A variety of underlying conditions increase the likelihood of children entering the labor force. Nearly half of Nepal’s population between 5 and 14 years of age is economically active, many in conditions classified by the International Labor Organization as ‘the worst forms of child labor’. In order to assess the relationship between portering and well-being outcomes, including diet, nutrition status, injury and social and behavioral risks, a cross-sectional study was conducted among long distance child porters in Eastern Nepal. Porters were consistently less well off than their non-portering peers according to a variety of indicators. Porters were 2.2 (95% CI: 1.4–3.4) times as likely not to have attended school in the past month and frequency of attendance was significantly lower among porters. Porters had worse diets and significantly lower Body mass indexes than controls; prevalence of anemia was 30% and the risk of anemia was 1.9 (95% CI: 1.1–3.1) times greater for porters as compared with controls. Injury rates within the past year were similar between the two groups, with 88% of participants reporting being injured. Prevalence of alcohol use among porters was 38% and porters were 2.9 (95 CI: 1.7–4.9) times more likely to consume alcohol than controls. Risk of sexual assault was 10.1 (95 CI: 2.3–43.9) times greater among porters as compared with their non-portering peers, and 91% indicated they felt portering negatively impacted their general well-being. Findings indicate that despite the Nepalese government’s legislative efforts to regulate to the portering industry, portering children experience a substantially increased risk of negative physical, emotional and educational outcomes due to their involvement in exploitive and dangerous work. The long-term ramifications of portering are harmful to the well-being of children, and in the long run, lack of education may reduce employment options and the chance to escape from a life of continued poverty.

Dot Enzyme Immunoassay (Typhidot(R)) in Diagnosis of Typhoid Fever in Children

Astrovirus Infection in Young Kenyan Children with Diarrhoea
Human astroviruses (HAstV) have been commonly identified worldwide as important aetiological agents of acute gastroenteritis in all age groups including the young, elderly and immunocompromised. However, limited data exist on the prevalence of this important pathogen in Kenya. The aim of this study was therefore to determine the prevalence of astrovirus (AstV) infection in Kenyan children younger than 10 years of age with diarrhoea. During the period February 1999 to September 2005, stool samples were collected from 476 children attending clinics in Nairobi (and its environs) and the Maua Methodist Hospital, Meru North, Kenya. The faecal specimens were tested by a commercial enzyme immunoassay kit for HAstV. AstV prevalence rates were found to be 6.3%. There was significantly high prevalence of AstV infection in children ≤5 years [5.3% (25/476)] than those >5 years [0.2% (1/476)] ( p < 0.01). Also, we showed a significantly high prevalence of AstV infection in children of ≤5 years [5.8% (20/341)] in Nairobi (urban setting) as compared with those of similar age in Maua (a rural setting) [3.7% (5/135)] ( p < 0.01). This study indicates that HAstV is an important pathogen associated with diarrhoea in young Kenyan children.

Drug Resistance in Tuberculosis

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Clinical Profile and Outcome of Conversion Disorder in Children in a Tertiary Hospital of North India
The clinical profile, commonly involved precipitating factors, comorbid conditions, treatment options and outcome of conversion disorder in 40 children in a tertiary level hospital in North India were studied, retrospectively. Majority of the patients were from rural India. Most common presenting symptom was psychogenic non-epileptic seizures; depression and anxiety were among the commonest comorbid conditions. Precipitating factors were predominantly scholastic problems. Treatment option included either psychotherapy only or combination of psychotherapy and pharmacotherapy. No significant difference was found in terms of outcome between the in-patient and out-patient treatment groups. This observation could be cost effective for developing countries like India, where the resources are very limited.

First Reference Curves of Waist and Hip Circumferences in An Asian Population of Youths: CASPIAN Study
The Objective of the present study is to develop the first age- and gender-specific reference curves for waist and hip circumferences in an Asian population of youths. This cross-sectional population survey was conducted in 2003–04 on a nationally representative sample of 21111 school-students living in urban (84.6%) and rural (15.4%) areas of 23 provinces in Iran. After anthropometric measurements, smoothed reference curves for waist and hip circumference (WC, HiC) and waist-to-hip ratio (WHR) were developed by the LMS method. In both genders, WC and HiC percentile values increased with age. For girls, the 50th to 95th percentile curves for WC had a sharp increase between 8 and 13 years and 11–15 years, respectively, and began to plateau after this age, whereas for boys, these curves had a persistent and less sharp increase with age, until the age of 18 years. The WHR curves of girls decreased with age until 15 years and began to plateau thereafter, whereas for boys the 25th to 95th curves had a plateau pattern. Comparison of the current reference curves with the British ones showed that in boys, the 5th and 50th percentile curves were similar in both studies, but the 95th percentile curve of our study was higher than the British curves. For girls, the 5th percentile curves of both studies were similar, but the 50th and 95th percentile curves of our study were higher than the British ones. These curves represent the first childhood WC, HiC and WHR reference curves obtained in Asia. These curves can provide baseline data for analysis of time trends, as well as for international comparisons.

Unusual Presentation of Plasmodium vivax Malaria with Severe Thrombocytopenia and Acute Renal Failure
Renal failure and uremic encephalopathy are rare findings in Plasmodium vivax malaria. Thrombocytopenia is also an unusual manifestation of P. vivax malaria. This report highlights the occurrence of these rare manifestations in an 8-year-old boy who presented to us with fever, rash and progressive deterioration of renal functions.

Prevalence of Pervasive Developmental Disorders in Preschool Children in the UAE
Available evidence from the literature suggests that the prevalence of autistic disorder may be on the rise world wide, but no prevalence studies have been carried out till date in the Arabian Gulf region. A representative random sample of 694 three-year-old United Arab Emirates national children was evaluated in a two-stage study in the community. In the first stage, using Autism Screening Questionnaire, 58 per 10 000 children were noted to have autistic features. In the second stage using clinical interview, the weighted prevalence was estimated to be 29 per 10 000 for a DSM-IV diagnosis of pervasive developmental disorder (PDD). However, none of these children had been diagnosed prior to the study. Presence of autistic features was associated with male gender, presence of behavioural problems and a family history of developmental delay. The rate of PDD observed in the UAE is comparable with that reported from western countries. However, the lack of recognition of these disorders suggests the need for a comprehensive screening program, as early diagnosis can open the door for early intervention which in turn may improve the prognosis.

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