Pediatric Knowledge Research Articles

Functional Abdominal Pain (FAP) in Children: Knowledge, Attitude, and Practice of Pediatricians in India

Functional Abdominal Pain (FAP) in Children: Knowledge, Attitude, and Practice of Pediatricians in India

Issues of interdisciplinary interaction during detection and diagnosis of tuberculosis in children and adolescents: a literature review and comments

Interdisciplinary interaction between phthisiatricians and pediatricians on the issues of detection and diagnosis of tuberculosis provides basis for the reduction of duration of the diagnostic process and the early identification of disease progression. The purpose of this review and comments is to systematize the knowledge of pediatricians about the detection and diagnosis of tuberculosis in children and adolescents in primary health care (PHC) facilities to improve the diagnostic process. We have performed an analysis and systematization of the current directive and methodological documents, articles on the detection and diagnosis of tuberculosis in PHC facitlities. The significance of skin immunological tests (Mantoux test using 5 tuberculin units (TU) of purified protein derivative (PPD)-L and a test with recombinant tuberculosis allergen (RTA)) during mass and selective screening to form groups at high risk for Tuberculosis and detect the disease is emphasized. The doctor’s actions based on the current guiding documents and laws are presented for cases when parents/legal representatives or the patient himself refuses from immunological skin tests. Positions that determine the need for interdisciplinary interaction for pediatricians on the issues of detection, diagnosis and differential diagnosis of tuberculosis are clearly articulated. The pathway to diagnosis begins with the formation of groups at high risk for tuberculosis in PHC facilities and with seeking medical help from a pediatrician in the presence of clinical signs similar to those of tuberculosis. Particular attention is paid to the detection of the disease when patients with clinical symptoms similar to those of tuberculosis seek medical help, and the missed opportunities for its early diagnosis are presented. Predictors allowing pediatricians to suspect tuberculosis and promptly refer a patient to a phthisiatrician to confirm / exclude the disease are provided.

Autism spectrum disorder: perspectives from paediatricians

Aims: Since the first medical contact of children and families is mostly with paediatricians, the knowledge and experience of paediatricians on Autism Spectrum Disorder (ASD) is extremely significant. It was aimed to investigate paediatricians’ general knowledge on ASD, daily practices in the outpatient clinic and ability to recognize warning signs. 
 Methods: A 40-item questionnaire prepared by the researchers was completed with 116 specialists or subspecialties working in public and private hospitals of two cities in Türkiye. 
 Results: While 41.7% of paediatricians received rotation training in residency, 32.8 % reported they have enough experience. While 87% considered ASD screening among their duties, only 12.8% stated they have enough time. The number of patients referred for formal assessment of ASD was low. Gender, type of expertise, duration of experience, and sense of competence were not associated with referral frequency. It’s been determined paediatricians have a lack of knowledge about ASD. While not responding to name and difficulty following the instructions were seen as most warning symptoms, other diagnostic criteria and accompanying symptoms were recognized insufficiently.
 Conclusions: In addition to increasing the duration and quality of child psychiatry education during residency, regulating the outpatient clinic conditions can overcome an important obstacle in the early diagnosis of ASD.

Evaluation of pediatricians' awareness about anaphylaxis.

Anaphylaxis is a severe hypersensitivity reaction with a rapid onset and is potentially life-threatening if not treated promptly. This study aimed to determine the level of knowledge of pediatricians in Turkey in recognizing and treating the clinical symptoms of anaphylaxis, compare the previous studies conducted in Turkey chronologically, and show the current trends on awareness of anaphylaxis in developed and developing countries in the world. Pediatric residents and specialists from all over Turkey were included in the study. A questionnaire was prepared by compiling the current literature. Questions were sent to pediatricians via online applications. Statistical tests were used to analyze the data. A total of 524 pediatricians participated in the study. All participants accepted that anaphylaxis was a life-threatening condition. Almost all suggested epinephrine as the primary drug used in anaphylaxis. The proportion of pediatricians who knew the appropriate dose, route of administration, and place of administration of epinephrine was 82.8%, 88.9%, and 89.7%, respectively. The rate of pediatricians who recognized the clinical features of anaphylaxis was over 90%. The proportion of pediatricians who knew the epinephrine auto-injector and dose was 74.4% and 53.1%, respectively. Pediatricians with less than 10 years of experience and those working in public hospitals had better knowledge about atypical symptoms of anaphylaxis. Although there are still inadequacies in identifying atypical symptoms and treating anaphylaxis, our study revealed that the level of awareness of anaphylaxis had shown an increasing trend in Turkey over time. On the other hand, the knowledge on diagnosing and treating anaphylaxis still needs to be improved, especially for physicians working in rural areas of developing countries.

Analysis of brazilian pediatricians’ knowledge of cow's milk protein allergy

To analyze the knowledge of Brazilian pediatricians about cow's milk protein allergy (CMPA) using a validated questionnaire. Quantitative study with a cross-sectional design in which an online questionnaire on CMPA knowledge was applied. The sample calculation indicated 1024 participants. The online form was divided into two blocks, the first comprising questions on the identification of pediatricians, and the second comprising the validated questionnaire, built from the Brazilian Consensus on Food Allergy (2018). The general evaluation of the questionnaire showed a percentage of agreement of 91% and a Content Validity Index of 0.95. The results of the applied questionnaires were presented in absolute and relative frequencies, mean, median, standard deviation, and percentiles. The level of significance was set at 5% (p

10 Paediatricians’ Awareness of Canadian Screen Time Guidelines, Perception of Screen Time Use, and Counseling during the COVID-19 Pandemic

Abstract Background Paediatricians are essential for guiding families on screen time use as digital media become increasingly prevalent, particularly through the COVID-19 pandemic. However, there is no literature on paediatrician awareness of Canadian guidelines or on perception of these guidelines during the pandemic. Objectives The aim of this study was to assess the knowledge, attitudes, and comfort of paediatricians with the Canadian Paediatric Society’s (CPS) screen time guidelines, specifically during the COVID-19 pandemic. Design/Methods Our survey was developed by a paediatric resident and paediatric endocrinologist, reviewed by local experts, and sent electronically to members of the Community and Developmental Paediatrics Sections of the CPS. Results All 53 respondents were aware of current CPS screen time guidelines, and the majority had fair to excellent knowledge of guidance for both age groups (<5 years, and school-aged children and adolescents). Over 80% noticed increased screen time use during the pandemic, and 98% were somewhat or very concerned about screen time use and their patients’ health or well-being. Qualitative data indicated paediatricians were concerned about associations between increased screen time with worsening behaviour, mental health concerns, obesity, and sedentary lifestyle. The greatest implementation barrier was perceived to be insufficient motivation or support from caregivers/families. Conclusion Our study demonstrates that paediatricians are highly knowledgeable and comfortable with current screen time guidelines, and frequently counsel their patients accordingly. Despite this, paediatricians are increasingly concerned with negative health outcomes associated with screen time use. We hope these results empower paediatricians to continue counseling patients and encourage further local advocacy and public education around increased screen time and related health risks in children.

Knowledge, Attitudes And Practices Of Paediatricians On The Management Of Childhood Eye Diseases In Ghana

Objective: To explore the knowledge, attitudes and practices of paediatricians on the management of eye diseases among children in Ghana.
 Methodology: This was a mixed model study, both quantitative and qualitative methods were employed among paediatricians practicing in hospitals across Ghana who consented to the study. Consecutive sampling was used to select participants. Self-administered, semi-structured questionnaires, in-depth interviews and focused group discussions were used to collect relevant data. Analysis was carried out with STATA version 14.
 Results: More than half (53, 60.2%) of Paediatricians practicing in Ghana had good knowledge of childhood eye diseases. Although almost all (89, 98.9%) paediatricians disagreed with the statement that ‘eye examination in children should be done only when the caregiver complains’ and a majority (79, 87.8%) of paediatricians responded “yes” to the question ‘do you do eye examination in children?’, fifty four (59.3%) indicated that in practice they only examined a child’s eye when the caregiver reports that the child has an eye problem, and only 24 (26.4%) indicated it was a routine part of every child’s examination in their practice. In addition, all paediatricians disagreed with the statement that ‘eye examination in children can only be done by an eye care worker’. These assertions were clarified during the in-depth interviews and focused group discussions where paediatricians conceded that only general inspection of the eyes is done when examining the eyes of children.
 Conclusion: Paediatricians had satisfactory knowledge and good attitude towards childhood eye diseases. However, their practices regarding childhood eye disease management were poor.

Knowledge and Role of Paediatricians/Paediatric Residents in Infant Oral Healthcare and Dental Home across Saudi Arabia: A Cross-Sectional Study.

The prevention of oral diseases in children is highly achievable through providing early exposure to oral healthcare habits, which would make children more receptive towards dental services. A cross-sectional study used a structured, self-explanatory questionnaire to evaluate the knowledge and role of 190 paediatricians and paediatric residents towards infant oral healthcare and the dental home across Saudi Arabia. The authors sent a link to the questionnaire, comprising 36 questions, by email, as a Google e-form. The response rate obtained was 87.36%. A major proportion (95.8%) of the respondents considered that paediatricians play an important role in promoting oral health. Around 45.8% of the practitioners recommended tooth brushing after the eruption of the first tooth. About 38% of the practitioners were unaware of the children's first dental visit. The majority (95.2%) agreed that there should be an increased awareness regarding home dental habits. Most of them (78.3%) examined the oral cavity for dental problems as a part of routine childcare, and the majority (75.3%) admitted that they did not evaluate fluoride needs. A statistically significant higher mean knowledge score was observed for practitioners with more than 30 years of experience (9.35 ± 2.29), and there was a significant positive correlation (r = 0.486) between the knowledge score and mean score for the role of paediatric practitioners. Overall, the study concluded that the knowledge of paediatricians and paediatric residents in SA towards infant oral healthcare and the dental home was inadequate, and their role in maintaining oral health was found to be moderately satisfactory.

Perceptions of pediatric residents and pediatricians about ethical dilemmas: The case of Turkey

BackgroundThis study determined the knowledge, attitudes, and behaviors of pediatricians and pediatric residents regarding issues of ethics, professional education, clinical ethical principles, and consent they encounter in health service delivery. MethodsParticipants in the study were 134 pediatricians and pediatric residents from three hospitals in Ankara, Turkey. Participants were asked questions regarding their sociodemographic characteristics, their knowledge and views of ethics and ethical education, whether they had ever encountered an ethical problem, their beliefs about obtaining consent from pediatric patients and their families, and case-based questions. All data were collected and evaluated. ResultsOf the participants in the study, 82 (61.2%) were residents, 41 (30.6%) were pediatricians, and 11 (8.2%) were faculty lecturers. The data revealed that 10% of the pediatricians and pediatric residents received ethical education, apart from medical ethics/deontology education at medical school, and 90.3% required further education on children and ethical problems. It was determined that 89% of residents and 78% of pediatricians needed help with the ethical problems they encountered during the diagnostic and treatment processes. Overall, 65.7% of the participants stated that the ethical problems they encountered affected the efficiency of health service delivery. It was observed that residents were more affected by ethical issues than pediatricians were. The present study revealed that pediatric residents and pediatricians need ethics education and there is a need to establish ethics counseling centers in hospitals. There is also a need for further studies in pediatrics and ethics.

Errors in the diagnosis and therapy of bronchial asthma in children

The analysis of outpatient records of children with bronchial asthma was carried out to identify the timeliness of the diagnosis of bronchial asthma, which showed that the diagnosis was made with a delay of 3.8 years. In children with prolonged persistent cough, repeated acute obstructive bronchitis, bronchophonography revealed latent bronchospasm, the subsequent appointment of preventive anti-inflammatory therapy to these patients made it possible to clarify the diagnosis of bronchial asthma in 58.9 % of cases. Analysis of the register of patients with bronchial asthma revealed the absence of basic therapy in 2/3 of children with a mild persistent course of the disease. The frequency of emergency medical calls and hospitalizations was higher in children with mild bronchial asthma who did not receive control therapy. An analysis of the expenditure of short-acting β2-agonists in 96 children with asthma indicates their excessive use in 50% of patients. Conducting training seminars increased the knowledge of district pediatricians on modern thera-peutic and diagnostic approaches to bronchial asthma.

Knowledge, attitudes and practices of general practitioners and paediatricians towards Group A beta-haemolytic streptococcal tonsillopharyngitis: A cross-sectional study from Türkiye.

General practitioners (GPs) and paediatricians are very important in the management of sore throat in terms of providing correct diagnosis and treatment. The aim of this study was to evaluate the knowledge, attitudes and practices of GPs and paediatricians towards Group A beta-haemolytic streptococcal (GABHS) tonsillopharyngitis. Three vignettes/case studies, in which the causative agents were GABHS, Epstein-Barr virus (EBV) and non-EBV viral infection, were presented as part of a questionnaire sent to paediatricians and GPs to elicit information regarding their diagnosis and treatment of tonsillopharyngitis. In all, 236 physicians responded to the questionnaire (126 paediatricians, 106 GPs). GPs registered more accurate diagnoses of GABHS tonsillopharyngitis and tended to administer more symptomatic treatment in the case of non-EBV tonsillopharyngitis than paediatricians. Paediatricians requested more tests in the diagnosis of GABHS tonsillopharyngitis than GPs. Most GPs and paediatricians possess adequate knowledge regarding GABHS diagnosis and the differential diagnosis of patients. Differences between the hospital and general practice settings may have affected the approach to symptomatic treatment and requesting tests.

Emergency paediatric medicine consultation—a practical guide to a consultation with refugee and asylum-seeking children within the paediatric emergency department

There are increasing numbers of refugee and asylum-seeking children entering the UK annually who face significant barriers to accessing healthcare services. Clinicians working in the emergency department should have an awareness of the journeys children may have taken and the barriers they face in accessing care and have a holistic approach to care provision. We conducted a narrative literature review and used experiential knowledge of paediatricians working in the Paediatric Emergency Department to formulate a step-by-step screening tool. We have formulated a step-by-step screening tool, CCHILDS (Communication, Communicable diseases, Health—physical and mental, Immunisation, Look after (safeguarding), Deficiencies, Sexual health) which can be used by healthcare professionals in the emergency department.Conclusion: Due to increasing numbers of refugee and asylum-seeking children, it is important that every point of contact with healthcare professionals is an impactful one on their health, well-being and development. Future work would include validation of our tool.What is Known:•The number of refugees globally are rapidly increasing, leading to an increase in the number of presentations to the PED. These patients are often medically complex and may have unique and sometimes unexpected presentations that could be attributed to by their past. There are a multitude of resources available outlining guidance on the assessment and management of refugee children.What is New:•This review aims to succinctly summarise the guidance surrounding the assessment of refugee children presenting to the PED and ensure that healthcare professionals are aware of the pertinent information regarding this cohort. It introduces the CCHILDS assessment tool which has been formulated through a narrative review of the literature and acts as a mnemonic to aid professionals in their assessment of refugee children in the PED.

Knowledge, Attitude and Practice of Pediatricians toward Early Childhood Caries in Upper Egypt (A Cross-Sectional Study )

Knowledge, Attitude and Practice of Pediatricians toward Early Childhood Caries in Upper Egypt (A Cross-Sectional Study )

Perspective of pediatricians about early childhood caries (ECC) in lumbini province Nepal: A major virulent dental problem

Early childhood caries (ECC) is a significant worldwide oral health problem that needs to be looked after by parents. Some parents do not care about the oral health of their children, and they more frequently visit pediatricians. So, pediatricians are one of the most reliable profession for preventing children’s oral diseases, and promoting awareness. The aim of the study was to know the knowledge and awareness of pediatricians’ about early childhood caries (ECC) in lumbini province, Nepal.A total of 40 pediatricians were selected by using census sampling method and were requested to fill out an objective questionnaire pertaining to individual’s knowledge about ECC, without providing any oral health information taking duration of the study from March 2021 to September 2021.About 23(56.5%) of pediatricians understood the importance of pediatric dentistry. About 34(86.2%) of pediatricians performed oral examination regularly. Around 17% of pediatricians had knowledge of the ECC. Only 14(33.3%) of pediatricians acknowledged the cariogenicity of sugar containing medical syrups.The study shows poor knowledge regarding ECC, oral health, and dental treatment need in children among the surveyed pediatricians although having good knowledge about pediatric speciality and importance of primary dentition. Thus, there is a need to update the Pediatricians on recent recommendations about ECC and its early screening.

Knowledge, Attitude, Practices, and Training of Pediatricians in India Regarding Sleep Disorders in Children: A Need to Wake Up!

Knowledge, Attitude, Practices, and Training of Pediatricians in India Regarding Sleep Disorders in Children: A Need to Wake Up!

The attitude and knowledge of pediatricians and family physicians toward COVID-19 vaccination in children: A cross-sectional study

ABSTRACT COVID-19 vaccines to children are expected to reduce the transmission of the disease to high-risk groups and achieve herd immunity in younger populations. A positive attitude toward COVID-19 vaccination in children among healthcare workers (HCWs) is predicted to reduce parents’ hesitancy to vaccinate their children. This study aimed to assess the knowledge and attitude of pediatricians and family physicians toward COVID-19 vaccination in children. A total of 112 pediatricians and 96 family physicians (specialists and residents) were interviewed to assess the level of knowledge, attitude, and perceived safety of COVID-19 vaccines for children. Physicians willing to receive regular COVID-19 vaccination (analogous to the influenza vaccine) had significantly higher knowledge and attitude scores (P < .05). Multivariate analysis indicated that a higher knowledge score and having at least five years of experience as a specialist were significantly associated with a positive attitude among pediatricians or family physicians (P < .05). Pfizer/BioNTech was the preferred COVID-19 vaccine in children among physicians of both groups (>67%). Around 71% of physicians believed COVID-19 vaccines for children do not cause or worsen any health condition. Educational and training programs that increase the knowledge of physicians about COVID-19 vaccines and their safety in children are recommended to inform a more positive attitude.

CLINICAL FEATURES AND MANAGEMENT OF FEBRILE SEIZURES IN PEDIATRICS

A febrile seizure (FS) may be defined as an event in infancy or childhood, mostly occurring between six months and five years of age. It is accompanied by fever but without signs of intracranial infection. These are not regarded as a type of epilepsy. Moreover, they are an age-dependent phenomenon which occurs in about 2 - 4 % of children. FS can lead to extreme fear in parents, even if they are generally harmless for children, which makes it important to manage parental anxiety in the most careful manner. This review focuses on the management of FS in the paediatric age. Most children with FS have high rate of prediction while few develop long-term health issues as shown by an analysis of the literature. Its diagnosis is clinical. Intracranial infections are important to exclude, particularly after a complex FS. Symptom control and treating the cause of the fever are elements of its management. It is crucial to improve the knowledge of paediatricians and neurologists on FS management due to the improper use of diagnostic tests and treatments and to standardize the diagnostic and therapeutic work-up.

Early childhood caries: Detection, prevention, and referral. A questionnaire study of general medical practitioners and pediatricians in the south of France

IntroductionEarly childhood caries (ECC) is an illness defined as the presence of one or more decayed, missing after caries, or filled tooth surfaces in any primary tooth in a child under the age of 6 years. It has a negative impact on the physical and the psychological development of children. General medical practitioners (GPs) and pediatricians, the first professionals involved in the follow-up of young children, are on the frontline of detecting and referring patients with caries or individual high-risk of carious lesions. The aims of this study were (1) to assess the current state of knowledge of pediatricians and GPs in the south of France regarding ECC detection and prevention, and (2) to understand whether there are difficulties in referring young patients for the early detection of carious lesions. MethodsA semi-structured questionnaire was circulated to GPs and pediatricians working in the Provence-Alpes-Côte d'Azur region (France). The questionnaire was divided into three parts related to the characteristics of the participants, to the current skill and knowledge of practitioners in detecting ECC (using clinical vignettes) and advising preventive measures, and to the dental examination and any difficulties in referring patients. ResultsThere were 97 participants in the study. Many oral hygiene measures were known but only just over half of the dietary risk factors were recognized. Participants seemed to be involved in detecting ECC, the majority very often examined teeth during their consultations. Practitioners recognized a carious lesion in only one of two cases. The lack of knowledge of the recommended age for the first consultation could be a barrier in referring patients to a dentist, for which pain remains the main reason for referral. ConclusionGPs and pediatricians should play a key role in the detection and prevention of ECC. Participants showed great interest in the topic of oral health. For better management, it would be beneficial to provide training resources with quick and efficient access to information.

Are pediatricians familiar with hereditary angioedema?

BackgroundHereditary angioedema (HAE) is an autosomal dominant disease characterized by recurrent episodes of subcutaneous or mucosal edema caused by excess bradykinin. The aim of the present study was to assess the knowledge of pediatricians about hereditary angioedema. MethodsAn online survey with 12 HAE-related and 14 demographics-related questions was e-mailed to all pediatricians who were members of the Brazilian Society of Pediatrics (n = 17 145) once a week during the months of June and July 2021. The electronic questionnaire assessed clinical manifestations, diagnosis, and treatment of hereditary angioedema in children and adolescents. ResultsFour hundred and fifty-five pediatricians responded to the questionnaire (2.6%), of whom 55 (12.1%) were board certified in Allergy and Immunology (A/I), while 400 (87.9%) were not (N-A/I). Three hundred and sixty-eight (80.9%) were female, 289 (55.7%) were under 50 years of age, 286 (62.9%) graduated from Medical School more than 10 years previously, 83 (18.2%) held an MSc/PhD degree, and 253 (55.6%) were living in the Southeast Region of Brazil. The median number of correct answers to the questions related to HAE among A/I was 7 out of 12 (58.3%), with median ranging from 4.5 to 8 correct answers, while for N-A/I it was 3 (25%), with median ranging from 2.5 to 4 correct answers (p < 0.001). ConclusionKnowledge about HAE among Brazilian pediatricians, whether board certified in Allergy and Immunology or not, was unsatisfactory. HAE is a rare disease, largely unknown among physicians; therefore, increasing awareness may lead to improvement in diagnosis and treatment.

Knowledge, perceptions, and behavior regarding children’s oral health among Syrian pediatricians: a cross-sectional study

BackgroundOral health has a direct impact on health-related quality of life (HRQoL). Hence, general health and oral health cannot be separated. Pediatricians play a pivotal role in providing primary care for infants and are the first to interact with them since birth. Therefore, the aim of this study was to evaluate the knowledge, perceptions, and behavior of Syrian pediatricians regarding children’s oral health.MethodsThis was a cross-sectional study. The questionnaire consisted of six main sections and required answers regarding demographic characteristics, knowledge, behavior, perceptions, and training received in oral health. The association between categorical variables was tested with Pearson’s chi-square tests and Fishers exact tests using SPSS ver. 23.ResultsThe response rate was 43.12% (229/531). Most of the participants (64.02%) got a poor level of knowledge and no significant association was found between knowledge level and years of experience (p = 0.270). The majority of the participants (99.13%) perceived that diet, bacteria, and sugar exposure time are the etiological factors of dental caries. The overwhelming majority of the participants (98.25%) acknowledged the need for further oral health training during residency.ConclusionsMost pediatricians reported a poor level of knowledge. It is recommended to update the postgraduate and residency curriculum to equip pediatricians with adequate knowledge regarding children’s oral health.