Pub Date : 2024-12-01DOI: 10.1016/j.gpeds.2024.100236
Sinan Uslu , Ersin Ulu
The care and follow-up of premature babies after they graduate from neonatal intensive care units (NICU) are essential for maintaining quality of life and maximizing well-being. Ensuring the standardization of this complex multi-disciplinary process and creating individualized care plans is one of the areas that clinicians find most difficult to solve. In this review article, recommendations including somatic growth, vaccination, respiratory system, visual, auditory, surgical, metabolic, and other system follow-up of preterm babies, starting from preparation for discharge and post-discharge from NICU, are discussed in the context of the literature.
{"title":"Follow-up of the preterm NICU graduates","authors":"Sinan Uslu , Ersin Ulu","doi":"10.1016/j.gpeds.2024.100236","DOIUrl":"10.1016/j.gpeds.2024.100236","url":null,"abstract":"<div><div>The care and follow-up of premature babies after they graduate from neonatal intensive care units (NICU) are essential for maintaining quality of life and maximizing well-being. Ensuring the standardization of this complex multi-disciplinary process and creating individualized care plans is one of the areas that clinicians find most difficult to solve. In this review article, recommendations including somatic growth, vaccination, respiratory system, visual, auditory, surgical, metabolic, and other system follow-up of preterm babies, starting from preparation for discharge and post-discharge from NICU, are discussed in the context of the literature.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143181646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-16DOI: 10.1016/j.gpeds.2024.100235
Yehonatan Adler , Shani Blushtein-Levin , Eli Somekh , Yoram Ben-Yehuda , Haim Bibi , Nathan Peled , Michael Wolf
Aim
To examine the validity of lateral neck x ray (LNXR) for the diagnosis of retropharyngeal infection (RPI) in emergency room (ER) settings. Effectiveness of conservative treatment with IV antibiotics for RPI was also examined.
Methods
A retrospective analysis of patients diagnosed with RPI at a university-affiliated primary care center, between the years 2012–2022. Pre-vertebral space diameter at C2 level on LNXR was compared to a control group as well as before and after treatment. A sensitivity analysis was performed.
Results
44 and 20 patients were included in the study and control group, respectively. Median pre-vertebral thickness was significantly different between the groups (14.9 mm [IQR: 12.5, 18.4] vs. 4.1 mm [3.6, 5], p < 0.001). Sensitivity and specificity of LNXR combined with clinical presentation for RPI diagnosis were 87 % and 74 %, respectively. Median pre-vertebral space diameter before and after treatment declined significantly (14.3 mm [12.3, 18.1] vs. 7.2 mm [4.6, 9.6], p < 0.001).
Conclusions
LNXR is a good and valid modality for the diagnosis of RPI, in conjunction with clinical presentation in ER setting. IV antibiotics are efficient for most children with RPI. Neck CT and surgical intervention should be reserved for select patients.
{"title":"The validity of lateral neck X-Ray for the diagnosis of retropharyngeal infection in pediatric patients","authors":"Yehonatan Adler , Shani Blushtein-Levin , Eli Somekh , Yoram Ben-Yehuda , Haim Bibi , Nathan Peled , Michael Wolf","doi":"10.1016/j.gpeds.2024.100235","DOIUrl":"10.1016/j.gpeds.2024.100235","url":null,"abstract":"<div><h3>Aim</h3><div>To examine the validity of lateral neck x ray (LNXR) for the diagnosis of retropharyngeal infection (RPI) in emergency room (ER) settings. Effectiveness of conservative treatment with IV antibiotics for RPI was also examined.</div></div><div><h3>Methods</h3><div>A retrospective analysis of patients diagnosed with RPI at a university-affiliated primary care center, between the years 2012–2022. Pre-vertebral space diameter at C2 level on LNXR was compared to a control group as well as before and after treatment. A sensitivity analysis was performed.</div></div><div><h3>Results</h3><div>44 and 20 patients were included in the study and control group, respectively. Median pre-vertebral thickness was significantly different between the groups (14.9 mm [IQR: 12.5, 18.4] vs. 4.1 mm [3.6, 5], <em>p</em> < 0.001). Sensitivity and specificity of LNXR combined with clinical presentation for RPI diagnosis were 87 % and 74 %, respectively. Median pre-vertebral space diameter before and after treatment declined significantly (14.3 mm [12.3, 18.1] vs. 7.2 mm [4.6, 9.6], <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>LNXR is a good and valid modality for the diagnosis of RPI, in conjunction with clinical presentation in ER setting. IV antibiotics are efficient for most children with RPI. Neck CT and surgical intervention should be reserved for select patients.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"11 ","pages":"Article 100235"},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of the study was to assess whether there was a difference in terms of severity in paediatric patients assessed for respiratory symptoms in paediatric emergency departments between those who tested positive for RSV and those who presented with viral co-infections in addition to RSV. It was also assessed whether there was a difference between the two groups in terms of need for hospitalisation and ventilation.
Methods
This is a single center study from October 2022 to February 2023, compared two groups of patients: those infected with RSV and those coinfected with RSV and other viruses. Parameters examined included the severity of illness, as measured by the Clinical Respiratory Score (CRS), the need for and duration of hospitalization, and the need for ventilation via high flow nasal cannula (HFNC).
Results
The correlation with disease severity assessed by CRS in the two groups with RSV only and coinfection was not statistically significant (p-value 0.281). The correlation in the two groups between the need for hospitalization (p-value 1) and the need for ventilation (p-value 0.302) was also not significant. No significant correlation was found between the age of patients and CRS (R = −0.26, p = 0.119) and the age of patients and days of hospitalization (R = −0.013, p = 0.938).
Conclusion
These findings highlight the importance of careful management of RSV infections in children. Despite the limitations, the lack of significant differences in disease severity indicates the need to explore additional preventive strategies, such as RSV vaccination, to improve the clinical approach.
{"title":"Pediatric RSV infection and respiratory coinfections: Is a link related to clinical severity? Single center retrospective study","authors":"Raffaele Falsaperla , Francesco Gambilonghi , Daria La Cognata , Lucia Giovanna Tardino , Silvia Marino , Patrizia Grassi , Grete Francesca Privitera , Vincenzo Sortino , Martino Ruggieri","doi":"10.1016/j.gpeds.2024.100233","DOIUrl":"10.1016/j.gpeds.2024.100233","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of the study was to assess whether there was a difference in terms of severity in paediatric patients assessed for respiratory symptoms in paediatric emergency departments between those who tested positive for RSV and those who presented with viral co-infections in addition to RSV. It was also assessed whether there was a difference between the two groups in terms of need for hospitalisation and ventilation.</div></div><div><h3>Methods</h3><div>This is a single center study from October 2022 to February 2023, compared two groups of patients: those infected with RSV and those coinfected with RSV and other viruses. Parameters examined included the severity of illness, as measured by the Clinical Respiratory Score (CRS), the need for and duration of hospitalization, and the need for ventilation via high flow nasal cannula (HFNC).</div></div><div><h3>Results</h3><div>The correlation with disease severity assessed by CRS in the two groups with RSV only and coinfection was not statistically significant (<em>p</em>-value 0.281). The correlation in the two groups between the need for hospitalization (<em>p-value</em> 1) and the need for ventilation (<em>p-value</em> 0.302) was also not significant. No significant correlation was found between the age of patients and CRS (<em>R</em> = −0.26, <em>p</em> = 0.119) and the age of patients and days of hospitalization (<em>R =</em> −0.013, <em>p =</em> 0.938).</div></div><div><h3>Conclusion</h3><div>These findings highlight the importance of careful management of RSV infections in children. Despite the limitations, the lack of significant differences in disease severity indicates the need to explore additional preventive strategies, such as RSV vaccination, to improve the clinical approach.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.gpeds.2024.100234
Joseph Haddad
{"title":"Children in jeopardy: Lessons learned from the Middle East Conflict!","authors":"Joseph Haddad","doi":"10.1016/j.gpeds.2024.100234","DOIUrl":"10.1016/j.gpeds.2024.100234","url":null,"abstract":"","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-08DOI: 10.1016/j.gpeds.2024.100232
Ranganatha A Devaranavadagi , Kavya M G , Netra S Kannur , Karthik Nagesh N
Background
With the current growth of many neonatal units in the country, good initial stabilization of sick neonates is possible at peripheral centers. However, poor neonatal transport and retrieval facilities are unfortunately leading to higher preventable mortality and morbidity in neonates arriving at a tertiary care center in poor condition.
Objective
To bridge the gap between referring hospital and tertiary care, this quality improvement initiative aimed to create a well-organized ‘network transport system’ for the round-the-clock provision of a city-wide retrieval system.
Methods and intervention
Various causes linked to adverse events in the transport and retrieval of sick infants were initially assessed through a ‘fishbone analysis’. A step-wise-driven PDSA cycle was performed. It was realized that a well-organized, centrally controlled network of fully equipped neonatal ambulances with trained personnel for delivering neonatal intensive care on wheels was necessary even in a tier-one city like Bengaluru, India. A network transport and retrieval system for the city of Bengaluru was systematically created, involving 10 partner hospitals in the Manipal group. Training of all personnel involved in transport, creating a good infrastructure of state-of-the-art ambulances, transport incubators with ventilators, remote monitoring systems, and the creation of a centralized helpline with 24/7 response. The facility was named Neonatal Care on Wheels (NOW) and was propagated as a NICU on Wheels.
Results
This initiative significantly improved the quality of neonatal transport as well as the stabilization of the neonate before transport.
Conclusion
This robust network transport has proven to show improvements in the quality of retrieval and survival similar to that seen in Western countries.
{"title":"Creation of a unique centrally monitored and operated neonatal transport network in a lower and middle-income country: A first of its kind initiative","authors":"Ranganatha A Devaranavadagi , Kavya M G , Netra S Kannur , Karthik Nagesh N","doi":"10.1016/j.gpeds.2024.100232","DOIUrl":"10.1016/j.gpeds.2024.100232","url":null,"abstract":"<div><h3>Background</h3><div>With the current growth of many neonatal units in the country, good initial stabilization of sick neonates is possible at peripheral centers. However, poor neonatal transport and retrieval facilities are unfortunately leading to higher preventable mortality and morbidity in neonates arriving at a tertiary care center in poor condition.</div></div><div><h3>Objective</h3><div>To bridge the gap between referring hospital and tertiary care, this quality improvement initiative aimed to create a well-organized ‘network transport system’ for the round-the-clock provision of a city-wide retrieval system.</div></div><div><h3>Methods and intervention</h3><div>Various causes linked to adverse events in the transport and retrieval of sick infants were initially assessed through a ‘fishbone analysis’. A step-wise-driven PDSA cycle was performed. It was realized that a well-organized, centrally controlled network of fully equipped neonatal ambulances with trained personnel for delivering neonatal intensive care on wheels was necessary even in a tier-one city like Bengaluru, India. A network transport and retrieval system for the city of Bengaluru was systematically created, involving 10 partner hospitals in the Manipal group. Training of all personnel involved in transport, creating a good infrastructure of state-of-the-art ambulances, transport incubators with ventilators, remote monitoring systems, and the creation of a centralized helpline with 24/7 response. The facility was named Neonatal Care on Wheels (NOW) and was propagated as a NICU on Wheels.</div></div><div><h3>Results</h3><div>This initiative significantly improved the quality of neonatal transport as well as the stabilization of the neonate before transport.</div></div><div><h3>Conclusion</h3><div>This robust network transport has proven to show improvements in the quality of retrieval and survival similar to that seen in Western countries.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.gpeds.2024.100230
C. Villaizán Pérez , M. Aparicio Rodrigo , F. Fehr
Primary care paediatrics is practiced throughout the countries of Europe with different structures of health care systems and identities of care providers. The best way to guarantee that paediatricians are competently trained and provide high quality care to children and adolescents in primary care is a flexible and comprehensive training program based on practice and demonstration of acquired competencies. Entrustable professional activities represent a significant step toward improving the training and assessment of future healthcare professionals. It may constitute a model that unifies the training standards in primary care and community paediatrics.
{"title":"Training in primary care paediatrics: The role of entrustable professional activities","authors":"C. Villaizán Pérez , M. Aparicio Rodrigo , F. Fehr","doi":"10.1016/j.gpeds.2024.100230","DOIUrl":"10.1016/j.gpeds.2024.100230","url":null,"abstract":"<div><div>Primary care paediatrics is practiced throughout the countries of Europe with different structures of health care systems and identities of care providers. The best way to guarantee that paediatricians are competently trained and provide high quality care to children and adolescents in primary care is a flexible and comprehensive training program based on practice and demonstration of acquired competencies. Entrustable professional activities represent a significant step toward improving the training and assessment of future healthcare professionals. It may constitute a model that unifies the training standards in primary care and community paediatrics.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"10 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.gpeds.2024.100229
Disha Nagpal , Hollis Lai , Monica Prasad Gibson , Mehdi Salehi Zeinabadi , Ida M Kornerup
Objective
Given the importance of diagnosing periodontal diseases in pediatric patients, the objective of this study was to examine knowledge, confidence, and clinical reasoning of third- and fourth-year dental students regarding periodontal diagnosis and treatment planning in pediatric patients.
Methods
An explanatory sequential mixed-method study was conducted in two phases. In the first phase, the survey questions were administered online to the third-and fourth-year dental students. Surveys tested for knowledge, confidence and clinical decision-making using questions and case-studies. Answers from periodontists and the pediatric dentists were used as the gold standard. For the next phase, individual interviews were recorded, transcribed, and coded followed by verbal analysis to assess their clinical reasoning for the specific diagnosis and treatment planning.
Results
While there was no overall difference in the knowledge and the confidence level between the students, they differed from the experts for some questions in confidence levels. As measured using the Script Concordance Test (SCT), no significant differences were observed between the participants in their clinical reasoning. The verbal analysis of the interview data showed that the students used three different patterns for searching through the problem space. Most of the students used the forward pattern of search and reported low confidence in diagnosing and treating pediatric periodontal diseases.
Conclusion
Due to low self-reported confidence in diagnosing periodontal disease in pediatric patients. Providing education solutions will improve the confidence of undergraduate dental students in diagnosing and treating periodontal disease.
{"title":"Knowledge, confidence and clinical reasoning of dental students for diagnosing pediatric periodontal diseases","authors":"Disha Nagpal , Hollis Lai , Monica Prasad Gibson , Mehdi Salehi Zeinabadi , Ida M Kornerup","doi":"10.1016/j.gpeds.2024.100229","DOIUrl":"10.1016/j.gpeds.2024.100229","url":null,"abstract":"<div><h3>Objective</h3><p>Given the importance of diagnosing periodontal diseases in pediatric patients, the objective of this study was to examine knowledge, confidence, and clinical reasoning of third- and fourth-year dental students regarding periodontal diagnosis and treatment planning in pediatric patients.</p></div><div><h3>Methods</h3><p>An explanatory sequential mixed-method study was conducted in two phases. In the first phase, the survey questions were administered online to the third-and fourth-year dental students. Surveys tested for knowledge, confidence and clinical decision-making using questions and case-studies. Answers from periodontists and the pediatric dentists were used as the gold standard. For the next phase, individual interviews were recorded, transcribed, and coded followed by verbal analysis to assess their clinical reasoning for the specific diagnosis and treatment planning.</p></div><div><h3>Results</h3><p>While there was no overall difference in the knowledge and the confidence level between the students, they differed from the experts for some questions in confidence levels. As measured using the Script Concordance Test (SCT), no significant differences were observed between the participants in their clinical reasoning. The verbal analysis of the interview data showed that the students used three different patterns for searching through the problem space. Most of the students used the forward pattern of search and reported low confidence in diagnosing and treating pediatric periodontal diseases.</p></div><div><h3>Conclusion</h3><p>Due to low self-reported confidence in diagnosing periodontal disease in pediatric patients. Providing education solutions will improve the confidence of undergraduate dental students in diagnosing and treating periodontal disease.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000976/pdfft?md5=188cc0e8d5a2870808121f8bfe3ea01d&pid=1-s2.0-S2667009724000976-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Ethiopian Federal Ministry of Health has been working by introducing vaccines, and integrating the management of newborn and child illnesses to prevent pneumonia, pneumonia-related hospitalization, and mortality. Despite these attempts, the prevalence of pneumonia and the proportion of hospitalizations have increased. Little is known about recovery time from severe pneumonia and its predictors in pediatric patients in the study area. Therefore, this study aimed to determine the time to recovery from severe pneumonia and its predictors in pediatric patients admitted to government hospitals in the southwest Region.
Methods and Materials
A hospital-based prospective follow-up study was conducted among 791 pediatric patients admitted with severe pneumonia at a governmental hospital in the South West Region, of Ethiopia. A systematic sampling technique was used to recruit participants. Data were entered into Epi-data 4.4.2.1 and exported to STATA 14 for analysis. The assumptions of Cox proportional hazard models and goodness of fit were assessed using the Shoenfield residual and Cox-Snell, respectively. Bivariate and multivariable Cox regression models were used to identify the predictors of time to recovery. Variables with a p-value of <0.05 at a 95 % confidence level in multivariable Cox regression model analysis were declared statistically significant predictors of time to recovery.
Results
This study revealed that 641 (81.04 %) participants recovered with an incidence rate of 12.48 per 100 person-day observations. The median time to recovery was 5 days. Rural residence [AHR=0.82; 95 % CI 0.69–0.97], hypoxemia [AHR=1.25; 95 % CI 1.01- 1.55], danger sign, [AHR=1.77; 95 % CI 1.28- 2.45], comorbidity [AHR=0.60; 95 % CI 0.50- 0.7] and history of previous respiratory infections [AHR=0.76; 95 % CI 0.64- 0.90] were found significant predictors of time to recovery from severe pneumonia.
Conclusion
In this study, the recovery rate from severe pneumonia among pediatric patients was low and the time to recovery was slightly prolonged with a median time to recovery of five days. Rural residence, hypoxemia, danger signs, comorbidity, and history of previous respiratory infections were independent predictors of time to recovery among pediatric patients. Therefore, the Ethiopian Federal Ministry of Health, family, community leaders, healthcare providers, and other stakeholders should provide timely initiation of advanced diagnosis, appropriate therapeutic interventions, and proper follow-up for pediatric patients with severe pneumonia to reduce mortality.
背景埃塞俄比亚联邦卫生部一直致力于通过引入疫苗、整合新生儿和儿童疾病管理来预防肺炎、肺炎相关住院和死亡。尽管做出了这些努力，但肺炎的发病率和住院比例仍在上升。研究地区的儿科患者对重症肺炎的康复时间及其预测因素知之甚少。因此，本研究旨在确定在西南部地区政府医院住院的儿科患者从重症肺炎中康复的时间及其预测因素。研究采用系统抽样技术招募参与者。数据输入 Epi-data 4.4.2.1 并导出到 STATA 14 进行分析。分别使用 Shoenfield 残差和 Cox-Snell 评估了 Cox 比例危险模型的假设和拟合优度。双变量和多变量 Cox 回归模型用于确定康复时间的预测因素。在多变量 Cox 回归模型分析中，如果在 95% 的置信水平下 p 值为 <0.05，则该变量被认为是对康复时间有统计学意义的预测因素。康复时间的中位数为 5 天。农村居民[AHR=0.82; 95 % CI 0.69-0.97]、低氧血症[AHR=1.25; 95 % CI 1.01-1.55]、危险征兆[AHR=1.77; 95 % CI 1.28-2.45]、合并症[AHR=0.60; 95 % CI 0.50-0.7]和既往呼吸道感染史[AHR=0.76; 95 % CI 0.64- 0.90]被认为是显著的预测因素。结论 在本研究中，儿童重症肺炎患者的康复率较低，康复时间略有延长，中位康复时间为 5 天。农村居民、低氧血症、危险体征、合并症和既往呼吸道感染史是预测儿童患者康复时间的独立因素。因此，埃塞俄比亚联邦卫生部、家庭、社区领袖、医疗服务提供者和其他利益相关者应为重症肺炎儿科患者提供及时的早期诊断、适当的治疗干预和适当的随访，以降低死亡率。
{"title":"Time to recovery from severe pneumonia and its predictors among pediatric patients admitted in South West Region governmental hospitals, South West Ethiopia: Prospective follow-up study","authors":"Yalemtsehay Dagnaw Genie , Alemayehu Sayih , Nigatu Dessalegn , Emebet Adugnaw , Aynalem Yetwale Hiwot , Tsegaw Biyazin Tesfa , Kassa Kindie , Lidiya Gutema , Ermias Ayalew , Belete Fenta Kebede","doi":"10.1016/j.gpeds.2024.100227","DOIUrl":"10.1016/j.gpeds.2024.100227","url":null,"abstract":"<div><h3>Background</h3><p>The Ethiopian Federal Ministry of Health has been working by introducing vaccines, and integrating the management of newborn and child illnesses to prevent pneumonia, pneumonia-related hospitalization, and mortality. Despite these attempts, the prevalence of pneumonia and the proportion of hospitalizations have increased. Little is known about recovery time from severe pneumonia and its predictors in pediatric patients in the study area. Therefore, this study aimed to determine the time to recovery from severe pneumonia and its predictors in pediatric patients admitted to government hospitals in the southwest Region.</p></div><div><h3>Methods and Materials</h3><p>A hospital-based prospective follow-up study was conducted among 791 pediatric patients admitted with severe pneumonia at a governmental hospital in the South West Region, of Ethiopia. A systematic sampling technique was used to recruit participants. Data were entered into Epi-data 4.4.2.1 and exported to STATA 14 for analysis. The assumptions of Cox proportional hazard models and goodness of fit were assessed using the Shoenfield residual and Cox-Snell, respectively. Bivariate and multivariable Cox regression models were used to identify the predictors of time to recovery. Variables with a p-value of <0.05 at a 95 % confidence level in multivariable Cox regression model analysis were declared statistically significant predictors of time to recovery.</p></div><div><h3>Results</h3><p>This study revealed that 641 (81.04 %) participants recovered with an incidence rate of 12.48 per 100 person-day observations. The median time to recovery was 5 days. Rural residence [AHR=0.82; 95 % CI 0.69–0.97], hypoxemia [AHR=1.25; 95 % CI 1.01- 1.55], danger sign, [AHR=1.77; 95 % CI 1.28- 2.45], comorbidity [AHR=0.60; 95 % CI 0.50- 0.7] and history of previous respiratory infections [AHR=0.76; 95 % CI 0.64- 0.90] were found significant predictors of time to recovery from severe pneumonia.</p></div><div><h3>Conclusion</h3><p>In this study, the recovery rate from severe pneumonia among pediatric patients was low and the time to recovery was slightly prolonged with a median time to recovery of five days. Rural residence, hypoxemia, danger signs, comorbidity, and history of previous respiratory infections were independent predictors of time to recovery among pediatric patients. Therefore, the Ethiopian Federal Ministry of Health, family, community leaders, healthcare providers, and other stakeholders should provide timely initiation of advanced diagnosis, appropriate therapeutic interventions, and proper follow-up for pediatric patients with severe pneumonia to reduce mortality.</p></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"9 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667009724000952/pdfft?md5=5fd3670aa98bf9f7047717941b4e0225&pid=1-s2.0-S2667009724000952-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142098171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.gpeds.2024.100224
Christine Magendie , Gottfried Huss , Laura Reali , Stephen Reingold
Unparalleled drug shortages during the winter of 2022/2023 had a profound impact on paediatric primary care across Europe. A survey conducted by the European Confederation of Primary Care Paediatricians (ECPCP) evaluated the availability of essential pediatric drugs and the resulting challenges. The survey was conducted between January and March 2023 and included responses from 640 paediatricians from 18 countries. The results of the survey indicated that there were substantial shortages, particularly of child friendly formulations of commonly prescribed medicines. Paediatricians in the survey feared that the use of less appropriate alternatives could potentially compromise the efficacy and safety of treatment. The survey findings highlight the urgent need for coordinated actions at multiple levels to ensure the availability of essential pediatric medications and safeguard children's health in future crises.
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