Global Pediatric Health最新文献

Objective: The American Heart Association (AHA) launched the 2022 guidelines for the diagnosis of hypertension (HT) by ambulatory blood pressure monitoring (ABPM). The present study aimed to evaluate the impacts of the 2022 AHA guidelines on the changes in the prevalence and phenotype of HT in children suspected of HT.

Methods: Consecutive 100 children aged 6 to 20 suspected of HT who underwent 24-hour ABPM were recruited. The patients were separated into 3 groups: escalated, de-escalated, and unchanged. Demographic data were compared between the 3 groups. Logistic regression analysis was performed to evaluate the factors associated with the escalation in the diagnosis of HT.

Results: The present study revealed that the prevalence of HT, including sustained and masked HT, increased from 48% by the 2014 AHA guidelines to 65% by the 2022 AHA guidelines. Patients in the escalated group tended to have a higher proportion of male gender, with an older age and a taller height compared to those in the de-escalated group. Multivariate analysis showed that height was the only factor associated with the escalation in the diagnosis of HT [OR 1.09 (1.01-1.19), P-value .04]. Five out of 6 (83.3%) patients in the escalated group with available echocardiographic results had left ventricular hypertrophy (LVH).

Conclusion: Using the 2022 AHA guidelines resulted in more detection of patients with HT, and almost 30% of the escalated group had LVH. This finding supports using the 2022 AHA guidelines to detect children at risk of developing cardiovascular diseases early.

Background. Neonatal jaundice is more common and complicated in low and middle-income countries. However, there is no adequate evidences on the prevalence of neonatal jaundice and associated factors in Ethiopia. Methods. An institution-based cross-sectional study was conducted from 15 April to 15 June 2021 among 340 neonates admitted to neonatal intensive care unit at public specialized hospitals in Bahir Dar city. Results. The prevalence of neonatal jaundice was found to be 38.8%. Conclusion. The prevalence of neonatal jaundice was relatively high. Being male, prematurity, maternal Rh negative, neonatal Rh positive, maternal blood type AB, and ABO incompatibility were predictor variables of neonatal jaundice. Therefore, healthcare facilities in Bahir Dar city should provide opportunities for testing blood groups and Rh factors of all women early during antenatal care follow-up. Moreover, the treatment of neonatal jaundice has to be easily accessible in all primary health care units of the district.

Objectives. This study aims to report clinical features and treatment outcomes of 16 cases diagnosed with post-influenza encephalopathy/encephalitis. Methods. We recorded clinical characteristics of 16 pediatric patients diagnosed with post-influenza encephalopathy/encephalitis at the Vietnam National Children's Hospital from January 2019 to January 2021. Results. There were 87.5% infected with influenza A, with influenza A/H1pdm09 and influenza A/H3 accounting for 88.9% and 11.1% respectively, and 12.5% of participants infected with influenza B. The time from onset to the appearance of neurological symptoms was 3 days, of which perceptual changes (93.8%), hypertonia (75%), and seizures (43.8%) were prevalent neurological symptoms. The majority of cases had normal cerebrospinal fluid. Cranial CT/MRI imaging revealed abnormalities in 87.5% of patients. 56.3% of patients had sequelae, including epilepsy and cerebral palsy; 25% recovered, and 18.8% died after treatment. Conclusions. Influenza-associated encephalitis/encephalopathy is a complication occurring early in children, with high mortality and sequelae rates.

Background. Pediatric diarrhea remains a public health concern. This study explored caretaker's knowledge, attitudes, and practices regarding the causes, treatments, and risks of diarrhea among under-fives in Korogwe and Handeni districts, north-eastern Tanzania. Methods. We conducted a qualitative, cross-sectional study. Participants were selected through purposive sampling. Data were gathered through in-depth interviews and focus group discussions, and they were analyzed using thematic analysis. Results. Most participants had good knowledge about the risks of diarrhea among under-fives. However, most participants had poor knowledge of the causes and treatments of diarrhea. A significant proportion of participants had negative attitudes and poor practices about the treatment of diarrhea. A small percentage of participants possessed positive attitudes and appropriate practices for managing diarrhea. Conclusion. To bridge the knowledge gaps among caretakers and promote positive attitudes and behaviors about the management of diarrheal diseases, health authorities are urged to strengthen health education in the study communities.

As the newly appointed Editor-in-Chief (EIC) of Global Pediatric Health (GPH), it is both an honor and a privilege to lead this prestigious journal, building upon the strong foundation established by my predecessor, Dr. Aishat Akere. Under her leadership and that of her predecessors, GPH has grown into a globally recognized platform for clinical studies, case studies, public health research, and health services delivery practices focused on the pediatric population. Dr. Akere's tenure was marked by significant achievements, including the expansion of the Editorial Board, which strengthened the journal's editorial team and expanded its global reach. My appointment comes at a time when the landscape of academic publishing is rapidly evolving, particularly with the rise in the number of online journals. Despite these changes, GPH continues to stand out, receiving over 230 submissions and more than 350 000 downloads in the year 2023 alone. These numbers reflect not only the journal's relevance but also the trust that researchers and clinicians worldwide place in GPH as a reliable source of high-quality pediatric health research. As I step into this role, my vision is to further elevate the journal's standing and impact by focusing on several key goals that align with the needs of our authors, the global community, and the field of pediatric health at large.

Introduction. Breastfeeding practices fall short of optimal levels globally, despite its known health benefits and World Health Organization endorsements. We aimed through this study to firstly estimate the global prevalence of principal indicators of breastfeeding practice in Tunisia. Secondly, we aimed to identify their associated factors and to assess the temporal trend of breastfeeding practice in Tunsia from 2000 to 2018. Methods. We extracted data from all available reports of Multiple Indicator Cluster Surveys (MICS) surveys conducted in Tunisia (MICS2000, 2006, 2012 and 2018) that were publicly available on the MICS UNICEF website prior to 2024. Results. Never breastfeeding prevalence was 4% (95% CI [3%-7%]) with a significant increase (P < 10^-3) from 2000 (2.4%) to 2018(7.8%). The prevalence of early breastfeeding initiation was 56% (95% CI [20%-87%]) with a significant decrease(P < 10^-3) from 2006(87.4%) to 2018(31.5%). The prevalence of exclusive breastfeeding was 15% (95% CI [5%-35%]) with a significant decrease(P < 10^-3) from 2000(46.4%) to 2018(13.4%). The prevalence of predominant breastfeeding was 41% (95% CI [31%-51%]) with a significant decrease(P < 10^-3) from 2000(50.5%) to 2018(30.4%). The prevalence of continued breastfeeding up to the age of 2 years was 19% (95% CI [16%-22%]) with no significant decrease from 2000 to 2018(P = .09). The mother educational level was significantly associated with early breastfeeding initiation, exclusive and predominant breastfeeding. A higher prevalence of exclusive breastfeeding was found among mothers from rural areas. Conclusions. Tunisia has been experiencing low rates of breastfeeding practice, with a concerning decline observed over the years. Addressing this issue effectively necessitates a comprehensive, multi-faceted approach that encompasses various aspects of society, healthcare, and policymaking.

Objective. Despite the remarkable progress made in the understanding and treatment of childhood nephrotic syndrome (NS), a lot is still unknown about its epidemiology in many African countries. This study sought to determine the clinicopathological features and treatment outcomes of children with NS at the largest tertiary hospital in Botswana. Methods. A retrospective study of 26 children with NS treated from 2009 to 2014 was conducted. Results. Mean age at presentation was 5.96 ± 3.06. Hematuria was found in 92.3%, low C3 in 26.7%, high creatinine in 19.2% and hypertension in 46.2% of the patients. 92.3% had primary NS out of which 23.1% had familial NS. HIV, tuberculosis and hepatitis B infections were diagnosed in 3.85%, 9.09% and 4.16% respectively. 69.2% had steroid-resistant nephrotic syndrome, focal segmental glomerulosclerosis (SRNS-FSGS). Conclusion. The frequency of primary SRNS-FSGS and familial SRNS appears to be much higher in Botswana highlighting the possibility of genetic causes.

Hemophilia is a congenital coagulopathy characterized by a deficiency of coagulation factors and the development of haematomas and haemarthrosis, either spontaneously or after minor trauma. Recurrent joint hemorrhage in hemophilia patients leads to progressive and degenerative arthropathy, which affects around 90% of patients with severe disease and contributes significantly to disease morbidity. Positive diagnosis is based on biology. Imaging, particularly MRI, plays an essential role in assessing the evolution and complications, especially osteoarticular complications. We report 2 cases of severe hemophilia A, who presented with almost identical clinical and radiological symptoms. The patients developed severe arthropathy with a course marked by recurrences of haemarthrosis.