Gail G. Harrison

Maternal obesity, weight gain in pregnancy, and infant birth weight☆

with streptococcus, staphylococcus, and E. roli. Ultimately, the diagnosis is made when the bacteria is cultured from either the throat, ceyvix, vagjna, urine, stool, or blood. Treatment should be started promptly because cure is dependent on it. Otherwise, transplacental spread of infection will lead to spontaneous abortion, intrauterine death, piemature labor and delivery, or neonatal sepsis and death, as in this case, secondary to complications of prematurity, i.e., respiratory distress syndrome and intraventricular hemorrhage. The drug of choice for Listeria is a penicillin, specifically ampicillin, or tetracycline; these antibiotics often empirically used. After appropriate treatment, repeat cultures should be taken to assure cure. If undiagnosed and not treated, maternal infection can lead to fetal infection via transplacental or direct-contact modes of spread. In summary, Listeria monocytogenes is a significant cause of spontaneous abortion, intrauterine death, premature labor, and neonatal sepsis. When suspected, it is easily treated with penicillin. The key to cure is prompt diagnosis and treatment. Failure to do so leads to serious sequelae and results in the additional trealment of an infected premature infant.

Dependability and precision of anthropometric measures in a longitudinal field study in an Egyptian village

Reliability and its components, precision and dependability, are analyzed for a complex dataset involving longitudinal anthropometric measurements on subjects of varying ages in an Egyptian village setting. Results are compared with other published datasets. Technical error of measurement is similar to or compares favorably with other datasets for both adults and children. Overall reliability is strongly influenced by dependability coefficients, which are calculated in this analysis over relatively longer time periods (2 weeks for young children and longer for older individuals) than in other comparable datasets. It is evident that some components of the theoretical construct of imprecision, i.e., measurement error derived from variation over longer periods of time in factors contributing to accuracy, are actually captured in the analytical component of variance called undependability.

Feeding the child with diarrhea: A strategy for testing a health education message within the primary health care system in Egypt

Abstract Egypt has successfully implemented a nationwide program of oral rehydration therapy (ORT) for acute diarrheal disease which should make a substantial impact on diarrhea-specific mortality. However, ORT alone cannot alleviate or prevent the malnutrition which commonly accompanies diarrhea. Traditional practices in Egypt result in food being withheld from children who have diarrhea, thus contributing to the vicious circle of diarrhea and malnutrition. Early and continued feeding of children with diarrhea has been shown to be effective when practiced; however, it requires specific efforts to educate mothers appropriately. This study was designed to address the operational problem of promoting the nutritional repletion of children with diarrhea. Specifically, the tasks were to design an appropriate and practical message for the education of mothers, to test its delivery through the existing primary health care (PHC) system, and to incorporate it into the nationwide program of diarrheal disease control. A baseline survey of knowledge, attitudes, and practice (KAP) of mothers and health center professionals was carried out in July 1985 in three areas of Egypt. A simple educational message was developed based on knowledge of existing practices, consistency with existing mass media messages, and the addition of a component specific to this project. The message was delivered through the PHC system for three months. No special infrastructure or training was developed; the directors of several programs in three governorates simply incorporated the message into their existing systems of information flow and training. A second KAP survey was conducted in the same centers in December 1985. The followup survey indicated several significant findings. Of mothers who had attended any PHC center in the previous three months, 78% reported that a staff member had talked to them about feeding their child during and after diarrhea. Behavioral differences were also reported. There was a statistically significant increase in the proportion who continued to give breast milk during diarrhea and a significant increase in ORT use. Health care providers in the follow-up survey reported giving more, and more appropriate, dietary advice. In conclusion, the PHC system, with no additional infrastructure, was able to successfully incorporate this educational component. The message has now been adopted by the mass media and other health education channels.

Composition of egyptian home remedies for diarrhea

Diarrhea is a major cause of morbidity and mortality in Egypt, as in many developing countries. Oral rehydration therapy (ORT) has been shown to be effective for the treatment of dehydration which often occurs during diarrhea. However, malnutrition, a common side effect of diarrheal illness, cannot be prevented or treated by ORT alone; the food and fluids which the child receives during and following diarrhea will determine to a large extent the nutritional consequences of the illness. This study investigated the types of traditional foods given to children ill with diarrhea, and their composition, in order to identify foods which are in traditional use which could be modified for use as an enriched ORT product. Between August and October, 1984, mothers of 3,130 children were interviewed while seeking medical care for their childrens diarrheal illnesses at health centers in several locations in Egypt. Information collected included age and sex of the child, type of water supply and drainage system in the...

1320 MATERNAL SMOKING AND BODY COMPOSITION IN THE NEWBORN

This study explores the relationship between maternal cigarette smoking and body composition of the newborn as reflected by anthropometric indices of subcutaneous fat and lean body mass.Subjects were 285 healthy, singleton, Caucasian, term infants whose mothers were either smokers (N=109, smoked before and during pregnancy) or nonsmokers (N=176, smoked neither before or during pregnancy). Mothers who smoked were younger (mean 22 vs 24 years, p<.05) but did not differ from nonsmokers in parity, height, prepregnant weight, weight gain in pregnancy, or length of gestation.Infants of smokers were 235 gm lighter (p<.001), 1 cm shorter (p<.001), and had smaller head circumferences (p<.05), arm circumferences (p<.001), and arm circumference/head circumference ratios (p<.01). Ponderal indices were similar. Calculated cross-sectional nonfat areas of the upper arm were also reduced (p<.001). Maternal smoking did not affect in utero fat deposition, as estimated by the cross-sectional fat area of the upper arm and biceps, triceps, subscapular, and abdominal skinfold thickness measurements.We conclude that the reduction in birthweight associated with maternal smoking is primarily a reduction in lean body mass.