The objective of the present study was to determine the prevalence of intellectual disability (ID) and its associated disabilities in rural South African children aged 2-9 years. It was undertaken in eight villages in the district of Bushbuckridge, Northern Province, South Africa. A two-phase design was utilized. The first phase involved screening children on a house-to-house basis by interviewing mothers or caregivers using an internationally validated questionnaire for detecting childhood disability in developing countries. The second phase consisted of a paediatric/neurodevelopmental assessment of the children who screened positive. A total of 6692 children were screened; 722 (10.8%) had a paediatric evaluation and 238 children were diagnosed with ID, giving a minimum observed prevalence of 35.6 per 1000 children in this population. The prevalence of severe and mild ID was 0.64 per 1000 and 29.1 per 1000 children, respectively. The male:female ratio of children with ID was 3:2. In the affected children, a congenital aetiology for the ID was determined in 49 subjects (20.6%), an acquired aetiology in 15 (6.3%) and the aetiology was undetermined in 174 children (73.1%). Epilepsy (15.5%) and cerebral palsy (8.4%) were the commonest associated disabilities. The present study represents the first data on the prevalence of ID and associated disabilities in rural South African children. The prevalence of ID was comparable with results from a study performed in one other African country (Zambia) as well as those from other developing countries. The data provide an initial factual insight into ID and its associated disabilities for healthcare, social service and educational policy planners. This study provides a basis for the initiation and development of appropriate and integrated services for the best possible care of individuals affected with these disabilities, and for their possible prevention.

Childhood disabilities, including intellectual disabilities (ID), are thought to occur in 5–17% of children in developing countries around the world. In order to identify and describe the childhood disabilities occurring in a rural South African population, as well as the context in which they occur, a study was carried out in the Bushbuckridge district in the poor northeast part of the country. Altogether, 6,692 children were screened in their homes in eight villages using the Ten Questions questionnaire. This questionnaire was used by local‐trained field‐workers in interviews with mothers and other carers, to screen children for five disorders (viz., intellectual, hearing, visual and movement disorders, and epilepsy). Altogether, 722 (10.8% of the total sample) children, who screened positive, were examined at clinics in their villages by a pediatrician for diagnostic, treatment, and referral purposes. In addition, 100 traditional healers in the district were interviewed with a specially designed schedule of questions to assess their attitudes toward disabilities and their management of affected children. The results showed that 291 (4.3%) children had at least one of the five disabilities. ID occurred in 3.6%, epilepsy in 0.7%, visual disorders in 0.5%, movement disorders in 0.5%, and hearing disorders in 0.3%. More boys than girls with hearing disorders were receiving special education. Many of the affected children were not receiving treatment or education, resulting in a reduction in their quality of life. Traditional healers were attempting to treat epilepsy and seldom referred affected children to hospital, although effective treatment was available there. Genetic factors were involved in about half the conditions, but genetic services were negligible. Appropriate health, diagnostic, treatment, educational, and supportive services are required for children with disabilities, and awareness of their needs and the resources to meet them should be increased in this community.

The long-term effects of kwashiorkor on the electroencephalogram were assessed by means of computer analysis techniques. The experimental group, consisting of 30 black children, 6 to 12 years old, hospitalized for the treatment of kwashiorkor during the first 27 months of life, was age-matched with three control groups. These were a group of siblings and of yardmates, neither of whom had been exposed to acute infantile malnutrition, and a very high socioeconomic group of white children. The results revealed significantly less alpha activity and more slow-wave activity in the electroencephalogram of the kwashiokor group than in those of the control groups. These findings confirmed previous results based on visual analysis procedures.

No abstract

No abstract

SUMMARY In a year long prospective study of diarrhoea in children under 2 years of age in Soweto, South Africa, Campylobacter jejuni was isolated in 18 of 60 children under 9 months of age with diarrhoea, compared with 4 of 60 age matched controls. In the older children, 16 of 51 children with diarrhoea and 17 of 51 control children excreted this organism in their faeces. These results indicate a change in susceptibility to C jejuni in children over 9 months of age. Campylobacter enteritis in the young children was usually mild, without macroscopic blood in the faeces, and prolonged excretion of the organism after acute attacks was not infrequent. Breast feeding did not seem to protect against colonisation with Cjejuni.

(1975). Archives of Disease in Childhood, 50, 220. Leucocyte function in children with kwashiorkor. A study of leucocyte response to infection, polymorphonuclear leucocyte chemotaxis and bactericidal activity, and nitroblue tetrazolium (NBT) reduction in children with kwashiorkor was undertaken and compared with a control group. The results show that total leucocyte counts were depressed in children with kwashiorkor, and lymphopenia was not infrequent. NBT reduction was normal. Abnormal polymorphonuclear leucocyte chemotaxis and bactericidal activity, though frequently found in children with kwashiorkor, was shown to be dependent on infection and not on protein depletion per se. Therefore, apart from some impairment of leucocyte mobilization in the presence of infection, the quality of polymorphonuclear function, as determined by the above techniques, appears to be normal in kwashiorkor.

No abstract