Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.
The weights and heights of 3,312 Malaysian primary school boys and girls, aged 6 to 11 years, belonging to various ethnic groups in Malaysia were measured. On the whole, the Chinese children were taller and heavier than the Malay and the Indian children who were the least heavy among the three ethnic groups. Economically the Indians were the poorest among the three ethnic groups and they also had the largest family size. When the household incomes were taken into consideration it was found that the growth achievement of the higher income children was better than that of the poorer children, irrespective of their ethnic groups. It is interesting to note that, although the Indian children as a whole, were the least heavy of the three ethnic groups, yet the growth achievement of the higher income Indian children was similar to that of the higher income Chinese children. The differences in growth achievement of the various ethnic groups are probably due to environmental differences, rather than genetic differences. It seems likely that Malaysian children of different ethnic groups (Malay, Chinese and Indian) can attain similar statures if environmental conditions are similar.
In Malysia, the proportion of children fully immunized againest diphtheria is generally low (20%). On the other hand, the Schick conversion rate rises with age and reaches 90% by 11 years of age. It is noted that asymptomatic carriers are an important epidemiological factor in diphtheria and that carrier rates for school children are high (prevalence of 7.5% while the rate of coloization with C. diphtheriae over a period of one year was 30%). Although immunization protects against clinical diphtheria, it does not prevent the carrier state. Thus, for the control of diphtheria, one should aim for 100% compliance. Some suggestions as to how higher levels of immunity may be achieved are described.
The draw-a-man (DAM) and draw-a-woman (DAW) tests were given to 307 schoolchildren in Petaling Jaya, Malaysia. The children were ethnically Malay, Chinese, or Indian (Tamil), and all came from lower socioeconomic groups. The standard scores of the Chinese children averaged 118 in the DAM and 112 in the DAW tests. These scores were significantly better than the American standards. Malay children scored significantly lower than Chinese, and Tamil children scored lower again. The nutritional status of the children had no influence on the scores. Chinese and Tamil children scored better in the DAM than the DAW, while in Malay boys the reverse was true. Malay children tended to emphasise clothing in the DAM, but Chinese and Tamil children scored better on items relating to facial features and body proportions. The Goodenough-Harris draw-a-person tests are obviously not culture-free, but the causes of ethnic differences have not been elucidated.