Pub Date : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1783
R. E. Drysdale, W. Slemming, T. Makusha, L. Richter
Background. Despite international evidence highlighting the benefits of male partners attending antenatal visits, including pregnancy ultrasound scans, it is unusual for South African (SA) men to attend such visits, and little is known about their experiences if they do. Objectives. To explore the experiences and antenatal attachment among male partners who attend early pregnancy ultrasound examinations in Soweto, SA. Methods. Pregnant women attending ultrasound examinations were invited to bring their partners with them. Both completed individual questionnaires, including the antenatal attachment scale. The results are based on a descriptive analysis of 102 mother-partner pairs. Results. The mean age of partners was 35 years. Only 32% of men were living with their pregnant partner. Before the ultrasound scan, 64% of men reported feeling very anxious, while 54% also felt anxious after the procedure. The ultrasound examination had a positive effect on men and their thoughts regarding their developing baby, with 30% stating that they were ready or excited to be a father. Twenty-eight percent believed their relationship with the mother was stronger as a result of participating in antenatal care. Conclusions. We found that prenatal ultrasound scans had a positive effect on male partners and their thoughts about the pregnancy, their forthcoming child and their relationship with and support for their partner. Health services in SA should accommodate partners/ fathers and encourage them to attend antenatal care, including pregnancy ultrasound scans. Interventions are needed to encourage more men to be involved – from conception – potentially addressing individual, familial, societal and structural barriers to involvement of the father in long-term maternal and child care.
{"title":"Male partners’ experiences of early pregnancy ultrasound scans in Soweto, South Africa: The Healthy Pregnancy, Healthy Baby randomised trial","authors":"R. E. Drysdale, W. Slemming, T. Makusha, L. Richter","doi":"10.7196/sajch.2022.v16i2.1783","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1783","url":null,"abstract":"Background. Despite international evidence highlighting the benefits of male partners attending antenatal visits, including pregnancy ultrasound scans, it is unusual for South African (SA) men to attend such visits, and little is known about their experiences if they do. \u0000Objectives. To explore the experiences and antenatal attachment among male partners who attend early pregnancy ultrasound examinations in Soweto, SA. \u0000Methods. Pregnant women attending ultrasound examinations were invited to bring their partners with them. Both completed individual questionnaires, including the antenatal attachment scale. The results are based on a descriptive analysis of 102 mother-partner pairs. \u0000Results. The mean age of partners was 35 years. Only 32% of men were living with their pregnant partner. Before the ultrasound scan, 64% of men reported feeling very anxious, while 54% also felt anxious after the procedure. The ultrasound examination had a positive effect on men and their thoughts regarding their developing baby, with 30% stating that they were ready or excited to be a father. Twenty-eight percent believed their relationship with the mother was stronger as a result of participating in antenatal care. \u0000Conclusions. We found that prenatal ultrasound scans had a positive effect on male partners and their thoughts about the pregnancy, their forthcoming child and their relationship with and support for their partner. Health services in SA should accommodate partners/ fathers and encourage them to attend antenatal care, including pregnancy ultrasound scans. Interventions are needed to encourage more men to be involved – from conception – potentially addressing individual, familial, societal and structural barriers to involvement of the father in long-term maternal and child care.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43366529","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1805
L. Arendse, D. Brits, E. Lambert, V. Gibbon
In South Africa (SA), it has been estimated that one-third of boys and 25% of girls under the age of 5 years are stunted, according to the World Health Organization (WHO) Multicentre Growth Reference Study. During the past decade, research in developed and developing countries has shown that the international growth standard overestimates stunting and/or wasting when compared with population-specific growth references. Population-specific growth references typically incorporate genetic and environmental factors and can therefore better inform public health by identifying children who may be at risk for malnutrition, or who may be ill. Using the universal growth standard in SA may not be accurately assessing growth. In this article, environmental and genetic factors, and their influence on growth, are reviewed. These points are illustrated through a brief history of the peopling of SA, with an understanding of the socioeconomic and political climate – past and present. We discuss the uniqueness of certain population groups in SA, with contributions regarding some of the shortest peoples in the world and a history of sociopolitical inequities, which may mean that children from certain population groups who are perfectly healthy would underperform using the universal growth standard. Therefore, we suggest that a local population-specific growth reference would serve to better inform public health policies, and address childhood health equity and physical developmental pathways to adult health risk status.
{"title":"Is the World Health Organization’s multicentre child growth standard an appropriate growth reference for assessing optimal growth of South African mixed-ancestry children?","authors":"L. Arendse, D. Brits, E. Lambert, V. Gibbon","doi":"10.7196/sajch.2022.v16i2.1805","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1805","url":null,"abstract":"\u0000In South Africa (SA), it has been estimated that one-third of boys and 25% of girls under the age of 5 years are stunted, according to the World Health Organization (WHO) Multicentre Growth Reference Study. During the past decade, research in developed and developing countries has shown that the international growth standard overestimates stunting and/or wasting when compared with population-specific growth references. Population-specific growth references typically incorporate genetic and environmental factors and can therefore better inform public health by identifying children who may be at risk for malnutrition, or who may be ill. Using the universal growth standard in SA may not be accurately assessing growth. In this article, environmental and genetic factors, and their influence on growth, are reviewed. These points are illustrated through a brief history of the peopling of SA, with an understanding of the socioeconomic and political climate – past and present. We discuss the uniqueness of certain population groups in SA, with contributions regarding some of the shortest peoples in the world and a history of sociopolitical inequities, which may mean that children from certain population groups who are perfectly healthy would underperform using the universal growth standard. Therefore, we suggest that a local population-specific growth reference would serve to better inform public health policies, and address childhood health equity and physical developmental pathways to adult health risk status. \u0000 \u0000 ","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45584771","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1878
K. Storm, M. van Dyk, A. V. van As
Background. Infants are entirely dependent on their caregivers, especially <6 months old when they are not yet mobile. While the epidemiology of injury among children in general has been described, the exact causes of infant injury have never been investigated in South Africa (SA). Objective. To describe causes of injury in infants aged <12 months, stratified for the four quarters of the first year of life, in order to identify opportunities for targeted prevention strategies based on local data. Methods. This retrospective audit study used data collected by ChildSafe SA from the Red Cross War Memorial Children’s Hospital in Cape Town, SA, over a 4-year period from January 2013 to December 2016. Infants <1 year of age presenting to the hospital’s trauma casualty department were included. Additionally, mortuary data on traumatic infant deaths in the hospital’s catchment area were collected. Results. A total of 2 279 injured infants were identified. More than half were male (55%; n=1 250) and the median age was 8 months (interquartile range 5 - 10 months). Leading causes of injury were falls (42%; n=957) and burns (32%; n=736). A significant association between the age group and the cause of injury (p<0.001) was found. From 2014 to 2016, an additional 27 infants were traumatically injured and died before arriving at the hospital. Conclusion. Falls and burns are a significant contributor to the burden of infant injuries in Cape Town. This underlines the urgent need for targeted prevention strategies to improve safety, taking poverty into account.
{"title":"Infant injuries treated at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa","authors":"K. Storm, M. van Dyk, A. V. van As","doi":"10.7196/sajch.2022.v16i2.1878","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1878","url":null,"abstract":"Background. Infants are entirely dependent on their caregivers, especially <6 months old when they are not yet mobile. While the epidemiology of injury among children in general has been described, the exact causes of infant injury have never been investigated in South Africa (SA). \u0000Objective. To describe causes of injury in infants aged <12 months, stratified for the four quarters of the first year of life, in order to identify opportunities for targeted prevention strategies based on local data. \u0000Methods. This retrospective audit study used data collected by ChildSafe SA from the Red Cross War Memorial Children’s Hospital in Cape Town, SA, over a 4-year period from January 2013 to December 2016. Infants <1 year of age presenting to the hospital’s trauma casualty department were included. Additionally, mortuary data on traumatic infant deaths in the hospital’s catchment area were collected. \u0000Results. A total of 2 279 injured infants were identified. More than half were male (55%; n=1 250) and the median age was 8 months (interquartile range 5 - 10 months). Leading causes of injury were falls (42%; n=957) and burns (32%; n=736). A significant association between the age group and the cause of injury (p<0.001) was found. From 2014 to 2016, an additional 27 infants were traumatically injured and died before arriving at the hospital. \u0000Conclusion. Falls and burns are a significant contributor to the burden of infant injuries in Cape Town. This underlines the urgent need for targeted prevention strategies to improve safety, taking poverty into account.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44976472","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1791
K. Fiddler, K. Pillay
Background. Healthcare workers play an important role in educating mothers living with HIV regarding appropriate infant and young child feeding (IYCF) practices. However, it is not known if healthcare workers in eThekwini, KwaZulu-Natal (KZN), have been adequately trained regarding IYCF in the context of HIV and how knowledgeable and confident they are. Objectives. To assess the training, confidence and knowledge of healthcare workers regarding IYCF in the context of HIV. Methods. This was a descriptive cross-sectional study, which used a self-administered questionnaire developed for this survey. Healthcare workers (n=188), primarily doctors and nurses in antiretroviral, antenatal and paediatric departments at three regional hospitals (Addington Hospital, Prince Mshiyeni Memorial Hospital and RK Khan Hospital) in eThekwini, KZN, participated. Results. Only 47.3% (n=89) of the participants had attended formal training on IYCF in the context of HIV. Most participants (n=171; 91.4%) felt they required more training. The mean overall confidence score of the group was 4.54 (standard deviation (SD) 1.28)%. The mean knowledge score of participants regarding IYCF in the context of HIV was 51.7%. The attendance of training did not equate to improved knowledge scores. Conclusions. Although the healthcare workers were confident with counselling on IYCF in the context of HIV, their knowledge levels were lower than expected. This could be attributed to a lack of training or outdated or inefficient training. There is a need to improve the coverage and quality of IYCF and HIV training. Training courses should address behaviour change and test for understanding.
{"title":"Training, confidence and knowledge of healthcare workers with regard to HIV and infant feeding in eThekwini, South Africa","authors":"K. Fiddler, K. Pillay","doi":"10.7196/sajch.2022.v16i2.1791","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1791","url":null,"abstract":"\u0000Background. Healthcare workers play an important role in educating mothers living with HIV regarding appropriate infant and young child feeding (IYCF) practices. However, it is not known if healthcare workers in eThekwini, KwaZulu-Natal (KZN), have been adequately trained regarding IYCF in the context of HIV and how knowledgeable and confident they are. \u0000Objectives. To assess the training, confidence and knowledge of healthcare workers regarding IYCF in the context of HIV. \u0000Methods. This was a descriptive cross-sectional study, which used a self-administered questionnaire developed for this survey. Healthcare workers (n=188), primarily doctors and nurses in antiretroviral, antenatal and paediatric departments at three regional hospitals (Addington Hospital, Prince Mshiyeni Memorial Hospital and RK Khan Hospital) in eThekwini, KZN, participated. \u0000Results. Only 47.3% (n=89) of the participants had attended formal training on IYCF in the context of HIV. Most participants (n=171; 91.4%) felt they required more training. The mean overall confidence score of the group was 4.54 (standard deviation (SD) 1.28)%. The mean knowledge score of participants regarding IYCF in the context of HIV was 51.7%. The attendance of training did not equate to improved knowledge scores. \u0000Conclusions. Although the healthcare workers were confident with counselling on IYCF in the context of HIV, their knowledge levels were lower than expected. This could be attributed to a lack of training or outdated or inefficient training. There is a need to improve the coverage and quality of IYCF and HIV training. Training courses should address behaviour change and test for understanding. \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45961899","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1943
M. Fallahi, F. Abdollahimajd, S. Tajali, R. Rakhshan, S. Shahnavaz, S. Tabatabaee, F. Palizban
Vasculitis is a rare disorder during the neonatal period. We present a term male neonate of consanguineous parents and birthweight of 4 030 g who presented at 11 days of life with an evolving skin rash. There was no history of drug exposure in the neonate except for routine care. On day 7 of life, multiple erythematous plaques with necrotic or pustular centres appeared. There were no signs of mucosal involvement or sepsis and laboratory findings were normal. Skin biopsy revealed small and intermediate vessel vasculitis. At follow-up 2 weeks after discharge from the hospital, the skin lesions persisted, and at age 2 months, the patient presented with features of severe pneumonia and subsequently died. Vasculitis was reported as the cause of death on postmortem biopsy.
{"title":"Neonatal medium-sized vessel vasculitis: A rare case report","authors":"M. Fallahi, F. Abdollahimajd, S. Tajali, R. Rakhshan, S. Shahnavaz, S. Tabatabaee, F. Palizban","doi":"10.7196/sajch.2022.v16i2.1943","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1943","url":null,"abstract":"Vasculitis is a rare disorder during the neonatal period. We present a term male neonate of consanguineous parents and birthweight of 4 030 g who presented at 11 days of life with an evolving skin rash. There was no history of drug exposure in the neonate except for routine care. On day 7 of life, multiple erythematous plaques with necrotic or pustular centres appeared. There were no signs of mucosal involvement or sepsis and laboratory findings were normal. Skin biopsy revealed small and intermediate vessel vasculitis. At follow-up 2 weeks after discharge from the hospital, the skin lesions persisted, and at age 2 months, the patient presented with features of severe pneumonia and subsequently died. Vasculitis was reported as the cause of death on postmortem biopsy.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48954134","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1897
C. Goosen, J. Baumgartner, N. Mikulic, S. Barnabas, M. Cotton, M. Zimmerman, R. Blaauw
Background. Data on iron and vitamin A deficiency are scarce in school-aged children living with HIV (HIV+) compared with children without HIV (HIV–). Both deficiencies can contribute to anaemia. Objective. To assess anaemia, iron and vitamin A status in a sample of HIV+ and HIV– school-aged children in South Africa. Methods. In this comparative cross-sectional study, biomarkers for anaemia (haemoglobin), iron (plasma ferritin (PF), soluble transferrin receptor), vitamin A (retinol-binding protein (RBP)) and inflammatory status (C-reactive protein, α-1-acid glycoprotein) were measured in 8 - 13-year-old children from Cape Town living with (n=143) and without HIV (n=148). Measurements of PF and RBP were adjusted for inflammation using a regression-correction approach. Results. HIV+ children had higher prevalences of anaemia (29% v. 14%; odds ratio (OR) = 2.6; 95% confidence interval (CI) 1.4 - 4.9; p=0.002), iron-deficient erythropoiesis (20% v. 9%; OR=2.5; 95% CI 1.2 - 5.0; p=0.013) and iron deficiency anaemia (11% v. 4%; OR=2.9; 95% CI 1.1 - 7.7; p=0.035) than HIV– children. Marginal vitamin A deficiency was noted in 52% of HIV+ and 57% of HIV– children (p=0.711). Subclinical inflammation was more prevalent in HIV+ than HIV– children (p=0.012). Conclusion. Anaemia, iron-deficient erythropoiesis and iron deficiency anaemia were more prevalent in HIV+ than HIV– children. Prevalence of marginal vitamin A deficiency was high in both groups. Efforts to improve micronutrient status and mitigate nutritional determinants of anaemia in HIV+ children from resource-limited settings should be prioritised.
{"title":"Anaemia, iron and vitamin A status among South African school-aged children living with and without HIV","authors":"C. Goosen, J. Baumgartner, N. Mikulic, S. Barnabas, M. Cotton, M. Zimmerman, R. Blaauw","doi":"10.7196/sajch.2022.v16i2.1897","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1897","url":null,"abstract":"Background. Data on iron and vitamin A deficiency are scarce in school-aged children living with HIV (HIV+) compared with children without HIV (HIV–). Both deficiencies can contribute to anaemia. \u0000Objective. To assess anaemia, iron and vitamin A status in a sample of HIV+ and HIV– school-aged children in South Africa. \u0000Methods. In this comparative cross-sectional study, biomarkers for anaemia (haemoglobin), iron (plasma ferritin (PF), soluble transferrin receptor), vitamin A (retinol-binding protein (RBP)) and inflammatory status (C-reactive protein, α-1-acid glycoprotein) were measured in 8 - 13-year-old children from Cape Town living with (n=143) and without HIV (n=148). Measurements of PF and RBP were adjusted for inflammation using a regression-correction approach. \u0000Results. HIV+ children had higher prevalences of anaemia (29% v. 14%; odds ratio (OR) = 2.6; 95% confidence interval (CI) 1.4 - 4.9; p=0.002), iron-deficient erythropoiesis (20% v. 9%; OR=2.5; 95% CI 1.2 - 5.0; p=0.013) and iron deficiency anaemia (11% v. 4%; OR=2.9; 95% CI 1.1 - 7.7; p=0.035) than HIV– children. Marginal vitamin A deficiency was noted in 52% of HIV+ and 57% of HIV– children (p=0.711). Subclinical inflammation was more prevalent in HIV+ than HIV– children (p=0.012). \u0000Conclusion. Anaemia, iron-deficient erythropoiesis and iron deficiency anaemia were more prevalent in HIV+ than HIV– children. Prevalence of marginal vitamin A deficiency was high in both groups. Efforts to improve micronutrient status and mitigate nutritional determinants of anaemia in HIV+ children from resource-limited settings should be prioritised.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47100438","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 : 2022-07-22DOI: 10.7196/sajch.2022.v16i2.1893
R. Krynauw, J. C. du Preez, J. V. van Zyl, M. Burger
Background. General movement assessment (GMA) is an assessment tool with high predictive validity for neurodevelopmental outcomes in preterm infants. Information available describing the trajectory of general movements (GMs) in high-risk preterm-born infants and the use thereof in low- and middle-income countries is limited. Objective. To describe the trajectories of GMs from birth until 12 - 14 weeks’ corrected age, and determine the association of known perinatal risk factors on GM trajectories in very low-birthweight and extremely low-birthweight preterm infants. Methods. This was a longitudinal, prospective cohort study with 119 preterm infants born at <33 weeks’ gestation and with a birthweight <1 500 g. GMs were recorded at four key age periods: 1 - 2 weeks after birth to 33 weeks post menstrual age (PMA); 34 - 37 weeks PMA; term equivalent age (TEA); and 12 - 14 weeks corrected age. Detailed perinatal data were collected. Results. A total of 300 GMAs were conducted, 157 during the preterm age, 55 during TEA and 88 at 12 - 14 weeks corrected age. At <33 weeks PMA, 96% of GMs were abnormal and 4% normal. At 34 - 37 weeks PMA, 89% of GMs were abnormal and 11% normal. All GMs recorded at term equivalent age were abnormal. At 12 - 14 weeks corrected age, 7% of GMs were abnormal and 93% normal. Conclusion. GMs were predominantly abnormal prior to term with a significant decrease in abnormality at 12 - 14 weeks corrected age. Lower birthweight and lower PMA were associated with increased odds for abnormal GMs. In a resource-constrained environment, observing GMs at 12 - 14 weeks corrected age (during the fidgety period) is a time- and cost-effective method to determine the risk for adverse neurodevelopment.
{"title":"The trajectory of general movements from birth until 12 - 14 weeks corrected age in very low birthweight and extremely low-birthweight infants born preterm","authors":"R. Krynauw, J. C. du Preez, J. V. van Zyl, M. Burger","doi":"10.7196/sajch.2022.v16i2.1893","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1893","url":null,"abstract":"\u0000Background. General movement assessment (GMA) is an assessment tool with high predictive validity for neurodevelopmental outcomes in preterm infants. Information available describing the trajectory of general movements (GMs) in high-risk preterm-born infants and the use thereof in low- and middle-income countries is limited. \u0000Objective. To describe the trajectories of GMs from birth until 12 - 14 weeks’ corrected age, and determine the association of known perinatal risk factors on GM trajectories in very low-birthweight and extremely low-birthweight preterm infants. \u0000Methods. This was a longitudinal, prospective cohort study with 119 preterm infants born at <33 weeks’ gestation and with a birthweight <1 500 g. GMs were recorded at four key age periods: 1 - 2 weeks after birth to 33 weeks post menstrual age (PMA); 34 - 37 weeks PMA; term equivalent age (TEA); and 12 - 14 weeks corrected age. Detailed perinatal data were collected. \u0000Results. A total of 300 GMAs were conducted, 157 during the preterm age, 55 during TEA and 88 at 12 - 14 weeks corrected age. At <33 weeks PMA, 96% of GMs were abnormal and 4% normal. At 34 - 37 weeks PMA, 89% of GMs were abnormal and 11% normal. All GMs recorded at term equivalent age were abnormal. At 12 - 14 weeks corrected age, 7% of GMs were abnormal and 93% normal. \u0000Conclusion. GMs were predominantly abnormal prior to term with a significant decrease in abnormality at 12 - 14 weeks corrected age. Lower birthweight and lower PMA were associated with increased odds for abnormal GMs. In a resource-constrained environment, observing GMs at 12 - 14 weeks corrected age (during the fidgety period) is a time- and cost-effective method to determine the risk for adverse neurodevelopment. \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44102772","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 : 2022-07-18DOI: 10.7196/sajch.2022.v16i2.1872
C. Chang, K. L. Petersen, A. Cilliers, U. Kalla
Background. Primary hyperoxaluria (PH) is a rare autosomal recessive condition characterised by defects in the metabolism of glyoxylate which leads to excess oxalate production. It is an important disease to diagnose as it can progress to kidney failure (KF). Objective. To describe the characteristics, diagnosis and management of PH in South Africa and to identify any determinants of KF and death. Method. A retrospective study of all children younger than 16 years of age, diagnosed with PH at the Paediatric Renal Unit, Chris Hani Baragwanath Academic Hospital, from 1984 - 2017. Results. A total of 24 patients were identified, of which 20 records were available for complete analysis. The median age of presentation was 6.0 years. The common clinical presentations were urolithiasis (90%), KF (85%), nephrocalcinosis (75%), urinary tract infections (55%) and haematuria (30%). Nephrocalcinosis was better detected on abdominal radiograph compared with ultrasonography. Both nephrocalcinosis (p=0.009) and haematuria (p=0.018) were significantly associated with KF. Five patients had A112D genetic mutation in the AGXT. Fourteen received dialysis and four were transplanted. The mortality rate in this study was 58.3%. Conclusion. Clinicians should have a high index of suspicion for PH in patients presenting with haematuria, urolithiasis and KF. This study supports the measurement of urine oxalate levels and abdominal radiographs in screening for PH in children presenting in KF.
{"title":"Primary hyperoxaluria: The Baragwanath experience","authors":"C. Chang, K. L. Petersen, A. Cilliers, U. Kalla","doi":"10.7196/sajch.2022.v16i2.1872","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1872","url":null,"abstract":"\u0000Background. Primary hyperoxaluria (PH) is a rare autosomal recessive condition characterised by defects in the metabolism of glyoxylate which leads to excess oxalate production. It is an important disease to diagnose as it can progress to kidney failure (KF). \u0000Objective. To describe the characteristics, diagnosis and management of PH in South Africa and to identify any determinants of KF and death. \u0000Method. A retrospective study of all children younger than 16 years of age, diagnosed with PH at the Paediatric Renal Unit, Chris Hani Baragwanath Academic Hospital, from 1984 - 2017. \u0000Results. A total of 24 patients were identified, of which 20 records were available for complete analysis. The median age of presentation was 6.0 years. The common clinical presentations were urolithiasis (90%), KF (85%), nephrocalcinosis (75%), urinary tract infections (55%) and haematuria (30%). Nephrocalcinosis was better detected on abdominal radiograph compared with ultrasonography. Both nephrocalcinosis (p=0.009) and haematuria (p=0.018) were significantly associated with KF. Five patients had A112D genetic mutation in the AGXT. Fourteen received dialysis and four were transplanted. The mortality rate in this study was 58.3%. \u0000Conclusion. Clinicians should have a high index of suspicion for PH in patients presenting with haematuria, urolithiasis and KF. This study supports the measurement of urine oxalate levels and abdominal radiographs in screening for PH in children presenting in KF. \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46407132","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 : 2022-07-11DOI: 10.7196/sajch.2022.v16i2.1816
C. Eke, R. Brown, R. D. De Lacy, E. Goddard
Background. Endoscopy is an important diagnostic and therapeutic mode of management in children with gastrointestinal disorders. Objective. To determine the indications, endoscopic yields and impact of the service on the ongoing health and complications among children who underwent gastrointestinal endoscopy at Red Cross War Memorial Children’s Hospital, Cape Town. Methods. A 10-year (2007 - 2016) retrospective study of children <18 years old who underwent gastrointestinal endoscopy was undertaken using relevant patients’ variables obtained from their hospital medical records. Data were analysed using Stata 13.1 (p<0.05). Results. A total of 402 children underwent a total of 695 gastrointestinal endoscopic procedures: 592 (85.2%) were gastroscopies, 78 (11.2%) combined gastroscopies with colonoscopies and 25 (3.6%) colonoscopy-only procedures, respectively. The main diagnostic indications for gastroscopy, gastroscopy combined with colonoscopy and colonoscopy-only were chronic abdominal pain (n=49; 12.2%), suspected inflammatory bowel disease (n=30; 7.5%) and rectal bleeding (n=13; 52.0%) respectively. The most common therapeutic indication for gastroscopy was change of a percutaneous endoscopic gastrostomy (n=143; 35.6%) while for colonoscopy 6 (5.8%) had polypectomy. Abnormal histopathological results were made from both macroscopically normal- and abnormal-looking tissues, though with no statistically significant relationship. Conclusion. Endoscopy offers diagnostic and therapeutic options in children. Positive histological findings were obtained in some cases where gastrointestinal mucosae appeared normal. There is need to obtain biopsies from both macroscopically normal- and abnormallooking gastrointestinal mucosae as positive histological findings could be made from them and hence improve diagnostic yield.
{"title":"Paediatric gastrointestinal endoscopy: Experience in Red Cross War Memorial Children’s Hospital, Cape Town, South Africa","authors":"C. Eke, R. Brown, R. D. De Lacy, E. Goddard","doi":"10.7196/sajch.2022.v16i2.1816","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1816","url":null,"abstract":"Background. Endoscopy is an important diagnostic and therapeutic mode of management in children with gastrointestinal disorders. Objective. To determine the indications, endoscopic yields and impact of the service on the ongoing health and complications among children who underwent gastrointestinal endoscopy at Red Cross War Memorial Children’s Hospital, Cape Town. Methods. A 10-year (2007 - 2016) retrospective study of children <18 years old who underwent gastrointestinal endoscopy was undertaken using relevant patients’ variables obtained from their hospital medical records. Data were analysed using Stata 13.1 (p<0.05). Results. A total of 402 children underwent a total of 695 gastrointestinal endoscopic procedures: 592 (85.2%) were gastroscopies, 78 (11.2%) combined gastroscopies with colonoscopies and 25 (3.6%) colonoscopy-only procedures, respectively. The main diagnostic indications for gastroscopy, gastroscopy combined with colonoscopy and colonoscopy-only were chronic abdominal pain (n=49; 12.2%), suspected inflammatory bowel disease (n=30; 7.5%) and rectal bleeding (n=13; 52.0%) respectively. The most common therapeutic indication for gastroscopy was change of a percutaneous endoscopic gastrostomy (n=143; 35.6%) while for colonoscopy 6 (5.8%) had polypectomy. Abnormal histopathological results were made from both macroscopically normal- and abnormal-looking tissues, though with no statistically significant relationship. Conclusion. Endoscopy offers diagnostic and therapeutic options in children. Positive histological findings were obtained in some cases where gastrointestinal mucosae appeared normal. There is need to obtain biopsies from both macroscopically normal- and abnormallooking gastrointestinal mucosae as positive histological findings could be made from them and hence improve diagnostic yield.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41799259","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 : 2022-06-16DOI: 10.7196/sajch.2022.v16.i2.1822
J. Nyasulu, R. Maphoto, M. Kamupira, N. Msomi
The World Health Organization recommends continuous immunisation coverage and polio surveillance standards for countries to sustain a polio-free status. We highlight experiences and lessons learnt by South Africa (SA) in losing – and subsequently regaining – its polio-free status. Following some decline in achieving acute flaccid paralysis surveillance and immunisation coverage targets, SA had its polio-free status withdrawn in 2017. Existing gaps were addressed and the polio-free status was regained in 2019. Lessons learnt from this experience include reaffirming the importance of continued commitment to polio eradication efforts, strengthening health systems through quality improvement projects, ensuring accountability in supervision, and monitoring of polio-related indicators. Consistent political commitment, collaboration and accountability are critical in sustaining the country’s health programmes, including maintaining a polio-free status and closing identified gaps.
{"title":"South Africa regains polio-free status: Processes involved and lessons learnt","authors":"J. Nyasulu, R. Maphoto, M. Kamupira, N. Msomi","doi":"10.7196/sajch.2022.v16.i2.1822","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16.i2.1822","url":null,"abstract":"The World Health Organization recommends continuous immunisation coverage and polio surveillance standards for countries to sustain a polio-free status. We highlight experiences and lessons learnt by South Africa (SA) in losing – and subsequently regaining – its polio-free status. Following some decline in achieving acute flaccid paralysis surveillance and immunisation coverage targets, SA had its polio-free status withdrawn in 2017. Existing gaps were addressed and the polio-free status was regained in 2019. Lessons learnt from this experience include reaffirming the importance of continued commitment to polio eradication efforts, strengthening health systems through quality improvement projects, ensuring accountability in supervision, and monitoring of polio-related indicators. Consistent political commitment, collaboration and accountability are critical in sustaining the country’s health programmes, including maintaining a polio-free status and closing identified gaps.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43479038","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}
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：