Diseases In School-age Children Research Articles

TuYou-County Pediatric Eye (TYPE) study, design issues, baseline demographic characteristics, and implications: Report number 1.

To report the rationale, design, and baseline demographic characteristics of TuYou-County Pediatric Eye study, which mainly aimed to determine the retinal microvascular changes with optical coherence tomography angiography (OCTA) and its association with eye abnormalities in school aged children and adolescents at suburban location in Northern China.TuYou-County Pediatric Eye study was a school-based survey conducted in TuYou-County. Multi-ethnic (Mongol, Han, and Hui) participants will be followed up for 5 years. Standardized ophthalmological examinations include visual acuity, ocular biometry, retinal photography, and OCTA. A questionnaire survey was conducted to collect variables regarding to eye disease such as parental history of eye diseases, near work, outdoor activities, living and eating habits, etc.After sampling, 687 participants were eligible for investigation, and 20 students did not attend the investigation, living 667 (response rate, 97.1%) students completed questionnaires and all ocular examinations. The average age of all participants was 14.9 ± 5.11.TYPE study is the first large-scale school-based multi-ethnic survey in suburban site of Northern China. Continuous identification of retinal microvascular changes with eye diseases will provide new insights into the control related diseases in school-age children and adolescents.

Global prevalence of congenital heart disease in school-age children: a meta-analysis and systematic review

BackgroundCongenital heart disease (CHD) is the commonest birth defect. Studies estimating the prevalence of CHD in school-age children could therefore contribute to quantifying unmet health needs for diagnosis and treatment, particularly in lower-income countries. Data at school age are considerably sparser, and individual studies have generally been of small size. We conducted a literature-based meta-analysis to investigate global trends over a 40-year period.Methods and resultsStudies reporting on CHD prevalence in school-age children (4–18 years old) from 1970 to 2017 were identified from PubMed, EMBASE, Web of Science and Google Scholar. According to the inclusion criteria, 42 studies including 2,638,475 children, reporting the prevalence of unrepaired CHDs (both pre-school diagnoses and first-time school-age diagnoses), and nine studies including 395,571 children, specifically reporting the prevalence of CHD first diagnosed at school ages, were included. Data were combined using random-effects models. The prevalence of unrepaired CHD in school children during the entire period of study was 3.809 (95% confidence intervals 3.075–4.621)/1000. A lower proportion of male than female school children had unrepaired CHD (OR = 0.84 [95% CI 0.74–0.95]; p = 0.001). Between 1970–1974 and 1995–1999, there was no significant change in the prevalence of unrepaired CHD at school age; subsequently there was an approximately 2.5-fold increase from 1.985 (95% CI 1.074–3.173)/1000 in 1995–1999 to 4.832 (95% CI 3.425–6.480)/1000 in 2010–2014, (p = 0.009). Among all CHD conditions, atrial septal defects and ventricular septal defects chiefly accounted for this increasing trend. The summarised prevalence (1970–2017) of CHD diagnoses first made in childhood was 1.384 (0.955, 1.891)/1000; during this time there was a fall from 2.050 [1.362, 2.877]/1000 pre-1995 to 0.848 [0.626, 1.104]/1000 in 1995–2014 (p = 0.04).ConclusionsGlobally, these data show an increased prevalence of CHD (mainly mild CHD conditions) recognised at birth/infancy or early childhood, but remaining unrepaired at school-age. In parallel there has been a decrease of first-time CHD diagnoses in school-age children. These together imply a favourable shift of CHD recognition time to earlier in the life course. Despite this, substantial inequalities between higher and lower income countries remain. Increased healthcare resources for people born with CHD, particularly in poorer countries, are required.

Prevalence of diarrheal diseases among schools with and without water, sanitation and hygiene programs in rural communities of north-eastern Ethiopia: a comparative cross-sectional study.

Diarrheal diseases are a significant cause of morbidity among school-aged children due to inadequate sanitation, lack of access to potable water and poor hygiene practices. Although the incidence of these illnesses can be reduced through improved water quality and the introduction of sanitation and hygiene programs in schools, there is limited evidence to demonstrate the impact of interventions in schools in Ethiopia. The purpose of this study was to compare the prevalence and associated factors of diarrheal diseases in school-aged children between schools in Habru District, north-eastern Ethiopia that adopted water, sanitation and hygiene (WASH) interventions and those that did not. A comparative cross-sectional study was conducted among 640 randomly selected school children (160 from schools that adopted WASH interventions and 480 from schools that did not). Trained data collectors used a pre-tested structured questionnaire and an observational checklist to collect the data. Descriptive statistics, such as frequencies and percentages, were computed to present the prevalence of diarrheal disease. Bivariate and multivariate logistic regression analyses were used to identify factors associated with diarrheal disease. The overall 2-week prevalence of diarrhea among school children was 30.5%. In WASH-implementing schools, the prevalence was 21.9%, significantly lower than in non-WASH-implementing schools (33.3%). In non-WASH-implementing schools, the odds of diarrheal diseases among students were significantly decreased in those students who used a clean school latrine, self-reported latrine utilization at home and were aware of the causes of diarrhea. Similarly, among students in WASH-implementing schools, self-reported latrine utilization at home, personal hygiene inspection and awareness of the causes of diarrhea were factors associated with decreasing odds of diarrhea occurrence. This study identified a high prevalence of a diarrheal disease among children in schools with no WASH interventions compared with schools that do have WASH interventions. This provides strong evidence for strengthening WASH programs in all rural schools to reduce the burden of diarrheal diseases.

Defining asthma in children: how well do parents, doctors and spirometry agree?

BackgroundBecause diagnosing asthma in school-aged children is challenging, a variety of proxies for asthma are used in clinical practice and research settings as indicators of this disease. We aimed to provide insight into the agreement between various asthma indicators based on parental report, medical diagnosis and spirometry.MethodsChildren from the WHISTLER birth cohort performed spirometry and were followed up with parental ISAAC (International Study of Asthma and Allergies in Childhood) questionnaires about asthma at 5 and 8 years of age. Medical data were extracted from primary care records. We compared 15 asthma indicators based on parental report, medical diagnosis and spirometry using positive agreement, κ statistics and latent class cluster analysis.ResultsAt 5 years of age, 1007 children completed a study visit, while 803 children visited at 8 years of age. Depending on the indicator, the responder and child's age, the asthma prevalence ranged from 0.2% to 26.6%. Cluster analysis revealed classes related to the presence of recent symptoms and a decreased lung function. Agreement between parents and doctors was generally low with κ coefficients ranging from 0.07 (recent wheeze) to 0.52 (recent asthma medication). Additionally, parental report showed to be sensitive to recall bias over time.ConclusionsDependent on the asthma indicator, the responder and the age of the child, substantial differences in agreement were observed between commonly used indicators associated with asthmatic disease in school-aged children. Most agreement between parents and doctors was seen for objective and recent indicators such as the recent use of asthma medication. We advocate caution when literature with different asthma indicators is compared.

A mango (Mangifera indica L.) juice by-product reduces gastrointestinal and upper respiratory tract infection symptoms in children

The study aimed to evaluate the effect of a mango juice by-product (JBP) on upper-respiratory and gastrointestinal tract infection symptoms in children (6–8 y) in a randomized, double-blind, parallel, case-control study. For two months, children drank either flavored water (control group) or a mango JBP-based beverage (0.04 g·ml−1; treatment group); such beverage provided 1.1 g, 278.6 mg and 7.8 mg of dietary fiber, extractable polyphenols (mono-to-hepta galloyl hexosides, mangiferin), and hydrolysable polyphenols (ellagic/gallic acid) per portion, respectively. Mango JBP reduced the incidence of gastrointestinal (flatulencies and abdominal inflammation; p ≤ 0.007) and upper-tract respiratory (crystalline mucus, itchy throat, runny nose, itchy nose, and sneezing; p ≤ 0.038) and such benefits were associated to increased serum levels of PAI-I, MIP-1a, and MIP-1b (p ≤ 0.04) and decreased levels of IgG, MIF, and osteopontin (p ≤ 0.01). We concluded that JBP-based beverage has immunomodulatory properties, useful to prevent or even treat common infectious diseases in school-age children.

Effect of breastfeeding duration on lung function, respiratory symptoms and allergic diseases in school-age children.

A positive effect of breastfeeding on lung function has been demonstrated in cohorts of children with asthma or risk for asthma. We assessed the impact of breastfeeding on lung function and symptoms at the age of 6 years in an unselected, healthy birth cohort. We prospectively studied healthy term infants from the Bern-Basel Infant Lung Development (BILD) cohort from birth up to 6 years. Any breastfeeding was assessed by weekly phone calls during the first year of life. Risk factors (eg, smoking exposure, parental history of allergic conditions, and education) were obtained using standardized questionnaires. The primary outcomes were lung function parameters measured at 6 years of age by spirometry forced expiratory volume in 1 second, body plethysmography (functional residual capacity [FRCpleth ], the total lung capacity [TLCpleth ], and the effective respiratory airway resistance [Reff ]) and fractional exhaled nitric oxide (FeNO). Secondary outcomes included ever wheeze (between birth and 6 years), wheeze in the past 12 months, asthma, presence of allergic conditions, atopic dermatitis, rhinitis, and positive skin prick test at the age of 6 years. In 377 children the mean breastfeeding duration was 36 weeks (SD 14.4). We found no association of breastfeeding duration with obstructive or restrictive lung function and FeNO. After adjustment for confounders, we found no associations of breastfeeding duration with respiratory symptoms or the presence of allergic conditions. This study found no evidence of an association between breastfeeding and comprehensive lung function in unselected healthy children with long-term breastfeeding. Our findings do not support the hypothesis that the duration of breastfeeding has a direct impact on lung function in a healthy population with low asthmatic risk.

Mucus plugging, air trapping, and bronchiectasis are important outcome measures in assessing progressive childhood cystic fibrosis lung disease.

To determine which outcome measures could detect early progression of disease in school-age children with mild cystic fibrosis (CF) lung disease over a two-year time interval utilizing chest computed tomography (CT) scores, quantitative CT air trapping (QAT), and spirometric measurements. Thirty-six school-age children with mild CF lung disease (median [interquartile range] age 12 [3.7] years; percent predicted forced expiratory volume in 1 second (ppFEV1 ) 99 [12.5]) were evaluated by serial spirometer-controlled chest CT scans and spirometry at baseline, 3-month, 1- and 2-years. No significant changes were noted at 3-month for any variable except for decreased ppFEV1 . Mucus plugging score (MPS) and QATA1andA2 increased at 1- and 2-years. The bronchiectasis score (BS), and total score (TS) were increased at 2-year. All variables tested with the exception of bronchial wall thickness score, parenchymal score (PS), and ppFEV1 , were consistent with longitudinal worsening of lung disease. Multivariate analysis revealed baseline PS, baseline TS, and 1-year changes in BS and air trapping score were predictive of 2-year changes in BS. MPS and QATA1-A2 were the most sensitive indicators of progressive childhood CF lung disease. The 1-year change in the bronchiectasis score had the most positive predictive power for 2-year change in bronchiectasis.

ADHD classification by dual subspace learning using resting-state functional connectivity.

As one of the most common neurobehavioral diseases in school-age children, Attention Deficit Hyperactivity Disorder (ADHD) has been increasingly studied in recent years. But it is still a challenge problem to accurately identify ADHD patients from healthy persons. To address this issue, we propose a dual subspace classification algorithm by using individual resting-state Functional Connectivity (FC). In detail, two subspaces respectively containing ADHD and healthy control features, called as dual subspaces, are learned with several subspace measures, wherein a modified graph embedding measure is employed to enhance the intra-class relationship of these features. Therefore, given a subject (used as test data) with its FCs, the basic classification principle is to compare its projected component energy of FCs on each subspace and then predict the ADHD or control label according to the subspace with larger energy. However, this principle in practice works with low efficiency, since the dual subspaces are unstably obtained from ADHD databases of small size. Thereby, we present an ADHD classification framework by a binary hypothesis testing of test data. Here, the FCs of test data with its ADHD or control label hypothesis are employed in the discriminative FC selection of training data to promote the stability of dual subspaces. For each hypothesis, the dual subspaces are learned from the selected FCs of training data. The total projected energy of these FCs is also calculated on the subspaces. Sequentially, the energy comparison is carried out under the binary hypotheses. The ADHD or control label is finally predicted for test data with the hypothesis of larger total energy. In the experiments on ADHD-200 dataset, our method achieves a significant classification performance compared with several state-of-the-art machine learning and deep learning methods, where our accuracy is about 90 % for most of ADHD databases in the leave-one-out cross-validation test.

High-Accuracy Classification of Attention Deficit Hyperactivity Disorder With l 2,1-Norm Linear Discriminant Analysis and Binary Hypothesis Testing

Attention Deficit Hyperactivity Disorder (ADHD) is a high incidence of neurobehavioral disease in school-age children. Its neurobiological diagnosis (or classification) is meaningful for clinicians to give proper treatment for ADHD patients. The existing ADHD classification methods suffer from two problems, i.e., insufficient data and noise disturbance. In this paper, a high-accuracy classification method is proposed by using brain Functional Connectivity (FC) as ADHD features, where an ${l_{2,1}}$ -norm Linear Discriminant Analysis (LDA) model and a binary hypothesis testing framework are effectively employed. In detail, we introduce a binary hypothesis testing framework to cope with insufficient data of ADHD database. The FCs of test data (without seeing its label) are used for training and thus affect the subspace learning of training data under binary hypotheses. On other hand, the ${l_{2,1}}$ -norm LDA model generates a subspace to represent ADHD features, aiming to overcome noise disturbance. By robustly learning ADHD features, the subspace energy difference between binary hypotheses becomes more discriminative. Thereby, the true hypothesis can be rightly estimated with its larger subspace energy, which provides reliable evidence to predict the label of test data. By the test on ADHD-200 database, it shows that our method outperforms other state-of-the-art methods with the significant average accuracy of 97.6%. Moreover, the corresponding result analysis with ADHD symptom score and the explanation of discriminative FCs between ADHD and healthy control groups are given, which further verifies the validity of our classification method.

Screening for celiac disease in school aged children in Croatia

Abstract Background Celiac disease primarily affects small intestine and occurs as an immune-based reaction to dietary gluten in wheat, barley and rye. There has been a significant increase in prevalence and an increase in diagnosis rate due to diagnostic tests improvements. Celiac disease can present with gastrointestinal and non-gastrointestinal abnormalities, but also many individuals may have no symptoms at all. Early diagnosis of celiac disease is essential, because untreated disorder may result in serious complications. The aim of this study was to detect celiac disease in asymptomatic school-aged children and to determine prevalence rate. Methods Cross sectional study was conducted on a sample of 2000 children in school year 2018/2019 in school health service. The sample comprised 15.8% of elementary school first grade population in City of Zagreb, aged 6-7 years. SimtomaX in-vitro rapid screening test was used to detect IgA and IgG deamidated gliadin peptide and/or IgA deficiency. Children with positive tests were referred to clinical diagnostic. Data were analysed by descriptive statistic. Results The study comprised 1404 children (51% girls, response rate 70%). Positive result was found in 5.6% children (42 girls and 37 boys). Up to now, celiac disease was confirmed with duodenal biopsy in 0.5% asymptomatic children (3 girls, 4 boys). Conclusions The results of the study showed prevalence of celiac disease of 0.5% in asymptomatic first grade school children. Children diagnosed with celiac disease require gluten-free diet and follow-up of gastroenterologist, nutritionist and school doctor. The results of the study will be used to raise the awareness and encourage more active search for celiac disease among asymptomatic school children. Key messages Recognition of celiac disease in asymptomatic children reduces risk of complications. Adequate diet for individuals with celiac disease should be ensured from kindergarten through school time.

Risk factors for progression of structural lung disease in school-age children with cystic fibrosis

BackgroundComputed tomography (CT) is used to monitor progression of structural lung disease (SLD) in children with cystic fibrosis (CF). Our goals were to identify the risk factors for the annual progression of SLD and the impacts of airway pathogens on SLD. MethodSeventy-five school-aged children diagnosed with CF underwent 200 CT scans at Gothenburg CF Centre in the period 2003–2015. SLD was evaluated with a quantitative scoring system. Mixed models were used to calculate the yearly progression rates of SLD and FEV1 and to analyse the effects of common airway pathogens in CF. ResultsThe yearly mean progression (95% CI) rates for total disease (%Dis), bronchiectasis (%Be), and FEV1 were 0.62 (0.38–0.86), 0.43 (0.28–0.58) and −0.16 (−0.18–0.13), respectively. Adjusting for airway pathogens, the yearly mean progression rates for %Dis, %Be and FEV1 were 0.23 (−0.04–0.51), 0.12 (0.00–0.25), and −0.12 (−0.16–0.08), respectively. A single infection with P aeruginosa was associated with significant increase in lung damage, assessed as %Dis (p = 0.044) and%Be (p = 0.0047), but not in FEV1 (p = 0.96). At age of 7 years, there was a good correlation between the extent of SLD and subsequent progression of %Dis (r = 0.63, p = 0.0042) and %Be (r = 0.74, p = 0.0057) while there was no significant correlation between the FEV1 and the rate of decline of FEV1 (r = −0.22, p = 0.12). ConclusionIntermittent respiratory infections with P aeruginosa were associated with significant SLD but no change in FEV1. More SLD at the age of 7 years signals a higher progression rate of SLD subsequently.

학령기 아동의 알레르기 질환 유병률과 관련요인: 국민건강영양조사 자료[2013~2016] 활용

Purpose: The purpose of this study was to examine factors affecting the prevalence of allergic diseases among school-aged children in order to establish a theoretical basis for a family-centered nursing intervention. Methods: A secondary data analysis study design was adopted. This study used raw data from the sixth (2013~2015) and seventh (2016) Korea National Health and Nutrition Examination Surveys, and 1,750 school-aged children (7~12 years) participated in the survey. The allergic diseases included allergic rhinitis, atopic dermatitis, and asthma. Data were analyzed using descriptive statistics, chi-squared tests, and multiple logistic regression. Results: Of the participants, 53.2% and 46.8% were boys and girls, respectively. The prevalence of allergic diseases was 38.6%. In the multiple logistic regression, girls had a 0.76 times lower risk of developing allergic diseases than boys (95% confidence interval [CI] = 0.62~0.93), and senior elementary school students (10~12 years) had a 1.24 times higher prevalence of allergic diseases (95% CI = 1.02~1.52) than junior elementary school students (7~<10 years). Families with three or more generations had a 0.60 times lower risk of allergic diseases than one-or two-generation families (95% CI = 0.60~0.93). Parents with allergic diseases showed a development of allergic diseases 2.27 times (95% CI = 1.84~2.80) higher than parents without allergic diseases. Allergic diseases were 0.58 times (95% CI = 0.37~0.90) less common in parents in average health and 0.61 times (95% CI = 0.39~0.96) less common in parents in good health than in parents in poor health. Conclusion: The findings of this study suggest that senior male school age children from one or two-generation families, having parents with allergic diseases or poor health status need special attention to prevent and manage allergic diseases. Future research in health promotion for families at high risk of allergic disease is warranted to prevent and manage potential allergic disease in school age children.

Increased Prevalence of Celiac Disease in School-age Children in Italy

Celiac disease is one of the most common diseases worldwide, with an apparent trend of increasing prevalence. We investigated the prevalence of celiac disease in children in Italy in 2015-2016 and compared that with data from 25 years ago. We screened 4570 children (5-11 years old, 80.1% of the eligible population) from metropolitan areas of Ancona and Verona for HLA genes associated with increased risk of celiac disease, and for total serum levels of IgA and IgA class anti-tissue transglutaminase in HLA positives. Diagnoses of celiac disease were confirmed by detection of anti-endomysial antibody and analysis of intestinal biopsies. The prevalence of celiac autoimmunity and celiac disease were calculated and compared with values from the same geographical area during the years 1993-1995, after adjustment for the different diagnostic algorithm. We identified 1960 children with celiac disease-associated haplotypes (43% of children screened; 95% CI, 40.8%-45.2%). The prevalence of celiac disease autoimmunity in the HLA-positive subjects was 96/1706 (5.62%; 95% CI, 4.53%-6.71%) and 54 of these children satisfied the diagnostic criteria for celiac disease. In the eligible population there were other 23 known cases of celiac disease. The overall estimated prevalence of celiac disease was 1.58% (95% CI, 1.26%-1.90%); this value is significantly higher than the 1993-1995 adjusted prevalence (0.88%; 95% CI, 0.74%-1.02%). We found the prevalence of celiac disease in children in Italy to be greater than 1.5%; this value has increased significantly over the past 25 years. Studies are needed to determine the causes of this large increase.

Clinical characteristics and prognosis of pediatric intracranial hemorrhage in pediatric intensive care unit: a prospective and single-center study

Objective To describe the etiology, clinical characteristics and prognosis in children with intracranial hemorrhage who were admitted to pediatric intensive care unit (PICU) and to analyze factors associated with poor prognosis, in order to provide evidence for prevention and early prognosis evaluation. Methods This was a prospective, single-center study including the children with intracranial hemorrhage who were admitted to PICU of Beijing Children′s Hospital from October 1, 2014 to January 31, 2017.Children′s basic information and survival on the 28th day after hospital discharge were collected.Prognosis was evaluated by means of pediatric cerebral performance category score (PCPC) or pediatric overall performance category score (POPC). The related factors with poor prognosis were analyzed. Results Ninety-five children(58 boys and 37 girls) were included; mortality at hospital and on the 28th day after discharge were 7.4% and 22.1%, respectively.Trauma(68.4%) was the most common cause for intracranial hemorrhage(ICH). The most common cause of spontaneous intracranial hemorrhage in infants was vitamin K deficiency (4/16 cases, 0.25), but hematological diseases in school-aged children (7/11 cases, 63.6%). Univariate analysis showed intraparenchymal, intraventricular, extradural hemorrhage.Multiple sites hemorrhage, trauma, hematological system diseases, surgery, and low Glasgow coma scale(GCS) at PICU discharge were associated with poor prognosis(χ2=9.653, 10.658, 7.237, 5.657, 10.966, 4.471, 7.429, 31.308, all P<0.05). Multivariate analysis showed that intraventricular hemorrhage and low GCS at PICU discharge were independent risk factors for poor prognosis(all P<0.001). ICH caused by trauma had a relatively better prognosis(P=0.015). Conclusions The majority of patients with ICH admitted to PICU are infants.The most common cause is trauma.The most common cause of spontaneous ICH in infants is vitamin K deficiency, but hematological diseases in school-aged children.ICH and low GCS at PICU discharge are independent risk factors for poor prognosis.ICH caused by trauma has a relatively better prognosis.Reducing accidental injury is the key to prevent ICH in children. Key words: Intracranial hemorrhage; Child; Trauma; Prognosis

Tuberculosis among School Age (6 - 18 Years) Children Seen in University of Port Harcourt Teaching Hospital: A Need for Effective School Health Services

Introduction: Tuberculosis (TB) still causes significant morbidity and mortality amongst adults and children despite all the efforts which have been put into the control of the disease. However, the prevalence of the disease in school age children is unknown because of scarcity of TB screening surveys in Nigerian schools. The aim of this study was to evaluate the proportion of school age children treated for TB in the Directly Observed Treatment Short Course (DOTS) clinic of University of Port Harcourt Teaching Hospital (UPTH). Methods: The records of all children 6 to 18 years who were treated in the DOTS clinic from 2011 to 2014 were reviewed. Information sought included age, sex, sputum Acid Fast Bacillus (AFB) status, Human Immunodeficiency Virus (HIV) status and treatment outcome. Results: One hundred and forty children aged 6 to 18 years were treated in the University Port Harcourt Teaching Hospital DOTS clinic, representing 41.79% of childhood TB cases seen over the study period. Seventy one (50.71%) patients were males and 69 (49.29%) were females. Their mean age was 12 ± 3.86. Thirty-one (22.14%) had smear positive TB. Sputum smear positivity was commonest (54.84%) among those who were 16 years and above compared to the other age groups and this is statistically significant (x2 = 17.72, p = 0.001). Forty-one (35%) patients were HIV positive and 6 (4.29%) were positive for both HIV and AFB. Ninety (64.29%) patients recovered fully following treatment, 48 (34.29%) were referred to other DOTS centres and 2 (1.43%) died. Gender, age group, AFB and HIV status showed no relationship with treatment outcome. Conclusion: School age children 6 to 18 years made up a large proportion of childhood TB cases seen within the study period in the DOTS clinic. More than one third of them were HIV/TB co-infected. An effective School Health Services should be established in schools in Port Harcourt to curb the spread of TB and other communicable diseases within the schools.

A Study to Assess the Effectiveness of Child to Child Approach on Knowledge and Practices Regarding Hand Washing among the Primary School Children of a Selected School Faridkot, Punjab

Introduction: Hand washing is part of our life. Hands are the main cause for disease transmission. They spread vector infection from one person to another. Hand washing with soap (HWWS) is a simple and effective measure to prevent transmission of fecaloral disease and other infectious diseases in school-age children. There are over 10 million episodes of food related infection in a year but most of these are probably related to improper hand washing. Many of these deaths are easily preventable through simple practices such as hand washing with soap. Evidence suggests that improved hand washing can have a major impact on public health in any country and significantly reduce the two leading causes of childhood mortality. There is need to enhance the knowledge and practice skill of hand washing among school children. Aim of the Study: Aim is to assess the effectiveness of child to child approach on knowledge and practices regarding hand washing among the primary school children of a selected school of Faridkot, Punjab. Material and Method: A quantitative approach with one group pre test-post test research design was selected for the present study. With simple random sampling (100) school children from the 3rd,4th and 5th classes, selected the 10 students from the all study subjects. Then pre test of whole children were taken. After pre test, intervention was given to the selected 10 students about hand washing after that, post test was taken, and allowed the selected students to teach the other students about hand washing. Socio demographic data sheet and tool, structured knowledge interview performa and observational checklist were prepared to assess the effectiveness of child to child approach on knowledge and practices regarding hand washing. Results: The present study revealed that interventions i.e. child to child approach were helpful in improving hand washing knowledge and practices among primary school children, post test mean score of knowledge was 15.2 respectively which was significant at p value <0.05, similarly post test mean of hand washing practices was 10.41, which was significant at p <0.05 level. Conclusion: Child to child approach is an effective intervention to raise the level of knowledge and improve the practices of hand washing. After being instructed, primary school children taught each other and to their siblings, playmate, and friends at home. There is no or little need of any supervision.

The Influence of Risk Factors on the Duodenum Ulcer Disease Development Among School-age Children

This article highlights the results of the analysis of digestive system diseases, which are risk factors for a duodenum ulcer disease development. This pathology is the second rate such in adults as in children at present. The prevalence of chronic gastritis and duodenitis among school-age children are 27,66% in the structure of the prevalence of diseases of the digestive system of this age group. The prevalence of chronic gastritis and duodenitis among children aged 15–17 years is 3.89 times higher than among children aged 0–14 years. Our researches have shown a high level of the prevalence of the digestive system various diseases among children, which are risk factors for the development of duodenal ulcer diseases. The current situation may be linked not only with economic instability, but also with the prevalence of harmful habits among children, neglect of a healthy lifestyle, etc.The objective: to study the influence of risk factors on the status of digestive system diseases in school-age children, primarily – of a duodenum ulcer disease.Materials and methods. The method of semantic evaluation of scientific documents and the method of system and process analysis were used.Results. Analysis of the studies show that there has been a lack of attention of parents, health workers and teachers to improve the physical activity of children. The reduction of physical activity of school-age children, restrictions on sports, as well as the majority of children «sedentary» lifestyle reduce energy costs, while the energy value of diets is growing. The dynamics of the distribution of schoolage children by health groups indicates a decrease the number of children with the first group of health according to school age in 2016: 21,5% (Junior), 12,6% (average), 10,8% (senior), while their peers 50 years ago there was a different proportion of the increase in the number of healthy children, in particular, 36,5% (Junior), 47,1% (middle), 62,0% (senior school age) with age. The definition of risk factors for child’s health allows us to determine the real threat to the schoolage children health, and makes it possible to prevent the duodenal ulcer disease in the early stages by of preventive measures.Conclusion. The researches results indicate an increase in the incidence, deterioration of physical and neuropsychological development, decrease in the level of physical activity of school-age children, which should be taken into account in the organization of treatment and preventive care for schoolchildren and is a confirmation of negative trends in the health of children in the modern world stage.

Perinatal Maternal Stress and Susceptibility to Infectious Diseases in Later Childhood: An Early Life Programming Perspective

There is evidence of transmission of stress-related dysregulation from parents to offspring during early developmental stages, leading to adverse health outcomes. This study investigates whether perinatal stress is linked to the risk of infectious diseases in children aged 7–11 years. We hypothesize that stress exposure during pregnancy and the first 6 months after birth independently predict common infectious diseases. Data are obtained from ELSPAC-CZ, a prospective birth cohort. Maternal stress, operationalized as the number of life events, is examined for pregnancy and the first 6 months postpartum. Children’s diseases include eye infection, ear infection, bronchitis/lung infection, laryngitis, strep throat, cold sores, and flu/flu-like infection. More prenatal and postnatal life events are both independently linked to a higher number of infectious diseases between the ages of 7–11 years. The effect is larger for postnatal vs. prenatal events, and the effect of prenatal events is attenuated after maternal health in pregnancy is controlled. The results suggest that perinatal stress is linked to susceptibility to infectious diseases in school-age children. Interventions to address stress in pregnant and postpartum women may benefit long-term children’s health.

Classification of ADHD with bi-objective optimization

Attention Deficit Hyperactive Disorder (ADHD) is one of the most common diseases in school aged children. In this paper, we consider using fMRI data with classification techniques to aid the diagnosis of ADHD and propose a bi-objective ADHD classification scheme based on L1-norm support vector machine (SVM). In our classification model, two objectives, namely, the margin of separation and the empirical error are considered at the same time. Then the normal boundary intersection (NBI) method of Das and Dennis is used to solve the bi-objective optimization problem. A representative nondominated set which reflects the entire trade-off information between the two objectives is obtained. Each representative nondominated point in the set corresponds to an efficient classifier. Finally a decision maker can choose a final efficient classifier from the set according to the performance of each classifier. Our scheme avoids the trial and error process for regularization hyper-parameter selection. Experimental results show that our bi-objective optimization classification scheme for ADHD diagnosis performs considerably better than some traditional classification methods.

Study of medico-biological, medico-social and organizational factors influencing the morbidity of school-age children

Aim. The study of the incidence among school-age children, and development of a complex of medico-biological, medico-social and organizational measures for improving health status of schoolchildren. Methods. Statistical, mathematical, sociological. Results. Morbidity among children in Kazan in 2015-2017 increased to 20.4%, incidence during this period increased by 38.6%. The conducted examination of physical development of schoolchildren revealed significant decrease of the ratio of students with normal physical development. While in primary school this parameter was 85.3±2.17%, in grades 8 to 11 it decreased to 77.8±1.98% (p &lt;0.01). The social and hygienic health characteristics of schoolchildren's health include the following: 25% of surveyed students live in families with a low subsistence level; 30% of schoolchildren are brought up in single-parent families; in 10% of cases parents do not allocate money for child nutrition at school; 30.5% of schoolchildren of grades 8 to 11 smoke; 35.9% of students of grades 8 to 11 drink alcohol; 34.9% of schoolchildren have conflicts with their classmates; 17.1% of schoolchildren of grades 8 to 11 do not eat hot meals at school; 28% of students consider themselves not informed about the issues of proper nutrition, etc. The conducted study of the schedule at schools demonstrated that the workload of the junior schoolchildren exceeds the age standards by 5-7 hours, and in the middle and senior classes the load turned out to be higher than the age standards by 5-10 hours. Conclusion. One-way ANOVA reflected that medico-biological, medico-social and organizational factors significantly influence the occurrence of diseases in school-age children; based on the data on the influence of unfavorable risk factors on the development of diseases in school-age children we will develop measures for medical and social prevention.