Lanka

Objective To study the prevalence of juvenile victimisation in a group of young adults. Method A juvenile victimisation questionnaire was distributed among 1322 Sri Lankan undergraduates. The questionnaire consisted of different modules (child maltreatment, conventional crime, peer-sibling victimisation, indirect victimisation, introduction to substances and parental deprivation). Results The response rate was 90%. The mean age of the cohort was 21.8 years. 59% were females. 44% and 36% had experienced sexual and physical maltreatment respectively. In both categories males were affected more than females (p Conclusion Many children in Sri Lanka are exposed to victimisation. They seem to suffer these in the very environments that should be nurturing and protecting them. Key words: juvenile victimisation, child maltreatment, Sri Lanka DOI: 10.4038/cmj.v54i3.1200 Ceylon Medical Journal Vol.54(3) 2009 80-84

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Juvenile victimisation in a group of young Sri Lankan adults

https://cmj.sljol.info/articles/10.4038/cmj.v52i1.1036/galley/964/download/

Strategies in the management of child maltreatment: should reporting be mandatory or voluntary?

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Filarial antigens detected in urine using the immunochromatographic card test.

Mucopolysaccaharidoses (MPSs) are a group of inherited storage diseases caused by a deficiency of lysosomal enzymes that degrade glycosaminoglycans (GAGs). The MPSs are a heterogenous group characterised by intra-lysosomal accumulation of GAGs, excessive urinary excretion of GAGs, and variable degrees of progressive mental and physical deterioration [1]. Mucopolysaccharidosis type IV (Morquio syndrome) is autosomal recessively inherited. The primary pathology is defective degradation of keratan sulphate due to one of two enzyme deficiencies; n-acetylgalactoseamine-6-sulfate (chromosome 16q) or β-galactosidase (chromosome 3p) [1,2].

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Aswini D Fernando

Papers

Health status of primary schoolchildren in Sri Lanka

Juvenile victimisation in a group of young Sri Lankan adults

Strategies in the management of child maltreatment: should reporting be mandatory or voluntary?

Filarial antigens detected in urine using the immunochromatographic card test.

A child with Morquio syndrome and mixed mitral valve disease