Tomiko Hokama

Iron status of newborns born to iron deficient anaemic mothers.

Haemoglobin, serum iron, total iron binding capacity, and serum ferritin were determined in newborns of 16 mothers with iron deficiency anaemia, 28 mothers with non-anaemic iron deficiency, and nine mothers with normal haemoglobin and serum ferritin levels. The results showed that there were no significant differences in the mean values of haemoglobin, serum iron, and total iron binding capacity among the newborns in the three groups. However, the mean value of serum ferritin differed significantly among the three groups, with the lowest values found in newborns of mothers with iron deficiency anaemia.

Intimate Partner Violence Among General and Urban Poor Populations in Kathmandu, Nepal:

Comparative studies are lacking on intimate partner violence (IPV) between urban poor and general populations. The objective of this study is to identify the prevalence and risk factors of physical IPV among the general and poor populations in urban Nepal. A cross-sectional study was conducted by structured questionnaire interview. Participants included 905 ever-married women in Kathmandu aged 15 to 49 years. Of the 905 participants, 680 were randomly selected from general population and 225 were recruited from urban poor population, who lived in purposively selected two communities. The prevalence and association between ever experiencing physical IPV and sociodemographic variables were examined. Results showed that the prevalence of physical IPV was 33.8% among the urban poor population (n = 225) and 19.9% among the general population (n = 680; p < .01). Several factors were significantly associated with physical IPV in both populations: the frequency of the husband’s drinking, polygyny, and lower household economic status. However, two factors were associated with physical IPV only among the general population: the husband’s lower educational level and early marriage. The conclusions of this study are that compared to the general population, the urban poor population showed a significantly higher prevalence of physical IPV and differences in the associated risk factors. The urban poor population requires focused data collection as well as tailored interventions to reduce IPV.

Iron Deficiency Anaemia and Child Development

A developmental test was carried out to evaluate the effect of iron deficiency anaemia on child development by using Bailey Scale of Infant Development (BSID) and Enjoji Scale of Infant Analytical development (ESID). The subjects were 54 children, divided into three groups. Group 1 consisted of 15 infants with anaemia; Group 2: 10 infants with a past history of anaemia and Group 3: 29 healthy normal infants without anaemia formed the control group. The characteristics of infants and their family background were not different among the three groups except for the male/female ratio. The mean mental developmental index (MDI) and psychomotor developmental index (PDI) of Group 1 and Group 2 were lower than that of control group using the BSID test. The mean speech development quotients of Group 1 and Group 2 were lower than that of control group in ESID. These tendencies were observed after subjects were stratified by sex. Therefore, the results of the study suggests that iron deficiency anaemia may affect child development especially speech development. Asia Pac J Public Health 2005: 17(1): 19-21.

Ethical Issues in Infant Feeding After Disasters

In the aftermath of many disasters the silence is punctuated by the crying of infants, hungry infants. The aim of this paper is to discuss ethical issues in feeding infants after disasters. The Asia Pacific region generates 25% of the world’s GDP, but experiences 45% of natural disasters and 42% of the economic losses due to disasters. The region has 61% of the world’s population, but 86% of the population affected by disasters. Breastfeeding, exclusive to six months and continuing thereafter, is important for growth and the health of the infant in the short term and later in life. In most natural disasters, mothers and infants will both suffer, but in some disasters, such as earthquakes and building collapses, infants can survive in small spaces. Infants separated from mothers require a wet nurse (rarely available) or feeding with infant formula and sterile water. Formula companies often donate supplies of infant formula but distribution should follow ethical principles. Mothers who are injured or short of food can still continue breastfeeding and don’t need formula. Where formula must be used, health workers need to follow the highest ethical standards to avoid promoting infant formula to vulnerable communities in the post recovery phase.

Incidence of Haemophilus influenzae in the throats of healthy infants with different feeding methods

Abstract Background: Haemophilus influenzae is the major cause of otitis media and lower respiratory tract infection in childhood. In the presence of human milk, which contains numerous host defense factors, Haemophilus influenzae may be inhibited in attaching to and colonizing pharyngeal cells. We investigated the incidence of H. influenzae in the throats of 162 healthy infants with different feeding methods: 70 breast‐fed, 49 mixed‐fed and 43 formula‐fed infants.

Brief report. Isolation of respiratory bacterial pathogens from the throats of healthy infants fed by different methods

Most bacterial infections are caused by organisms that have already colonized the host. Bacterial attachment to pharyngeal cells and proliferation may be necessary to infect the lower respiratory tract or middle ear. We investigated the incidence of pathogenic bacteria isolated from the throat of healthy infants with different feeding methods. The protecting role of breastmilk is also discussed. The incidence of respiratory bacterial pathogens isolated from the oropharynx of 113 normal infants with different feeding methods was investigated. Group A beta haemolytic Streptococcus, Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis were selected as respiratory bacterial pathogens. No respiratory bacterial pathogens were detected in breastfed and mixed-fed infants. Haemophilus influenzae and Moraxella catarrhalis were isolated from the oropharynx of formula-fed infants. The incidence of respiratory bacterial pathogens did differ among infants with different feeding methods. These results suggest that breastmilk may inhibit the colonization by respiratory bacterial pathogens of the throat of infants, by enhancing mucosal immunity against respiratory tract infection.

Dietary Guidelines for the Asia Pacific Region

Nutrition is a major determinant of health throughout all stages of life and together with smoking is the most important risk factor for morbidity and mortality in the Asia Pacific Region. The workshop participants examined Dietary Guidelines and Food Guides that are in use in our region, together with additional materials from the World Health Organization, UNICEF and the World Cancer Research Foundation. The resulting set of guidelines is meant as a reminder of the main issues to be covered in a general public health education program. It may also be of value in reminding public health practitioners, educators, administrators, and policy makers of current nutrition issues. It may additionally be useful as a checklist of the issues to be considered in public health programs and regulations. The main areas of nutrition that are included in the Guidelines are eating a variety of foods, including vegetables, fruits, whole grain cereals, and nuts. Choose fish, poultry, and meats grown in a sustainable way. Appropriate growth, including avoiding obesity, and physical activity are important. Breastfeeding is the basis of infant nutrition and nutrition of mothers is an important public health measure. Negative factors in the Asian diet include salt, refined sugar, alcohol and fats. The APACPH Dietary Guidelines will need to be kept under review and modified to meet regional differences in food supply. The Guidelines will be useful as a checklist of the issues to be considered in public health programs, addressing both acute and chronic diseases.

Island Health: Hope and Challenges for Public Health

The Asia-Pacific region is a region of small islands, perhaps 100 000 of them. The health, communication, and development problems of islands present difficult challenges for the delivery of health care. The discussions at the Okinawa Symposium centred on how health can be provided to all in the region, not only those in metropolitan areas, but also the poor in rural areas and those on living on far-flung island archipelagos. It is important to apply principles of “public health” and “primary health care” so that all island residents may have a reasonable expectation of health care. Schools of public health have a special responsibility to educate those who are responsible for the delivery and management of health care in these remote locations. The development of telehealth systems will be important to support health workers in remote locations and to deliver continuing education programs.

Levels of serum ferritin and total body iron among infants with different feeding regimens

The levels of serum ferritin and total body iron of healthy infants were analyzed to evaluate iron status among infants with different feeding regimens. The results showed that the levels of serum ferritin and total body iron were lower in breast‐fed infants than in partially breast‐fed or formula‐fed infants at late infancy and 18 months of age.

A study of the hemoglobin levels in breast-fed infants in one village of Okinawa prefecture

We investigated the prevalence of anemia and the hemoglobin levels in breast‐fed infants. Three hundred and fifty‐six healthy children with different feeding methods were studied longitudinally. The results showed that the prevalence of anemia was higher and the hemoglobin levels were lower in breast‐fed infants compared with those in partially breast‐fed or formula‐fed infants at late infancy.