Pub Date : 2022-10-11DOI: 10.7196/sajch.2022.v16i3.1842
M. Hbish, Jing Chen, P. Jeena
Background. The surgical management of children with bronchiectasis has seldom been reported.Objective. To describe the presentation, surgical management and outcomes in children with bronchiectasis presenting for surgery. Methods. We retrospectively reviewed the electronic records of 0 - 13-year-old children who underwent pulmonary resection for bronchiectasis at Inkosi Albert Luthuli Central Hospital, Durban, South Africa, between January 2004 and December 2014. Clinical, radiological and preoperative bronchoscopic findings, as well as surgical and histological outcomes, were analysed.Results. Eighty-eight patients underwent surgical resection. The female/male ratio was 3:2, with a mean age at surgery of 8.2 (range 2 - 13) years; 39 patients were HIV infected and 39 were HIV uninfected. Tuberculosis (TB) (n=68; 77.2%) was the most common cause of bronchiectasis, and recurrent chest infection (n= 45; 51.1%) was the most common clinical finding. Radiological examination confirmed isolated left-sided disease in 40 children (45.4%), isolated right-sided disease in 28 (31.8%) and bilateral disease in 20 (22.7%). Saccular disease with fibrocavitation (n=35; 39.7%) was the most common morphological disease type. Preoperative bronchoalveolar lavage samples confirmed a bacterial cause in 27 patients (30.6%). The most common operative procedures were primary pneumonectomy in 33 patients (37.0%), lobectomy in 30 (34.0%) and bilobectomy in 13 (14.7%). Seventy-five patients were asymptomatic after the operation and complications occurred in 13. Two children (2.2%), one with sepsis and the other with intraoperative hypoxia, died. Seventy patients underwent complete resection. At 1 month after surgery, 89.2% of patients were asymptomatic, while 77.7% of symptomatic patients were HIV positive.Conclusions. Complete pulmonary resection in children with advanced-stage bronchiectasis is safe, with a low morbidity and mortality. Surgery in HIV-positive patients was not associated with worse outcomes and is not contraindicated. HIV- and TB-preventive measures could reduce the burden of childhood bronchiectasis.
背景。小儿支气管扩张症的手术治疗鲜有报道。目的:探讨支气管扩张症患儿的临床表现、手术治疗及预后。方法。我们回顾性地回顾了2004年1月至2014年12月在南非德班Inkosi Albert Luthuli中心医院因支气管扩张而行肺切除术的0 - 13岁儿童的电子记录。分析临床、影像学和术前支气管镜检查结果，以及手术和组织学结果。88例患者接受了手术切除。男女比例为3:2，平均手术年龄8.2岁(2 - 13岁);39例感染艾滋病毒，39例未感染艾滋病毒。结核病(TB) (n=68;77.2%)是支气管扩张最常见的原因，复发性胸部感染(n= 45;51.1%)是最常见的临床表现。影像学检查证实孤立性左侧病变40例(45.4%)，孤立性右侧病变28例(31.8%)，双侧病变20例(22.7%)。伴有纤维空化的囊性疾病(n=35;39.7%)为最常见的形态学疾病类型。术前支气管肺泡灌洗样本证实27例患者(30.6%)为细菌病因。最常见的手术方式是33例(37.0%)的原发性全肺切除术，30例(34.0%)的肺叶切除术和13例(14.7%)的胆叶切除术。术后无症状75例，并发症13例。2例患儿(2.2%)死亡，1例败血症，1例术中缺氧。70例患者接受了完全切除。术后1个月，89.2%的患者无症状，77.7%有症状的患者HIV阳性。晚期支气管扩张儿童全肺切除术是安全的，发病率和死亡率低。hiv阳性患者的手术与较差的预后无关，也没有禁忌症。预防艾滋病毒和结核病的措施可以减轻儿童支气管扩张的负担。
{"title":"Surgical treatment of bronchiectasis in children: An 11-year experience at a central health facility in KwaZulu-Natal, South Africa","authors":"M. Hbish, Jing Chen, P. Jeena","doi":"10.7196/sajch.2022.v16i3.1842","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i3.1842","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Background. The surgical management of children with bronchiectasis has seldom been reported.Objective. To describe the presentation, surgical management and outcomes in children with bronchiectasis presenting for surgery. Methods. We retrospectively reviewed the electronic records of 0 - 13-year-old children who underwent pulmonary resection for bronchiectasis at Inkosi Albert Luthuli Central Hospital, Durban, South Africa, between January 2004 and December 2014. Clinical, radiological and preoperative bronchoscopic findings, as well as surgical and histological outcomes, were analysed.Results. Eighty-eight patients underwent surgical resection. The female/male ratio was 3:2, with a mean age at surgery of 8.2 (range 2 - 13) years; 39 patients were HIV infected and 39 were HIV uninfected. Tuberculosis (TB) (n=68; 77.2%) was the most common cause of bronchiectasis, and recurrent chest infection (n= 45; 51.1%) was the most common clinical finding. Radiological examination confirmed isolated left-sided disease in 40 children (45.4%), isolated right-sided disease in 28 (31.8%) and bilateral disease in 20 (22.7%). Saccular disease with fibrocavitation (n=35; 39.7%) was the most common morphological disease type. Preoperative bronchoalveolar lavage samples confirmed a bacterial cause in 27 patients (30.6%). The most common operative procedures were primary pneumonectomy in 33 patients (37.0%), lobectomy in 30 (34.0%) and bilobectomy in 13 (14.7%). Seventy-five patients were asymptomatic after the operation and complications occurred in 13. Two children (2.2%), one with sepsis and the other with intraoperative hypoxia, died. Seventy patients underwent complete resection. At 1 month after surgery, 89.2% of patients were asymptomatic, while 77.7% of symptomatic patients were HIV positive.Conclusions. Complete pulmonary resection in children with advanced-stage bronchiectasis is safe, with a low morbidity and mortality. Surgery in HIV-positive patients was not associated with worse outcomes and is not contraindicated. HIV- and TB-preventive measures could reduce the burden of childhood bronchiectasis. \u0000 \u0000 \u0000 \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43838467","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16.i3.1876
M. Hendricks, M. Sambo, R. Laubscher, S. Pendlebury, L. Bourne
Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization’s child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative.Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children’s growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.
{"title":"Determinants of diarrhoeal disease in children living in low-income households in a periurban community in Cape Town, South Africa","authors":"M. Hendricks, M. Sambo, R. Laubscher, S. Pendlebury, L. Bourne","doi":"10.7196/sajch.2022.v16.i3.1876","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16.i3.1876","url":null,"abstract":"Background. Water, sanitation and hygiene are critically important in reducing morbidity and mortality from childhood diarrhoeal disease and malnutrition in low-income settings.Objectives. To assess the association of diarrhoeal disease with factors relating to domestic hygiene, the environment, sociodemographic status and anthropometry in children <2 years of age.Methods. This was a case-control study conducted in a periurban community 35 km from the centre of Cape Town, South Africa. The study included 100 children with diarrhoeal disease and 100 age-matched controls without diarrhoea, who were recruited at primary healthcare clinics. Sociodemographic status, environmental factors and domestic hygiene were assessed using a structured questionnaire; anthropometry was assessed using the World Health Organization’s child growth standards. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with diarrhoea. Results. The results of the univariate logistic regression showed significant susceptibility to diarrhoea in study cases compared with controls when the caregiver was ≥25 years old (odds ratio (OR) 1.82; 95% confidence interval (CI) 1.02 - 3.23; p=0.042); when children were in day care or cared for by a family member or a relative than when cared for by their mother (OR 1.97; 95% CI 1.06 - 3.65; p=0.032); and when the mothers were employed rather than at home (OR 2.23; 95% CI 1.21 - 4.12; p=0.01). Multivariate logistic regression analysis was used to identify predictors of diarrhoea, which entailed relaxing the inclusion criteria for the univariate analysis variables (p<0.25). The predictors significantly associated with diarrhoea were household problems relating to rat infestation (OR 2.44; 95% CI 1.13 - 5.28; p=0.027); maternal employment (OR 2.47; 95% CI 1.28 - 4.76; p=0.007); and children in day care or cared for by a relative (OR 2.34; 95% CI 1.21 - 4.54; p=0.01). Significantly more of the mothers who were employed than those who were unemployed had children in day care or cared for by a relative.Conclusion. Practices relating to employment, childcare and the domestic environment were significant predictors of diarrhoea. Effective policy implementation on water, sanitation and domestic hygiene could prevent diarrhoeal disease and reduce its impact on children’s growth, especially during the annual diarrhoeal surge season in this and similar periurban communities.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43726461","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16i3.1826
Chris Hani Baragwanath, J. Carreira, D. Kruger, J. Loveland
Background. Road traffic accidents (RTAs) are a leading cause of injury and death globally, particularly among children. Pedestrians are most often injured, especially in middle- and low-income countries. The epidemiology, patterns and severity of injuries in children involved in RTAs in our community are hard to obtain.Objectives. To evaluate the aetiological spectrum, injury characteristics and treatment outcomes of paediatric patients involved in RTAs, who presented to Chris Hani Baragwanath Academic Hospital (CHBAH), a tertiary hospital in Soweto, South Africa. Methods. Patients ≤10 years old, who were involved in RTAs and seen at CHBAH, were included in the study.Results. The study was conducted from 20 August 2017 to 31 March 2018, and included the data of 156 patients. Their ages ranged from 13 days to 10 years (65% were boys). Pedestrian vehicle accidents accounted for 78.8% of the injuries, with 60.8% of the children being unaccompanied by an adult. Motor vehicle accidents accounted for 19.2% of the injuries, with 92% of the children being unrestrained in the vehicle. Of the patients, 73.2% (n=112/153) underwent radiography and 44.4% required computed tomography (CT) scans, the majority being CT scans of the brain for suspected head injuries. Soft-tissue injuries accounted for 78.9% of cases, followed mainly by head (39.7%) and limb (16%) injuries. Only 12% of patients required surgical intervention, with 42% of the operations being for orthopaedic injuries.Conclusion. The abovementioned data demonstrate that there is a lack of use of child restraints for children travelling as passengers in vehicles, and inadequate supervision of children on and around roads. This study supports other evidence, as it suggests that the paediatric population involved in RTAs is largely injured as pedestrians, and that males tend to be involved in more RTAs than females. The majority of injuries sustained involved the soft tissues, followed by head injuries.
{"title":"Clinical evaluation and outcomes in children ≤10 years old involved in road traffic accidents, presenting to Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa","authors":"Chris Hani Baragwanath, J. Carreira, D. Kruger, J. Loveland","doi":"10.7196/sajch.2022.v16i3.1826","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i3.1826","url":null,"abstract":"\u0000 \u0000 \u0000 \u0000Background. Road traffic accidents (RTAs) are a leading cause of injury and death globally, particularly among children. Pedestrians are most often injured, especially in middle- and low-income countries. The epidemiology, patterns and severity of injuries in children involved in RTAs in our community are hard to obtain.Objectives. To evaluate the aetiological spectrum, injury characteristics and treatment outcomes of paediatric patients involved in RTAs, who presented to Chris Hani Baragwanath Academic Hospital (CHBAH), a tertiary hospital in Soweto, South Africa. \u0000Methods. Patients ≤10 years old, who were involved in RTAs and seen at CHBAH, were included in the study.Results. The study was conducted from 20 August 2017 to 31 March 2018, and included the data of 156 patients. Their ages ranged from 13 days to 10 years (65% were boys). Pedestrian vehicle accidents accounted for 78.8% of the injuries, with 60.8% of the children being unaccompanied by an adult. Motor vehicle accidents accounted for 19.2% of the injuries, with 92% of the children being unrestrained in the vehicle. Of the patients, 73.2% (n=112/153) underwent radiography and 44.4% required computed tomography (CT) scans, the majority being CT scans of the brain for suspected head injuries. Soft-tissue injuries accounted for 78.9% of cases, followed mainly by head (39.7%) and limb (16%) injuries. Only 12% of patients required surgical intervention, with 42% of the operations being for orthopaedic injuries.Conclusion. The abovementioned data demonstrate that there is a lack of use of child restraints for children travelling as passengers in vehicles, and inadequate supervision of children on and around roads. This study supports other evidence, as it suggests that the paediatric population involved in RTAs is largely injured as pedestrians, and that males tend to be involved in more RTAs than females. The majority of injuries sustained involved the soft tissues, followed by head injuries. \u0000 \u0000 \u0000 \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47549889","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16i3.1879
W. Bezuidenhout, J. Cummings, L. De Klerk, D. Finlay, C. Lewis, L. Pienaar, A. Bouwer, R. Coetzee, G. Joubert
Background. Children are dependent on their caregivers to accurately administer medication to them.Objectives. To determine the knowledge and practices of primary caregivers regarding their methods of oral liquid medication administration, preferred measuring utensils, accuracy of preferred measuring utensils and different medication classifications that they collected. The study was conducted at Pelonomi Polyclinic Pharmacy, Bloemfontein, South Africa.Methods. A quantitative, cross-sectional descriptive study (with analytical aspects) was conducted, which used consecutive, convenient sampling. The pharmacy staff assisted in recruiting participants, after which a screening form was used to determine their eligibility. Participants were provided with an information document and consent form. The liquid medication was classified according to a drug classification list, and one medication was selected for the focus of the structured interview. The questionnaire was completed using REDCap. Thereafter, researchers used the information on the medication label to determine the accuracy of the caregiver’s answers.Results. The majority of the 89 participants (56.2%) answered all 3 administration-related questions correctly, with 84.3% answering the questions regarding quantity and frequency correctly. The medication measure (43.8%) was the preferred measuring utensil for any liquid medication at home, and the syringe (53.9%) for the selected liquid medication used in the interview, both accurate measuring utensils. Most children (56.2%) were prescribed ‘other medication’ (e.g. vitamins and mineral supplements), followed by analgesics (47.2%) and antibiotics (42.7%).Conclusion. Primary caregivers at Pelonomi Polyclinic Pharmacy know how to administer oral liquid medication to children accurately. Most caregivers indicated that they use accurate measuring utensils
{"title":"The knowledge and practices of caregivers regarding the administration of oral liquid medication to children at a healthcare clinic in Bloemfontein, South Africa","authors":"W. Bezuidenhout, J. Cummings, L. De Klerk, D. Finlay, C. Lewis, L. Pienaar, A. Bouwer, R. Coetzee, G. Joubert","doi":"10.7196/sajch.2022.v16i3.1879","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i3.1879","url":null,"abstract":"Background. Children are dependent on their caregivers to accurately administer medication to them.Objectives. To determine the knowledge and practices of primary caregivers regarding their methods of oral liquid medication administration, preferred measuring utensils, accuracy of preferred measuring utensils and different medication classifications that they collected. The study was conducted at Pelonomi Polyclinic Pharmacy, Bloemfontein, South Africa.Methods. A quantitative, cross-sectional descriptive study (with analytical aspects) was conducted, which used consecutive, convenient sampling. The pharmacy staff assisted in recruiting participants, after which a screening form was used to determine their eligibility. Participants were provided with an information document and consent form. The liquid medication was classified according to a drug classification list, and one medication was selected for the focus of the structured interview. The questionnaire was completed using REDCap. Thereafter, researchers used the information on the medication label to determine the accuracy of the caregiver’s answers.Results. The majority of the 89 participants (56.2%) answered all 3 administration-related questions correctly, with 84.3% answering the questions regarding quantity and frequency correctly. The medication measure (43.8%) was the preferred measuring utensil for any liquid medication at home, and the syringe (53.9%) for the selected liquid medication used in the interview, both accurate measuring utensils. Most children (56.2%) were prescribed ‘other medication’ (e.g. vitamins and mineral supplements), followed by analgesics (47.2%) and antibiotics (42.7%).Conclusion. Primary caregivers at Pelonomi Polyclinic Pharmacy know how to administer oral liquid medication to children accurately. Most caregivers indicated that they use accurate measuring utensils","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41398985","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16i3.1890
K. Keeling, J. Price, K. Naidoo
Background. Pneumonia is one of the leading causes of under-5 death in South Africa and accounts for a substantial burden of paediatric intensive care unit (PICU) admissions. However, little is known about PICU outcomes in HIV-exposed uninfected (HIV-EU) children with pneumonia, despite the growing size of this vulnerable population.Objectives. To determine whether HIV exposure without infection is an independent risk factor for mortality and morbidity in childrenadmitted to PICU with pneumonia.Methods. This retrospective review included all patients with pneumonia admitted to the PICU at Chris Hani Baragwanath AcademicHospital between 1 January 2013 and 31 December 2014. Patients were classified as HIV-unexposed (HIV-U), HIV-EU and HIV-infected.Medical records were reviewed to determine survival to PICU discharge, duration of PICU admission and duration of mechanicalventilation. Survival analysis was used to determine the association between HIV infection/exposure with mortality, and linear regression was used to examine the association with length of stay and duration of mechanical ventilation. This study included 107 patients: 54 were HIV-U; 28 were HIV-EU; 23 HIV-positive; and 2 had an unknown HIV status.Results. Overall, 84% (n=90) survived to PICU discharge, with no difference in survival based on HIV infection or exposure. Both HIV-EUand HIV-U children had significantly shorter PICU admissions and fewer days of mechanical ventilation compared with HIV-infectedchildren (p=0.011 and p=0.004, respectively).Conclusion. HIV-EU children behaved similarly to HIV-U children in terms of mortality, duration of PICU admission and length ofmechanical ventilation. HIV infection was associated with prolonged length of mechanical ventilation and ICU stay but not increasedmortality
{"title":"HIV exposure and its association with paediatric ICU outcomes in children admitted with severe pneumonia at Chris Hani Baragwanath Academic Hospital, South Africa","authors":"K. Keeling, J. Price, K. Naidoo","doi":"10.7196/sajch.2022.v16i3.1890","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i3.1890","url":null,"abstract":"Background. Pneumonia is one of the leading causes of under-5 death in South Africa and accounts for a substantial burden of paediatric intensive care unit (PICU) admissions. However, little is known about PICU outcomes in HIV-exposed uninfected (HIV-EU) children with pneumonia, despite the growing size of this vulnerable population.Objectives. To determine whether HIV exposure without infection is an independent risk factor for mortality and morbidity in childrenadmitted to PICU with pneumonia.Methods. This retrospective review included all patients with pneumonia admitted to the PICU at Chris Hani Baragwanath AcademicHospital between 1 January 2013 and 31 December 2014. Patients were classified as HIV-unexposed (HIV-U), HIV-EU and HIV-infected.Medical records were reviewed to determine survival to PICU discharge, duration of PICU admission and duration of mechanicalventilation. Survival analysis was used to determine the association between HIV infection/exposure with mortality, and linear regression was used to examine the association with length of stay and duration of mechanical ventilation. This study included 107 patients: 54 were HIV-U; 28 were HIV-EU; 23 HIV-positive; and 2 had an unknown HIV status.Results. Overall, 84% (n=90) survived to PICU discharge, with no difference in survival based on HIV infection or exposure. Both HIV-EUand HIV-U children had significantly shorter PICU admissions and fewer days of mechanical ventilation compared with HIV-infectedchildren (p=0.011 and p=0.004, respectively).Conclusion. HIV-EU children behaved similarly to HIV-U children in terms of mortality, duration of PICU admission and length ofmechanical ventilation. HIV infection was associated with prolonged length of mechanical ventilation and ICU stay but not increasedmortality","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47261127","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16i3.1901
R. Malan, J. van der Linde, A. Kritzinger, M. Coetzee, M. Graham, E. Krüger
Background. Clear risk profiles of neonates with mild and moderate hypoxic-ischaemic encephalopathy (HIE) are lacking.Objective. To describe and compare factors associated with mild and moderate HIE in South African neonates.Methods. A prospective, comparative design was used to describe factors among South African neonates with mild (n=13) and moderate (n=33) HIE in an urban tertiary academic hospital. HIE diagnosis and encephalopathy grading were conducted using the modified Sarnat stages. Thompson scores were recorded. Participants’ clinical records were reviewed to identify factors. Descriptive data were obtained. Chi-square and Fisher’s exact tests were used to compare categorical data, and Mann-Whitney tests were used to compare continuous data between groups.Results. Significant differences were found between groups’ admission (p<0.001) and highest Thompson scores (p<0.001). The mild group’s APGAR scores were significantly higher than those of the moderate group at five (p=0.012) and ten minutes (p=0.022). Duration of resuscitation (p=0.011) and time to spontaneous respiration (p=0.012) also differed significantly between groups. Significantly more moderate than mild participants received therapeutic hypothermia (TH) (p<0.001).Conclusion. Clinical tests and management factors differed significantly between groups. The findings provided the multidisciplinary team with an increased understanding of the heterogeneous HIE population and add to existing evidence for identifying neonates eligible for TH in resource-limited settings.
{"title":"South African neonates with mild and moderate hypoxic-ischaemic encephalopathy","authors":"R. Malan, J. van der Linde, A. Kritzinger, M. Coetzee, M. Graham, E. Krüger","doi":"10.7196/sajch.2022.v16i3.1901","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i3.1901","url":null,"abstract":"Background. Clear risk profiles of neonates with mild and moderate hypoxic-ischaemic encephalopathy (HIE) are lacking.Objective. To describe and compare factors associated with mild and moderate HIE in South African neonates.Methods. A prospective, comparative design was used to describe factors among South African neonates with mild (n=13) and moderate (n=33) HIE in an urban tertiary academic hospital. HIE diagnosis and encephalopathy grading were conducted using the modified Sarnat stages. Thompson scores were recorded. Participants’ clinical records were reviewed to identify factors. Descriptive data were obtained. Chi-square and Fisher’s exact tests were used to compare categorical data, and Mann-Whitney tests were used to compare continuous data between groups.Results. Significant differences were found between groups’ admission (p<0.001) and highest Thompson scores (p<0.001). The mild group’s APGAR scores were significantly higher than those of the moderate group at five (p=0.012) and ten minutes (p=0.022). Duration of resuscitation (p=0.011) and time to spontaneous respiration (p=0.012) also differed significantly between groups. Significantly more moderate than mild participants received therapeutic hypothermia (TH) (p<0.001).Conclusion. Clinical tests and management factors differed significantly between groups. The findings provided the multidisciplinary team with an increased understanding of the heterogeneous HIE population and add to existing evidence for identifying neonates eligible for TH in resource-limited settings.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41807107","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 : 2022-10-11DOI: 10.7196/sajch.2022.v16.i3.1709
HL Davids, NV Roman, EG Rich R
Background. Hookah pipe smoking is a high-risk phenomenon which is widely seen as an acceptable social practice, but the extent of its acceptability is not very clear among South African youth, nor is the influence of peers very clear.Objective. To establish a link between social acceptability and peer pressure and to compare this relationship among hookah pipe users and non-users in a sample of South African adolescents.Methods. A cross-sectional comparative correlation study was conducted among Grade 9 adolescents attending secondary schools in the Metro East Education District in Cape Town. The final sample comprised 270 participants. A questionnaire was used to collect data which were analysed using SPSS.Results. No relationship was found between peer pressure and social acceptability, but a relationship was found between parental rules and monitoring around tobacco use for hookah pipe users. A significant difference was also found in attitudes towards hookah use among users and non-users.Conclusion. This descriptive study of hookah pipe users and non-users among Grade 9 adolescents is a further study in the quantitative research approach and may be helpful in gaining more insight into understanding how parental rules and monitoring are put in place and why users’ and non-users’ attitudes towards tobacco use differ significantly. The implications and significance of this study are further explained.
{"title":"Peer pressure and social acceptability between hookah pipe users and non-users among a sample of South African adolescents","authors":"HL Davids, NV Roman, EG Rich R","doi":"10.7196/sajch.2022.v16.i3.1709","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16.i3.1709","url":null,"abstract":"Background. Hookah pipe smoking is a high-risk phenomenon which is widely seen as an acceptable social practice, but the extent of its acceptability is not very clear among South African youth, nor is the influence of peers very clear.Objective. To establish a link between social acceptability and peer pressure and to compare this relationship among hookah pipe users and non-users in a sample of South African adolescents.Methods. A cross-sectional comparative correlation study was conducted among Grade 9 adolescents attending secondary schools in the Metro East Education District in Cape Town. The final sample comprised 270 participants. A questionnaire was used to collect data which were analysed using SPSS.Results. No relationship was found between peer pressure and social acceptability, but a relationship was found between parental rules and monitoring around tobacco use for hookah pipe users. A significant difference was also found in attitudes towards hookah use among users and non-users.Conclusion. This descriptive study of hookah pipe users and non-users among Grade 9 adolescents is a further study in the quantitative research approach and may be helpful in gaining more insight into understanding how parental rules and monitoring are put in place and why users’ and non-users’ attitudes towards tobacco use differ significantly. The implications and significance of this study are further explained.","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47684788","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.v16i2.1846
W. Slemming, S. Norris, K. Kagura, H. Saloojee, L. Richter
Background. Deeper insight into relationships between social factors and early childhood growth and development is required, particularly in low-resource settings. Objectives. To determine (i) associations between early linear growth and child development at 5 years; and (ii) whether early childhood growth mediates relationships between maternal education, household socioeconomic status (SES) and subsequent child development. Methods. This study used data from the Birth to Twenty Plus study, a longitudinal South African birth cohort study. The study sample comprised 636 participants with complete data at all relevant time points for the analysis. Household SES and maternal education were measured during pregnancy and the first two years of life, and growth between birth and 4 years of age. Child development was assessed using the Revised Denver Pre-screening Developmental Questionnaire (R-DPDQ). Multivariable regression analyses were used to investigate the association between SES, maternal education, growth and child development, and structural equation modelling was used to analyse the mediation of growth. Results. In both sexes, higher birthweight and household SES were associated with higher R-DPDQ scores. Increased relative linear growth, particularly between 0 and 2 years, was associated with higher R-DPDQ scores among boys (β=0.82; 95% confidence interval (CI): 0.27 - 1.37) at age 5. Growth status but not SES mediated the association between maternal education and R-DPDQ scores. Conclusion. Child development at 5 years was independently associated with SES and birthweight. The negative effects of lower maternal education on child development was attenuated by better growth.
{"title":"Child development at age 5 years: The effects of maternal education, socioeconomic status and early-life growth examined prospectively in a lowresource setting","authors":"W. Slemming, S. Norris, K. Kagura, H. Saloojee, L. Richter","doi":"10.7196/sajch.2022.v16i2.1846","DOIUrl":"https://doi.org/10.7196/sajch.2022.v16i2.1846","url":null,"abstract":"\u0000Background. Deeper insight into relationships between social factors and early childhood growth and development is required, particularly in low-resource settings. \u0000Objectives. To determine (i) associations between early linear growth and child development at 5 years; and (ii) whether early childhood growth mediates relationships between maternal education, household socioeconomic status (SES) and subsequent child development. \u0000Methods. This study used data from the Birth to Twenty Plus study, a longitudinal South African birth cohort study. The study sample comprised 636 participants with complete data at all relevant time points for the analysis. Household SES and maternal education were measured during pregnancy and the first two years of life, and growth between birth and 4 years of age. Child development was assessed using the Revised Denver Pre-screening Developmental Questionnaire (R-DPDQ). Multivariable regression analyses were used to investigate the association between SES, maternal education, growth and child development, and structural equation modelling was used to analyse the mediation of growth. \u0000Results. In both sexes, higher birthweight and household SES were associated with higher R-DPDQ scores. Increased relative linear growth, particularly between 0 and 2 years, was associated with higher R-DPDQ scores among boys (β=0.82; 95% confidence interval (CI): 0.27 - 1.37) at age 5. Growth status but not SES mediated the association between maternal education and R-DPDQ scores. \u0000Conclusion. Child development at 5 years was independently associated with SES and birthweight. The negative effects of lower maternal education on child development was attenuated by better growth. \u0000","PeriodicalId":44732,"journal":{"name":"South African Journal of Child Health","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2022-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45744026","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.v16i2.1783
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":null,"pages":null},"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.v16i2.1878
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":null,"pages":null},"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}
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