Abstract: Obesity is a complex public health issue with increasing prevalence in childhood and with a large burden on physical and mental health. Recent data suggest the effectiveness of multi-component approach, of interventions aimed at changing parenting style, and of group educational sessions. In particular, interventions containing a family-behavioral component produce larger effect sizes than alternative treatment groups. Many models have been developed for the multi-component and multi-stakeholder treatment of childhood obesity, with a frequent discrepancy in the intensity of the treatment programme and in the resources available within clinics.Looking for effective strategies for the treatment of childhood obesity we built a Multi-component Obesity Group Experience (MOGE) model, analysing BMI and fat mass reduction as primary outcomes and qualitative improvements in the behavior towards nutrition and lifestyle as secondary one. Thirty-five consecutive obese children (20 girls, BMI z-score 2.1+0.2), were treated by MOGE model and the results were compared with 35 matched obese subjects of the same age (control group followed with a traditional treatment). After 3, 6 and 12 months of treatment it has been observed a significant reduction of BMI z-score and body fat mass. Moreover, a clinically significant psychological wellness was observed in children of MOGE group.

Keywords: Obesity, weight management, multi-component-group-programme, parenting style, behavior.

Abstract: Long-chain polyunsaturated fatty acids (LC-PUFA), especially linoleic acid (LA), arachidonic acid (AA), alpha- linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are essential to infant growth and development during early life. Up till now, there is only limited number of studies with large sample size on LC-PUFA in breast milk in China. In order to better understand the LC-PUFA levels in Chinese women, we report an analysis that included 44 studies of 3815 subjects from the latest 10-year peer-reviewed papers of breast milk studies of fatty acid profiles from China and other regions: Asia (excluding China), Europe, America and Africa. The results showed that Chinese women had significantly higher LA and ALA levels in the breast milk than European and other Asian women. The DHA level in the breast milk of Chinese women meets the Chinese and international recommended intake for young infants. This review provides comprehensive investigation on the LC-PUFA levels in the mature milk of Chinese women in most recent publications and server as a reference for further studies on human milk in China.

Keywords: Human milk, long-chain polyunsaturated fatty acid, review, China, maternal diet.

Abstract: Background: Though treatment of severe acute malnutrition cases in both the in-patient care and the out-patient care has been going on since 2011 at the Tamale Teaching Hospital, little is known about the clinical treatment outcomes and factors that may be associated with the recovery rate in the in-patient setting. This study investigated the clinical treatment outcomes and determinant factors likely to be associated with recovery rates at the Hospital.

Methods: We performed a retrospective chart review (RCR) of all pediatric patients aged (0-11 years of age) who were diagnosed of severe acute malnutrition between March 2011 and December 2013. Logistic regression modeling was used to determine the risk factors of severe malnutrition.

Results: Of the 630 cases that were reviewed, only 19.5 % recovered (having mid-upper-arm-circumference measure ≥125 mm, or oedema resolved, or gained 5g/kg/body weight for 2 consecutive days at the time of discharge), 1.7 % defaulted, and 65.2 % were referred to out-patient care units for continued treatment. The observed case fatality rate was 13.5 %. Marasmic cases had more chronic co-morbid conditions at admission compared to kwashiorkor patients (81.7% vs. 69.3%, p=0.01).

Conclusions: Case fatality rate in this population was quite high. Case referral to out-patient care unit was appropriately high. Malaria was the most common co-morbid condition diagnosed among the cases reviewed. Younger age, 15% or more increase in weight, and type of malnutrition were the main predictors of recovery from severe acute malnutrition in the in-patient care setting.

Keywords: In-patient care, severe acute malnutrition, under-five children, recovery rate, fatality rate, medical complications, Tamale Teaching Hospital, Northern Ghana.

Abstract: Background: The lack of Parental supervision, including psycho social problems and decrease access to basic needs such as food, shelter, clothing, education and health care are examples of the enormous challenges faced by Vulnerable children (VC). These challenges pushes VC to adopt survival and coping strategies, of which some are exposure variables of sexually transmitted infection including HIV infection. In addition, some of these children were orphaned and made vulnerable by HIV. As such, VC should benefit from a health provider initiated counseling and testing for HIV as recommended by the Nigerian HIV policy. However, focus on screening VC for HIV infection has been abysmal; it is on this premise that this study set out to determine the HIV prevalence of vulnerable children in Jos, Nigeria.

Methods: Vulnerable children were sampled from 3 different institutions and from households in 3 different communities in Jos, Plateau State with the assistance of Non-Governmental organizations involved in the care of VC. All VC enrolled were interviewed, clinically examined and screened for HIV based on national protocol and standard. Data generated were analyzed using CDC epi info version 7. A p value less than 0.05 was considered statistically significant.

Results: Out of the 237 children enrolled 145 (61.2%) were male VC while 92(38.8%) were female vulnerable children, giving a male female ratio of 1.0: 0.6. HIV sero - positivity was identified in 9 of the 237 VC giving a prevalence of 3.8%, amongst the study subjects. Out of the 9 HIV positive VC, 7 VC (77.8%) were resident in institutions; only two household VC were HIV positive. There was no statistically significant association between place of residence, age of VC, gender and type of vulnerability and HIV status among the studied population.

Conclusion: The HIV prevalence of 3.8% in vulnerable children is enormous and appears to be higher amongst children resident in orphanages than those in household.

Keywords: Vulnerable children, HIV, AIDS, orphans, Jos.