Global Pediatric Health最新文献

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.

Background. Rheumatic heart disease remains a significant health burden in resource-limited settings. This study investigated the clinical characteristics and valve lesion patterns of RHD in children from Eastern Ethiopia, comparing newly diagnosed and known RHD patients. Objective. This study aimed to characterize the clinical features and valve lesion patterns in children with Rheumatic heart disease and provide a comparative analysis between newly diagnosed and known cases. Methods. A hospital-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized Hospital from January 1 to December 31, 2021. A total of 39 children with RHD were included, with data collected from medical records, clinical assessments, and echocardiographic evaluations. Descriptive statistics and chi-square tests were used for analysis. Results. Among the 39 children studied, 25 were newly diagnosed and 14 were known RHD cases. The majority were female (71.8%). The median age was 10 years. Shortness of breath (53.9%) and cough (38.5%) were the most common presenting complaints. Only 14.3% of known RHD patients were adherent to secondary prophylaxis. Severe acute malnutrition and severe anemia were the most common comorbidities. Class IV heart failure was present in 89.7% of the patients. Echocardiographic findings revealed that all patients had mitral valve involvement, with mitral regurgitation (94.9%) being the most frequent. Conclusion. This study revealed that rheumatic diseases in children in Eastern Ethiopia present at advanced stages. Low adherence to secondary prophylaxis and high rates of severe heart failure highlights the consequences of delayed diagnosis and management. These findings underscore the urgent need for better healthcare infrastructure, enhanced prevention programs, and improved strategies to increase prophylaxis adherence to prevent disease progression and improve outcomes for affected children.

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.

Objectives. Case management, which is defined as a fully collaborative process that includes evaluation, planning, execution, coordination and supervision, has been widely used in the field of chronic diseases. However, the clinical effect of case management in pediatric patients with congenital heart disease (CHD) is unclear. This study was to explore the effects of case management model in pediatric patients with CHD. Methods. A total of 110 pediatric CHD patients referred to our center from January 2018 to January 2020 were enrolled for analysis. Patients were randomly assigned to a case management (experimental) group or a conventional nursing (control) group. Patient satisfaction, quality of life, and clinical outcomes were compared between the 2 groups. Results. Compared with that in the control group, patient satisfaction rate was significantly greater in the experimental group. Furthermore, the experimental group showed more significant improvement in quality of life than the control group did (73.8 ± 12.3 vs 66.5 ± 14.2, P < .001). In addition, the readmission rate in the experimental group was significantly lower than that in the control group (5% vs 20%, P = .022). Conclusions. Case management mode can be effectively applied in pediatric patients with CHD, which can improve patient satisfaction rate, health-related quality of life and lower the readmission rate.

Background. Vaccine-preventable diseases contribute significantly to under-five deaths, particularly in low- and middle-income countries. In Uganda, immunization coverage disparities persist among marginalized communities like the Batwa. This study explores perspectives on pediatric vaccination within the Indigenous Batwa in western Uganda. Methods. A qualitative phenomenological approach was used, with data from 15 mothers/caretakers, 8 health extension workers, and 3 community leaders in Kisoro district. Interviews were conducted privately, audio-recorded, and analyzed thematically. Results. Three themes emerged: (1) Misconceptions and concerns about vaccine safety and distrust in Western medicine; (2) Cultural beliefs favoring traditional healing; and (3) Access challenges, including geographical and socioeconomic barriers. Trust and comfort with healthcare providers, especially Batwa, were vital to reducing stigma. Conclusion. Addressing misconceptions, educating on vaccine safety, and building trust are key. Culturally sensitive programs and engaging Batwa care providers can improve vaccine uptake and acceptance by enhancing comfort and trust in vaccination efforts.

Objective. To determine clinical presentations and laboratory findings of meningitis outbreak among children in 2023 in Iraq. Method. the demographic data (gender, age, symptoms, and disease transmission among family members) were collected from child patients, who were admitted to Halabja and Sulaimania pediatric teaching hospital in the period of 15 March 2023 to 1st of August, 2023. The blood and cerebrospinal fluid (CSF) specimens were collected for hematological, biochemical, microscopic, and microbiological examinations, including culturing and FilmArray meningitis/encephalitis panel. Results. The population studied were 170 children between 1 and 18 years old, Males were 110 (64.7%), and females were 60 (35.3%). Children between 5 and 10 years old had the highest frequency, whereas only 2 children were <1 year. Clinical symptoms were fever in 100%, followed by headache, vomiting, convulsion, photophobia, and lethargy (79%, 12%, 3%, 3%, 2%) respectively. CSF parameters were: 38.8% of them had >1000 leucocytes/µ, followed by 31.2% for those who had <300 cells/µ, differential CSF leucocytes, 82.4% were monocytes, and sugar was normal at 84.1%. while protein was <40 mg/d in 55.9% of them. Conclusion. Meningitis outbreak due to enterovirus was recorded, and age predilection and clinical presentation refer to different serotypes. Further work is needed to define the species and serotypes of the virus and define the environmental source of the virus.

Psychological and social support is one of the factors that promote resilience in refugee children. Immigrant children with thalassemia have special psychosocial needs in the host country. The comfort model can help identify psychosocial needs. We applied Kolcaba's comfort theory to an 8-year-old Afghan boy with a history of thalassemia in Iran. According to Kolcaba's model, the taxonomy of psychological and social comfort needs were separation from mother, anxiety due to unfamiliarity with the hospital, fear of interaction and preference for silence, different culture and place of living, language barrier. To address his psychospiritual and sociocultural comfort care, we used coaching and comfort food interventions recommended by Kolcaba. The use of Kolcaba's Comfort Theory was helpful in promoting the child's emotional and social comfort in the case of an Afghan refugee child with thalassemia in Iran.