Table Of ContentCHILD HEALTH IN THE TROPICS
Sixth Nutricia - Cow & Gate Symposium
CHILD HEALTH
IN THE TROPICS
Leuven, 18-21 October 1983
EDITORS:
R.E. EECKELS, O. RANSOME-KUTI, C.C. KROONENBERG
'iB
1985 MARTIN US NIJHOFF PUBLISHERS ......
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
BOSTON / DORDRECHT / LANCASTER
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Library of Congress Cataloging in Publication Data
Nutricia-Cow & Gate Symposium (6th: 1983 : Louvain,
Belgium)
Child health in the tropics.
Includes index.
1. Child health services--Tropics--Congresses.
2. Children--Tropics--Nutrition--Congresses. 3. Diarrhea
in children--Tropics--Congresses. 4. Infants (Newborn)-
Tropics--Congresses. I. Eeckels, R. E. II. Ransome
Kuti, O. III. Kroonenberg, C. C. IV. Title. [DNLM:
1. Child Nutrition--congresses. 2. Diarrhea--congresses.
3. Perinatology--congresses. 4. Primary Health Care-
congresses. 5. Tropical Medicine--congresses.
W3 NU777 6th 1983c I WC 680 N976 1983cl
RJ103.T76N88 1983 362.1'9892'00913 85-8895
ISBN-13: 978-94-010-8719-3 e-ISBN-13: 978-94-009-5012-2
DOl: 10.1007/978-94-009-5012-2
Copyright
© 1985 by Martinus Nijhoff Publishers, Dordrecht.
Softcover reprint of the hardcover 1s t edition 1985
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishers,
Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht,
The Netherlands.
Preface
It is almost twenty years ago since under Nutricia's auspices the first Nutricia
Symposium took place. Professor Jonxis was mainly responsible for the organiza
tion of the earlier symposia, whilst Professor Visser organized the fifth Nutricia
Symposium in 1978.
This book is the commitment to paper of the lectures given during the sixth
Nutricia/Cow & Gate Symposium held in Louvain in 1983. Both Professor
Eeckels and Professor Ransome-Kuti succeeded in collecting a panel of experts
on 'Child Health in the Tropics'.
We hope, in fact we are sure, that you will consider the contents of this book a
daily stimulation in your medical profession.
October 1984
Contents
Preface......................................................... V
List of authors .................................................. XI
List of participants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. XIV
SESSION I
FEEDING, FEEDING PRACTICES AND GROWTH
Chairman: Chap-Yung Yeung
A. Omololu, The practice of breastfeeding . . . . . . . . . . . . . . . . . . . . . . . . . . 3
M.G.M. Rowland, S.G.l. Goh, S. Tullock, D.T. Dunn and R.l. Hayes,
Growth and weaning in urban Gambian infants. . . . . . . . . . . . . . . . . . . . 9
W. Klaver, Some considerations on the formulation of weaning mixes. . 19
R.G. Hendrickse, The influence of mycotoxins on child health in the
tropics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
V.S. Tanphaichitr, C. Tuchinda, V. Suvatte and S. Tuchinda, Bodily
growth in thalassemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
L. Sinisterra, Ecological evaluation of human development: the case of the
child in the tropics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
SESSION II
DIARRHOEAL DISEASES
Chairman: o. Ransome-Kuti
A.M. Molla, S.A. Sarker, A. Molla, M. Kathoon, W.B. Greenough III,
Rice based oral rehydration therapy in acute diarrhoea: a superior
therapy and a medium for calorie supplementation . . . . . . . . . . . . . . . . . 65
Chap-Yung Yeung, Acute infantile gastroenteritis in Hong Kong. . . . . . . 71
T.K. Okeahialam, Diarrhoeal diseases in children and oral rehydration in
VIII
Nigeria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
S.R. Khan, Diarrhoeal diseases in Pakistani children. . . . . . . . . . . . . . . . . 89
Suharyono, Diarrhoeal diseases and mortality in infants and children . . . 99
J.M. Feris and H.R. Mendoza, Acute diarrhea in the Dominican Republic 107
A. MolIa, A.M. Molla and M. Khatun, Effect of nutritional status of
children on intake and absorption of nutrients . . . . . . . . . . . . . . . . . . . . . 113
SESSION III
NUTRITION
Chairman: J.H.P. Jonxis
Y.N. Mathur and D.H. Rao, Methods for evaluating nutrition and health
status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
D. Morley, Assessing nutrition at village level . . . . . . . . . . . . . . . . . . . . . . . 133
R. Sakr, S. Samuel, D. Fieita, A. Abdelwahab, A study of some aspects of
marginal malnutrition amongst Egyptian infants and young children . . 141
V. Tanphaichitr, Epidemiology and clinical assessment of vitamin deficien-
cies in Thai children. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 157
D. Brasseur, Ph. Goyens and H.L. Vis, Some aspects of protein-energy
malnutrition in the highlands of Central Africa. . . . . . . . . . . . . . . . . . . . . 167
J .M. Bengoa, Perspectives on world malnutrition. . . . . . . . . . . . . . . . . . . . 179
SESSION IV
THE NEWBORN INFANT
Chairman: O.P. Ghai
N. Tafari, Sources of excess low birth weight in developing countries. . . 201
E.R. Boersma, Th.M. Hoorntje, N.H. Hutter, P.J. Offringa, J.P.H.
Jonxis and R.A. Soer, Some aspects of perinatal growth: can perinatal
health be measured in kilograms? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
S.A. Olowe, Maturity of the Nigerian newborn infant. . . . . . . . . . . . . . . . 223
S.R. Daga and A.S. Daga, Neonatal intensive care in the developing
countries: conservative or agressive approach. . . . . . . . . . . . . . . . . . . . . . 233
A. Alisjahbana and A. Usman, Determinants of fetal growth and early
postnatal growth in a rural area of Indonesia ., .... '. . . . . . . . . . . . . . . . 247
S. Martodipuro, The pregnancy monitoring chart: an approach to reduce
the prevalence of low birth weight by village cadres ................ 261
J .A. Kusin and S. Kardjati, The mother-infant dyad in Madura, Indonesia:
nutrhional aspects ............................................. 269
Chap-Yung Yeung, Erythrocyte glucose-6-phosphate dehydrogenase
(G6PD) deficiency and neonatal hyperbilirubinaemia . . . . . . . . . . . . . . . 281
IX
SESSION V
TRAINING AND TEACHING - PRIMARY HEALTH CARE SYSTEMS
Chairman: R.G. Hendrickse
J.P. Stanfield, Training of overseas paediatricians in the U.K.: relevance to
primary child health care ....................................... 289
A. Pradilla, Nutrition in primary health care: functional analysis. . . . . . . 295
z. Isani, Primary health care in the hospital. . . . . . . . . . . . . . . . . . . . . . . . . 303
A. Bamisaiye, Utilisation of child health services in developing countries 309
R.E. Brown, What has medicine in the Western World learned from work
in developing countries? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
P.G. Janssens, Summing up and conclusions. . . . . .. . . . . . . .. .. . . . . . . .. 333
Index of subjects .......... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 339
List of authors
A. Alisjahbana, Department of Child Health, Medical School, University Padjadjaran,
Bandung, Indonesia
Co-author: A. Usman
A. Bamisaiye, Institute of Child Health and Primary Care, College of Medicine, Univer
sity of Lagos, P.M.B. 1001, Surulere, Lagos, Nigeria
J.M. Bengoa, Vittoria, Spain
E.R. Boersma, St. Elisabeth Hospital, Willemstad, Cura<;ao, Netherlands Antilles
Co-authors: Th.M. Hoorntje, N.H. Hutter, PJ. Offringa, J.H.P. Jonxis, R.A. Soer
D. Brasseur, Department of Pediatrics, Free University of Brussels, Belgium
Co-authors: Ph. Goyens, H.L. Vis
R.E. Brown, St. Joseph's Hospital and Medical Centre, Department of Community
Medicine, 703 Main Street, Paterson, New Jersey 07503, U.S.A.
S.R. Daga, Institute of Child Health and Department of Preventive & Social Medicine,
Grant Medical College & J.J. Hospital, Bombay, 400008 India
Co-author: A.S. Daga
J.M. Feris, Children's Hospital 'Dr. Robert Reid Cabral', Santo Domingo, Dominican
Republic
Co-author: R. Mendoza
R.G. Hendrickse, Department of Tropical Pediatrics, School of Tropical Medicine,
Pembroke Place, Liverpool L3 5QA, U.K.
Z. Isani, National Institute of Child Health, Jinnah Postgraduate Medical Centre,
Karachi, Pakistan
P.G. Janssens, Former Director, Institute of Tropical Medicine, Nationale Straat 155,
2000 Antwerp, Belgium
S.R. Khan, King Edward Medical College, Lahore, Pakistan
W. Klaver, International Course in Food Science and Nutrition, Lawickse Allee 11, 6701
AN Wageningen, The Netherlands
J.A. Kusin, Royal Tropical Institute, Amsterdam, The Netherlands
Co-author: S. Kardjati
S. Martodipuro, Research and Development Center for Health Service, Ministry of
Health, 17 Indrapura Surabaya, Indonesia
Y.N. Mathur, National Institute of Nutrition, Indian Council of Medical Research,
Hyderabad-500 007, India
Co-author: D.H. Rao
A. Molla, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box
128, Dhaka-2, Bangladesh
XII
Co-authors: A.M. MoIla, M. Khatun
A.M. MoIla, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO
Box 128, Dhaka-2 Bangladesh
Co-authors: S.A. Sarker, A. MoIla, M. Khatoon, W.B. Greenough III
D. Morley, Institute of Child Health, University of London, Tropical Child Health Unit,
30 Guildford Street, London WC1N 1EH, U.K.
T.e. Okeahialam, Department of Pediatrics, University of Nigeria Teaching Hospital,
P.M.B. 1129, Enugu, Nigeria
S.A. Olowe, Department of Pediatrics, CoIlege of Medicine, University of Lagos, P.M.B.
12003, Lagos, Nigeria
A. Omololu, University of Ibadan, Department of Human Nutrition, Ibadan, Nigeria
A. Pradilla, World Health Organisation, 1211 Geneva 27, Switzerland
M.G.M. Rowland, Medical Research Council Laboratories, P.O. Box 273, Bangui,
Gambia
Co-authors: S.G.J. Goh, S. TuIloch, D.T. Dunn, R.1. Hayes
R. Sakr, Pediatric Department and the Biochemistry Department, Cairo University, al
Falaki Square, Bab El Louk, Cairo, Egypt
Co-authors: D. Fleita, S. Samuel, A. Abdelwahab
L. Sinisterra, Human Ecology Research Foundation, Apartado Aereo 7308, Cali, Colom
bia
J.P. Stanfield, University of Newcastle upon Tyne, Department of Child Health, Newcas
tle upon Tyne NE14LP, U.K.
Suharyono, Department of Child Health, Medical School, University of Indonesia/Dr.
Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
N. Tafari, Department of Pediatrics and Child Health, Perinatal Care Unit, P.O. Box
1768, Addis Ababa, Ethiopia
v. Tanphaichitr, Division of Nutrition and Biochemical Medicine, Department of Medi
cine and Research Centre, Faculty of Medicine, Ramathibodi Hospital and Institute of
Nutrition, Mahidol University, Rama 6 Road, Bangkok 10400, Thailand
V.S. Tanphaichitr, Division of Hematology and Endocrinology, Department of Pedi
atrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700,
Thailand
Co-authors: e. Tuchinda, V. Suvatte, S. Tuchinda
Chap-Yung Yeung, Department of Pediatrics, University of Hong Kong, Queen Mary
Hospital, Hong Kong
List of participants
W.Y. Aalbersberg, Ede, The Netherlands Y.N. Mathur, Hyderabad, India
B.S.F. Adjou-Moumouni, Cotonou, Republic A. Molla, Dhaka, Bangladesh
of Benin A.M. Molla, Dhaka, Bangladesh
A. Alisjahbana, Bandung, Indonesia e. Morley, London, U.K.
A. Bamisaiye, Lagos, Nigeria T.e. Okeahialam, Enugu, Nigeria
E.R. Boersma, Willemstad, Cura~ao, S.A. Olowe. Lagos, Nigeria
Netherlands Antilles A. Omololu, Ibadan, Nigeria
C. Bourgeois, Brussels, Belgium M. Parent, Liege, Belgium
D. Brasseur, Brussels, Belgium A. Pradilla, Geneva, Switzerland
R.E. Brown, Paterson, New Jersey, U.S.A. L.H.J. Ramaekers, Maastricht, The
e.A. Canosa, Valencia, Spain Netherlands
e. Chintu, Lusaka, Zambia O. Ransome-Kuti, Lagos, Nigeria
S.R. Daga. Bombay, India M.G.M. Rowland, Banjul, The Gambia
A.M.F.L.P. da Graca. Maputo, Mozambique R. Sakr, Cairo, Egypt
G.A. de Jonge, Amsterdam, The Netherlands E.D.A.M. Schretlen, Nijmegen, The
R. de Meijer, Leuven, Belgium Netherlands
N.A. de Soto, Santo Domingo, Dominican J. Senecal, Rennes, France
Republic J. Senterre, Liege, Belgium
R. Eeckels. Leuven. Belgium L. Sinisterra, Cali, Colombia
E. Eggermont, Leuven, Belgium J.P. Stanfield, Newcastle upon Tyne, U.K.
H. Ejoh, Onitsha-Anabra State, Nigeria Suharyono, Salemba-Jakarta, Indonesia
J.M. Feris, Santo Domingo, Dominican A.H. Sutanto. Medan, Indonesia
Republic N. Tafari, Addis Ababa, Ethiopia
J. Fernandes, Groningen, The Netherlands V. Tanphaichitr, Bangkok, Thailand
O.P. Ghai. New Delhi, India V.S. Tanphaichitr, Bangkok, Thailand
Ph. Goyens, Brussels, Belgium Tu Giay, Hanoi, Vietnam
R. Gyselings. Mons. Belgium K. Vallante, Leuven, Belgium
K. Haque, Riad. Saudi Arabia J.L. van den Brande, Utrecht. The
R.G. Hendrickse. Liverpool, U.K. Netherlands
R.J.J. Hermus. Zeist, The Netherlands H.H. van Gelderen, Leiden, The Netherlands
Z. Isani, Karachi, Pakistan H. van Loon, Antwerp, Belgium
P.G. Janssens. Antwerp. Belgium V.W.A. Vermeulen, Cura~ao, Netherlands
J.H.P. Jonxis. Groningen, The Netherlands Antilles
S. Kardjati. Amsterdam. The Netherlands H.K.A. Visser, Rotterdam, The Netherlands
H. Khalifa, Casablanca. Maroc J. Vuylsteke, Antwerp, Belgium
S.R. Khan. Lahore. Pakistan H.W.A. Voorhoeve, Rijswijk, The
W. Klaver, Wageningen, The Netherlands Netherlands
J.A. Kusin. Amsterdam, The Netherlands O.e. Ward, Crumlin-Dublin. Eire
A.A.O. Laditan, Ibadan, Nigeria e.A. Winkel, Colombia
B. Madukwe, Lagos. Nigeria J.L. Yntema, Cura~ao. Netherlands Antilles
S. Martodipuro, Surabaya, Indonesia Chap-Yung Yeung, Hong Kong
Participants Nutricia/Cow & Gate
e. Bosmans O.D. Suurenbroek
G. de Graaf J. Wells
e.e. Kroonenberg B. van Woelderen
J. Norton-Booth
