High Infant Mortality Research Articles

Phenotypic Characterization of ENPP1 Deficiency: Generalized Arterial Calcification of Infancy and Autosomal Recessive Hypophosphatemic Rickets Type 2

Abstract Generalized arterial calcification of infancy (GACI) and autosomal recessive hypophosphatemic rickets type 2 (ARHR2) are age-related phenotypes of the rare genetic mineralization disorder, ENPP1 Deficiency, which evolve on a phenotypic continuum. To date, our understanding of the clinical spectrum of ENPP1 Deficiency is based on small studies or case reports, across which there is significant variability in clinical presentation, and limited duration of follow-up. From a previously published large retrospective natural history study, we performed a subgroup analysis to elucidate the most prevalent signs and symptoms of ENPP1 Deficiency diagnosed as GACI or ARHR2 to illustrate the onset and incidence of these complications over the lifetime, and to characterize the associated medical burden of disease. Of the 84 individuals with ENPP1 Deficiency analyzed, 51 had a recorded diagnosis of GACI, 11 were diagnosed with ARHR2, and 22 were diagnosed with both. We confirmed that those diagnosed with GACI presented predominantly with early-onset arterial calcification, respiratory distress, heart failure, and hypertension, necessitating acute inpatient care and leading to high (44%) infant mortality. Notably, we found that the majority (60.3%) of those with a history of GACI had prenatal ultrasound anomalies, including effusions, polyhydramnios, and hydrops fetalis. We estimated that 70% of individuals with ENPP1 Deficiency who survive to age 10 will have developed musculoskeletal complications, primarily rickets and/or osteomalacia. The clinical picture of ARHR2 in this study extended beyond skeletal deformities to include hearing impairment, joint involvement, and ongoing risk of cardiovascular problems. This study sheds light on the signs and symptoms of ENPP1 Deficiency in the real world, with implications for life-long patient monitoring.

An Application Of Double Hierarchical Generalized Linear Model To Infant Mortality Rates In China

High infant mortality rate is still a worldwide problem and the situation is even worse in some developing countries or regions with political instability, low economic levels and epidemic diseases. In addition, some studies have shown that infant mortality rate affects fertility rate, so it is important to reduce the infant mortality rate when China’s population has already started to grow negatively in 2022. Infant mortality rate is a discrete count data. This kind of data usually does not follow the basic assumption of normality, so the use of ordinary linear regression models on it may produce inconsistent or biased estimates. Double hierarchical generalized linear model (DHGLM) are a class of models that exist specifically for count data. They can model the mean and proportion parameters hierarchically and specify random effects for the mean and dispersion which is a good solution to the problem of underestimating standard errors due to overdispersion of the data. This paper proposes a double hierarchical generalized linear model combined with the integrated nested laplace approximation within markov chain monte carlo (MCMCINLA) to analyze the data of infant mortality rate in China. At the same time, a spatial lag term is added to the model to analyze the spatial correlation of the data. Finally, the influence of economic or medical factors on infant mortality rate is analyzed and some policy suggestions are given to reduce infant mortality rate according to the analysis results.

More Complex Investigations Improved Diagnoses of Community-Acquired Pneumonia in Children With Different Vaccination Histories.

Community-acquired pneumonia (CAP) significantly contributes to high infant mortality in Kazakhstan and developing effective treatment methods is critical. The aim of this study was to explore the microbiological and immunological characteristics of CAP in vaccinated and unvaccinated paediatric patients. The study was carried out in the Regional Children's Clinical Hospital and the research centre of Karaganda Medical University, Republic of Kazakhstan. It comprised 85 children aged 2 months to 3 years who had been diagnosed with CAP and had received inpatient treatment from 2017 to 2019. Of these, 45 had complete pneumococcal vaccinations and 40 had not. Their CAP diagnoses were confirmed by microscopic, bacteriological and radiological methods and vaccination status. General clinical examinations were conducted. The study showed the diagnostic and prognostic value of the level of cytokines, depending on the severity of the children's CAP. The level of monocytic chemoattractant protein-1 was 2.1 pg/mL in the vaccinated children with mild CAP and 3.4 pg/mL in those with impaired immunisation. Pneumococcal vaccination affected the aetiological structure of CAP in early childhood. More complex clinical and immunological diagnostic methods increased the efficiency of diagnosing CAP in children with different vaccination histories.

IMPACT OF THE WAR AND THE COVID-19 PANDEMIC ON THE MORTALITY RATE OF CHILDREN UNDER THE AGE OF 1 YEAR IN UKRAINE IN UKRAINE

Background. The war and the consequences of the COVID-19 pandemic have an extremely negative impact on the morbidity and mortality of the child population. The aim of the study is to analyse the impact of the war and the consequences of the COVID-19 pandemic on the dynamics of infant mortality and its components in Ukraine from 2020 to 2023.Study materials and methods. Retrospective analysis and assessment of infant mortality and its components in Ukraine for theperiod from 2020 to 2023 was carried out on the basis of the data of the sectoral statistics of the state institution «Public Health Centre of the Ministry of Health of Ukraine». The methods of systematic approach, statistical data processing and epidemiological analysis of graphical representation were used.Results and discussion. In 2023, after three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion of Ukraine, the infant mortality rate increased to 7.45 ‰ or 11.69 % compared to 2020. This increase was mainly due to a relatively higher increase in postneonatal mortality and late neonatal mortality in the current environment compared to early neonatal mortality. Certain conditions occurring in the perinatal period, congenital anomalies (malformations), malformations and chromosomal disorders, respiratory diseases, especially acute respiratory diseases of the upper airways, pneumonia, infl uenza, some infectious and parasitic diseases and diseases of the nervous system are the main causes of mortality in children in the fi rst year of life in 2023. In the structure of infant mortality, the proportion of deaths of children under 1 year of age due to infectious and parasitic diseases, respiratory diseases and external causes (injuries, poisoning, accidents), diseases of the nervous system and diseases of the circulatory system has increased signifi cantly in the last 4 years, which may also be a result of the direct and indirect synergistic eff ects of the war and the COVID-19 pandemic. The highest infant mortality rates were observed in Kherson (28.27 per cent), Zakarpattia (11.5 per cent), Dnipropetrovsk (9.29 per cent), Kirovograd (9.19 per cent), Donetsk (9.12 per cent), Zhytomyr (8.93 per cent) and Chernihiv (8.71 per cent) regions, which may indicate inadequate staffi ng and resources for paediatric services, particularly as a result of the war. Of particular concern is the 11.5 per cent increase in out-of-hospital mortality in the fi rst year of life compared with 2020, which may be due to the deterioration in the availability of medical care for children as a result of the hostilities in the east and south of the country.Conclusion. After three years of the COVID-19 pandemic and against the background of the ongoing Russian invasion, Ukraine has experienced an increase in infant mortality, with an increase in the incidence of children under one year of age and a greater increase in postneonatal and late neonatal mortality compared with a relatively small increase in early neonatal mortality.

Evaluating the Knowledge, Attitudes, and Practices of Exclusive Breastfeeding among Mothers Attending Postnatal at the Kenema Government Referral Hospital

Introduction: Exclusive breastfeeding offers both mothers and infants vital psychological and health benefits. However, its practice has declined globally, including in Sierra Leone, where inappropriate feeding practices contribute to high infant mortality. Malnutrition causes 60% of 10.9 million infant deaths, which are often linked to poor breastfeeding habits. Addressing cultural barriers and misconceptions is key to promoting exclusive breastfeeding. The findings of this study will guide policymakers in designing strategies to improve breastfeeding practices and reduce infant mortality nationwide. Aim: This study aimed to evaluate the knowledge, attitudes, and practices toward exclusive breastfeeding among mothers attending a postnatal clinic at the Kenema Government Referral Hospital. Method: This cross-sectional descriptive study evaluated the knowledge, attitudes, and practices (KAPs) of exclusive breastfeeding among 233 mothers attending the postnatal clinic at Kenema Government Referral Hospital. Data were collected via a structured questionnaire based on the health belief model (HBM). Stratified random sampling was employed, and face-to-face interviews were conducted in local languages. Statistical analysis included chi-square tests and logistic regression to determine associations and predictors of exclusive breastfeeding. Ethical approval was obtained, and participant confidentiality was maintained throughout the study. Result: Among the 233 mothers, 96.1% were aware of exclusive breastfeeding (EBF), with healthcare workers being the primary source (78.5%). Approximately 55.8% knew that EBF should last for six months, but 25.3% discarded colostrum. A positive attitude towards breastfeeding was reported by 59.1% of mothers, with 75.6% practising EBF on demand. Chi-square tests revealed significant associations between knowledge (p = 0.0004), attitude (p = 0.017), and EBF. Logistic regression revealed that knowledge (OR = 2.12) and attitude (OR = 1.57) were strong predictors of EBF, whereas self-efficacy showed a weaker effect (OR = 1.35). Conclusion: This study revealed that while mothers had high levels of knowledge and positive attitudes toward exclusive breastfeeding, their practices did not meet WHO recommendations. Key gaps include understanding the role of breastfeeding in pregnancy prevention and milk production. Enhanced public awareness, government policy integration, and future research on sociocultural factors are recommended.

Polygenic Selection and Environmental Influence on Adult Body Height: Genetic and Living Standard Contributions Across Diverse Populations.

We analyzed whole-genome sequencing (WGS) data from 51 populations and combined WGS and array data from 89 populations. Multiple types of polygenic scores (PGS) were employed, derived from multi-ancestry, between-family genome-wide association study (GWAS; MIX-Height), European-ancestry, between-family GWAS (EUR-Height), and European-ancestry siblings GWAS (SIB-Height). Our findings demonstrate that both genetic and environmental factors significantly influence adult body height between populations. Models that included both genetic and environmental predictors best explained population differences in adult body height, with the MIX-Height PGS and environmental factors (Human Development Index [HDI] + per capita caloric intake) achieving an R2 of .83. Our findings shed light on Deaton's 'African paradox', which noted the relatively tall stature of African populations despite poor nutrition and childhood health. Contrary to Deaton's hypotheses, we demonstrate that both genetic differences and environmental factors significantly influence body height in countries with high infant mortality rates. This suggests that the observed tall stature in African populations can be attributed, in part, to a high genetic predisposition for body height. Furthermore, tests of divergent selection based on the QST (i.e., standardized measure of the genetic differentiation of a quantitative trait among populations) and FST (neutral marker loci) measures exceeded neutral expectations, reaching statistical significance (p < .01) with the MIX-Height PGS but not with the SIB-Height PGS. This result indicates potential selective pressures on body height-related genetic variants across populations.

Spatial Clustering of Infant Mortality in Uttar Pradesh, India

Infant mortality in India has significantly decreased over the past decade. Improvements in educational status, health, wealth and occupation have contributed to this reduction in infant mortality. Despite this decreasing trend, further reduction remains a major concern. Infant mortality serves as a prime indicator of sustainable development goals (SDGs). To accelerate the achievement of these goals, authorities need to focus on the effective deployment of resources. The purpose of this study is to determine the spatial distribution of infant mortality and understand the factors responsible for higher infant mortality rates. The study contains data from 8627 sampling units (as provided in Civil Registration System (CRS) records), representing the number of children born. Infant mortality rates were calculated, and a spatial statistic was used to identify clusters of total infant mortalities in space. A clustered pattern of areas with higher Infant mortality was observed. Hence, prioritizing these areas with higher Infant mortality and considering the responsible factors for interventions is advisable.. KEYWORDS :Spatial, Spatial-temporal, Clustering, Infant mortality.

Evaluation of Achievement of Health Nutrition Program Indicators Mother and Child Towards the Healthy Family Index in Kalibobo District, Nabire District

Maternal and child health issues are still a serious concern for the government today. The high maternal, infant and toddler mortality rates make KIA a top priority in the Ministry's program.Health problems at the Kalibobo Health Center are still the center of attention where in 2023 there were 2 child deaths including nutritional problems. Objective: To analyze the achievement of indicators of the nutritional health program, mothers and children against the healthy family index in Kalibobo Village, Nabire Regency. Method: Observational research is descriptive. Using the Community Diagnosis (Needs Assessment) method with a cross-sectional approach. The sample size120 familiesusing cluster random sampling method. The interview results were collected and data reduction, data presentation and conclusion drawing were carried out. Results: ANC examination 74% (national target 95%), complete basic immunization 89% (national target 90%), infants aged 0-6 months who received exclusive breastfeeding 67% (national target 60%) and toddlers whose growth was monitored 75% (national target 85%). Conclusion: Based on the 4 indicators evaluated, there are 2 indicators that can be said to be successful, namely the achievement of toddlers who received complete basic immunization and infants aged 0-6 months who received exclusive breastfeeding. Suggestion: to establish cross-sector cooperation in the community so that community knowledge, attitudes, and behavior can be better in utilizing existing health services, especially maternal and child health services.

Therapeutic endoscopic retrograde cholangiopancreatography in a patient with asplenia-type heterotaxy syndrome: A case report

BACKGROUND Asplenia-type heterotaxy syndrome (HS) is rare and refers to visceral malposition and dysmorphism. It is associated with a high infant mortality rate due to cardiac anomalies, and related digestive endoscopic interventions are poorly understood. With the improved long-term prognosis of these individuals after modern cardiac surgery, intra-abdominal anomalies have become increasingly significant. CASE SUMMARY Herein, we report successful endoscopic retrograde cholangiopancreatography (ERCP) in a 14-year-old male with asplenia-type HS that involved unique imaging findings and technical difficulties. His anatomic anomalies included complex congenital heart disease, midline liver placement, an absent spleen, a left-sided inferior vena cava, and dextroposition of the stomach and pancreas. He suffered from choledocholithiasis with obstructive jaundice, and the stone was successfully extracted with a basket following endoscopic papillary balloon dilation. CONCLUSION Although anatomic anomalies in HS increase the degree of technical difficulty when performing ERCP, they can be safely managed by experienced endoscopists, as illustrated by the present case. Identifying these variations with imaging modalities and being aware of them before initiating an invasive intervention are crucial to preventing potential complications.

Strengthening Maternal and Child Health Services: Evaluating the KIA Book Training Program for Posyandu Cadres

This study explores the effects of a comprehensive training program on the skills, knowledge, and motivation of Posyandu cadres in Guntung Manggis, Banjarbaru, Indonesia—a region with notably high maternal and infant mortality rates. The sample included 68 Posyandu cadres, divided equally into intervention and control groups. The intervention group underwent an interactive, hands-on training program, which led to significant improvements in knowledge and practical skills compared to the control group. Post-training, the intervention group’s mean skills score increased from 48.24 ± 6.47 to 74.15 ± 7.85, while the control group showed no significant change. These findings suggest that comprehensive training programs, which incorporate practical and interactive components, are more effective than traditional lecture-based methods in enhancing cadre competencies. It is recommended that health authorities consider adopting such training programs on a larger scale, particularly in high-need areas, as a strategy to improve maternal and child health outcomes and reduce maternal and infant mortality rates.

Influence of Political Guidelines and National Health Strategies on Resource Mobilisation for Integrated Community Care in Burkina Faso

Background: High infant mortality and inadequate access to care have led Burkina Faso to offer integrated community care for childhood illnesses (iCCM) for many years. Studies show that uptake is low and infant and child mortality remains high. The aim of the study is to analyse the influence of policies and strategies on the implementation of community-based management of childhood illnesses. Methods: A mixed methods cross sectional study was conducted in Burkina Faso in the health districts of Boussouma and Boussé. Data was collected from February to March 2023 using interviews of 29 people and administered questionnaires to 42 health workers. Descriptive statistics and thematic analysis was used respectively for quantitative and qualitative analysis. Nvivo 14 was used for qualitative analysis.Results: Overall, 29 people from various structures and 42 health workers took part in this study. The iCCM is well described and integrated into strategic documents and several activities are planned by stakeholders. Despite this strategic commitment, geographical coverage is still insufficient, according to our respondents. Financial resources and especially health products are not enough to meet needs. Conclusions: There is effective ownership of policy orientations and guidelines, but only partial. Vigorous action is needed on governance and funding alignment. The study identified the level of institutionalisation of iCCM and the efforts needed to improve coverage, particularly in terms of funding for drugs and equipment by government.

Effects of health expenditure, death rate, and infant mortality rate on life expectancy: A case study of the United States

Understanding the factors that influence life expectancy (LEXP) is crucial for promoting economic development, as a nation's prosperity depends on the health of its population. Various socioeconomic, nutritional, lifestyle, genetic, and environmental factors can significantly impact a nation’s health and longevity. Our study investigates these drivers of LEXP, focusing on the United States as a case study. Using quarterly data from 2000 to 2022, we examined the relationship between LEXP and multiple determinants, including environmental degradation, income levels, inflation dynamics, educational attainment, birth and death rates, health expenditure patterns, urbanization trends, and infant mortality rates. Employing advanced analytical methodologies, we accounted for the nonlinear nature of the time series data by utilizing approaches such as quantile-on-quantile Kernel Regression Least Squares and quantile-on-quantile Granger causality. The study revealed that factors such as inflation rate, rapid urbanization, high birth rates, CO2 emissions, death rates, and infant mortality negatively affect LEXP. On the other hand, higher income levels, educational attainment, food production, and health expenditure positively influence LEXP. Based on these findings, we have proposed significant policy recommendations.

IMPACTO DA PNEUMONIA NA MORTALIDADE INFANTIL: ANÁLISE HOSPITALAR NO ESTADO DA BAHIA

Introduction: Pneumonia is a severe respiratory infection, often caused by bacteria, viruses, or fungi, that primarily affects the lungs and can impair gas exchange, leading to respiratory difficulties. In Brazil, pneumonia presents a significant public health challenge, with a particular impact on children under five years of age. This issue is especially evident in the state of Bahia, where the infant mortality rate due to pneumonia is one of the highest in the country. The causes of this high mortality are linked to a combination of factors such as lack of access to adequate medical care, low vaccination coverage, poor living conditions, overcrowded homes, and insufficient air quality. Objectives: The main objective of this study is to analyze the impact of pneumonia on infant mortality in the state of Bahia, focusing on hospital data analysis between 2020 and 2024. The research aims to identify the epidemiological trends of the disease, understand the associated risk factors, and encourage the implementation of public policies to reduce infant mortality caused by pneumonia. Justification: This research is relevant to public health because it highlights the persistent high rates of infant mortality due to pneumonia, a critical issue in socially vulnerable areas. The study contributes to understanding the social, economic, and healthcare access factors affecting the child population in Bahia, providing essential data for more effective public health policies. Methodology: The study is of an epidemiological nature, using a quantitative approach. Data were collected from records of pediatric pneumonia cases provided by the Health Department of the State of Bahia (SESAB) and DATASUS, covering the period from 2020 to 2024. Data on incidence, mortality, demographic characteristics (age, sex, race/ethnicity), and regional conditions were analyzed. The analysis was performed using descriptive statistics and techniques such as calculating mortality rates and identifying risk factors. Results and Discussion: The data revealed that between January 2020 and September 2024, there were 295 deaths due to pneumonia in children in Bahia. The highest mortality was observed in the age groups under 1 year (33.6%) and 1 to 4 years (37.3%), indicating extreme vulnerability of these age groups to the disease. Additionally, pneumonia mortality was higher among children of mixed-race (parda) background (76.3%), reflecting socioeconomic and healthcare access inequalities, particularly in peripheral and rural areas. A slight predominance of deaths among girls was also observed, though the gender difference was small (2.37%). Conclusion: This study highlights the social and regional inequalities contributing to high infant mortality from pneumonia in Bahia, emphasizing the difficulties in accessing healthcare services in more vulnerable areas. The analysis revealed that children under 5 years of age, especially those under 1 year old, are the most affected. To reduce these rates, it is urgent to implement public policies focused on improving healthcare access, expanding vaccination coverage, and strengthening living conditions in the most underserved areas of Bahia.

Parent Narratives Provide Perspectives on the Experience of Care in Trisomy 18.

Trisomy 18 syndrome, also known as Edwards syndrome, is the second most common autosomal chromosome syndrome after Down syndrome. Trisomy 18 is a serious medical disorder due to the increased occurrence of structural defects, the high neonatal and infant mortality, and the disabilities observed in older children. Interventions, including cardiac surgery, remain controversial, and the traditional approach is to pursue pure comfort care. While the medical challenges have been well-characterized, there are scant data on the parental views and perspective of the lived experience of rearing a child with trisomy 18. Knowledge of the parental viewpoints can help clinicians guide families through decision-making. Our aim was to identify parents' perspectives by analyzing a series of narratives. In this qualitative study, we collected 46 parent narratives at the 2015 and 2016 conferences of the Support Organization for Trisomy 18 & 13 (SOFT). The participants were asked to "Tell us a story about your experience." Inductive content analysis and close reading were used to identify themes from the stories. Dedoose, a web-based application to analyze qualitative data, was used to code themes more systematically. Of the identified themes, the most common included Impact of trisomy 18 diagnosis and Surpassing expectations. Other themes included Support from professionals, A child, not a diagnosis, and Trust/lack of trust. We examined the voice and the perspectives of the parents in their challenges in caring for their children with this life-limiting condition. The exploration of the themes can ideally guide clinicians in their approach to the counseling and care of the child in a shared decision-making approach.

Analysis Of Occupational Safety and Health Promotion Implementation On Employees At Pt. Siantar Ice Factory

Background: Mortality rates over time can describe the state and development of public health. Maternal Mortality Rate is one of the important indicators in determining the health of the community. Improving the health status of mothers and children (KIA) is still one of the main priorities in health development in Indonesia, due to the still high Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Indonesia.Objectives: o analyze the implementation of occupational safety and health promotion for Employees at PT. Pabrik Es Siantar.Research method: ualitative method with a qualitative descriptive approach that does not provide treatment to research subjects with qualitative research that aims to explore a problem with detailed limitations, as well as in-depth data collection.Results: The number of informants in this study was 7 people. Data collection was carried out using an in-depth interview method equipped with a voice recorder to 7 informants. Based on the results of the research conducted, the results of the analysis showed that there were still many employees who worked but still ignored the importance of K3 such as not using PPE while working which is one of the things that must be worn while working. this can endanger workers because the risk of work accidents while working is very high, including in the production section.Conclusion: promotion and occupational safety and health facilities are quite good, only employee awareness is still lacking. Suggestions that can be given are Suggestions that can be given are to carry out supervision of all work processes that are further improved so that workers do things outside of work procedures, and to equip personal protective equipment in each division according to their work.

Debuting an innovative model for integrated child health care in the Southeast region, Bulgaria

Abstract Background Demographic indicators are fundamental drivers for health policy action. The Southeast Region (SER) is the largest statistical region (NUTS 2) in Bulgaria (BG), distinguished by the highest Infant mortality rates (IMR) and teenage crude fertility rates across the European Union (EU). For instance, the 2022 statistics reveal an IMR of 8.2 per 1000 live births in SER, notably higher than Bulgaria’s average of 4.8 and the EU’s average of 3.3. This disparity highlights the critical need for region-specific health initiatives aimed at curtailing IMR and harmonizing health outcomes throughout the EU territories. This report outlines such an initiative under the project code BG16FFPR003-2.001-012, recently funded by the EU. The novel SER initiative: This is the first presentation of the concept of integrated territory investments (CITI) and the innovative model for integrated child health care in SER, BG. The project impacts child health care across the four districts of SER - Burgas, Sliven, Yambol, Stara Zagora. The municipalities have collaboratively submitted 24 project proposals with educational bodies, NGOs, public institutions, and the Ministry of Health. The theoretical frame of the project’s model is underpinned by three foundational pillars: 1) Prevention in primary healthcare; 2) Child health care in hospitals; 3) Development of human resources, providers of health care. The forthcoming infrastructural, organisational, and capacity-building interventions will remain adaptable yet aligned with the overarching CITI framework. Conclusions A current phase of public discourse on the CITI concept and the innovative integrated model in SER is underway. Stakeholders are actively encouraged to provide input either through discussions or by participating in designated online surveys. Community engagement is instrumental in evaluating and prioritizing these initiatives, which aim to fundamentally transform the SER by leveraging its unique territorial potential. Key messages • Demographic indicators drive health policy. Project BG16FFPR003-2.001-012 targets EU disparities, lowering IMR and balancing fertility rates. • This is the first presentation of the “Innovative model for integrated child health care in SER”. The EPH Conference provides an ideal platform for sharing and discussion.

Prediction model for early diagnosis of late-onset sepsis in preterm newborns.

Late-onset neonatal sepsis has a high mortality rate in premature infants. To date, no single test in the evaluation of neonatal sepsis has been demonstrated to be both sensitive and specific enough to assist in timely decision making. The aim of our study is to develop a predictive model that can be applied to all premature babies, using clinical and laboratory findings in premature babies, to recognize late-onset neonatal sepsis. 65 premature patients diagnosed with culture-proven late-onset neonatal sepsis and hospitalized in Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital neonatal intensive care unit between January 2018 and December 2020, and 65 premature newborns of similar age and gender who did not have sepsis were included in the study retrospectively. In our study, feeding difficulties, worsening in clinical appearance and fever were found to be significant among clinical findings, while thrombocytopenia and high C-reactive protein among laboratory findings are the strongest data supporting late-onset neonatal sepsis. In multiple regression analysis, thrombocytopenia, mean platelet volume, C-reactive protein, lymphocyte count and feeding difficulties had the highest odds ratio (p < 0.05). By converting these data into a scoring system, a nomogram was created that can be easily used by all clinicians. In our study, we developed a scoring system that can be easily applied to all premature patients by evaluating the clinical and laboratory findings in late-onset neonatal sepsis. We think that it will help in recognizing late-onset neonatal sepsis and strengthening the treatment decision. Predicting the individual probability of sepsis in preterm newborns may provide benefits for uninfected newborns to be exposed to less antibiotics, not to be separated from mother and baby, and to reduce healthcare system expenditures. The nomogram can be used to assess the likelihood of sepsis and guide treatment decision.

Child health in the first 100 years of Republic of Türkiye: a story of hope, labor and success.

The Republic of Türkiye commemorated its 100th year in 2023. Within one century, a battle weary, poor country has changed into a powerful, game changing leader in the world. This was accomplished by the motivation and overwork of the Turkish nation and a great leader, Mustafa Kemal Atatürk. The status of child health in 1923 can be summarized as high infant and under-five mortality rates, epidemic diseases and hardly any healthcare facilities and health-care professionals. Since a healthy, well educated workforce was one of the main requirements for the development of the young republic, child health was given a great emphasis. With the efforts of the whole nation, many children's hospitals were established, infant mortality decreased, and malaria, neonatal tetanus, polio and diphtheria were eradicated. In this article, the progression of child health in the first 100 years of the Republic of Türkiye will be reviewed.

Fatalism or vigilance? Exposure to infant and maternal deaths and subsequent use of maternal health services in Malawi

In developing contexts, where formal health services are still expanding, understanding what factors discourage individuals from using health services is critical to advance population health. A long theorized, but rarely investigated, conjecture is that in high-mortality contexts, exposure to death can beget fatalism, or even foster distrust of formal healthcare, locking families into cycles of low use of health services. A counter perspective, however, suggests exposure to death can encourage individuals’ health vigilance, corresponding with their higher use of health services. We test these competing ideas by analyzing the associations between women’s intimate exposure to death in the context of pregnancy and delivery via (1) a sister’s maternal death and (2) an infant child’s neonatal death, and their subsequent use of maternal health services. We focus on the context of Malawi, a setting that features high maternal and infant mortality rates, similar to those observed across much of sub-Saharan Africa, as well as persistent gaps in service use. Specifically, we use Malawi Demographic and Health Survey (2015–16) data to examine if a sister’s maternal death or a child’s neonatal death corresponds with a woman’s odds of attending full antenatal care during a subsequent pregnancy or delivering the pregnancy at a formal health facility. Given the qualitatively distinct nature of losing one’s only or first child, we also assess if the effect of a child’s neonatal death varies by birth order. The results show that maternal and neonate death exposures correspond generally with women’s higher use of maternal health services, challenging the notion that exposure to death fosters fatalism or distrust. Although the results vary in significance, the nuanced findings highlight women’s vigilance in the face of health threats, emphasizing their resilience amid a high burden of familial loss.

Analisis performa inkubator grashof dengan menggunakan lampu LED sebagai pemanas

The high infant mortality rate that occurs between the time after the baby's birth and the time when the baby is not exactly one year old is due to hypothermia/hypertermia, insufficient access to doctors and inability to pay for the use of pre-natal care equipment. Research has been conducted on the analysis of the performance of grashof incubators using LED lamps and copper fiber as heaters to determine the efficiency of LED lights when used for heating in a baby incubator (grazhof inkubator). The results of the research show that 20 watt LED lamp with the addition of fibre as a medium for the heating of air inside incubators is more efficient in tempering the air to reach a temperature of 35oC compared to a 25 watt fiber lamp that does not use a heater fiber. Temperature testing in a baby incubator is measured using a K-type thermocouple due to good accuracy and high sensitivity to temperature changes that need to be monitored in real time. From the results of the analysis of energy efficiency and heating speed (free convection) obtained results that show that with the addition of copper syrup as a heating medium in the incubator has a real influence on the speed of heating air inside the incubators.