Common Childhood Illnesses Research Articles

Is Helminthiasis a Precipitating Factor for Frequently Relapsing Nephrotic Syndrome?

Nephrotic Syndrome (NS) is a common childhood illness. It is a disease of relapse and remission with major concern to manage the cases with relapse. Helminthiasis also a common problem in our subcontinent. So, it is very important to find out any relation with helminthiasis and relapse in children. In our study, 88 patients, clinically diagnosed as minimal change nephrotic syndrome, were studied to find out any relationship with helminthiasis and frequent relapse. 36 patients (40.9%) had no helminthic infection, 34 patients (38.6%) had helminthiasis and 18 patients (20.5%) had atopic disorders. 62 patients were successfully followed up for 6 months. Relapses occurred 47.8% (11/23) patients in non-helminthiasis group. 88.5% (23/26) in helminthiasis group and 84.6% (11/13) in atopic group, patients who completed follow up. Thirteen percent (3) patients in non-helminthiasis group, 50% (13) in helminthiasis group and 38.5% (5) in atopic group were found to be frequent relapser. The differences were statistically significant.
 Pulse Volume 12-14 2020-2022 p.10-12

Improving outcomes for children with malaria, diarrhoea and pneumonia in Mozambique: A cluster randomised controlled trial of the inSCALE technology innovation.

The majority of post-neonatal deaths in children under 5 are due to malaria, diarrhoea and pneumonia (MDP). The WHO recommends integrated community case management (iCCM) of these conditions using community-based health workers (CHW). However iCCM programmes have suffered from poor implementation and mixed outcomes. We designed and evaluated a technology-based (mHealth) intervention package 'inSCALE' (Innovations At Scale For Community Access and Lasting Effects) to support iCCM programmes and increase appropriate treatment coverage for children with MDP. This superiority cluster randomised controlled trial allocated all 12 districts in Inhambane Province in Mozambique to receive iCCM only (control) or iCCM plus the inSCALE technology intervention. Population cross-sectional surveys were conducted at baseline and after 18 months of intervention implementation in approximately 500 eligible households in randomly selected communities in all districts including at least one child less than 60 months of age where the main caregiver was available to assess the impact of the intervention on the primary outcome, the coverage of appropriate treatment for malaria, diarrhoea and pneumonia in children 2-59months of age. Secondary outcomes included the proportion of sick children who were taken to the CHW for treatment, validated tool-based CHW motivation and performance scores, prevalence of cases of illness, and a range of secondary household and health worker level outcomes. All statistical models accounted for the clustered study design and variables used to constrain the randomisation. A meta-analysis of the estimated pooled impact of the technology intervention was conducted including results from a sister trial (inSCALE-Uganda). The study included 2740 eligible children in control arm districts and 2863 children in intervention districts. After 18 months of intervention implementation 68% (69/101) CHWs still had a working inSCALE smartphone and app and 45% (44/101) had uploaded at least one report to their supervising health facility in the last 4 weeks. Coverage of the appropriate treatment of cases of MDP increased by 26% in the intervention arm (adjusted RR 1.26 95% CI 1.12-1.42, p<0.001). The rate of care seeking to the iCCM-trained community health worker increased in the intervention arm (14.4% vs 15.9% in control and intervention arms respectively) but fell short of the significance threshold (adjusted RR 1.63, 95% CI 0.93-2.85, p = 0.085). The prevalence of cases of MDP was 53.5% (1467) and 43.7% (1251) in the control and intervention arms respectively (risk ratio 0.82, 95% CI 0.78-0.87, p<0.001). CHW motivation and knowledge scores did not differ between intervention arms. Across two country trials, the estimated pooled effect of the inSCALE intervention on coverage of appropriate treatment for MDP was RR 1.15 (95% CI 1.08-1.24, p <0.001). The inSCALE intervention led to an improvement in appropriate treatment of common childhood illnesses when delivered at scale in Mozambique. The programme will be rolled out by the ministry of health to the entire national CHW and primary care network in 2022-2023. This study highlights the potential value of a technology intervention aimed at strengthening iCCM systems to address the largest causes of childhood morbidity and mortality in sub-Saharan Africa.

Copula based trivariate spatial modeling of childhood illnesses in Western African countries

Acute respiratory infections (ARI), diarrhea, and fever are three common childhood illnesses, especially in sub-Saharan Africa. This study investigates the marginal and pairwise correlated effects of these diseases across Western African countries in a single analytical framework. Using data from nationally representative cross-sectional Demographic and Health Surveys, the study analyzed specific and correlated effects of each pair of childhood morbidity from ARI, diarrhea, and fever using copula regression models in fourteen contiguous Western African countries. Data concerning childhood demographic and socio-economic conditions were used as covariates. In this cross-sectional analysis of 152,125 children aged 0–59 months, the prevalence of ARI was 6.9%, diarrhea, 13.8%, and fever 19.6%. The results showed a positive correlation and geographical variation in the prevalence of the three illnesses across the study region. The estimated correlation and 95% confidence interval between diarrhea and fever is 0.431(0.300,0.539); diarrhea and ARI is 0.270(0.096,0.422); and fever and ARI is 0.502(0.350,0.614). The marginal and correlated spatial random effects reveal within-country spatial dependence. Source of water and access to electricity was significantly associated with any of the three illnesses, while television, birth order, and gender were associated with diarrhea or fever. The place of residence and access to newspapers were associated with fever or ARI. There was an increased likelihood of childhood ARI, diarrhea, and fever, which peaked at about ten months but decreased substantially thereafter. Mother’s age was associated with a reduced likelihood of the three illnesses. The maps generated could be resourceful for area-specific policy-making to speed up mitigation processes.

Factors associated with parental self-medication for common childhood illnesses during the COVID-19 pandemic: a single centre study

Background &amp; Objective: People's interest regarding self-medication increased during the first half of 2020, when the COVID-19 was proclaimed a pandemic, although it has always persisted due to multiple factors. We aimed to identify the factors associated with the use of parental self-medication for their child’s illness during the COVID-19 pandemic.&#x0D; Methodology: A cross-sectional descriptive study was conducted at the pediatrics department at Darul Sehat Hospital, Karachi. An interviewer-administered questionnaire was used. We included 275 parents visiting the outpatient clinics with their children of ages 1 to 12 y. Chi-square test of independence was used to check the association of self-medication with studied factors. P-values less than 0.05 were considered significant.&#x0D; Results: Out of 275 parents, 85% were practicing self-medication. 60.3% children suffered from some illness. Parents sought medical advice from pharmacists in 65% of cases, and allopathic drugs were preferred in 64% of cases. 70% of the patients used medicine until recovered, while 41.9% had to seek medical advice. Frequent symptoms obsereved and treated with self-medication were headaches 19.2% and fever 18.8%.&#x0D; Conclusion: Parental self-medication for common childhood illnesses was substantially more prevalent during the COVID-19 pandemic. Allopathic medicines were preferred choice of parents while pharmacists were commonly consulted for information regarding drugs.&#x0D; Abbreviations: OTC: Over-the-counter;&#x0D; Key words: Self-medication; Side effects; Pharmacists: Medications; Antipyretics&#x0D; Citation: Saeed F, Bham SQ, Mohammed Iqbal M, Sharif UHA. Factors associated with parental self-medication for common childhood illnesses during the COVID-19 pandemic: a single centre study. Anaesth. pain intensive care 2023;27(3):405−412.&#x0D; DOI: 10.35975/apic.v27i3.2097&#x0D; Received: December 26, 2022; Reviewed: January 15, 2023; Accepted: April 13, 2023

Prevalence and outcomes of COVID-19 in children with respiratory and gastrointestinal symptoms

More than a year after its declaration as a pandemic, Coronavirus disease 2019 (COVID-19) remains a global health problem. The common symptoms of COVID-19 are like the presentation of common childhood illnesses. Hence, we determined the prevalence, and outcomes of COVID-19 in children with respiratory and gastrointestinal symptoms.This study was a retrospective review of data obtained from the screening of children with respiratory and or gastrointestinal symptoms for COVID-19. All children aged 1 month to 18 years with respiratory and or gastrointestinal symptoms were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) using real-time polymerase chain reaction (RT-PCR). The tests for COVID-19 along their socio-demographic and clinical parameters were extracted from the hospital records.We recruited 129 children with a median (IQR) age of 1.1(0.5 – 2.3) years. Most of the children 111(86.0%) were under-five. Out of 129 children, 13 (10.1%) were positive for COVID-19 and 10 of the 13 positive cases were under-five. The COVID-19 status had no relationship with age, gender, and socioeconomic status, p >0.05. Children with a history of contact with a confirmed case had a significant association with COVID-19 (OR 110.368, CI 5.519-2207.306). Amongst the clinical features, the presence of fever was associated with COVID-19 (OR 4.4 CI 1.239-14.750)Conclusion: This study shows a higher likelihood of COVID-19 in children with a history of contact and fever.

Examining the relationship between armed conflict and coverage of maternal and child health services in 35 countries in sub-Saharan Africa: a geospatial analysis

Armed conflict is on the rise in sub-Saharan Africa and affects public infrastructures, including health systems, although evidence on population health is sparse. We aimed to establish how these disruptions ultimately affect health service coverage. We geospatially matched Demographic and Health Survey data with the Uppsala Conflict Data Program Georeferenced Events Dataset, covering 35 countries for the period from 1990 to 2020. We relied on linear probability models with fixed effects to capture the effect of nearby armed conflict (within 50 km of the survey cluster) on four service coverage indicators along the continuum of maternal and child health care. We also investigated effect heterogeneity by varying conflict intensity and duration, and sociodemographic status. The estimated coefficients represent the decrease in the probability (in percentage points) of the child or their mother being covered by the respective health service following deadly conflicts within 50 km. Any nearby armed conflict was associated with reduced coverage for all examined health services, with the exception of early antenatal care: early antenatal care (-0·5 percentage points, 95% CI -1·1 to 0·1), facility-based delivery (-2·0, -2·5 to -1·4), timely childhood vaccination (-2·5, -3·1 to -1·9), and treatment of common childhood illnesses (-2·5, -3·5 to -1·4). For all four health services, the negative effects increased for high-intensity conflicts and were significant throughout. When examining conflict duration, we did not find negative effects on the treatment of common childhood illnesses in prolonged conflicts. The analysis on effect heterogeneity revealed that, except for timely childhood vaccination, the negative effects of armed conflict on health service coverage were more pronounced in urban settings. Our findings suggest that health service coverage is significantly affected by contemporaneous conflict, but health systems can adapt to provide routine services, such as child curative services, in situations of prolonged conflict. Our analysis underlines the importance of studying health service coverage during conflict both at the finest possible scales and across different indicators, pointing at the need for differential policy interventions. None. For the French and Portuguese translations of the abstract see Supplementary Materials section.

Association between a complex community intervention and quality of health extension workers' performance to correctly classify common childhood illnesses in four regions of Ethiopia

Association between a complex community intervention and quality of health extension workers' performance to correctly classify common childhood illnesses in four regions of Ethiopia

The obstacles of diagnosing and achieving glycaemic control in breastfeeding infant with type 1 diabetes mellitus with diabetic ketoacidosis- a case report

Diabetes mellitus (DM) with diabetic ketoacidosis (DKA) is uncommon in infancy and its presentation can mimic some common childhood illnesses. The spontaneity of the young infant, inherent communication difficulties, insulin treatment and eating pattern poses major technical, medical and psychological challenges. Training the family to care for the diabetic infant is also challenging for all. We present a case of a 10-month old diabetic infant with poor glycaemic control and DKA. The justification for this is because DM with DKA is uncommon in infancy and its presentation may be mistaken for other illnesses such as meningitis, encephalitis and cerebral malaria among others, so it needs a high index of suspicion in other to avoid morbidity and mortality. The objective of reporting this case is to create awareness that although DM is uncommon in infancy, but can still occur. It should therefore be looked for.

Assessment Of Adenoid Nasopharyngeal Ratio In Children With Symptoms Suggestive Of Obstructive Adenoid Disease

Background: Adenoid hypertrophy (AH) is a common childhood illness that occurs due to obstruction of the nasopharynx by enlarged adenoids. Lateral nasopharyngeal X-ray is used for diagnosis and assessment of patency of the nasopharyngeal air column by assessing the Adenoid Nasopharyngeal Ratio (ANR). This study aims to assess the ANR of symptomatic patients with AH that presented to Ear, Nose and Throat/ Head and Neck Surgeon (ENT/HNS) Department of the University of Abuja Teaching Hospital (UATH).&#x0D; Methodology: This was a retrospective study conducted in the ENT/HNS Department of UATH, Gwagwalada from January 2019 to December 2021. The case notes and lateral nasopharyngeal xrays of 112 children aged between 3 months to 15 years, diagnosed with Adenoid Hypertrophy, were retrieved. Relevant information such as demographics, and Lateral Nasopharyngeal X-ray measurements were extracted.&#x0D; Results: A total number of 112 participants were enrolled into this study. Out of these, 77 (68.8%) were males and 35 (31.2%) were females. The mean age of participants was 3.86 0.27 years, and age range was 3 months to 15 years. Most participants were between 0 – 5 years. The mean ANR among participants was 0.69 0.02. The minimum ANR was 0.03, and the maximum ANR was 1.00 Majority of participants had ANR 0.69. None of the participants between 10 – 15 years had an ANR &gt; 0.79. Regression analysis showed statistically significant correlation between ANR and Age (p = 0.05).&#x0D; Conclusion: We observed an Adenoidal Nasopharyngeal Ratio that was lower than the benchmark of ANR considered for AH, this may probably be due to our inability to control the timing for obtaining the radiographs from clinic visit and some may have commenced treatment

Spatial distribution of common childhood illnesses, healthcare utilisation and associated factors in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey.

Childhood illnesses, such as acute respiratory illness, fever, and diarrhoea, continue to be public health problems in low-income countries. Detecting spatial variations of common childhood illnesses and service utilisation is essential for identifying inequities and call for targeted actions. This study aimed to assess the geographical distribution and associated factors for common childhood illnesses and service utilisation across Ethiopia based on the 2016 Demographic and Health Survey. The sample was selected using a two-stage stratified sampling process. A total of 10,417 children under five years were included in this analysis. We linked data on their common illnesses during the last two weeks and healthcare utilisation were linked to Global Positioning System (GPS) information of their local area. The spatial data were created in ArcGIS10.1 for each study cluster. We applied a spatial autocorrelation model with Moran's index to determine the spatial clustering of the prevalence of childhood illnesses and healthcare utilisation. Ordinary Least Square (OLS) analysis was done to assess the association between selected explanatory variables and sick child health services utilisation. Hot and cold spot clusters for high or low utilisation were identified using Getis-Ord Gi*. Kriging interpolation was done to predict sick child healthcare utilisation in areas where study samples were not drawn. All statistical analyses were performed using Excel, STATA, and ArcGIS. Overall, 23% (95CI: 21, 25) of children under five years had some illness during the last two weeks before the survey. Of these, 38% (95%CI: 34, 41) sought care from an appropriate provider. Illnesses and service utilisation were not randomly distributed across the country with a Moran's index 0.111, Z-score 6.22, P<0.001, and Moran's index = 0.0804, Z-score 4.498, P< 0.001, respectively. Wealth and reported distance to health facilities were associated with service utilisation. Prevalence of common childhood illnesses was higher in the North, while service utilisation was more likely to be on a low level in the Eastern, South-western, and the Northern parts of the country. Our study provided evidence of geographic clustering of common childhood illnesses and health service utilisation when the child was sick. Areas with low service utilisation for childhood illnesses need priority, including actions to counteract barriers such as poverty and long distances to services.

Knowledge and perspectives in management of common childhood illnesses by caregivers to under-five children in southwestern nigeria: synopsis of self-medication practices

The information and opinions of the caregivers about various childhood ailments serve as a fundamental foundation for the practice of self-medication among under-five-year-old children. The outcome of the health status of children under five is greatly influenced by the scope of such knowledge and perception. The usage of medications for children is a major global problem since they are viewed as a vulnerable population. Although self-medication behaviors are widespread in Nigeria, little is known about how they affect the youngest, most vulnerable children. The knowledge and perceived management of common pediatric disorders among children under the age of five by their caregivers in southwest Nigeria were the subjects of this study. Based on their degree of cosmopolitanism and lack of cosmopolitanism, two local government areas from the states of Lagos and Osun were chosen for the study. Nine hundred and sixty-eight caregivers to under-five children were systematically randomly selected for the study. Data were collected with the aid of structured interviewer-administered questionnaire through the use of Open Data Kit. The knowledge and the perception of caregivers were assessed via vignette-designed questions that were explained to the respondents by the trained research assistants. The data were analyzed using the STATA Package software. The unit of analysis was frequency distribution and percentages. The common childhood illnesses identified by the respondents were malaria, otitis media (ear infection), gastro-enteritis (diarrheal and vomiting), measles, mumps, respiratory tract infection, and febrile convulsion. In general, the caregivers showed a very good knowledge of the CCI presented to them. They identified correctly the illnesses associated with the symptoms. In assessing the possible causes of these CCI, the caregivers commonly attributed the cause to natural phenomena like weather, seasonal changes, dust, and sunny environment. Also, poor hygienic conditions and infection by parasites were identified to be responsible for these CCI. However, their perceived causes of some CCI were very poor. The most visited source of procurement of medicaments was pharmacy or chemist shops in their locality. Pharmacists, friends, and parents were the sources of medication by adolescents as they procured over-the-counter drugs, analgesics, and antibiotics to self-medicate. The classes of products used mostly were drugs prescribed by doctors and any available medicine in their home. The predominant reason given by a greater proportion of the respondents is their affordability of the products which was represented by the cheap cost of self-medication practice in this study. In conclusion, the caregivers in this study are very knowledgeable on the various CCI affecting their under-five children and their belief in the probable causes of the CCI are tuned towards natural causes, infection by parasites, and environmental causes. It is believed that the degree of the caregiver’s knowledge will determine the quality of childcare practice to their under-five children.

Association between disability status and health care utilisation for common childhood illnesses in 10 countries in sub-Saharan Africa: a cross-sectional study in the Multiple Indicator Cluster Survey.

Approximately 70 million children in sub-Saharan Africa (SSA) are disabled, yet little is known about the prevalence of and care-seeking patterns for common childhood illnesses, such as acute respiratory infection (ARI), diarrhoea, and fever. Data were from 10 SSA countries with data available from 2017 to 2020 in the UNICEF-supported Multiple Indicator Cluster Survey (MICS) online repository. Children aged 2-4 years who completed the child functioning module were included. Using logistic regression, we examined the association between disability and ARI, diarrhoea and fever in the past two weeks and care-seeking behaviour for these illnesses. Using multinomial logistic regression, we examined the association between disability and the type of health care providers from which caregivers sought care. There were 51,901 children included. Overall, there were small absolute differences in illnesses between disabled and non-disabled children. However, there was evidence disabled children had a greater odds of ARI (aOR=1.33, 95% C.I 1.16-1.52), diarrhoea (aOR=1.27, 95% C.I. 1.12-1.44), and fever (aOR=1.19 95% CI 1.06-1.35) compared to non-disabled children. There was no evidence that caregivers of disabled children had a greater odds of seeking care for ARI (aOR=0.90, 95% C.I 0.69-1.19), diarrhoea (aOR=1.06, 95% C.I. 0.84-1.34), and fever (aOR=1.07, 95% C.I 0.88-1.30) compared to caregivers of non-disabled children. Caregivers of disabled children had a higher odds of seeking care from a trained health worker for ARI (aOR=1.76, 95% C.I. 1.25-2.47) and fever (aOR=1.49, 95% C.I. 1.03-2.14) or non-health professional (aOR=1.89, 95% C.I. 1.19-2.98) for ARI than from an unspecified health facility worker compared to caregivers of non-disabled children, but no associations were not seen for diarrhoea. While the data showed relatively small absolute differences, disability was associated with ARI, diarrhoea and fever and caregivers of disabled children sought care from trained health workers for ARI and fever more than non-disabled children. The overall small absolute differences show closing gaps in illness and access to care may be possible, but highlights that more research on illness severity, care quality, and outcomes should be conducted to further assess health inequities for disabled children. SR receives funding from the Rhodes Trust.

Factors associated with wasting and stunting among children aged 06–59 months in South Ari District, Southern Ethiopia: a community-based cross-sectional study

BackgroundChild undernutrition is a major public health problem in Ethiopia despite different nutrition-specific and sensitive interventions implemented by the government. However, evidence regarding the burden and responsible factors is limited in the South Ari district. Hence, this study aimed to assess factors associated with wasting and stunting among children aged 06–59 months in the South Ari district, Southern Ethiopia, 2021.MethodsA community-based cross-sectional study was conducted from March 11 to April 11, 2021, among 717 households with at least one child aged 06–59 months. Anthropometric measurements were taken using standard procedures and were converted to height for age Z score and weight-for-height using WHO Anthro software Version 3.2.2. Data were checked and entered into Epi-Data Version 3.1 and analyzed using SPSS Version 25.0. Binary logistic regression analysis was fitted to identify predictors of wasting and stunting. A p-value < 0.05 was used to declare statistical significance.ResultThe prevalence of wasting and stunting among children aged 06–59 months in the district was 9.1% (95% CI: 7.07%, 11.41%) and 59.97% (95% CI: 56.28%, 63.58%), respectively. Family size (8 and above) (AOR = 3.03, 95% CI: 1.31, 7.03), family size (5 to 7) (AOR = 2.05, 95% CI: 1.11, 3.81), poor and medium wealth index (AOR = 3.69, 95% CI: 1.65, 8.26) and (AOR = 2.29, 95% CI: 1.01, 5.16), insufficient maternal knowledge on child feeding practice (AOR = 2.58, 95% CI: 1.31, 5.07), presence of diarrhea in the past two weeks (AOR = 2.05, 95% CI: 1.10, 3.85), non-exclusive breastfeeding (AOR = 2.65, 95% CI: 1.51, 4.65), and birth interval of < 24 months (AOR = 4.49, 95% CI: 2.40, 8.37) were factors significantly associated with wasting. Whereas, children in the age group of 24–59 months (AOR = 2.24, 95% CI: 1.58, 3.16), non-exclusive breastfeeding (AOR = 1.81, 95% CI: 1.24, 2.65), birth interval of fewer than 24 months (AOR = 1.54, 95% CI: 1.11, 2.14), sub-optimal child dietary diversity score (AOR = 1.59, 95% CI: 1.14, 2.22), being a non-beneficiary of productive safety-net program (AOR = 1.91, 95% CI: 1.24, 2.95), and household food insecurity (AOR = 2.60, 95% CI: 1.86, 3.64) were factors significantly associated with stunting.ConclusionsWasting and stunting were found to be key public health problems in the South Ari District. Hence, further interventions should consider strategies to enhance household food security and integration of productive safety net programs with primary health care services. Rigorous work is required in advocating and strengthening the provision of family planning services, child care, and integrated management of common childhood illnesses. Moreover, behavioral change communication is highly demanded to improve child feeding practices.

The upregulation of peripheral blood polyamine metabolites spermidine and spermine in children with hand, foot, mouth disease is related to enterovirus 71 capsid protein VP1, but not VP4.

Hand, foot, and mouth disease (HFMD) is a common viral childhood illness caused most commonly by enterovirus 71 (EV71) and coxsackievirus A16. The pathogenesis of EV71 has been extensively studied, and the regulation of the host immune response is suspected to aggravate the serious complications induced by EV71. Our previous research showed that EV71 infection significantly increased the release of circulating interleukin (IL)-6, IL-10, IL-13, and IL-27. Notably, these cytokines are related to the EV71 infection risk and clinical stage. Polyamines are compounds that are ubiquitous in mammalian cells and play a key role in various cellular processes. Several studies have shown that targeting polyamine metabolic pathways can reduce infections caused by viruses. However, the significance of polyamine metabolism in EV71 infection remains largely unknown. Serum samples from 82 children with HFMD and 70 healthy volunteers (HVs) were collected to determine the polyamine metabolites spermidine (SPD) and spermine (SPM), and IL-6 levels. In addition, peripheral blood mononuclear cells (PBMCs) were treated with EV71 viral protein 1 (VP1) and EV71 VP4, and the cells and supernatant were then collected to analyze the expression of polyamine metabolism-related enzymes by western blot. The data were analyzed using GraphPad Prism 7.0 software (USA). The serum polyamine metabolites SPD and SPM were elevated in the HFMD patients, especially in the EV71-infected children. Further, a positive correlation was found between serum SPD and IL-6 levels in the EV71-infected children. We also found that the upregulation of peripheral blood polyamine metabolites in the EV71-infected HFMD children was related to EV71 capsid protein VP1, but not VP4. VP1 may promote the expression of polyamine metabolism-related enzymes and promote the production of polyamine metabolites, thereby upregulating the SPD/nuclear factor kappa B/IL-6 signaling pathway. However, VP4 has the opposite effect in this process. Our results suggest that EV71 capsid protein may regulate the polyamine metabolic pathways of infected cells in a variety of ways. This study provides insights into the mechanism of EV71 infection and polyamine metabolism and has good reference value for the development of EV71 vaccine.

Utilization of Integrated Community Case Management of Common Childhood Illness and Associated Factors among Mothers/Caregivers in Wonsho District, Sidaama Region: Ethiopia

Integrated Community Case Management (ICCM) is a community care strategy which seeks to extend case management of childhood illness beyond health facilities to the community level so that more children have access to lifesaving treatments.

Geographical variation of common childhood illness and its associated factors among under-five children in Ethiopia: spatial and multilevel analysis

Although substantial progress has been made in reducing child mortality over the last three decades, the magnitude of the problem remains immense. Ethiopia is one of the countries with a high under-five mortality rate due to childhood illnesses including acute respiratory infections, diarrhea, and fever that varies from place to place. It is vital to have evidence of the factors associated with childhood illnesses and the spatial distribution across the country to prioritize and design targeted interventions. Thus, this study aimed to investigate the spatial cluster distribution and associated factors with common childhood illnesses. Secondary data analysis based on the 2016 Ethiopian Demographic and Health Survey data was carried out. A total weighted sample of 10,417 children was included. The study used ArcGIS and SaTScan software to explore spatial distribution. For associated factors, a multilevel binary logistic regression model was fitted using STATA V.14 software. Adjusted Odds Ratios (AOR) with a 95% Confidence Interval (CI) and p-value ≤ 0.05 in the multivariable model were used to declare significant factors associated with the problem. ICC, MOR, PCV, and deviance (−2LLR) were used to check model fitness and model comparison. In this study, the prevalence of common childhood illnesses among under-five children was 22.5% (95% CI: 21.6–23.3%). The spatial analysis depicted that common childhood illnesses have significant spatial variation across Ethiopia. The SaTScan analysis identified significant primary clusters in Tigray and Northern Amhara regions (log-likelihood ratio (LLR) = 60.19, p < 0.001). In the multilevel analysis, being rural residence [AOR = 1.39, 95% CI (1.01–1.98)], small child size at birth [AOR = 1.36, 95% CI (1.21–1.55)], high community poverty [AOR = 1.26, 95% CI (1.06–1.52)], mothers aged 35–49 [AOR = 0.81, 95% CI (0.69–0.94)], the household had electricity [AOR = 0.77, 95% CI (0.61–0.98)], the household had a refrigerator [AOR = 0.60, 95% CI (0.42–0.87)], improved drinking water [AOR = 0.82, 95% CI (0.70–0.95)], improved toilet [AOR = 0.72, 95% CI (0.54–0.94)], average child size at birth [AOR = 0.83, 95% CI (0.75–0.94)] were significantly associated with common childhood illnesses. Common childhood illnesses had spatial variations across Ethiopia. Hotspot areas of the problem were found in the Tigray, Northern Amhara, and Northeast SNNPR. Both individual and community-level factors affected common childhood illnesses distribution and prevalence in Ethiopia. Therefore, public health intervention should target the hotspot areas of common childhood illnesses to reduce their incidence in the country.

Evaluation of Integrated Community Case Management of Common Childhood Illness Program: Quality of Program Implementation in Hadiya Zone, Ethiopia

<i>Background:</i> Integrated community case management of common childhood illnesses (ICCM) is life saving curative health service delivery for common childhood illnesses (CHI) at health post and community level before developing a complication. ICCMCHI quality has little information in the study area. <i>Methods and Materials:</i> The focus of this evaluation was to evaluate the process of ICCMCHI program, and the approach of this evaluation was formative. Availability of program resources, compliance of health extension workers with ICCM guideline and acceptability of services were the dimensions of this study. The case study was conducted with both quantitative and qualitative data. Fifty-seven health posts were included from three woreda of the zone by deviant sampling techniques. For qualitative data health extension workers and health care managers were included. Data was analyzed by using SPSS soft ware version-20. Univariate, bivariate and multivariate logistic regression were used for quantitative data, and qualitative data was analyzed by using thematic analysis. <i>Result:</i> Compliance was 76% which is good even though most of health extension workers (HEW) were missing opportunities and identified reasons were an inadequate use of ICCM chart booklet and poor supportive supervision. 423 mothers or caregivers with sick under-five children were interviewed from 57 health posts. The mean score of client satisfaction on the quality of ICCM services received was 48.97. Satisfaction of caregivers with a mean score of client satisfaction on quality ICCM services was associated with primary level education, family annual income of and Muslim religion and received information about when to return for next revisit were found to be more likely to satisfy on the quality of ICCM services provided. <i>Conclusion and Recommendation:</i> Quality of ICCMCHI program was evaluated as good. There was an inadequate level of resource availability. Client’s satisfaction with integrated community case management of common childhood illness services was also good. All concerned bodies from local government and development partners are expected to strengthen regular supportive supervision, clinical mentoring, and continues performance review.

AN APPRAISAL ON TUNDEKERI WITH SPECIAL REFERENCE TO TONSILLITIS.

The classification of Mukha Rogas has been done either on the basis of involvement of Doshas or based on the site of occurrence of the diseases. Kaumaarbhritya is one of the branches of Ayurved which deals with Bharan(nutrition), poshan, Dhatri, Kshirdosh and its treatment. Tundekeri means Shotha(inflammation). In ayurveda it resembles cotton fruit. The symptoms of Tundekeri are more like Tonsillitis. Tonsillitis is a common illness in childhood. Tundekeri shows the symptoms of pain in the throat, dysphagia, swelling of tonsils. If these symptoms are treated in time, we can avoid further suppurative tonsillitis and enlargement of tonsils among childhoods. Acharya Sushruta advised surgical management in tonsillitis, while Acharya Vagbhata advised conservative treatment on tonsillitis which mainly includes Nasya, Pratisaran, Gandush etc. Recurrent attacks of diseases like tonsillitis affect the normal growth and development of a child and may lead to various health hazards. Tundikeri occurs due to Kapha prakopa and Rakta dushti and Doshas are situated in Talu and Kantha Pradesh. Drugs having Shothahar, Sandhaniya, Ropan, Lekhan, Rakta stambhan, Vedana sthapan and Pitta Kapha shamak properties are supposed to be ideal for the treatment of Tonsillitis.

Artificial Intelligence in pediatric dentistry: A Narrative review

The most common chronic childhood illnesses are oral ones, a severe public health concern for children of all ages in developing and industrialized nations. Early detection and treatment of these disorders are essential for a child's dental health and overall well-being. Recently, the area of pediatric dentistry has made extensive use of artificial intelligence (AI). This systematic review aims to evaluate the effectiveness of artificial intelligence models created for use in pediatric dentistry (PD).

«Երեխաներին կրծքով կերակրման խրախուսման և մանկական սննդի շրջանառության մասին» ՀՀ օրենքի խախտման «նուրբ» արվեստը / "Fine" Art of Violating the RA Law "Օn the Promotion of Breastfeeding and the Circulation of Baby Food"

In the Republic of Armenia, since 2014, breastfeeding of children has been encouraged by the relevant law, which was adopted within the framework of obligations arising from membership in international organizations. Breastfeeding is essential for a baby's survival and health. Breast milk is a safe, natural, nutritious and sustainable food for babies, and it contains antibodies that help protect against many common childhood illnesses such as diarrhea and respiratory illnesses. It seems that breastfeeding is a natural process and should be obtained automatically, without special efforts... But, it wasn’t there ... Even natural phenomena can have a number of nuances and peculiarities, the insufficient mastery of which often leads to seemingly insurmountable problems, encouraging desperate mothers to give up the exclusive gift of breastfeeding. Instead of appropriate specialized support in the given situation, it is often recommended to feed babies with artificial milk in maternity hospitals, which, apart from being a gross violation of the existing law, inadvertently hints at the tendencies to artificially forming an offer for disguised business interests...