Healthy School Children Research Articles

Dietary Habits of adolescents in higher secondary school in Bhutan: An In-Depth Analysis of Nationally Representative Data

Bhutan is a small landlocked country that lies between the two most populous countries in the world India and China, with a total area of 38,394 square kilometers. A peaceful mountainous kingdom in the Himalayas mandated free education to all children of school-going age up to the 12th standard. Recognizing that education is the fundamental link to national progress, the Royal Government of Bhutan has always and will continue to emphasize education as a priority sector, In doing so, through a dynamic professional health system in the country, Bhutan has made enormous strides in the field of education that promote healthy and happy school children. However, as Bhutan steadily proceeds along its development path, substantial challenges remain, including the dietary habits of an adolescent in higher secondary schools. Therefore, this paper intends to explore the dietary habits among adolescents in higher secondary school. And this will contribute empirical data evidence for the policy framers and implements of the nutrition department at higher authority and school level to improve the dietary habits of adolescents.

Heart Rate Variability Of Moscow Secondary Schoolboys Living In Different Environmental Conditions

The presented empirical study assesses the state of the cardiovascular system of Moscow schoolchildren living in different environmental conditions. 233 practically healthy schoolchildren (109 boys and 124 girls aged 11.4 to 12.6 years) took part in the comprehensive study of HRV and the state of adaptive processes when living in different ecological conditions of the capital megapolis. On the basis of different ecological and social conditions the schoolchildren were divided into 4 compared groups. The comparative analysis of the obtained HRV data of schoolchildren of different groups showed differences in the adaptation processes and in the indices of the wave activity of the sympathetic and parasympathetic departments of the ANS.

Applicability of Boston University approach for prediction of mesiodistal width of canines and premolars in the primary schoolchildren of rural Bengaluru: An in vivo study.

Boston University (BU) approach is a method for early prediction of unerupted permanent mandibular teeth widths based on the mesiodistal widths (MDWs) of primary mandibular canines and first molars. The present study was conducted to test the validity of BU approach by comparing it with Tanaka-Johnston (T/J) approach in the contemporary population. The aim of the study was to determine the applicability of BU approach for prediction of the MDWs of canines and premolars in the primary schoolchildren of rural Bengaluru. The study was conducted in 100 healthy schoolchildren of rural Bengaluru aged between 7 and 11 years. The MDWs of canines and premolars were predicted using both T/J and the considered BU approaches for all the children and were compared. The correlation coefficient showed a statistically significant correlation between the predicted tooth size from the two predicted methods in the upper and lower arches (P < 0.001), with Pearson's correlation coefficient showing the very strong positive relationship (r = 0.7). Significant differences were seen between the mean predicted width of canines and premolars by both the approaches (P < 0.001). In spite of the limitations, we recommend the use of BU approach to predict arch length-tooth material discrepancy at an early age and to get at least an approximate estimation of the required space. We also advocate the necessity of further research on this approach prospectively.

Corrected and Republished: Applicability of Boston University approach for prediction of mesiodistal width of canines and premolars in the primary schoolchildren of rural Bengaluru: An in vivo study.

Boston University (BU) approach is a method for early prediction of unerupted permanent mandibular teeth widths based on the mesiodistal widths (MDWs) of primary mandibular canines and first molars. The present study was conducted to test the validity of BU approach by comparing it with Tanaka-Johnston (T/J) approach in the contemporary population. The aim of the study was to determine the applicability of BU approach for prediction of the MDWs of canines and premolars in the primary schoolchildren of rural Bengaluru. The study was conducted in 100 healthy schoolchildren of rural Bengaluru aged between 7 and 11 years. The MDWs of canines and premolars were predicted using both T/J and the considered BU approaches for all the children and were compared. The correlation coefficient showed a statistically significant correlation between the predicted tooth size from the two predicted methods in the upper and lower arches (P < 0.001), with Pearson's correlation coefficient showing the very strong positive relationship (r = 0.7). Significant differences were seen between the mean predicted width of canines and premolars by both the approaches (P < 0.001). In spite of the limitations, we recommend the use of BU approach to predict arch length-tooth material discrepancy at an early age and to get at least an approximate estimation of the required space. We also advocate the necessity of further research on this approach prospectively.

Anemia grave aguda desencadeada por eritrovírus B19

INTRODUCTION: Parvovirus B19 is an erythrovirus, included in the family Parvoviridae, subfamily Parvovirinae. It is a very small virus (25nm in diameter), consisting of a highly tropic DNA strand for erythropoietic precursor cells causing inhibition of erythropoiesis and cytotoxic effects. The infection may lead to transient aplastic crisis (CAT) and chronic anemia, depending on the host. Generally, erythrovirus infection in children and adults does not require specific therapy, just the symptoms presented. Blood transfusion may be necessary in cases of severe anemia. OBJECTIVE: To report a case of transient aplastic crisis triggered by erythrovirus in previously healthy schoolchildren. CASE REPORT: A 10-year-old patient with a disability, vomiting, asthenia, and three episodes of falling from ones height. Laboratory tests suggested severe anemia and confirmed transient aplastic crisis triggered by B19 erythrovirus. CONCLUSION: This report contributes to inform professionals about the transient aplastic crisis triggered by erythrovirus B19 in a previously healthy child, as an alert for an early diagnosis and a good supportive treatment. This case had a benign course, there was a need for blood transfusion and the treatment was only supportive.

Assessment of Group a Streptococcus and Antimicrobial Resistance Pattern in School Going Children in Morang District, Nepal

Introduction: Group A hemolytic Streptococcal infections has worldwide distribution among children and it poses an important problem globally. There is lack of baseline information regarding Group A hemolytic streptococci in school going children in the eastern part of Nepal.&#x0D; Objective: The study was conducted for assessing the carrier rate of Group A hemolytic streptococci in school going children in eastern part of Nepal.&#x0D; Methodology: This study was community based cross-sectional study. During the study of 9 months, a total of 518 patients (school-going children) from different school who were symptomatic as well as asymptomatic were enrolled. All samples were collected by rubbing quickly and thoroughly over either tonsils (or tonsillar fossa) and over the posterior wall of the pharynx using light pressure and were subjected to microbial analysis in the clinical Microbiology Laboratory. The specimens were inoculated immediately into Blood agar (BA) and MacConkey agar (MA) and were incubated at 37°C aerobically and were checked for growth after overnight incubation. The identification of bacterial isolates was carried out by Clinical and Laboratory Standards Institute (CLSI) guidelines with colonial morphology and staining reactions. Biochemical tests such as catalase, bacitracin sensitivity test (0.004 units) and Lancefield grouping (PastorexTM Strep) were performed. All the identified S. pyogenes isolates thus obtained were subjected to in vitro antibiotics sensitivity testing by using Kirby-Bauer disc- diffusion method as recommended by CLSI (2014).&#x0D; Results: During 9 months period total 518 throat swabs (303 male and 215 female)from school going children attending government and private school were collected after taking verbal consent and were cultured on blood agar and MacConkey agar.Streptococcus pyogenes was identified by using standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method. Group A streptococci (GAS) was isolated from 28 (5.4%) school going children, of which 15 (5%) were male and 13 (7%) were female. There was no significant sex difference in colonization of GAS (p&gt;0.05). Majority of cases were asymptomatic. In this study it was observed that the sensitive drugs for GAS were Penicillin and their deravatives (100%), Ciproflocaxin (100%) and Azithromycin (100%) followed by Erythromycin (75%) and Cotrimoxazole (71.4%) (Table 9,10).&#x0D; Conclusion: The present preliminary study provides the base-line information on the GAS carriage rate and resistance trend among healthy school children. The present study showed that Penicillin and its derivatives should be used to treat a case of GAS pharyngitis and Azithromycin for those who are allergic to Penicillin. The present study also showed that Staphylococcus aureus as an equally important agent of pharyngitis and hence throat swab culture should be requested for appropriate therapy.

Can the supplementary consumption of baobab (Adansonia digitata L.) fruit pulp improve the hemoglobin levels and iron status of schoolchildren in Kenya? Findings of a randomized controlled intervention trial

PurposeIn the rural Kenyan diet, the bioavailability of iron is low and predisposes the population to iron deficiency. Fruit pulp of the indigenous baobab tree contains significant amounts of vitamin C, which enhances non-heme iron bioavailability. We studied the impact of baobab fruit pulp (BFP) consumption on the hemoglobin (Hb) and iron status of Kenyan schoolchildren.MethodsThe single-blind randomized controlled intervention trial was implemented daily among apparently healthy schoolchildren aged 6–12 years with hemoglobin level < 12.2 g/dl. For 12 weeks, children in the intervention group (n = 29) received a drink with BFP, while the control group (n = 29) received an isoenergy drink without BFP. At baseline and endline, blood samples were taken.ResultsThe development of hemoglobin, ferritin (FER) and soluble transferrin receptor (sTfR) did not differ significantly between the intervention and control groups. However, in the intervention group, Hb levels improved slightly (2.2%), while they decreased slightly (1.2%) in the control group. Levels of geometric means of sTfR remained almost unchanged (0.7%) in the intervention group and slightly worsened (2.7%) in the control group. In both the groups, geometric mean of FER levels decreased, yet to a smaller extent in the intervention (17.3%) than in the control (26.0%) group.ConclusionEven though no significant effects of BFP could be detected in this study, the identification of products such as BFP remains pertinent to help improve non-heme iron absorption in the most vulnerable populations.

Is replacing sedentary time with bouts of physical activity associated with inflammatory biomarkers in children?

This study aimed to investigate the theoretical impact of reallocating a specific amount of sedentary time with an equal amount of (a) total and (b) ≥1-minute bout-accumulated time spent in different activity intensities, on inflammatory biomarkers in 8- to 9-year-old children. Accelerometry and inflammatory biomarker baseline data from the Transform-Us! Study (complete cases n=149) were utilized. Isotemporal linear models with the Gaussian distribution and identity link functions were used to assess associations between the activity replacements and seven individual inflammatory biomarkers, including C-reactive protein (CRP), and Interleukin (IL)-2, IL-6, IL-8, and IL-10, as well as combined inflammatory and pro-inflammatory composite scores. Eighty-five percent of children met physical activity recommendations. Replacing 10minutes of sedentary time per day with VPA, regardless of how this was accumulated, was beneficially associated with CRP and both combined composite scores. In contrast, replacing 10min/day of sedentary time with≥1-minute MPA bouts was detrimentally associated with CRP and the inflammatory composite score. Substitutions with other activity intensities were not significantly associated with any individual inflammatory biomarkers, or combined inflammatory and pro-inflammatory composite scores. In healthy and active school-aged children, evidence of the theoretical impact of replacing sedentary time with physical activity, regardless of intensity or accumulation, on markers of systemic inflammation was limited. Longitudinal research is needed to investigate the long-term impacts of reallocating sedentary time with physical activity, and particularly VPA, for inflammatory biomarkers in children, including those with increased risk of inflammation.

Association of TNF (rs1800629) promoter polymorphism and schistosomiasis with sub-microscopic asymptomatic Plasmodium falciparum infections in a schistosomiasis-endemic area in Zimbabwe.

Infection with Plasmodiumfalciparum parasites may result in a wide spectrum of symptoms ranging from asymptomatic to mild or severe. A number of factors are associated with this heterogeneous response to P.falciparum infection. In the present study, associations of sub-microscopic asymptomatic P.falciparum with Schistosoma species and TNF (rs1800629) polymorphism were investigated. 361 clinically healthy primary school children were microscopically screened for S.haematobium, S.mansoni and P.falciparum. Sub-microscopic asymptomatic P.falciparum infections were determined by PCR. Genotypic profiles were identified using ARMS-PCR. Logistic regression was used to assess the association of sub-microscopic asymptomatic P.falciparum with Schistosoma species and TNF (rs1800629) polymorphism. 17.2% of the children were infected with S.mansoni, and 27.4% were infected with S.haematobium. Microscopic examination of thick smears detected only one child infected with P.falciparum. Based on PCR results, 46.1% were infected with sub-microscopic asymptomatic P.falciparum. Children carrying heterozygous AG (OR: 16.964, 95% CI: 0.496-586.547) and homozygous GG (OR: 2.280, 95% CI: 0.111-46.796) genotypes of rs1800629 were associated with an increased likelihood of sub-microscopic asymptomatic P.falciparum infections compared with those carrying homozygous AA genotype. Children without S. haematobium infections (OR: 1.051, 95% CI: 0.146-8.985) and S. mansoni (OR: 2.658, 95% CI: 0.498-14.184) also had an increased likelihood (risk) of being infected with sub-microscopic asymptomatic P.falciparum compared with the Schistosoma-infected groups. However, all the associations observed were not statistical significant. No associations were observed between rs1800629 and schistosomiasis with sub-microscopic asymptomatic P.falciparum infections. This study also reports a high prevalence of sub-microscopic asymptomatic P.falciparum infection concomitant with low malaria transmission.

Cortisol daily rhythm in saliva of healthy school children

To investigate the daily rhythm of cortisol levels in saliva of school children. Probands (10-14 years, both genders) were recruited via personal contact and school visits. Exclusion criteria included hormonal and dental treatments during the trial, pharmaceuticals containing cortisol, or poor oral hygiene. Each volunteer collected 20 saliva samples during one day at defined times starting immediately after waking up and ending at night. Additionally, they completed a sampling diary. Saliva samples were analysed in duplicate using a commercial cortisol luminescence kit. Cortisol concentration in saliva followed a daily rhythm. Within 20 minutes after waking up cortisol reached the highest level of 9.69 (+/-3.89) nmol/L. After 90 minutes cortisol concentration decreased linearly by 50% and stagnated at 4.14 (+/-1.93) nmol/L for 3 to 8 hours. Thereafter, levels decreased gradually reaching almost zero after 14 hours. Overall, no gender-specific differences in saliva cortisol levels were observed except for 3 time points: 3, 10 and 11 hours after waking. This study establishes guidelines for a normal secretion pattern, plus explores pain level measurements and their correlation to saliva cortisol levels in this age group.

Helicobacter pylori, clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage in healthy school-aged children: A case-control study

BackgroundHelicobacter pylori is acquired largely in early childhood, but its association with symptoms and indirect biomarkers of gastric damage in apparently healthy children remains controversial. We aimed to relate persistent H. pylori infection in apparently healthy school-aged children with clinical, laboratory, and noninvasive biomarkers suggestive of gastric damage using a case-control design. Materials and methodsWe followed up 83 children aged 4–5 years with persistent H. pylori infection determined by stool antigen detection and/or a urea breath test and 80 noninfected matched controls from a low-income to middle-income, periurban city in Chile for at least 3 years. Monitoring included clinical visits every 4 months and annual assessment by a pediatric gastroenterologist. A blood sample was obtained to determine laboratory parameters potentially associated with gastric damage (hemogram and serum iron and ferritin levels), biomarkers of inflammation (cytokines, pepsinogens I and II, and tissue inhibitor metalloproteinase 1), and expression of cancer-related genes KLK1, BTG3, and SLC5A8. ResultsPersistently infected children had higher frequency of epigastric pain on physical examination (40% versus 16%; P = 0.001), especially from 8 to 10 years of age. No differences in anthropometric measurements or iron-deficiency parameters were found. Persistent infection was associated with higher levels of pepsinogen II (median 12.7 ng/mL versus 9.0 ng/mL; P < 0.001); no difference was observed in other biomarkers or gene expression profiles. ConclusionsH. pylori infection in apparently asymptomatic school-aged children is associated with an increase in clinical symptoms and in the level of one significant biomarker, pepsinogen II, suggesting early gastric involvement.

ELECTROENCEPHALOGRAPHIC MONITORING OF THE BRAIN FUNCTIONAL CONDITION IN MODERN UKRANIAN SCHOOLCHILDREN

The aim: To monitor the brain functional state of generally healthy Ukrainian schoolchildren according to computer electroencephalography (EEG). Materials and methods: EEG examination of 125 practically healthy (according to medical records) schoolchildren of both sexes, which were divided into 3 age groups: 1) 8-12 years old (n = 49); 2) 13-16 years old (n = 42); 3) 17-18 years old (n = 34). EEG was recorded at rest with eyes closed and during functional tests (eye opening, hyperventilation). Visual and spectral analyzes of the EEG were carried out, types of EEG were determined according to A.E. Zhirmunskaya. (1991) in the adaptation of N.L. Gorbachevskaya et al. (1999). Results: The peak frequency of alpha activity is in the range of 9 to 11.5 Hz, with a tendency to increase as you grow older. A disorganized type of EEG with a predominance of alpha activity dominates with an organized type of EEG. For most schoolchildren, normal EEG reactivity predominates in response to functional tests. The detection rate of short fragments of pathological activity in the background did not exceed 8%, but increased to 20% with hyperventilation. Conclusions: Only a third of modern Ukrainian schoolchildren classified as "healthy" have a physiological type of EEG, which indicates the optimal functional state of the brain. The remaining part of generally healthy schoolchildren have EEG changes, which reflect initial functional disorders mainly at the level of nonspecific structures and the brain stem.

Lysine Bioavailability in School-Age Children Consuming Rice Is Reduced by Starch Retrogradation

Rice is one of the most commonly consumed cereal grains and is part of staple diets in the majority of the world. However, it is regarded as an incomplete protein, with lysine being a limiting amino acid. Our objectives were to determine the bioavailability of lysine in school-age children consuming cooked white rice and to assess the effect of rice starch retrogradation. Bioavailability or metabolic availability (MA) of lysine was determined using the indicator amino acid oxidation (IAAO) method in a repeated-measures design. Six healthy school-age children (3 boys, 3 girls) with a mean±SD age of 6.8±0.98y randomly received 4 crystalline l-lysine intakes (2, 6, 10, 14 mg · kg-1 · d-1), and 5 rice intakes to provide lysine at 8, 11, or 14 mg · kg-1 · d-1. The 14 mg · kg-1 · d-1 intakes were measured twice as warm rice and once as cold rice (to assess the impact of starch retrogradation on MA). Diets provided protein at 1.5 g · kg-1 · d-1 and calories at 1.7 times the participant's measured resting energy requirement, and were isonitrogenous. Breath samples were collected at baseline and during an isotopic steady state for 13C enrichment measurement. The MA of lysine from rice was determined by comparing the IAAO response of rice with l-lysine using the slope-ratio and single intake methods. Starch retrogradation was characterized using differential scanning calorimetry. MA of lysine in warm rice measured in school-age children was 97.5% and was similar to a repeated rice study (97.1%) within the same study population. MA of lysine was reduced significantly (P<0.05) to 86.1% when the cooked rice was consumed cold, which corresponded to detectable starch retrogradation. To our knowledge, this is the first study to measure the MA of lysine from rice in school-age children. Although the bioavailability of lysine from rice is high, it can be reduced by retrogradation of its starch component.This trial was registered at clinicaltrials.gov as NCT04135040.

Physical activity assessment in children and adolescents with juvenile idiopathic arthritis compared with controls

ObjectiveWe aimed to assess physical activity (PA) in children with juvenile idiopathic arthritis (JIA) compared with healthy peers and to determine factors influencing PA level. MethodsThis was a cross-sectional study of the measured level of PA in children with JIA, compared with age- and gender-matched healthy schoolchildren. PA was estimated using a physical activity questionnaire for children and for adolescents (cPAQ/aPAQ). Disease activity was evaluated with the Juvenile Arthritis Disease Activity Score (JADAS). Functional ability was assessed with the Childhood Health Assessment Questionnaire (CHAQ). ResultsA total of 55 children with JIA and 55 healthy control schoolchildren were included. Children with JIA had significantly lower levels of PA compared with their healthy peers as assessed with the cPAQ/aPAQ (P=0.0121). In total, 76% of the JIA group spent the day sleeping and sitting, which was significantly higher compared with the reference group (P=0.001 and P=0.055, respectively). Low PA level was associated with systemic JIA (P=0.002, OR=2.123), polyarticular JIA with positive rheumatoid factor (P=0.001, OR=2.014), JADAS-27≥6 (P=0.001, OR=2.524), patients undergoing treatment (P=0.001, OR=1.271), and higher CHAQ (P=0.002, OR=2.461). ConclusionChildren with JIA were less physically active than their healthy peers and less active than recommended for general health.

Fundamental Differences in Visual Perceptual Learning between Children and Adults

It has remained uncertain whether the mechanisms of visual perceptual learning (VPL)1-4 remain stable across the lifespan or undergo developmental changes. This uncertainty largely originates from missing results about the mechanisms of VPL in healthy children. We here investigated the mechanisms of task-irrelevant VPL in healthy elementary school age children (7-10 years old) and compared their results to healthy young adults (18-31 years old). Subjects performed a rapid-serial-visual-presentation (RSVP) task at central fixation over the course of several daily sessions while coherent motion was merely exposed as a task-irrelevant feature in the visual periphery either at threshold or suprathreshold levels for coherent motion detection. As a result of this repeated exposure, children and adults both showed enhanced discrimination performance for the threshold task-irrelevant feature as in previous studies with adults.5-8 However, adults demonstrated a decreased performance for the suprathreshold task-irrelevant feature whereas children increased performance. One possible explanation for this difference is that children cannot effectively suppress salient task-irrelevant features because of weaker selective attention ability compared to that of adults.9-11 However, our results revealed to the contrary that children with stronger selective attention ability, as measured by the useful field of view (UFOV) test, showed greater increases in performance for the suprathreshold task-irrelevant feature. Together, these results suggest that the mechanisms of VPL change dramatically from childhood to adulthood due to a change in the way learners handle salient task-irrelevant features.

Pediatric Inflammatory Multisystem Syndrome Associated With SARS-CoV-2: A Case Series Quantitative Systematic Review.

Pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (PIMS-TS) is infrequent, but children might present as a life-threatening disease. In a systematic quantitative review, we analyzed 11 studies of PIMS-TS, including 468 children reported before July 1, 2020. We found a myriad of clinical features, but we were able to describe common characteristics: previously healthy school-aged children, persistent fever and gastrointestinal symptoms, lymphopenia, and high inflammatory markers. Clinical syndromes such as myocarditis and Kawasaki disease were present in only one third of cases each one. Pediatric intensive care unit admission was frequent, although length of stay was less than 1 week, and mortality was low. Most patients received immunoglobulin or steroids, although the level of evidence for that treatment is low. The PIMS-ST was recently described, and the detailed quantitative pooled data will increase clinicians' awareness, improve diagnosis, and promptly start treatment. This analysis also highlights the necessity of future collaborative studies, given the heterogeneous nature of the PIMS-TS.

Cardiovascular impact of COVID-19 with a focus on children: A systematic review.

BACKGROUNDSince the beginning of the pandemic, coronavirus disease-2019 (COVID-19) in children has shown milder cases and a better prognosis than adults. Although the respiratory tract is the primary target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cardiovascular involvement is emerging as one of the most significant and life-threatening complications of SARS-CoV-2 infection in adults.AIMTo summarize the current knowledge about the potential cardiovascular involvement in pediatric COVID-19 in order to give a perspective on how to take care of them during the current pandemic emergency. METHODSMultiple searches in MEDLINE, PubMed were performed using the search terms “COVID-19” or “SARS-CoV-2" were used in combination with “myocardial injury” or "arrhythmia" or “cardiovascular involvement” or "heart disease" or "congenital heart disease" or “pulmonary hypertension” or "long QT" or “cardiomyopathies” or “channelopathies” or "Multisystem inflammatory system" or "PMIS" or “MIS-C” or ”Pediatric multisystem inflammatory syndrome" or "myocarditis" or "thromboembolism to identify articles published in English language from January 1st, 2020 until July 31st, 2020. The websites of World Health Organization, Centers for Disease control and Prevention, and the Johns Hopkins Coronavirus Resource Center were reviewed to provide up to date numbers and infection control recommendations. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts concerning the subject were reviewed by the authors, and the data were extracted using a standardized collection tool. Data were subsequently analyzed with descriptive statistics. For Pediatric multisystemic inflammatory syndrome temporally associated with COVID-19 (PMIS), multiple meta-analyses were conducted to summarize the pooled mean proportion of different cardiovascular variables in this population in pseudo-cohorts of observed patients.RESULTSA total of 193 articles were included. Most publications used in this review were single case reports, small case series, and observational small-sized studies or literature reviews. The meta-analysis of 16 studies with size > 10 patients and with complete data about cardiovascular involvement in children with PMIS showed that PMIS affects mostly previously healthy school-aged children and adolescents presenting with Kawasaki disease-like features and multiple organ failure with a focus on the heart, accounting for most cases of pediatric COVID-19 mortality. They frequently presented cardiogenic shock (53%), ECG alterations (27%), myocardial dysfunction (52%), and coronary artery dilation (15%). Most cases required PICU admission (75%) and inotropic support (57%), with the rare need for extracorporeal membrane oxygenation (4%). Almost all of these children wholly recovered in a few days, although rare deaths have been reported (2%). Out of PMIS cases we identified 10 articles reporting sporadic cases of myocarditis, pulmonary hypertension and cardiac arrythmias in previously healthy children. We also found another 10 studies reporting patients with pre-existing heart diseases. Most cases consisted in children with severe COVID-19 infection with full recovery after intensive care support, but cases of death were also identified. The management of different cardiac conditions are provided based on current guidelines and expert panel recommendations. CONCLUSIONThere is still scarce data about the role of cardiovascular involvement in COVID-19 in children. Based on our review, children (previously healthy or with pre-existing heart disease) with acute COVID-19 requiring hospital admission should undergo a cardiac workup and close cardiovascular monitoring to identify and treat timely life-threatening cardiac complications.

No effect of 6-month supplementation with 300mg/d docosahexaenoic acid on executive functions among healthy school-aged children: a randomized, double-blind, placebo-controlled trial.

Docosahexaenoic acid (DHA) plays an essential role in brain, and its status is dependent on dietary intakes. School-aged children in rural China, who consume diets low in omega-3 polyunsaturated fatty acids, may benefit from DHA supplementation. Therefore, this trial was performed to examine the effect of 6-month DHA supplementation on executive functions (EFs) among healthy school-aged children in rural China. A randomized, double-blind, placebo-controlled trial was conducted among 106 primary school children aged 7-12years in rural China. Participants were randomized to receive either 300mg/d DHA or placebo for 6months. EFs including working memory and cognitive flexibility were evaluated at baseline, at 3months and at 6months, using Digit Span Backwards and Wisconsin card sorting test, respectively. Socio-demographic data were collected at baseline, and erythrocyte membrane fatty acids and serum neurotransmitters were measured at baseline and after 6-month intervention. Ninety-four children (88.7%) completed the study according to the protocol. Changes in erythrocyte membrane fatty acids indicated good compliance of the participants. There was no significant intervention effect on serum neurotransmitters. In two-factor ANCOVA, both groups showed a significant improvement in the Digit Span Backwards and the Wisconsin card sorting test from baseline to endpoint. However, no significant intervention effect was found on any EF scores. Linear regression analysis suggested no significant association between changes in erythrocyte DHA level with changes in any EF scores. Supplementation with 300mg/d DHA for 6months had no benefit on EFs including working memory and cognitive flexibility among healthy school-aged children. This trial was registered at clinicaltrials.gov as NCT02308930 on December 5, 2014.

Prevalence and Subtype Distribution of Blastocystis sp. in Senegalese School Children.

Blastocystis sp. is an enteric protozoan that frequently colonizes humans and many animals. Despite impacting on human health, data on the prevalence and subtype (ST) distribution of Blastocystis sp. remain sparse in Africa. Accordingly, we performed the first multicenter and largest epidemiological survey ever conducted on Blastocystis sp. for this continent. A total of 731 stool samples collected from healthy school children living in 10 villages of the northwestern region of Senegal were tested for the presence of Blastocystis sp. by real-time polymerase chain reaction followed by subtyping of positive samples. Considerable variation in prevalence between villages (51.7 to 100%) was evident with the overall prevalence being 80.4%. Mixed infections were identified in 23% of positive individuals. Among 453 school children with a single infection, ST2 was predominant, followed by ST1, ST3, ST7, ST10, and ST14; this is the first report of ST10 and ST14 in humans. Genetic polymorphisms were evident at the intra-ST level with the identification of numerous ST1 to ST3 genotypes. ST1 showed the greatest intra-ST diversity followed by ST2 and ST3. The prevalence and distribution of STs and genotypes varied among target villages, pointing to several potential infection sources, including human-to-human, zoonotic, and waterborne transmission.

An Integrated Study of Toxocara Infection in Honduran Children: Human Seroepidemiology and Environmental Contamination in a Coastal Community.

(1) Background: Infections caused by Toxocara canis and T. cati are considered zoonoses of global importance. Reports from North and South America indicate that human infections are widespread in both continents, but epidemiological information from Central America is still lacking. (2) Methodology: In the present cross-sectional multi-year study, we aimed to undertake the first seroepidemiological and environmental study on toxocariasis in Honduras. This included the determination of seroprevalence of anti-Toxocara spp. antibodies in children using a Toxocara spp. purified excretory-secretory antigens enzyme-linked immunosorbent assay (TES-ELISA) and a confirmatory Western blot. As well, through statistical analysis including logistic regression we aimed at identifying relevant biological and epidemiological factors associated with seropositivity. The study also entailed detection of parasites’ eggs in the soil samples both through Sheather’s concentration method and a nested polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. (3) Results: The study was undertaken in a coastal community of Honduras in 2 different years, 2015 and 2017. A total of 88 healthy schoolchildren completed the study, with participation of 79% (73/92) and 65% (46/71) of the student body in 2015 and 2017, respectively. Thirty-one children participated in both years (i.e., dual participants). Through both serological tests, seropositivity was confirmed in 88.6% (78/88) of children. Due to the high number of seropositives, logistic regression analysis was not possible for most socio-economic and epidemiological variables. Eosinophilia, on the other hand, was associated with seropositivity, independently of other intestinal helminthic infections. Continued seropositivity was observed in most of the dual participants, while seroconversion was determined in 8 of these children. Microscopic examination of soil samples did not yield any positive results. Through nested PCR-RFLP, 3 of the 50 samples (6%) were positive for Toxocara spp.; two were identified as T. canis and one as T. cati. (4) Conclusions: This work documents for the first time, high levels of human exposure to Toxocara spp. in Honduras. These findings, along with the country’s favorable epidemiological conditions for this zoonosis, emphasize the need for more research to determine whether this infection is underreported in the country.