RESUMO
Forty-eight children (M age = 4.8 years) infected with HIV/AIDS and living in the Dominican Republic were randomly assigned to a massage therapy or a play session control group. The children in the massage therapy group received two weekly 20-min massages for 12 weeks; the children in the control group participated in a play session (coloring, playing with blocks) for the same duration and length as the massage therapy group. Overall, the children in the massage therapy group improved in self-help abilities and communication, suggesting that massage therapy may enhance daily functioning for children with HIV/AIDS. Moreover, the HIV infected children who were six or older also showed a decrease in internalizing behaviors; specifically depressive/anxious behaviors and negative thoughts were reduced. Additionally, baseline assessments revealed IQ equivalence below normal functioning for 70% of the HIV infected children and very high incidences of mood problems (depression, withdrawn) for 40% of the children and anxiety problems for 20% of the children, suggesting the need for better monitoring and alternative interventions in countries with limited resources to improve cognition and the mental health status of children infected with HIV/AIDS.
RESUMO
PURPOSE: The effectiveness of massage therapy on immune parameters was evaluated in young Dominican HIV+ children without current access to antiretroviral therapies. METHODS: Eligible children, who were followed at the Robert Reid Cabral Hospital (San Domingo, Dominican Republic), were randomized to receive either massage treatment or a control/friendly visit twice weekly for 12 weeks. Blood was drawn at baseline and following the 3-month intervention for determinations of CD4, CD8, and CD56 cell counts and percentage, along with activation markers (CD25 and CD69). RESULTS: Despite similar immune parameters at baseline in the two groups, significantly more of the control group exhibited a decline in CD4 cell count (>30%, p = 0.03), postintervention. The decrease was particularly evident in older (5-8 years) children in the control arm, who demonstrated a significant reduction in both CD4 and CD8 cell counts compared to massage-treated older children who remained stable or showed immune improvement. Additionally, a significant increase in CD4+CD25+ cells was observed over the 12-week trial in the massage-treated older children (p = 0.04) but not in the control group. In younger massage-treated children, (2-4 years old), a significant increase in natural killer cells was shown. CONCLUSION: Together these findings support the role for massage therapy in immune preservation in HIV+ children.
Assuntos
Síndrome da Imunodeficiência Adquirida/imunologia , Síndrome da Imunodeficiência Adquirida/terapia , Proteção da Criança , Massagem/métodos , Contagem de Linfócito CD4 , Relação CD4-CD8 , Criança , Pré-Escolar , República Dominicana , Feminino , HIV-1 , Humanos , Masculino , Resultado do TratamentoRESUMO
OBJECTIVES: This study was designed to explore whether parental activities such as repairing cars, welding, and rebuilding car batteries are risk factors for lead poisoning among Cuban refugee children in Miami-Dade County. METHODS: The authors performed a cross-sectional study of 479 children aged 12-83 months who had lived in Cuba during the six months prior to immigrating to the U.S. Lead levels were obtained, and parents provided information on demographics, home/neighborhood environment in Cuba prior to immigration, family/occupational factors prior to immigration, and child behavior factors. RESULTS: Of 479 children, 30 (6.3%) had elevated blood lead levels (EBLLs), defined as > or = 10 microg/dL, based on the Centers for Disease Control and Prevention action level. In multivariate analysis, racial/ethnic identification other than white, living in a home built after 1979, car repair in the home or yard, eating paint chips, and male sex were independently associated with EBLL. CONCLUSIONS: Risk factors for lead poisoning among immigrant children may differ from those among U.S.-born children. Screening of immigrant children who may have been exposed in their country of origin and education of immigrant parents about lead exposure hazards associated with activities such as car repair should be considered in the design of lead poisoning prevention and control programs.