Journal of Tropical Pediatrics最新文献

{"title":"Adenovirus respiratory infection with severe pneumonia in hospitalized children: a case series.","authors":"Subhasree Beura, Debasmita Rath, Basudev Biswal, Mahima Panigrahi, Bikash Parida","doi":"10.1093/tropej/fmae034","DOIUrl":"10.1093/tropej/fmae034","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468815","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":"Prevalence of unplanned extubation in a tertiary care neonatal intensive care unit.","authors":"Heladia García, Dulce Ivonne Ramos-Soto, Guadalupe Miranda-Novales, Laura Luna-Santos","doi":"10.1093/tropej/fmae039","DOIUrl":"10.1093/tropej/fmae039","url":null,"abstract":"<p><p>Orotracheal intubation and mechanical ventilation (MV) have become routine practices in intensive care units. Unplanned extubation (UE) is one of the most important complications, particularly in premature infants and critically ill newborns. The objective of this study was to determine the prevalence of UE in a tertiary care neonatal intensive care unit (NICU). In this analytical cross-sectional retrospective study, all data, including perinatal data, indications for ventilatory support, days of MV at the time of UE, work shift, month of the event, reintubation, and postextubation complications, were obtained from the manual review of clinical charts. In total, 151 neonates, who received invasive MV, were included in this study. The prevalence of UE was 2.0/100 days of ventilation. The most affected were premature infants, with a gestational age of ≤ 32 weeks (54.7%) and a birth weight of ≤ 1500 g. The main cause for UE was deficient fixation of the endotracheal tube (ETT) (27.7%). Most UE events occurred during night shifts (48.1%). Reintubation was required in 83.3% of newborns. Immediate complications developed in 96.3% of the UE events, including desaturation (57.7%) and bradycardia (36.5%). The prevalence of UE was high, particularly in premature infants, with a high rate of reintubation and immediate complications. Standardized protocols for ETT care must be implemented to reduce these events.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468831","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":"Dedication.","authors":"Elizabeth Montgomery Collins, Cosmina Gingaras, Dumbani Kayira, Priyanka Madaan, Lola Madrid Castillo, Ronald Eveillard, Seema Jilani, Joseph L Mathew, Shahid Akhtar Siddiqui","doi":"10.1093/tropej/fmae056","DOIUrl":"https://doi.org/10.1093/tropej/fmae056","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950747","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":"Real-world use of the CarestartTM glucose-6-phosphate dehydrogenase rapid diagnostic test to determine G6PD deficiency in Nigerian neonates.","authors":"Ejiroghene Orubu, Katherine Satrom, Beatrice Ezenwa, Iretiola Fajolu, Troy Lund, Abigail Obi, Chinyere Ezeaka, Tina Slusher","doi":"10.1093/tropej/fmae050","DOIUrl":"10.1093/tropej/fmae050","url":null,"abstract":"<p><p>G6PD deficiency (G6PDd) is the most common X-linked genetic disease worldwide and the most common cause of severe neonatal hyperbilirubinemia (NH) in Nigeria. Screening for G6PDd has been recommended for over thirty years but is still not routinely done in Nigeria. We sought to investigate a low-cost rapid diagnostic test to determine G6PDd in Nigerian neonates. Enrolled neonates were screened using the CareStartTM G6PD point-of-care rapid diagnostic test; and mothers/caregivers of neonates with G6PDd were asked about their cord care product(s); transcutaneous bilirubin levels were done on neonates with G6PDd using the JM 103 meter. One hundred and forty neonates were enrolled between 15 January and 1 July 2022. Eighteen (12.8%) of all neonates enrolled and 13.9% of enrolled males (0% of females) were G6PDd. Seventeen of the mothers/caregivers of the G6PDd neonates were asked about cord care. The majority of mothers/caregivers (15/17, 88%%) reported including methylated spirits in their neonate's cord care; seven of these used chlorohexidine plus methylated spirits (41.2%) while only one mother/caregiver used chlorohexidine alone. One mother/caregiver used mentholatum alone and another used mentholatum, chlorhexidine gel, and methylated spirits. Maximum bilirubin levels for those infants with G6PDd ranged from 3.2 to 18.8 mg/dl with 16/17 (94.1%) of bilirubin levels exceeding 5.5 mg/dl. This study again highlights the need for large-scale G6PDd screening. Additionally, it highlights the need to correlate the type of cord care with the risk of NH in future studies.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751186","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":"Evaluation of the relationship between day or night birth time and morbidities and mortality in premature infants less than 32 weeks in a Turkish NICU.","authors":"Mustafa Senol Akin, Ufuk Cakir","doi":"10.1093/tropej/fmae049","DOIUrl":"https://doi.org/10.1093/tropej/fmae049","url":null,"abstract":"<p><p>Staffing levels, fatigue, and intervention timing may vary based on working hours and potentially influence the clinical outcomes of newborns. It remains unclear how the birth time of premature infants throughout the day affects their clinical outcome. This study aimed to compare the clinical outcomes of premature infants born during and after work hours. In this single-center retrospective cohort study, infants born at <32 weeks of age were categorized into two groups based on birth time. The first group included infants born during daytime working hours on weekdays, whereas the second group included infants born during nighttime working hours on weekdays, weekends, and public holidays. Both groups were compared in terms of clinical outcomes. Data from 572 patients born at <32 weeks of age were analyzed, with 137 (24%) infants in the on-hours group and 435 (76%) in the off-hours group. No significant differences were observed between the groups in terms of gestational age (GA) (27.4 ± 2.8 weeks vs. 27.7 ± 2.7 weeks), birth weight (BW) (1132 ± 459 g vs. 1064 ± 450 g), and gender distribution (53.2% vs. 55.4% male) (P > .05). There were no significant differences in other clinical outcomes, morbidities, or mortality rates between the groups (P > .05). Despite potential fluctuations in neonatal intensive care unit (NICU) staffing levels during on- and off-duty hours, the morbidity and mortality of premature infants aged <32 weeks were not affected in our unit. Each NICU should assess whether delivery time influences clinical outcomes, based on unique care conditions. The change in clinical outcomes depending on the time of birth may be particularly important in low- and middle-income countries (LMIC). Negative results may be an indication that the staff is under excessive workload. In addition, by providing a solution to the cause of the detected problem, both clinical outcomes may be improved and patient care costs due to morbidity may be reduced. Our results may be particularly important for studies to be conducted on this subject in LMIC.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818539","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":"SimCapture app video performance assessment versus real-time instructor-based performance evaluation of undergraduates in neonatal resuscitation-an agreement study.","authors":"Anish Sinha, Somashekhar M Nimbalkar, Reshma K Pujara, Purvi Rachit Patel, Mayur K Shinde, Swati Sethi, Rashmi Aradhya, Dipen Vasudev Patel","doi":"10.1093/tropej/fmae033","DOIUrl":"10.1093/tropej/fmae033","url":null,"abstract":"<p><p>Undergraduates are trained in the basic neonatal resuscitation programme (NRP) and evaluated for skill acquisition by NRP performance evaluation test (PET). Video use improves the validity of assessment when video-information adequacy, intrusiveness to students, and educational purpose are adequately balanced. We evaluated whether there was a difference between instructor's real-time assessment and video-based assessment done by another independent assessor using videos recorded via the SimCapture application. Undergraduates were trained in basic neonatal resuscitation and were evaluated at the end for skill acquisition by PET as a part of a randomized control trial (RCT). Video recording of the PET assessment was done with the SimCapture app. Independent assessors evaluated recorded videos to evaluate and validate real-time instructor performance evaluation time assessments. We conducted an agreement study to evaluate the difference between a real-time instructor and video assessments. We trained 143 students; 139 videos were evaluated. The Bland-Altman plot showed good agreement. For the post-test result, 66 (47.5%) passed, and 73 (52.5%) failed according to the real-time assessment, while 61 (43.8%) passed and 78 (56.1%) failed according to the video assessment. The agreement between the two assessments was 94.9%, with a kappa value of 0.898. Indicating the need for positive pressure ventilation (PPV), 138 (99.3%) did correctly in real-time assessment, while 133 (95.6%) did correctly in video assessment with agreement of 96.4% but low kappa of 0.27. We conclude that the instructors' assessment was excellent and didn't differ from assessments obtained from recorded videos and vice-versa.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375643","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: Prevalence of overweight and obesity, dietary behaviors, and physical activities among sixth graders: a cross-sectional study in Ho Chi Minh City, Vietnam.","authors":"","doi":"10.1093/tropej/fmae042","DOIUrl":"10.1093/tropej/fmae042","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468827","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":"Impact of age on antimicrobial prescriptions in hospitalized children at three academic centres in South Africa: a point prevalence survey.","authors":"Ashendri Pillay, Terusha Chetty, David P Moore, Zainab Waggie, Firdose L Nakwa, Alison van Kwawegen, Reenu Thomas, Maria Karsas, Jeané Cloete, Yusentha Balakrishna, Tarylee Reddy, Moherndran Archary, Ameena Goga, Prakash Jeena","doi":"10.1093/tropej/fmae041","DOIUrl":"10.1093/tropej/fmae041","url":null,"abstract":"<p><p>Antimicrobial resistance is a global threat in children, and the emergence of multi-drug-resistant organisms is of concern. This secondary analysis of an antimicrobial point prevalence survey (PPS) in children evaluates the impact of age on antimicrobial use. The mean antimicrobial prescriptions were assessed in neonates, infants, young children (1-5 years), school-going children (6-12 years), and adolescents (13-15 years) from a cross-sectional PPS at three academic hospitals between September 2021 and January 2022. Primary and secondary diagnoses, antibiotic type (World Health Organization AWaRe and Anatomical Therapeutic Chemical classifications), and the incidence of healthcare-associated infections (HAI) were evaluated per age category. Multiple regression models were used to analyse age-related risk factors for HAI. The number of antimicrobials per child (1.7-1.9 per patient) was higher in neonates and infants compared to children 6-12 years old (1.4 per patient). Watch antibiotics, especially carbapenems, were commonly prescribed in neonates (32.5%) and infants (42.2%). Reserve antimicrobial use was notable in neonates (4.7%) and infants (4.1%). The incidence risk ratio (IRR) of HAI was higher in neonates and infants (IRR 2.13; 95% CI 1.23-3.70, IRR 2.20; 95% CI 1.40-3.45, respectively) compared to 6- to 12-year-olds. On multivariate analysis of participants according to age, being HIV infected, length of stay >6 days, high McCabe severity score, having surgery and receipt of blood transfusion were associated with an increased risk of HAI (P < .001 for all) while on univariate analysis only, being premature and/or underweight was associated with an increased risk of HAI in infants (P < .001 for both). Infants with risk factors for HAI significantly influenced antimicrobial prescribing, underscoring the necessity for tailored antimicrobial stewardship and enhanced surveillance. The increased use of Watch antibiotics, particularly carbapenems, in infants warrants closer scrutiny. Further research is required to identify inappropriate antimicrobial use in high-risk hospitalized young children.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468829","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":"Prevalence and associated risk factors of myocardial ischemia in children living with sickle cell anemia in Lagos, Nigeria.","authors":"Oluwatoyin Adeniyi, Abideen Salako, Ogochukwu Sokunbi, Oluwatosin Odubela, Oladapo Aworanti, Christy Okoromah, Adebola Akinsulie","doi":"10.1093/tropej/fmae035","DOIUrl":"10.1093/tropej/fmae035","url":null,"abstract":"<p><p>Myocardial ischemia (MI) in children living with sickle cell anemia (SCA) is rarely reported. MI among children living with this disease could portend untoward outcomes on their quality of life and survival. This study evaluated the prevalence and associated risk factors of MI in children living with SCA during a vaso-occlusive crisis (VOC) compared with those with SCA who had no symptoms nor an MI in the past (those in \"steady state\") in Lagos, Nigeria. This comparative cross-sectional study was conducted over 10 months (between March and December 2019) among 250 children living with SCA aged 6 months-18 years (125 in VOC and 125 age and sex-matched controls in steady state). The assessment of MI was determined by measuring cardiac troponin T (cTnT) and electrocardiography (ECG). The prevalence of MI measuring cTnT alone in children with SCA during VOC and steady state was 42.4% and 23.2%, respectively. Comparatively, measuring ECG alone, the prevalence of MI in VOC and steady state was 40.8% and 20.8%, respectively. The prevalence of MI measuring cTnT and ECG in children with SCA in VOC and steady state was 38.4% and 20%, respectively. Older age, severity of pain, longer duration of illness, frequent crises per year, elevated white blood cells, and platelet count were significantly associated with MI in participants with SCA. However, with multivariate analysis, age, severity of pain, and elevated platelet counts remained significantly associated with the occurrence of MI. This study affirms the high prevalence of MI in children with SCA irrespective of the diagnostic criteria. Routine evaluation should be done in this cohort to avert MI-associated sequelae.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468830","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":"Words for Pui-Ying.","authors":"Wieger Voskuijl","doi":"10.1093/tropej/fmae055","DOIUrl":"https://doi.org/10.1093/tropej/fmae055","url":null,"abstract":"","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":"70 6","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950750","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}