Lancet Child & Adolescent Health最新文献

{"title":"Developmental considerations in the quest for paediatric mTBI biomarkers","authors":"Miriam Beauchamp","doi":"10.1016/S2352-4642(24)00326-2","DOIUrl":"10.1016/S2352-4642(24)00326-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 1","pages":"Pages 3-5"},"PeriodicalIF":19.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Universal newborn screening for congenital cytomegalovirus infection","authors":"Prof Mark R Schleiss MD ,&nbsp;Daniel Blázquez-Gamero PhD","doi":"10.1016/S2352-4642(24)00237-2","DOIUrl":"10.1016/S2352-4642(24)00237-2","url":null,"abstract":"<div><div>Congenital cytomegalovirus (CMV) infection is the leading infectious cause of childhood disability, in particular sensorineural hearing loss (SNHL). Timeliness of diagnosis is crucial, since the presence of CMV in any compartment (eg, blood, urine, or saliva) after age 21 days can mean postnatal acquisition of infection, particularly in breastfed infants. Given these issues, there is considerable interest in implementation of screening programmes—either universal screening (where all newborns are tested) or targeted screening. Targeted screening is typically based on the outcome of a newborn hearing screen, and can be influenced in some strategies by findings of other signs suggestive of congenital CMV. Universal screening is likely to have the greatest overall benefit. Early identification of congenital CMV allows for interventions such as antiviral therapy (when indicated) and enables anticipatory audiological monitoring that facilitates timely detection of delayed-onset SNHL. However, there are debates about the effectiveness of screening programmes. Most infants with congenital CMV are unaffected and do not appear to be at risk for adverse neurodevelopment outcomes, except for SNHL. Screening can, therefore, raise unwarranted concern among parents and clinicians in these cases. The best clinical sample for diagnostic testing is unclear. PCR testing of saliva is sensitive but has a risk of yielding false-positive results in infants without congenital CMV. Resolving the technological issues has improved the sensitivity of dried blood spot (DBS) PCR but the technique remains suboptimum. An advantage to DBS PCR testing is that an infrastructure exists to add this test to existing newborn screening programmes. In this Review, the advantages and disadvantages of congenital CMV screening are discussed, along with high-priority areas for future research that will inform and direct this rapidly evolving field.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 1","pages":"Pages 57-70"},"PeriodicalIF":19.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End violence against children and adolescents: integrate climate policy into the 2030 SDGs","authors":"Ilan Cerna-Turoff ,&nbsp;Karen M Devries","doi":"10.1016/S2352-4642(24)00301-8","DOIUrl":"10.1016/S2352-4642(24)00301-8","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 1","pages":"Pages 7-8"},"PeriodicalIF":19.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A reduced-dose recombinant pertussis vaccine booster in Thai adolescents: a phase 2/3, observer-blinded, randomised controlled, non-inferiority trial","authors":"Prof Thanyawee Puthanakit MD ,&nbsp;Auchara Tangsathapornpong MD ,&nbsp;Suvaporn Anugulruengkitt PhD ,&nbsp;Rapisa Nantanee MD ,&nbsp;Pornumpa Bunjoungmanee MD ,&nbsp;Souad Mansouri PhD ,&nbsp;Librada Fortuna MD ,&nbsp;Wassana Wijagkanalan PhD ,&nbsp;Terapong Tantawichien MD ,&nbsp;TDA205 study team","doi":"10.1016/S2352-4642(24)00173-1","DOIUrl":"10.1016/S2352-4642(24)00173-1","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;A resurgence of pertussis has increased the demand for low-cost vaccines. The aim of this study was to test the immunogenicity of a booster acellular monovalent pertussis vaccine containing reduced-dose (2 μg) recombinant pertussis toxin (PT) and 5 μg filamentous haemagglutinin (FHA; ap&lt;sub&gt;gen&lt;/sub&gt;) against a version of ap&lt;sub&gt;gen&lt;/sub&gt; containing tetanus and reduced-dose diphtheria toxoids (Tdap&lt;sub&gt;gen&lt;/sub&gt;) and a licensed vaccine containing chemically detoxified PT and FHA combined with tetanus toxoid and reduced-dose diphtheria toxoid (Tdap&lt;sub&gt;chem&lt;/sub&gt;).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This phase 2/3, observer-blinded, randomised, controlled, non-inferiority trial was done in adolescents aged 9–17 years at two clinical research centres in Bangkok and Pathum Thani, Thailand. Eligible participants were screened and randomly assigned (1:1:1) to receive one booster dose of ap&lt;sub&gt;gen&lt;/sub&gt;, Tdap&lt;sub&gt;gen&lt;/sub&gt;, or Tdap&lt;sub&gt;chem&lt;/sub&gt; vaccine. Participants were followed up until day 336 post-immunisation. The primary endpoint was non-inferior seroconversion rates in Tdap&lt;sub&gt;gen&lt;/sub&gt; and Tdap&lt;sub&gt;chem&lt;/sub&gt; vaccine groups, with seroconversion rate defined as the proportion of participants with at least a four-fold increase on day 28 post-immunisation relative to baseline of anti-PT and anti-FHA IgG. The non-inferiority for seroconversion rates of anti-PT and anti-FHA IgG was defined as the lower bound of the two-sided 95% CI of the seroconversion rate for Tdap&lt;sub&gt;gen&lt;/sub&gt; compared with Tdap&lt;sub&gt;chem&lt;/sub&gt; exceeding −10%. Immunogenicity was analysed in the per-protocol population. All safety data were collected, and the prevalence of adverse events was analysed in the intention-to-treat population. This trial was registered on the Thai Clinical Trial Registry (TCTR20181031001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between June 18, and Aug 3, 2019, 450 adolescents (mean age 12·1 years, SD 2·5) were enrolled and randomly assigned (150 participants in each group). Day 28 anti-PT IgG seroconversion rates were 141 (94%) of 150 participants who received Tdap&lt;sub&gt;gen&lt;/sub&gt; (95% CI 88·8–97·0) and 105 (71%) of 149 participants who received Tdap&lt;sub&gt;chem&lt;/sub&gt; (62·7–77·2; p&lt;0·0001). Day 28 anti-FHA IgG seroconversion rates were 144 (96%) of 150 participants who received Tdap&lt;sub&gt;gen&lt;/sub&gt; (91·4–98·3) and 124 (83%) of 149 participants who received Tdap&lt;sub&gt;chem&lt;/sub&gt; (76·4–88·4; p&lt;0·0001). The difference in seroconversion rates was 23·5% (95% CI 15·3–31·8) for anti-PT IgG and 12·8% (6·0–19·6) for anti-FHA IgG, when comparing the Tdap&lt;sub&gt;gen&lt;/sub&gt; versus the Tdap&lt;sub&gt;chem&lt;/sub&gt; vaccine group. No vaccine-related serious adverse events were reported.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Recombinant Tdap&lt;sub&gt;gen&lt;/sub&gt; vaccine showed non-inferior immunogenicity compared with Tdap&lt;sub&gt;chem&lt;/sub&gt; at day 28 in terms of seroconversion rate of anti-PT IgG and anti-FHA IgG relative to baseline. The reduced-dose ap","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 900-909"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to Lancet Child Adolesc Health 2024; 8: 482–90","authors":"","doi":"10.1016/S2352-4642(24)00311-0","DOIUrl":"10.1016/S2352-4642(24)00311-0","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Page e17"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric acute liver failure: a multidisciplinary perspective on when a critically ill child is unsuitable for liver transplantation","authors":"Prof Akash Deep MD ,&nbsp;Emma C Alexander MBBS ,&nbsp;Joe Brierley MBChB ,&nbsp;Mihaela Damian MD ,&nbsp;Anish Gupta MBBS ,&nbsp;Valerie McLin MD ,&nbsp;Moinak Sen Sarma MBBS ,&nbsp;James E Squires MD ,&nbsp;Barbara E Wildhaber MD","doi":"10.1016/S2352-4642(24)00255-4","DOIUrl":"10.1016/S2352-4642(24)00255-4","url":null,"abstract":"<div><div>Paediatric acute liver failure is a devastating condition with high morbidity and mortality, which is challenging to manage for the hepatologist, intensivist, and associated specialists. Emergency liver transplantation is required for 10–20% of patients, but for 10% of critically ill children, liver transplantation is deemed unsuitable; the child might be too unwell, or the underlying cause might carry a poor prognosis. Other social, logistical, or ethical considerations are often relevant. Liver transplantation when a patient is too unwell creates perioperative risk to the child that could lead to morbidity, mortality, and potential graft wastage, which is detrimental for others on the waiting list. Donor liver scarcity should prompt an evaluation of whether a transplant is justified through a holistic multidisciplinary lens that considers medical, social, logistical, and ethical concerns. In this Review, we explore, from a multidisciplinary perspective, why a critically unwell child with paediatric acute liver failure might be unsuitable for liver transplantation.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 921-932"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pattern of childhood infections during and after the COVID-19 pandemic","authors":"Ulrikka Nygaard PhD ,&nbsp;Mette Holm PhD ,&nbsp;Prof Helena Rabie PhD ,&nbsp;Maren Rytter PhD","doi":"10.1016/S2352-4642(24)00236-0","DOIUrl":"10.1016/S2352-4642(24)00236-0","url":null,"abstract":"<div><div>The rates of most paediatric infectious diseases declined during the initial phase of the COVID-19 pandemic due to the implementation of non-pharmaceutical interventions. However, after the gradual release of these interventions, resurgences of infections occurred with notable variations in incidence, clinical manifestations, pathogen strains, and age distribution. This Review seeks to explore these changes and the rare clinical manifestations that were made evident during the resurgence of known childhood infections. The magnitude of resurgences was possibly caused by a profound population immunity debt to specific pathogens in combination with the coinciding reappearance of viral and bacterial infections, rather than novel pathogen variants, increased antimicrobial resistance, or altered childhood immune function. As the usual patterns of paediatric infectious diseases were disrupted during the COVID-19 pandemic, the consequences of a population immunity debt were unravelled, and new insights into pathogen transmissibility, disease pathogenesis, and rare clinical manifestations were revealed.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 910-920"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The world in 2024 was not all right for children","authors":"The Lancet Child & Adolescent Health","doi":"10.1016/S2352-4642(24)00308-0","DOIUrl":"10.1016/S2352-4642(24)00308-0","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Page 843"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out of Zimbabwe: fragmented families and mental health","authors":"Tanaka J Marukutira,&nbsp;Shaniqua Marukutira,&nbsp;Thandekile W Nkomazana","doi":"10.1016/S2352-4642(24)00309-2","DOIUrl":"10.1016/S2352-4642(24)00309-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 854-855"},"PeriodicalIF":19.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The underestimated burden of tuberculosis in children","authors":"Nicole Salazar-Austin ,&nbsp;Lisa Marie Cranmer","doi":"10.1016/S2352-4642(24)00297-9","DOIUrl":"10.1016/S2352-4642(24)00297-9","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"8 12","pages":"Pages 845-847"},"PeriodicalIF":19.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}