Pub Date : 2023-03-10DOI: 10.7196/sajch.2023.v17i1.1929
C. van der Bijl, W. J. Steinberg, T. E. Kellerman, J. Botes, C. van Rooyen
Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing onbreastfeeding and factors that impact the decision on feeding method.Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the ageof 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infantfeeding intentions and behaviours.Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusivebreastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median duration for bothchildren was 3 months shorter. The intention to express breastmilk at work was 67.7% for Child 1 and 57.7% for Child 2; however,the actual outcome was less than half of the intention (32.0%). Most respondents (71.0%) indicated there was no dedicated area forexpressing breastmilk at their place of work.Conclusion. The intention to exclusively breastfeed was high (6 months), but the actual duration was 3 months shorter. The percentage of doctor mothers who eventually expressed breastmilk at work was less than half of those who intended to do so. Breastfeeding female doctors need more support in the postpartum period, especially when returning to work after maternity leave
{"title":"Breastfeeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa","authors":"C. van der Bijl, W. J. Steinberg, T. E. Kellerman, J. Botes, C. van Rooyen","doi":"10.7196/sajch.2023.v17i1.1929","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1929","url":null,"abstract":"Background. Doctor mothers are a high-risk group for early cessation of breastfeeding. Improving breastfeeding among doctor mothers would not only improve the wellbeing of their babies, but the experience might also enhance their advocacy for breastfeeding to patients.Objective. To describe the infant feeding intentions and behaviours of doctor mothers in Bloemfontein, South Africa, focusing onbreastfeeding and factors that impact the decision on feeding method.Methods. This was a descriptive study. The target population included female medical doctors with a biological child under the ageof 5 years, recruited via snowball sampling. Respondents completed an electronic questionnaire, answering questions regarding infantfeeding intentions and behaviours.Results. There were 104 respondents who provided information on 132 children. The median intended duration of exclusivebreastfeeding for the first-born child was 6 months and 6.5 months for the second-born, but the actual median duration for bothchildren was 3 months shorter. The intention to express breastmilk at work was 67.7% for Child 1 and 57.7% for Child 2; however,the actual outcome was less than half of the intention (32.0%). Most respondents (71.0%) indicated there was no dedicated area forexpressing breastmilk at their place of work.Conclusion. The intention to exclusively breastfeed was high (6 months), but the actual duration was 3 months shorter. The percentage of doctor mothers who eventually expressed breastmilk at work was less than half of those who intended to do so. Breastfeeding female doctors need more support in the postpartum period, especially when returning to work after maternity leave","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49266976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-10DOI: 10.7196/sajch.2023.v17i1.xx
T. C. Gcaba, R. Singh, P. Jeena
Background. The routine use of empiric antibiotics in neonates born to mothers with prolonged rupture of membranes (PROM) iscontroversial.Objectives. To determine the incidence of probable and proven sepsis in such neonates and identify risk factors for sepsis and theiroutcomes.Methods. This was a retrospective chart review conducted at King Edward VIII Hospital over two years. Study participants included 200neonates and 181 mothers. Data were captured onto Microsoft Excel, collated and analysed using descriptive statistics and comparative data utilising the R Core Team’s R Statistical Computing Software, 2020.Results. Seven neonates (3.5%) had proven sepsis, 58 (29%) had probable sepsis, and 135 (67.5%) were without sepsis. Two (1.0%) neonates died and 188 (94.0%) received antibiotics. White cell count was normal in all cases without sepsis and abnormal in 65.5% and 28.6% of cases with probable and proven sepsis, respectively. A raised C-reactive protein was observed in only 22.4% and 14.3% of neonates with probable and proven sepsis, respectively. One hundred and sixty-seven (83.5%) mothers had no Group B Streptococcus (GBS) screening. Of those screened, three had GBS infection, but two did not receive antibiotics.Conclusions. The incidence of sepsis following PROM is low. Identifying neonates at risk is challenging, but the absence of clinical features and normal rapidly obtained supportive laboratory markers of sepsis provides reassurance that antibiotics could be temporarily withheld. Better GBS screening programmes and appropriate antibiotic responses for pregnant women should be implemented rigorously.
{"title":"The value of routine empiric antibiotic use in neonates born to mothers with prolonged rupture of membranes","authors":"T. C. Gcaba, R. Singh, P. Jeena","doi":"10.7196/sajch.2023.v17i1.xx","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.xx","url":null,"abstract":"Background. The routine use of empiric antibiotics in neonates born to mothers with prolonged rupture of membranes (PROM) iscontroversial.Objectives. To determine the incidence of probable and proven sepsis in such neonates and identify risk factors for sepsis and theiroutcomes.Methods. This was a retrospective chart review conducted at King Edward VIII Hospital over two years. Study participants included 200neonates and 181 mothers. Data were captured onto Microsoft Excel, collated and analysed using descriptive statistics and comparative data utilising the R Core Team’s R Statistical Computing Software, 2020.Results. Seven neonates (3.5%) had proven sepsis, 58 (29%) had probable sepsis, and 135 (67.5%) were without sepsis. Two (1.0%) neonates died and 188 (94.0%) received antibiotics. White cell count was normal in all cases without sepsis and abnormal in 65.5% and 28.6% of cases with probable and proven sepsis, respectively. A raised C-reactive protein was observed in only 22.4% and 14.3% of neonates with probable and proven sepsis, respectively. One hundred and sixty-seven (83.5%) mothers had no Group B Streptococcus (GBS) screening. Of those screened, three had GBS infection, but two did not receive antibiotics.Conclusions. The incidence of sepsis following PROM is low. Identifying neonates at risk is challenging, but the absence of clinical features and normal rapidly obtained supportive laboratory markers of sepsis provides reassurance that antibiotics could be temporarily withheld. Better GBS screening programmes and appropriate antibiotic responses for pregnant women should be implemented rigorously.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46743554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-10DOI: 10.7196/sajch.2023.v17i1.1779
D. Abdou, L. Selim, R. Coster, J. Smet, G. Nakhla, D. Mehaney
Background. Mitochondrial respiratory chain (RC) disorders are a growing group of disorders with a large variety of clinical presentations ranging from well-defined clinical syndromes to nonspecific manifestations, such as failure to thrive, exercise intolerance and seizures.Objective. To describe the clinical, biochemical, and histochemical spectrum of 38 Egyptian patients clinically suspected of havingmitochondrial RC disorders.Methods. A total of 38 patients (female, n=18 (47.4%); male, n=20 (52.6%)) clinically suspected of having mitochondrial diseases had been referred to the Inherited Metabolic Diseases Laboratory at Cairo University Children’s Hospital. Laboratory investigations and analyses included histochemical staining of cytochrome c oxidase and succinate dehydrogenase in muscle biopsies, as well as spectrophotometric assays of RC complexes in muscle homogenates.Results. Twenty-three patients (60.5%) were diagnosed with different RC enzyme deficiencies. Fifteen patients (65%) had complex Ideficiency and all of them also had lactic acidosis (mean (standard deviation)) plasma lactate concentration of 4 (1.65) mmol/L). Twopatients (9%) with marked complex IV deficiency both showed COX-negative ragged red fibers (RRFs) on histochemical staining.Combined complex I and complex II deficiency with scattered COX-stain deficiency and RRFs was diagnosed in 2 patients (5.25%), whilea further 2 patients (5.26%) had combined (complex I, II+III, complex IV) deficiencies. Isolated complex II deficiency was diagnosed in2 patients (5.26%) and 15 (39.5%) patients had normal RC enzyme activities.Conclusion. Biochemical assay of RC complexes is considered the cornerstone for diagnosis of RC complex mitochondrial disorders.These disorders are common among Egyptian paediatric patients.
{"title":"Clinical, biochemical, and histopathological diagnosis of Egyptian paediatric patients with suspected mitochondrial diseases: A hospital‑based study","authors":"D. Abdou, L. Selim, R. Coster, J. Smet, G. Nakhla, D. Mehaney","doi":"10.7196/sajch.2023.v17i1.1779","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1779","url":null,"abstract":"Background. Mitochondrial respiratory chain (RC) disorders are a growing group of disorders with a large variety of clinical presentations ranging from well-defined clinical syndromes to nonspecific manifestations, such as failure to thrive, exercise intolerance and seizures.Objective. To describe the clinical, biochemical, and histochemical spectrum of 38 Egyptian patients clinically suspected of havingmitochondrial RC disorders.Methods. A total of 38 patients (female, n=18 (47.4%); male, n=20 (52.6%)) clinically suspected of having mitochondrial diseases had been referred to the Inherited Metabolic Diseases Laboratory at Cairo University Children’s Hospital. Laboratory investigations and analyses included histochemical staining of cytochrome c oxidase and succinate dehydrogenase in muscle biopsies, as well as spectrophotometric assays of RC complexes in muscle homogenates.Results. Twenty-three patients (60.5%) were diagnosed with different RC enzyme deficiencies. Fifteen patients (65%) had complex Ideficiency and all of them also had lactic acidosis (mean (standard deviation)) plasma lactate concentration of 4 (1.65) mmol/L). Twopatients (9%) with marked complex IV deficiency both showed COX-negative ragged red fibers (RRFs) on histochemical staining.Combined complex I and complex II deficiency with scattered COX-stain deficiency and RRFs was diagnosed in 2 patients (5.25%), whilea further 2 patients (5.26%) had combined (complex I, II+III, complex IV) deficiencies. Isolated complex II deficiency was diagnosed in2 patients (5.26%) and 15 (39.5%) patients had normal RC enzyme activities.Conclusion. Biochemical assay of RC complexes is considered the cornerstone for diagnosis of RC complex mitochondrial disorders.These disorders are common among Egyptian paediatric patients.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46272392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-21DOI: 10.7196/sajch.2023.v17i1.1884
T. Mabelane, Cert. Allerg, M. C. Khaba, FC Path, E. Kiragu, MMed Paeds
Cow’s milk allergy (CMA) is one of the most common food allergies in the first years of life. CMA is classified as immunoglobulin E (IgE)or non-IgE-mediated reactions. IgE-mediated reactions are typically of immediate onset, with symptoms manifesting within 2 hours after ingestion. However, non-IgE-mediated reactions are delayed and mostly occur between 2 and 48 hours post exposure. This report describes a 17-year-old who presented with a long-standing history of pustular lesions immediately after cow’s milk ingestion. Allergy tests, which included skin-prick test (SPT); specific IgE to cow’s milk; cow’s milk IgE components; and Cellular antigen stimulation test (CAST) yielded insignificant results. However, an oral food challenge resulted in pustular lesions and abdominal pain within 30 and 120 minutes, respectively. A swab from a pustule cultured Staphylococcus aureus. CMA was confirmed and managed with dietary restriction. It is uncommon for non- IgE reactions to occur with immediate symptoms. S. aureus may be associated with atypical skin manifestation of CMA.
{"title":"An atypical presentation of non-IgE-mediated cow’s milk allergy associated with Staphylococcus aureus: A case study","authors":"T. Mabelane, Cert. Allerg, M. C. Khaba, FC Path, E. Kiragu, MMed Paeds","doi":"10.7196/sajch.2023.v17i1.1884","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1884","url":null,"abstract":"Cow’s milk allergy (CMA) is one of the most common food allergies in the first years of life. CMA is classified as immunoglobulin E (IgE)or non-IgE-mediated reactions. IgE-mediated reactions are typically of immediate onset, with symptoms manifesting within 2 hours after ingestion. However, non-IgE-mediated reactions are delayed and mostly occur between 2 and 48 hours post exposure. This report describes a 17-year-old who presented with a long-standing history of pustular lesions immediately after cow’s milk ingestion. Allergy tests, which included skin-prick test (SPT); specific IgE to cow’s milk; cow’s milk IgE components; and Cellular antigen stimulation test (CAST) yielded insignificant results. However, an oral food challenge resulted in pustular lesions and abdominal pain within 30 and 120 minutes, respectively. A swab from a pustule cultured Staphylococcus aureus. CMA was confirmed and managed with dietary restriction. It is uncommon for non- IgE reactions to occur with immediate symptoms. S. aureus may be associated with atypical skin manifestation of CMA.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46737143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-21DOI: 10.7196/sajch.2023.v17i1.1885
S. Mansoor, K. Petersen, UK Kala, P. Mosiane
Background. Crescentic glomerulonephritis (CGN) as a cause of progressive renal failure is rare. Crescent formation on kidney biopsyrepresents a response to injury of the glomerular capillary walls. There are limited published reports on paediatric CGN in Africa.Objectives. To describe the clinical presentation and outcome of children with CGN in Soweto, South Africa, over a 22-year period.Methods. A retrospective study was conducted at the Paediatric Renal Unit at Chris Hani Baragwanath Academic Hospital. Childrenyounger than 14 years with crescent formation in more than 50% of glomeruli on renal biopsy were included in the study. Kidney biopsy specimens were examined by light microscopy, immunofluorescence and electron microscopy. Demographic and clinical data were extracted from the patient files.Results. During the study period, 961 kidney biopsies were performed. Fourteen patients (1.5%) met inclusion criteria of crescents in>50% of glomeruli. Common clinical findings were oedema (n=13; 93%), microscopic haematuria (n=12; 86%), hypertension (n=11; 79%)and proteinuria (n=10; 71%). The median estimated glomerular filtration rate (eGFR) at presentation was 23.9 mL/min/1.73m2. Thirteen patients (93%) had immune-complex-mediated glomerulonephritis. The underlying cause was acute post-infectious glomerulonephritis in 9 patients (64%), membranoproliferative glomerulonephritis and IgA nephropathy in 2 patients each (14%) and global sclerosis in 1 patient (7%). Prolonged duration of symptoms resulted in a lower eGFR at follow-up. Treatment included peritoneal dialysis, methylprednisolone and cyclophosphamide. Seven (54%) patients had a normal eGFR at a median (range) follow-up of 36.7 (4.5 - 61.5) months. Six (46%) patients had progressed to chronic kidney disease stages 2 - 5. One patient was followed up for less than 3 months, and therefore was not included in the follow-up results.Conclusion. Poor outcomes were observed in patients who presented late. The clinical findings of haematuria, hypertension and acutekidney injury warrant early referral and kidney biopsy to determine management.
{"title":"Crescentic glomerulonephritis in children: A retrospective review of data from Chris Hani Baragwanath Academic Hospital","authors":"S. Mansoor, K. Petersen, UK Kala, P. Mosiane","doi":"10.7196/sajch.2023.v17i1.1885","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1885","url":null,"abstract":"Background. Crescentic glomerulonephritis (CGN) as a cause of progressive renal failure is rare. Crescent formation on kidney biopsyrepresents a response to injury of the glomerular capillary walls. There are limited published reports on paediatric CGN in Africa.Objectives. To describe the clinical presentation and outcome of children with CGN in Soweto, South Africa, over a 22-year period.Methods. A retrospective study was conducted at the Paediatric Renal Unit at Chris Hani Baragwanath Academic Hospital. Childrenyounger than 14 years with crescent formation in more than 50% of glomeruli on renal biopsy were included in the study. Kidney biopsy specimens were examined by light microscopy, immunofluorescence and electron microscopy. Demographic and clinical data were extracted from the patient files.Results. During the study period, 961 kidney biopsies were performed. Fourteen patients (1.5%) met inclusion criteria of crescents in>50% of glomeruli. Common clinical findings were oedema (n=13; 93%), microscopic haematuria (n=12; 86%), hypertension (n=11; 79%)and proteinuria (n=10; 71%). The median estimated glomerular filtration rate (eGFR) at presentation was 23.9 mL/min/1.73m2. Thirteen patients (93%) had immune-complex-mediated glomerulonephritis. The underlying cause was acute post-infectious glomerulonephritis in 9 patients (64%), membranoproliferative glomerulonephritis and IgA nephropathy in 2 patients each (14%) and global sclerosis in 1 patient (7%). Prolonged duration of symptoms resulted in a lower eGFR at follow-up. Treatment included peritoneal dialysis, methylprednisolone and cyclophosphamide. Seven (54%) patients had a normal eGFR at a median (range) follow-up of 36.7 (4.5 - 61.5) months. Six (46%) patients had progressed to chronic kidney disease stages 2 - 5. One patient was followed up for less than 3 months, and therefore was not included in the follow-up results.Conclusion. Poor outcomes were observed in patients who presented late. The clinical findings of haematuria, hypertension and acutekidney injury warrant early referral and kidney biopsy to determine management.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49513118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-21DOI: 10.7196/sajch.2023.v17i1.1939
M. Selse, RT Saggers, E. Hentz, A. Elfvin, DE Ballot
Background. Necrotising enterocolitis (NEC) is an inflammatory disease almost exclusively affecting preterm infants. Previous research has presented a higher mortality rate in infants requiring surgical treatment compared with infants receiving medical treatment. However, the knowledge of mortality and morbidity of the disease in low- and middle-income countries is still limited.Objectives. To review infants with NEC admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH),determine a potential difference in mortality between medically and surgically treated infants, and to identify characteristics and factors associated with mortality among these infants.Methods. This retrospective study described infants with NEC born between 1 January 2016 and 31 December 2018 who were admittedto the neonatal unit. The characteristics and survival of these infants were compared using univariate and multivariate analyses.Results. During the study period, 5 061 infants were admitted to the neonatal unit, of which 218 infants were diagnosed with NEC.The period prevalence of NEC was 4.3% among all neonatal infants and 11.0% among very-low-birthweight (VLBW) infants. Mortalitywas significantly higher among surgically treated infants with NEC compared with medically treated infants (p=0.025, odds ratio 1.888(95% confidence interval 1.082 - 3.296)). Late-onset sepsis was significantly more common among VLBW infants with NEC (71.3%)compared with VLBW infants without NEC (27.1%). Among infants with late-onset sepsis, Gram-negative bacteria, multidrug-resistantbacteria and fungal sepsis was significantly more common in the group of infants with NEC.Conclusions. Infants with NEC treated surgically at CMJAH have an increased risk of dying compared with those receiving medicaltreatment, likely due to the severity of disease. Furthermore, this study emphasised the burden of sepsis among infants with NEC and may contribute to a better knowledge of NEC in South Africa.
{"title":"Outcome of infants with necrotising enterocolitis at Charlotte Maxeke Johannesburg Academic Hospital, South Africa","authors":"M. Selse, RT Saggers, E. Hentz, A. Elfvin, DE Ballot","doi":"10.7196/sajch.2023.v17i1.1939","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1939","url":null,"abstract":"Background. Necrotising enterocolitis (NEC) is an inflammatory disease almost exclusively affecting preterm infants. Previous research has presented a higher mortality rate in infants requiring surgical treatment compared with infants receiving medical treatment. However, the knowledge of mortality and morbidity of the disease in low- and middle-income countries is still limited.Objectives. To review infants with NEC admitted to the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH),determine a potential difference in mortality between medically and surgically treated infants, and to identify characteristics and factors associated with mortality among these infants.Methods. This retrospective study described infants with NEC born between 1 January 2016 and 31 December 2018 who were admittedto the neonatal unit. The characteristics and survival of these infants were compared using univariate and multivariate analyses.Results. During the study period, 5 061 infants were admitted to the neonatal unit, of which 218 infants were diagnosed with NEC.The period prevalence of NEC was 4.3% among all neonatal infants and 11.0% among very-low-birthweight (VLBW) infants. Mortalitywas significantly higher among surgically treated infants with NEC compared with medically treated infants (p=0.025, odds ratio 1.888(95% confidence interval 1.082 - 3.296)). Late-onset sepsis was significantly more common among VLBW infants with NEC (71.3%)compared with VLBW infants without NEC (27.1%). Among infants with late-onset sepsis, Gram-negative bacteria, multidrug-resistantbacteria and fungal sepsis was significantly more common in the group of infants with NEC.Conclusions. Infants with NEC treated surgically at CMJAH have an increased risk of dying compared with those receiving medicaltreatment, likely due to the severity of disease. Furthermore, this study emphasised the burden of sepsis among infants with NEC and may contribute to a better knowledge of NEC in South Africa.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41558132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-21DOI: 10.7196/sajch.2023.v17i1.1942
K. Flack, M. Hauptfleisch, L. Scher
Background. Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder that is present in all populations andresults in muscle weakness owing to anterior horn cell degeneration. SMA is divided into three clinical subtypes and is an importantgenetic cause of morbidity and mortality but has not been well studied in sub-Saharan Africa.Objective. This study aims to describe the clinical features and genetic findings in black patients with SMA presenting to the Division ofPaediatric Neurology at Chris Hani Baragwanath Academic Hospital (CHBAH) over a 30-year period.Method. This study was a retrospective review of patient records. The study population was black paediatric neurology patients withclinical SMA, who attended CHBAH Neurology Clinic between 1988 and 2018. Patients were categorised into SMA type 1, 2 or 3 basedon their neurology assessment and clinical features were recorded.Results. The clinical findings in the study population (with SMA), i.e. hypotonia, areflexia and tongue fasciculations, were similar to those found in international studies. More than half of the patients (65.6%; n=86/131) had genetic tests, of which 84.8% were positive for SMA. This value was significantly higher than previously reported results from South Africa. At least 23.6% (n=31/131) had facial involvement.Conclusions. This study adds to the limited body of research on SMA in sub-Saharan Africa and highlights the lower frequency of ahomozygous deletion seen in the black South African population compared with the expected 95% worldwide.
{"title":"A review of spinal muscular atrophy in black South African paediatric patients","authors":"K. Flack, M. Hauptfleisch, L. Scher","doi":"10.7196/sajch.2023.v17i1.1942","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1942","url":null,"abstract":"Background. Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder that is present in all populations andresults in muscle weakness owing to anterior horn cell degeneration. SMA is divided into three clinical subtypes and is an importantgenetic cause of morbidity and mortality but has not been well studied in sub-Saharan Africa.Objective. This study aims to describe the clinical features and genetic findings in black patients with SMA presenting to the Division ofPaediatric Neurology at Chris Hani Baragwanath Academic Hospital (CHBAH) over a 30-year period.Method. This study was a retrospective review of patient records. The study population was black paediatric neurology patients withclinical SMA, who attended CHBAH Neurology Clinic between 1988 and 2018. Patients were categorised into SMA type 1, 2 or 3 basedon their neurology assessment and clinical features were recorded.Results. The clinical findings in the study population (with SMA), i.e. hypotonia, areflexia and tongue fasciculations, were similar to those found in international studies. More than half of the patients (65.6%; n=86/131) had genetic tests, of which 84.8% were positive for SMA. This value was significantly higher than previously reported results from South Africa. At least 23.6% (n=31/131) had facial involvement.Conclusions. This study adds to the limited body of research on SMA in sub-Saharan Africa and highlights the lower frequency of ahomozygous deletion seen in the black South African population compared with the expected 95% worldwide.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47366095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-16DOI: 10.7196/sajch.2023.v17i1.1958
AO Olajide-Ibiejugba, V. Nkosi, F. Rathogwa-Takalani, J. Shirinde, J. Wichmann, R. Green, K. Voyi
Proper asthma control can lessen the negative effects of asthma in adolescents, such that they can lead a normal and physically activelife. The study aimed to compare self-reported asthma control and actual test scores among adolescents in the inner provinces (Gauteng and North West) of South Africa. The asthma control test (ACT) questionnaire was administered to 123 of adolescents who had reported doctor-diagnosed asthma during the cross-sectional study. There was a statistically significant difference between self-reported asthma control and actual test scores among study participants (p=0.003). Out of the 90 study participants who claimed that their asthma was controlled, only 25 (27.78%) were correctly classified as ‘controlled’ according to the ACT. A high percentage (72.22%) of adolescents misclassified their asthma as ‘controlled’, whereas it was not. There is a lack of studies on asthma control in Africa.
{"title":"Asthma control among adolescents in the inner provinces of South Africa: Perception v. reality","authors":"AO Olajide-Ibiejugba, V. Nkosi, F. Rathogwa-Takalani, J. Shirinde, J. Wichmann, R. Green, K. Voyi","doi":"10.7196/sajch.2023.v17i1.1958","DOIUrl":"https://doi.org/10.7196/sajch.2023.v17i1.1958","url":null,"abstract":"Proper asthma control can lessen the negative effects of asthma in adolescents, such that they can lead a normal and physically activelife. The study aimed to compare self-reported asthma control and actual test scores among adolescents in the inner provinces (Gauteng and North West) of South Africa. The asthma control test (ACT) questionnaire was administered to 123 of adolescents who had reported doctor-diagnosed asthma during the cross-sectional study. There was a statistically significant difference between self-reported asthma control and actual test scores among study participants (p=0.003). Out of the 90 study participants who claimed that their asthma was controlled, only 25 (27.78%) were correctly classified as ‘controlled’ according to the ACT. A high percentage (72.22%) of adolescents misclassified their asthma as ‘controlled’, whereas it was not. There is a lack of studies on asthma control in Africa.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41750546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-15DOI: 10.7196/sajch.2022.v16i4.1856
R. Singh, M. Adhikiri, P. Tinarwo, P. Jeena
Background. Meconium aspiration syndrome (MAS) occurs in approximately 5% of babies born through meconium-stained amniotic fluid. Risk factors associated with severity of MAS in neonates from developing countries has been infrequently described. Objective. To identify incidence and risk factors associated with the severity of MAS in a lower middle-income country. Method. A retrospective descriptive analysis was conducted on records of neonates diagnosed with MAS at four regional hospitals in the eThekwini district of KwaZulu-Natal, South Africa, between 1 January 2015 and 31 December 2017. Results. A total of 187 neonates had been diagnosed with MAS, of whom 157 survived. The overall incidence of MAS was 2 per 1 000 live births. All the neonates were born through thick meconium. The majority (n=119, 63.6%) of patients were male. Asphyxia was documented in 97 cases (51.9%) and was significantly associated with severe disease (p<0.001). Seizures were noted in 91patients (48.7%), of which 86 (94.5%) occurred in neonates with asphyxia. A quarter of the sample (n=47, 25%) were outborn, with severe disease associated significantly with this group (p=0.025). Multiple logistic regression showed that the occurrence of seizures was significantly associated with severe MAS, (adjusted odds ratio = 23.7, 95% confidence interval 7.58 - 97.7; p<0.001). Conclusion. Neonates born through thick meconium, with moderate to severe asphyxia that is associated with seizures are at increased risk of developing severe MAS. Close monitoring of labour in the intrapartum period, early recognition of fetal distress and timely obstetric intervention are crucial to prevent asphyxia.
{"title":"Epidemiology and risk factors for acquiring and predicting disease severity in meconium aspiration syndrome","authors":"R. Singh, M. Adhikiri, P. Tinarwo, P. Jeena","doi":"10.7196/sajch.2022.v16i4.1856","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i4.1856","url":null,"abstract":"Background. Meconium aspiration syndrome (MAS) occurs in approximately 5% of babies born through meconium-stained amniotic fluid. Risk factors associated with severity of MAS in neonates from developing countries has been infrequently described. \u0000Objective. To identify incidence and risk factors associated with the severity of MAS in a lower middle-income country. \u0000Method. A retrospective descriptive analysis was conducted on records of neonates diagnosed with MAS at four regional hospitals in the eThekwini district of KwaZulu-Natal, South Africa, between 1 January 2015 and 31 December 2017. \u0000Results. A total of 187 neonates had been diagnosed with MAS, of whom 157 survived. The overall incidence of MAS was 2 per 1 000 live births. All the neonates were born through thick meconium. The majority (n=119, 63.6%) of patients were male. Asphyxia was documented in 97 cases (51.9%) and was significantly associated with severe disease (p<0.001). Seizures were noted in 91patients (48.7%), of which 86 (94.5%) occurred in neonates with asphyxia. A quarter of the sample (n=47, 25%) were outborn, with severe disease associated significantly with this group (p=0.025). Multiple logistic regression showed that the occurrence of seizures was significantly associated with severe MAS, (adjusted odds ratio = 23.7, 95% confidence interval 7.58 - 97.7; p<0.001). \u0000Conclusion. Neonates born through thick meconium, with moderate to severe asphyxia that is associated with seizures are at increased risk of developing severe MAS. Close monitoring of labour in the intrapartum period, early recognition of fetal distress and timely obstetric intervention are crucial to prevent asphyxia. ","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42011916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-15DOI: 10.7196/sajch.2022.v16i4.1875
A. Harper, A. Rothberg, E. Chirwa, S. Mall
Background. Literature is inconclusive regarding an association between maternal depression, low birthweight (LBW) and stunting in early childhood. While some studies have found an association, others have not. Maternal food insecurity is a risk factor for both maternal depression and reduced linear growth in early childhood. Objective. This study examined the relationship between maternal depression, food insecurity, LBW and stunting in the first five years of life. The study employed longitudinal data of South African women and children from the National Income Dynamics Study (NIDS). Methods. Mothers were classified into four groups: food insecure and depressed; food insecure only; depressed only; and neither food insecure nor depressed. During data collection, 22% of women were pregnant and the remaining 78% were pre-conception. The primary outcomes were low birthweight and height-for-age (HAZ) scores. Generalised Linear Mixed Effects (GLME) models were used to account for women having more than one child. GLME models with a Gaussian link function were used to compare mean differences in birthweight and HAZ scores. Multivariable regression models were used to examine factors associated with depression. Results. Food insecurity was significantly associated with depression among pre-conceptional and pregnant women. There was no statistically significant difference in birthweight or linear growth across groups, but this may be influenced by proximity of depression measurement in relation to outcomes. Conclusion. Food insecurity is a potentially modifiable risk factor for depression and may be a confounding factor in studies that have found associations between depression and child health outcomes.
{"title":"Examining maternal depression, birthweight and linear growth: Findings from the South African National Income Dynamics Study","authors":"A. Harper, A. Rothberg, E. Chirwa, S. Mall","doi":"10.7196/sajch.2022.v16i4.1875","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i4.1875","url":null,"abstract":"Background. Literature is inconclusive regarding an association between maternal depression, low birthweight (LBW) and stunting in early childhood. While some studies have found an association, others have not. Maternal food insecurity is a risk factor for both maternal depression and reduced linear growth in early childhood. \u0000Objective. This study examined the relationship between maternal depression, food insecurity, LBW and stunting in the first five years of life. The study employed longitudinal data of South African women and children from the National Income Dynamics Study (NIDS). \u0000Methods. Mothers were classified into four groups: food insecure and depressed; food insecure only; depressed only; and neither food insecure nor depressed. During data collection, 22% of women were pregnant and the remaining 78% were pre-conception. The primary outcomes were low birthweight and height-for-age (HAZ) scores. Generalised Linear Mixed Effects (GLME) models were used to account for women having more than one child. GLME models with a Gaussian link function were used to compare mean differences in birthweight and HAZ scores. Multivariable regression models were used to examine factors associated with depression. \u0000Results. Food insecurity was significantly associated with depression among pre-conceptional and pregnant women. There was no statistically significant difference in birthweight or linear growth across groups, but this may be influenced by proximity of depression measurement in relation to outcomes. \u0000Conclusion. Food insecurity is a potentially modifiable risk factor for depression and may be a confounding factor in studies that have found associations between depression and child health outcomes. ","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47573287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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