Diseases In School-age Children Research Articles

Studies on the Relationship of Air Pollution and Respiratory Disease in School-Aged Children in Shenyang, an Industrial Area of Northeast China as Assessed by ATS-DLD Questionnaire and Respiratory Function

Studies on the Relationship of Air Pollution and Respiratory Disease in School-Aged Children in Shenyang, an Industrial Area of Northeast China as Assessed by ATS-DLD Questionnaire and Respiratory Function

Respiratory disease screening in school-aged children using portable spirometry

To assess the prevalence of respiratory disease in school-aged children and to determine the value of field spirometry. Data on 313 1st and 4th graders from four public schools in Lisbon were analyzed. A respiratory self-answered questionnaire and standard spirometry were performed. Descriptive and bivariate analysis was followed by multiple logistic regression. Thirty-five percent of the children presented at least one episode of wheezing (18% ≥ 2 episodes), and 4% had asthma. Wheezing was more frequent with family history of atopy (adjusted OR = 2.7; 95%CI 1.4-5.1), maternal smoking during pregnancy, lower respiratory tract infection (LRTI) (adjusted OR = 2.8; 95%CI 1.2-6.2), bronchiolitis (adjusted OR = 3.3; 95%CI 1.3-8.2), and allergy to aeroallergens (adjusted OR = 3.2; 95%CI 1.4-7.2). Asthma was more frequent with previous history of LRTI (adjusted OR = 14.6; 95%CI 1.7-122.9) and allergy to aeroallergens (adjusted OR = 8.2; 95%CI 2.0-34.2). Fifty-five percent of spirometry measurements met the acceptability criteria of the American Thoracic Society and of the European Respiratory Society. Wheezers presented mean lower z scores for forced expiratory volume in 1 second (FEV1), ratio between FEV1 and forced vital capacity (FVC) (FEV1/FVC), and forced expiratory flow between 25 and 75% (FEF25-75) (p < 0.05), as well as higher percentage of abnormal FEV1, FEV1/FVC and FEF25-75/ (FEF25-75, p < 0.05). This pilot study showed a high prevalence of obstructive airway symptoms in school-aged children in Lisbon. Symptoms assessed by the questionnaire showed good correlation with spirometric values. The small prevalence of asthma leads us to speculate that asthma is under-diagnosed in this population.

Development and Evaluation of an Integrated Asthma Awareness Curriculum for the Elementary School Classroom

Asthma is one of the most common causes of school absenteeism, and many children are affected by, or encounter, it in the school setting. An integrated curriculum that presents asthma as a real world example can raise all children's awareness and understanding of asthma, not just those with the condition. A 15-lesson, asthma-based curriculum was developed to integrate with and enhance the core subjects of math, science, and communication arts. A pilot test was performed in fourth- and fifth-grade classes to assess student asthma knowledge gain, teacher acceptance, and grade appropriateness of the curriculum. During the 2006-2007 school year, 15 teachers were recruited from the St. Louis, MO, USA area to assess the curriculum through teaching and administering pre- and post-unit tests and completing a teacher evaluation for each lesson taught. Four additional classrooms served as comparisons. Paired t tests were used for each lesson taught, to evaluate pre-/post-test and classroom differences, and focus groups were used for qualitative evaluation. There was an increase in asthma knowledge between pre- and post-tests in both grades, individually and combined (p < 0.001). Intervention post-test scores were higher than comparison classroom scores (p < 0.001). Teacher feedback indicated that the lessons enhanced previously learned skills and increased students' overall understanding of asthma. Offering asthma education in the classroom can provide an opportunity for all students to gain asthma knowledge and build health literacy about a leading chronic disease in school-aged children.

Rastreio de patologia respiratória em crianças em idade escolar com o uso de espirometria portátil

OBJETIVOS: Avaliar a prevalencia de doenca respiratoria em criancas em idade escolar e determinar o valor da espirometria de campo. METODOS: Avaliaram-se 313 alunos do primeiro e quarto ano de quatro escolas de Lisboa. Aplicou-se questionario respiratorio auto-preenchido, e efetuou-se espirometria. Realizou-se analise descritiva e bivariada seguida de analise de regressao logistica multipla. RESULTADOS: Trinta e cinco por cento das criancas tiveram pelo menos um episodio de sibilância (18% > 2 episodios), e 4% tiveram diagnostico de asma. Sibilância foi mais frequente com historia familiar de atopia (OR ajustado = 2,7, IC95% 1,4-5,1), tabagismo na gravidez, infeccao respiratoria baixa (IRB) (OR ajustado = 2,8; IC95% 1,2-6,2), bronquiolite (OR ajustado = 3,3; IC95% 1,3-8,2) e alergia a aeroalergenos (OR ajustado = 3,2; IC95% 1,4-7,2). Asma foi mais frequente com historia de IRB (OR ajustado = 14,6; IC95% 1,7-122,9) e alergia a aeroalergenos (OR ajustado = 8,2; IC95% 2,0-34,2). Cento e sessenta e nove (54%) valores espirometricos preencheram criterios de aceitabilidade. O grupo com sibilância tinha em media valores de escore z inferiores para volume expiratorio forcado no primeiro segundo (VEF1), razao entre VEF1 e capacidade vital forcada (CVF) (VEF1/CVF) e fluxo expiratorio forcado entre 25 e 75% (FEF25-75) (p < 0,05), alem de maior percentagem de criancas com valores anormais para VEF1, VEF1/CVF e FEF25-75 (FEF25-75, p < 0,05). CONCLUSOES: Este estudo piloto revelou frequencia elevada de sintomatologia respiratoria obstrutiva em escolares em Lisboa. Verificou-se boa correlacao entre o questionario e os valores espirometricos. A baixa prevalencia de asma leva-nos a especular que este diagnostico esteja subestimado nesta populacao.

134 Prevalence of rheumatic heart disease in SENEGAL. An echocardiographic screening

Background Most of the epidemiological studies of the prevalence of rheumatic heart disease have used clinical screening with echocardiographic confirmation of suspected cases. A recent study with systematic echographic screening of all surveyed children shows a higher prevalence of rheumatic heart disease in Cambodgia and Mozambique (10 times grater than what was found by clinical screening alone). We conducted this study to estimate the prevalence of rheumatic heart disease in school-age children of Senegal, a sub-saharan African country. Methods Randomly selected school children from 5 to 18 years of age in Dakar, the capital city of Senegal, were screened for rheumatic heart disease according to standard clinical and echocardiographic criteria. The echocardiographic examination was performed with a Sonosite Micromax Machine using M-Mode, 2D, Color flow, pulse Doppler and continous Doppler. Results The total population was 2004 children. 51.6% were male. The mean age was 14 years. Clinical examination detected rheumatic heart disease that was confirmed by echocardiography in 3 children. The echocardiographic screening detected 15 cases of rheumatic heart diseases. The prevalence rates was 1.5 cases per 1000 using clinical criteria and 7.5 cases per 1000 if echocardiographic screening was used. Males were more affected than girls. The mitral valve was involved alone in 53.3% of cases. Mitral and aortic valves were both involved in 40% of cases. The aortic valve was involved alone in 6.7% of cases. Conclusion Our studies confirmed that echocardiographic screening, as compared with clinical screening, is more accurate and showed a higher prevalence of rheumatic heart disease. However, the prevalence rate in Senegal is lower than that found in Mozambique and Cambodgia, using the same criteria.

A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children

Objective: To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India. Design: Population-based, cross-sectional study. Participants: A total of 3314 school children, 1789 from urban areas and 1525 from rural areas. Methods: The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation. Results: In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (≤20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children. Conclusions: Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.

Exercise-Induced Asthma is Associated with Impaired Quality of Life Among Children with Asthma in Japan

Asthma is the most common chronic diseases in school-aged children in Japan. It is important to consider health-related quality of life (QoL) among children with chronic diseases when treatment decisions are made. A school-based survey was conducted in randomly selected public schools in Tokyo by using a KINDL questionnaire for evaluating QoL and the international study of asthma and allergy on childhood (ISAAC) questionnaire, which is designed for comparing the asthma prevalence in various countries, from May to June in 2005. We recruited approximately 10% of the total children 6-7-years-old and 13-14-years-old living in Tokyo for sampling. Response rate of this questionnaire was 86% (22,645 children) in the 6-7-year-old group and 64% (12,879 children) in the 13-14-year-old group. Comparing asthmatics with non-asthmatics in the same age, QoL of children with asthma was significantly impaired. The severity of QoL of children with asthma was significantly impaired. QoL of children with exercise-induced asthma (EIA) were more significantly impaired than ones without EIA and showed lower scores in the categories of physical functioning, emotional and school activities than those without EIA. Of note, QoL was more impaired in the EIA-positive group among severe asthmatics, suggesting that QoL of children with even severe asthma could be improved when EIA is appropriately controlled. Existence of EIA among asthmatic children most strongly impairs their QoL. We should be more cautious about the management of EIA.

Rheumatic Heart Disease in Asia

A few years ago, my colleagues and I conducted a systematic review of data relating to the global burden of group A streptococcal diseases.1,2 Population-based data on rheumatic heart disease prevalence from 1985 through 2002 were included. We estimated that there were a minimum of 15.6 million people in the world with rheumatic heart disease, with 282 000 new cases each year and 233 000 resultant deaths each year; however, we also noted that the estimates of the number of cases in school-aged children in China (176 500) and Asia Other (102 000; Asia excluding South-Central Asia and China) were based on very few studies, none of which used echocardiography to confirm the presence of rheumatic heart disease lesions. Moreover, 5 of the 6 studies included in the Asia Other estimate came from 1 country, the Philippines. We therefore urged caution in interpreting these data from Asia, other than South-Central Asia, and concluded that there was an urgent need for more population-based data from this part of the world. In the 5 years since that review was compiled, more data have emerged to clarify the burden of rheumatic heart disease in Asia, which will be summarized here. Clinical Perspective p 2753 The previous report included Medline searches and other searches to retrieve articles from 1980 to 2002 with population-based studies of rheumatic heart disease prevalence. To update these data for the present study, a Medline search was conducted with the terms rheumatic fever or rheumatic heart disease and Asia . The abstracts of all articles retrieved from 2003 through November 2007 were reviewed, and the manuscripts of relevant articles were reviewed in full. Population-based studies of the prevalence of rheumatic heart disease in school-aged children were used to update the regional prevalence estimates from the previous review. Additional studies …

FEV0.75/FVC: AN ALTERNATIVE TO FEV1/FVC IN PRESCHOOL CHILDREN

PURPOSE: FEV1 /FVC is useful in evaluating obstructive airways disease in school age children. As preschool children can perform reliable spirometry but have short expiratory times, FEV1 cannot always be determined. Furthermore, when measurable, FEV1 /FVC is higher than described in older children. As FEV0.5/FVC and FEV0.75/FVC have been proposed as alternative measures, we aimed to describe these ratios in our population and determine if they could be surrogates for FEV1 /FVC in this age group.

Prevalence of cavities and periodontal diseases in school age children in Cali’s public school district in the year 2005.

Introduction: The Health Secretary of Cali wanted to know the buccodental status among school children to establish if necessary public health measures. Objectives: To determine the epidemiological oral health profile on scholars at the public schools of Cali, 2005. Methodology: This descriptive study used who oral index systematic and conglomerate multiestrata were performed a total of 784 children were examined for determining their Oral Health Status. Range of age was 5-13 years old. Study children came from 47 public schools. Results: Caries history was detected in 77% of children and actual caries prevalence was 67.7% DMF-d index was 0.64 at five y/o and increase to 3.5 at 12 years/old children. 46.1 % of the evaluated children were periodontally healthy, 34.3% had gingivitis and bleed on probing and 19.6% had dental calculus. Periodontal disease prevalence has 53.9%. Analysis: Children without caries history were higher here when compared the results of National Oral Health morbility study, 1998. Cali level of caries risk were intermediary as compares to National standing DMF-d indicators. Conclusions: It is necessary that the city of Cali establish a strategy to improve the standards in Oral Health among their young populatio. DMF-d indicator at 12 years/old children set them at an intermediary caries level of risk. These might be priority of Public Health Policy.

Lung function tests in preschool children

Measurement of lung function is an integral component of respiratory physiology and of clinical assessment of lung diseases in school age children and adults. Pulmonary function test of infants and children under the age of 2 years have now been standardised and are being used both in research and as an adjunct to clinical management. By contrast, until recegntly, children of preschool age, i.e. between 2-6 years represented a major challenge for pulmonary function test assessment, this particular period commonly being referred to as the 'dark ages' of Pediatric Pulmonology. Measurement of lung function in preschool-aged children is now feasible. However, much work remains to be done in standardizing how these tests are performed, and in understanding the most appropriate role for the various tests in the study of growth and development of the respiratory system and in the clinical management of children in this age group. As the field develops and the knowledge of respiratory physiology in this age group expands, investigation of different and more appropriate algorithm use in preschool children, together with development of more appropriate reference data, may result in improved disease discrimination.

Parenting children with diabetes and Belsky's Determinants of Parenting Model: literature review

This paper provides a critical appraisal of the parenting literature as related to children with diabetes and proposes an adapted model of Belsky's Determinants of Parenting. Diabetes is the leading endocrine disease in school-aged children. As primary healthcare providers, parents assume responsibility for the daily management of their children's diabetes. It is therefore inevitable that parenting becomes a crucial variable in determining diabetes control. However, the literature examining parenting children with a chronic illness such as diabetes is limited. A literature search was conducted using the CINAHL, EMBASE, PsychINFO, and Social Science Index databases and the terms 'parenting', 'determinants of parenting', 'Belsky's Determinants of Parenting' and combined with 'children' and 'type 1 diabetes'. Parenting and nursing literature from 1984 to 2004 was included if it was related to parenting determinants and diabetes control in children. The literature retrieved was critically appraised and synthesized in relation to Belsky's Determinants of Parenting Model. By incorporating new knowledge, an adapted Determinants of Parenting Model is proposed. The adapted model reflects a bi-directional relationship between parenting and child characteristics. Specifically, suggestions for future research on the adapted model and the bi-directional relationship between parenting and child characteristics are also discussed. Recommendations are presented for use of the adapted Determinants of Parenting Model for future nursing research. Future research will need to focus on establishing causal links between the determinants, identifying the extent to which each determinant influences parenting, and parenting determinants questionnaire development.

P9-10 Prevalence and clinical spectrum of congenital structural heart disease in school-aged children: a population-based study using portable echocardiographic screening

P9-10 Prevalence and clinical spectrum of congenital structural heart disease in school-aged children: a population-based study using portable echocardiographic screening

Seroprevalence and sociocultural conditionants of Chagas disease in school-aged children of marginal zones of Asunción.

Chagas disease is becoming a public health problem in Latin America due to the wide distribution, the high prevalence, the magnitude of the damage caused and the difficulties to control it. In Paraguay, the disease is mainly distributed in the departments of Paraguarí, Cordillera and Central. Prevalence in marginal zones, where migrations from rural populations and endemic areas make possible the urbanization of the disease, has no been studied yet. This is a descriptive study with a cross-sectional sampling and a probabilistic system recruitment carried out in school aged children from marginal zones of Asunción to determine the prevalence of Chagas' disease. Serological methods, parasite isolation and questionnaires were used to achieve the goals. Nine hundred and fifty three children were studied to determine the prevalence of Chagas' disease in marginal zones which was 1.4%.

Prevalencia de asma en niños escolares de Mérida, Yucatán

A survey was conducted in Merida, Yucatan, between February and June 1994 in order to determine the prevalence of asthma and the frequency of a family history of the disease in school-age children. A random sample was taken of 505 children of both sexes between the ages of 6 and 12 who were enrolled in elementary schools in the urban area of Merida. Every child's father or mother was surveyed and asked if the child had had recurrent episodes of loud, difficult breathing with wheezing chest sounds, if he or she had had bronchitis, asthmatiform bronchitis, or asthma, and if the mother, father, or any of the siblings had ever suffered from asthma. A total of 61 children with asthma (cumulative prevalence, 12%) was found. Among these children a history of maternal or paternal asthma was more frequent (25 and 18%, respectively) than in other children (10 and 6%, respectively), the difference being statistically significant (P < 0.002) in both cases. Results show the high prevalence of asthma in Merida and suggest that heredity plays a role in the development of the disease.

Otitis Media in Children With Learning Disabilities and in Children With Attention Deficit Disorder With Hyperactivity

A retrospective study was conducted to compare history of middle ear disease children with an attention deficit disorder with hyperactivity (ADD-H) and children with a learning disability. Of 138 children evaluated in a child development clinic, learning disability without ADD-H was diagnosed in 45 (29 boys, 16 girls; mean age = 9.5 years) and ADD-H without learning disability was diagnosed in 21 (17 boys, 4 girls; mean age = 8.5 years). Based on parental report, children with ADD-H had significantly more complaints of earaches during the preceding 3 months and significantly more ear infections during the preceding year. Specifically, no between-group differences were observed for total number of ear infections since birth, extended antibiotic therapy, tympanostomy tube placement, or recent hearing problems. Although middle ear disease in preschool children has repeatedly been linked to later language deficits, this study suggests that middle ear disease in school-age children may also be associated with hyperactivity and/or inattention, independently of learning disability.

The renal functional reserve in health and renal disease in school age children

The capacity to increase the glomerular filtration rate (GFR) in response to stimuli is a characteristic of the healthy kidney. To establish normal limits of this functional reserve is of clinical relevance because its loss may be the earliest indication of renal damage. For this purpose we have used a method applicable in clinical practice: one-hour clearances of creatinine (CCr) done under water diuresis, before (unstimulated) and two hours after (stimulated) a test meat meal, taking a single postmeal blood sample. Urine collection was done by voluntary voiding under direct supervision. In studies done in 14 control subjects, inulin clearance (CIn)/CCr ratios were (mean +/- SEM) 1.04 +/- 0.05 and 0.96 +/- 0.03, in unstimulated and stimulated clearances, respectively. In studies repeated at three to nine week intervals, we found a variation coefficient (mean +/- SEM) of 24.5 +/- 3.11% and 9.25 +/- 1.43% (P less than 0.001) for the unstimulated and stimulated CCr, respectively. The corresponding values for CIn were 19.3 +/- 2.36% and 9.17 +/- 1.19% (P less than 0.001), suggesting that stimulated GFR values are more stable. Unstimulated and stimulated GFR and renal functional reserve (stimulated CCr - unstimulated CCr) were studied in 260 school aged children, ages 6 to 16 years (140 boys and 120 girls). The distribution of the renal functional reserve was approximately Gaussian but the distribution of the urinary creatinine excretion, unstimulated and stimulated GFR had considerable positive skewness.(ABSTRACT TRUNCATED AT 250 WORDS)

Use of Tape-recorded Heart Sounds in Screening of Children with Heart Disease

This article reports on the application of an automatic tape-recording unit to the case-finding of children with heart disease. Field studies with this apparatus have been carried out among the elementary school population in Chicago. The incidence of heart disease in school-age children in the United States is approximately 5% according to several investigators. Since almost all heart disease in children is associated with the production of cardiac murmurs or alteration of the cardiac sounds, a screening test based on auscultation would seem logical. Though there is a small group of patients in whom auscultation alone is insufficient to make a definite statement regarding the significance of a murmur, the subjective interpretation of auscultatory findings by a trained listener in the majority of cases is more reliable than phonocardiographic recordings. The functional or innocent systolic murmur cannot usually be distinguished from the organic one by graphic methods; also, a faint systolic murmur can be recorded by the phonocardiogram in all children at rest. The great advantage of auscultation, according to Rushmer, is that it apparently involves "those characteristics of auditory perception that allow a person to recognize a familiar voice even when distorted by the telephone." With the apparatus described, a technician can produce good quality recordings of apical and basilar cardiac sounds from 250 children during an average school day. The physician-listener, after a training period to become proficient with the playback procedure, can evaluate 140 patients per hour. The aim is to pick out those patients who should be recalled for physical examination because of unusual records of "auscultatory" findings. From the field studies it was apparent that the accuracy of the screening physician was the same whether he employed tape-recordings or clinical auscultation. Furthermore, there was relatively low recall rate of "false positive" interpretations, i.e., 30 per 1,000. The economy and convenience, as regards the physician's time, for screening large populations for heart disease are apparent. Further investigation by other teams of the ease and accuracy of tape-recording cardiac sounds for case-finding seem indicated.