Robust oral health data collection in birth cohort studies is needed to understand the oral microbiome in relation to oral and general health. The aim of this paper is to describe the collection of oral health data in toddlers participating in a birth cohort focussing on microbiome development. Hereby, we aim to support the interpretation of variance in microbiome data. The Amsterdam Infant Microbiome Study (AIMS, n = ~500) is a longitudinal prospective birth cohort assessing microbiota, general health status, demographics, (oral) health behaviour and dietary behaviour in children from birth up to three years. The Oral Health Study (OHS) is a sub-study of AIMS, assessing the oral health of children and their mothers. From the mothers, data on periodontal health (clinical attachment loss, gingival bleeding), oral hygiene (dental plaque, calculus) and dental caries (DMFS) is collected. In children, data on caries prevalence (ICDAS) and infection (pufa), oral hygiene (dental plaque, calculus), Obstructive Sleep Apnoea (OSA), oromuscular function, and bitter taste sensitivity are collected. Enrolment in OHS started in October 2022 and is planned to continue up to December 2028. In October 2024, 64 mother-child pairs were enroled in the study. Data collection is expected to be completed by January 2028. Results will be shared at international conferences and via peer-reviewed publications.
Objectives The New AntiBiotic treatment Options for uncomplicated GOnorrhoea trial compared the efficacy of gentamicin, ertapenem and fosfomycin with ceftriaxone. Ertapenem was non-inferior to ceftriaxone for treating Neisseria gonorrhoeae, but participants receiving ertapenem commonly reported having diarrhoea. We assessed diarrhoea trajectories, estimated the probability of remaining with diarrhoea over time and identified determinants of diarrhoea.Methods Participants were randomly assigned (1:1:1:1) to receive intramuscular 5 mg/kg gentamicin (maximum 400 mg), intramuscular 1000 mg ertapenem, oral 6 g fosfomycin or intramuscular 500 mg ceftriaxone (control group). Following antibiotic treatment, participants self-reported adverse events, including diarrhoea, in a paper diary until 30 days after treatment. In this secondary analysis, we assessed the frequency of diarrhoea in each study arm. Kaplan-Meier methods were used to estimate the probability of remaining with diarrhoea over time in each study arm. Determinants of diarrhoea in the ertapenem arm were assessed using relative risk regression.Results Among 343 participants randomised, 2/102 (2.0%) in the gentamicin arm, 49/97 (50.5%) in the ertapenem arm, 32/37 (86.5%) in the fosfomycin arm and 11/103 (10.7%) in the ceftriaxone arm reported diarrhoea. Median duration of diarrhoea varied between 1 and 2 days across arms. In the ertapenem arm, only having an anal N. gonorrhoeae and/or anal Chlamydia trachomatis infection (prevalence ratio=2.29, 95% CI 1.04 to 5.02) was associated with increased diarrhoea risk.Conclusions Ertapenem was associated with high frequency of diarrhoea, which was mostly short-lived. Continued evaluation of the tolerability of ertapenem could help increase acceptability of this potential second-line treatment against N. gonorrhoeae.Trial registration number NCT03294395.
School attendance is essential for children and adolescents and plays a vital role in their cognitive, social, physical, and mental health. Extensive school absenteeism is a risk factor for adverse health outcomes, both in the short and long term. The MASS intervention focuses on the early identification of school absenteeism following reports of illness-related absences by schools. Currently, a structural pathway for signalling school absenteeism from within curative healthcare is missing. As a physician, it is important to address school absenteeism when consulting with children or adolescents and their parents. Consider school attendance as a routine aspect of overall health, and be aware that psychosocial problems often underlie significant absenteeism. If concerns arise, actively collaborate with the youth health professional as part of an integrated care approach.
BACKGROUND From 1 March 2020, the Centre for Sexual Health Amsterdam limits presumptive treatment for chlamydia or gonorrhoea to clients notified by steady partners. Treatment after notification by non-steady partners requires a positive test result. AIM We aimed to evaluate this change in policy on unnecessary antibiotic treatment, time to treatment and lost to follow-up clients. METHODS We included consultations (with testing) following partner notification for chlamydia or gonorrhoea between 1 March 2017 and 1 March 2023. Primary outcome was unnecessary antibiotic treatment (presumptive treatment with negative test result) before vs after the policy change. We also assessed return for treatment of confirmed and not presumptively treated individuals after the policy change. RESULTS From 4,579 consultations, unnecessary antibiotics were prescribed for 786/1,318 (59.6%) clients for chlamydia and 729/1,117 (65.3%) clients for gonorrhoea before 1 March 2020. After 1 March 2020, this decreased to 324/1,275 (25%) and 341/1,369 (25%), respectively, corresponding to a relative reduction of 58% for chlamydia (adjusted relative risk (aRR): 0.42; 95% confidence interval (CI): 0.37–0.47) and 63% (aRR: 0.37; 95% CI: 0.33–0.42) for gonorrhoea. After the policy change, clients not given presumptive treatment but later diagnosed returned after a median of 7 days (interquartile range (IQR): 5–8) for chlamydia and 6 days (IQR: 4–7) for gonorrhoea. Missed treatment occurred in 4/155 (2.6%) of chlamydia and 5/158 (3.2%) of gonorrhoea consultations. CONCLUSION The new partner management protocol substantially reduced unnecessary antibiotic treatment for chlamydia and gonorrhoea. The majority of confirmed infections still received appropriate treatment.
Abstract Background Children’s perspectives on optimal health care are rarely considered in health care research. These routine health assessments are carried out by Youth Health Care services (YHC), which provide school health care as part of preventive care for children. The aim of this study is to explore the perspectives of children aged 9 to 12 years old, on current routine health assessments in Dutch school health services and how these could be improved to better align their preferences and needs. Methods We conducted a qualitative focus group study with Dutch primary school children, 9 to 12 years old, who received their routine health assessment from YHC in the past twelve months. Discussion topics included experiences with preventive youth health care services, preferences regarding involvement of parents, and suggestions for improvement of the services. Reflexive thematic analysis was conducted using the 6-step approach by Braun and Clarke. Results Six focus groups were conducted with in total 41 children. We identified four main themes; ‘We want more! Monitoring health matters to children’; ‘Feeling safe and comfortable: be the nice and sweet professional in a two-way conversation’; ‘Parents know a lot, but not everything: mixed feelings on their role and presence’, and ‘Preventive youth health care should be organized more attractive’. Conclusion Our sample of Dutch children perceived preventive routine health assessments as important to monitor their health and suggested more frequent and comprehensive assessments. The children’s perspectives, provided relevant insights in how to design child-friendly preventive youth health care.
