Journal of Tropical Pediatrics最新文献

{"title":"Revised one-bag IV fluid protocol for pediatric DKA: a feasible approach and retrospective comparative study.","authors":"Durmuş Doğan, Hatice D C Gökalp, Erdal Eren, Halil Sağlam, Ömer Tarım","doi":"10.1093/tropej/fmae003","DOIUrl":"10.1093/tropej/fmae003","url":null,"abstract":"<p><strong>Background: </strong>This study compared the effectiveness of the traditional and revised one-bag protocols for pediatric diabetic ketoacidosis (DKA) management.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included children diagnosed with DKA upon admission between 2012 and 2019. Our institution reevaluated and streamlined the traditional one-bag protocol (revised one-bag protocol). The revised one-bag protocol rehydrated all pediatric DKA patients with dextrose (5 g/100 ml) containing 0.45% NaCl at a rate of 3500 ml/m2 per 24 h after the first 1 h bolus of normal saline, regardless of age or degree of dehydration. This study examined acidosis recovery times and the frequency of healthcare provider interventions to maintain stable blood glucose levels.</p><p><strong>Results: </strong>The revised one-bag protocol demonstrated a significantly shorter time to acidosis recovery than the traditional protocol (12.67 and 18.20 h, respectively; p < 0.001). The revised protocol group required fewer interventions for blood glucose control, with an average of 0.25 dextrose concentration change orders per patient, compared to 1.42 in the traditional protocol group (p < 0.001). Insulin rate adjustments were fewer in the revised protocol group, averaging 0.52 changes per patient, vs. 2.32 changes in the traditional protocol group (p < 0.001).</p><p><strong>Conclusion: </strong>The revised one-bag protocol for pediatric DKA is both practical and effective. This modified DKA management achieved acidosis recovery more quickly and reduced blood glucose fluctuations compared with the traditional one-bag protocol. Future studies, including randomized controlled trials, should assess the safety and effectiveness of the revised protocol in a broad range of pediatric patients with DKA.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10858344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139712482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single centre analysis of factors influencing surgical treatment of splenic trauma in children.","authors":"Jun Gang Zhao, Chen-Xiang Hao, Yong-Gen Xu, Feng Liu, Guo-Ji Zhu","doi":"10.1093/tropej/fmae005","DOIUrl":"10.1093/tropej/fmae005","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate determinants impacting the surgical management of splenic trauma in paediatric patients by scrutinizing age distribution, etiological factors and concomitant injuries. The analysis seeks to establish a foundation for delineating optimal operative timing.</p><p><strong>Methods: </strong>A cohort of 262 paediatric cases presenting with splenic trauma at our institution from January 2011 to December 2021 underwent categorization into either the conservative or operative group.</p><p><strong>Results: </strong>Significantly disparate attributes between the two groups included age, time of presentation, blood pressure, haemoglobin levels, blood transfusion requirements, thermal absorption, American Association for the Surgery of Trauma (AAST) classification and associated injuries. Logistic regression analysis revealed age, haemoglobin levels, AAST classification and blood transfusion as autonomous influencers of surgical intervention (OR = 1.024, 95% CI: 1.011-1.037; OR = 1.067, 95% CI: 1.01-1.127; OR = 0.2760, 95% CI: 0.087-0.875; OR = 7.873, 95% CI: 2.442-25.382; OR = 0.016, 95% CI: 0.002-0.153). The AAST type and age demonstrated areas under the receiver operating characteristic (ROC) curve of 0.782 and 0.618, respectively.</p><p><strong>Conclusion: </strong>Age, haemoglobin levels, AAST classification and blood transfusion independently influence the decision for surgical intervention in paediatric patients with splenic trauma. Age and AAST classification emerge as viable parameters for assessing and prognosticating the likelihood of surgical intervention in this patient cohort.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746836","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":"Hemodynamic effects of noradrenaline in neonatal septic shock: a prospective cohort study.","authors":"Aditya Kallimath, Reema Garegrat, Suprabha Patnaik, Yogen Singh, Naharmal B Soni, Pradeep Suryawanshi","doi":"10.1093/tropej/fmae001","DOIUrl":"10.1093/tropej/fmae001","url":null,"abstract":"<p><strong>Background: </strong>The incidence of neonatal septic shock in low-income countries is 26.8% with a mortality rate of 35.4%. The evidence of the hemodynamic effects of noradrenaline in neonates remains sparse. This study was carried out to evaluate the effects of noradrenaline in neonates with septic shock.</p><p><strong>Methods: </strong>This was a single-center prospective cohort study in a tertiary care hospital's level III neonatal intensive care unit. Neonates with septic shock and those who received noradrenaline as a first-line vasoactive agent were included. Clinical and hemodynamic parameters were recorded before and after one hour of noradrenaline infusion. The primary outcomes were: response at the end of one hour after starting noradrenaline infusion and mortality rate.</p><p><strong>Results: </strong>A total of 21 babies were analyzed. The cohort comprised 17 preterm neonates. The mean age of presentation with septic shock was 74.3 h. Resolution of shock at one hour after starting noradrenaline was achieved in 76.2% of cases. The median duration of hospital stay was 14 days. The mean blood pressure improved after the initiation of noradrenaline from 30.6 mm of Hg [standard deviation (SD) 6.1] to 37.8 mm of Hg (SD 8.22, p < 0.001). Fractional shortening improved after noradrenaline initiation from 29% (SD 13.5) to 45.1% (SD 21.1, p < 0.001). The mortality rate was 28.6% in our study.</p><p><strong>Conclusion: </strong>Noradrenaline is a potential drug for use in neonatal septic shock, with improvement in mean blood pressure and fractional shortening; however, further studies with larger sample sizes are needed to confirm our findings before it can be recommended as first-line therapy in neonatal septic shock.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702855","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 cerebral autoregulation of oxygen by NIRS method during postnatal transition period in term and late preterm newborns without resuscitation requirement.","authors":"Omer Ertekin, Mehmet Buyuktiryaki, Sehribanu Isik, Nilufer Okur, Serife Suna Oguz","doi":"10.1093/tropej/fmae004","DOIUrl":"10.1093/tropej/fmae004","url":null,"abstract":"<p><strong>Background: </strong>Pulse oximetry is commonly used to monitor arterial oxygen saturation and heart rate during the transition period and reference intervals have been determined. However, the effect of the change in arterial oxygen saturation on tissue oxygenation does not seem to be the same. So, a non-invasive method for monitoring cerebral or regional tissue oxygenation will be potentially useful for vulnerable infants. This study aims to evaluate the effectiveness of cerebral autoregulation in the first 10 min after delivery in term and late preterm newborns without resuscitation requirement.</p><p><strong>Methods: </strong>Cerebral tissue oxygen saturation was measured in the first 10 min after birth with near-infrared spectroscopy (NIRS) from the left forehead. Peripheral oxygen saturation was measured with pulse oximetry from the right hand and cerebral fractional tissue oxygen extraction was calculated.</p><p><strong>Results: </strong>Nineteen late preterms and 20 term infants were included in the study. There was no statistically significant difference between median cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction values of late preterm and term infants (p < 0.001). There was a strong inverse relationship between cerebral tissue oxygen saturation and cerebral fractional tissue oxygen extraction (p < 0.001).</p><p><strong>Conclusions: </strong>In late preterm infants similar to term infants, arterial oxygen saturation and cerebral tissue oxygen saturation increased with time, but inverse reduction of cerebral fractional tissue oxygen extraction showed the presence of an active autoregulation in the brain. This can be interpreted as the ability of the brain to protect itself from hypoxia by regulating oxygen uptake during normal fetal-neonatal transition process. A larger scale multi-center randomized control trial is now needed to further inform practice.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136929","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 pattern of functional gastrointestinal disorders among secondary school adolescents in Lagos, Nigeria.","authors":"Tolulope Kumolu-Johnson, Idowu Odunayo Senbanjo","doi":"10.1093/tropej/fmad048","DOIUrl":"10.1093/tropej/fmad048","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on functional gastrointestinal disorders (FGIDs) among sub-Saharan African children. This study aimed to determine FGID prevalence and pattern among secondary school adolescents in Lagos, Nigeria.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted among adolescents aged 10-18 years in Isolo, Lagos, Nigeria from December 2020 to March 2021. A multi-stage sampling technique was used to select a total of 696 students from four secondary schools. Data were collected using a specifically designed questionnaire, the ROME IV questionnaire (QPGS-IV), and analyzed using the Statistical Package for the Social Sciences (SPSS) version 24.</p><p><strong>Results: </strong>The mean age of the adolescents was 13.6 ± 2.1. A total of 221 (31.8%) adolescents fulfilled the criteria for at least one of the FGIDs. The most common FGIDs were functional constipation (10.1%), functional dyspepsia (9.4%) and abdominal migraine (8.6%). There was no significant difference in the overall prevalence of FGIDs between age groups (p = 0.07) and genders (p = 0.949). However, the prevalence of FGID sub-types showed that abdominal migraine, irritable bowel syndrome and functional non-retentive fecal incontinence were significantly higher in the age group 10-12 years (p = 0.045, p = 0.029 and p = 0.027, respectively) while only functional vomiting was significantly higher in male compared to female (p = 0.038).</p><p><strong>Conclusion: </strong>FGIDs are common among adolescents in Lagos, Nigeria. The pattern of FGIDs shows similarities and differences with reports from other parts of the world. Healthcare workers must be aware of these disorders to provide optimal care.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139417436","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":"Risk factors for mortality in an African pediatric emergency department: case of Sourô Sanou Hospital, a prospective, cross-sectional study.","authors":"Makoura Barro, Cheick Ahmed Ouattara, Bintou Sanogo, Abdel Aziz Baby, Ad Bafa Ibrahim Ouattara, Fatimata Sahoura Nacro, Isidore Tiandiogo Traoré, Angèle Kalmogho, Alain Saga Ouermi, Réné Souanguimpari Ouoba, Klangboro Raymond Cessouma, Boubacar Nacro","doi":"10.1093/tropej/fmad044","DOIUrl":"10.1093/tropej/fmad044","url":null,"abstract":"<p><strong>Background: </strong>Childhood mortality rates remain high in sub-Saharan Africa. This study aimed to assess the causes and associated factors of pediatric emergency mortality at the Sourô Sanou University Hospital of Bobo-Dioulasso.</p><p><strong>Methodology: </strong>This was a cross-sectional study with prospective collection from June to August 2020. We documented and analyzed demographic and clinical characteristics by means or proportions. Logistic regression was performed to identify the factors associated with childhood mortality.</p><p><strong>Results: </strong>From 618 pediatric patients admitted to pediatric emergency unit, 80 (12.9%) were documented as death outcomes. The mean age was 34.10 ± 36.38 months. The male sex represented 51.25%. The main diagnoses were severe malaria (61.25%), acute gastroenteritis (11.25%) and pneumonia (10%); 48.75% of the patients were malnourished and only 55% were fully immunized. The average length of hospitalization was 2.73 ± 3.03 days. Mortality was a strongly significant association with late come to the emergency unit (AOR = 1.11, CI = 1.04-1.18), young maternal age (AOR = 0.95, CI = 0.92-0.99) and incomplete vaccination (AOR = 1.94, CI = 1.13-3.31).</p><p><strong>Conclusion: </strong>The in-hospital mortality rate was 12.94%; younger maternal age, delay in consultation, unimmunized or incompletely immunized status and shorter hospital stays were significantly associated with death.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805868","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":"Antimicrobial resistance and epidemic clustering of late-onset neonatal infections in a Brazilian intensive care unit.","authors":"Felipe Teixeira de Mello Freitas, Marcela Santos Corrêa da Costa, Kaylla Heduarda Rodrigues da Costa, Everton Giovanni Alves","doi":"10.1093/tropej/fmad045","DOIUrl":"10.1093/tropej/fmad045","url":null,"abstract":"<p><p>Nosocomial infections in the neonatal intensive care unit (NICU) tend to cluster and multidrug-resistant (MDR) pathogens are rising in developing countries. We did a retrospective cohort study of neonates admitted to a NICU in Brazil with late-onset neonatal sepsis (LOS) confirmed by blood culture from October 2012 to December 2016 and from July 2018 to December 2021. We defined a cluster of infection when at least two cases of LOS occurred within two different time intervals: 15 and 30 days with the same pathogen in different patients. A random amplified polymorphic DNA (RAPD) was performed from samples from one of these clusters. A logistic regression model was applied having death as the outcome and the infection with an MDR pathogen as the exposure of interest. There were 987 blood cultures from 754 neonates, 621 (63%) were gram-positive cocci, 264 (30%) were gram-negative rods and 72 (7%) fungi. A third of Enterobacterales were resistant to cefepime and a third of non-fermenting glucose rods were resistant to carbapenems. There were 100 or 104 clusters of infection in the 15- or 30-day interval, respectively. A RAPD analysis from an outbreak of MDR Acinetobacter baumannii showed that all five samples belonged to a single clone. An infection with an MDR pathogen was associated with death (OR 1.82, 95% CI 1.03-3.21). In conclusion, clusters of infections in a Brazilian NICU are a frequent phenomenon as seen elsewhere. They suggest cross-transmission of pathogens with increasing antimicrobial resistance and should prompt intensified surveillance and infection control measures.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805777","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":"The new Xpert Mycobacterium tuberculosis/rifampicin (MTB/Rif) Ultra assay in comparison to Xpert MTB/Rif assay for diagnosis of tuberculosis in children and adolescents.","authors":"Harveen Kaur, Vishal Guglani, Lipika Singhal, Shivani Randev, Pankaj Kumar, Varsha Gupta","doi":"10.1093/tropej/fmad046","DOIUrl":"10.1093/tropej/fmad046","url":null,"abstract":"<p><strong>Background: </strong>Microbiological diagnosis of pediatric tuberculosis (TB) using conventional microbiological techniques has been challenging due to paucibacillary nature of the disease. Molecular methods using cartridge-based tests like Xpert, have immensely improved diagnosis. A novel next-generation cartridge test, Xpert Ultra, incorporates two additional molecular targets and claims to have much lower detection limit. We attempted to compare the two techniques in presumptive pediatric TB patients.</p><p><strong>Objectives: </strong>The aim of this study was to compare the diagnostic performance of Xpert MTB/Rif Ultra with Xpert MTB/Rif for the detection of pediatric TB.</p><p><strong>Study design: </strong>This is an observational comparative analytical study.</p><p><strong>Methods: </strong>Children under 15 years of age with presumptive TB were enrolled. Appropriate specimens were obtained (sputum, induced sputum or gastric aspirate for suspected pulmonary TB, cerebrospinal fluid for suspected tubercular meningitis and pleural fluid for suspected tubercular pleural effusion), subjected to smear microscopy, mycobacterial culture, Xpert and Xpert ultra tests and other appropriate diagnostic investigations.</p><p><strong>Results: </strong>Out of 130 enrolled patients, 70 were diagnosed with TB using a composite reference standard (CRS). The overall sensitivity of Xpert was 64.29% [95% confidence interval (CI) 51.93-75.93%] and that of Xpert Ultra was 80% (95% CI 68.73-88.61%) with 100% overall specificity for both. The sensitivity of Xpert and Xpert Ultra in pulmonary specimens (n = 112) was 66.67% and 79.37% and in extrapulmonary specimens (n = 18) was 42.86% and 85.71%, respectively.</p><p><strong>Conclusion: </strong>Our study found Ultra to be more sensitive than Xpert for the detection of Mycobacterium tuberculosis in children. Our findings support the use of Xpert Ultra as initial rapid molecular diagnostic test in children under evaluation for TB.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138805880","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":"SARS-CoV-2 reinfections in the pediatric cohort-a single-center experience.","authors":"Asli Arslan, Zumrut Sahbudak Bal, Ece Erci, Sema Yıldırım Arslan, Nimet Melis Bilen, Gülhadiye Avcu, Candan Çiçek, Ferda Ozkinay, Zafer Kurugol","doi":"10.1093/tropej/fmad049","DOIUrl":"10.1093/tropej/fmad049","url":null,"abstract":"<p><strong>Background: </strong>This study focused on timelines of infection episodes and dominant variants and aims to determine disease severity and outcome of pediatric patients with reinfection.</p><p><strong>Materials and methods: </strong>This study retrospectively evaluated the medical records of the hospitalized patients and/or outpatients aged 0-18 with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction between March 2020 and September 2022 at Ege University Children's Hospital.</p><p><strong>Results: </strong>Ninety-one pediatric patients reinfected with SARS-CoV-2 were included in the study. There was an underlying disease in 26.4% of the patients. The median time between the two infection episodes was 184 (90-662) days. There were 24 patients (26.3%) with the first infection in pre-Delta period; 17 (18.6%) of them were reinfected in Omicron BA.1 period, while 7 (7.6%) in Omicron BA.4/BA.5 period. Forty-five patients (49.4%) were infected initially in the Delta period; 35 patients (38.4%) were reinfected in the Omicron BA.1 period, while 10 patients (10.9%) were reinfected in the Omicron BA.4/BA.5 period. Twenty-two patients (24.1%) had the first infection in the Omicron BA.1 period and then reinfected in the Omicron BA.4/BA.5 period. Patients with reinfection more frequently displayed a symptom (84.6% vs. 94.5%, p = 0.03). The hospitalization rate significantly declined in reinfection (15.3% vs. 7.6%, p = 0.03). Severe disease, treatment needs and steroid use were decreased in reinfections without a significant difference (p > 0.05). Intensive care unit admission was not altered.</p><p><strong>Conclusion: </strong>This study revealed that reinfections frequently develop in previously healthy children but do not cause more severe outcomes. The risk of symptomatic reinfections is still high due to the effect of the Omicron variant.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139048991","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":"Evaluating blood culture collection practice in children hospitalized with acute illness at a tertiary hospital in Malawi.","authors":"Victoria Temwanani Mukhula, Philliness Prisca Harawa, Chisomo Phiri, Stanley Khoswe, Emmie Mbale, Caroline Tigoi, Judd L Walson, James A Berkley, Robert Bandsma, Pui-Ying Iroh Tam, Wieger Voskuijl","doi":"10.1093/tropej/fmad043","DOIUrl":"10.1093/tropej/fmad043","url":null,"abstract":"<p><strong>Background: </strong>Blood culture collection practice in low-resource settings where routine blood culture collection is available has not been previously described.</p><p><strong>Methodology: </strong>We conducted a secondary descriptive analysis of children aged 2-23 months enrolled in the Malawi Childhood Acute Illness and Nutrition (CHAIN) study, stratified by whether an admission blood culture had been undertaken and by nutritional status. Chi-square test was used to compare the differences between groups.</p><p><strong>Results: </strong>A total of 347 children were included, of whom 161 (46%) had a blood culture collected. Children who had a blood culture collected, compared to those who did not, were more likely to present with sepsis (43% vs. 20%, p < 0.001), gastroenteritis (43% vs. 26%, p < 0.001), fever (86% vs. 73%, p = 0.004), and with poor feeding/weight loss (30% vs. 18%, p = 0.008). In addition, hospital stay in those who had a blood culture was, on average, 2 days longer (p = 0.019). No difference in mortality was observed between those who did and did not have a blood culture obtained.</p><p><strong>Conclusion: </strong>Blood culture collection was more frequent in children with sepsis and gastroenteritis, but was not associated with mortality. In low-resource settings, developing criteria for blood culture based on risk factors rather than clinician judgement may better utilize the existing resources.</p>","PeriodicalId":17521,"journal":{"name":"Journal of Tropical Pediatrics","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10699738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}