Journal of Tropical Pediatrics最新文献_第2页

Colistin-resistant Klebsiella pneumoniae sepsis in neonates and infants: an alarming crisis in an Indian NICU. 新生儿和婴儿中耐粘菌素肺炎克雷伯菌败血症：印度新生儿重症监护室的一个令人震惊的危机。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmae044

Sushil Kumar, Akanksha Verma, Anita Singh, Kirti M Naranje, Richa Misra

{"title":"Colistin-resistant Klebsiella pneumoniae sepsis in neonates and infants: an alarming crisis in an Indian NICU.","authors":"Sushil Kumar, Akanksha Verma, Anita Singh, Kirti M Naranje, Richa Misra","doi":"10.1093/tropej/fmae044","DOIUrl":"10.1093/tropej/fmae044","url":null,"abstract":"Emergence of multidrug-resistant strain of Klebsiella pneumoniae has led to limited number of antimicrobial options for treatment. Even though outbreaks of colistin-carbapenem-resistant K. pneumoniae (CCRKp) are evolving, reported literature is scarce. This is a retrospective case series of three infants who acquired CCRKp sepsis during an outbreak in a Level III neonatal intensive care unit (NICU) of a tertiary care centre in Northern India. Data were retrieved from medical records of patients. Three babies developed new onset clinical worsening during an outbreak of sepsis. All had respiratory comorbidities and previous antibiotic exposure prior to isolation of CCRKp sepsis from blood. The organism was sensitive to combination of ceftazidime plus avibactam and tetracyclines in two infants; in one other newborn, no sensitive antibiotic was found. Two neonates deceased due to multiorgan dysfunction. An outbreak investigation revealed one common source of sterile water used in a humidifier. The outbreak was resolved by temporarily closing the NICU, segregating the infected infants and using corrective measures such as procuring a fresh batch of sterile water bottles, disinfecting the NICU, and reinforcing the use of antiseptic techniques. The emergence of CCRKp is alarming, particularly in low- and middle-income countries and tropical regions where such outbreaks are difficult to control due to limited healthcare infrastructure. These findings highlight the urgent need for stringent antimicrobial stewardship practices, enhanced infection control, and tailored interventions in resource-limited settings. It is also to be emphasized that the main mechanism of carbapenem resistance in Kp organisms in Asia seems to be different from the West and is mainly mediated by metallo-beta-lactamases and Class D carbapenemases.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425418","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}

引用次数: 0

Fluid restriction for term infants with hypoxic-ischemic encephalopathy following perinatal asphyxia-a randomized controlled trial. 围产期窒息后足月婴儿缺氧缺血性脑病的液体限制：一项随机对照试验

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf009

Anitha Ananthan, Haribalakrishna Balasubramanian, Ruchi Nanavati, Prashanth Raghavendra

{"title":"Fluid restriction for term infants with hypoxic-ischemic encephalopathy following perinatal asphyxia-a randomized controlled trial.","authors":"Anitha Ananthan, Haribalakrishna Balasubramanian, Ruchi Nanavati, Prashanth Raghavendra","doi":"10.1093/tropej/fmaf009","DOIUrl":"10.1093/tropej/fmaf009","url":null,"abstract":"Fluid management in the first postnatal week among infants with perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE) is an important knowledge gap. We aimed to evaluate the effects of fluid restriction on short- and long-term outcomes in infants with HIE. Term infants with moderate or severe HIE on therapeutic hypothermia were randomized within 6 hours of age to receive either restricted intravenous maintenance fluids (45 ml/kg/day on day 1 to a maximum of 120 ml/kg/day on day 6) vs conventional fluid (60 ml/kg/day on day 1 to a maximum of 150 ml/kg/day on day 6). The primary outcome was a composite of mortality or neurological abnormality at hospital discharge. We studied neurodevelopmental disability at 18-24 months using Bayley Scales of Infant Development, third edition. A total of 210 infants were randomized. Three infants died during the hospital stay. The primary outcome of mortality or neurological abnormality at discharge was not significantly different between the restricted and the conventional fluid group [57% vs 53%, RR: 1.07 (95% CI: 0.83, 1.37), P-value .58]. The incidence of cranial magnetic resonance imaging abnormalities was similar in the groups (65% vs 71%, P-value .30). There were no differences in the rates of severe neurodevelopmental disability at 18-24 months in the two groups [27% vs 28%, RR: 0.96 (95% CI: 0.62, 1.50), P-value .88]. Adverse outcomes were similar in both groups. Fluid restriction in the first postnatal week of life did not improve short- and long-term neurodevelopmental outcomes in term infants with moderate or severe HIE.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476799","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}

引用次数: 0

Scrub typhus masquerading as other conditions among the pediatric population in India: a case series. 在印度儿科人群中伪装成其他疾病的恙虫病：一个病例系列。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf011

Deblina Patra, Ritajyoti Ghosh, Sumanta Laha, Aizuddin Sk, Sarbik Sarkar, Aditya Kayal, Tarak Nath Ghosh

引用次数: 0

Continuous positive airway pressure versus conventional oxygen therapy in meconium aspiration syndrome: a randomized controlled trial. 持续气道正压与传统氧疗治疗胎粪吸入综合征：一项随机对照试验。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf002

Arifa Mustaqeem, Anita Yadav, Jogender Kumar, Pradeep Debata

引用次数: 0

Health-care providers' knowledge and quality of neonatal care in the first 2 h of life in a district hospital on Pemba Island, Tanzania: a prospective cohort study. 坦桑尼亚奔巴岛一家地区医院保健提供者在生命最初2小时的新生儿护理知识和质量：一项前瞻性队列研究。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf018

Mathilde Languille Lassen, Lærke Vinge Larsen, Said Mzee, Said Mouhammed Ali, Ulrikka Nygaard, Anja Poulsen, Stine Lund

{"title":"Health-care providers' knowledge and quality of neonatal care in the first 2 h of life in a district hospital on Pemba Island, Tanzania: a prospective cohort study.","authors":"Mathilde Languille Lassen, Lærke Vinge Larsen, Said Mzee, Said Mouhammed Ali, Ulrikka Nygaard, Anja Poulsen, Stine Lund","doi":"10.1093/tropej/fmaf018","DOIUrl":"10.1093/tropej/fmaf018","url":null,"abstract":"To assess the knowledge of health workers on neonatal management, describe neonatal care in the first 2 h of life, and health outcomes of neonates in Tanzania. A prospective cohort study was performed from January to April 2022 at a district hospital on Pemba Island, Tanzania. Women admitted in active labor, and their neonates were eligible for inclusion. Standardized observations in the first 2 h after birth, followed by a clinical examination, and interviews on days 7 and 28 were performed. Health workers were given multiple-choice questions on neonatal management. Immediate skin-to-skin care was performed in 23% of neonates and breastfeeding was initiated during the first hour of life in 46%. At 2 h of life, 10% had blood glucose <2.5 mmol/L (mean: 3.71, SD 1.1), 44.6% had hypothermia with temperature <36.5°C (mean: 36.5, SD 0.5), and 2% low saturation <90%. Health workers had on average 42% correct answers on \"neonatal management\". The neonatal mortality rate (NMR) corresponds to 23 per 1000 livebirths. Considerable challenges in neonatal care were identified, including low-cost, high-impact interventions such as skin-to-skin care and immediate breastfeeding. The NMR was above the Sustainable Development Goal target. Further research is needed to assess the impact of training on neonatal care and outcomes in this and similar settings.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753458","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}

引用次数: 0

Congenital syphilis: epidemiological profile of Brazilian regions in the last decade. 先天性梅毒：近十年来巴西地区的流行病学概况。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf003

Maria Eugênia Costa Casagrande, Anderson Soares da Silva, Altacílio Aparecido Nunes

{"title":"Congenital syphilis: epidemiological profile of Brazilian regions in the last decade.","authors":"Maria Eugênia Costa Casagrande, Anderson Soares da Silva, Altacílio Aparecido Nunes","doi":"10.1093/tropej/fmaf003","DOIUrl":"10.1093/tropej/fmaf003","url":null,"abstract":"Congenital syphilis (CS) is transmitted to the fetus through the transplacental route at any stage of gestation when the pregnant women are either untreated or inadequately treated. In this study, we aimed to analyze trends in epidemiological indicators of CS in Brazil. This is a cross-sectional study utilizing data on CS across Brazilian regions from 1 January 2012 to 31 December 2021. Epidemiological indicators such as incidence, prevalence, and case-fatality rates were calculated. During the evaluated period, 192 055 CS cases were recorded in Brazil. Among pregnant women who underwent prenatal care, 58.5% were diagnosed during pregnancy, 33.9% at the time of birth, and 7.5% after birth. In 77.5% of the notifications, the partners were not treated. The average number of cases diagnosed during prenatal care was 5.6 times higher than those not reported. The Southeast region presented the highest incidence rate per 1000 live births, whereas the Midwest region had the lowest incidence. Despite an increase in rates across all regions and Brazil overall, there was no significant difference (P-value > .05) between the means for the two evaluated periods. However, there was a significant decrease (P-value < .05) in the case-fatality rate in the Northeast (1.9%-1.25%) and South (2.15%-0.92%) regions, as well as throughout Brazil (from 1.77% to 1.24%). The findings indicate that the incidence rates of CS continue to rise, suggesting that the disease remains a significant public health issue in Brazil. Effective preventive measures are urgently required.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476796","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}

引用次数: 0

Evaluating the efficacy of very high-dose oral prednisolone in West syndrome: in Uttar Pradesh, India, a resource-limited setting. 评估非常大剂量口服强的松龙治疗West综合征的疗效：在资源有限的印度北方邦。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf005

Chandra Prabha, Chandra Kanta, Arpita Bhriguvanshi, Sanjeev Kumar Verma

{"title":"Evaluating the efficacy of very high-dose oral prednisolone in West syndrome: in Uttar Pradesh, India, a resource-limited setting.","authors":"Chandra Prabha, Chandra Kanta, Arpita Bhriguvanshi, Sanjeev Kumar Verma","doi":"10.1093/tropej/fmaf005","DOIUrl":"10.1093/tropej/fmaf005","url":null,"abstract":"Managing West syndrome (WS) becomes arduous in regions where access to adrenocorticotropic hormone and vigabatrin is limited, particularly in developing nations. This study aimed to evaluate the efficacy of very high-dose oral prednisolone in children diagnosed with WS. Children aged 2-36 months presenting with WS were consecutively enrolled and given oral prednisolone @ 8 mg/kg/day (maximum 40 mg) for two weeks followed by tapering doses over the subsequent two weeks. Weekly follow-ups were conducted until therapy completion, followed by bi-weekly assessments for three months. Responses (primary outcome) were assessed at two weeks and categorized as complete (spasm-free), partial (>25% reduction), or no response (<25% reduction). Neurodevelopmental outcomes, clinical-radiological profiles, safety, and therapy response predictors were also assessed. Of the 80 children, 73.7% exhibited a complete response, while 21.2% and 5% showed partial and no response, respectively. The mean age at spasm onset and presentation was 4.98 ± 4.37 months and 14.36 ± 7.13 months, respectively. Perinatal brain injury accounted for 87.5% of WS cases. Adverse effects, including weight gain (8.7%), irritability, hypertension, and disturbed sleep (3.7% each), were noted. Spasm cessation at 2 weeks, appropriate gestational age, and the absence of other seizure types were predictive of a favorable response. High-dose oral prednisolone emerges as an effective, low-cost, and safer first-line treatment option with minimal adverse effects in the Uttar Pradesh region in India, and this would likely be true in other resource-limited settings.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425511","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}

引用次数: 0

Septic pulmonary embolism associated with Staphylococcus aureus: case series and review of the literature. 与金黄色葡萄球菌相关的化脓性肺栓塞：系列病例和文献综述。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2025-02-05 DOI: 10.1093/tropej/fmaf008

Asena Ünal, Ulaş Özdemir, Nisanur Tapaç, Fatma Kılınç, Emel Bakanoğlu, Fatma Tuğba Çetin, Merve Kılıç Çil, Ümmühan Çay, Özlem Özgür Gündeşlioğlu, Rıza Dinçer Yıldızdaş, Ümit Çelik, Derya Alabaz

{"title":"Septic pulmonary embolism associated with Staphylococcus aureus: case series and review of the literature.","authors":"Asena Ünal, Ulaş Özdemir, Nisanur Tapaç, Fatma Kılınç, Emel Bakanoğlu, Fatma Tuğba Çetin, Merve Kılıç Çil, Ümmühan Çay, Özlem Özgür Gündeşlioğlu, Rıza Dinçer Yıldızdaş, Ümit Çelik, Derya Alabaz","doi":"10.1093/tropej/fmaf008","DOIUrl":"10.1093/tropej/fmaf008","url":null,"abstract":"Septic pulmonary embolism (SPE) is a rare, life-threatening disease in children. We assessed the clinical, microbiological, radiological, and treatment results of patients who developed SPE due to Staphylococcus aureus (S. aureus). We retrospectively reviewed the medical records of patients with SPE associated with S. aureus between 2012 and 2023. Six patients were included in the study; the median age was 13 years (range: 9-16 years), and four (66.7%) of them were boys. At admission, the most common complaints were chest pain (83.3%), respiratory distress (83.3%), limb swelling (83.3%), limitation of movement in the extremities (83.3%), fever (50%), fatigue (50%), and cough (16.7%). Extrapulmonary septic foci were identified as follows: septic arthritis in four patients (66.7%), soft tissue infection in one patient (16.7%), and deep vein thrombosis in one patient (16.7%). Methicillin-resistant S. aureus was the most common causative pathogen (66.7%) and methicillin-susceptible S. aureus was found in 33% of patients. The median length of hospital stay was 43.5 days (range: 25-45 days). Three (50%) patients required intensive care, and one required mechanical ventilation support. No mortality was observed. In our study, the clinical and radiological features of staphylococcal SPE in children were nonspecific, similar to the literature. Although no mortality was observed in our study, previous studies have reported mortality rates of up to 11.8% in children with SPE. Early diagnosis, appropriate antibiotic treatment, and respiratory support are important in patients with SPE, especially in low-income settings where timely access to healthcare and diagnostic resources may be limited.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 2","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468483","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}

引用次数: 0

Prevalence and associated factors of anaemia and iron-deficiency anaemia among adolescent Sudanese schoolchildren: a cross-sectional study. 苏丹青少年学童中贫血和缺铁性贫血的患病率及其相关因素：一项横断面研究。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2024-12-05 DOI: 10.1093/tropej/fmae047

Hiba M Osman, Almarwa A Osman, Abdullah Al-Nafeesah, Ashwaq AlEed, Ishag Adam

{"title":"Prevalence and associated factors of anaemia and iron-deficiency anaemia among adolescent Sudanese schoolchildren: a cross-sectional study.","authors":"Hiba M Osman, Almarwa A Osman, Abdullah Al-Nafeesah, Ashwaq AlEed, Ishag Adam","doi":"10.1093/tropej/fmae047","DOIUrl":"https://doi.org/10.1093/tropej/fmae047","url":null,"abstract":"Anaemia among adolescents is a worldwide health problem; however, data on anaemia among adolescents in Sudan are scarce. A cross-sectional study was conducted to investigate the prevalence and associated factors of anaemia and iron-deficiency anaemia among adolescent schoolchildren in northern Sudan. Socio-demographic information was collected using a questionnaire. A total of 309 adolescents (52.4% female and 47.6% male) were enrolled in the study. Seventy-five (24.3%) adolescents had anaemia, and none had severe anaemia. In the multivariate analysis, history of pica [adjusted odds ratio (AOR) = 2.30, 95% confidence interval (CI) = 1.31-4.02] was associated with increased odds of anaemia, and an increased level of serum ferritin (AOR = 0.97, 95% CI = 0.95-0.99) was associated with decreased odds of anaemia. Of the adolescents, 189 (61.2%) and 55 (17.8%) had iron deficiency and iron-deficiency anaemia, respectively. In the multivariate analysis, being female (AOR = 3.13, 95% CI = 1.88-5.23) and having a history of pica (AOR = 1.85, 95% CI = 1.03-3.31) were associated with increased odds of iron deficiency. This study showed a high prevalence of anaemia and iron-deficiency anaemia among adolescents in this part of Sudan, which was associated with a history of pica.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828888","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}

引用次数: 0

Outcomes of HIV-infected children on antiretroviral therapy for at least 10 years at the Essos Hospital Centre, Cameroon: contributing to the elimination of paediatric AIDS in tropical settings. 在喀麦隆埃索斯医院中心接受至少10年抗逆转录病毒治疗的艾滋病毒感染儿童的结果：有助于消除热带地区的儿科艾滋病。

IF 1.8 4区医学

Journal of Tropical Pediatrics Pub Date : 2024-12-05 DOI: 10.1093/tropej/fmae052

Anne Esther Njom Nlend, Joseph Fokam, Suzanne Mekoui, Jeannette Epée Ngoué, Annie Carole Nga Motaze, Vittorio Colizzi, Carlo-Federico Perno, Alexis Ndjolo, Gregory-Edie Halle-Ekane, Arsene Sandie

{"title":"Outcomes of HIV-infected children on antiretroviral therapy for at least 10 years at the Essos Hospital Centre, Cameroon: contributing to the elimination of paediatric AIDS in tropical settings.","authors":"Anne Esther Njom Nlend, Joseph Fokam, Suzanne Mekoui, Jeannette Epée Ngoué, Annie Carole Nga Motaze, Vittorio Colizzi, Carlo-Federico Perno, Alexis Ndjolo, Gregory-Edie Halle-Ekane, Arsene Sandie","doi":"10.1093/tropej/fmae052","DOIUrl":"10.1093/tropej/fmae052","url":null,"abstract":"Evidence on long-term outcomes of children receiving antiretroviral therapy (ART) in low- and middle-income countries (LMICs) is of utmost importance to optimize current and future therapeutic strategies for HIV. We sought to ascertain the long-term responses among ART-experienced children and their potential implications. A retrospective, observational, facility-based cohort study was conducted among 136 ART-experienced children monitored for 10 years (2007-2017) at the Essos Hospital Centre in Yaoundé, Cameroon. Primary outcomes were good clinical response defined as the World Health Organization (WHO) clinical stage 1/2, immune restoration as CD4 >500 cells/mm3, viral suppression (VS) as viral load (VL) <1000, or viral undetectability as VL <40 copies/ml at the last follow-up and their predictors (P < .05). At ART initiation among the 90 eligible children, median (interquartile range) age was 29.5 (11-60) months, 53.3% were males, 34.5% were at WHO clinical stage 1/2, median-CD4 was 497 cells/mm3, and initial ART-regimens were mainly zidovudine-lamivudine-nevirapine (85.5%) and zidovudine-lamivudine-efavirenz (12.2%). After 10 years of follow-up, 36.7% were switched to protease-based ART regimens, those at WHO clinical stage 1/2 improved to 75.5%; median-CD4 increased to 854 cells/mm3; 83.3% achieved VS, while only 10% achieved viral undetectability. Following multivariate analysis, no predictor of VS or immune recovery was identified (P > .05). In this LMIC, long-term outcomes of children on ART appear encouraging, characterized by moderate VS rate and immune recovery. However, challenges in achieving viral undetectability indicate continuous viral replication and risks of drug resistance emergence that may jeopardize effectiveness of future paediatric ART strategies.","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"71 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824207","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}

引用次数: 0