Morbidity In Children Research Articles

The many faces of sickle cell disease in children: complications in the appendicular skeleton.

Sickle cell disease (SCD) is a hereditary red cell disorder with clinical manifestations secondary to sickling or crescent-shaped distortion of the red blood cells. Musculoskeletal complications of SCD are often the main causes for acute and chronic morbidities in children with manifestations including osteomyelitis, osteoporosis and osteonecrosis. This article aims to familiarise the paediatric radiologist with appendicular skeletal complications of SCD in the paediatric population and their imaging appearance.

[Analysis of the results for genetic disease screening among 1 000 newborns from Huzhou].

To analyze the types and distribution of pathogenic variants for neonatal genetic diseases in Huzhou, Zhejiang Province. One thousand neonates (48 ~ 42 h after birth) born to Huzhou region were selected as the study subjects. Dry blood spot samples were collected from the newborns, and targeted capture high-throughput sequencing was carried out for pathogenic genes underlying 542 inherited diseases. Candidate variants were verified by Sanger sequencing. Among the 1 000 newborns, the male to female ratio was 1.02 : 1.00. No pathogenic variants were detected in 253 cases, whilst 747 cases were found to carry at least one pathogenic variant, which yielded a carrier rate of 74.7%. The most frequently involved pathogenic gene was FLG, followed by GJB2, UGT1A1, USH2A and DUOX2. The variants were classified as homozygous, compound heterozygous, and hemizygous variants. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), 213 neonates were verified to have carried pathogenic and/or likely pathogenic variants, with a positive rate of 21.3%. The most commonly involved genes had included UGT1A1, FLG, GJB2, MEFV and G6PD. Newborn screening based on high-throughput sequencing technology can expand the scope of screening and improve the positive predictive value. Genetic counseling based on the results can improve the patients' medical care and reduce neonatal mortality and childhood morbidity, while provide assistance to family members' health management and reproductive decisions.

Diabetic ketoacidosis in type 1 diabetes mellitus in children and adolescents

Background: Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). Although T1DM can occur in children and adults, DKA caused by T1DM is more severe in children and adolescents and metabolic changes occur more rapidly. This review discusses clinical factors associated with DKA assessed during diagnosis in children and adolescents with T1DM.Current Concepts: DKA is a severe complication that can occur in children with T1DM because of insulin deficiency, leading to high levels of catabolism with increased gluconeogenesis, glycogenolysis, lipolysis, muscle proteolysis, hyperglycemia, and osmotic diuresis. High levels of counterregulatory hormones that enhance ketogenesis have also been noted. High blood sugar levels, dehydration, and the release of ketone bodies into the circulation cause high occurrence of acidosis. DKA can lead to life-threatening complications, such as cerebral edema, which is more common in children than in adults. Other potential complications include kidney failure, respiratory distress, and cardiovascular collapse. Children with T1DM are at a higher risk of developing DKA, particularly during times of illness or stress, or when insulin doses are missed or insufficient. In addition, undiagnosed T1DM in children can lead to DKA when the body enters a state of severe insulin deficiency.Discussion and Conclusion: The risks should be detected earlier and the pathogenesis of T1DM should be understood and assessed by physicians in children and adolescents during check-ups. Furthermore, efforts to increase public awareness are required to reduce the cognitive delays associated with DKA.

Approaches for prevention of mother-to-child transmission of HIV services during coronavirus disease 2019

Background: During the coronavirus disease 2019 (COVID-19) pandemic, there was a reduction in access to prevention of mother-to-child transmission (PMTCT) of human Immunodeficiency virus (HIV) services globally, yet this programme is critical for reducing paediatric HIV incidence. To minimise the impact of COVID-19 and prevent disruptions to the PMTCT service provision, innovative strategies had to be developed and implemented.Aim: The study aimed to describe the approaches that were developed and utilised during the COVID-19 pandemic in enhancing PMTCT services in Tshwane primary healthcare facilities.Settings: Three primary healthcare facilities that were providing PMTCT services during the COVID-19 pandemic located in the Tshwane district, Gauteng province, South Africa.Methods: The study is part of a larger study that focused on the experiences of healthcare workers who were rendering PMTCT services during the COVID-19 pandemic. An interpretative phenomenological analysis (IPA) design was employed to gain insight into the experiences of 16 purposively sampled healthcare workers who were providing PMTCT services during the pandemic in Tshwane district facilities. In-depth individual audio-recorded interviews were conducted with study participants, following a semi-structured interview guide. Data analysis was performed using an IPA framework.Results: Three superordinate themes emerged: strategies utilised for providing care, community-based initiatives, and support systems to enhance the PMTCT service access.Conclusion: Strengthening community-based initiatives and support systems is important for the enhancement of the PMTCT programme during and beyond the pandemic.Contribution: Community-based initiatives are critical in continuity of PMTCT services, reducing HIV incidence, under-five child morbidity and mortality particularly during emergency situations.

Neurological Presentation of Lead Toxicity: A Case Report

Acute encephalopathy, caused by infectious agents, metabolic or mitochondrial dysfunction, brain tumor, or prolonged exposure to toxic elements, is a significant cause of morbidity and mortality in young children. Lead encephalopathy that occurs due to prolonged lead ingestion or exposure in children is not uncommon, and many such cases have been reported in the past. This report shares the authors’ experience of the missed diagnosis of lead encephalopathy, its red flags, and its relation to pica as a root cause. A 14-month-old boy, resident of Delhi, India, was admitted with vomiting, irritability, and two episodes of abnormal limb movements, with the first symptom starting when he was 11 months old. His case was initially treated as acute disseminated encephalomyelitis, but he showed no improvement. The child was then referred to the Sir Ganga Ram Hospital, New Delhi, India. The boy presented with severe anemia, along with basophilic stippling on the peripheral smear during routine investigations. Suspecting lead poisoning, blood lead levels were checked, and were found to be grossly elevated. The child was then started on chelation therapy. Multiple doses of chelation (dimercaprol and D-penicillamine) were given, and sequential blood lead levels were monitored, which showed a marked decrement. The child was discharged, and is being monitored routinely. Lead poisoning remains a neglected public health issue, especially in children, and delay in identification can cause significant morbidity and mortality. Pediatricians and general practitioners must be aware of this risk, especially in children with iron deficiency anemia exhibiting pica.

Disease-specific Quality of Life in Irish Children with Otitis Media with Effusion

Introduction: Otitis media with effusion (OME) is one of the most common diseases of childhood and causes significant morbidity for children. The benefits of ventilation tubes (VTs) are well established, but the subjective impact of surgery on Irish children’s quality of life (QoL) has not been studied. Methods: A prospective single-unit cohort study used a validated QoL survey (Otitis Media-6 [OM-6]) to determine the impact of VT placement on QoL. The OM-6 survey uses a Likert scale, with the higher the value on the Likert scale, the poorer the QoL perceived. Results: Seventy-six children with a mean (range) age of 6 (0.5–13) years were recruited for this study. The overall mean OM-6 score for the 76 children was 3.2. Twenty-six children proceeded to surgery. The mean OM-6 score in this cohort preoperatively was 4.5 and reduced to 1.35 at 3 months post-VT placement. Conclusion: This study highlights the poor QoL experienced by Irish children with OME. The OM-6 scores are considerably higher in our series than previously published international series. VT insertion leads to an improvement in QoL scores. This validated questionnaire should be a routine adjunct in the holistic management of children with OME.

The Role of Soluble Urokinase Plasminogen Activator Receptor (suPAR) as an Early Indicator of Mortality in Pediatric Septic Shock.

Despite advancements in antibiotic therapy and resuscitation protocols, sepsis and septic shock remain major contributors to morbidity and mortality in children. We aimed to investigate the utility of soluble urokinase plasminogen activator receptor (suPAR) for the early detection of septic shock and to evaluate its accuracy in predicting mortality. A prospective study was conducted in a tertiary pediatric emergency department (ED), enrolling patients diagnosed with the sepsis, severe sepsis, or septic shock. In addition to assessing infection biomarkers such as C-reactive protein and procalcitonin, suPAR levels were quantified upon admission using enzyme-linked immunosorbent assay. The primary outcome measure was 30-day mortality. Overall 72 patients and 80 healthy children included. Plasma suPAR levels demonstrated a statistically significant elevation in the sepsis, severe sepsis, and septic shock groups compared with the control group (p < 0.001 for all). The septic shock group exhibited the highest suPAR levels upon admission, surpassing both the sepsis and severe sepsis groups (p = 0.009 and 0.042). ROC analysis underscored the promising potential of suPAR with an AUC of 0.832 for septic shock. Analysis of mortality prediction revealed significantly higher suPAR levels in nonsurvivors than survivors (9.7 ng/mL vs. 4.2 ng/mL; p < 0.001). Employing plasma suPAR levels to discriminate between mortality and survival, a threshold of ≥7.0 ng/mL demonstrated a sensitivity of 90.9% and specificity of 71.0%. Plasma suPAR levels have the potential as a biomarker for predicting mortality in children with septic shock. In pediatric septic shock, the presence of plasma suPAR ≥7 ng/mL along with an underlying disease significantly increases the risk of mortality.

Advocacy for neonates: Will respiratory syncytial virus monoclonal antibodies and maternal vaccine be made available in India?

Respiratory syncytial virus (RSV)-related morbidity in children has been widely described. Research has led to the availability of palivizumab for decades in high-income countries. Ongoing research underlines the high priority given to this conundrum. Nirsevimab, a long-acting monoclonal antibody, and a maternal vaccine have been developed and approved for RSV. Neither of these are available in India. Improving the survival of extreme preterm neonates in our country should parallel other strategies to protect them from diseases that affect these high-risk neonates. This case series comprises sick RSV-infected infants from our centre over a single season. Of 187 young infants who presented to the Neonatology Department with features of viral lower respiratory infections, 9 (4.8%) required intensive care. All of them were positive for RSV by nasopharyngeal polymerase chain reaction. A total of 25 (13%) required hospitalisation. Preterm infants presented with apnea or severe respiratory distress. All 9 in the intensive care unit required respiratory support, and 8 needed invasive ventilation. The median duration of hospital stay for these infants was 18 (7–37) days. This report is an appeal to stakeholders towards making these evidence-based prophylactic methods available in India. A preventable problem in high-risk neonates could be reduced. Improving neonatal survival and outcomes calls for our country to be at par with high-income countries for RSV prevention. RSV-related morbidity is an endemic conundrum with a high disease burden. We could take prompt action, akin to efforts taken during the COVID-19 pandemic.

Granulocyte- Macrophage Colony-Stimulating Factor Reverses Immunosuppression Acutely Following a Traumatic Brain Injury and Hemorrhage Polytrauma in a Juvenile Male Rat Model.

Traumatic brain injury (TBI) is a common cause of morbidity and mortality in children. We have previously shown that TBI with a concurrent extracranial injury reliably leads to post-injury suppression of the innate and adaptive immune systems. In patients with post-injury immune suppression, if immune function could be preserved, this might represent a therapeutic opportunity. As such, we examined, in an animal injury model, whether systemic administration of granulocyte macrophage colony-stimulating factor (GM-CSF) could reverse post-injury immune suppression and whether treatment was associated with neuroinflammation or functional deficit. Prepubescent male rats were injured using a controlled cortical impact model and then subjected to removal of 25% blood volume (TBI/H). Sham animals underwent surgery without injury induction, and the treatment groups were sham and injured animals treated with either saline vehicle or 50 μg/kg GM-CSF. GM-CSF was administered following injury and then daily until sacrifice at post-injury day (PID) 7. Immune function was measured by assessing tumor necrosis factor-α (TNF-α) levels in whole blood and spleen following ex vivo stimulation with pokeweed mitogen (PWM). Brain samples were assessed by multiplex enzyme-linked immunosorbent assay (ELISA) for cytokine levels and by immunohistochemistry for microglia and astrocyte proliferation. Neuronal cell count was examined using cresyl violet staining. Motor coordination was evaluated using the Rotarod performance test. Treatment with GM-CSF was associated with a significantly increased response to PWM in both whole blood and spleen. GM-CSF in injured animals did not lead to increases in levels of pro-inflammatory cytokines in brain samples but was associated with significant increases in counted astrocytes. Finally, while injured animals treated with saline showed a significant impairment on behavioral testing, injured animals treated with GM-CSF performed similarly to uninjured animals. GM-CSF treatment in animals with combined injury led to increased systemic immune cell response in whole blood and spleen in the acute phase following injury. Improved immune response was not associated with elevated pro-inflammatory cytokine levels in the brain or functional impairment.

Clinicopathological profile and management challenges of congenital encephaloceles in a tertiary hospital in southwest Nigeria.

A congenital encephalocele is the herniation of intracranial contents through skull defects of various sizes. Depending on the site, content, and size, it is associated with significant morbidity and mortality in children. There is a paucity of recent and comprehensive local clinical data regarding this anomaly. Understanding the peculiarities, clinical-pathologic profiles, and management challenges will help prevent and effectively manage congenital encephalocele to improve outcomes. This was a retrospective study of all cases of congenital encephalocele managed between July 2000 and December 2023 at a tertiary hospital in the southwest region of Nigeria. Relevant demographic, clinicopathological, and management data were retrieved and analysed. There were 31 females and 11 males. Their ages ranged from 3hours to 24years. Sixteen (35.3%) were delivered in a non-health facility. Birth asphyxia was reported in 5 babies. Few mothers (4.8%) used preconception folic acid. Anaemia (n = 5) and sepsis (n = 4) were the common preoperative morbidities. All patients had definitive surgery, with 18 operated on within the first month of life. Cerebrospinal fluid (CSF) leak was the most common postoperative complication and was significantly observed in the sincipital group (p = 0.018). Thirty-one patients (73.8%) presented for follow-up after surgery, and the mean follow-up duration was 26.6weeks. Mortality was recorded in a patient (2.4%) due to Klebsiella meningitis. Congenital encephaloceles are relatively common in our setting. Therefore, there is a need to address the associated poor maternal and neonatal health conditions. Early surgery can be performed with a favourable outcome.

Revaccination against COVID-19: Current Status of the Problem

The considerable success of vaccination against the new coronavirus infection, which has led to a decrease in morbidity and mortality in adults and children, requires the study of the problem of revaccination against SARS-CoV-2. The pathogenic properties of the virus and its unpredictable mutations continue to support an unfavorable epidemic situation in different regions of the world. Revaccination regimens against SARS-CoV-2 are being developed in different countries and populations based on epidemiological indications. The issue of introducing vaccination against a new coronavirus infection into national vaccination calendars for adults and children is debatable and requires further study.

Dental status of children of early and preschool age in Moscow

INTRODUCTION. Conducting an epidemiological survey allows us to obtain reliable initial data on the level of prevalence and intensity of dental diseases, identify priority needs for providing all types of dental care to children, plan and implement dental programs, focusing on the initial dental status of the child population at different age periods.AIM. To study the dental status of children of early and preschool age based on data from a cross-sectional epidemiological study.MATERIALS AND METHODS. A cross-sectional epidemiological survey of the child population was conducted as part of preventive medical examinations of minors to study the dental morbidity of children of early (1–3 years) and preschool (4–6 years) age in Moscow. The study involved 1470 Moscow children aged 1 to 6 years old. The results of the survey were processed statistically.RESULTS. Data analysis showed that the indicator of the need for oral sanitation tends to increase as children grow older. A statistically significant dependence of the need for rehabilitation on the age group was revealed. The indicator of previously sanitized children is variable at different age periods. The rate of natural sanitation decreases as children grow older. A statistically significant dependence of natural sanitation on the age group was revealed. Categorical variables (absolute and relative) of the need for sanitation are higher among girls in all age groups and lower among boys. But statistically significant differences in the need for sanitation in boys and girls were observed only in the age group 1 year, 3 years and 5 years. In the age groups of 2, 4 and 6 years, there was a similar need for sanitation among boys and girls; no statistically significant differences were identified, despite the fact that categorical variables (absolute and relative indicators) indicated a higher need for sanitation of the oral cavity in girls than boys.CONCLUSIONS. Categorical (absolute and relative) variables indicate that the need for oral sanitation in girls is higher than in boys at all age periods.

Determinants of second-dose measles vaccination dropout in Ethiopia: A community-based matched case-control study

BackgroundMeasles vaccination is the most important public health intervention and a cost-effective strategy to reduce morbidity and mortality in under-five children. Although Ethiopia's government developed a measles elimination strategic plan by 2020, the full coverage of immunization was 43 %. Therefore, this study aimed to identify determinants of second-dose measles vaccination (MCV2) dropout among children aged 24–35 months in East Bale Zone, Ethiopia. MethodA community-based matched case-control study was conducted among 351 children (117 cases and 234 controls). Children who received the first dose of measles vaccine but did not receive the second dose were cases, and children who received both doses of measles vaccine were control. The matches were based on age and residence. The data were collected using a structured questionnaire, entered into Epi Data 3.1, cleaned, exported, and analyzed using Stata version 16.1. A multivariable conditional logistic regression analysis was performed. Variables with a P value of <0.05 were considered significant determinants of the dependent variable at the 95 % confidence level. ResultsMothers who were unable to read and write (mAOR: 4.0; 95 % CI: 1.59–10.2), did not receive counseling (mAOR: 3.19; 95 % CI: 1.62–6.27), spent ≥30 min to reach health facilities (mAOR; 2.76, 95 % CI: 1.25–6.1), and did not attend postnatal care (mAOR; 3.46, 95 % CI: 1.58–7.57) were significantly and positively associated with second-dose measles vaccination dropout. In addition, mothers who had poor knowledge of second-dose measles vaccination (mAOR; 3.20, 95 % CI: 1.50–6.70) and waited more than an hour for measles vaccination at health facilities (mAOR; 2.61, 95 % CI: 1.0–6.20) were significantly more likely to experience second-dose measles vaccine dropout. ConclusionsThe key factors associated with second-dose measles vaccination dropout are maternal illiteracy, lack of PNC, inadequate maternal knowledge and poor counseling about MCV2 vaccination, long distances travel to healthcare facilities and extended waiting times at vaccination providing sites. Health extension workers emphasize strengthening home visit programs in catchment households to improve mothers' awareness of measles vaccination.

The Nurse Practitioner’s Role in Safeguarding Children from Physical Abuse

Child physical abuse (CPA) is among the leading causes of morbidity and mortality in young children. Nurse practitioners are ideally positioned to institute prevention strategies against CPA and need to be able to recognize the often subtle or nonspecific features of CPA. Early identification of CPA allows for more prompt intervention, which can ameliorate health outcomes among these highly vulnerable patients. All nurse practitioners, even those with only 1 pediatric patient under their care, need to have basic CPA competencies, including identification of red flags, knowledge of risk factors, provision of appropriate screening, and facilitation of early intervention strategies.

Study of acute kidney injury in children with nephrotic syndrome in a rural tertiary care hospital

Background: Acute kidney injury (AKI) is a common comorbidity in critically ill children and is associated with an increased risk of morbidity and mortality in children with nephrotic syndrome. The etiology of AKI in nephrotic syndrome is complex and multifactorial. Aims and Objectives: To determine the proportion, risk factors, and outcomes of patients with AKI in children hospitalized with nephrotic syndrome. Materials and Methods: This cross-sectional study was done on children between 1 month and 14 years of age attending the pediatric department for 1 year from October 2020 to June 15, 2022. Detailed history, physical examination, and investigations were done in children with nephrotic syndrome as per pro forma. Information was collected on demographic variables, vital signs, anthropometry, diagnosis, comorbidities, therapies, presence of hypovolemia, sepsis or shock, use of diuretics or nephrotoxic medications, need for oxygen, mechanical ventilation, vasopressors or renal replacement therapy, length of hospital stay, and outcome at discharge. For those children having AKI, clinical outcomes were measured in terms of duration of hospital stay, recovery of S.creatinine, and urine output. Results: A total of 64 patients with nephrotic syndrome were enrolled in this study. Fifteen patients had AKI (23.4%) among children with nephrotic syndrome. The most common etiology being sepsis accounting for 4 out of 15 (26.7%) of total cases followed by acute respiratory distress syndrome (13.3%), nephrotoxic medications (13.3%), renal parenchymal disease (13.3%), Post-streptococcal glomerulonephritis (13.3% each) and Sickle cell disease with nephritis and acute fulminant hepatitis (6.7%). There was significantly more mortality among subjects with stage 2 (14.3%) and 3 (14.3%) kidney disease. Conclusion: AKI is common in our children with nephrotic syndrome and the main risk factors of AKI include sepsis, gross hematuria, urinary tract infections, peritonitis, and exposure to potentially nephrotoxic medications. There is a need to identify the patients with nephrotic syndrome at risk of AKI and apply strategies to prevent AKI in focused at-risk groups.

Assessing bacterial prevalence and resistance in paediatric meningitis: safeguarding the central nervous system.

Paediatric bacterial meningitis (PBM) represents a major contributor to childhood morbidity and mortality globally, with heightened susceptibility in low- and middle-income nations where antimicrobial resistance (AMR) is highly prevalent. Pakistan exemplifies this setting, with widespread antibiotic overuse driving AMR expansion. Thus, expediting PBM diagnosis and targeted antibiotic therapy is imperative yet challenged by the dynamic local epidemiology. This study aimed to delineate the recent bacterial etiologies and AMR profiles of PBM from a major Pakistani diagnostics laboratory to inform empirical treatment. This prospective observational investigation evaluated PBM epidemiology in patients under 18 years old admitted to the study hospital. Standard cerebrospinal fluid analysis identified bacterial pathogens and antibiotic susceptibility patterns. Among 171 PBM cases, 152 (88.9%) had bacterial isolates confirmed via culture. The cohort was 42.7% male with a mean age of 3 months. The most prevalent pathogens among infants younger than 3 months were Escherichia coli, Enterococcus faecium, and Staphylococcus epidermidis, contrasting with S. epidermidis, Streptococcus pneumoniae, and Staphylococcus hominis predominating in older children. Staphylococcal isolates exhibited considerable penicillin and erythromycin resistance but maintained vancomycin and linezolid susceptibility. Other resistance patterns varied. These findings highlight the pressing threat of paediatric AMR in Pakistan, underscoring the need for vigilant AMR surveillance and judicious antimicrobial use. This study provides a reference to current PBM epidemiology to guide context-specific empirical therapy.

Early-life gut microbiota associates with allergic rhinitis during 13-year follow-up in a Finnish probiotic intervention cohort.

Perinatal and early-life factors reported to affect risk of allergic diseases may be mediated by changes in the gut microbiota. Here, we explored the associations between the infant gut microbiota and allergic morbidity in childhood until 13 years of age in a subgroup of the FLORA probiotic intervention cohort. A mixture of four probiotic strains with galacto-oligosaccharides was administrated to the mothers from the 36th week of the pregnancy and later to their infants until 6 months of age. The infants were monitored for the manifestations of atopic eczema, food allergy, allergic rhinitis, and asthma by a pediatrician at 2 and 5 years of age; the allergic status was subsequently verified by a questionnaire at 10 and 13 years of age. The fecal microbiota at 3 months was profiled by 16S rRNA amplicon sequencing targeting the V3-V4 region, with and without adjusting for potentially important early-life factors. Overall, the positive diagnosis for allergic rhinitis between 2 and 13 years was associated with microbiota composition both in non-adjusted and adjusted models. This association was more pronounced in children born to one parent with confirmed atopic diseases compared to those who had two atopic parents and was characterized by a lower relative abundance of Bifidobacterium and Escherichia/Shigella spp. and a higher proportion of Bacteroides. While the probiotic and galacto-oligosaccharides intervention in the entire cohort was previously shown to reduce the prevalence of eczema to a certain extent, no associations were found between the 3-month gut microbiota and childhood eczema in the studied sub-cohort.IMPORTANCEAllergic diseases have increased in prevalence during the past decades globally. Although probiotics have been considered a promising strategy for preventing certain allergy related symptoms, studies connecting the infant gut microbiota and later life allergic morbidity in various populations remain limited. The present study supports an association between the infant microbiota and allergic morbidity after first years of life, which has been rarely examined.CLINICAL TRIALSRegistered at ClinicalTrials.gov (NCT00298337).

Prevalence of Childhood Dermatological and Ocular Morbidities: A Cross-Sectional Study

Abstract Introduction: Screening many children within a certain age group for the presence of illnesses can be efficiently conducted through school surveys. This study aims to analyze the prevalence of dermatological and ocular morbidities in school children. Methods: A school-based cross-sectional observational study was conducted in Government and Private schools of Latur, involving 500 school children aged between 5-14 years. Results: The prevalence of dermatological morbidities in our research was found to be 69%, with boys showing a prevalence of 50.6% and girls 18.4%. Prevalence of ocular morbidities was 7.6%, with boys showing a prevalence of 4.2% and girls 3.4%. Among dermatological manifestations, infections and infestations were the most observed (44%), followed by eczema (dermatitis) (13%). Refractive error was the most common ocular morbidity observed in boys (33.3%), followed by Vitamin A deficiency (28.57%). In girls, refractive error was the most common ocular morbidity (35.29%), followed by Vitamin A deficiency (29.41%). Conclusion: Urgent attention is needed to address these health issues early on to improve children's overall well-being. The findings contribute valuable insights for future research and targeted public health interventions aimed at promoting the health of school children.

Assessment of factors related to caregivers and children on the IMCI program outcomes in Baghdad City in 2021

Background: The implementation of the Integrated Management of Childhood Illness (IMCI) program has led to enhancement in outcomes for many treatable childhood diseases. This study aims to assess how implementing IMCI affects child mortality and morbidity in Iraq. Methods: A cross-sectional study spanning from January to December 2021 was carried out at primary healthcare centers (PHCCs) with IMCI units in Baghdad, Iraq. Using a lottery sampling method, 40 PHCCs were randomly chosen from a total of 235 centers across both sides of the city. A universal sampling technique was adopted to select all children attending these PHCCs regularly. With a p-value below 5%, multiple logistic regression analyses were performed to identify the significant independent predictors at a 95% confidence interval. Results: The majority of caregivers were mothers (97.8%), aged 20 to 30 years (75.8%), and housewives (59.2%). Sixty percent of children (6 to 35 months) had normal anthropometric measurements. Bottle feeding was common (44.2%), and most children had a normal neonatal history (82.9%). In bivariate analysis, the severity of illness, severe cases of diarrhea, and acute respiratory infection (ARI) showed significant associations with worsened or not improved outcomes (χ2 = 18.900, p &lt; 0.001; χ2 = 6.265, p= 0.016; and χ2 = 7.549, p= 0.003, respectively). However, multiple logistic regression analysis indicated that mild and moderate illness severity (OR = 10.634, 95% CI: 6.985 to 16.192, p &lt; 0.001), strict breastfeeding (OR = 3.307, 95% CI: 1.703 to 6.421, p &lt; 0.001), and completing treatment at home (OR = 6.190, 95% CI: 4.115 to 9.311, p &lt; 0.001) significantly improved outcomes through IMCI services. Conclusion: Severe illness, especially in diarrhea and ARI, correlates with poorer outcomes. Conversely, exclusive breastfeeding, prompt medical attention within a day of illness onset, and completing home treatment are associated with improved outcomes.

WILL ULTRASOUND REVOLUTIONIZE THE DIAGNOSIS OF PNEUMONIA IN CHILDREN POPULATION?

Worldwide, pneumonia continues to be a major cause of morbidity and mortality in children. The effectiveness of ultrasonography and chest radiography (X-ray) in the diagnosis of pneumonia in pediatric patients is examined in this paper. Although chest radiography has been the norm for years, worries about radiation exposure have made ultrasonography seem like a viable substitute. This article assesses both modalities' diagnostic value and accuracy through a review of recent literature. As a potentially useful diagnostic tool, ultrasonography has advantages over chest X-rays, including accessibility, low radiation dose, and similar diagnostic efficacy. Ultrasound has a high negative predictive value, which indicates that it may be used to efficiently triage patients in emergencies. The decision between an X-ray and an ultrasound ultimately comes down to several variables, such as patient condition, physician skill, and equipment accessibility. However, considering ultrasound's safety record and diagnostic capabilities, it offers a strong substitute for diagnosing pneumonia in kids, in line with WHO guidelines to reduce radiation exposure in this susceptible group.