G. Bayhan, H. Akça, Ayla Akça Çağlar, Funda Kurt, L. Akcan Yıldız, S. Şenel, C. Karacan
Abstract Objective Closing of schools within the scope of the pandemic measures and switching to online education have negatively affected the mental and physical health of children as well as their education. The effect of complete reopening of schools on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully known. In the 2021–2022 academic year, the Ministry of National Education of Türkiye has decided to continue face-to-face education at all levels and in all private and public schools, by following a series of measures. There are no studies on school transmission reported from Türkiye since then. This study aimed to assess the dynamics of coronavirus diseases 2019 (COVID-19) transmission in schools by evaluating the data of the school contact screening outpatient clinic of a tertiary children's hospital. Methods According to the Ministry of National Education guidelines in Türkiye, all students in a class with two polymerase chain reaction (PCR)–confirmed COVID-19 cases are sent to their homes and have a SARS-CoV-2 PCR test on the fifth day. While the students with negative test results return to school, students who test positive continue to stay at home until the 10th day. The current study retrospectively analyzed the screening results of primary, middle, and high school students who presented at the school contact screening polyclinic during the first semester of the 2021–2022 academic season. Results There were a total of 11,608 presentations to the school contact screening polyclinic, and 1,107 children tested positive with SARS-CoV-2 PCR (9.5%). The median weekly positivity rate was 9.7% in primary school, 9.4% in middle school, and 5.6% in high school. The weekly positivity rate increased from the 16th week at all school levels; the positivity rates ran in parallel before this time but significantly increased from the 16th week to the half-term break. Conclusion The curve of the positivity rates in schools was similar to Türkiye's pandemic curve. In this respect, the low SARS-CoV-2 transmission in schools correlated with the low number of cases in the community.
{"title":"SARS-CoV-2 Transmission among Students after the Full Reopening of Schools","authors":"G. Bayhan, H. Akça, Ayla Akça Çağlar, Funda Kurt, L. Akcan Yıldız, S. Şenel, C. Karacan","doi":"10.1055/s-0042-1760193","DOIUrl":"https://doi.org/10.1055/s-0042-1760193","url":null,"abstract":"Abstract Objective Closing of schools within the scope of the pandemic measures and switching to online education have negatively affected the mental and physical health of children as well as their education. The effect of complete reopening of schools on the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not fully known. In the 2021–2022 academic year, the Ministry of National Education of Türkiye has decided to continue face-to-face education at all levels and in all private and public schools, by following a series of measures. There are no studies on school transmission reported from Türkiye since then. This study aimed to assess the dynamics of coronavirus diseases 2019 (COVID-19) transmission in schools by evaluating the data of the school contact screening outpatient clinic of a tertiary children's hospital. Methods According to the Ministry of National Education guidelines in Türkiye, all students in a class with two polymerase chain reaction (PCR)–confirmed COVID-19 cases are sent to their homes and have a SARS-CoV-2 PCR test on the fifth day. While the students with negative test results return to school, students who test positive continue to stay at home until the 10th day. The current study retrospectively analyzed the screening results of primary, middle, and high school students who presented at the school contact screening polyclinic during the first semester of the 2021–2022 academic season. Results There were a total of 11,608 presentations to the school contact screening polyclinic, and 1,107 children tested positive with SARS-CoV-2 PCR (9.5%). The median weekly positivity rate was 9.7% in primary school, 9.4% in middle school, and 5.6% in high school. The weekly positivity rate increased from the 16th week at all school levels; the positivity rates ran in parallel before this time but significantly increased from the 16th week to the half-term break. Conclusion The curve of the positivity rates in schools was similar to Türkiye's pandemic curve. In this respect, the low SARS-CoV-2 transmission in schools correlated with the low number of cases in the community.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"077 - 082"},"PeriodicalIF":0.3,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43339173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Saritas Nakip, S. Kesici, B. Bozkurt, Y. Ozsurekci, H. Demirbilek, B. Bayrakcı
Abstract Objective Multisystem inflammatory syndrome in children (MIS-C) patients might be at risk for hyperglycemia and associated complications. Herein, we aimed to determine the incidence of hyperglycemia, understanding the underlying risk factors in MIS-C patients. Methods All MIS-C patients were retrospectively evaluated and compared according to the presence of hyperglycemia and the need of insulin. Inflammatory markers and body mass index Z-scores were also compared. Results The median age of the patients with hyperglycemia was higher than those without ( p = 0.001). Disease severity scores of patients with hyperglycemia were higher. Procalcitonin levels of patients with hyperglycemia were higher, while ferritin, CRP, and interleukin-6 levels were not. BMIs of patients with hyperglycemia were higher ( p = 0.01) but BMI Z-scores were similar ( p = 0.055). There was a positive correlation between BMIs and CRP (r: 0.31, p = 0.015). There was a positive correlation between procalcitonin (r: 0.431, p = 0.001) and CRP (r: 0.279, p = 0.029) and maximum PG. Conclusion Hyperglycemia is a common feature of MIS-C patients and is associated with the severity of the inflammation. As a novel finding, high CRP and procalcitonin should be considered as predictive markers for impaired glucose homeostasis in MIS-C patients.
{"title":"Incidence and Risk Factors of Hyperglycemia in Severe Multisystem Inflammatory Syndrome in Children: A Retrospective Case-Control Study","authors":"O. Saritas Nakip, S. Kesici, B. Bozkurt, Y. Ozsurekci, H. Demirbilek, B. Bayrakcı","doi":"10.1055/s-0042-1758744","DOIUrl":"https://doi.org/10.1055/s-0042-1758744","url":null,"abstract":"Abstract Objective Multisystem inflammatory syndrome in children (MIS-C) patients might be at risk for hyperglycemia and associated complications. Herein, we aimed to determine the incidence of hyperglycemia, understanding the underlying risk factors in MIS-C patients. Methods All MIS-C patients were retrospectively evaluated and compared according to the presence of hyperglycemia and the need of insulin. Inflammatory markers and body mass index Z-scores were also compared. Results The median age of the patients with hyperglycemia was higher than those without ( p = 0.001). Disease severity scores of patients with hyperglycemia were higher. Procalcitonin levels of patients with hyperglycemia were higher, while ferritin, CRP, and interleukin-6 levels were not. BMIs of patients with hyperglycemia were higher ( p = 0.01) but BMI Z-scores were similar ( p = 0.055). There was a positive correlation between BMIs and CRP (r: 0.31, p = 0.015). There was a positive correlation between procalcitonin (r: 0.431, p = 0.001) and CRP (r: 0.279, p = 0.029) and maximum PG. Conclusion Hyperglycemia is a common feature of MIS-C patients and is associated with the severity of the inflammation. As a novel finding, high CRP and procalcitonin should be considered as predictive markers for impaired glucose homeostasis in MIS-C patients.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"031 - 037"},"PeriodicalIF":0.3,"publicationDate":"2022-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43796209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aslı Soğukpınar Önsüren, M. Mutluay, Muhammed Seyithanoğlu, B. Tanrıverdi
Objective This study aimed to assess the role of thiol/disulfide homeostasis and oxidative stress in the saliva of children with severe early childhood caries (S-ECC). Methods Eighty children aged 3 to 6 years were involved in this case-control study. The study consisted of two groups: the study group (S-ECC) and the control group with no caries. Thiol/disulfide homeostasis and antioxidant levels were calculated after obtaining unstimulated saliva samples from all participating children. Results The native/total thiol and total oxidant status (TOS) levels of the study group were higher than those of the control group, though not statistically significant (p > 0.05). The oxidative stress index (OSI) value was significantly higher in the study group compared to the control group (p = 0.024). Conclusion Our results confirmed that the thiol/disulfide homeostasis was reduced, and disulfide formation, which is rereducible to thiol, was insufficient in children with S-ECC to compensate oxidative stress compared with the control group. Also, thiol levels were inadequate to compensate for oxidative stress, and thiol/disulfide homeostasis was not an independent parameter for S-ECC. Besides, the increases in the TOS level and OSI value show that oxidative stress had significant effects on S-ECC's etiopathogenesis.
{"title":"Evaluation of Salivary Thiol/Disulfide Homeostasis and Oxidative Stress in Children with Severe Early Childhood Caries Using a Novel Method","authors":"Aslı Soğukpınar Önsüren, M. Mutluay, Muhammed Seyithanoğlu, B. Tanrıverdi","doi":"10.1055/s-0042-1753463","DOIUrl":"https://doi.org/10.1055/s-0042-1753463","url":null,"abstract":"\u0000 Objective This study aimed to assess the role of thiol/disulfide homeostasis and oxidative stress in the saliva of children with severe early childhood caries (S-ECC).\u0000 Methods Eighty children aged 3 to 6 years were involved in this case-control study. The study consisted of two groups: the study group (S-ECC) and the control group with no caries. Thiol/disulfide homeostasis and antioxidant levels were calculated after obtaining unstimulated saliva samples from all participating children.\u0000 Results The native/total thiol and total oxidant status (TOS) levels of the study group were higher than those of the control group, though not statistically significant (p > 0.05). The oxidative stress index (OSI) value was significantly higher in the study group compared to the control group (p = 0.024).\u0000 Conclusion Our results confirmed that the thiol/disulfide homeostasis was reduced, and disulfide formation, which is rereducible to thiol, was insufficient in children with S-ECC to compensate oxidative stress compared with the control group. Also, thiol levels were inadequate to compensate for oxidative stress, and thiol/disulfide homeostasis was not an independent parameter for S-ECC. Besides, the increases in the TOS level and OSI value show that oxidative stress had significant effects on S-ECC's etiopathogenesis.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48667316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Can Monkeypox Infection Be Serious Problem for Children?","authors":"Ayse Ruveyda Ugur, M. Özdemir","doi":"10.1055/s-0042-1755193","DOIUrl":"https://doi.org/10.1055/s-0042-1755193","url":null,"abstract":"","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44752019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ozlem Erdede, Erdal Sarı, Nihan Uygur Külcü, R. G. Sezer Yamanel
Objective Health care utilization has declined significantly during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to analyze the impact of COVID-19 lockdowns on pediatric admissions in a Turkish medical center. Methods This retrospective study was conducted by analyzing the numbers and records, including diagnoses, of patients admitted to our pediatric department between March 11, 2020 (the day of the first confirmed COVID-19 case in Turkey) and June 11, 2020 and comparing it with the diagnoses and numbers for the same period in 2019. The most common reasons for admissions were investigated. Results Totally, 89,607 patients were included. Patient visits reduced drastically by 63.11 to 36.89% during the lockdown period compared to the preceding year. In addition to the impact of COVID-19 lockdowns on the total volume of patients, we observed significant variations in the distribution of diagnoses among children. The percentage of respiratory, gastrointestinal, immunological, and ophthalmologic diseases and allergic reactions statistically decreased (p < 0.001). In contrast, the relative percentage of neonatal, urogenital, neurological, cardiovascular, hematological, and dermatological diseases significantly increased (p < 0.001) among emergency department (ED) admissions. Notably, the percentage of respiratory diseases among ED patients decreased by 66.81 to 33.19%. Conclusion COVID-19 strongly affected health care utilization. The public must be educated about the safety of hospital environments, and families should be encouraged to visit hospitals in case of emergencies. Additionally, changes in public health advice may help alter health care consumption patterns.
{"title":"The Impact of COVID-19 Lockdown on Pediatric Hospital Admissions in Turkey","authors":"Ozlem Erdede, Erdal Sarı, Nihan Uygur Külcü, R. G. Sezer Yamanel","doi":"10.1055/s-0042-1755237","DOIUrl":"https://doi.org/10.1055/s-0042-1755237","url":null,"abstract":"\u0000 Objective Health care utilization has declined significantly during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to analyze the impact of COVID-19 lockdowns on pediatric admissions in a Turkish medical center.\u0000 Methods This retrospective study was conducted by analyzing the numbers and records, including diagnoses, of patients admitted to our pediatric department between March 11, 2020 (the day of the first confirmed COVID-19 case in Turkey) and June 11, 2020 and comparing it with the diagnoses and numbers for the same period in 2019. The most common reasons for admissions were investigated.\u0000 Results Totally, 89,607 patients were included. Patient visits reduced drastically by 63.11 to 36.89% during the lockdown period compared to the preceding year. In addition to the impact of COVID-19 lockdowns on the total volume of patients, we observed significant variations in the distribution of diagnoses among children. The percentage of respiratory, gastrointestinal, immunological, and ophthalmologic diseases and allergic reactions statistically decreased (p < 0.001). In contrast, the relative percentage of neonatal, urogenital, neurological, cardiovascular, hematological, and dermatological diseases significantly increased (p < 0.001) among emergency department (ED) admissions. Notably, the percentage of respiratory diseases among ED patients decreased by 66.81 to 33.19%.\u0000 Conclusion COVID-19 strongly affected health care utilization. The public must be educated about the safety of hospital environments, and families should be encouraged to visit hospitals in case of emergencies. Additionally, changes in public health advice may help alter health care consumption patterns.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46868762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Timur, U. Demirpek, Başak Ceylan Demirbaş, Esra Türe, M. Korkmaz, A. Timur
Abstract Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection. Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied. Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower. Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered.
{"title":"Coronavirus Disease 2019 in Pediatric Emergency Room: The Dilemma of Cycle Threshold Value","authors":"D. Timur, U. Demirpek, Başak Ceylan Demirbaş, Esra Türe, M. Korkmaz, A. Timur","doi":"10.1055/s-0042-1758743","DOIUrl":"https://doi.org/10.1055/s-0042-1758743","url":null,"abstract":"Abstract Objective The havoc caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic could not have been predicted, with children being affected worldwide. Testing for SARS-CoV-2 infection helped to define the interventions against the spread of the disease. A polymerase chain reaction (PCR) test has been the mainstay of diagnostic testing. Cycle threshold (Ct) is a semiquantitative value that indicates approximately how much viral genetic material was in the sample. The aim of this study was to evaluate the impact of Ct values among children with SARS-CoV-2 infection. Methods Between May 3, 2020 and August 3, 2020, clinical laboratory input and the data of patients with positive SARS-CoV-2 PCR tests were retrospectively studied. Results There was no statistical significance between Ct values and the patient's status, symptoms other than fever, or other laboratory findings. However, the Ct value of patients who had symptoms at the time of admission to the hospital was significantly lower. Conclusion In this study, symptomatic patients had lower Ct than asymptomatic patients that reflected higher viral loads. In evidence-based medicine applications, it might be useful to correlate the clinical history with laboratory test results. Even symptomatic patients with high Ct value coinfections, or an alternative acute infection, should be considered.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"010 - 016"},"PeriodicalIF":0.3,"publicationDate":"2022-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44051160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Selve Çınaroğlu Saka, Hale Molla Kafi, Z. Cakın, Cem Koray Firat, A. Toprak, Ö. Türel
Abstract Objective Vaccination is an important measure for the prevention of coronavirus disease 2019 (COVID-19). In the present study, we aimed to evaluate parents' attitudes toward vaccinating themselves and their children. We also searched whether information about the multisystem inflammatory syndrome in children (MIS-C), a severe complication of COVID-19, could change parents' decisions on vaccinating their children. Methods A questionnaire form consisting of sociodemographic features, COVID-19 vaccination practices, and knowledge about MIS-C was applied to parents of children attending Bezmialem Vakıf University Hospital from March through June 2022. Factors affecting vaccine hesitancy were evaluated. Results Among 383 parents, COVID-19 history was present in 248 (64.8%), and 165 (43.1%) were hesitant to vaccinate themselves. The number of cases where both parents had received at least one dose of COVID-19 vaccine was 256/354 (72.3%). The most common reasons for vaccine hesitancy were vaccines being new in 53/165 (32.1%) and fears of side effects in 95/165 (57.6%). Parents' hesitation toward vaccination of their children with the COVID-19 vaccine was highest for the 0 to 6 age group (78.9%) (73.6% in the 6–12 age group, and 47.3% in the 12–18 age group). In total, 365/383 (95.3%) parents did not have an opinion about MIS-C. After information was given, 62.5% of the 302 participants who opposed vaccinating children under 6 years changed their decision to have their children vaccinated. Conclusion Although routine childhood vaccinations were performed in 99% of children, more than half of parents were hesitant to vaccinate their children with the COVID-19 vaccine. The majority did not have an opinion about MIS-C. Briefings by pediatricians about complications of COVID-19 will help avoid vaccine hesitancy.
{"title":"Parents' Attitudes toward COVID-19 Vaccination: A Study from Two Centers in Istanbul","authors":"Selve Çınaroğlu Saka, Hale Molla Kafi, Z. Cakın, Cem Koray Firat, A. Toprak, Ö. Türel","doi":"10.1055/s-0042-1760635","DOIUrl":"https://doi.org/10.1055/s-0042-1760635","url":null,"abstract":"Abstract Objective Vaccination is an important measure for the prevention of coronavirus disease 2019 (COVID-19). In the present study, we aimed to evaluate parents' attitudes toward vaccinating themselves and their children. We also searched whether information about the multisystem inflammatory syndrome in children (MIS-C), a severe complication of COVID-19, could change parents' decisions on vaccinating their children. Methods A questionnaire form consisting of sociodemographic features, COVID-19 vaccination practices, and knowledge about MIS-C was applied to parents of children attending Bezmialem Vakıf University Hospital from March through June 2022. Factors affecting vaccine hesitancy were evaluated. Results Among 383 parents, COVID-19 history was present in 248 (64.8%), and 165 (43.1%) were hesitant to vaccinate themselves. The number of cases where both parents had received at least one dose of COVID-19 vaccine was 256/354 (72.3%). The most common reasons for vaccine hesitancy were vaccines being new in 53/165 (32.1%) and fears of side effects in 95/165 (57.6%). Parents' hesitation toward vaccination of their children with the COVID-19 vaccine was highest for the 0 to 6 age group (78.9%) (73.6% in the 6–12 age group, and 47.3% in the 12–18 age group). In total, 365/383 (95.3%) parents did not have an opinion about MIS-C. After information was given, 62.5% of the 302 participants who opposed vaccinating children under 6 years changed their decision to have their children vaccinated. Conclusion Although routine childhood vaccinations were performed in 99% of children, more than half of parents were hesitant to vaccinate their children with the COVID-19 vaccine. The majority did not have an opinion about MIS-C. Briefings by pediatricians about complications of COVID-19 will help avoid vaccine hesitancy.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"127 - 131"},"PeriodicalIF":0.3,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42390365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olugbenga Akinrinoye, A. Labaeka, Kayode Raphael Fowobaje, H. Graham, A. Falade
Abstract Objective Community-acquired pneumonia (CAP) is the commonest cause of death in under-5 children worldwide. Although the mortality from CAP has decreased over the last decade, it is still unacceptably high in lower-middle-income countries (LMICs). We aimed to determine the case fatality rate (CFR), and factors associated with treatment failure and outcome, using recommended antimicrobials. Methods A 5-year retrospective review of severe pediatric pneumonia admissions between August 1st, 2014 and July 31st, 2019 at the University College Hospital, Ibadan, Nigeria was conducted. Relevant clinical information including antibiotics use and outcome was analyzed using descriptive statistics, test of association, and logistic regression. Results There were 588 children aged 2 to 59 months, male:female ratio was 1.5:1. About two-thirds were aged ≤12 months. The majority were fully immunized for age (87.2%), about 34% were malnourished and 68% were hypoxemic at presentation. Only 71% of children were commenced on the recommended first-line antibiotics following the Pediatric Association of Nigeria (PAN) antibiotic guidelines. Initial antibiotics were changed in 22.3% of the patients. The need to change intravenous (iv) amoxicillin plus iv gentamicin was necessary in 23.80% compared with 18.1% for iv cefuroxime plus iv gentamicin. Severe acute malnutrition (odds ratio [OR]: 2.8 [95% confidence interval [CI]: 1.1–7.3]) and hypoxemia (OR:2.3 [95%CI: 1.0–5.6]) were independently associated with antibiotics change. The CFR was 1.36%. Conclusion The low CFR suggests a better outcome compared with other previous studies in LMICs. However, the high rate of antibiotics changes (22.3%) was possibly due to failure of first line antibiotics; especially among malnourished and hypoxemic children. Randomized controlled trial of iv cefuroxime plus gentamicin versus iv amoxicillin plus gentamicin is recommended.
{"title":"Low Mortality among Under-5 Children with Severe Community-Acquired Pneumonia: A 5-Year Retrospective Analysis of 588 Admissions in Ibadan, Nigeria","authors":"Olugbenga Akinrinoye, A. Labaeka, Kayode Raphael Fowobaje, H. Graham, A. Falade","doi":"10.1055/s-0043-1767815","DOIUrl":"https://doi.org/10.1055/s-0043-1767815","url":null,"abstract":"Abstract Objective Community-acquired pneumonia (CAP) is the commonest cause of death in under-5 children worldwide. Although the mortality from CAP has decreased over the last decade, it is still unacceptably high in lower-middle-income countries (LMICs). We aimed to determine the case fatality rate (CFR), and factors associated with treatment failure and outcome, using recommended antimicrobials. Methods A 5-year retrospective review of severe pediatric pneumonia admissions between August 1st, 2014 and July 31st, 2019 at the University College Hospital, Ibadan, Nigeria was conducted. Relevant clinical information including antibiotics use and outcome was analyzed using descriptive statistics, test of association, and logistic regression. Results There were 588 children aged 2 to 59 months, male:female ratio was 1.5:1. About two-thirds were aged ≤12 months. The majority were fully immunized for age (87.2%), about 34% were malnourished and 68% were hypoxemic at presentation. Only 71% of children were commenced on the recommended first-line antibiotics following the Pediatric Association of Nigeria (PAN) antibiotic guidelines. Initial antibiotics were changed in 22.3% of the patients. The need to change intravenous (iv) amoxicillin plus iv gentamicin was necessary in 23.80% compared with 18.1% for iv cefuroxime plus iv gentamicin. Severe acute malnutrition (odds ratio [OR]: 2.8 [95% confidence interval [CI]: 1.1–7.3]) and hypoxemia (OR:2.3 [95%CI: 1.0–5.6]) were independently associated with antibiotics change. The CFR was 1.36%. Conclusion The low CFR suggests a better outcome compared with other previous studies in LMICs. However, the high rate of antibiotics changes (22.3%) was possibly due to failure of first line antibiotics; especially among malnourished and hypoxemic children. Randomized controlled trial of iv cefuroxime plus gentamicin versus iv amoxicillin plus gentamicin is recommended.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":"18 1","pages":"153 - 162"},"PeriodicalIF":0.3,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49358592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tugce Unalan-Altintop, Gökçe Celep, Fikriye Milletli-Sezgin, Pelin Onarer, Melih Gozukara, Işıl Bilgiç, Esra Onal, Muhammed Enis Can, Havva İpek Demir
Objective The research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly consists of adult patients, leaving its impact on children understudied. This study aims to investigate the correlations between viral load, clinical course, age, and Alpha variant (B.1.1.7) in children. Methods The study was conducted on children under the age of 18 years, who were admitted to Amasya University Sabuncuoglu Serefeddin Research and Training Hospital in Turkey between February and April 2021. ΔCt values, which were obtained by real-time polymerase chain reaction (PCR), were analyzed to estimate the viral loads of the patients. Alpha variant (B.1.1.7) positivity was determined by real-time PCR. Results There was no difference between estimated viral loads of different clinical courses (p > 0.05), or between asymptomatic and symptomatic patients (p > 0.05). Viral loads were found to decrease with increasing age (p = 0.002). Also, a higher rate of symptomatic disease was found in children under the age of 4 years (p < 0.05). Alpha variant (B.1.1.7) was not found to be associated with severe disease in children (p > 0.05). Conclusion Our results demonstrate higher viral loads and symptomatic disease in children under the age of 4 years. Alpha variant (B.1.1.7) was not found to be related to disease severity. There has not been a consensus on the vaccination of the pediatric population worldwide. More studies are needed to understand the viral kinetics of SARS-CoV-2 and its severity on children to build effective vaccination strategies in children as public health restrictions are eased.
{"title":"The Impact of Alpha Variant (B.1.1.7), Viral Load, and Age on the Clinical Course of Pediatric COVID-19 Patients","authors":"Tugce Unalan-Altintop, Gökçe Celep, Fikriye Milletli-Sezgin, Pelin Onarer, Melih Gozukara, Işıl Bilgiç, Esra Onal, Muhammed Enis Can, Havva İpek Demir","doi":"10.1055/s-0042-1750317","DOIUrl":"https://doi.org/10.1055/s-0042-1750317","url":null,"abstract":"\u0000 Objective The research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly consists of adult patients, leaving its impact on children understudied. This study aims to investigate the correlations between viral load, clinical course, age, and Alpha variant (B.1.1.7) in children.\u0000 Methods The study was conducted on children under the age of 18 years, who were admitted to Amasya University Sabuncuoglu Serefeddin Research and Training Hospital in Turkey between February and April 2021. ΔCt values, which were obtained by real-time polymerase chain reaction (PCR), were analyzed to estimate the viral loads of the patients. Alpha variant (B.1.1.7) positivity was determined by real-time PCR.\u0000 Results There was no difference between estimated viral loads of different clinical courses (p > 0.05), or between asymptomatic and symptomatic patients (p > 0.05). Viral loads were found to decrease with increasing age (p = 0.002). Also, a higher rate of symptomatic disease was found in children under the age of 4 years (p < 0.05). Alpha variant (B.1.1.7) was not found to be associated with severe disease in children (p > 0.05).\u0000 Conclusion Our results demonstrate higher viral loads and symptomatic disease in children under the age of 4 years. Alpha variant (B.1.1.7) was not found to be related to disease severity. There has not been a consensus on the vaccination of the pediatric population worldwide. More studies are needed to understand the viral kinetics of SARS-CoV-2 and its severity on children to build effective vaccination strategies in children as public health restrictions are eased.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41543398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Nassar, M. Allam, Samer Elkhayat, Y. W. Darwish, M. Shata
Objective Vitamin D has many immune benefits and because its deficiency impacts most age groups, it became a nutrient of interest in the coronavirus disease 2019 (COVID-19) era. The objective of this study was to highlight the contribution of vitamin D status to the disease severity of hospitalized pediatric patients suffering from COVID-19 infection. Methods This was a cross-sectional study that was conducted on 42 children with documented positive polymerase chain reaction for COVID-19 infection. Detailed history taking and thorough clinical examination were done for each recruited patient. Besides the laboratory and radiological assessment done for COVID-19 patients, 25 hydroxy vitamin D levels [25(OH) D] in the serum were estimated using enzyme linked immunosorbent assay. Results Using the cutoff level of 10 ng/mL, only 40% of the patients were below this level and 60% had their vitamin D level more than or equal to 10 ng/mL. Significantly more patients of the first group needed oxygen support (denoting more severe COVID-19 infection and lung involvement). The older the patients, the more evident was vitamin D deficiency among them, and 25(OH) D values were not correlated to weight for length nor weight categories in the studied series of patients suffering from COVID-19. Conclusion Vitamin D deficiency affects the severity of pediatric COVID-19 infection in hospitalized patients. It is prudent to advise vitamin D level assessment in such cases and promptly manage the patients accordingly. We recommend further studies to assess the effect of vitamin D supplementation on the clinical outcome of COVID-19 in the pediatric population and other vulnerable groups.
{"title":"Severity of Pediatric COVID-19: Role of Vitamin D","authors":"M. Nassar, M. Allam, Samer Elkhayat, Y. W. Darwish, M. Shata","doi":"10.1055/s-0042-1750312","DOIUrl":"https://doi.org/10.1055/s-0042-1750312","url":null,"abstract":"\u0000 Objective Vitamin D has many immune benefits and because its deficiency impacts most age groups, it became a nutrient of interest in the coronavirus disease 2019 (COVID-19) era. The objective of this study was to highlight the contribution of vitamin D status to the disease severity of hospitalized pediatric patients suffering from COVID-19 infection.\u0000 Methods This was a cross-sectional study that was conducted on 42 children with documented positive polymerase chain reaction for COVID-19 infection. Detailed history taking and thorough clinical examination were done for each recruited patient. Besides the laboratory and radiological assessment done for COVID-19 patients, 25 hydroxy vitamin D levels [25(OH) D] in the serum were estimated using enzyme linked immunosorbent assay.\u0000 Results Using the cutoff level of 10 ng/mL, only 40% of the patients were below this level and 60% had their vitamin D level more than or equal to 10 ng/mL. Significantly more patients of the first group needed oxygen support (denoting more severe COVID-19 infection and lung involvement). The older the patients, the more evident was vitamin D deficiency among them, and 25(OH) D values were not correlated to weight for length nor weight categories in the studied series of patients suffering from COVID-19.\u0000 Conclusion Vitamin D deficiency affects the severity of pediatric COVID-19 infection in hospitalized patients. It is prudent to advise vitamin D level assessment in such cases and promptly manage the patients accordingly. We recommend further studies to assess the effect of vitamin D supplementation on the clinical outcome of COVID-19 in the pediatric population and other vulnerable groups.","PeriodicalId":16739,"journal":{"name":"Journal of Pediatric infectious diseases","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47440784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：