BMC Pediatrics最新文献

{"title":"Sex differences in the relationship between body mass index in Chinese adolescents and future risk of hypertension: a decade-long cohort study.","authors":"Rongtian Liu, Haofei Hu, Changchun Cao, Yong Han, Yuxin Bai, Wei Feng","doi":"10.1186/s12887-025-05555-2","DOIUrl":"10.1186/s12887-025-05555-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the relationship between body mass index (BMI) during adolescence and the future risk of developing hypertension, with a particular focus on potential sex differences.</p><p><strong>Methods: </strong>This study was a secondary analysis based on a cohort study involving 2,020 adolescents aged 10-15 years who underwent health check-ups at the MJ Health Screening Center between 1999 and 2008. Cox proportional hazards regression models were used to evaluate the association between BMI and hypertension risk, with stratification by gender. Cox proportional hazards regression with cubic spline functions was employed to explore potential nonlinear relationships, and sensitivity analyses were conducted to ensure robustness.</p><p><strong>Results: </strong>The multivariate Cox proportional hazards regression model showed a significant positive association between BMI and hypertension risk in the overall adolescent population and particularly in males, with hazard ratios (HRs) of 1.204 (95% CI: 1.038-1.396) and 1.181 (95% CI: 1.013-1.377), respectively. In females, a nonlinear relationship with a threshold effect was identified, with an inflection point at a BMI of 24.11 kg/m². Beyond this threshold, each 1 kg/m² increase in BMI was associated with a 3.491-fold higher risk of hypertension (HR = 4.491, 95% CI: 1.185-17.020).</p><p><strong>Conclusion: </strong>Among Chinese adolescent males, there was a positive dose-response relationship between BMI and future hypertension risk. In adolescent females, a specific nonlinear association with a threshold effect (inflection point: 24.11 kg/m²) was observed. Maintaining a BMI below 24.11 kg/m² in adolescent females may reduce their future risk of developing hypertension.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"187"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the efficacy of N-acetylcysteine in diminishing the duration and frequency of rotavirus-induced gastroenteritis: a preliminary randomized, placebo-controlled, double-blind clinical trial.","authors":"Behrooz Heydari, Majid Aflatonian, Mina Bagherizadeh, Farahnaz Hoseinzade, Fatemeh Saghafi","doi":"10.1186/s12887-025-05534-7","DOIUrl":"10.1186/s12887-025-05534-7","url":null,"abstract":"<p><strong>Background: </strong>Globally, gastroenteritis stands as a primary contributor to child mortality, annually taking the lives of 3 million children under the age of 5 years. Rotavirus, a major factor in viral diarrhea among children aged 6 months to 2 years, presents with severe symptoms such as watery diarrhea and vomiting. Although mortality rates have decreased due to supportive care and vaccines, promising alternatives like N-acetylcysteine (NAC) show potential benefits in laboratory studies, indicating a possible supplementary strategy for managing rotavirus infections by reducing the duration and antigen excretion in feces.</p><p><strong>Methods: </strong>During this double-blind clinical trial, 71 patients, confirmed to have gastroenteritis resulting from rotavirus using a rapid diagnostic strip, were randomly allocated to two groups. One group was prescribed NAC at a dosage of 60 mg/kg/day, while the other received a placebo. The patient's progress was monitored daily until their gastroenteritis improved, and details regarding the duration of diarrhea and the frequency of bowel movements were recorded for each participant.</p><p><strong>Results: </strong>The average duration of diarrhea in the NAC group and the placebo group was 2 and 3 days, respectively, with a level of p = 0.121. During the diarrhea period, the number of bowel movements in the NAC group was recorded at 28.1 ± 21.6 times, whereas in the placebo group, it was 35.3 ± 33.1 times, yielding a p-value of 0.409.</p><p><strong>Conclusions: </strong>Even though the effects of NAC were observed in lowering the duration of the period and decreasing the frequency of bowel movements in gastroenteritis, these results did not reach statistical significance. Hence, the data from this study suggest that NAC may not effectively reduce the duration of diarrhea and the frequency of bowel movements linked to gastroenteritis caused by rotavirus.</p><p><strong>Trial registration: </strong>IRCT20181208041882N13, 14-10-2023 ( https://irct.behdasht.gov.ir/trial/68259 ).</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"186"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11900640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: The effect of a comprehensive intervention on anthropometric indices, dietary intake, and physical activity of adolescent boys with overweight.","authors":"Fatemeh Sadat Hashemi Javaheri, Zahra Mousavi, Saeideh Mohammadi, Arezoo Amjadi, Khadijeh Abbasi Mobarakeh, Seyedeh Hayedeh Mousavi Shalmani, Mahdieh Torkaman, Masoomeh Alsadat Mirshafaei, Sara Khoshdooz, Zahra Saeedirad, Naser Kalantari, Parmis Mirzaei, Saeid Doaei, Nastaran Keshavarz Mohammadi, Maryam Gholamalizadeh","doi":"10.1186/s12887-025-05574-z","DOIUrl":"10.1186/s12887-025-05574-z","url":null,"abstract":"","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"188"},"PeriodicalIF":2.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital cytomegalovirus in eastern Uganda: prevalence and outcomes.","authors":"Noela Regina Akwi Okalany, Ingunn Marie S Engebretsen, David Mukunya, Martin Chebet, Francis Okello, Andrew D Weeks, Edrin Mwanda, Rita Muhindo, Fred Bisso, Thorkild Tylleskär, Peter Olupot-Olupot, Kathy Burgoine","doi":"10.1186/s12887-025-05518-7","DOIUrl":"10.1186/s12887-025-05518-7","url":null,"abstract":"<p><strong>Background: </strong>Cytomegalovirus (CMV) infection poses risks to both maternal and neonatal health, however there are limited comprehensive data on congenital CMV in low-resource settings where the virus is widespread, particularly among women of reproductive age. Our research in eastern Uganda aimed to assess the prevalence of congenital CMV and outcomes among infants to inform public health policies and interventions in similar settings, addressing a significant gap in current knowledge.</p><p><strong>Methods: </strong>We conducted a descriptive study, nested within the BabyGel Trial, across Mbale and Budaka districts in eastern Uganda, between May 2023 and January 2024. Infants underwent saliva sampling within the first week of life, which was validated through urine polymerase chain reaction testing within the first 21 days of life. At three months of age, a cranial ultrasound examination, neurological examination, developmental evaluation, and audiological assessment were conducted for all infants diagnosed with congenital CMV infection. Statistical analyses were performed using Stata 17.0.</p><p><strong>Results: </strong>Congenital CMV infection was found in 5 out of 1,265 newborns tested, indicating a prevalence of 0.4% (95% CI: 0.16 to 0.96). Of these 5 infected infants, two experienced febrile illness at birth and required hospitalisation within the first week of life, and three had findings on ultrasound examination consistent with congenital cytomegalovirus during the neonatal period. Audiologic follow-up until three months of age revealed that three infants had failed unilateral and bilateral hearing screening. Neurodevelopment assessments using the Malawi Development Assessment Tool fell within optimal ranges for all 5 infants; however, when evaluated using the Hammersmith Infant Neurological Examination, four infants scored below optimal levels.</p><p><strong>Conclusion: </strong>Our community-based study revealed a low prevalence of congenital CMV infection. Further longitudinal multi-site research is needed to assess the generalisability of these findings. Also, long-term follow-up of children is crucial to understanding the outcomes and sequelae of infected infants to inform prevention strategies, targeted interventions and scalable screening frameworks in resource-limited settings.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"179"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatment and prognosis of primary pulmonary rhabdomyosarcoma: A systemic review.","authors":"Yinjie Tao, Weishi Cheng, Hongnan Zhen, Jing Shen, Hui Guan, Zhikai Liu","doi":"10.1186/s12887-025-05521-y","DOIUrl":"10.1186/s12887-025-05521-y","url":null,"abstract":"<p><strong>Background: </strong>Primary pulmonary rhabdomyosarcoma (RMS), a rare soft tissue sarcoma, is characterized by a high recurrence rate and a poor prognosis. This systematic review aims to summarize the clinical characteristics, pathological features, treatment, and clinical outcomes of primary pulmonary RMS, and to analyze prognostic-related risk factors to provide robust evidence for future treatment strategies.</p><p><strong>Methods: </strong>Five databases (MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials, EMBASE, and Web of Science) were searched using the relevant terms including \"pulmonary\", \"lung\", \"alveolar\", \"ERMS\", \"ARMS\", \"RMS\" and \"rhabdomyosarcoma\". Cases with a definitive pathological diagnosis of RMS, complete treatment information, a minimum follow-up period of at least three months, and detailed follow-up records were included. The primary study endpoints were cancer-specific survival (CSS) and progression-free survival (PFS).</p><p><strong>Results: </strong>22 articles spanning from 1955 to 2023 met the inclusion criteria for the systematic review. The median patient age was 10.5 (2.0, 52.5) years. 22 cases (78.6%) presented with respiratory symptoms due to pulmonary masses at the initial diagnosis. 10 cases were diagnosed with the embryonal type, and the majority (n = 20, 71.4%) underwent surgical treatment. The average PFS time was 60.9 ± 14.8 months. Patients at TNM stage IV were more prone to progression, and CSS was associated with factors including age ≥ 18 years, primary tumor size ≥ 10 cm, and non-surgical treatment. Surgery was identified as an independent factor that could shorten progression time (HR = 4.58 (1.32-15.90), P = 0.017) and improve tumor-related survival (HR = 8.11 (1.45-45.50), P = 0.017).</p><p><strong>Conclusions: </strong>Patients with higher TNM stages who did not undergo surgery tended to have more aggressive tumors, whereas primary tumors ≥ 10 cm and ages ≥ 18 years were associated with increased tumor-related mortality. Surgery, the primary treatment modality, independently improved CSS rates. Exploring optimal comprehensive treatment strategies that combine surgery, radiotherapy, and chemotherapy represents the principal direction for future research.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"185"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of complement C5-inhibitor eculizumab in patients with infection-associated hemolytic uremic syndrome - a case-series report.","authors":"Petra Varga, Erika Biró, Andrea Berkes, Erzsébet Lakatos, Edit Szikszay, Zoltán Prohászka, Tamás Szabó","doi":"10.1186/s12887-025-05546-3","DOIUrl":"10.1186/s12887-025-05546-3","url":null,"abstract":"<p><strong>Background: </strong>Hemolytic uremic syndrome (HUS), characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia and acute kidney injury (AKI), remains a leading cause of pediatric AKI. The complement system has a crucial role in the pathogenesis of atypical hemolytic uremic syndrome (aHUS) and eculizumab (ECZ) was approved as standard of care for its treatment. The two widely characterized forms of infection-associated HUS are Shiga toxin-producing E. coli (STEC)-HUS and Streptococcus pneumoniae-associated (SP)-HUS. Extrarenal manifestations such as central nervous system (CNS) involvement occur approximately in 20% of the cases and are accompanied by higher mortality. Abnormalities of the alternative complement pathway may also contribute to the development of both STEC-HUS and SP-HUS, offering a potential treatment option for complement C5 inhibition. Beyond best supportive care as standard therapeutic approach, ECZ has been successfully used in both STEC-HUS and SP-HUS patients. We provide further support that early use of ECZ for infection-associated HUS with severe clinical manifestation and abnormal complement-activation profile may be an effective therapeutic approach.</p><p><strong>Case presentation: </strong>We report on three children (median age: 2 years, range: 2-10 years) diagnosed with infection-associated HUS treated with complement C5-inhibitor ECZ. All three patients were treated with ECZ and had excellent outcome. We retrospectively analyzed the clinical course, laboratory data and outcome of children with infection-associated HUS treated with ECZ.</p><p><strong>Conclusion: </strong>In accordance with previous observations ECZ is an efficacious therapeutic choice in severe HUS patients with multiorgan involvement. A detailed complement activation profile, especially sC5b-9, is useful to indicate ECZ administration.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"181"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of children during hospitalization: content analysis of interviews and paintings.","authors":"Lida Abazari, Asma Ghonchehpour, Aida Abazari, Zahra Isari, Mohammad Hossein Abbaszadeh, Asghar Tavan","doi":"10.1186/s12887-025-05529-4","DOIUrl":"10.1186/s12887-025-05529-4","url":null,"abstract":"<p><strong>Background: </strong>Limited options are available to evaluate children's feelings about healthcare during hospitalization. Among the few tools available, this study aimed to extract children's experiences of hospitalization through interviews accompanied by painting.</p><p><strong>Methods: </strong>This qualitative study examined children aged 3 to 12 hospitalized in the pediatric ward from 2022 to 2023. Data were collected through 20 paintings and 45 in-depth interviews. The data was analyzed using conventional content analysis using MAXQDA Ver-20.</p><p><strong>Findings: </strong>The study's results reported the two main themes of pleasant and unpleasant factors. The main theme of pleasant factors included appropriate behavior, a happy and child-friendly environment, and suitable facilities for children. The main theme of unpleasant factors included restricted movement, procedural type, and time.</p><p><strong>Conclusion: </strong>In the present study, children considered appropriate nurse and physician behavior, a cheerful and child-friendly environment, appropriate and child-friendly interactions, and the opportunity to play in the ward as pleasant and effective factors in their care. Additionally, painful procedures, limited mobility, lack of access to television, and being hospitalized on the night shift were reported as unpleasant factors by the children.</p><p><strong>Implications to practice: </strong>Identifying the pleasant and unpleasant factors experienced by children can provide a more suitable therapeutic environment for them. In addition, knowing these factors can help establish effective communication between nurses and healthcare providers with children.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"183"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial and temporal variation of pneumonia incidence among under-five children in central gondar zone, Northwest Ethiopia, 2013- 2022.","authors":"Kidist Asrat Degif, Mulat Gebrehiwot, Garedew Tadege, Lidetu Demoze, Gelila Yitageasu","doi":"10.1186/s12887-025-05550-7","DOIUrl":"10.1186/s12887-025-05550-7","url":null,"abstract":"<p><p>Pneumonia is one of the major causes of morbidity and mortality among under-five years old children's worldwide, with Ethiopia having the highest rates among Sub-Saharan African nations. Effective control and preventative measures will be made clear by comprehending the spatial, temporal, and spatiotemporal variation of pneumonia incidence among under-five children. A time series cross-sectional study design was conducted from 1 January 2013 to 31 December 2022 using pneumonia reports obtained from the Central Gondar Zone health department and Gondar administrative health department. Fifteen districts and one administrative city were included and geocoded in the study.Spatial, temporal, and space-time scan spatial statistics were employed to identify clusters of pneumonia incidence among under-five children and were performed by using Excel and the SaTScan program, and the map was plotted using ArcGIS. Pneumonia incidence among under-five children reveals a general trend of rise and seasonal variation in the study area. During this study period, 147,294 under-five cases of pneumonia were reported and males made up most cases accounting for 54.94%. The average cumulative incidence proportion was 9.1. Purely high-rate spatial clusters were detected in Dembiya, Chilga, Wogera, and Gondar Zuria between 2013 and 2018. Gondar City, Wogera, and Gondar Zuria were high-rate spatial clusters detected between 2019 and 2022. The purely temporal cluster was observed from 2017 to 2018 and 2021 to 2022. Spatiotemporal clusters were detected in Dembia, Chilga, Gondar Zuria, and Wogera from 2013 - 2018 and in Gondar City, Wogera, and Gondar Zuria from 2019 - 2022. During this period pneumonia showed seasonal variation with two major peak months namely in April and October. Under five children pneumonia was found to have spatial, temporal, spatiotemporal clustering, and seasonal patterns. Also, the incidence increased over time. Interventional and preventive strategies should be developed and given priority to the areas that have been detected as hot spots in this study to reduce the mortality and morbidity of under 5 children caused by pneumonia.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"182"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between energy intake and asthma in Americans aged 1-18 years: a cross-sectional study.","authors":"Lin Jun Du, Chao Che, Qian Liu, Xiaolan Zhang, Ning Feng, Lifang Chen, Lili Wang","doi":"10.1186/s12887-025-05552-5","DOIUrl":"10.1186/s12887-025-05552-5","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate the effects of total dietary energy intake on asthma.</p><p><strong>Study selection: </strong>The study was a retrospective cross-sectional study of Americans aged 1-18 year. Comprehensive demographic, dietary, examination, laboratory, and asthma questionnaire data were collected for each participant. Multivariate logistic regression, restricted triple spline curves, threshold effects, and stratified analyses were used for analysis.</p><p><strong>Results: </strong>Of 12,090 participants, 1,893 (15.66%) had a diagnosis of asthma. After accounting for potential confounders, compared with the group with the lowest energy intake (Q1), groups 2 (Q2), groups 3 (Q3), and groups 4 (Q4) had adjusted odds ratios (ORs) of 0.72 (0.62-0.85), 0.63 (0.51-0.77) and 0.55 (0.43-0.7) for asthma. The relationship between total energy intake and asthma showed an L-shaped curve (p = 0.001). The results were further verified by stratification and sensitivity analyses. In the threshold analysis, we found that the saturation effect was reached at a total energy intake of 56.442 kcal/kg/day with an OR of 0.981 (0.973-0.989).</p><p><strong>Conclusion: </strong>The prevalence of asthma in Americans aged 1-18 years was associated with total dietary energy intake in an L-shaped curve, with a significant turning point found at approximately 56.442 kcal/kg/day.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"180"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment of a neonatal nursery in a rural district hospital in Malawi: a retrospective review of neonatal outcomes in Neno District Hospital (2014-2021).","authors":"Mc Geofrey Mvula, Moses Banda Aron, Isaac Mphande, Lemekeza Namwali, Lawrence Nazimera, Martha Kusamba, Enoch Ndarama, Paul Sonenthal, Alden Hooper Blair, Kimberly Baltzell, Fabien Munyaneza, Chiyembekezo Kachimanga, Beatrice Matanje, Emilia Connolly","doi":"10.1186/s12887-025-05558-z","DOIUrl":"10.1186/s12887-025-05558-z","url":null,"abstract":"<p><strong>Background: </strong>Despite efforts to improve neonatal care worldwide, neonatal mortality rates in sub-Saharan Africa remain high. Adequate space, equipment, and staff are vital to improving mortality rates through high-quality care. We evaluated the impact of a district-level neonatal special care nursery over seven years at Neno District Hospital, Malawi.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study to measure the neonatal outcomes in the neonatal special care nursery before nursery establishment (study period I, 2014-2015), following the establishment of a small nursery (study period II, 2016-2018), then with a transition to a larger nursery (study period III, 2019-2021). We extracted data from the neonatal registers and employed descriptive statistics and chi-square tests to compare the overall neonatal outcomes between study periods. We performed logistic regression to isolate factors associated with neonates alive at discharge.</p><p><strong>Results: </strong>Of the 1366 neonates observed over the entire study period, the three primary admission diagnoses were birth asphyxia (30.1%), sepsis (29.0%), and prematurity (20.9%). The proportion of neonates discharged alive increased from 61.9% to 74.3% and then 87.6% in study periods I, II, and III, respectively. Neonates admitted during study periods II and III were over two and five times more likely to be discharged alive than neonates admitted during study period I in multivariate analysis controlling for sex (SPII aOR = 2.42; 95% CI: 1.43-4.08; SPIII aOR = 5.32; 95% CI: 3.13-8.98; p < 0.001). There was no difference in being discharged alive for neonates admitted with prematurity compared to birth asphyxia (aOR 0.87; 95% CI: 0.51-.151) but neonates admitted with sepsis were over two times more likely to be discharged alive than birth asphyxia (aOR = 2.64; 95% CI: 1.67-4.29). Neonates admitted with a birth weight of <math><mo>≤</mo></math> 1500 g were 69% less likely to be discharged alive than neonates admitted with a birth weight > 2500 g (aOR = 0.31, 95% CI: 0.16-0.58; p < 0.001).</p><p><strong>Conclusions: </strong>The establishment and systems strengthening of a neonatal nursery at Neno District Hospital resulted in a significant increase of neonates discharged alive from the neonatal special care nursery. A multidimensional approach to ensuring resource inputs and ongoing strengthening efforts in Malawi is critical to decreasing neonatal mortality within the special care nursery.</p>","PeriodicalId":9144,"journal":{"name":"BMC Pediatrics","volume":"25 1","pages":"184"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}