Global Pediatric Health最新文献

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.

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.

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.

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.