Hospitalization Rates In Children Research Articles

Overview of Respiratory Tract Infections among Children under Five Years in Ghana

It is well-documented that respiratory tract infections, especially in children, have the highest incidence and mortality rates in developing countries. Infections of the sinuses, throat, airways, and lungs are collectively referred to as Respiratory Tract Infections by the National Health Services (NHS). According to the statistics, in Ghana, the seasonal patterns of reported paediatric cases were different in the Northern sector than in the Central and Southern sectors. Hospitalization rates for children in the Volta Region showed clear seasonal trends, with most ailments being more common during the dry seasons than the wet ones. The purpose of this study is to examine respiratory tract infections among children under five years in Ghana. This will give readers and policy makers the nature and the condition of RTIs among children in Ghana. The study used the systematic review method to achieve this objective. The type of systematic review method used was the rapid review, which uses existing research documents and data to draw new findings.
 The study found that, there is high rate of respiratory tract infections among children in Ghana. This is attributed to many factors. Poor breastfeeding and supplemented eating in early life may lead to childhood wasting, the leading cause of mortality in under-5s with poorer RTI worldwide. Severe acute malnutrition is one of numerous socioeconomic variables that have increased pneumonia, diarrheal illness, and malaria prevalence and severity. Other variables that have contributed to this rise including low birth weight, under-vaccination, parental smoking, early childhood respiratory impairment owing to indoor air pollution, other diseases, and overcrowding.
 This study recommends that, much attentions should be given to children in Ghana. Prevention strategies for RTIs include frequent nutritional programs, campaigns, and education in the district to address stunting and underweight in children younger than five, as well as correct complementary feeding. Further population-based study in different parts of Ghana might strengthen these results.

Palivizumab Prophylaxis in Infants and Young Children at Increased Risk of Hospitalization for Respiratory Syncytial Virus Infection.

Guidance from the American Academy of Pediatrics (AAP) for the use of palivizumab prophylaxis against respiratory syncytial virus (RSV) was first published in a policy statement in 1998. AAP recommendations have been updated periodically to reflect the most recent literature regarding children at greatest risk of severe RSV disease. Since the last update in 2014, which refined prophylaxis guidance to focus on those children at greatest risk, data have become available regarding the seasonality of RSV circulation, the incidence and risk factors associated with bronchiolitis hospitalizations, and the potential effects of the implementation of prophylaxis recommendations on hospitalization rates of children with RSV infection. This technical report summarizes the literature review by the Committee on Infectious Diseases, supporting the reaffirmation of the 2014 AAP policy statement on palivizumab prophylaxis among infants and young children at increased risk of hospitalization for RSV infection. Review of publications since 2014 did not support a change in recommendations for palivizumab prophylaxis and continues to endorse the guidance provided in the 2021 Red Book.

Increased Rates of Hospitalized Children with Type 1 and Type 2 Diabetes Mellitus in Central Brooklyn during the COVID-19 Pandemic.

Following reports of increased new-onset diabetes and worse severity of DKA for children with diabetes following SARS-CoV-2 infection, we studied hospitalization rates for children with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in our center during the citywide shutdown. Methods. We conducted a retrospective chart review of children admitted to our two hospitals from January 1, 2018, to December 31, 2020. We included ICD-10 codes for diabetic ketoacidosis (DKA), hyperglycemic hyperosmolar syndrome (HHS), and hyperglycemia only. Results. We included 132 patients with 214 hospitalizations: 157 T1DM, 41 T2DM, and 16 others (14 steroid induced, 2 MODY). Overall admissions rates for patients with all types of diabetes were 3.08% in 2018 to 3.54% in 2019 (p = 0.0120) and 4.73% in 2020 (p = 0.0772). Although there was no increase of T1DM admissions across all 3 years, T2DM admission rates increased from 0.29% to 1.47% (p = 0.0056). Newly diagnosed T1DM rates increased from 0.34% in 2018 to 1.28% (p = 0.002) in 2020, and new-onset T2DM rates also increased from 0.14% in 2018 to 0.9% in 2020 (p = 0.0012). Rates of new-onset diabetes presenting with DKA increased from 0.24% in 2018 to 0.96% in 2020 (p = 0.0014). HHS increased from 0.1% in 2018 to 0.45% in 2020 (p = 0.044). The severity of DKA in newly diagnosed was unaffected (p = 0.1582). Only 3 patients tested positive for SARS-CoV-2 infection by PCR. Conclusion. Our urban medical center is located in Central Brooklyn and serves a majority who are Black. This is the first study investigating pediatric diabetes cases admitted to Brooklyn during the first wave of the pandemic. Despite the overall pediatric admissions declining in 2020 due to the citywide shutdown, overall hospitalization rates in children with T2DM and in new-onset T1DM and T2DM increased, which is not directly associated with active SARS-CoV-2 infection. More studies are needed to elucidate the reason for this observed increase in hospitalization rates.

Types of upper and lower respiratory tract infection in pediatrics

The most prevalent diseases in infants and children, are respiratory infections including the common cold, acute rhinosinusitis, acute otitis media, flu-like illness, acute bronchitis, and pneumonia. Despite being mostly innocuous, they have a large negative impact on society and are a leading source of morbidity and mortality globally. They are further divided into two classes upper respiratory tract and lower respiratory tract infections. The purpose of this research is to review the available information about types of upper and lower respiratory tract infection in paediatrics. The common upper respiratory tract infections include acute pharyngitis which is usually self- limiting and benign and is mostly caused by viruses while inflammation of the mucosa of the paranasal sinuses and nasal cavity is a sign of acute rhinosinusitis. Common colds frequently come with uncomplicated rhinosinusitis, which does not have any clinically visible spread of the inflammation outside the paranasal sinuses and nasal cavity. A viral or bacterial infection of the middle ear causes acute otitis media. Bronchitis, bronchiolitis and pneumonia are lower respiratory infections common among children. More than one-third of children develop bronchiolitis in the first two years of life, which is the most common reason for hospitalization in the first year of life. The hospitalization rate for children has increased from 1% to 3% over the past 30 years while pneumonia is a significant contributor of morbidity and mortality among under 5 years children. Early diagnosis and prompt management can lead to better health outcomes among children.

Burden of Pediatric SARS-CoV-2 Hospitalizations during the Omicron Wave in Germany.

(1) Background: When the Omicron variant of SARS-CoV-2 first emerged in Germany in January 2022, data on related disease severity among children and adolescents were not yet available. Given Omicron’s high transmissibility, the ability to assess its impact on admission and hospitalization rates in children’s hospitals is critical for the purpose of understanding the scope of its burden on the German healthcare system. (2) Methods: From 24 January 2022 to 31 July 2022, SARS-CoV-2 cases admitted to German pediatric hospitals were monitored via a national, clinician-led reporting system (CLRS) established by the German Society for Pediatric Infectious Diseases (DGPI). Cases treated on general wards and intensive care units, as well as patient age and the need for respiratory support, were recorded. (3) Results: From January to July 2022, a median of 1.7 cases (range 0.4–3) per reporting pediatric hospital per day was hospitalized in general wards, whereas a median of 0.1 cases (range 0–0.4 cases) was admitted to intensive care units. Of all hospitalized patients, 4.2% received respiratory support. (4) Conclusions: Despite the high incidence rates documented in connection with the Omicron variant in early 2022, the number of pediatric hospital admissions, and especially the number of cases with the need for intensive care treatment and respiratory support due to symptomatic SARS-CoV-2 infection, remained relatively low. Higher Omicron incidence rates had only a modest impact on SARS-CoV-2-related admissions and hospitalization in German children’s hospitals.

Rotaviruses and Noroviruses as Etiological Agents of Acute Intestinal Diseases of Ukrainian Children.

(1) Background: Rotavirus and norovirus infections are the primary viral causes of childhood diarrhea. In Ukraine, the diarrhea-linked infant mortality rate is low, but the number of children infected is quite high. This study examined the rates of rotavirus and norovirus infections throughout Ukraine. (2) Methods: Fecal samples for children admitted to hospitals in six Ukrainian cities (Kyiv, Lviv, Sumy, Odesa, Kharkiv, and Uman) were tested for the presence of rotavirus and norovirus. (3) Results: The overall rate of hospitalized children suffering from diarrhea with confirmed presence of rotavirus or norovirus in fecal samples was significant (20.67% and 27.94%, respectively). Samples obtained from children from Lviv had significantly higher rates of the viruses, and Kyiv and Uman had significantly lower rotavirus or norovirus detection levels than expected. (4) Conclusion: Childhood diarrhea impacts Ukraine significantly. The economic and societal effects of the failure to address this public health issue are indicated by the hospitalization rate of children with preventable illnesses. The geographical disparities in Ukraine for child hospitalizations caused by rotavirus and norovirus infections could result from environmental (sanitary factors or water purity issues) or social factors. Further research is needed to completely characterize infant viral infections in Ukraine.

The youngest are hit hardest: The influence of the COVID-19 pandemic on the hospitalization rate for children, adolescents, and young adults with anorexia nervosa in a large German representative sample.

The COVID-19 pandemic has severely impacted the mental health of children and adolescents. Young people at risk for anorexia nervosa (AN) have been especially shown to be affected. There are no studies that have investigated the respective proportions of hospitalized children, adolescents, and young adults separately as well as of both sexes during the COVID-19 crisis. This study is based on the administrative data of the largest German statutory health insurance. All children (0-14 years) and adolescents (15-19 years) with a discharge diagnosis of typical and atypical AN according to the International Classification of Diseases (ICD)-10 were included. Admission rates per 10,000 person-years were calculated separately by sex and age group, based on admission numbers from the 9-month interval from January to September of 2019, 2020, and 2021 and the number of insured persons per sex and age group of each year. The entire sample comprised approximately 4.7 million children and adolescents. There was a highly significant increase of 40% (relative risk (RR): 1.4; [1.27, 1.55]; p < 0.0001) in admission rates in the female children's and the adolescents' group (RR:1.32; [1.24, 1.41]; p< 0.0001) between the pre-COVID-19 and peri-COVID-19 periods in 2019 and 2021, respectively. Among males, hospitalization rates significantly increased in the children (RR: 1.69; [1.09, 2.62]; p < 0.02). Young people appear to be especially prone to develop AN during a crisis, such as with social isolation and school closures. Home-based or mobile pediatric services should be established to prevent this often chronic and disabling disorder in young patients.

English

Increasing cases of COVID-19 have been reported in children globally. Admission frequency, though, is significantly lower than adults in COVID-19. Recent evidence suggests that children likely have the same or higher viral loads. Our study is retrospective, with the purpose to describe the clinical spectrum of this disease in children and response of treatments, along with its effect in the neonatal period. As very few cases have been encountered with severe disease, and are illustrated in this study, attempting to understand the course of severe illness. Globally and, as compared with adults, fewer cases of COVID-19 have been reported in children (age 0 - 17 years).1,2 Hospitalization rates in children are significantly lower than hospitalization rates in adults with COVID-19, suggesting that children may have a less severe illness from COVID - 19 compared to adults.3,4 Recent evidence suggests that children likely have the same or higher viral loads in their nasopharynx compared with adults,5,6 and those children can spread the virus effectively in households and camp settings.7,8 At our institute, 10 % of the total COVID-19 cases were from the paediatric population. Among the early neonatal period following delivery to a COVID positive mother, most of them were FT deliveries (83 %), with the majority delivered vaginally. In relation to PT cases, all were delivered vaginally including 4 cases of documented intrauterine device (IUD) by induction of labour with a zero transplacental transmission rate. Out of positive cases in the perinatal period, all were presented as necrotizing enterocolitis (NEC). In the paediatric age group of 1 month – 17 years, varied symptoms were present. Children having comorbidities contributed to poor prognosis.

Effectiveness of Smartphone-Based Community Case Management on the Urgent Referral, Reconsultation, and Hospitalization of Children Aged Under 5 Years in Malawi: Cluster-Randomized, Stepped-Wedge Trial.

BackgroundIntegrated community case management (CCM) has led to reductions in child mortality in Malawi resulting from illnesses such as malaria, pneumonia, and diarrhea. However, adherence to CCM guidelines is often poor, potentially leading to inappropriate clinical decisions and poor outcomes. We determined the impact of an e-CCM app on the referral, reconsultation, and hospitalization rates of children presenting to village clinics in Malawi.ObjectiveWe determined the impact of an electronic version of a smartphone-based CCM (e-CCM) app on the referral, reconsultation, and hospitalization rates of children presenting to village clinics in Malawi.MethodsWe used a stepped-wedge, cluster-randomized trial to compare paper-based CCM (control) with and without the use of an e-CCM app on smartphones from November 2016 to February 2017. A total of 102 village clinics from 2 districts in northern Malawi were assigned to 1 of 6 clusters, which were randomized on the sequencing of the crossover from the control phase to the intervention phase as well as the duration of exposure in each phase. Children aged ≥2 months to <5 years who presented with acute illness were enrolled consecutively by health surveillance assistants. The primary outcome of urgent referrals to higher-level facilities was evaluated by using multilevel mixed effects models. A logistic regression model with the random effects of the cluster and the fixed effects for each step was fitted. The adjustment for potential confounders included baseline factors, such as patient age, sex, and the geographical location of the village clinics. Calendar time was adjusted for in the analysis.ResultsA total of 6965 children were recruited—49.11% (3421/6965) in the control phase and 50.88% (3544/6965) in the intervention phase. After adjusting for calendar time, children in the intervention phase were more likely to be urgently referred to a higher-level health facility than children in the control phase (odds ratio [OR] 2.02, 95% CI 1.27-3.23; P=.003). Overall, children in the intervention arm had lower odds of attending a repeat health surveillance assistant consultation (OR 0.45, 95% CI 0.34-0.59; P<.001) or being admitted to a hospital (OR 0.75, 95% CI 0.62-0.90; P=.002), but after adjusting for time, these differences were not significant (P=.07 for consultation; P=.30 for hospital admission).ConclusionsThe addition of e-CCM decision support by using smartphones led to a greater proportion of children being referred to higher-level facilities, with no apparent increase in hospital admissions or repeat consultations in village clinics. Our findings provide support for the implementation of e-CCM tools in Malawi and other low- and middle-income countries with a need for ongoing assessments of effectiveness and integration with national digital health strategies.Trial RegistrationClinicalTrials.gov NCT02763345; https://clinicaltrials.gov/ct2/show/NCT02763345

A Paper-Based IL-6 Test Strip Coupled With a Spectrum-Based Optical Reader for Differentiating Influenza Severity in Children.

Influenza virus infection is a major worldwide public health problem. Influenza virus infections are associated with a high hospitalization rate in children between the ages of 5 and 14. The predominant reason for poor influenza prognosis is the lack of any effective means for early diagnosis. Early diagnosis of severe illness is critical to improving patient outcome, and could be especially useful in areas with limited medical resources. Accurate, inexpensive, and easy-to-use diagnostic tools could improve early diagnosis and patient outcome, and reduce overall healthcare costs. We developed an interleukin-6 paper-based test strip that used colloidal gold-conjugated antibodies to detect human interleukin-6 protein. These complexes were captured on a paper-based test strip patterned with perpendicular T lines that were pre-coated with anti-human interleukin-6 antibodies. Applied serum samples interacted with these antibodies and presented as colored bands that could be read using a spectrum-based optical reader. The full-spectrum of the reflected light interleukin-6 protein signal could be obtained from the spectral optics module, and the standard could be used to quantitatively analyze interleukin 6 level in serum. We retrospectively evaluated 10 children (23 serum samples) with severe influenza virus infections, 26 children (26 serum samples) with mild influenza virus infections, and 10 healthy children (10 serum samples). Our system, the combined use of a paper-based test strip and a spectrum-based optical reader, provided both qualitative and quantitative information. When used with the optical reader, the detection limit was improved from a qualitative, naked-eye level of 400 pg/ml to a quantitative, optical reader level of 76.85 pg/ml. After monitoring serum interleukin-6 level via our system, we found a high correlation between our system results and those obtainable using a conventional sandwich enzyme-linked immunosorbent assay method (Rho = 0.706, p < 0.001). The sensitivity and specificity for differentiating between severe and mild influenza using our combined method (test strip coupled with optical reader) were 78.3 and 50.0%, respectively. When interleukin-6 was combined with serum C-reaction protein, the sensitivity and specificity were 85.7 and 95.5%, and the receiver operating characteristic area-under-the-curve was quite high (AUC = 0.911, p < 0.001). The potential advantages of our system, i.e., a paper-based test strip coupled with a spectrum-based optical reader, are as follows: 1) simple user operation; 2) rapid turnaround times–within 20 min; 3) high detection performance; and, 4) low-cost fabrication.

COVID-19 hospitalization rate in children across a private hospital network in the United States: COVID-19 hospitalization rate in children

ObjectivesThere are limited studies with varying results evaluating the rate of hospitalizations of pediatric patients tested for COVID-19 in the United States. More information in the pediatric COVID-19 literature is needed. The objective of this study was to describe the rates of positive tests, hospitalization, severe disease, and mortality for COVID-19 in children. Material and MethodsWe performed a retrospective analysis of data collected from a data warehouse from 184 hospitals across the United States. All cases of pediatric patients who were tested for COVID-19 were analyzed for test positivity, hospitalization, severe disease, and mortality. A separate subgroup analysis for ages < 1 year, 1–4 years, 5–8 years, 9–14 years, and 15–17 years was performed. ResultsOf 24,781 patient encounters, we found a test positivity rate of 11.15% (95% CI: 10.76–11.55). There were 142 admissions out of the 2,709 symptomatic patients, 5.24% (95% CI: 4.43–6.15) admission rate. Of those admitted, we found that 54.93% (78/142) were admitted to the PICU, but only 22 of the 142 admissions, 15.49% (95% CI: 9.97–22.51), were determined to have severe COVID-19 disease. One patient died during the study period giving an overall pediatric mortality rate of 0.04% (95% CI: 0.00–0.21). ConclusionIn our sample, we found a test positivity rate of 11.15%. We also report a 5.24% hospitalization rate with 15.49% of admitted patients with severe disease. Lastly, we also report a very low mortality rate of 0.04% of all patients who tested positive for COVID-19.

Pediatric interregional healthcare mobility in Italy

BackgroundThe analysis of interregional healthcare mobility represents one of the main criteria for evaluating Regional Healthcare Systems, both in terms of its economic-financial relevance and the quality and satisfaction of the services provided. The aim of the study is to analyze healthcare mobility and its associated cost in Italy in 2019 for all children ≤ 14 years of age.MethodsWe collected data from the “Rapporto annuale sull’attività di ricovero ospedaliero – Dati SDO 2019” published by the Italian Ministry of Health. These data represent the tool for collecting information relating to all hospitalization services provided in accredited public and private hospitals present throughout the national territory. We collected data for all Italian regions and clustered them in two geographical areas: Center-North regions and South regions (including Sicily and Sardinia). We have analyzed the magnitude of the mobility of children among regions and in particular from the South to the Center-North and the relative cost of this interregional mobility.Results The hospitalization rate of children residing in the South regions was higher than that of children residing in the Center-North regions (13.9% vs 12.3%). Children residing in the South were more frequently treated in other regions than those living in the Center-North (11.9% vs 6.9%). Even considering the high complexity hospitalizations, children living in the South more frequently underwent treatment in other regions (21.3% vs 10.5% of the Center-North). The cost of passive mobility amounts to € 103.9 million for the South regions (15.1% of the total hospitalizations’ expenditure) and the 87.1% of this cost refers to the mobility to the hospitals of Center-North. The cost of healthcare migration from South regions to other South regions was much lower (12.9%, equal to € 13.4 million).ConclusionsHealthcare mobility, while affecting all Italian regions, is particularly relevant in the South regions and indicates a lack of pediatric care, which should be strengthened by creating services that are currently not evenly distributed throughout the territory.

The impact of 10-valent pneumococcal conjugate vaccine upon hospitalization rate of children with pneumonia in different Brazilian administrative regions

BackgroundStreptococcus pneumoniae is the most frequent bacterial causative agent of pneumonia. Due to its significant contribution to the morbidity and mortality profile and the country’s economy, the 10-valent pneumococcal vaccine (PCV10) was introduced in Brazil in 2010. Brazil is divided into five administrative regions which differ in social-economic indices among each other. Estimates of PCV10 impact on hospitalization rates due to pneumonia stratified by distinct Brazilian regions are limited. We assessed this issue. MethodsThis is a population-based ecological investigation. Data about hospitalizations due to pneumonia, asthma or urinary tract infection (UTI) among patients aged under 20 years in the pre-exposure (2003–2009) and in the post-exposure (2011–2017) periods were retrieved from the National Health System – Hospital Information System (SIH-SUS) database. The total resident population by age group in each year was retrieved from the Brazilian Institute for Geography and Statistics database. Hospitalization rates were estimated for each Brazilian region and the rates obtained in the pre-exposure and in the post-exposure periods were compared by Prais-Winsten regression. The Human Development Index (HDI) evolved differently in the distinct regions during the study period. ResultsOverall, hospitalization rates due to pneumonia declined by 34.5%. Similar trends were observed for hospitalization rates due to asthma and UTI. The same pattern was observed in each Brazilian region. However, the North region was the only one that presented an exponential incidence decline pattern, which could be explained by PCV10 implementation (declined by 10.8% in the quadratic regression, p < 0.01). Only in the North region, significant decline was observed among patients aged 0–4 years (-12.5%; p = 0.01), 5–9 years (-38.5%; p < 0.01) or 10–14 years (-10.7%; p = 0.03). ConclusionSignificant variation in the downward trend of hospitalization rate was only found in the North region, which evolved from very low HDI in 2003; medium HDI in 2010 to high HDI in 2017.

1397. Long term impact of the 13-valent pneumococcal conjugate vaccine use in infant immunization program on all-cause pneumonia hospitalizations in British Columbia, Canada: a time series analysis

BackgroundPneumonia is a leading cause of hospitalization and in-patient mortality globally. We determined the impact of 13-valent pneumococcal conjugate vaccine (PCV13) use on all-cause pneumonia hospitalization rates eight years after the vaccine was introduced in British Columbia, Canada.MethodsRoutine administrative databases, such as, hospital discharge abstract databases, registry and demographics were used to build the cohort. Overall and age-specific all-cause pneumonia hospital admissions per month (Jan 2000 to Dec 2018) for those aged < 2 years, 2-5 years, 6-17 years, 18-64 years and ≥ 65 years were obtained using International Classification of Diseases 9 and 10 codes (480-486, J12-J18). Changes in the all-cause pneumonia hospitalization incidence rates before and after the PCV13 vaccine program introduction were evaluated using a negative binomial regression and time-series modelling while adjusting for seasonality, influenza-likeness illnesses, 7-valent pneumococcal conjugate vaccine (PCV7) program and pre-PCV13 vaccine secular trends.ResultsLong term use of the PCV13 vaccine in the infant immunization program was associated with significant declines in all-cause pneumonia hospitalization rates among all children, < 2 years (IRR: 0.63; 95% Confidence Interval (CI): 0.59-0.67), 2-5 years (IRR: 0.82; 95%CI: 0.77-0.87) and 6-17 years (IRR: 0.73; 95%CI: 0.69-0.78). All-cause pneumonia rates did not change significantly in those aged 18-64 years (IRR: 0.98; 95%CI: 0.96-1), whereas a modest increase was observed in those 65 years and over (IRR: 1.05; 95%CI: 1.02-1.07). Consequently, we did not observe significant change in the overall rate (IRR: 1.02; 95%CI: 1-1.02).ConclusionSignificant reduction in all-cause pneumonia hospitalization rates in children demonstrates long term beneficial effect of PCV13 use. A modest increase in all-cause pneumonia hospitalization rates in adults aged 65 years and over indicates a need for further microbial investigation.DisclosuresNirma Khatri Vadlamudi, BA, BS, MPH, Pfizer Inc (Research Grant or Support) Fawziah Marra, BSc (Pharm), PharmD, Pfizer Inc (Research Grant or Support)

Telephone surveillance during the COVID-19 pandemic: Is it a helpful diagnostic tool for detecting acute pulmonary exacerbations in children with chronic lung disease?

Introduction The global burden of the 2019 novel coronavirus disease pandemic on the healthcare system, as well as the high transmission risk of coronavirus disease has led to the use of alternative strategies for evaluation of children with chronic conditions. In this context, telemedicine has become the effective and affordable choice. In this study we aimed to evaluate the efficiency of telephone visits to determine pulmonary exacerbations and hospitalization rates of children with cystic fibrosis and interstitial lung disease. Methods A total of 119 children with cystic fibrosis or interstitial lung disease were enrolled and provided cases in which telephone visits were applied during the peak time of the coronavirus disease pandemic in our country. The recordings of respiratory, gastrointestinal and other symptoms, nutrition status, rate of acute pulmonary exacerbation, treatments initiated by telephone visits, referral to hospital and hospitalization were established from the electronic health reports of the patients. Results Thirteen patients (10.9%) were symptomatic, 12 of them (10%) were diagnosed with acute pulmonary exacerbation. One patient was diagnosed with peripheral facial paralysis. Nine patients were recalled to the hospital and seven patients (5.8%) were hospitalised. Discussion Using telemedicine the health status of patients can be defined, and patients can be guided on proper healthcare that they need, especially during the times of pandemics which we are facing. Communication with patients while minimising the risk of exposure to coronavirus disease is an important advantage of telemedicine. Telemedicine will have to be implemented on our daily medical practice in the near future.

Regional asthma hospitalization rates and global asthma mortality rate in Chilean children.

In recent years, there has been a significant increase in asthma hospitalization rates in children, however, regional and mortality rates are yet unknown. To determine regional asth ma hospitalization rates in children and the global mortality rate in this age group. We determined asthma hospitalization rates in the 15 regions of the country existing at the time of the study, between 2008 and 2014, based on the number of hospital discharges in each region and the population at risk of hospitalization. The mortality rate was obtained using the ratio between deaths due to asthma in children aged 5 to 15 and the exposed population. the 5th region presented the highest hospitalization rate (7.6 per 10,000 inhabitants). Except for 4 regions, the median hospitalization rates of the different regions were similar to those found in the Metro politan Region. The overall mortality rate due to asthma in 5 to 15-year-old children was 0.37 per 100,000 inhabitants in the analyzed period. most regions of the country have similar hospitalization rates to the Metropolitan Region and the 5th region presents the highest hospitali zation rate due to asthma. The global mortality rate in children between 5 and 15 years old is 0.37 per 100,000 inhabitants.

Risk of Repeated Admissions for Respiratory Syncytial Virus in a Cohort of >10 000 Hospitalized Children.

The objective was to describe respiratory syncytial virus (RSV) hospitalizations in Alberta, Canada over a 13-year period with an emphasis on the incidence and risk factors for repeat hospitalizations attributable to new RSV infections. This was a retrospective database analysis. The Alberta Health Services Discharge Abstract Database was searched for patients <5 years of age admitted to any hospital with a primary diagnosis of RSV from July 1, 2004 through June 30, 2017. Clinical characteristics were compared for children with repeat RSV admission during the same RSV season (but >30 days apart so presumably due to separate infections) compared with all other children with RSV admissions. During the study period, 10 212 children had 10 967 RSV admissions. The RSV hospitalization rate was 1.6%. A total of 666 children (6.5%) were readmitted for RSV at least once during the study period, of whom 433 (4.2%) were readmitted within 30 days of the initial hospital discharge. There were 36 children (0.35%) with 2 RSV admissions >30 days apart during the same RSV season. When compared to all other children with RSV admissions, they were more likely to have congenital heart disease or to have been diagnosed with RSV pneumonia (vs bronchiolitis or upper respiratory tract infection) during their initial hospitalization. The RSV hospitalization rate in children <5 years of age was 1.6%. Repeat RSV infections requiring readmission during the same RSV season occurred following only 0.35% of RSV hospitalizations.

Trends of Hospitalization for Acute Alcohol Intoxication in Slovenian Children and Adolescents with and without Dual Disorder. Implications for a Correct Intervention.

Background: Binge drinking and other forms of ethanol abuse are, when present, a serious problem in preteens and adolescents worldwide. Aim: The present study has analyzed the trend in alcohol-related intoxications requiring the hospitalization of children, adolescents and young adults aged less than 21 years in Slovenia in the 1999–2018 period. Methods: We performed a retrospective study on patients discharged after hospitalizations due to mental and behavioral disorders due to acute alcohol intoxication (MBDAAI) or hospitalizations due to the toxic effects of alcohol (TEA We considered three groups: children (aged 10–14), adolescents (aged 15–19) and young adults (20–21 years old). Hospitalization rates and time trends were analyzed using joinpoint regression to obtain the annually calculated age- and sex-specific rates and the annual percentage of change (APC). Results: Considering a total of 2912 MBDAAI-hospitalizations, 15–19-year-old subjects showed a significantly higher hospitalization rate compared to the immediately younger and older age groups and a significant increase in hospitalization rates in the period 1999–2011, followed by a significant decrease. Considering 1143 TEA-hospitalizations, we observed a continuous decrease in the hospitalization rates for children and young adults and, conversely, a continuous even if less than significant increase for adolescents aged 15–19. Conclusions: Alcohol consumption in Slovenian children and adolescents is a highly important health concern. Special attention to public health problem of severe alcohol abuse requiring hospitalization in children and adolescents is needed, especially with possible crisis of SARS-CoV-2/Covid-19 situation.

The association between timely opioid administration and hospitalization in children with sickle cell disease presenting to the emergency department in acute pain.

The National Heart, Lung, and Blood Institute guidelines for sickle cell disease (SCD) pain crisis management recommend opioids within 60 minutes of emergency department (ED) registration and every 30 minutes thereafter until acute pain is managed. These guidelines are based on expert opinion without published, supporting data. To evaluate the association between timely ED opioid administration and hospitalization rates in children with SCD. Retrospective cohort of children presenting to a children's hospital ED with SCD pain between January 1, 2014, and April 30, 2018. Visits were extracted using ICD codes, chief complaints, and receipt of at least one opioid, and then reviewed to confirm the visit was an uncomplicated pain crisis. The primary outcome was hospitalization, yes or no. Generalized estimating equations were used to determine adjusted odds of hospitalization for the timely administration of initial and second doses of opioids. Of the 902 eligible visits, 368 (40.8%) resulted in hospitalization. The mean (SD) age was 11.9 (± 5.2) years. The first opioid was administered within 60 minutes of arrival in 601 (66.6%) visits. The second opioid was administered within 30 minutes of the first in 84 (12.3%) visits. Receipt of the first opioid within 60 minutes of arrival was not associated with decreased hospitalization (1.30 [0.96-1.76]). However, receipt of the second dose within 30 minutes of the first was associated with decreased hospitalization (0.56 [0.33-0.94]). This study suggests an association between children with SCD receiving a second dose within 30 minutes of the first opioid dose and decreased hospitalizations.

Şanlıurfa’nın Halfeti ilçesindeki akut gastroenteritli çocuklarda rotavirüs ve adenovirüs sıklığı

Background/Aim: Enteric viruses (rotavirus, adenovirus, norovirus, etc.) have been reported as the most common cause of non-bacterial acute gastroenteritis. Rotavirus can cause severe fluid and electrolyte imbalance and the development of fatal complications during the course of the disease if not diagnosed and treated early. The aim of study was to evaluate the frequency, epidemiological characteristics, clinical and laboratory data of rotavirus and enteric adenovirus agents in children presenting with diarrhea. Material and Method: The records of patients with diarrhea between ages of 0-12 who applied to Halfeti State Hospital between July 2017 and July 2019 and diagnosed with acute gastroenteritis and whose rotavirus and enteric adenovirus tests (examined by immunochromatographic methods) were requested were evaluated retrospectively. The frequency of rotavirus and adenovirus gastroenteritis, demographic data, clinical status, laboratory findings of these patients; age groups, gender and seasonal distribution were examined. SPSS 25.0 package program was used for statistical analysis. Results: 640 patients were included in the study. The median age of the patients was 22 months and 57% were male. Rotavirus was detected in 40% of the patients and adenovirus was found in 10.2% of the patients. It was found that the hospitalization rates of children with positive rotavirus were higher than other groups. The children with rotavirus are mostly in winter; children with adenovirus mostly in spring; rotavirus and adenovirus negative children were admitted to the emergency department mostly during the summer months. Conclusion: Viral agents constitute an important part of acute gastroenteritis in our region. It was found that stool examinations were important in the diagnosis of rotavirus and adenovirus gastroenteritis causing high mortality and morbidity. We think that unnecessary antibiotic use will decrease with appropriate treatment and the incidence of the disease and hospitalization cost burden will decrease with increasing rotavirus vaccination rates for Turkey.