Infectious Disease In Young Children Research Articles

Experimental animal models for development of human enterovirus vaccine.

Enterovirus infections induce infectious diseases in young children, such as hand, foot, and mouth disease which is characterized by highly contagious rashes or blisters around the hands, feet, buttocks, and mouth. This predominantly arises from enterovirus A71 or coxsackievirus A16 infections and in severe cases, they can lead to encephalitis, paralysis, pulmonary edema, or even fatality, representing a global health threat. Due to the absence of effective therapeutic strategies for these infections, various experimental animal models are being investigated for the development of vaccines. During the early stages of research on enterovirus infections, non-human primate infections exhibited symptoms like those in humans, leading to their utilization as model animals. However, due to economic and ethical considerations, their current usage is limited. While enterovirus infections do not readily occur in mice, an infection model with mouse-adapted strain in neonatal mice has been employed. Cellular receptors have been identified in human cells, and genetically modified mice expressing these receptors have been used. Most recently, the utilization of Mongolian gerbil model is actively being considered and should be pursued for further animal model development. So, herein, we provide a summarized overview of the current portfolio of available enterovirus infection models, emphasizing their respective advantages and limitations.

Evidence on postbiotics in infants and children.

The aim is to provide updated information on the concept of postbiotics and recent data on the efficacy of postbiotics for the prevention and treatment of childhood diseases. In line with a recently proposed consensus definition, a postbiotic is 'a preparation of inanimate microorganisms and/or their components that confers a health benefit on the host'. Although inanimate, postbiotics may exert health benefits. There are only limited data on infant formulas containing postbiotics, but they are well tolerated, support adequate growth and demonstrate no potential identifiable risks, although clinical benefits remain limited. Currently, there is only limited support for postbiotic use for treating diarrhoea and preventing common paediatric infectious diseases in young children. Given the limited evidence, sometimes with a high risk of bias, caution is justified. No data in older children and adolescents are available. The consensus definition of postbiotics facilitates further research. As not all postbiotics are the same, the type of disease and specific postbiotic studied should be considered when choosing postbiotics for the prevention or treatment of childhood diseases. Additional studies are needed to assess disease conditions responsive to postbiotics. Mechanisms of action of postbiotics need to be evaluated and characterized.

Rainfall variability and risk of infectious diseases in young children: a global analysis

Preventable infectious diseases, such as pneumonia and diarrhea, are the leading cause of child death under the age of five worldwide. Populations in low- and middle-income countries bear the brunt due to poor living conditions which are conducive to such diseases. Increasing climate variability due to climate change will undermine future efforts to control infectious diseases. This paper provides new empirical evidence on the link between climate variability and human infectious diseases, focusing on symptoms of cough, fever and diarrhea in children under the age of five. We use the most recent Demographic and Health Surveys (DHS) for 20 low- and middle-income countries (n=450,000) in combination with high resolution climate data. A standardised measure of precipitation anomalies is constructed, which allows assessing the relationship between both dry and wet spells and the selected symptoms. Multi-level logistic regression with a random effect for the primary sampling unit and sampling weights and meta-analysis techniques are employed in the study. The preliminary results show that excessive precipitation raises the risk of diarrhoea, cough and fever among children under five years of age in 12 of the 20 countries examined. Unimproved sanitation and unsafe drinking water sources were key drivers of these associations. Effect measure modification analysis reveals that sharing a toilet with other families modifies the risk of these three diseases. As a next step, we plan to conduct a meta-analysis examining standardized precipitation anomalies and these three health outcomes to generate a pooled estimate of risk across all LMICs in the study. The present study calls for urgent action to expand water supply and improve access to safe sanitation facilities in the world’s poorest countries.

Causes of violation of vaccination schedule in young children

The high frequency of severe and complicated forms of infectious diseases in young children, with the possibility of death, confirms the importance of timely specific protection of this age group. In order to identify the causes of violation of the terms of vaccination of young children, 469 histories of children from 0 to 12 months of life were studied. The analysis showed that only 77% of the observed children in the first year of life were vaccinated according to the immunization schedule, whereas in 23% of cases, violations of the vaccination status were found. In 45% of children, the time of immunization was violated already at the stage of the maternity hospital: only every fifth child was not vaccinated because of health reasons, while 79% of children did not receive prophylactic vaccinations due to the mother’s refusal. Medical abductions prevailed in the structure of violations of vaccination terms in the сhildren’s оutpatient: 39% of children were vaccinated with deviations from the schedule due to temporary contraindications, 22% were vaccinated later than terms due to unreasonable medical leads. In 39% of cases of violation of vaccine status is associated with a misunderstanding of the parents of the risk of infectious diseases and the effectiveness of the child’s protection through immunization. Of these, 22% of children were denied, 10% of children were vaccinated with a significant delay, 7% of children did not reach the сhildren’s оutpatient during the year without an explanation of the reasons. Thus, the analysis showed that the majority of the observed children (57%) did not receive timely protection against infectious diseases due to attitudes towards vaccinations of parents, 43% of children were not vaccinated due to medical abductions.

Dynamic Properties of Tympanic Membrane in a Chinchilla Otitis Media Model Measured With Acoustic Loading.

Otitis media is the most common infectious disease in young children, which results in changes in the thickness and mechanical properties of the tympanic membrane (TM) and induces hearing loss. However, there are no published data for the dynamic properties of the TM in otitis media ears, and it is unclear how the mechanical property changes are related to TM thickness variation. This paper reports a study of the measurement of the dynamic properties of the TM in a chinchilla acute otitis media (AOM) model using acoustic loading and laser Doppler vibrometry (LDV). AOM was created through transbullar injection of Haemophilus influenzae into the middle ear, and AOM samples were prepared 4 days after inoculation. Vibration of the TM specimen induced by acoustic loading was measured via LDV over a frequency range of 0.1-8 kHz. The experiment was then simulated in a finite element (FE) model, and the inverse-problem solving method was used to determine the complex modulus in the frequency domain. Results from 12 ears (six control and six AOM) show that the storage modulus of the TM from AOM ears was on average 53% higher than that of control ears, while the loss factor was 17.3% higher in control ears than in AOM ears at low-frequency (f < 1 kHz). At high-frequency (e.g., 8000 Hz), there was a mean 40% increase in storage modulus of the TM from AOM compared to control samples. At peak frequency (e.g., 3 kHz), there was a 19.5% increase in loss factor in control samples compared to AOM samples. These findings quantify the changes induced by AOM in the chinchilla TM, namely, a significant increase in both the storage and loss moduli.

It’s about More Than Just Baby Teeth: An Examination of Early Oral Care in Canada

It may come as a surprise to the public and to medical practitioners that the most common infectious disease in young children is dental decay and that oral health is the most prevalent unmet healthcare need of children. Children who present with early childhood caries (ECC) can suffer from pain, sleeplessness, malnutrition, difficulty playing, struggles in school, and toxic stress. Although it is almost completely preventable through low-cost preventive measures, prevalence is very high in Canada affecting over one quarter of children. Several factors interact on different levels (child, family and community) to create a situation in which ECC prevails. Recommendations for prevention are presented and include early visits to a dentist, dental care as part of prenatal care, interdisciplinary collaboration across health and social services, as well as many others.

Performance of reversed transcription loop-mediated isothermal amplification technique detecting EV71: a systematic review with meta-analysis.

Human enterovirus 71 (EV71) is the major etiological agent of hand, foot and mouth disease (HFMD), which is a common infectious disease in young children. Studies in the past have shown that reversed transcription loop-mediated isothermal amplification (RT-LAMP) was a rapid approach for the detection of EV71 in HFMD. This meta-analysis study is to evaluate the diagnostic role of RT-LAMP in detecting EV71 infection. A comprehensive literature research of PubMed, Embase, Wan Fang Data, and Chinese National Knowledge Infrastructure databases was conducted on articles aiming at the diagnostic performance of RT-LAMP in EV71 detection published before February 10, 2014. Data from selected studies were pooled to yield the summary sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and receiver operating characteristic (SROC) curve by using STATA VERSION 12.0 software. Ten studies including a total of 907 clinical samples were of high quality in this meta-analysis. Overall, the pooled sensitivity, specificity, PLR, NLR, DOR, and the area under the SROC curve was 0.99 (0.97, 1.00), 0.97 (0.94, 1.00), 5.90 (95% CI: 3.90-8.94), 0.20 (95% CI: 0.14-0.29), and 1.00 (95% CI: 0.99-1.00), respectively. The univariate analysis of potential variables showed some changes in the diagnostic performance, but none of the differences reached statistical significance. Despite inter-study variability, the test performance of RT-LAMP was consistent with real-time RT-PCR in detecting EV71. This meta-analysis suggests that RT-LAMP is a useful diagnostic tool with high sensitivity and specificity for detecting EV71.

Effect of the specific infant formula mixture of oligosaccharides on local immunity and development of allergic and infectious disease in young children: randomized study

AimThe aim of our open prospective randomized nutritional intervention study was to evaluate the effect of feeding with a standard infant formula enriched with the specific mixture of oligosaccharides on local digestive immunity system and further development of allergic and infectious diseases in young children. Material and methodsDepending on the type of feeding the infants were divided into 3 groups (with random allocation to one of the formula feeding groups): 80 infants who were breastfed, 80 infants consuming the formula supplemented with oligosaccharides, 80 infants fed with a standard formula. ResultsBreastfed infants had the highest content of Bifidobacteria and Lactobacilli in feces (9.047±1.075 and 7.26±0.65CFU/g accordingly). In infants fed with formula supplemented with scGOS/lcFOS fecal concentrations of Bifidobacteria and Lactobacilli were similar to those in breastfed infants (8.92±1.011 and 7.22±0.74CFU/g accordingly). It was found that infants fed with breast milk and supplemented formula had significantly less allergic reactions to food products compared to the babies from the third group (3.92% and 4.84% vs. 16.98% accordingly; p<0,05). ConclusionsThe mixture of prebiotic oligosaccharides (scGOS/lcFOS – 9:1; 8g/L) has a similar to breast milk positive impact on the factors of local digestive immunity system in formula-fed infants. This effect may reduce the risk of allergic and infectious diseases in children aged up to 18 months of life, compared with babies fed with the standard formula without oligosaccharides.

Development and Evaluation of a Reverse Transcription-Loop-Mediated Isothermal Amplification Assay for Rapid Detection of Enterovirus 71

Human enterovirus 71 (EV71) is the major etiological agent of hand, foot, and mouth disease (HFMD), which is a common infectious disease in young children and infants. EV71 can cause various clinical manifestations and has been associated with severe neurological complications; it has resulted in fatalities during recent outbreaks in Asian-Pacific regions since 1997. The early and rapid detection is critical for prevention and control of EV71 infection, since no vaccine or antiviral drugs are currently available. In this study, a simple and sensitive reverse transcription-loop-mediated isothermal amplification (RT-LAMP) assay was developed for rapid detection of EV71. The detection limit of the RT-LAMP assay was approximately 0.01 PFU per reaction mixture, and no cross-reactive amplification with other enteroviruses was observed. The assay was evaluated further with 40 clinical specimens and exhibited 92.9% sensitivity and 100% specificity. This RT-LAMP assay may become a useful alternative in clinical diagnosis of EV71, especially in resource-limited hospitals or rural clinics of China and other countries in the Asian-Pacific region.

Nutritional status of Amerindian children from the Beni River (lowland Bolivia) as related to environmental, maternal and dietary factors

To report the nutritional status of children aged up to 15 years and their mothers living in a remote Amazonian area of Bolivia, and to study its main social, familial and maternal determinants. Fifteen Beni River communities located at the foot of the Andes. Cross-sectional survey of riverside populations. All childbearing mothers and their children in the 15 communities were examined. Information on household production, dietary habits and demography was collected. Individual clinical, anthropometric and parasitological examinations were carried out. A total of 631 persons were examined: 171 mothers and 460 children and adolescents aged 0 to 15 years. There were no cases of severe wasting, but 41% of 0-5-year-olds and 36% of 5-10-year-olds were stunted. Among 346 stool specimens examined, 75% were positive for at least one helminth. Diversity of food and quality of diet were satisfactory in 54% of households, but 27% had low diversity scores. Mothers were lighter and shorter than those observed at the national level: 20% had height below 145 cm. Prevalence of anaemia (42%) was also higher. In pre-school children, multivariate analysis indicated a relationship between growth retardation and household factors such as dietary quality, ethnic group and clinical state, but not maternal anthropometry. In contrast, in school-age children and adolescents, growth retardation was related to maternal characteristics. Growth retardation appeared mainly during the weaning period and did not seem to improve thereafter. To ameliorate this situation, an effort should be made to prevent common parasitic and infectious diseases in young children. Follow-up of pregnant mothers during pregnancy and delivery also needs to be reinforced.

Child-care practices: effects of social change on the epidemiology of infectious diseases and antibiotic resistance.

The increasing number of mothers of young children in the work force and the resultant escalated use of child-care facilities has had a marked effect on the epidemiology of infectious diseases in young children. Children attending child care are at high risk for respiratory and gastrointestinal tract illnesses. The high prevalence of infectious diseases in the child-care setting is accompanied by high usage of antibiotics, which in turn has resulted in spread of antibiotic-resistant organisms. The infectious disease standards of the American Public Health Association/American Academy of Pediatrics guidelines were developed to prevent and limit transmission of infectious diseases in the child-care setting. Adherence to these standards is essential but will not completely eliminate the increased risk of infectious diseases in child-care settings. New challenges need to be addressed to assure that optimal health promotion and disease prevention is practiced in child-care settings. We approach the 21st century with a vast amount of medical knowledge, molecular technology, highly effective vaccines, and powerful antimicrobial agents. However, at the same time we face many unsolved serious problems, such as preventing or controlling the emergence and spread of antibiotic-resistant organisms that adversely affect our ability to treat infectious diseases. Further research is needed concerning the relations between child care, the use of antibiotics, and transmission of antibiotic-resistant organisms in order to design and implement the most effective strategies for preventing or controlling antibiotic resistance. The potential risk for transmission of HIV in the child-care setting also needs to be recognized, and procedures to prevent transmission of blood-borne pathogens need to be followed. Monitoring compliance with national standards for child-care facilities, dissemination of information concerning infectious diseases and use of antibiotics, and development and use of new vaccines are strategies which should be used to help protect the health of children in child-care environments.

Cardiovascular diseases in the United States

For an adequate understanding of the problem of cardiovascular diseases in the United States today, it is valuable to review the evolution of the health picture during the last 50 to 100 years. This has been a period of remarkahle advance, probably unparalleled in any previous era of human history. Progress has tjeen particularly great in lengthening the expectation of life at birth (Fig. 1 and 2, Tables I--IIIt).r-8 For all persons, life expectancy at birth has increased more than 20 years, from ahout 48 years in 1900 to about 69 years in 1959. For white males the increase has been 19.1 years (39.6 per cent), from 48.2 to 67.3 years, since the turn of the century; for white females it has increased by 22.8 years (44.6 per cent), from 51.1 to 73.9 years. Longevity of the nonwhite (chiefly Negro) population has also improved greatly during the twentieth century; the difference between whites and nonwhites in average length of life has decreased considerably, to 6.4 years for males and 7.7 years for females (Table I). This phenomenal advance in life expectancy is attributable first of all to the conquest of infectious diseases, particularly acute infectious diseases in young children, which previously took a heavy toll (Fig. 1 and 2, Tahle III).~-~ In 1901 less than 80 per cent of newborn infants in the United States could he expected to survive t Tables noted throughout paper will appear in author’s reprints. to their fifth birthday. The corresponding figure for 1959 was almost 97 per cent. In 1901 a little over 75 per cent of newborn infants could be expected to reach their fifteenth birthday; the figure for 1959 was over 96 per cent. Appreciable decreases in mortality among middle-aged and older people also have occurred during recent decades, largely as a result of advances in the control of infectious diseases, particularly pneumonia and tuberculosis (Fig. 1 and 2, Tables I and IV). A major consequence of these developments has been a marked increase in the number of middle-aged and elderly persons in the United States. By 1960 there were almost 17 million persons aged 65 and over-more than five times as many as in 1900. In the same period the number of middle-aged persons (45-64) increased from 10 million to 36 million. Persons 65 and over and those 45 to 64 constituted 4 per cent and 14 per cent, respectively, of the total population in 1900; by 1960 these percentages had increased to 9 per cent and 20 per cent9 Howeuer, for the incwusing millions of middleaged and elderly persons, the outlook for life rxpctancy today is only moderately better than it was at the turn of the century. The death rates for persons aged 45 to 64 and those 65 and over have declined much less than death rates for children and young adults (Fig. 2). Therefore, for white males and females aged 40, life expectancy has increased only 3.8 and 4.7 years, respectively, since 1900-l 902 ; for nonwhites, the corresponding figures are only 4.7 and 6.9 years (Table I). The situation is similar at age 60. Males have generally done less well than females, white males the least well. The fundamental reason for this is the slow progress against the cardiovascular diseases (Fig. l-3 and Table IV). In fact, for middleaged males, particularly white males, the