BMC Pediatrics最新文献

Purpose: To elucidate the global epidemiology of Ophthalmia Neonatorum (ON), as well as its causative organisms and their antibiotic susceptibility patterns.

Methods: A systematic review of studies reporting the epidemiology of ON was performed using four electronic databases: PubMed, Scopus, Web of Science, and Medline. Data were extracted and study-specific estimates were combined using meta-analysis to obtain pooled proportions.

Results: A total of 25 studies, which evaluated the epidemiology of ON in 1,117,966 live births, were included in this study. A total of 2,902 cases of ON were identified. The global incidence and prevalence of ON are 2.04% [(95% CI 0.70-5.79%), I² = 99.4%] and 7.79% [(95% CI 2.93-19.10%), I² = 99.1%], respectively. Staphylococcus spp. (gram-positive) and Serratia marcescens (gram-negative) were the most frequently isolated bacteria associated with the incidence of ON. The pooled resistance of Staphylococcus aureus and Escherichia coli are highest to Penicillin [91.67% (95% CI 87.96-94.31%) and 100.00% (95% CI 0.00-100.00%), respectively], and lowest to Gentamicin [20% (95% CI 15.85-24.91%) and 59.30% (95% CI 52.36-65.89%), respectively]. The pooled resistance of Pseudomonas spp. and Klebsiella spp. to Gentamicin are 50% [(95% CI 43.11 to 56.89%), I² = 0.00%] and 50.02% [(95% CI 27.50-72.53%), I² = 95.3%], respectively.

Conclusion: ON is a common ocular morbidity in neonates, especially in those from low-income settings. It is important that all newborns receive adequate preventive care, regardless of their socioeconomic status, in order to reduce the risk of visual impairment and blindness.

Background: Overweight and obesity are global issues, especially among women of childbearing age, linked to adverse maternal and neonatal outcomes. These risks vary by age, race, and ethnicity, with increasing rates among immigrant and minority women. This study compares overweight and obesity rates, pregnancy weight gain, and neonatal outcomes in Turkish and Syrian immigrant/refugee women.

Methods: In this retrospective study, at Buca Seyfi Demirsoy Hospital in Izmir, Turkey a total of 1353 mother-infant pairs were checked for eligibility. Of the entire cohort of 1353 mother-infant pairs, 323 pairs with complete medical records were included. The primary outcome was rate of pregestational obesity or overweight as secondary outcomes were weight gain during pregnancy and adherence to guidelines, neonatal outcomes according to different BMI categories and possible impact of maternal weight gain on neonatal morbidities in two different ethic populations.

Results: Of the 323 mother-infant pairs, overweight/obese mothers had higher birth weights and cesarean-section rates. Syrian mothers were more likely to gain less weight than recommended. Neonatal outcomes, such as hospitalization and SGA/LGA birth rates, were similar across groups, with varying compliance to weight gain guidelines.

Conclusions: Pre-pregnancy BMI and gestational weight gain significantly affect some of the neonatal outcomes. High obesity rates and ethnic disparities highlight the need for culturally tailored prenatal care to improve maternal and neonatal health, especially in immigrant populations. Further research with larger, diverse cohorts is needed.

In spite of the commendable global Pneumococcal Conjugate Vaccine (PCV) coverage in the last two decades, completion and timeliness of receipt of all the required doses are still below target. In Uganda, the 3 + 0 PCV regimen has been reported to have a steady decline in the completion rate and the reasons for the delayed completion are unidentified. This study aimed at assessing the influence of socio-demographic factors on delayed PCV completion among young children. A cross-sectional study design among 362 child/caretakers pairs in Bugongi Town Council was employed. Using stratified sampling - Allocation Proportional to Size, data was collected using pretested questionnaires; entered and analysed using STATA v14 and significant statistical association was considered at P ≤ 0.05. Of the 362 children, majority (53.87%) were boys. Child mean age was 25.1 ± 14.3 months. 87.6% caretakers were females and majorities of them were aged 20-29yrs (47.8%), peasant farmers (79.8%), married (90.6%), attained primary education (63.5%) and earned average monthly income of UGX 10,000 - UGX 50,000 (41.4%). Of the 362 children, 92 (25.4%) had delayed to receive their PCV-3 doses. Only boy child [cOR = 1.65, (95%CI: 1.03-2.66); P = 0.039) and caretaker's age 30-39 [cOR = 2.12 (95%CI: 1.06-4.24); P = 0.033) showed statistical significance at bivariate analysis. The multivariate model found parent's age 20-29 years [aOR = 2.39 (1.14-5.01); P = 0.021] and 30-39 years [aOR = 2.51 (1.16-5.45); P = 0.020] as positively associated factors whereas being married [aOR = 0.20 (0.04-0.96); P = 0.044] was the only negatively associated factors to delayed completion of PCV vaccination among young children. Among children who complete the last dose of PCV vaccination, a considerable proportion are actually receiving it late which may result into eventual failure to curb the targeted pneumococcal infections. Thus, concerted efforts in terms of sensitization are un-doubtfully desired especially among caretakers aged 20-39 years as well as those who are not married.

Objective: To explore the effect of short-acting growth hormone (GH) supplementation on bone age and growth rate of children with idiopathic short stature.

Methods: The authoritative databases such as PubMed, Medline, and Web of Science were extensively searched through the systematic and comprehensive literature retrieval strategy to compile the clinical research data on the treatment of idiopathic short stature with short-acting GH. The study will be strictly screened to ensure that all enrolled research subjects are patients with idiopathic short stature, and the intervention method is defined as short-acting GH replacement therapy, and a reasonable control group is set, such as placebo treatment, to ensure the scientificity and comparability of research results. Outcome index data such as basic characteristics, sample size, follow-up time, and total effective rate of the included studies were extracted. In this study, RevMan 5.3, a professional statistical software tool, was used to systematically perform the meta-analysis process. Weighted average difference (WMD) was calculated as the primary outcome to evaluate the effect of bone age and growth rate, and the WAD in adverse reactions was considered as the secondary outcome.

Results: Nine studies were included in the study, and 491 patients with idiopathic short stature were included in the study. The results of the meta-analysis showed that there was no significant difference in bone age but a significant difference in growth rate when compared with the control group.

Conclusion: Short-acting GH supplementation can significantly improve the growth rate of children with idiopathic short stature, but has little effect on bone age.

Background: Competing definitions of posttraumatic stress disorder (PTSD) have been proposed by ICD-11 and DSM-5; it is unclear which diagnostic model works best for children and adolescents. Although other studies have predicted the impact of these models by approximating the criteria using older measures, this study advances the research by comparing measures designed to assess ICD-11 and DSM-5 criteria in hurricane-exposed youth. This study evaluates ICD-11 and DSM-5 (both the standard and preschool-age) diagnostic models by identifying diagnostic rates, evaluating diagnostic concordance, investigating the predictive value of constructs associated with PTSD (demographics, disaster threat and exposure, functional impairment), and examining model fit.

Method: The sample was exposed to Hurricane Ian (2022), a deadly Category 5 hurricane. Parents reported on disaster exposure and their child's PTSD symptoms (n = 152; ages 7-17) using the International Trauma Questionnaire for Children and Adolescents Caregiver Version (ITQ-CG) for ICD-11 criteria and UCLA PTSD Reaction Index for DSM-5, Parent/Caregiver Report Version (RI-5) for DSM-5 criteria.

Results: ICD-11 PTSD symptom criteria rates were 24% and dropped to 20% when the impairment criterion was added. PTSD symptom criteria rates were 11% (10% with impairment) for DSM-5 and 13% (12% with impairment) for DSM-5 Preschool. ICD-11 rates were higher than DSM-5 and DSM-5 Preschool rates. There was no difference between DSM-5 and DSM-5 Preschool rates of PTSD. There was moderate to substantial concordance between ICD-11 and the DSM-5 models. All diagnostic models were associated with exposure and impairment, but only ICD-11 was associated with threat. ICD-11 was the only one to evidence acceptable model fit.

Conclusions: Using the ITQ-CG and RI-5 to assess PTSD in youth, results showed higher PTSD diagnostic rates for ICD-11 than DSM-5; this contradicts prior findings (based off approximated ICD-11 criteria) and seems largely due to differences in symptom thresholds used by the two measures. The ITQ-CG exhibited excellent model fit and was associated with several constructs important to PTSD.

Introduction: Morbidity and mortality associated with congenital anomalies are higher in low-income countries. People's knowledge, beliefs, and attitudes towards congenital anomalies vary from community to community. In some communities, it is believed to be untreatable and the burden remains devastating. Studies addressing the societal perspectives were scarce, therefore this study aimed to explore beliefs and perceptions in the community about congenital anomalies.

Methodology: This study was conducted in Southern Ethiopia, Dilla town from September to November 2023. A qualitative study with a community-based exploratory study design was implemented. A total of 33 participants who were selected conveniently among permanent residents of Dilla town were included. Data were collected using face-to-face in-depth interviews and focus group discussions. The collected data were transcribed verbatim and translated into the English language. Data analysis was implemented thematically using Open Code 4.03 software. Finally, the result was presented descriptively based on the themes that emerged. Trustworthiness was ensured throughout the data analysis.

Result: In this study, most participants poorly understood congenital anomalies. God's punishment, curse, parents' sin, magical practices and evil spirits, illness, lack of pregnancy care and contraceptive pills were the believed causes of congenital anomalies. The burden of congenital anomalies dismantles the social, economic, and psychological dimensions of the life of parents. In addition, the study identified attitudinal variations and doubts about treatment outcomes and prevention strategies of congenital anomalies.

Conclusion: This study highlights that people's perceived knowledge, beliefs, and awareness of congenital malformations were limited to socio-cultural and religious roots. Understanding beliefs and perceived knowledge would be significant in planning risk-reduction strategies. Hence health education, behavioral change communications, and information dissemination strategies should be strengthened at each community level.

Background: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder affecting multiple systems. However, arterial stenosis is a rare manifestation in patients with NF1. Since the symptoms of arterial stenosis caused by NF1 are often atypical and have a high under-diagnosis rate, this can lead to serious complications such as hypertension, ischemic stroke, or even death. The aim of our research is to analyse the clinical characteristics of arterial stenosis in pediatric patients with NF1 and to summarise its diagnosis, treatment and prognosis.

Methods: We conducted a retrospective review of data from patients with NF1 treated at Beijing Children's Hospital from 2016 to 2020. Patients diagnosed with arterial stenosis, identified through clinical symptoms, physical examination, arterial ultrasonography, or imaging studies, were included in this study. These patients received symptomatic drug and/or surgical treatments and were followed up regularly. We summarized demographic characteristics, sites of arterial stenosis, clinical manifestations, and treatment outcomes.

Result: Among the 258 patients with NF1 treated at our hospital, 12 (4.7%) had arterial stenosis, comprising 9 males and 3 females with a median age of 7 years (range: 1-14 years). Renal artery stenosis was diagnosed in 7 patients (58.3%), while internal carotid artery (ICA) stenosis was diagnosed in 5 patients (41.7%). The predominant symptoms of renal artery and ICA stenosis were renal hypertension and convulsions, respectively. Antihypertensive drugs were effective in 5 patients with renal hypertension; 2 patients required balloon dilatation of the renal artery due to inadequate response to medication. Oral antiepileptic treatment was effective in 3 patients with ICA stenosis, and encephaloduroarteriosynangiosis was effective in the remaining 2 cases. The follow-up period ranged from 2 to 6 years, with a median duration of 3 years. No deterioration or mortality was observed during the follow-up period.

Conclusions: Arterial stenosis was present in approximately 4.7% of patients with NF1, predominantly affecting the renal artery and ICA. Renal hypertension and convulsions were the primary symptoms of renal artery and ICA stenosis, respectively. Early diagnosis and intervention can substantially improve the prognosis of these patients.

Background: Anaemia is a major cause of morbidity among children under five years in Uganda. However, its magnitude among refugee populations is marginally documented. In this study, the prevalence and contributors to anaemia among children 6 to 59 months in Kyangwali refugee settlement in Western Uganda was determined.

Methods: This was a cross-sectional study that was carried out among 415 mother- child dyads at Kwangwali refugee settlement. Anaemia was determined by measuring haemoglobin concentration using the HaemoCue method, while nutritional status was examined using standard World Health Organisation (WHO) nutritional indices. Data abstraction forms, pretested questionnaires and face to face interviews were used to collect patient data. Associations between the independent variables and anaemia were examined using modified Poisson regression with robust standard errors. In all statistical tests, a P- value of < 0.05 was considered as significant.

Results: The proportion of children with anaemia was 49.2% (95% CI: 44.4-53.9). Anaemia was 1.4 times (95% CI = 1.13-1.82; p = 0.003) more prevalent among wasted children than the normal children. The prevalence of anaemia was also higher among underweight children than those with normal weight (aPR = 1.37, 95% CI = 1.11-1.70; p = 0.004). Additionally, the prevalence of anaemia was higher among children of birth order of 6 or above (aPR = 2.00, 95% CI = 1.22-3.29; p = 0.006), while anaemia prevalence was lower among children whose mothers' had attained secondary level of education (aPR = 0.19, CI = 0.04-0.98; p = 0.048) and those who fed on fish (aPR = 0.75, 95% CI = 0.57-0.99; p = 0.039) and meals prepared with oils and fats (aPR = 0.70, 95% CI = 0.51-0.97; p = 0.029). There was no significant relationship between anaemia occurrence and the household dietary diversity score.

Conclusions: About half of the study children were found to be anaemic. The most significant contributors to anaemia in the study population were malnutrition, maternal education, feeding practices and birth order. The study findings suggest need of screening of children for anaemia at all nutritional clinics, promotion of education, addressing barriers to sustainable food supply and accessibility of nutrient-dense foods, treating anaemia in children alongside other micronutrient deficiencies and addressing the nutritional needs of multiparous mothers in refugee communities.

Background: Consequences of lung injury and inflammation in preterm infants with bronchopulmonary dysplasia (BPD) contribute to prolonged oxygen requirements. Home oxygen therapy (HOT) is an alternative way of respiratory support in infant with BPD. However, there is no consensus on weaning guidelines. Our objective is to identify the median age of HOT discontinuation and the factors that might predict the duration of HOT in a resource poor country.

Methods: All preterm (≤ 36 weeks' gestation) infants diagnosed with BPD who required HOT after discharged from Ramathibodi Hospital during January 2000 - December 2019 comprised this retrospective study. Timing of HOT withdrawal was identified. Demographic data, severity of BPD, maternal condition, respiratory support, comorbidities, complications, and growth were recorded and analyzed as factors associated of home oxygen withdrawal.

Results: Of 8581 preterm infants born during the 20-year period, 563 (6.6%) had BPD. Among 40 infants treated with HOT, 18 (45%) were successfully weaned from oxygen within 12 months. The median corrected age (CA) of oxygen withdrawal was 13.8 months (8.5, 22.1). Longer duration of total respiratory support, longer length of hospital stay and poor growth determined by weight, length and head circumference were associated with longer duration of HOT. Greater weight gain was associated with a shorter duration of HOT at 12 months CA (adjusted OR, 1.97; 95% CI, 1.13-3.23; p = 0.015).

Conclusions: The median corrected age of oxygen withdrawal in Thai BPD infants was 13.8 months. Severe BPD and poor linear growth were associated with prolonged HOT.