Lancet Child & Adolescent Health最新文献

{"title":"Child and adolescent mortality from severe NCDs and injuries: a call for inclusion","authors":"Neil Gupta , Ana Olga Machatine De Almeida Hausse Mocumbi , Fouzia Shafique , Raoul Bermejo , Gene Bukhman","doi":"10.1016/S2352-4642(25)00187-7","DOIUrl":"10.1016/S2352-4642(25)00187-7","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 10","pages":"Pages 689-691"},"PeriodicalIF":15.5,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812967","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":"Differentiating dengue, Zika, and chikungunya in paediatric populations","authors":"Gabriela Paz-Bailey , Randall J Nett","doi":"10.1016/S2352-4642(25)00194-4","DOIUrl":"10.1016/S2352-4642(25)00194-4","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 614-615"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779839","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":"Luciana Rodrigues Silva: paediatric gastroenterologist and trailblazer in Brazil","authors":"Tony Kirby","doi":"10.1016/S2352-4642(25)00220-2","DOIUrl":"10.1016/S2352-4642(25)00220-2","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Page 621"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779929","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 2025; 9: 578–612","authors":"","doi":"10.1016/S2352-4642(25)00215-9","DOIUrl":"10.1016/S2352-4642(25)00215-9","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Page e17"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779928","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":"Comparison of dengue, chikungunya, and Zika among children in Nicaragua across 18 years: a single-centre, prospective cohort study","authors":"Fausto Andres Bustos Carrillo PhD , Sergio Ojeda MD , Nery Sanchez MD , Miguel Plazaola MD , Damaris Collado BS , Tatiana Miranda BS , Saira Saborio MSc , Brenda Lopez Mercado BS , Jairo Carey Monterrey BS , Sonia Arguello BS , Lora Campredon MPH , Zijin Chu MPH , Colin J Carlson PhD , Prof Aubree Gordon PhD , Angel Balmaseda MD , Guillermina Kuan MD , Prof Eva Harris PhD","doi":"10.1016/S2352-4642(25)00168-3","DOIUrl":"10.1016/S2352-4642(25)00168-3","url":null,"abstract":"<div><h3>Background</h3><div>Dengue, chikungunya, and Zika are diseases of major human concern. Differential diagnosis of these three diseases is complicated in children and adolescents due to overlapping clinical features (signs, symptoms, and complete blood count results). Few studies have directly compared these three diseases. We aimed to use 18 years of primary care observations from a paediatric cohort to characterise the distinguishing features of dengue, chikungunya, and Zika.</div></div><div><h3>Methods</h3><div>This single-centre prospective cohort study was based on the ongoing Pediatric Dengue Cohort Study (PDCS), which started on Aug 30, 2004, in District II of Managua, Nicaragua. The PDCS was initiated to study dengue virus infections in children who attended the Health Center Sócrates Flores Vivas (HCSFV) for their medical needs; over the years, the PDCS expanded the age range (2 to <10 years expanded to 2 to <18 years). The PDCS also expanded eligibility criteria to include chikungunya virus and Zika virus before they entered the geographical study area in August, 2014 and January, 2016, respectively. For this study, we included laboratory confirmed cases of dengue, chikungunya, and Zika enrolled in the PDCS between Jan 19, 2006, and Dec 31, 2023, and evaluated at the HCSFV. We assessed clinical features (clinical records and laboratory results) during the first 10 days of illness using generalised additive models, day-specific and disease-specific prevalence estimates, and machine learning models.</div></div><div><h3>Findings</h3><div>We characterised 1405 dengue, 517 chikungunya, and 522 Zika cases. The median age was 10·0 years (IQR 7·0–12·7); 1165 (47·7%) cases were male and 1279 (52·3%) were female. The prevalence of many clinical features shown by dengue, chikungunya, and Zika cases differed substantially overall, by age, and by day of illness. The presence of basophilia (prevalence difference 42·3% [95% CI 37·4 to 47·0]), monocytopenia (13·0% [10·0 to 16·4]), abdominal pain (19·1% [15·7 to 22·9]), and leukopenia (41·1% [36·2 to 45·6]) best distinguished dengue; the presence of arthralgia (60·5% [56·3 to 64·2]) and absence of papular rash (–14·9% [–17·2 to –12·7]), leukopenia (–32·0% [–36·7 to –27·1]), and conjunctival injection (–4·9% [–6·6 to –3·3]) best distinguished chikungunya; and the presence of generalised rash (35·0% [30·1 to 39·7]) and absence of fever (–37·3% [–41·7 to –33·0]), headache (–36·2% [–41·1 to –31·2]), myalgia (–30·1% [–33·9 to –26·2]), and lymphocytopenia (–41·9% [–46·6 to –37·1]) best distinguished Zika. Dengue and chikungunya cases showed similar temperature dynamics during acute illness, and their mean temperatures were higher than Zika cases. 62 laboratory confirmed afebrile dengue cases, which would not be captured by any widely used international case definition, presented most similarly to afebrile Zika cases, but five (8·1%) had warning signs of dengue disease severity. Based on boosted r","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 622-633"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779779","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":"Risk stratification of childhood infection using host markers of immune and endothelial activation in Asia (Spot Sepsis): a multi-country, prospective, cohort study","authors":"Arjun Chandna DPhil , Constantinos Koshiaris DPhil , Raman Mahajan MPH , Riris Adono Ahmad PhD , Dinh Thi Van Anh MD , Khalid Shams Choudhury MPH , Suy Keang MD , Phung Nguyen The Nguyen PhD , Sayaphet Rattanavong MD , Souphaphone Vannachone MD","doi":"10.1016/S2352-4642(25)00183-X","DOIUrl":"10.1016/S2352-4642(25)00183-X","url":null,"abstract":"<div><h3>Background</h3><div>Prognostic tools for febrile illnesses are urgently required in resource-constrained community contexts. Circulating immune and endothelial activation markers stratify risk in common childhood infections. We aimed to assess their use in children with febrile illness presenting from rural communities across Asia.</div></div><div><h3>Methods</h3><div>Spot Sepsis was a prospective cohort study across seven hospitals in Bangladesh, Cambodia, Indonesia, Laos, and Viet Nam that serve as a first point of contact with the formal health-care system for rural populations. Children were eligible if aged 1–59 months and presenting with a community-acquired acute febrile illness that had lasted no more than 14 days. Clinical parameters were recorded and biomarker concentrations measured at presentation. The primary outcome measure was severe febrile illness (death or receipt of organ support) within 2 days of enrolment. Weighted area under the receiver operating characteristic curves (AUC) were used to compare prognostic accuracy of endothelial activation markers (ANG-1, ANG-2, and soluble FLT-1), immune activation markers (CHI3L1, CRP, IP-10, IL-1ra, IL-6, IL-8, IL-10, PCT, soluble TNF-R1, soluble TREM1 [sTREM1], and soluble uPAR), WHO danger signs, the Liverpool quick Sequential Organ Failure Assessment (LqSOFA) score, and the systemic inflammatory response syndrome (SIRS) score. Prognostic accuracy of combining WHO danger signs and the best performing biomarker was analysed in a weighted logistic regression model. Weighted measures of classification were used to compare prognostic accuracies of WHO danger signs and the best performing biomarker and to determine the number of children needed to test (NNT) to identify one additional child who would progress to severe febrile illness. The study was prospectively registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT04285021</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>3423 participants were recruited between March 5, 2020, and Nov 4, 2022, 18 (0·5%) of whom were lost to follow-up. 133 (3·9%) of 3405 participants developed severe febrile illness (22 deaths, 111 received organ support; weighted prevalence 0·34% [95% CI 0·28–0·41]). sTREM1 showed the highest prognostic accuracy to identify patients who would progress to severe febrile illness (AUC 0·86 [95% CI 0·82–0·90]), outperforming WHO danger signs (0·75 [0·71–0·80]; p<0·0001), LqSOFA (0·74 [0·69–0·78]; p<0·0001), and SIRS (0·63 [0·58–0·68]; p<0·0001). Combining WHO danger signs with sTREM1 (0·88 [95% CI 0·85–0·91]) did not improve accuracy in identifying progression to severe febrile illness over sTREM1 alone (p=0·24). Sensitivity for identifying progression to severe febrile illness was greater for sTREM1 (0·80 [95% CI 0·73–0·85]) than for WHO danger signs (0·72 [0·66–0·79]; NNT=3000), whereas specificities were comparable (0·81 [0·78–0·83] f","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 634-645"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779780","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":"Access to therapy for children and adolescents with multiple sclerosis: global considerations in preventing disease progression","authors":"Prof E Ann Yeh MD MA ,&nbsp;Prof Helen Tremlett PhD ,&nbsp;Rabporn Suntornlohanakul MD ,&nbsp;Daniela Castillo-Villagran MD ,&nbsp;Beyza Ciftci MD MSc ,&nbsp;Prof Silvia Tenembaum MD ,&nbsp;Andrea Savaransky MD ,&nbsp;Prof Lekha Pandit MD ,&nbsp;Prof Ming Lim MD PhD","doi":"10.1016/S2352-4642(25)00133-6","DOIUrl":"10.1016/S2352-4642(25)00133-6","url":null,"abstract":"<div><div>Paediatric-onset multiple sclerosis comprises approximately 1·5% of prevalent multiple sclerosis cases and is associated with higher disease burden, early and progressive motor and cognitive disability in young adulthood, and high levels of depression and fatigue. Observational data and randomised controlled trials have shown marked effects of multiple sclerosis disease-modifying therapies on MRI activity and long-term outcomes, including disease progression, in the paediatric population. We present a comprehensive review of published literature focused on issues of access to therapy in children and adolescents with paediatric-onset multiple sclerosis. In this Review, we identify regional variability in availability of multiple sclerosis therapies and examine issues, such as differences in access to care and time to diagnosis, criteria for regulatory approval, availability of insurance, and government supports. Finally, we outline specific future directions that should be taken to address these barriers and ensure better and equal therapy access for all children and adolescents with multiple sclerosis.</div></div>","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 673-684"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779283","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":"US medical groups sue to reverse overhaul of vaccine recommendations","authors":"Bryant Furlow","doi":"10.1016/S2352-4642(25)00240-8","DOIUrl":"10.1016/S2352-4642(25)00240-8","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 10","pages":"Pages 694-695"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796795","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":"Biomarkers for early identification of severe febrile illness among children in community settings: spot on?","authors":"Mihir R Atreya ,&nbsp;Vanessa S Lanziotti","doi":"10.1016/S2352-4642(25)00210-X","DOIUrl":"10.1016/S2352-4642(25)00210-X","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 615-617"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779840","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":"Safety of auditory interventions for vulnerable hospitalised infants: more is not always better","authors":"Carmina Erdei","doi":"10.1016/S2352-4642(25)00165-8","DOIUrl":"10.1016/S2352-4642(25)00165-8","url":null,"abstract":"","PeriodicalId":54238,"journal":{"name":"Lancet Child & Adolescent Health","volume":"9 9","pages":"Pages 619-620"},"PeriodicalIF":15.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779927","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}