Impact of mid day meal program on educational and nutritional status of school children in Karnataka

OBJECTIVE

To assess the effect of the Mid Day Meal (MDM) Program on enrollment, attendance, dropout rate and retention rate in the schools and its impact on nutritional status as well as on school performance.

DESIGN

Comparison by multistage random sampling.

SUBJECTS

Primary school children, who are attending the school in the MDM and non-MDM areas.

RESULTS

A total of 2,694 children (MDM: 1361; Non-MDM : 1333) from 60 schools were covered in the study. Results of the study indicated better enrollment (p<0.05) and attendance (p<0.001), higher retention rate with reduced dropout rate (p<0.001) a marginally higher scholastic performance and marginally higher growth performance of MDM children.

CONCLUSION

MDM program is associated with a better educational and nutritional status of school children in Karnataka.

Prediction of birth weights from body weights of newborns

OBJECTIVE

To evaluate the accuracy of prediction of birth weights from body weights of newborns till six days after birth.

DESIGN

Prospective follow-up.

SETTING

Four villages near Hyderabad.

METHODS

Weights of 47 newborns were recorded daily from the day of birth for seven days. The birth weights were regressed on the weights of the babies taken on the 2nd day to the 7th day. Specificity and sensitivity of the predicted birth weights to arrive at the prevalence of low birth weight (LBW) were computed.

RESULTS

The co-efficient of determination (R-square) for between the days measurements decreased from 95% on the second day to 86% on seventh day with an increase in the standard error of the estimate from 84 g to 154 g. Based on the "predicted birth weights", the prevalence of LBW in the community was arrived at and compared with the actual observation. The sensitivity and specificity of these regression equations was high and ranged from 0.95 to 0.85 and 0.96 to 0.93, respectively.

CONCLUSIONS

In situations where the birth weight cannot be recorded, weight of the baby taken within the first week after birth may be reliably utilized to assess the "birth weight", particularly in relation to categorization as LBW. This methodology can serve as a tool to monitor various developmental programs aimed at improving birth weights.

Acceptability trials with ready to eat foods in a rural area

Acceptability trials with three types of recipes was carried out on 184 young preschoolers (6 months to 35 months) residing in four nearby villages around Hyderabad. Results of this study indicated that among the 3 types of supplementary foods (Sweet Ready Mix, Sweet Ready Mix with Amylase and Therapeutic food tested here, the Therapeutic food was more acceptable (taste, smell and bulk) to the children. The criteria for acceptability of the food was defined as the ability of 75% of the children to consume 75% or more of the food supplement at one sitting for 70% of the days of the trial. The Therapeutic food, a calorie dense supplement, met the above criteria. The acceptability was poor for the Sweet Ready Mix and Sweet Ready Mix with Amylase (< 4%) mainly due to quantity rather than taste and smell as revealed by the mothers. The mothers of the children also liked the taste and smell of the therapeutic food better. Consumption of the therapeutic food caused minimal side effects like diarrhea and vomiting when compared to side effects after eating Sweet Ready Mix and Sweet Ready Mix with Amylase in children.

Nutrition, health and psychosocial profile of institutionalized children

A study was undertaken to assess the health, nutrition and psychosocial profile of Institutionalized children in four States--Uttar Pradesh, Andhra Pradesh, Karnataka and West Bengal. A sample of 3,822 children from 70 institutions in 6-18 years age group formed the subjects of the study. It was observed that the destitute children were mainly taken care of in three types of institutions, viz, Voluntary, Government Aided and Government run institutions. Calorie deficiency and deficiency of Vitamins and minerals characterized the diets of these children. In general, there was no deficit of protein in their diets. Growth wise, these children were retarded both in height and weight compared to standards. However, they fared better in comparison to their age and sex counterparts in the rural and urban poor. Psychosocial profile of these children indicated that the prevailing environment in the institutions is less conducive for intellectual stimulation but not so for the development of skills of self-help, locomotion, socialization and imagery.

Effect of massive dose vitamin A on morbidity and mortality in Indian children

The effect of vitamin A supplementation on preschool child morbidity and mortality was assessed in a prospective double-blind placebo-controlled study around Hyderabad, India. Every six months 200,000 IU vitamin A was given to 7691 children (treatment group) whereas 8084 children received a placebo (control group). Morbidity and mortality data were collected every three months. Risk of respiratory infection was higher in children with mild xerophthalmia than in children with normal eyes. Vitamin A supplementation had no effect on morbidity status. Mortality rates were similar in the two groups; it was highest in children who did not receive either vitamin A or placebo. The findings suggest that vitamin A supplementation alone may not reduce child mortality.

Impact of massive doses of vitamin A on incidence of nutritional blindness

In a longitudinal study designed to assess the impact of a massive-dose vitamin A programme on the incidence of keratomalacia, 50 000 preschool children in 450 slum areas in Hyderabad city (India) were given 200 000 IU of vitamin A once every 6 months. During the study period, the incidence of keratomalacia in areas covered by the programme decreased by about 80%, while in control areas the reduction was of the order of 20%. To test whether large doses of vitamin A supplements prevented keratomalacia, a case-control analysis was done, with patients with severe protein-energy malnutrition being used as controls. The high odds ratio clearly indicated that keratomalacia was more likely to occur in children not receiving supplements.

Relationship between biochemical and clinical indices of B-vitamin deficiency. A study in rural school boys

1. A study amongst schoolboys in villages around Hyderabad, India, showed that almost all the boys had riboflavin deficiency, 61% had pyridoxine deficiency, and 9.4% had thiamin deficiency as judged by enzymic tests. 2. The prevalence of angular stomatitis was 41.3% and that of glossitis was 18.2%. Biochemical deficiency of riboflavin and pyridoxine was marginally higher in children with angular stomatitis with or without associated glossitis, than in children without oral lesions. 3. Treatment with B-complex vitamins (containing 4 mg riboflavin and 10 mg pyridoxine) daily for 1 month produced significant reduction in the prevalence of glossitis but had no effect on angular stomatitis. The latter responded to topical application of gentian violet. 4. Small but significant changes in erythrocyte enzymes occurred over the period of 1 month even without vitamin supplements. 5. Results suggest that while glossitis is a relatively early manifestation of riboflavin or pyridoxine deficiency or both, angular stomatitis has a more complex aetiology perphaps associated with infection.

Rose Bengal staining for detection of conjunctival xerosis in nutrition surveys

A hospital cum community based study indicated that rose Bengal staining of the eye could not only confirm clinically diagnosed cases of conjunctival xerosis but also detect those missed by clinical examination. However, some cases thus detected did not respond to a massive oral dose of vitamin A.