To investigate netrin-1 (NT-1) and neuron-specific enolase (NSE) in the umbilical cord as biomarkers in HIE stage II/III. We included 100 infants with HIE stage II/III and 100 controls. Cord samples were taken to determine the levels of NT-1 and NSE. The HIE group showed significantly higher NT-1 (343.3 ± 100.6 pg/mL) and NSE (55.17 ± 13.4 ng/mL; P = .037, P = .007, respectively) than the control group, which had NT-1 (268.1 ± 79.3 pg/mL) and NSE (31.3 ± 19.5 ng/mL). The cut-off values for NT-1 and NSE were 289.3 pg/mL and 31.9 ng/mL, respectively. NT-1 had a sensitivity of 92%, a specificity of 100%, a positive predictive value (PPV) of 94%, and a negative predictive value (NPV) of 100%. The sensitivity, specificity, PPV, and NPV for NSE were all 100%. NT-1 and NSE can be reliable biomarkers for predicting HIE stage II/III.
Objective: To report an outbreak of multi drug resistant Serratia infection in a tertiary level neonatal unit from eastern India. Method: Relevant data were retrieved from review of medical records. Standard methods for management of outbreak were carried out, and numerous infection control measures were implemented. Result: Out of the 6 reported cases of Serratia marcescens blood stream infections, majority were premature and all of them had a prior exposure to broad spectrum antibiotics. Most of the neonates (83.3%) survived. Median time of onset of symptoms was 22.5 (range: 2-83) days. Respiratory difficulty and thrombocytopenia were the most common presenting feature and laboratory abnormality observed. Conclusion: Serratia marcescens may lead to potentially serious outbreak neonatal unit. Prompt isolation of cases, Improving hand hygiene practice amongst healthcare professionals, limiting the use of broad spectrum antibiotics in NICU could help to contain the outbreaks to a large extent.
Objectives. To evaluate the interaction between childhood asthma and S. 25(OH) cholecalciferol among Bangladeshi children. Methods. This case control study was conducted in child asthma clinic, Bangladesh Shishu Hospital Institute during March-August 2021. Comparison was made between clinically-diagnosed (following GINA guideline) asthmatic children (2-12 years-old) (cases = 87) and age and sex-matched children having no respiratory illness (controls = 90) using SPSS’ (Statistical Package for Social Science, V.23.0 Windows) software. Results. Serum 25(OH) cholecalciferol was found to be significantly lower among the cases than the controls ( P < .01). The cases had 3.4 times higher likelihood of having low vitamin D (combined deficient + insufficient) than the controls ( P < .01). Conclusions. The results of the study demonstrate an association of Serum 25 (OH) cholecalciferol with asthma which underscores the importance of potential future trial to evaluate the efficacy of Vitamin-D supplementation for understanding the outcomes of asthmatic Bangladeshi children. Keywords , , vitamin D status , asthma , case-control , children
Objective. Analyzing possible determinants for pulmonary tuberculosis (PTB) in under-five children with stunting and severely stunting in Bandung. Methods . Data was collected from 64 community health centers in Bandung using multiple stratified random sampling. Medical history, body measurements, tuberculin skin tests (TST), and chest X-rays (CXR) were collected. Possible determinants to PTB were analyzed using multiple logistic regression ( P value of <.05 was significant). Results . 169 under-five children with stunting and severely stunting were included. 59.76% of children were diagnosed with PTB. The absence of BCG scars and weight-for-age were significant determinants of PTB ( P value <.05). Conclusions . PTB was observed in more than half of stunted and severely stunted under 5 children. BCG scars are a protective factor, while weight-for-age is a risk factor for stunting and severe stunting.
Pediatric Emergency Departments (PEDs) in low- and middle-income countries (LMICs) face significant challenges in managing infectious diseases due to limited resources, poor infrastructure, and socioeconomic barriers. This review explores the burden of infectious diseases in pediatric populations, the diagnostic tools available, treatment protocols, and preventive measures implemented in LMIC PEDs. We emphasize the need for an integrated approach to improve health outcomes, focusing on enhancing healthcare infrastructure, training healthcare workers, and promoting public health awareness. Key recommendations and future directions are discussed to address the critical gaps and challenges in managing pediatric infectious diseases in these settings.
Objective . We examined childhood vaccinations coverage and its associated factors in sub-Saharan Africa (SSA) countries. Methods . We used demographic and health surveys (DHSs) data collected between 2008 and 2022 from 35 SSA countries. A sample of 358 949 under-5 children was analyzed. Percentage and multivariable binary logistic regression analyses were conducted. A 5% significance level was set. Results . Rwanda (7461/8092; 92.2%), Burundi (10 792/13 192; 81.8%), Gambia (6548/8362; 78.3%), Kenya (14 570/19 530; 74.6%), and Burkina Faso (8739/12 343; 70.8%) had the leading coverage of under-5 children who received all basic vaccinations in the first year of life. For every unit increase in the age of a child, there was 72% increase in the odds of vaccination. Children from older mothers had higher odds of vaccination, when compared with children with mothers aged 15 to 19 years. There was a 6% reduction in the odds of vaccination among children from rural residence, when compared with their urban counterparts. Children with educated mothers had over two times higher odds of vaccination, when compared with those from mothers with no formal education. Children from rich households had higher odds of vaccination, when compared with children from poorest household. There was a 13% increase in the odds of vaccination among children covered by health insurance, when compared with those not covered by health insurance. Conclusion . Vaccination uptake for children under-5 in SSA was found to be sub-optimal and associated with several factors. A health educational intervention for pregnant women could potentially increase the uptake of vaccines among children.
Background . Primary thrombotic microangiopathy includes hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli , atypical hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura. Methodology . A retrospective study that included patients younger than 18 years diagnosed with primary thrombotic microangiopathy between 2011 and 2021. Results . Thirty patients were included, of which 63% corresponded to a hemolytic uremic syndrome caused by Shiga toxin-producing Escherichia coli , and 30% to the atypical hemolytic uremic syndrome. The median age was 2.8 years and female sex predominated at 57%. On admission to the emergency room, fever and fatigue were the most frequent symptoms (93%), followed by oliguria and anuria (80%). 48% of patients received hemodialysis during their care. Mortality was estimated at 13%. Conclusion . This study constitutes the largest series of primary thrombotic microangiopathy in the pediatric population of Latin America, where the etiological and clinical behavior of this condition is described.
Objective . To assess the performance of hemoglobin level and red blood cell parameters (mean corpuscular volume [MCV], mean corpuscular hemoglobin [MCH], mean corpuscular hemoglobin concentration [MCHC], and red blood cell distribution width [RDW]) in the diagnosis of iron deficiency among adolescents in eastern Sudan. Methods. A cross-sectional study. Results. Of 374 adolescents. The median age was 14.1 years. Of the participants, 62 (16.6%) had iron deficiency (serum ferritin level of < 15 µg/l). The hemoglobin, MCV, MCH, and MCHC values were significantly lower in adolescents with iron deficiency. The area under the receiver operating characteristic (ROC) curve was 0.71 for hemoglobin, 0.60 for MCV, 0.67 for MCH, 0.71 for MCHC, and 0.73 for RDW. Conclusion. In the current study, hemoglobin and red blood cell parameters were fairly accurate in diagnosing iron deficiency. They can be used to diagnose iron deficiency to avoid extra expense for the patients.
Working with chronically ill children can overwhelm for professionals. It is necessary to study the factors related to compassion fatigue and satisfaction in order to effectively deal with it. Using a narrative review and inclusion criteria, we searched online databases for related studies from 2000 to 2023. Twelve articles were included in the final review. Understanding compassion fatigue/satisfaction will help to solve personal and professional problems and increase productivity, leading to positive outcomes for the patient, family, and the organization. This study identifies several factors that contribute to compassion fatigue (CF) in pediatric healthcare providers. These factors include workload, patient connections, lack of support, exposure to trauma, personal trauma, job dissatisfaction, and neglecting self-care. It is crucial to address these factors through targeted interventions and organizational support. Implementing evidence-based interventions shows promise in reducing the impact of CF, fostering a resilient healthcare workforce, and improving patient care.
A 7-month-old girl had been suffering from progressively deteriorating pneumonia despite getting multiple courses of broad-spectrum antibiotics as well as anti-fungal drugs for adequate duration. To find out the cause behind this deterioration, the patient underwent thorough clinical and relevant laboratory evaluation including chest radiology & imaging, screening for primary immune deficiency disorders (PID), cystic fibrosis, tuberculosis, invasive fungal pneumonia, congenital heart disease, covid pneumonia, TORCH etc. but failed to solve the mystery. Upon further detailed re-evaluation, it was discovered that the child had a history of being forcefully fed lentil-based khichuri (a rice-lentil mixed dish) during her weaning process and diagnosis was finally confirmed as hypersensitive pneumonia due to lentil aspiration by a high level of IgG, specific to lentil antigen. Treatment was commenced with prednisolone resulting in significant improvement in her clinical and radiological condition within 72 hours.
Background. Vitamin D deficiency (VDD) is a global health concern affecting people of all ages. The Ethiopian guidelines recommend sun exposure for neonates starting from 2 weeks old, with 15 to 20 minutes per day. However, evidence suggests that the implementation of this recommendation is inconsistent. Most studies conducted in Ethiopia regarding infant sunlight exposure have been limited to health facilities and towns. Objective. this study aimed to assess mothers’ practice, and factors affecting the sunlight exposure of their infants in Adami Tulu Jido Kombolcha district, East Shoa Zone, Oromia Region, Ethiopia, 2022. Method. A community based cross-sectional study design was conducted among 575 mothers with their infant’s from March 11 to 25, 2022. A lottery method sampling technique was employed to select local administrative units and systematic random sampling employed to select study participants. Practices and knowledge were assessed by categorizing mothers based on their responses to practice and knowledge questions, respectively. Mothers who scored above the mean value of 4.5 were classified as having good practice, while those who scored 6.9 or below on the knowledge questions were classified as having poor knowledge. Data were collected through face-to-face interviews using both semi-structured and structured questionnaires. The data were then entered into EPI Data version 3.1 and exported to SPSS version 25 for analysis. The association between variables was analyzed using bivariate and multivariable binary logistic regression and level of significant determined with adjusted odd ratio at 95% CI and P -value less than <.05. Result. All 575 mothers were interviewed and responded 100%. Out of 567 mothers, 55.2% had good practice of infant sunlight exposure. Lack of advice at health facility (AOR = 3.05, 95% CI: 1.08, 8.60), absence of postnatal care follow up (AOR = 2.38, 95% CI: 1.15, 4.94) and poor knowledge about sunlight exposure (AOR = 1.70, 95% CI: 1.15, 2.50) were factors associated with practice of infant sunlight exposure. Conclusions. In this study, more than half of the mothers had good practice of infants’ sunlight exposure. This study highlights the importance of improving maternal knowledge and healthcare practices related to infant sunlight exposure. Key factors affecting these practices include lack of advice at health facilities, absence of postnatal care follow-up, and poor maternal knowledge. To address these issues, healthcare providers, local health offices, and mass media should focus on educational programs and strengthening advice during health visits. Future research should use validated tools and mixed-method approaches to better understand the social and cultural factors at play. Establishing national guidelines and studying infant serum vitamin D levels can further enhance community awareness and promote the benefits of sunlight exposure.
Background. This study assessed determinants of timely vaccination among children aged from 0 to 23 months in Wolaita Zone Public hospitals, southern Ethiopia: A facility-based cross-sectional study in the study area. Methods and material. An institution-based cross-sectional study was undertaken in Wolaita Zone Public hospitals from December 12 2023 to January 12 2024, G.C. Study subjects were randomly selected through systematic sampling method. Data were gathered by structured questionnaire, entered into Epidata 4.6 and transferred to SPSS 23 for analysis. An adjusted odds ratio (AOR) along with a 95% confidence interval at a P < .05 was used to declare significance level. Results. This study found that 71.5% of children were vaccinated timely. Time to reach the health facility, place of delivery, ANC follow-up, attitude, and knowledge of women, significantly attributed to timely vaccination. Conclusion. About 71.5% of study participants vaccinated their children on the national recommended vaccination schedule. Highly strategic interventions should be taken in improving timely vaccination and identified factors.
Objective . To systematically review studies to provide the pooled estimate of undernutrition among children and adolescents with cancer living in sub-Saharan African countries. Methods . The review followed the recommendations outlined in the PRISMA statement. Online searches were performed on electronic databases such as PubMed, Scopus, Embase, and Hinari; gray literature sources: such as Google, Google Scholar, and university repositories were also searched. A random effect model was used to drive the pooled prevalence, and was reported at a 95% Confidence Interval (CI). Heterogeneity was assessed using subgroup analysis and univariable meta-regression. The effect of each study on the overall prevalence was assessed using leave-one-out sensitivity analysis. In all the models, statistical significance was set at P -value <.05. Result . A total of 623 articles were identified, and 21 articles were retrieved for the final analysis. The overall pooled prevalence of undernutrition was 41.34% (95% CI: 31.64%, 51.04%). The highest prevalence of undernutrition was observed from studies that used Arm Muscle Area (AMC) for age to assess undernutrition: 61.66% (95% CI: 47.59%, 75.72%). The protocol for this review has been registered at PROSPERO (CRD42024510052). Conclusion . The prevalence of undernutrition in sub-Saharan African countries was considerably high. Therefore, policy directions and cost-effective approaches that sustainably address undernutrition among pediatric patients with cancers are needed.
Scabies is an enormous global public health problem and one of the World Health Organization’s 20 most neglected tropical diseases. Scabies affects all groups with children and elderly, particularly in resource scarce countries, among the most vulnerable in terms of prevalence, morbidity, and preventable sequalae. The medical community now recognizes the preventable life-threatening secondary complications attributable to scabies. Nodular scabies occurs in more than 10% of patients despite successful treatment of primary scabies and is particularly easy to misdiagnose. We report a case of nodular scabies in a 6-year-old child. He presented with severe deformity to the head of the penis and severe pruritis lasting for many months. Our case highlights the importance of understanding the differences in disease pathophysiology between scabietic infestation and hypersensitivity to its retained products to better direct effective treatment. Proper diagnosis and treatment of nodular scabies will undoubtedly curb secondary complications on a global scale.
Introduction. Osteoarticular infections (OI) in children cause considerable morbidity with associated long-lasting sequelae. Comprehensive clinical and microbiological data in Mongolian children are missing. Objectives. To generate epidemiological, clinical and microbiological data on osteoarticular infections (OI) in Mongolian children after the introduction of a standardized management protocol. Methods. A prospective study was done between 2019 and 2022 at the only tertiary pediatric hospital in Mongolia. Results. Forty-two children presented with septic arthritis (SA), 6 with osteomyelitis (OM) and 23 with combined SA and OM. Newborns and young infants (<= 3 months) comprised 38.%. A causative organism was identified in 38 children: Staphylococcus aureus (n = 31), Klebsiella spp (n = 3), Enterobacter spp (n = 2), Enterobacter spp + Klebsiella spp (n = 1) and Candida albicans (n = 1). Five children (7%) had sequelae. Mongolian children with OI were younger compared to other cohorts. Conclusion. A standardized protocol for the management of OI in children was taken up well by the patients and treating staff leading to improved pathogen detection, facilitating antimicrobial stewardship in the future.
Objectives. Extremes of maternal age at childbirth may influence child nutritional outcomes, but this is under-researched in Roma populations. Methods. The study was a secondary data analysis of Multiple Indicator Cluster Surveys for Serbian Roma settlements and included 2564 children aged 0 to 59 months. Results. About 19% of children were stunted, 9% underweight, 16% were unwanted and born with a low birth weight. Logistic and linear regressions show that maternal age at childbirth had no association with either nutritional or growth outcomes of Roma children ( P > .05). Instead, child characteristics: being born as a boy, low birth weight, unwanted, younger age, and maternal characteristics: short birth spacing, higher parity and low socioeconomic status were associated with children’s malnutrition. Conclusion. Maternal age at childbirth per se does not increase the chances of poor child health outcomes, as the risks seem to be related more to individual child and maternal characteristics and maternal behavioral patterns.
Background . Pneumonia and bronchiolitis are common childhood illnesses caused by the respiratory syncytial virus. A systematic analysis of published epidemiological data in sub-Saharan African children under the age of 5 was conducted. Methods . To retrieve literature, electronic databases, indexing services, and directories such as PubMed/MEDLINE, Scopus, EMBASE (Elsevier), Google Scholar, and Worldcat were utilized. Data from the included studies were extracted after screening and eligibility evaluation. Results . The pooled prevalence rate of respiratory syncytial virus was 21% (95% CI: 17, 25). Subgroup analysis based on participants’ ages showed that, prevalence was highest in children <6 months (32%). High prevalence was also found in children who were hospitalized (27%), children co-infected with HIV (28%), and children co-infected with bacteria respiratory pathogens (22%). Conclusion . The prevalence of respiratory syncytial virus infection was high in children in sub-Saharan African countries. Therefore, it should be prioritized as a major health problem.
Objective . Congenital hypothyroidism (CH) is a treatable condition with a good outcome if diagnosed promptly. However, neonatal screening programs are not routinely available in developing countries in Pakistan. Method . To highlight the practices of newborn screening in Pakistan, an online survey was conducted. Google forms were circulated to national pediatric societies and hospitals. Results . Out of 341 respondents most were consultant pediatrician (n = 212, 62.17%) followed by residents (n = 80, 23.41%). Majority, (n = 309, 90.6%) believed it was essential to screen all newborns for CH. However, in practice only (n = 141, 41.3%) were offering screening. The most common reasons cited for not screening was the cost of test (n = 110, 32.2%), non-availability of testing services (n = 29, 8.5%) and lack of any implemented screening policies in the hospitals or national guidelines (n = 20, 5.8%). Differences in practice were also observed at provincial levels ( P < .05). Conclusion . This survey highlights marked variation in CH newborn screening practices.
