clove and Nutrition-Disorders

This paper compares the effects of goat's milk and cow's milk on weight gain and fat absorption, in children with overt malnutrition.. Thirty hospitalized malnourished children aged from 1 to 5 years were included in a randomized double-blind trial. The children were fed either goat or cow's milk with a randomized will defined composition, added with vegetable oil, sugar, vitamins and minerals o achieve 1,000 kcal/liter. Children were offered 100 kcal/kg on the first day, with a regular daily increase in energy intake thereafter that reached 200 kcal/kg per day on the tenth day.. Both groups of children had the same degree of malnutrition on inclusion. The mean weight-for-height Z score was -1.7 in both groups. One death with candidiasis occurred in the goat's milk group. Weight gain was similar in both groups: 8.5 g/kg/day (SE = 1.37) with goat's milk and 7.8 (SE = 1.9) with cow's milk. There was no significant difference in HEM intake: 157 ml/kg/day (SE = 4), vs 162 (SE = 4) for goat and cow's milk, respectively. Fat absorption coefficients on the 15th day of treatment were also similar in both groups.. These results suggest that goat's milk has a nutritional value similar to that of cow's milk and could be used as an alternative to cow's milk for rehabilitating undernourished children.

Topics: Animals; Cattle; Child, Preschool; Double-Blind Method; Energy Intake; Goats; Humans; Infant; Intestinal Absorption; Madagascar; Milk; Nutrition Disorders; Weight Gain

Topics: Academies and Institutes; Child Welfare; Child, Hospitalized; Child, Preschool; Humans; Immunization; Infant; Infection Control; Madagascar; Nutrition Disorders

Burkitt Lymphoma (LB), a very progressive malignant lymphoma, can now be cured by chemotherapy. However, protocols used currently by developed countries are costly and can cause problems of tolerance for underprivileged children.. To develop a protocol of care for Malagasy children suffering from LB.. A retrospective study of the files of children aged under 15 aged years, hospitalised for LB with anatomo-pathological evidence, in the Antananarivo Oncology Unit from October 1985 to June 2000. Clinical characteristics, (paraclinical) investigations, treatment and responses to treatment were studied.. 40 medical records included a LB anatomo-pathological evidence. The mean age of children was 7.5 years, with a sex ratio in favour of males. All children were underweight. Maxillo-facial tumours prevailed. Other locations for tumours had also been observed, both unique or immediately multiple. Patients seem to have arrived at the hospital in the early stages of the disease, but lack of investigation probably introduced biases to the evaluation of these stages. Chemotherapy, even though incomplete due to its cost, remained the main means of treatment. Generally speaking, an immediate, favourable response was obtained, but the toxicity of chemotherapy, especially haematological toxicity, contributed to malnutrition. Overall results indicated an immediate mortality rate of 22.5%, but there was loss of follow-up for many patients.. A specific protocol of LB care in Madagascar appears to be possible. Such a protocol should be based on experience with treatments, and should take into account disease characteristics, the response of Malagasy children to the treatment, as well as the country's economic state.

Topics: Adolescent; Antineoplastic Agents; Burkitt Lymphoma; Child; Child, Preschool; Facial Neoplasms; Female; Humans; Infant; Infant, Newborn; Madagascar; Male; Maxillary Neoplasms; Nutrition Disorders; Prospective Studies; Radiotherapy; Remission Induction; Retrospective Studies

There are very few documented large-scale successes in nutrition in Africa, and virtually no consideration of contracting for preventive services. This paper describes two successful large-scale community nutrition projects in Africa as examples of what can be done in prevention using the contracting approach in rural as well as urban areas. The two case-studies are the Secaline project in Madagascar, and the Community Nutrition Project in Senegal. The article explains what is meant by 'success' in the context of these two projects, how these results were achieved, and how certain bottlenecks were avoided. Both projects are very similar in the type of service they provide, and in combining private administration with public finance. The article illustrates that contracting out is a feasible option to be seriously considered for organizing certain prevention programmes on a large scale. There are strong indications from these projects of success in terms of reducing malnutrition, replicability and scale, and community involvement. When choosing that option, a government can tap available private local human resources through contracting out, rather than delivering those services by the public sector. However, as was done in both projects studied, consideration needs to be given to using a contract management unit for execution and monitoring, which costs 13-17% of the total project's budget. Rigorous assessments of the cost-effectiveness of contracted services are not available, but improved health outcomes, targeting of the poor, and basic cost data suggest that the programmes may well be relatively cost-effective. Although the contracting approach is not presented as the panacea to solve the malnutrition problem faced by Africa, it can certainly provide an alternative in many countries to increase coverage and quality of services.. This paper describes two case studies; namely, the Secaline Project in Madagascar and the Community Nutrition Project in Senegal in Africa as examples of malnutrition prevention using the contracting approach in rural, as well as urban areas. This article explains what is meant by "success" in the context of these two projects, how these results were achieved, and how certain difficulties were avoided. Both projects are very similar in the type of service they provide, and how they combine private administration with public finance. This article illustrates that contracting out is a feasible option to be seriously considered for organizing certain prevention programs on a large scale. Both projects were able to achieve results in providing preventive nutrition services through the private sector, which is outside the dominance of health care professionals. Thus, it shows that this type of service can be contracted out to nonspecialists. The next step is for the two projects to form the basis for a dialogue with Ministries of Health on health sector reforms, in order to extend these examples and to duplicate them in other countries and other preventive services such as AIDS prevention, or family planning services. Although the contracting approach is not presented as the panacea to solve the malnutrition problem faced by Africa, it can certainly provide an alternative in many countries to increase coverage and quality of services.

Topics: Child, Preschool; Female; Humans; Infant; Infant, Newborn; Madagascar; Nutrition Disorders; Nutritional Status; Organizational Case Studies; Outcome Assessment, Health Care; Outsourced Services; Preventive Health Services; Senegal

An epidemiological study of human intestinal helminthiasis was conducted during July and August 1995, in the middle west of Madagascar, with 4571 adults and children ranging from six months to 90 years, in 61 communities between Betafo and Miandrivazo. Faecal examination utilising the MIF concentration method revealed that ascariasis was the dominant nematodosis in the middle west with high prevalences in the high-altitude communities. Ascaris lumbricoides prevalences increase among children and women. Interesting more than 50% of the pattern, ascariasis is a public health problem and its association with infant malnutrition is statistically significant. Hookworm infection prevalence is higher in low-altitude communities, it increases among adults. The Trichuris trichiura prevalences were lower than the prevalences of ascariasis and hookworm infection in all of the communities. Important variations of the prevalences of intestinal helminthiasis are observed essentially in relation with climatic conditions.

Topics: Adolescent; Adult; Aged; Altitude; Ascariasis; Child; Child, Preschool; Female; Hookworm Infections; Humans; Infant; Intestinal Diseases, Parasitic; Madagascar; Male; Middle Aged; Nematode Infections; Nutrition Disorders

This article discusses the success of the Madagascar Food Security and Nutrition project in decreasing malnutrition and monitoring child health. Success has occurred in the following realms: effective collaboration between government and nongovernmental organizations (NGOs), capacity building through investment in training of community workers, increased quality of services provided by community nutrition workers, community involvement, government commitment, and a flexible program design. NGOs were able to respond to community concerns by adding program inputs without losing the focus on core nutrition interventions. Community workers were selected from a group of mothers. Women were trained to monitor the growth of all children under age 5. Children who were severely malnourished were identified and referred to rehabilitation centers for treatment lasting up to 3 weeks. The program offered support and nutrition education for mothers of sick children. One drawback of the treatment program was the inability of mothers to stay for long periods of time during the duration of treatment. The program offers distribution of iodine capsules as part of a long-term salt iodization program that is supported by UNICEF and the World Bank. The program also offers microcredit. Since 1993, 28,000 children under age 5 have been weighed each month. These children came from two provinces and belonged to 300,000 families. The monitored children were 66% of the total number of children aged under 5 years. Malnutrition rates decreased from 46% to 37%.

Topics: Africa; Africa South of the Sahara; Africa, Eastern; Africa, Northern; Child Nutritional Physiological Phenomena; Child Welfare; Community Health Workers; Conservation of Natural Resources; Deficiency Diseases; Delivery of Health Care; Developing Countries; Disease; Economics; Education; Environment; Food Supply; Health; Health Education; Health Personnel; Health Planning; Health Services; Income; Madagascar; Nutrition Disorders; Nutritional Physiological Phenomena; Organization and Administration; Primary Health Care

The relationships between Ascaris lumbricoides worm burden, growth status, general delayed cutaneous hypersensitivity (DCH) response, and plant anthelmintic use were investigated in a 12-mo prospective survey of 663 children, 4-10 yr old, living in the Ranomafana rainforest, Madagascar. Initial fecal examinations revealed prevalences of 93% for A. lumbricoides, 55% for Trichuris trichuria, and 27% for hookworm. After anthelmintic treatment and a 12-mo reinfection period, 428 of the children participated in worm expulsion studies using pyrantel pamoate, revealing an overdispersed A. lumbricoides worm population, mean = 19.2 (SD = 20.4). Malnutrition was common with 72% of the children growth stunted, 61% underweight, and 6% wasted. The children were also skin tested to recall antigens for DCH, with 94% reacting. The DCH immune response was significantly decreased in the malnourished children; however, DCH was not reduced in relation to increasing worm intensity. Growth status, growth velocity, and triceps skinfold did not vary significantly in relation to A. lumbricoides worm burden. Traditional plant anthelmintic treatment was effective in significantly reducing worm intensity. This study indicates that, in human communities where the children are predominately stunted, A. lumbricoides does not aggregate in the most malnourished or immunodepressed children.

Topics: Analysis of Variance; Animals; Anthelmintics; Anthropometry; Ascariasis; Ascaris lumbricoides; Child; Child Development; Child, Preschool; Cross-Sectional Studies; Feces; Female; Humans; Hypersensitivity, Delayed; Madagascar; Male; Nutrition Disorders; Parasite Egg Count; Phytotherapy; Prevalence; Prospective Studies; Regression Analysis; Skin Tests

1992 Madagascar Demographic and Health Survey (DHS) data indicate that Madagascar has a long way to go in order to realize its 1990 National Population Policy Law goal of reducing fertility from 6.1 to 4.0 by the year 2000. Madagascar DHS data are based upon a nationally representative sample of 6260 women aged 15-49. Only 62% of sampled women in union knew a modern method of contraception and 45% knew where they could obtain one. 56% of rural women and 38% of women with no education were similarly knowledgeable. Injection, the pill, and female sterilization are the best known modern methods. The infrequent airing and limited reach of family planning messages found only 6% of respondents reporting hearing a family planning message on the radio or television in the month preceding the survey. An aggressive and widespread information, education, and communication program is therefore needed to increase the level of knowledge about modern contraceptive methods. There is considerable unmet need for family planning in Madagascar. 40% of married women in 1992 reported that they did not want to have any more children, while another 30% reported wanting to space their next birth. Only 5% of married women, however, were then currently using modern methods, and 12% were using traditional methods, mainly periodic abstinence. As for maternal and child health, 163 children under five years old die per 1000 births, with the level of mortality inversely related to the level of education attained by the mother. The under-five mortality rate is 183/1000 in rural areas and 142/1000 in urban areas. In 1992, 78% of mothers received antenatal care from an health professional, and an health professional was present at delivery for 57% of births. Only 43% of children aged 12-23 months, however, have received all recommended vaccinations, such that childhood illnesses, particularly diarrhea, are common among young children. More than 50% of children under five are stunted, and 40% are underweight.

Topics: Africa; Africa South of the Sahara; Africa, Eastern; Africa, Northern; Contraception; Contraception Behavior; Demography; Developing Countries; Disease; Economics; Educational Status; Family Planning Services; Health Services Needs and Demand; Infant Mortality; Knowledge; Madagascar; Mortality; Nutrition Disorders; Population; Population Dynamics; Research; Social Class; Socioeconomic Factors

Topics: Amino Acids; Animal Feed; Animals; Chromatography; Dietary Proteins; Madagascar; Nutrition Disorders; Plant Proteins; Plants