International Journal of Pediatrics最新文献

Background: Newborn hypothermia is a critical global health challenge, particularly in low-resource settings, where it significantly contributes to neonatal morbidity and mortality. A mere one-degree drop in a newborn's body temperature can substantially increase the risk of death. Understanding hypothermia factors is key to developing strategies to reduce neonatal mortality. Despite its status as a leading cause of neonatal death, no studies have been conducted in the study area to determine the prevalence and associated factors of neonatal hypothermia. Method: An institution-based cross-sectional study of 237 participants employed systematic random sampling. Data collection involved interviews and chart reviews, analyzed using SPSS Version 27.0. Bivariable logistic regression identified associations with a p value < 0.25, and multivariate logistic regression determined significant factors with a p value < 0.05. Result: The prevalence of neonatal hypothermia among newborns in this study was 54% (128 cases). Mothers whose labor was induced were 2.3 times more likely to have a hypothermic newborn (AOR = 2.276, 95% CI: 1.019-5.081). Newborns delivered at home were seven times more likely to develop hypothermia (AOR = 7.031, 95% CI: 1.018-48.582). Additionally, mothers without pregnancy complications were 0.4 times less likely to have a hypothermic baby compared to those who experienced pregnancy complications (AOR = 0.464, 95% CI: 0.235-0.997). Conclusion: The prevalence of neonatal hypothermia in the study area was found to be 54%. Factors associated with neonatal hypothermia included labor induction, home delivery, and complications during pregnancy.

Background: Pediatric fever is considered one of the most common reasons for parents presenting to the emergency department (ED). As there is little information involving parental knowledge, management techniques, and consultation of medical professionals regarding complaints of pediatric fever in Lebanon, it is important to investigate whether the parents know how to deal with a febrile fever in child before bringing them to the ED in order to determine the need for parental educational programs for fever management and to possibly limit unnecessary hospital visits. Study Design: This study recruited 191 participants to fill a questionnaire of 21 questions divided into three sections assessing parental sociodemographic characteristics, knowledge, and attitudes towards pediatric fever during presentation to the ED in two medical centers in Lebanon. The participant population was then stratified and compared on the basis of gender and knowledge level. Results: When assessing participants' knowledge, 119 (62.3%) of participants had a high level of knowledge, and 72 (37.7%) had a low level of knowledge on pediatric fever. The two groups showed different approaches towards low-grade fevers with the high knowledge group presenting to the ED mostly during high-grade fevers of 39°C or more. Conclusion: While the population of the current study showed similar levels of knowledge as those in studies from different parts of the world, around 50% of the participants showed higher levels of knowledge, thus proving that there is still a need for parental awareness and education regarding the causes of fever, its risks and benefits during disease progression, and appropriate ways of management.

Background: Double burden of malnutrition (DBM) is a complex nutritional phenomenon, where an individual or a household simultaneously face two contradictory forms of nutritional adversities. Studies on assessing the prevalence, trends, and determinants of DBM at household in Pakistan are scarce, so this study measured the prevalence, trends, and determinants of DBM at household level using nationally representative datasets. Methods: Data of last two waves of Demographic and Health Surveys (DHS) of Pakistan conducted in 2012-2013 and 2017-2018 were used to assess the DBM prevalence, trends, and determinants at the household level. Data of mother-child dyads aged between 15 and 49 years and 0 and 59 months was included, while data with incomplete anthropometry or anthropometric outliers was excluded. Results: Across two survey periods, there has been a significant decrease in pediatrics stunting from 45% to 37.3%, while a rapid proliferation of maternal obesity from 45% to 52.3% was reported. Similarly, the prevalence of DBM at household level was 17.3% in 2012-2013, which increased to 18.9% in 2017-2018. Among different provinces of Pakistan, Baluchistan, Khyber Pakhtunkhwa (KPK) and Federally Administered Tribal Areas (FATA) have significantly higher prevalence of DBM at household than Islamabad Capital Territory (ICT). Factors such as child age, birth order, and socioeconomic status were significantly associated with DBM in Pakistani households. Conclusion: DBM in Pakistan is a complex and chronic challenge, which affects almost one-fifth of households. There is need to urgently address the issues of DBM and to improvise nutrition specific and nutrition sensitive interventions to curtail the issues pertaining to DBM at household.

Aims: To examine the prevalence of children's social media use for entertainment, sex differences in usage, perceptions of how restricting their access may affect them, the reasons behind these views, and predictors of social media use. Methods: Four hundred children aged 8-17 living in Tema, Greater Accra Region, Ghana, were sampled for the quantitative data, while 59 children were sampled for the qualitative data. Descriptive statistics, Pearson's chi-square test, and binary logistic regression were used to analyze the quantitative study, while the qualitative data were analyzed thematically. Results: Nearly 9 out of 10 children use social media for entertainment. Male children are more likely to use social media for entertainment than girls. The findings suggest that denying children access to social media for entertainment may result in negative consequences such as boredom, a scarcity of entertainment options, a lack of access to the most recent information on entertainment advancements and trends, and missed opportunities for online learning and content creation. Conclusion: This study demonstrates that most children use social media for entertainment, and limiting children's access to social media may lead to information isolation, entertainment deficit, and digital disengagement. Consequently, stakeholders must devise interventions that enhance children's access and responsible use of social media for entertainment. Future studies should examine children's frequency and intensity of social media use and its potential benefits and associated risks.

Introduction: The Swedish child health care (CHC) program provides voluntarily, at no cost, services for children from birth to 5 years old. Participation rates are 99% of Swedish parents enrolling their children in some form of CHC program. Parental groups, comprising parents with similar experiences, can help reduce parental stress and foster the development of effective coping strategies. The study is aimed at evaluating a digital support intervention involving parents, child health nurses, and researchers. Methods: This cluster-randomized, prospective pilot intervention study, conducted in northern Sweden, had three follow-up points: baseline, 4 months, and 8 months. Data were collected from autumn 2022 to late spring 2023 and evaluated effects on parental stress and satisfaction, eHealth literacy, and satisfaction with CHC, accessibility, and support. The 18-item Parental Stress Scale was used to assess parental stress and satisfaction. eHealth literacy was measured using the 10-item eHEALS scale, and parental satisfaction and opinions on accessibility to CHC were measured using a three-item Visual Analogue Scale. The intervention group was offered to participate in various digital activities, while the control group received the usual CHC. Results: Parental satisfaction and stress levels within and between the intervention and control groups showed no significant changes from baseline to 8 months. Regarding eHealth literacy, differences were observed between the groups; however, both groups demonstrated improvement at the 8-month follow-up. The control group scored higher in eHealth literacy from baseline. The same pattern was identified regarding the parents' perceptions of internet usability and importance. Concerning satisfaction with CHC, accessibility, and support, the control group scored higher at baseline. Interestingly, the lines of the intervention and control groups crossed over at the 8-month follow-up. Conclusion: Despite a limited outcome change, the results showed a tendency to benefit some parents. Our findings suggest that further evaluation, possibly with other more suitable measurements or questionnaires, an extended intervention period, and a larger sample, is necessary to understand the implications of these results fully.

Rationale: Young people with neuromuscular diseases (NMDs) are especially at risk of being absent from school because of various symptoms, consequences of their disease, and frequent hospital visits. Growing up with a chronic disease can entail an increased risk of poor educational outcomes. Aims: The study is aimed to investigate factors of importance for continuing with upper secondary and/or higher education after primary education when living with NMD, including expectations, support, and accessibility. In addition, we wanted to assess educational absence, discontinuation of studies, motivation, and sense of belonging. Method: This cross-sectional study was founded in a national online questionnaire survey based on patient-reported outcomes from people with NMD. Five hundred and one persons were invited to participate. Data were analyzed using IBM SPSS Statistics 26. All variables were presented as numbers and percentages. Results: Responses were obtained from 172 (34.3%) young people with NMD. Twenty (11.6%) answered that their parents'/relatives' educational expectations for them were lower than their own expectations. Forty (24.4%) answered that their teachers seldom or never planned the lessons in ways that were inclusive for them. Forty-five (27.7%) responded that they were always or mostly more absent than their classmates in primary and lower secondary education. Thirty-two (24.8%) respondents who had started upper secondary education had dropped out of one or more educational programs. Thirty-one (18.6%) answered they seldom or never had a sense of belonging at school. Conclusion: Our results show novel knowledge on factors of importance for continuing education after primary school in young people with NMD. We found that teachers and parents carry a responsibility to show expectations to young people with NMD to ensure that the young people acquire adequate academic skills and actively participate in classroom activities. Supportive initiatives to prevent loneliness are important for keeping young people with NMD in the educational system.

Background: The most used manikin for neonatal resuscitation training is NeoNatalie (N), a low-fidelity manikin. A new manikin, NeoNatalie Live (NL), has been developed with more fidelity. We completed a noninferiority RCT to evaluate skill acquisition and to assess retention after 4 months of using these manikins. Methodology: Performance evaluation test (PET), a 14-item checklist, was used to assess students' skills before and after training and after 4 months. The maximum score was 100, and the noninferiority limit was 5. One hundred forty-three medical students were assigned randomly into two groups: N (n = 72) and NL (n = 71). Half of each group was evaluated on a simulator different from the one they were trained on. Results: Mean (SD) pretest PET scores (before training) for the NL and N groups were comparable across groups (39.5 [18.15] vs. 34.8 [19.10]; p = 0.13). The PET score was comparable between NL and N after training (82.46 [10.28] vs. 80.52 [13.07], absolute difference 1.93; 95% CI [-1.956343, 5.830363]; p = 0.83 [1-sided]). NL was statistically noninferior to N as the lower bound of 95% CI of absolute difference is greater than the noninferiority margin (-1.95 > -5). A similar finding was observed in retention after 4 months (76.09 [15.80] vs. 73.33 [18.42]; absolute difference 2.75; 95% CI [-2.92457, 8.43271], p = 0.83 [1-sided]). The mean gain of PET score within the group (posttest minus pretest) for NL and N was comparable (42.97 [17.11] vs. 45.73 [19.51]; absolute difference 2.76; 95% CI [-8.835228, 3.306668], p = 0.81 [1-sided]). Conclusion: There was an improvement in scores in the posttest for both manikins. The NL was noninferior as compared to N.

This study examined children with visual impairments (CwVI) satisfaction with school facilities, CwVIs' reasons for their satisfaction or dissatisfaction with school facilities, and steps to enhance their inclusion in teaching and learning. Grounded in Bronfenbrenner's ecological systems theory (EST) (1979), the study employed a mixed-methods approach, including a survey of 288 CwVIs, 73 key informant interviews (KIIs), 14 focus group discussions (FGDs), observations, and documentary reviews to complement the findings. The results revealed that 60.8% of CwVIs were satisfied with their school facilities, while 39.1% were dissatisfied. Key factors contributing to satisfaction included the suitability of the school compound and classroom furniture arrangement, which minimized accidents. In contrast, unsafe compounds, overcrowded classrooms, and poorly arranged furniture disrupted navigation and participation, exposing vulnerabilities in their learning environment. The findings highlighted the vital role of family and community involvement in fostering inclusive attitudes and advocating for infrastructure and resource improvements. Families actively supporting these efforts can significantly enhance support systems for CwVIs. The study underscores the need for collaboration between families and schools to build cohesive support networks that address the academic and social needs of CwVIs, fostering an inclusive learning environment.

Background: We examined the relationship between the 5-min Apgar score and other individual and contextual neonatal characteristics with early neonatal mortality (before 24 h) in Ecuadorian neonates. Methods: We conducted a retrospective case-control study using data from the Ecuadorian National Surveillance System for Neonatal Mortality, covering January 2014 to September 2017. We analyzed data for neonates who died within 28 days of birth, focusing on mortality before 24 h (early death). Multilevel multivariate logistic regression was used to calculate crude and adjusted odds ratios (aORs) for early death based on 5-min Apgar scores and other neonatal factors. The random effects variable in this model was altitude at which neonates were attended; this component of the model allows the intercept estimates to vary randomly among the groups of altitude, suggesting that there are differences between these groups that could influence the study results at which the neonates were attended. Results: Of 2144 neonates analyzed, 53.2% were male, with an average gestational age of 30.8 weeks and a mean birth weight of 1525.2 g. More than half (56.0%) were delivered by caesarean section. Common comorbidities included prematurity (39.4%), asphyxia (31.2%), and infections (24.7%). Also, 17.4% had Apgar scores of ≤ 3. After adjustment, Apgar scores of ≤ 3 were linked to significantly increased odds of death before 24 h, with an aOR of 20.65 (95% CI: 5.99-71.28, p < 0.001). Conclusions: This study demonstrated that the Apgar score, among other determinants, was significantly associated with early neonatal mortality (before the first 24 h). This association was independent of type of delivery, comorbidities, disorders related to asphyxia, prematurity, infections, and other medical disorders, as well as varying levels of care from primary to tertiary. These findings underscore the importance of Apgar evaluation in neonates and suggest a predictive value of the score for early neonatal mortality.

Background: Cervical lymphadenitis is prevalent in children. Several viruses and bacteria can cause cervical lymphadenitis. Staphylococcus aureus and Streptococcus pyogenes are known to predominate as bacterial causes. Choosing the effective antibiotic regimen to treat cervical lymphadenitis is difficult because of temporal and geographical variations in its etiologies and antibiotic resistance. We aim to elucidate the etiologies, treatment, and outcomes of cervical lymphadenitis in children in Iran. Methods: A total of 113 patients admitted to the Children's Medical Center in Iran were included in this retrospective cross-sectional study. Patients under 18 years in medical records were evaluated for demographics, signs and symptoms, lymph node aspiration or surgical drainage culture and antibiogram results, type and duration of treatment, complications, treatment failure, and patient discharge instructions. Results: Patients' mean age was 3.5 years (SD: 2.9; range: 3 months to 13 years), and 70 (62%) were male. Of 113 patients, 38 (34%) had a prior history of upper respiratory tract infection (URI), 2 (1.7%) had dental caries, 1 (0.9%) had Hodgkin's lymphoma, and 72 (64.1%) patients did not have any accompanying illnesses in presentation. The most common clinical manifestation was neck swelling or erythema (99.1%), followed by fever (73%), neck pain (30%), and torticollis (9%). Twenty-one (18.5%) patients underwent cervical lymph node aspiration, and 7 (6%) underwent surgical incision and drainage, of which 17 (61%) had a positive culture. Staphylococcus aureus was isolated in 16 (94%) cases. No positive culture was reported regarding fungi and acid-fast bacilli. Regarding their antibiogram reports, the lowest resistance rates were to vancomycin, cotrimoxazole, and oxacillin (6% each), followed by clindamycin and erythromycin (12% each) and penicillin (94%). The mean duration of hospitalization was 6 days (SD: 3.2; range: 2-22 days). Thirty-three (29%) patients underwent surgical drainage along with antibiotic therapy. Conclusion: Cervical lymphadenitis was prevalently accompanied by URI. Swelling and erythema in the neck were the most common clinical manifestations. The most common isolated organism was Staphylococcus aureus. We did not find Streptococci, which might be due to the beta-lactam usage before hospital admission. Most of the patients were treated with clindamycin during hospitalization. However, resistance to clindamycin was higher than that of other antibiotics effective against Staphylococci and Streptococci, like oxacillin. We recommend considering this resistance pattern in choosing antibiotics to prevent treatment failure and reduce the need for surgery.