José Geraldo Ribeiro Gregório, Thayla Amorim Santino, Girlene Souza de Azevedo, Janiele de Sales Tavares, Thamyris de Sales Regis, Jousilene de Sales Tavares, Gabriela Lopes Gama, Adriana Melo
{"title":"The burden of musculoskeletal symptoms in caregivers of children with congenital Zika syndrome: a cross-sectional study.","authors":"José Geraldo Ribeiro Gregório, Thayla Amorim Santino, Girlene Souza de Azevedo, Janiele de Sales Tavares, Thamyris de Sales Regis, Jousilene de Sales Tavares, Gabriela Lopes Gama, Adriana Melo","doi":"10.1093/tropej/fmaf039","DOIUrl":"https://doi.org/10.1093/tropej/fmaf039","url":null,"abstract":"<p><p>The continuous daily care required by children with congenital Zika syndrome (CZS) may overload the lives of caregivers. However, little is known about the factors associated with musculoskeletal symptoms experienced by caregivers. This study aimed to investigate the prevalence of musculoskeletal symptoms in caregivers of children with CZS and identify its associated factors. This cross-sectional study included caregivers of children with CZS from northeast Brazil. Musculoskeletal symptoms were assessed using the Nordic Musculoskeletal Questionnaire. Information about caregivers, pregnancy, childbirth, general aspects, and neuropsychomotor development of children with CZS were also recorded. Musculoskeletal symptoms of caregivers were analyzed using bivariate analysis and binary logistic regression. We included 41 caregivers, of whom 39 (95.12%) had musculoskeletal symptoms in the last 12 months, and 31 (75.61%) had symptoms in the last 7 days. However, less than half considered these symptoms incapacitating to require the absence from their activities (43.90%) or a medical consultation (26.83%). The presence of symptoms in at least one body region was associated with occupational activities, number of children with or without disability, caregiver age, current head circumference, child age, and ability of the child to sit without support. Musculoskeletal symptoms were not considered incapacitating by caregivers of children with CZS despite its high prevalence. The characteristics of the caregiver and children were associated with the prevalence of musculoskeletal symptoms.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Enhancing accuracy: point-of-care ultrasound for rapid confirmation of central line placement in neonates-an observational study.","authors":"Aril Bhatia, Arjun Verma, Sourabh Singh, Madhu Mathur, Manika Chhabra, Jyoti More Dhage","doi":"10.1093/tropej/fmaf037","DOIUrl":"10.1093/tropej/fmaf037","url":null,"abstract":"<p><p>To assess the diagnostic accuracy of point-of-care ultrasound against single or multiple check X-rays done to confirm central line position. This cross-sectional observational study was conducted in a tertiary neonatal intensive care unit from March 2023 to March 2024. Point-of-care Ultrasound (USG) and radiograph were performed on infants who underwent central line placement. Diagnostic accuracy of USG was presented by sensitivity, specificity, PPV, NPV, positive likelihood ratio, and negative likelihood ratio. Of the 160 central lines, 109 (68.1%) vs. 102(63.8%) central lines were defined as optimally placed on the radiograph and POCUS, respectively. The sensitivity and specificity of POCUS in confirming central line tip position were 93.58% and82.35%, respectively. The positive predictive value and the negative predictive value were 91.89% and 85.71%, respectively. The positive likelihood ratio was 5.3%, and the negative likelihood ratio was 0.08%. Overall accuracy of POCUS to radiography was 90% [95% confidence interval (CI) 84.27-94.18]. The study also revealed that a significantly shorter time was required in bedside POCUS with a mean duration of 4 minutes as compared to X-ray where the mean duration was 19 minutes. Point-of-care ultrasound can be used as an alternative to bedside radiographic examination in confirming the catheter tip position with diagnostic accuracy of 90%.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aslihan Kose Cetinkaya, Fatma Nur Sari, Mehmet Buyuktiryaki, Ozlem Bozkurt, Erbu Yarci, Sabriye Korkut, Evrim Alyamac Dizdar
{"title":"Postnatal weight gain of premature small for gestational age versus appropriate for gestational age infants during NICU stay.","authors":"Aslihan Kose Cetinkaya, Fatma Nur Sari, Mehmet Buyuktiryaki, Ozlem Bozkurt, Erbu Yarci, Sabriye Korkut, Evrim Alyamac Dizdar","doi":"10.1093/tropej/fmaf036","DOIUrl":"https://doi.org/10.1093/tropej/fmaf036","url":null,"abstract":"<p><p>To assess the feeding characteristics and postnatal weight gain of premature small for gestational age (SGA) versus appropriate for gestational age (AGA) infants during neonatal intensive care unit stay and to investigate the association between postnatal growth failure (PGF) and neonatal variables. This retrospective study was conducted on premature infants with a birth weight ≤1500 g and a gestational age <32 weeks, born between January 2013 and June 2016. The infants were categorized into two groups: SGA (n = 42) and AGA (n = 380). The groups were compared in terms of demographics, clinical characteristics, and PGF at discharge. PGF was defined as a decrease in the z-score of more than 1.34 from birth to discharge. Multiple logistic regression analysis was used to identify variables associated with PGF. SGA infants had a longer time to achieve full enteral feeding (P = .010) and a longer duration of total parenteral nutrition (P = .001). Although the frequency of feeding intolerance was higher in SGA infants, the difference was not statistically significant (P = .056). The overall prevalence of PGF at discharge was 42% and comparable between the two groups. Late-onset sepsis, hemodynamically significant patent ductus arteriosus and lower weight z-score at fourth week of life [adjusted odds ratio (aOR) = 1.69, 95% confidence interval (CI) = 1.06-2.69, P = .027; aOR = 1.75, 95% CI = 1.14-2.68, P = .01; and aOR = 1.86, 95% CI = 1.21-2.86, P = .004, respectively) were independently associated with an increased risk of PGF. SGA infants experienced more severe growth failure at discharge compared to AGA infants. However, the rate of PGF was similar between the two groups.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dipen V Patel, Hetal P Budh, Reshma K Pujara, Somashekhar M Nimbalkar
{"title":"Efficacy of cloth-to-cloth contact versus conventional care in thermoregulation of term newborns: an open-label randomized controlled trial.","authors":"Dipen V Patel, Hetal P Budh, Reshma K Pujara, Somashekhar M Nimbalkar","doi":"10.1093/tropej/fmaf035","DOIUrl":"10.1093/tropej/fmaf035","url":null,"abstract":"<p><p>Neonatal hypothermia is a major contributor to morbidity and mortality in low- and middle-income countries (LMICs). While effective in reducing hypothermia, implementation of skin-to-skin contact (SSC) is often hindered by its privacy concerns. This study aimed to evaluate the efficacy and feasibility of cloth-to-cloth contact (CCC) as an alternative to SSC in term newborns at postnatal ward, where the newborn is dressed and placed in the kangaroo position on the mother's chest without exposing her bare skin. In this randomized trial, stable term newborns in a postnatal ward were assigned to either conventional care (dressed, kept beside the mother) or CCC (dressed, held in kangaroo position with both mother and baby clothed). Axillary temperatures were recorded up to 48 hours of life, and mothers' experiences with CCC were assessed using a structured questionnaire. Eighty-seven neonates were enrolled (43 conventional care, 44 CCC), with 369 and 379 temperature recordings, respectively. Mean axillary temperatures were similar between groups up to 42 hours. At 48 hours, the CCC group had a significantly higher mean temperature [36.85 (0.26)°C] than the conventional care group [36.73 (0.28)° C] (P = .04). The overall incidence of hypothermia was comparable, except in winter, when it was higher in the conventional care group (35.2%) than in the CCC group (22.8%) (P = .008). Most mothers found CCC feasible and preferred it over conventional care. CCC is an effective and feasible intervention for preventing hypothermia in term newborns, especially during colder months in LMIC settings.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shruti Kaushal, Sunil Kumar Dhatwalia, Rakesh Yadav, Sumedha Sharma, Pankaj C Vaidya, Joseph L Mathew, Sunil Sethi
{"title":"Comparison of Xpert® MTB/RIF and Xpert® MTB/RIF Ultra in pediatric pulmonary tuberculosis diagnosis.","authors":"Shruti Kaushal, Sunil Kumar Dhatwalia, Rakesh Yadav, Sumedha Sharma, Pankaj C Vaidya, Joseph L Mathew, Sunil Sethi","doi":"10.1093/tropej/fmaf034","DOIUrl":"10.1093/tropej/fmaf034","url":null,"abstract":"<p><p>The World Health Organization (WHO) recommends Xpert® MTB/RIF (Xpert) and its advanced version, Xpert® MTB/RIF Ultra (Xpert Ultra), as first-line diagnostic tests for detecting pulmonary tuberculosis (PTB) and rifampicin resistance in children suspected of having the disease. Respiratory specimens (gastric lavage/bronchoalveolar lavage/sputum/endotracheal aspirate) obtained from 116 children with presumptive PTB were simultaneously processed using liquid medium culture, Xpert assay, and Xpert Ultra assay. Among the specimens from 116 children, six were excluded due to culture contamination (n = 5) or error in Xpert Ultra results (n = 1). Among the remaining 110 specimens, 20 were positive by liquid culture. The former and latter, of the two comparator tests gave a sensitivity of 90% and 95%, respectively. The respective specificity was 93.3% and 88.9%. Xpert Ultra showed a statistically significant slightly higher sensitivity than Xpert. Xpert Ultra showed slightly higher sensitivity than Xpert, with a minimal loss in specificity, partly due to the inclusion of trace results, which help detect paucibacillary cases.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haziqah Itqan Alias, Malanashita Ganeson, Maizatil Elina Binti Abdul Hamid, Rushdi Bin Mohamad Khir, Chandrashekhar T Sreeramareddy
{"title":"Epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia-analyses of hospital-based registry data from 2000 to 2022.","authors":"Haziqah Itqan Alias, Malanashita Ganeson, Maizatil Elina Binti Abdul Hamid, Rushdi Bin Mohamad Khir, Chandrashekhar T Sreeramareddy","doi":"10.1093/tropej/fmaf038","DOIUrl":"https://doi.org/10.1093/tropej/fmaf038","url":null,"abstract":"<p><p>Childhood drowning is a major cause of morbidity and mortality with significant economic and social implications, especially in low- and middle-income countries. Despite this, there is a lack of good-quality epidemiological data on childhood drowning. We report the epidemiology of fatal and non-fatal unintentional childhood drowning in Malaysia between the years 2000 and 2022. Data about childhood drowning were obtained from a hospital-based registry gathered by the National Health Informatics Centre, the Ministry of Health, Malaysia. Child population data were downloaded from the Malaysian Census. Overall incidence rates (IRs), case fatality rates (CFRs), and IR and CFR by age, sex, race, and region were calculated. Binary logistic regression was used to determine the factors associated with fatality. Between the years 2000 and 2022, a total of 4247 cases of drowning were reported. IR was significantly higher among children aged 0-9, boys, Bumiputera, and the East Coast and Borneo regions. Overall CFR was 3.7%. Age, year of hospitalization, and Bumiputera were associated with CFR. The site of drowning was unspecified in 84% of cases, while for those recorded, natural water sources and swimming pools accounted for most sites. While the annual incidence of drowning has remained nearly constant throughout the years, the fatality rate has increased between 2010 and 2022. Our report provides leads for further research data requirements to understand childhood drowning epidemiology better and improve preventive measures.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafaela Cristina Vieira E Souza, Luana Caroline Dos Santos
{"title":"Development and behavior screening of 4-year-old Brazilian children: prevalence and associated factors.","authors":"Rafaela Cristina Vieira E Souza, Luana Caroline Dos Santos","doi":"10.1093/tropej/fmaf033","DOIUrl":"https://doi.org/10.1093/tropej/fmaf033","url":null,"abstract":"<p><p>Early identification of developmental and behavioral delays could improve child's health in the long term. The aim was to determine the prevalence and explore the associated factors with child development and behavior. A cross-sectional study was carried out with Brazilian children aged 4 years old and their respective caregivers. Child's development and behavior were assessed using the Brazilian screening tool version of the Survey of Well-being of Young Children. Generalized linear models were used to analyze the associations between explicative variables and outcomes. Prevalence of suspected development delay was 28.0% and behavior problems was 39.5%. Children sex, school period, daily reading, and behavior domain were associated with development domain, while sleeping time, development domain, food insecurity, and ultraprocessed food score were associated with behavior domain. It is necessary to encourage the expansion of screening instruments in daily primary health-care practice, expand professional's specialization, and improve multisectoral integration.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabriye Korkut, Yüksel Oğuz, Davut Bozkaya, Şehribanu Işık, Demet Çam, Dilek Uygur, Sara Erol, Şerife Suna Oğuz
{"title":"Evaluation of the effects of delayed cord clamping in neonates with intrauterine growth restriction.","authors":"Sabriye Korkut, Yüksel Oğuz, Davut Bozkaya, Şehribanu Işık, Demet Çam, Dilek Uygur, Sara Erol, Şerife Suna Oğuz","doi":"10.1093/tropej/fmaf029","DOIUrl":"10.1093/tropej/fmaf029","url":null,"abstract":"<p><p>To assess the effects of delayed cord clamping (DCC) at birth on newborns diagnosed with intrauterine growth restriction (IUGR). This prospective, randomized, controlled study included newborns diagnosed with IUGR during pregnancy follow-up and born at a gestational age of ≥28 weeks. Early cord clamping (ECC) was performed immediately after birth, whereas DCC was performed 60 s postdelivery. The ECC and DCC groups were compared based on cord blood and 24-h venous hematocrit levels, polycythemia rates, and clinical complications associated with polycythemia. A total of 96 newborns, 48 in each group, were analyzed. Gestational weeks, birth weight, Apgar score, delivery mode, and maternal features were similar between the groups (P > .05). At 24 h postnatally, hematocrit values were significantly higher in the DCC group (61.27% ± 5.93%) compared to the ECC group (57.42% ± 7.10%) (P = .005). The 24-h polycythemia rate was also higher in the DCC group (31.3% vs. 12.5%, P = .02). Partial exchange transfusion (PET) was required for one neonate in the DCC group (2.1%). The rates of respiratory distress, phototherapy-requiring jaundice, hypoglycemia within the first two days, intensive care admission, and need for close monitoring were similar between the groups (P > .05). In neonates with IUGR, delayed cord clamping for 60 s at birth led to increased venous hematocrit levels and a higher polycythemia rate. Larger studies are warranted to clarify whether DCC influences the need for PET and the frequency or severity of polycythemia-associated clinical complications.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 5","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to: Placental weight: Relation to maternal weight and growth parameters of full-term babies at birth and during childhood.","authors":"","doi":"10.1093/tropej/fmaf028","DOIUrl":"https://doi.org/10.1093/tropej/fmaf028","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy of Lactobacillus reuteri DSM 17938 in Thai children with acute gastroenteritis and normal or mild dehydration in an outpatient setting: a randomized controlled trial.","authors":"Lakkana Rerksuppaphol, Sanguansak Rerksuppaphol","doi":"10.1093/tropej/fmaf027","DOIUrl":"10.1093/tropej/fmaf027","url":null,"abstract":"<p><p>Lactobacillus reuteri DSM 17938 (L. reuteri) has been recommended for treating acute diarrhoea; however, literature data about its efficacy are scarce and controversial. This study investigated the effectiveness of L. reuteri supplementation on the treatment outcome of children with acute diarrhoea. A randomized double-blind controlled trial was conducted in children with acute diarrhoea who attended the outpatient clinic of Srinakharinwirot University Hospital, Thailand. Eligible children were randomly allocated to receive either L. reuteri 1 × 108 colony-forming units or a placebo for 5 days. The primary outcome was the time diarrhoea was resolved. Of the 48 participants (23 in L. reuteri and 25 in the placebo group), 29 (60.4%) were male and the mean age (range) was 12.3 months (1-26 months). The median time for diarrhoea to be resolved was significantly shorter in the L. reuteri group compared to the control (48 and 60 h, respectively, P-value = .042). The percentage of participants who recovered within 48 h was significantly higher in the L. reuteri group (65.2%) compared to the control group (36.0%) [relative risk (RR) 3.33, 95% confidence interval (CI) 1.02-10.89, P-value = .043]. The percentage of participants who recovered from diarrhoea within 72 h was 87.0% and 60%, respectively, [RR 4.44, 95% CI 1.04-19.0, P-value = .036]. No persistent diarrhoea or severe adverse effects were observed in both groups.The use of L. reuteri DSM 17938 as an adjunct therapy led to a significantly shorter duration of diarrhoea in children with acute diarrhoea.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}