William E Miall

A longitudinal study of child growth in a rural community in Jamaica.

A longitudinal study of the growth of a cohort of 229 infants born in a rural area in Jamaica and followed to their 4th birthdays is described, and this paper reports analyses of the anthropometric measurements. Moderate impairment of growth affected the majority of children and was most marked between the ages of 3 and 15 months. Severe impairment occurred in boys more often than girls and in this comm unity was rarely attributable to disease. The concept of weight faltering has been investigated in some detail; failure to gain weight for a period of 6 months occurred in almost half the children but was not, by itself, a useful prognostic index of malnutrition; it occurred commonly in children of above average weight whose subsequent growth was normal. The provision of intensive care at specially appointed child welfare clinics did not completely prevent the development of serious malnutrition.

Socio-economic and cultural influences on child growth in rural Jamaica

A semi-longitudinal study of growth in children up to 5 years of age in a rural Jamaican community is described. One of its aims was to investigate the relationship between growth and factors in the social environment such as family structure, parental characteristics, housing and income. A strong relationship between growth and socio-economic variables was found. This apparently masked whatever effects the quality of care or separation from parents may have had upon child growth.

Heights and weights of adults in rural and urban areas of Jamaica.

Two populations, one rural and one urban, were denned geographically and numerically by a private census. The rural population lived about 16 miles north west of the capital city, Kingston, in an area sur rounding the village of Lawrence Tavern. The terrain is a complex of steep hills intersected by valleys lying between 750 and 2,000 ft above sea level. Agriculture is the main occupation and most of the land is under cultivation, a variety of fruits and vegetables being grown for home consumption or for sale in local markets. The houses are scattered, some of them being situated several miles from the nearest road. The people must in general lead energetic lives, not only when they are working but when they move about the hilly countryside. The diet is low in calories, proteins, and fats compared with that in North America or Britain (Cruickshank and Fox, 1961). The urban population lived in Greenwich Town, a section of Kingston, which is on level ground near the sea. Kingston is the only city of any size, the population of the metropolitan area being 380,000 out of a total Jamaican population of 1,610,000 according to the 1960 census. Employment was varied as is usual in a city. The diet was not investi gated. Almost all inhabitants of both areas were of predominantly African origin with a small varying mixture of European stock; most of their ancestors had come from the western coast of Africa in the 17th and 18th centuries. The populations in both areas were mostly poor. The sur eys were carried out by two of us (WEM and JL) from March to July, 1959, in Lawrence Tavern and from August to December, 1959, in Kingston. A portable bathroom scale was used for weighing. Heights were measured by a horizontal bar sliding on a vertical rod which was fixed to a small wooden platform on which the subject stood upright. Shoes were removed but other clothes were worn.

Serum lipids and their relation to blood glucose and cardiovascular measurements in a rural population of Jamaican adults

Abstract Total cholesterol and triglycerides were determined in fasting serum for a population sample of rural Jamaican adults aged 25–64 yr. Cholesterol values were generally lower than in populations in developed countries while triglyceride values were similar to those found in some studies in developed countries and much lower than those in other studies in the same countries. Correlation and covariance analysis showed that persons with above average lipids were heavier for their height, had larger infrascapular skinfold thickness and had higher levels of insulin in serum taken after a fast and 1 hr after an oral challenge of 100 g glucose. Evidence is given that persons responding positively to a standard effort pain questionnaire or having certain ECG changes suggestive of ischaemia cannot be discriminated from persons without these findings by cholesterol or triglycerides. This result is discussed in the light of findings in a longitudinal study of a sample of persons drawn from the same rural area and it is suggested that some of the changes indicative of cardiac ischaemia may have arisen from disease of vessels other than the major extramural arteries.

Haematological investigations of population samples in Jamaica

No large-scale studies of the prevalence of anaemia in the general populations of any of the West Indian territories have been reported previously. Interest in the medical characteristics of West Indian populations is increasing, both within the Caribbean area and in those countries where West Indian immigrants form an important section of the community, and in this paper we report the results of haematological investigations carried out as part of a series of surveys of cardiovascular disease in the adult population of Jamaica.

Heights and Weights of Adults in Rural and Industrial Areas of South Wales

Although surveys of stature, especially of weight, provide useful information on the general health of a population, there is a lack of recent anthropometric publications from Britain. The results of the national survey taken in 1943 (Kemsley, 1950) are unlikely to reflect present conditions. Here recorded are the results of surveys of heights and weights of Welsh adults living in the Vale of Glamorgan, a rural area, in 1956, and in the Rhondda Fach, a coal-mining district, in 1958.

Serum insulin and blood sugar levels in a rural population of Jamaican adults

Abstract Serum insulin and blood sugar concentrations were measured in 538 rural Jamaican adults aged 25–64 yr living in a defined area (77.3% response). The measurements were made in blood samples taken from the respondents in the fasting state and 1 hr after a drink equivalent to 100 g of glucose (Glucola). Insulin values measured in fasting and one hour post challenge sera are given by age and sex. The one hour insulin values were much higher in women than men. This difference was not completely explained by the effects of age, obesity, blood sugar or smoking habit, and it is suggested that the higher levels in women may be related in part to their higher levels of oestrogens and growth hormone. This finding has implications for the selection of control groups of normal people for use in comparative studies.

Serological tests for treponemal disease in adults in two Jamaican communities.

Serological tests for treponemal disease are positive in many Jamaicans. Grant (1956) reported that from 1952 to 1954 of 12,820 men applying for farm employment in the United States, 2,869 (22 per cent.) were reactive in either the Venereal Disease Research Laboratory (VDRL) or the Kolmer-Wassermann tests; the ages were not stated but were probably mostly between 20 and 40 years. This reactivity is mainly caused either by syphilis or by yaws, the latter being a disease which used to be widespread in many rural areas but was not transmitted in Kingston, the capital city. The importance of yaws rather than syphilis as a cause of positive serological tests is suggested by the prevalence in different parishes. For example, 39 per cent. of applicants from the rural parish of St. Thomas, where yaws was once common, were positive, but only 15 per cent. of applicants from Kingston. As, however, considerable migration had taken place into the city, it is not certain how many of those from Kingston had lived in rural areas as children, at the age when they were most likely to be infected with yaws. Chambers (1938) in Jamaica found that the incidence of primary yaws lesions reached its peak between the ages of 5 and 9 years, with the next most frequent incidence between the ages of 6 months and 4 years. Tumer and Saunders (1935) reported that 90 per cent. of Jamaican patients with yaws gave a history of infection before the age of 15 years. This paper records the prevalence of serological reactivity to VDRL and Reiter protein complement-fixation (RPCF) tests in surveys of representative groups of adults aged 35-64 years living in a rural area, Lawrence Tavern, where yaws had once been prevalent and also in a population in August Town in the suburbs of Kingston, where a