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Wei Sheng Yan Jiu. 2007 Mar; 36(2):203-6.OBJECTIVE: To compare children's growth patterns and estimates of malnutrition using the WHO standards versus the NCHS reference in China. METHODS: Data originated from China children nutrition surveillance in 2005, Z-scores and prevalence of malnutrition were compared between standards. RESULTS: There was substantial difference in Z-scores between standards in rural (P < 0.0001). According to the WHO standards, prevalence of underweight in rural was lower than that of underweight based on the NCHS reference (6.1% . vs. 8.6%, P < 0.0001). Except for children under 6 months, all age groups underweight rates were lower according to the WHO standards. Prevalence of stunting in rural was higher based on the WHO standards (16.3% . vs. 13.0%, P < 0.0001), prevalences of stunting under 6 months were 2.1 times of that based on NCHS reference. As for wasting, there were no differences between standards, but wasting was substantially higher during the first half of infancy. Overweight rates based on the WHO standards were higher than those based on NCHS reference in urban (6.7% . vs. 5.4%, P < 0.0001). CONCLUSION: In comparison with NCHS reference, population estimates of malnutrition would vary by age, growth indicator based on WHO standards. The WHO standards could provide a better tool to monitor the rapid and changing rate of growth in early infancy, further analysis on existing data was needed.
Epidemiology and clinical features of pneumonia according to radiographic findings in Gambian children.
Tropical Medicine and International Health. 2007 Nov; 12(11):1377-1385.The objective was to assess the effect of vaccines against pneumonia in Gambian children. Data from a randomized, controlled trial of a 9-valent pneumococcal conjugate vaccine (PCV) were used. Radiographic findings, interpreted using WHO definitions, were classified as primary end point pneumonia, 'other infiltrates / abnormalities' pneumonia and pneumonia with no abnormality. We calculated the incidence of the different types of radiological pneumonia, and compared clinical and laboratory features between these groups. Among children who did not receive PCV, the incidence of pneumonia with no radiographic abnormality was about twice that of 'other infiltrates' pneumonia and three times that of primary endpoint pneumonia. Most respiratory symptoms, reduced feeding and vomiting occurred most frequently in children with primary endpoint pneumonia. These children were more likely to be malnourished, to have bronchial breath sounds or invasive bacterial diseases, and to die within 28 days of consultation than children in the other groups. Conversely, a history of convulsion, diarrhoea or fast breathing, malaria parasitaemia and isolation of salmonellae were commoner in children with pneumonia with no radiographic abnormality. Lower chest wall indrawing and rhonchi on auscultation were seen most frequently in children with 'other infiltrates / abnormalities' pneumonia. Primary endpoint pneumonia is strongly associated with bacterial aetiology and severe pneumonia. Since this category of pneumonia is significantly reduced after vaccination with Hib and pneumococcal vaccines, the risk-benefit of antimicrobial prescription for clinical pneumonia for children with increased respiratory rate may warrant re-examination once these vaccines are in widespread use. (author's)