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  • Title: Determinants of growth in the first 6 months of life among the urban poor in Sudan.
    Author: Zumrawi FY, Dimond H.
    Journal: J Trop Med Hyg; 1988 Jun; 91(3):139-46. PubMed ID: 3392764.
    Abstract:
    This paper presents part of a longitudinal study carried out in the three towns of Khartoum Province in the period December 1983 to April 1985. It was attempting to determine the duration of satisfactory breast-feeding in healthy breast-fed infants of mothers attending maternal and child health centres in the three towns; Khartoum, Khartoum-North and Omdurman. The main objective of the present paper is to compare samples from the three towns in terms of the factors affecting weight gain. Four hundred and thirty-nine infants were recruited at birth and home visited every 2 weeks. At each visit weight was measured and it was recorded whether any supplements had been given and whether the child had been ill. Length was measured every 4 weeks. There were significant differences between the samples from the three towns in attained weights and weight increments. Weight gains were lowest in the Khartoum North sample in the first 3 months, but from 3 to 6 months were highest, almost equalling the NCHS reference. In the Khartoum and Omdurman samples growth from 0 to 3 months exceeded the reference but from 3 to 6 months was less than the reference. Fifty per cent of infants were supplemented by 13 weeks in the Omdurman sample; the median time of supplementation in the other two samples was 17 weeks. Only in Khartoum did delaying supplementation seem to benefit growth. Infections were most common among the Omdurman sample.(ABSTRACT TRUNCATED AT 250 WORDS) In Khartoum province, the Sudan, health workers visited 439 infants from birth to 1 year to measure growth and assess health. Paradoxically, infants living in Khartoum North gained weight more slowly in the 1st 3 months than the other 2 towns, but thereafter gained the most weight. On the other hand, in the 1st 3 months infants from Khartoum and Omdurman gained more weight than those from Khartoum North, but from 3-6 months their weight gain was significantly lower. Infections occurred most often in infants from Omdurman. Maternal antepartum weight, a measure of nutritional state, was lowest in Omdurman. Parity was highest in Khartoum North. Birth weight was lowest in Omdurman and highest in Khartoum North. The mothers in Khartoum North had the lowest incomes, generally did not have higher education and did not own their homes or did not have a separate kitchen. Adequate ventilation and sewage disposal were worst in Khartoum North, although most of these dwellings were connected to a water supply. The data showed that a variety of environmental and other factors in the Omdurman group produced unfavorable effects on weight gain, even though the mothers were on average less poor and the housing conditions were generally better than the Khartoum North group. Improved growth in Khartoum North may be attributed to the better accessibility of water and the consequential lower incidence of diarrhea. Another possible explanation may be that 2/3 of the mothers in Khartoum North did not work, and therefore had close contact with their babies and more time to care for them. These assumptions do not account for the poor growth during the 1st 3 months, however. A more complex analysis of the data that will indicate the relative importance of different factors and their degree of interaction is needed.
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