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Paediatrics and International Child Health

Rosine Nyirasafari, Mark H Corden, Angélique Charlie Karambizi, Jean Claude Kabayiza, Jean Damascene Makuza, Rex Wong, Michael F Canarie
BACKGROUND: The enormous burden of critical illness in resource-limited settings has led to a growing interest in paediatric critical care in these regions. However, published data on the practice of critical care and patient outcomes in these settings are scant. OBJECTIVE: This study sought to identify risk factors associated with mortality in the newly established Paediatric Intensive Care Unit (PICU) at Kigali University Teaching Hospital (KUTH) in Rwanda and test the predictive ability of a newly devised mortality risk score, the modified PRISM (MP) score...
December 6, 2016: Paediatrics and International Child Health
Suchismita Mishra, Yadlapalli S Kusuma, Bontha V Babu
BACKGROUND: In India, migrant status, tribal affiliation and poverty render tribal migrants more vulnerable than any other group which leads to high treatment costs and the risk of low access to health care. OBJECTIVE: To examine treatment-seeking behaviour and out-of-pocket (OOP) expenditure on the treatment of childhood illnesses, with a focus on gender in a migrant tribal community in Bhubaneswar, eastern India. METHODS: A total of 175 households with a child aged 0-14 years and who had migrated within the last 12 years were selected from tribal-dominated slums...
December 6, 2016: Paediatrics and International Child Health
Sophie Harvey, Jo Callaby, Lesley Roberts
BACKGROUND: Inappropriate infant and young child feeding practices contribute to malnutrition, infection and long-term development limitation. AIMS: To explore complementary feeding and food safety in Muhoroni District, Nyanza Province in rural Kenya. OBJECTIVES: To compare practices with the Infant and Young Child Feeding (IYCF) guidelines, and identify associations with inappropriate practices. METHODS: Between January and April 2014, a questionnaire completed by primary caregivers of children aged 6-23 months asked about foods the child had received in the previous 24 hours, the introduction of complementary foods, and the food hygiene practices undertaken by the caregiver...
December 6, 2016: Paediatrics and International Child Health
Ana L Creo, Tom D Thacher, John M Pettifor, Mark A Strand, Philip R Fischer
Worldwide, nutritional rickets continues to be an evolving problem with several causes. This paper provides an updated literature review characterising the prevalence, aetiology, pathophysiology and treatment of nutritional rickets worldwide. A systematic review of articles on nutritional rickets from various geographical regions was undertaken. For each region, key information was extracted, including prevalence, cause of rickets specific to the region, methods of confirming the diagnosis and current treatment and preventive measures...
December 6, 2016: Paediatrics and International Child Health
Michael France
Homozygous familial hypercholesterolaemia (HoFH) is an inherited disease causing an approximately fourfold increase in blood low-density lipoprotein cholesterol (LDLC) from birth compared with the age-matched normal population owing to reduced low-density lipoprotein receptor (LDLR) activity. Such elevated cholesterol is associated with accelerated atheromatous disease, particularly of the aortic root and coronary arteries. However, HoFH is clinically heterogeneous, reflecting residual low-density lipoprotein receptor (LDLR) activity...
November 2016: Paediatrics and International Child Health
Shivani Deswal, Akshay Kapoor, Anupam Sibal, Vikas Kohli
Familial hypercholesterolaemia (FH) is an autosomal dominant lipid disorder. Homozygous FH (HFH), though rare, presents in early childhood. Two different presentations of HFH are reported. The first child presented at 5 years of age with xanthomas on the knees, elbows and buttocks and failure to thrive since the second year of life. He was found to be hypertensive with moderate aortic regurgitation. He is now stable on statins and antihypertensives. The second child presented at 10 years of age with multiple xanthomas and severe aortic stenosis...
November 2016: Paediatrics and International Child Health
Dirga Kumar Lamichhane, Jong Han Leem, Hwan Cheol Kim, Myung Sook Park, Ji Young Lee, So Hyun Moon, Jung Keun Ko
BACKGROUND: Childhood undernutrition remains a highly influential risk factor in terms of the global burden of disease. Increasing evidence links infant and young child feeding (IYCF) practices to undernutrition. However, the results are inconsistent, and more country-specific studies are needed. OBJECTIVES: To determine the associations between IYCF practices and nutritional outcomes among children aged 0-23 months using a nationally representative dataset. METHODS: The study used data from the 2011 Nepal Demographic and Health Survey, and the data were analysed for children aged 0-23...
November 2016: Paediatrics and International Child Health
Chih-Chen Chang, Li-Ang Lee, Shao-Hsuan Hsia, Chuen Hsueh, Chao-Jan Wang
A 15-year-old boy presented with airway obstruction and a history of sore throat and progressive dyspnoea for 1 month. A lateral neck radiograph showed an enlarged epiglottis, and a neck computed tomography (CT) demonstrated a cyst attached to the lingual surface of the epiglottis. A large epiglottic cyst, 4 cm in length, was removed surgically. Epiglottic cysts have been reported to cause airway obstruction in neonates, infants and adults, but, to the best of our knowledge, it has rarely been reported in adolescents...
November 2016: Paediatrics and International Child Health
E A Disu, S O Akodu, O G Arinola, I N Diaku-Akinwumi, B Adedokun, C O Olopade, O F Njokanma
BACKGROUND: Children with sickle cell disease (SCD) are particularly susceptible to pneumococcal infection. Administration of the 13-valent conjugate pneumococcal vaccine which is now available in Nigeria may help to reduce the incidence. OBJECTIVES: To determine the serum level of pneumococcal-specific IgG (PIgG) in a cohort of patients with SCD after administration of a single-dose of a 13-valent pneumococcal conjugate vaccine. METHODS: The study was conducted between December 2011 and March 2012 among children with SCD aged 5 months to 5 years attending the sickle cell clinic in five public hospitals in Lagos...
November 2016: Paediatrics and International Child Health
Kennedy Obebi Cliff-Eribo, Helen Sammons, Kristina Star, I Ralph Edwards, Adeline Osakwe, Imti Choonara
BACKGROUND: Adverse drug reactions (ADRs) in children recorded in national pharmacovigilance databases in high-income countries have been analysed. Nigeria has a population of 31 million children and became a member of the WHO Programme for International Drug Monitoring in 2004 since when it has been submitting reports of suspected ADRs to the WHO Global Individual Case Safety Report database, VigiBase. OBJECTIVE: To gain information on reported ADRs in Nigerian children aged 0-17 years in VigiBase from 2005 to 2012...
November 2016: Paediatrics and International Child Health
Shukri Raban, Shalini Santhakumaran, Quanitah Keraan, Yaseen Joolay, Sabita Uthaya, Alan Horn, Neena Modi, Michael Harrison
BACKGROUND: Optimal feeding regimens for infants ≤ 1000 g have not been established and are a global healthcare concern. AIMS AND OBJECTIVES: A controlled trial to establish the safety and efficacy of high vs low volume initiation and rapid vs slow advancement of milk feeds in a resource-limited setting was undertaken. METHODS: Infants ≤ 1000 g birthweight were randomised to one of four arms, either low (4 ml/kg/day) or high (24 ml/kg/day) initiation and either slow (24 ml/kg/day) or rapid (36 ml/kg/day) advancement of exclusive feeds of human milk (mother's or donor) until a weight of 1200 g was reached...
November 2016: Paediatrics and International Child Health
M Piastra, A Tempera, E Luca, E Buffone, C Cafforio, V Briganti, O Genovese, M Marano, D Rigante
Streptococcus pneumoniae sepsis has high morbidity, particularly if complicated by renal injury. Four patients with S. pneumonia invasive infections complicated by renal disorders are presented. The first case was an 18-month-old girl with pneumococcal empyema complicated by haemolytic uraemic (HUS) syndrome. She made a full recovery after mechanical ventilation, inotropic support and haemodiafiltration. The second was a 4-year-old boy who presented with acute post-infectious glomerulonephritis associated with bilateral pneumococcal pneumonia...
November 2016: Paediatrics and International Child Health
Jurai Wongsawat, Malinee Chittaganpitch, Somtavil Ampornareekul, Somkid Srisophaa, Sirirat Likanonsakul
BACKGROUND: Clinical practice guidelines for influenza have been implemented to maximise the appropriate use of empirical oseltamivir; however, good predictive values are required. METHODS: Between October 2011 and September 2013, children aged < 15 years who presented at the Bamrasnaradura Infectious Diseases Institute with an influenza-like illness plus either (i) pneumonia or (ii) being in a higher risk group for influenza complications were prospectively enrolled...
November 2016: Paediatrics and International Child Health
Firat Erdogan, Kudret Kulak, Ozmen Öztürk, İlke Özahı İpek, Ömer Ceran, Hüseyin Seven
BACKGROUND: Periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis (PFAPA) syndrome is a common disorder in children but there is little or no consensus on its optimal diagnosis and management. OBJECTIVES: To compare the outcome of different management approaches - medical therapy or tonsillectomy. METHODS: The medical records of children diagnosed with PFAPA between 2008 and 2013 were retrospectively reviewed according to the modified Thomas test criteria...
November 2016: Paediatrics and International Child Health
Chinyere U Onubogu, Ifeoma N Onyeka, Dorothy O Esangbedo, Chika Ndiokwelu, Selina N Okolo, Elizabeth K Ngwu, Bright I Nwaru
BACKGROUND: Inadequate breastfeeding practices contribute to malnutrition in young children. AIMS AND OBJECTIVES: This study examined changes in breastfeeding practices and the nutritional status of children (0-35 months, n = 37154) using data from the nationally-representative Nigerian Demographic and Health Surveys for 1990-2008. METHODS: The study estimated the relative changes in the proportion of children meeting recommended breastfeeding practices and the anthropometric indices of the children during the study period, by region, place of residence, maternal education and maternal occupation...
November 2016: Paediatrics and International Child Health
Kahabi Ganka Isangula, Megan E Kassick, Allan Kaijunga Kairuki, Robson Amunga Meda, Erica Thomas, Akwila Temu, Georgina Msemo, Mary Azayo, Brett D Nelson
OBJECTIVES: Worldwide, there has been renewed emphasis on reducing neonatal mortality in low-resource countries. The Helping Babies Breathe (HBB) programme has been shown to reduce newborn deaths. The aim of this study is to present provider-level perceptions and experiences of the HBB programme implemented at-scale in Tanzania and identify key lessons learned for scalability in similar and other settings. METHODS: Focus group discussions with HBB-trained providers were conducted using a prospective longitudinal study design between October 2013 and May 2015...
September 29, 2016: Paediatrics and International Child Health
Emily Mosites, Elizabeth Dawson-Hahn, Judd Walson, Ali Rowhani-Rahbar, Marian L Neuhouser
Reducing the burden of stunting in childhood is critical to improving health in low- and middle-income settings. However, because many aetiologies underlie linear growth failure, stunting has proved difficult to prevent and reverse. Understanding the contributions these aetiologies make to the burden of stunting can help the development of targeted, effective interventions. To begin to frame these causes, a qualitative and a quantitative framework of the primary drivers of stunting in low-resource settings were developed...
September 29, 2016: Paediatrics and International Child Health
Nicolaus W Glomb, Manish I Shah, Andrea T Cruz
BACKGROUND: There is global variation in the ability of hospital-based emergency centres to provide paediatric emergency medicine (PEM) services. Although minimum standards have been proposed, they may not be applicable in resource-limited settings. OBJECTIVE: The goal was to identify reasonable minimum standards to provide safe and effective care for acutely ill children in resource-limited settings. METHODS: Using previously proposed standards from the International Federation of Emergency Medicine (IFEM), a modified Delphi approach was used to reach agreement regarding minimum standards for PEM in resource-limited settings...
September 29, 2016: Paediatrics and International Child Health
Ira Shah, Forum Shah
BACKGROUND: The prevalence of drug-resistant (DR) tuberculosis (TB) in children is increasing. Although, in India, multi-drug-resistant (MDR) TB rates have been relatively stable, the number of children with pre-extensively drug-resistant and extensively drug-resistant (XDR) TB is increasing. AIM: To determine whether the prevalence of DR TB in children in Mumbai is changing and to study the evolving patterns of resistance. METHODS: A retrospective study was undertaken in 1311 paediatric patients referred between April 2007 and March 2013 to the Paediatric TB clinic at B...
August 9, 2016: Paediatrics and International Child Health
Ampaiwan Chuansumrit, Jiraporn Laothamathat, Nongnuch Sirachainan, Witaya Sungkarat, Pakawan Wongwerawattanakoon, Patrapop Kumkrua
BACKGROUND: MRI imaging is an alternative to serum ferritin for assessing iron overload in patients with thalassaemia disease. AIMS: To correlate liver iron concentration (LIC) determined by MRI and clinical and biochemical parameters. METHODS: An MRI study using cardiovascular magnetic resonance (CMR) tools to determine cardiac and liver iron was undertaken in adolescents with thalassaemia disease. RESULTS: Eighty-nine patients (48 males) with thalassaemia disease were enrolled...
August 2016: Paediatrics and International Child Health
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