Annals of Tropical Paediatrics最新文献

{"title":"Lactobacillus acidophilus and Bifidobacterium bifidum stored at ambient temperature are effective in the treatment of acute diarrhoea.","authors":"S Rerksuppaphol,&nbsp;L Rerksuppaphol","doi":"10.1179/146532810X12858955921159","DOIUrl":"https://doi.org/10.1179/146532810X12858955921159","url":null,"abstract":"<p><strong>Introduction: </strong>Probiotics have demonstrated potential to reduce duration of diarrhoea and frequency of watery stools. Probiotics such as Lactobacillus acidophilus and Bifidobacterium bifidum (Infloran(®)) are usually maintained at a storage temperature of 4°C which is generally not feasible in tropical or sub-tropical countries.</p><p><strong>Aim: </strong>The efficacy of Infloran(®) for treatment of acute diarrhoea when stored at 28-32°C (room temperature) was evaluated.</p><p><strong>Methods: </strong>This was a double-blind, randomised study of infants and children aged 2 months to 7 years with acute diarrhoea. Patients were randomly assigned to receive Infloran(®) stored at 4°C, at room temperature, or to a placebo group. Duration of diarrhoea was a primary outcome, while the number of stools, hospital stay and requirement for rehydration fluid were secondary outcomes.</p><p><strong>Results: </strong>Probiotics shortened duration of diarrhoea (34.1 and 34.8 hrs when stored either at 4°C or at room temperature, respectively, and 58 hrs with placebo, p<0.01) and reduced the number of stools (7.3 and 8 vs 15.9 with placebo, p<0.01).</p><p><strong>Conclusion: </strong>Administration of probiotics is beneficial as additional treatment of acute diarrhoea and efficacy is not affected by storage temperature.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 4","pages":"299-304"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12858955921159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal brucellosis: rare and preventable.","authors":"Pablo Yagupsky","doi":"10.1179/146532810X12786388978445","DOIUrl":"https://doi.org/10.1179/146532810X12786388978445","url":null,"abstract":"In industrialised countries, brucellosis prevention is now under strict veterinarian control and is close to being eradicated. In developing countries, however, it continues to be an important zoonosis in many regions such as Latin America, the Mediterranean basin, the Middle East and central Asia. Brucellosis is mostly caused by Brucella melitensis, B. abortus and B. suis. It is maintained in nature among a variety of mammals, feral and domesticated, for which the different Brucella species exhibit a relative host preference. Brucellae are highly infective (infective dose between 10 and 100 organisms), and humans acquire the disease by exposure to infected animals and their products, usually through the gastro-intestinal tract, by aerosol inhalation and through abraded skin. Human-to-human transmission is rare and has been reported after blood transfusion, bone marrow transplantation and by the transplacental route, as in the infants described in the two reports in this issue. In endemic areas, brucellosis is particularly common in children who acquire the disease by ingesting contaminated dairy products, especially unpasteurised milk and soft cheese derived from unvaccinated bovines, sheep and goats. Neonates become infected congenitally by the transplacental route in the course of a maternal bacteraemic episode, by exposure to blood, urine or genital secretions during delivery, and by breastfeeding; these are also the main routes of dissemination of brucellae among mammalian reservoirs. Accidental acquisition of the disease through blood and exchange transfusion in the neonatal period has also been rarely reported. In animals, invasion of the trophoblast by circulating organisms is a frequent event in the course of the disease, and usually causes septic abortions. This tendency has been attributed to the high concentration of erythritol, an essential growth factor for the bacterium, in placental tissues of susceptible ungulates. Deliveries and abortions of infected animals also play an important role in the dissemination of brucellae within herds through contamination of pastures by infected blood, lochia and genital secretions, and the organism can survive in the soil for several weeks. The issue of whether brucellosis can also cause abortion or premature delivery in humans is subject to controversy. Brucella species have been isolated from human fetal or placental tissue but it has been suggested that the disease causes fewer spontaneous abortions in humans than it does in animals because of the absence of erythritol in human tissues. However, a study by Khan et al. demonstrated an excess of 1st and 2nd-trimester spontaneous abortions among pregnant women with active infection and Elshamy & Ahmed showed that Saudi women with positive serological tests for brucellosis have a higher incidence of miscarriage and intrauterine fetal death than control women with negative serology. Obviously, the observed poor outcome of pregnancy might not necess","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 3","pages":"177-9"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12786388978445","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40057610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ileal perforation in a child with abdominal tuberculosis.","authors":"I Shah,&nbsp;A Rahangdale","doi":"10.1179/146532810X12786388978805","DOIUrl":"https://doi.org/10.1179/146532810X12786388978805","url":null,"abstract":"<p><p>A 6-year-old boy presented with a 1-month history of fever followed by abdominal distension, constipation and bilious vomiting for 2 days. The clinical impression was of intestinal obstruction. At exploratory laparotomy, there was an ileal perforation secondary to tuberculosis. There are many case reports of tubercular ileal perforation in adults but in children it is very rare.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 3","pages":"241-3"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12786388978805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40058025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locally produced ready-to-use supplementary food is an effective treatment of moderate acute malnutrition in an operational setting.","authors":"L Lagrone,&nbsp;S Cole,&nbsp;A Schondelmeyer,&nbsp;K Maleta,&nbsp;M J Manary","doi":"10.1179/146532810X12703901870651","DOIUrl":"https://doi.org/10.1179/146532810X12703901870651","url":null,"abstract":"<p><strong>Background: </strong>Typical treatment of moderate acute malnutrition, simple wasting, in sub-Saharan Africa consists of dietary counselling and/or general or targeted distribution of corn/soy-blended flour (CSB). A randomised clinical effectiveness trial in 2007 showed CSB to be less effective than ready-to-use supplementary food (RUSF).</p><p><strong>Aim: </strong>To determine the operational effectiveness of treating moderate acute malnutrition with RUSF.</p><p><strong>Methods: </strong>Children aged 6-59 months were recruited in rural southern Malawi. Each child received 65 kcal/kg/d of locally produced soy/peanut RUSF, a product that provided about 1 RDA of each micronutrient. Anthropometric measurements were taken every 2 weeks and additional rations of RUSF were distributed at this time if the child remained wasted. Study participation lasted up to 8 weeks.</p><p><strong>Results: </strong>Of the 2417 children enrolled, 80% recovered, 4% defaulted, 0.4% died, 12% remained moderately wasted and 3% developed severe acute malnutrition. Weight, length and MUAC gain were 2.6 g/kg/d, 0.2 mm/d and 0.1 mm/d respectively. Cost per child treated was $5.39.</p><p><strong>Conclusions: </strong>This intervention proved to be robust, maintaining high recovery rates and low default rates when instituted without the additional supervision and beneficiary incentives of a research setting.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 2","pages":"103-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12703901870651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29032655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alopecia in vitamin D-dependent rickets type II responding to 1α-hydroxycholecalciferol.","authors":"V Kumar,&nbsp;M Kumar,&nbsp;M Yadav","doi":"10.1179/146532810X12858955921357","DOIUrl":"https://doi.org/10.1179/146532810X12858955921357","url":null,"abstract":"<p><p>A 4-year-old boy presented with rickets, alopecia and macrocephaly along with elevated serum levels of 1,25(OH)₂D₃ which was diagnostic of vitamin D-dependent rickets type II. The rickets responded to conventional doses of 1α-hydroxycholecalciferol together with oral calcium supplement and there was also improvement in the alopecia. In patients with vitamin D-dependent rickets type II with alopecia, although rickets improves with treatment, improvement in alopecia has not been reported before.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 4","pages":"329-33"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12858955921357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular manifestations of sickle cell disease.","authors":"A O Fadugbagbe,&nbsp;R Q Gurgel,&nbsp;C Q Mendonça,&nbsp;R Cipolotti,&nbsp;A M dos Santos,&nbsp;L E Cuevas","doi":"10.1179/146532810X12637745451870","DOIUrl":"https://doi.org/10.1179/146532810X12637745451870","url":null,"abstract":"<p><p>Sickle cell disease (SCD) is the most common genetic disease worldwide. The increase in life expectancy of SCD patients in recent years has led to the emergence of more complications of the disease, e.g. ocular, which in the past were uncommon. This review describes current knowledge of the ocular manifestations of patients with SCD. SCD can affect virtually every vascular bed in the eye and can cause blindness in the advanced stages. The most significant ocular changes are those which occur in the fundus, which can be grouped into proliferative sickle retinopathy, and non-proliferative retinal changes based on the presence of vascular proliferation. This distinction is important because the formation of new vessels is the single most important precursor of potentially blinding complications. Although various systemic complications of SCD are known to be more common in patients with the Hb SS genotype, visual impairment secondary to proliferative sickle retinopathy is more common in patients with the Hb SC genotype. There is also an increase with age in the incidence and prevalence rates of all ocular complications of SCD. It is therefore recommended that all patients with SCD undergo periodic ophthalmological screening from the age of 10 years.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 1","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12637745451870","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28749789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Growth in children and adolescents with sickle cell disease in Yemen.","authors":"A-W M Al-Saqladi,&nbsp;H A Bin-Gadeen,&nbsp;B J Brabin","doi":"10.1179/146532810X12858955921113","DOIUrl":"https://doi.org/10.1179/146532810X12858955921113","url":null,"abstract":"<p><strong>Background: </strong>Physical growth is known to be impaired in children with sickle cell disease (SCD) and the prevalence and severity vary with geographical location. The factors which contribute to this sub-optimal growth are poorly understood.</p><p><strong>Objectives: </strong>To describe the growth status of children and adolescents with SCD in Yemen using the new WHO reference values and to assess correlation of growth indicators with disease severity and with haematological and biochemical parameters.</p><p><strong>Methods: </strong>A cross-sectional study of children <16 years with SCD was conducted at Al-Wahda General Teaching Hospital, Aden. Anthropometric measurements of weight, length/height, mid-upper-arm circumference (MUAC) and body mass index (BMI) were collected. Disease severity was assessed using a severity index (SI) score.</p><p><strong>Results: </strong>A total of 102 children (56 male) were included and their mean age was 7.2 years (range 6 months to 15 years). Low weight, height and BMI-for-age Z-scores (<-2 SD) were observed in 45%, 54% and 35% of children, respectively. Regression analyses indicated an association of low height-for-age with male gender (p=0.02), low weight-for-age and weight-for-height with increased age (both p<0.001), low weight-for-age with raised alkaline phosphatase (p=0.04), and low BMI with reduced plasma albumin (p=0.04). There was no correlation between growth deficits and SI or anaemia severity.</p><p><strong>Conclusion: </strong>Growth is severely impaired in children and adolescents with SCD in Yemen. Growth monitoring and nutritional support should be included in their comprehensive care package.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 4","pages":"287-98"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12858955921113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29502788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacteraemia with pleural effusions complicating typhoid fever caused by high-level ciprofloxacin-resistant Salmonella enterica serotype Typhi.","authors":"S Mohanty,&nbsp;R Gaind,&nbsp;B Paglietti,&nbsp;P Paul,&nbsp;S Rubino,&nbsp;M Deb","doi":"10.1179/146532810X12786388978760","DOIUrl":"https://doi.org/10.1179/146532810X12786388978760","url":null,"abstract":"<p><p>An unusual case of bacteraemia with bilateral pleural effusion caused by Salmonella enterica serotype Typhi in a 10-year-old previously healthy girl is reported. The organism was isolated from pleural fluid aspirate and from blood, and exhibited high-level ciprofloxacin resistance (MIC 16 μg/ml) associated with triple mutations in the QRDRs of the gyrA and parC genes leading to the amino-acid changes Ser83→Phe and Asp87→Asn in gyrA and Ser80→Ile in parC. The patient was successfully treated with parenteral ceftriaxone and intercostal chest tube drainage. The case is notable because of the important issue of antimicrobial resistance in S. Typhi and the therapeutic dilemma faced by clinicians regarding the empirical use of ciprofloxacin and newer fluoroquinolones.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 3","pages":"233-40"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12786388978760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40058024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coeliac disease presenting as acute pancreatitis in a 3-year-old.","authors":"I M Halabi","doi":"10.1179/146532810X12786388978887","DOIUrl":"https://doi.org/10.1179/146532810X12786388978887","url":null,"abstract":"<p><p>A 3-year-old boy presented with a history of intermittent abdominal pain and vomiting from the age of 1 year. Raised serum amylase and lipase levels supported a diagnosis of acute pancreatitis. Subsequent investigation confirmed coeliac disease. This is the youngest patient to be reported with this combination.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 3","pages":"255-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12786388978887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40058028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunity to hepatitis B vaccine in Tanzanian under-5 children.","authors":"J Metodi,&nbsp;S Aboud,&nbsp;R Mpembeni,&nbsp;E Munubhi","doi":"10.1179/146532810X12703902516167","DOIUrl":"https://doi.org/10.1179/146532810X12703902516167","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B vaccine was introduced in Tanzania in 2002 and is administered as DPT-hepatitis B at 4, 8 and 12 weeks of life.</p><p><strong>Aim: </strong>To determine immunity to hepatitis B virus in children under 5 years attending reproductive and child health (RCH) clinics.</p><p><strong>Methods: </strong>A cross-sectional, health facility-based study was conducted between July and December 2007 at Temeke, Amana and Mwananyamala municipal hospitals in Dar es Salaam, Tanzania. Children under 5 years who had received DPT-HB vaccine as evidenced by RCH card number 1 were included. Blood samples were collected to determine hepatitis B surface antigen (HB(s)Ag) and antibodies to hepatitis B surface antigen (anti-HB(s)) and hepatitis B core antigen (Anti-HB(c)). An anti-HB(s) level of > or =10 mIU/ml is regarded as protective. Nutritional and HIV status were also determined.</p><p><strong>Results: </strong>A total of 296 children under 5 years vaccinated with DPT-HB were recruited, 153 (51.7%) of whom were male. Altogether, 205 (69.3%) children had anti-HB(s) levels > or =10 mIU/ml. The number of DPT-HB vaccine doses, time interval since last DPT-HB dose and HIV status were significant predictors of anti-HB(s) levels. Five children (1.7%) were positive for HB(s)Ag, suggesting possible vertical transmission. No child had anti-HB(c) antibodies.</p><p><strong>Conclusion: </strong>More than two-thirds of children under 5 years had protective anti-HB(s) levels. A change in the hepatitis B immunisation schedule to include a dose immediately after birth should improve immunity.</p>","PeriodicalId":50759,"journal":{"name":"Annals of Tropical Paediatrics","volume":"30 2","pages":"129-36"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1179/146532810X12703902516167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29032658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}