BMJ Paediatrics Open最新文献

{"title":"Pattern and appropriateness of antibiotic therapy for acute respiratory tract infection among under-five children accessing care in a tertiary facility, Sokoto, Nigeria.","authors":"Fatima Ishaq Abubakar, Hadiza Kubra Ahmed, Omotolani Olawunmi Akintunde, Idrees Abiodun Rufai","doi":"10.1136/bmjpo-2025-003468","DOIUrl":"https://doi.org/10.1136/bmjpo-2025-003468","url":null,"abstract":"<p><strong>Introduction: </strong>Acute respiratory tract infections (ARIs) are a major cause of antibiotic use among under-five (U5) children, often leading to inappropriate prescriptions that contribute to antimicrobial resistance, adverse drug reactions and higher healthcare costs.</p><p><strong>Objectives: </strong>To assess the pattern and rate of antibiotic prescriptions and evaluate their appropriateness based on WHO and Paediatric Association of Nigeria guidelines for ARI treatment among U5 children at Usmanu Danfodiyo University Teaching Hospital, Sokoto METHODS: A retrospective review of medical records (case folders and prescription sheets) was conducted for U5 children diagnosed with ARI over a 10-month period at the paediatric outpatient and inpatient units, Department of Paediatrics, UDUTH. Data extracted included patient sociodemographic characteristics, ARI diagnosis based on Integrated Management of Childhood Illnesses/WHO criteria and antibiotic/medication details (class, name, route, dose, frequency, duration and regimen). Analysis was performed using SPSS V.20.0; p<0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 2140 drugs and 1545 antibiotics were prescribed, averaging 2.2 and 1.6 per patient, respectively. Upper respiratory tract infections accounted for 66.2% of antibiotic indications. The antibiotic prescription rate was 100.0 %, with 71.0% administered parenterally. Most prescriptions used generic names (96.5%) and were listed in the National Essential Medicines List (100%). Cephalosporins were most frequently prescribed (46.4%), followed by penicillins; fluoroquinolones were least prescribed (1.2%). Mono-antibiotic therapy was used in 53.2% of cases. Notably, 81.5% of prescriptions came from second-line therapies. Appropriate prescribing was observed for duration (93.6%), dose (66.0%), frequency (69.7%) and indication/choice (66.5%).</p><p><strong>Conclusion: </strong>Despite encouraging adherence to appropriate antibiotic dosage regimen, the high rate of antibiotic prescription, parenteral antibiotic administration and alternative antibiotic use highlights ongoing concerns with risk of resistance, adverse effects and treatment failure. Strengthening antibiotic stewardship and adherence to first-line guidelines is crucial to optimise ARI treatment in resource-limited settings.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942291","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":"Do neonatal intensive care unit (NICU) health workers know about retinopathy of prematurity (ROP)? A qualitative study at a Regional Referral Hospital in Uganda.","authors":"Innocent Ayesiga, Primrose Magala, Tom Didimus Ediamu, Hana El Diwany, Ian Ly Yeung, Alex Wasomoka, Henry Muwonge, Phillip Musoke, Elias Musiime, Abraham Tumwesigye, Pius Atwau, Noreen Atwijukire, Iddi Ndyabawe, Anne Mpaire Musika, Himanshu I Patel, Aeesha Nj Malik, Ibrahim Bwaga, Sheba Gitta Nakacubo","doi":"10.1136/bmjpo-2024-003104","DOIUrl":"https://doi.org/10.1136/bmjpo-2024-003104","url":null,"abstract":"<p><strong>Introduction: </strong>Retinopathy of prematurity (ROP) is a significant cause of blindness and visual impairment in preterm infants globally, particularly in low-income and middle-income countries. ROP is associated with prematurity, and with the increase in the survival of preterm infants, its global burden continues to rise. However, there is limited information available on health workers' perspectives regarding ROP in Uganda.</p><p><strong>Methods: </strong>This qualitative study explored health workers' experiences regarding ROP in the neonatal intensive care unit (NICU) at Hoima Regional Referral Hospital. This study involved in-depth interviews with eight health workers working in the NICU. We examined individual, facility and national factors that could impact the health workers' perspectives on ROP at the hospital. The data obtained were transcribed and coded, and themes were generated for further analysis.</p><p><strong>Results: </strong>We identified key barriers and facilitators to effective ROP care. Four major themes emerged from the analysis: (1) Knowledge and awareness of ROP, (2) Challenges and limitations in implementing the ROP screening programme, (3) Training and guidelines for ROP screening and treatment and (4) Recommendations for ROP prevention screening and management. ROP awareness, knowledge of ROP and witchcraft and ROP were identified as specific subthemes under the knowledge and awareness of ROP theme.</p><p><strong>Discussion and conclusion: </strong>This study reveals significant gaps in health workers' knowledge and awareness of ROP. Limited access to essential equipment and specialised personnel may further limit ROP screening capacity. We suggest implementing a multidisciplinary team approach, continuous professional development and establishing national ROP guidelines. We recommend developing a formal training structure and syllabus for ROP screening. The training can enhance task shifting among health workers in areas without specialised health workers. Addressing the identified barriers is crucial for improving the care and outcomes for preterm infants in Uganda and similar settings.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942246","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":"Qualitative approach to assess maternal knowledge, attitude and practice regarding oral rehydration solution preparation and administration among under-5 children suffering from diarrhoea in Dhaka, Bangladesh.","authors":"Md Ridwan Islam, Md Fuad Al Fidah, Syed Jayedul Bashar, Rukaeya Amin, Sneha Paul, Chowdhury Ali Kawser, Tahmeed Ahmed, Sharika Nuzhat","doi":"10.1136/bmjpo-2025-003577","DOIUrl":"10.1136/bmjpo-2025-003577","url":null,"abstract":"<p><strong>Background: </strong>Oral rehydration salt (ORS) solution has been instrumental in substantially reducing diarrhoea-related mortality, particularly in resource-constrained settings such as Bangladesh. However, the full effectiveness of ORS is often undermined by inadequate preparation, improper storage and incorrect administration. We aimed to evaluate mothers' knowledge, attitude and practice regarding ORS preparation and administration for children suffering from diarrhoea in this study.</p><p><strong>Methods: </strong>The study was carried out at Dhaka Hospital, ICDDR,B, using a qualitative research approach. Based on data saturation, in-depth interviews were conducted with 31 mothers of children under 5 who sought care at the hospital between February and April 2024. The transcribed data were analysed using qualitative content analysis to describe and analyse data.</p><p><strong>Results: </strong>Although the majority of the mothers had a positive attitude regarding ORS preparation and administration, they lacked proper knowledge on several points, which hampered correct practices. Ten mothers did not know the correct amount of sachet powder to use, while nine mothers lacked the proper knowledge regarding the right amount of water to prepare ORS, which was rather alarming. Only five mothers recognised that ORS does not transfer to the baby through breast milk. Fourteen mothers provided ORS to their child after each episode of purging while the rest did not. Only 15 mothers adhered to the recommended feeding practices while administering ORS during their child's illness.</p><p><strong>Conclusion: </strong>This study underscores mothers' need for proper health education regarding the preparation and administration of ORS as well as targeted policies promoting the efficacy of ORS in diarrhoea.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942327","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":"Scoping review of evidence-based practice guidelines for the evaluation and care of young children with developmental disabilities in LMIC settings: evidence for action.","authors":"Dorcas N Magai, Brad D Berman, Agnes M Mutua, Tracey Smythe, Bolajoko O Olusanya, Sheffali Gulati, Angelina Kakooza Mwesige, Andrew Blaikie, Rebecca Claire Lusobya, David Coghill, Melissa Gladstone","doi":"10.1136/bmjpo-2025-003571","DOIUrl":"10.1136/bmjpo-2025-003571","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood disability is increasingly prevalent, particularly in low-income and middle-income countries, as more children survive worldwide. Global practice guidelines are essential to address the need for timely identification, evaluation and management of children with developmental disabilities, particularly in resource-limited settings. This scoping review aims to summarise recent evidence-based practice guidelines for the assessment and care of children aged 0-5 years at risk or with developmental disabilities and identify those practice guidelines that are suitable for use across both global and resource-limited settings.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, CINAHL as well as websites for professional associations using Google to identify evidence-based practice guidelines for specific developmental disabilities with established global prevalence estimates. We identified additional literature through snowballing. Practice guidelines were included if they were published between September 2012 and June 2024, were in English, and demonstrated a systematic process of reviewing available evidence, which then provided information on the detection, diagnosis, treatment and management of children under five with developmental disabilities. Three reviewers independently screened results by title, abstract and full text. Study characteristics and outcome data were extracted, and results were narratively synthesised.</p><p><strong>Results: </strong>43 practice guidelines met the eligibility search criteria. Few evidence-based practice guidelines were generated from resource-limited settings (n=3, 7.0%). Of these, two were published in Malaysia and one from Cameroon. Most of the practice guidelines focused on both assessment and management (n=20, 46.5%), with some addressing only assessment (n=9, 20.9%) or management of the conditions (n=14, 32.6%).</p><p><strong>Conclusions: </strong>Practice guidelines focusing on the identification and support of children with developmental disabilities, chiefly published within high-income settings, are available to be selectively adapted and utilised across similar localities globally. All young children with developmental disabilities worldwide have the right to access equitable, timely and quality health and developmental care services.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882091","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":"Implementation of a brief training programme to reduce mask leak with a respiratory function monitor.","authors":"Neaha Patel, Ludovic Chassin, Burak Salgin","doi":"10.1136/bmjpo-2025-003589","DOIUrl":"10.1136/bmjpo-2025-003589","url":null,"abstract":"<p><p>Respiratory function monitors (RFMs) can provide real-time data including expiratory tidal volumes and interface leak during delivery room (DR) neonatal resuscitation. However, concerns have been raised within previous randomised controlled trials and systematic reviews that effectuating RFMs routinely for DR resuscitation is limited by lack of comprehensive staff training. The International Liaison Committee on Resuscitation have also recently declared a knowledge gap in terms of the training required to be competent in utilising an RFM during neonatal resuscitation. We conducted an experiment with thirteen medical students who had no prior resuscitation experience to see if visual feedback from an RFM could improve mask leak when ventilating an extremely preterm manikin. Following a brief training session with hands-on practice, 260 breaths were analysed and median mask leak improved from 6% (IQR 1-6%) during the first breath to 0% (IQR 0-1%) by the twentieth and final breath. The median expiratory tidal volume was 3.6 mL (IQR 3.4-3.8 mL) and remained stable. This manikin experiment has demonstrated that even a short and experiential training session with an RFM for participants with no prior resuscitation training can be effective in reducing mask leak.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871461","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":"Admissions and outcomes after perinatal asphyxia and hypoxic-ischaemic encephalopathy before and after therapeutic hypothermia: a retrospective population-based study.","authors":"Karoline Aker, Janicke M Syltern, Miriam Martinez-Biarge, Ragnhild Støen","doi":"10.1136/bmjpo-2025-003530","DOIUrl":"10.1136/bmjpo-2025-003530","url":null,"abstract":"<p><strong>Background: </strong>Hypoxic-ischaemic encephalopathy (HIE) is the leading cause of brain injury in term infants, and therapeutic hypothermia (TH) has been shown to improve outcomes for infants with moderate/severe HIE. We aimed to describe admission rates and outcomes after perinatal asphyxia and HIE before and after the implementation of TH in June 2007.</p><p><strong>Methods: </strong>This single-centre, retrospective, population-based study included term/near-term infants born between January 2003 and December 2011 and admitted to a level III neonatal unit with International Statistical Classification of Diseases and Related Health Problems, 10th Revision diagnoses P20, P21, P90 and/or P91, and a clinical picture compatible with asphyxia/HIE. Outcome measures were clinical characteristics during neonatal admission and survival without cerebral palsy (CP) at 9-10 years. Data were collected from medical records and the Norwegian Quality and Surveillance Registry for CP.</p><p><strong>Results: </strong>The admission rate related to perinatal asphyxia was 7.63 per 1000 term/near-term live births and did not change over time. The incidence of HIE increased significantly after the implementation of TH (from 2.69 to 4.21 per 1000 term/near-term live births, incidence rate ratio 1.56 (95% CI 1.06 to 2.34)). Among 255 included infants (62% boys, mean birth weight 3691 g), significantly more infants were diagnosed with HIE after the implementation of TH compared with before (54% vs 36%, respectively, p=0.005). A total of 227 (92%) of 247 infants survived without CP, with no difference between the time periods. Among infants with moderate/severe HIE born after the implementation of TH, 20 (67%) of 30 infants were cooled and 80% of cooled and 33% of non-cooled infants survived without CP.</p><p><strong>Conclusions: </strong>Admission rates and outcomes were stable during these 9 years, but more infants were reported with HIE after the implementation of TH. Non-cooled infants with moderate/severe HIE born after the implementation of TH had poor outcomes, and early clinical HIE evaluation remains a major challenge.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871460","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":"Risk factors for hospital admission and length of stay for children with and without congenital anomalies: a EUROlinkCAT cohort study.","authors":"Joanne Given, Ester Garne, Joan K Morris, Silvia Baldacci, Elisa Ballardini, Mika Gissler, Francesca Gorini, Sonja Kiuru-Kuhlefelt, Stine Kjaer Urhoj, Marco Manfrini, Joachim Tan, Maria Loane","doi":"10.1136/bmjpo-2025-003586","DOIUrl":"10.1136/bmjpo-2025-003586","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate risk factors for hospital admission and length of stay (LOS) among children with and without congenital anomalies (CAs).</p><p><strong>Design: </strong>A population-based linkage cohort study including 50 353 children with major CAs and 1 259 925 children without CAs from four EUROCAT registry areas in three countries. Data on children born 1995-2014 were linked to hospital discharge databases 1995-2015. HRs and incidence rate ratios estimated risk of admission and LOS for children aged <1 and 1-4 years by birth cohort, gestational age, sex, maternal age, multiple births and maternal education. Estimates were pooled using random effects meta-analysis.</p><p><strong>Results: </strong>In children <1 year, twins/triplets with CAs were 34% more likely to be admitted and had over two times the LOS compared with singletons, while twins/triplets without CAs were over two and a half times as likely to be admitted and had six times longer stays. Despite this, a higher proportion of twins/triplets with CAs were admitted compared to those without CAs (91% vs 65%) and had longer LOS (20 days vs 10). Smaller increases in risk of admission or LOS were found in boys, young mothers and low maternal education. Preterm birth was a major risk factor for admission and LOS.</p><p><strong>Conclusions: </strong>While the impact of risk factors on hospital admission and LOS was generally greater in children without CAs, a higher proportion of children with CAs were admitted and had longer stays. These findings have implications for health care planning and for counselling parents regarding their child's future healthcare needs.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854462","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":"Feasibility and clinical utility of daytime polysomnography performed in NICU to diagnose sleep disordered breathing in infants.","authors":"Dimple Goel, Andrew Wilson, Anne O'Donnell, Chloe Lappin, Rhiannon Plavsic, Tracey Verstandig, Shripada Rao, Max K Bulsara, Kellie Francis, Catherine Dunstan, Gareth Baynam, Karen Waters","doi":"10.1136/bmjpo-2025-003641","DOIUrl":"10.1136/bmjpo-2025-003641","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility and clinical utility of daytime polysomnography (PSG) in infants <3 months of age.</p><p><strong>Methods: </strong>A prospective observational study of a convenience cohort analysing PSGs that were conducted for clinical purposes in infants less <3 months of age, between 1 May 2021 and 31 May 2024. A comparison was made between results for daytime PSG in the neonatal intensive care unit (NICU) and overnight PSG in the sleep laboratory. The type of PSG performed (daytime vs overnight) was based on the workflow of the sleep laboratory. Primary outcomes were successfully completed PSGs (feasibility) and per cent sleep efficiency (clinical utility). Secondary outcomes compared other sleep parameters between groups. Patient and public feedback directly informed the development of the research question and outcome measures.</p><p><strong>Results: </strong>Of 60 PSGs, 28 were daytime and 32 were overnight. Daytime studies had a younger age (median 18 vs 55 days, p<0.001) and shorter median recording time (8.2 vs 10.4 hours, p<0.001). All daytime PSGs were successful, indicating feasibility. After adjusting for age at PSG and total recording time, per cent sleep efficiency was equivalent in the two groups (95% CI -12.4 to 5.7; p 0.456), indicating their clinical utility. For secondary outcomes, daytime PSGs had a higher % rapid eye movement (REM) sleep by 9.9% points (95% CI 1.1 to 18.8; p 0.028) compared with overnight PSG. Parameters that were not different included: frequency of spontaneous arousals, REM latency, sleep latency, Apnoea-Hypopnoea Index and Obstructive Apnoea-Hypopnoea Index. A decline in requests for overnight PSGs and a corresponding increase in daytime PSGs over the course of the study were observed.</p><p><strong>Conclusion: </strong>Daytime PSGs performed in NICU were feasible and provided clinically useful results in infants <3 months of age. Availability of daytime PSGs performed at the infant's bedside expands resource capacity and has the potential for cost savings.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854460","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":"Efficacy of zinc supplementation for young infants with clinical severe infection in Tanzania: study protocol for a randomised controlled trial.","authors":"Karim P Manji, Sarah Somji, Mohamed Bakari, Wafaie W Fawzi, Upendo Kibwana, Rodrick Kisenge, Abuu S Kisumuni, Enju Liu, Neema Mafie, Fredrick A Maleko, Nahya Salim, Christopher P Duggan, Christopher R Sudfeld","doi":"10.1136/bmjpo-2025-003804","DOIUrl":"10.1136/bmjpo-2025-003804","url":null,"abstract":"<p><strong>Introduction: </strong>Innovative interventions will be essential for countries in sub-Saharan Africa to achieve the 2030 Sustainable Development Goal for child mortality. Infections among young infants, including sepsis, meningitis and pneumonia, continue to cause a large burden of morbidity and mortality in low-income and middle-income countries. Zinc is an essential micronutrient with a well-established role in human health and immune system function, and supplementation may improve survival and treatment outcomes for infants with bacterial infections.</p><p><strong>Methods and analysis: </strong>We will conduct an individually randomised, quadruple-blind trial of zinc supplementation among 3250 infants 0-59 days old with clinical severe infection (CSI) in Dar es Salaam, Tanzania. Infants with CSI will be randomised to receive either (1) zinc citrate supplementation consisting of 5 mg elemental zinc taken two times per day for 14 days or (2) a matching placebo supplementation taken two times per day for 14 days. Infants will be followed for 90 days postrandomisation. The coprimary outcomes are (1) infant death (all-cause mortality to 90 days) and (2) treatment failure (composite outcome of death during initial hospitalisation, need for additional respiratory support, use of vasoactive medicines or change of antibiotics). Secondary outcomes include important infant health and nutritional outcomes.</p><p><strong>Ethics and dissemination: </strong>The trial protocol was approved by Harvard T. H. Chan School of Public Health Institutional Review Board, the Muhimbili University of Health and Allied Sciences Institutional Review Board, the National Health Research Ethics Sub-Committee and the Tanzania Medicine and Medical Device Authority. Findings will be disseminated locally, regionally and internationally at scientific conference presentations and as peer-reviewed publications.</p><p><strong>Trial registration number: </strong>NCT06102044; ClinicalTrials.gov identifier.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854443","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":"Leveraging large language models to inform paediatric chronic condition care: a cross-sectional study.","authors":"Syed Furrukh Jamil, Nada N Alshathri, Seham S Alsalamah, Nura A Almansour, Faris S Alsalamah, Tahir K Hameed, Jubran T Alqanatish","doi":"10.1136/bmjpo-2025-003742","DOIUrl":"10.1136/bmjpo-2025-003742","url":null,"abstract":"<p><p>This study assessed how ChatGPT 3.5, ChatGPT 4.0 and Google Gemini perform in providing educational content about coeliac disease and type 1 diabetes mellitus. We analysed 76 frequently asked questions for accuracy, comprehensiveness, readability and consistency. The models delivered highly accurate and comprehensive responses across the board. While ChatGPT 4.0 offered the most readable content, all models struggled with overall readability. Each model maintained consistent performance throughout testing. These results indicate that large language models show promise as supplementary tools for patient education in chronic paediatric conditions, though improvements in readability are needed to enhance accessibility.</p>","PeriodicalId":9069,"journal":{"name":"BMJ Paediatrics Open","volume":"9 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854461","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}