K. R. Sundaram

Strategies which reduced sepsis-related neonatal mortality

The neonatal mortality rate (per 1000 live births) dropped from 36.6 in 1985 to 23.9 in 1986. Neonatal sepsis ranked as number 2 as a cause of neonatal mortality in 1985, while it dropped to rank 4 (even lower than major malformations) in 1986. The decline in the sepsis-related neonatal mortality was due to reduced incidence of sepsis (38.2 and 18.8 per 1000 live births during 1985 and 1986 respectively) and improved survival (case fatality rates of 24.6% vs 17.7% in 1985 and 1986 respectively). The strategies which reduced the incidence of nosocomial infections included decongestion of use of the nursery, discontinuation of use of heparinised saline for flushing intravenous lines and routine use of intravenous cannulas instead of metallic scalp vein needles.

Simple tricoloured measuring tapes for identification of low birthweight babies by community health workers.

A total of 446 singleton neonates were subjected to measurements of birthweight, chest circumference (CC) and mid-arm circumference (MAC). A high degree of correlation between birthweight and CC as well as MAC was observed. Chest circumference correlated better with birthweight than MAC. Further analysis of data showed that CC measurements of less than or equal to 30.0 cm and less than or equal to 27.5 cm reliably identify neonates less than 2500 g and less than 2000 g, respectively, with a high degree of specificity and predictive value. The corresponding values for MAC were less than or equal to 9.0 cm and less than or equal to 8.5 cm, respectively. Using these inferences, two tricoloured measuring tapes, one each for CC and MAC, are proposed as simple screening tools for use by primary health workers for identifying low-birthweight neonates in the community without resorting to weighing scales.

Indices of physical build, nutrition and obesity in school-going children

Physical growth and growth indices were determined in 728 school children aged 5–15 years from low and lower middle socioeconomic groups (LSE) and 512 school children from high socioeconomic group (HSE). Growth of children from HSE group was comparable to Harvard standards and it was higher than ICMR: Class-I; and that of children from LSE group was very low compared to Harvard and ICMR Class I standards. It is suggested that growth norms of Indian children belonging to high socioeconomic class could be taken as standards for comparison.Ten indices were analysed, and Weight/Height2 was satisfactory comparatively for the classification of nutrition and obesity and Chest/Height for classification of physical build in the age group 5 to 9 years and 5 to 15 years respectively.

Factors predicting the non-utilisation of immunisation services using logistic regression technique

A cross sectional study was conducted to determine the variables which have an individual predictive power on nonutilisation of immunisation services using logistic regression model. Children between 12 and 23 months of age were assessed and enroled using a pretested interview schedule. Statistical analysis was done using descriptive statistics, univariate analysis using Chi Square tests and multivariate logistic regression analysis. Of the 200 children studied 56% were fully immunised. Only illiterate mothers (p < 0.05) and poor access (>3 km) to health facility (p < 0.001) were found to have an independent predictive power on the nonutilisation of immunisation services. Sex of the child, parity levels, socioeconomic status did not independently influence the utilisation puriem. It is possible to identify these still existing small pockets of nonusers of immunisation services through the predictive variables and target them through special efforts.

National family health survey and children

This article aims to describe the National Family Health Survey (NFHS) being carried out in India with its first round during 1992–93 (NFHS-I) and second round during 1998–99 (NFHS-II), with special reference to information available in relation to children. The survey was on lines of the existing systems of Demographic Surveys (DHS) in various developed as well as developing countries. Another important objective of the survey was to provide quality data to the researchers to carry out analytical work on various aspects. Further, the survey has paved the way to carry out comparative studies not only between states in India but also between countries. An attempt has also been made here to present salient features of comparative results under NFHS-I and NFHS-II.

Age at which chest circumference overtakes head circumference in children

Maximum likelihood method with probit transformation was applied to estimate median age at which chest circumference (CC) overtook head circumference (HC) in 1206 children from rural areas of Ballabhgarh in Haryana and in 1505 children from a slum population in Delhi. The results showed that, in case of rural area, this phenomenon occurred at an average age of 31.36 months and in children from urban slums, at an average age of 28 months. In both the areas, this phenomenon occurred at an average age of 20 to 21 months in normally nourished children. In children with grade I malnutrition, this was delayed by about 10 months as compared to those with normal nutrition and in children with grade II or worse malnutrition, this was further delayed by another 9 to 13 months on an average as compared to those with grade I malnutrition. These differences were found to be statistically significant (p<0.001). These results indicate that the longer the delay in CC overtaking HC, the chance is higher for the children to be severely malnourished. Considering the relative ease of measuring head and chest circumferences, this parameter (age of CC crossing HC) could be useful in assessing the long term trend in the improvement of childhood nutrition in developing countries.

Skin test and RAST in children allergic to common allergens

Ninety children with bronchial asthma were evaluated for the presence of house dust, house dust mite. Aspergillus fumigatus and milk allergy in vivo by prick test (skin test) and in vitro by RAST. Of the 20 children tested for house dust allergy 12 were positive by skin test and six by RAST. Only six were positive by both methods. Of 25 children tested for house dust mite, 16 were positive by skin test, 13 by RAST and 11 by both methods. Of 35 children tested for aspergillus fumigatus, 25 were positive by skin test, 19 by RAST and 11 were positive by both methods. In the case of 10 children under three years of age with known hypersensitivity to milk, all were negative by prick test and three were moderately positive by RAST method. The correlation of skin test with RAST was 65% for house dust, 72% for house dust mite, 37% for aspergillus fumigatus and 70% for milk. Overall correlation of skin test with RAST was 56·7%.

Law-like relationship between height and weight of school children.

AbstractEhrenberg’s Law-like relationship between height and weight [log

Epidemiological models and related simulation results for understanding of contraceptive adoption in India

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