Prevalence Of Infants Research Articles

Life-threatening methaemoglobinaemia secondary to cetrimide

Methaemoglobinaemia is a rare but potentially life-threatening condition in which there is diminution of the oxygen-carrying capacity of the circulating haemoglobin. It can result from either congenital or acquired processes. Acquired methaemoglobinaemia is more prevalent than congenital methaemoglobinaemia, and notably it has a higher prevalence in infants and neonates than in adults; it results from exposure to oxidising agents. Methaemoglobin forms when haemoglobin is oxidised to contain iron in the ferric (Fe3+) state rather than the normal ferrous (Fe2+) state. Methaemoglobinaemia is a clinical diagnosis and is suspected in the presence of hypoxaemia refractory to supplemental oxygen and in the presence of chocolate-coloured blood. Symptoms are usually dependent on the methaemoglobin levels; at levels higher than 35%, systemic symptoms from tissue hypoxia may be fatal. We present a case of severe life-threatening methaemoglobinaemia following intra-abdominal use of cetrimide during hydatid cyst removal in a 60-year-old female.

Down syndrome and associated atrioventricular septal defects in a nationwide Norwegian cohort: Prevalence, time trends, and outcomes.

The prevalence of Down syndrome (DS) is approximately 1 per 1000 births and is influenced by increasing maternal age over the last few decades. DS is strongly associated with congenital heart defects (CHDs), especially atrioventricular septal defect (AVSD). Our objectives were to investigate the prevalence of live-born infants with DS having a severe CHD in the Norwegian population over the last 20 years and compare outcomes in infants with AVSD with and without DS. Information on all births from January 1, 2000 to December 31, 2019 was obtained from the Medical Birth Registry of Norway. We also obtained data on all infants with severe CHDs in Norway registered in Oslo University Hospital's Clinical Registry for Congenital Heart Defects during 2000-2019 and accessed individual-level patient data from the electronic hospital records of selected cases. Infants with AVSD and DS were compared to infants with AVSD without chromosomal defects. Crude and adjusted odds ratios (ORs) of infant mortality and need for surgery during the first year of life, with associated 95% confidence intervals (CIs), were estimated by logistic regression. A total of 1 177 926 infants were live-born in Norway during the study period. Among these, 1456 (0.1%) had DS. The prevalence of infants with DS having a severe CHDs was relatively stable, with a mean of 17 cases per year. The most common CHD associated with DS was AVSD (44.4%). Infants with AVSD and DS were more likely to have cardiac intervention during their first year of life compared to infants with AVSD without chromosomal defects (adjusted OR [aOR]: 2.52; 95% CI 1.27, 4.98). However, we observed no difference in infant mortality during first year of life between the two groups (aOR: 1.08; 95% CI 0.43, 2.70). The prevalence of live-born infants with severe CHDs and DS has been stable in Norway across 20 years. Infants with AVSD and DS did not have higher risk of mortality during their first year of life compared to infants with AVSD without chromosomal defects, despite a higher risk of operative intervention.

Epidemiology, Outcomes, and Trend Analysis of Hospitalized Infants With Respiratory Syncytial Virus (RSV) Bronchiolitis From 1997 to 2019.

Background Most children with respiratory syncytial virus (RSV) infection have a self-limiting course that can be managed with supportive care, and hospitalization is uncommon. The objectives of this study were to evaluate the epidemiology, outcomes, associated comorbidities, and temporal trends in the prevalence of infants one to 24 months of age who required hospitalization for RSV infection in the United States of America from 1997 to 2019. Methods In this retrospective cross-sectional study, we utilized the Kids' Inpatient Database (KID) to investigate the prevalence and outcomes of RSV bronchiolitis within a large cohort of discharged patients from 1997 to 2019. We included children one to 24 months of age admitted with a diagnosis of RSV bronchiolitis. Neonates were excluded from the analysis. A chi-square for linear trend was used to analyze trends in the prevalence of RSV bronchiolitis hospitalization, the presence of complex chronic conditions (CCC), congenital heart disease (CHD), the use of non-invasive and invasive mechanical ventilation (NIV and IMV), and hospital mortality. Results There were a total of 566,786 infants aged one to 24 months hospitalized with RSV infection out of a total of 9,309,597 discharges during the eight-year cohort, with a hospital prevalence of 60.9 per 1000 discharges and a hospital mortality rate of 0.09% (95% confidence interval (CI): 0.08%-0.1%). There was no trend in hospitalization rates of RSV infections per 100,000 U.S. population during the study period, with a decrease in hospital mortality trend. Children with RSV bronchiolitis were more likely to have government insurance and reside in zip codes with the lowest income quartile. There was a significant seasonal and regional variation in RSV-related hospitalizations. The presence of CCC was identified in 2.4% of the RSV group compared to 5.1% of non-RSV discharges (odds ratio (OR): 0.46, 95% CI: 0.45-0.47; p<0.001). The prevalence of RSV among all discharges has significantly increased over the study period, rising from 51.6 cases per 1000 discharges in 1997 to 180.1 cases per 1000 discharges in 2019 (p<0.001). The prevalence of CCC and CHD among RSV patients has also shown an upward trend, with CCC cases increasing from 1,411 in 1997 to 2,795 in 2019 and CHD cases rising from 1,795 to 3,622 during the same period. The use of invasive mechanical ventilation, non-invasive ventilation, and extracorporeal membrane oxygenation has consistently increased over time. Additionally, complications such as the need for cardiopulmonary resuscitation have demonstrated a similar increasing trend, although they have remained overall low. However, population-based hospitalization rates showed no significant trend. Conclusions The hospitalization rates at a population level in the United States for RSV infection in children aged one to 24 months remained steady from 1997 to 2019, while hospital mortality rates showed a declining trend. There is an increased proportion of comorbid conditions and increased resource utilization in children with RSV. These findings are important for monitoring the effectiveness of preventive strategies for severe RSV infections.

MDB-41. TARGETING PBK IN GROUP 3 MEDULLOBLASTOMA

Abstract BACKGROUND Group 3 medulloblastoma (MB) remains a challenging diagnosis especially due to a tendency for higher prevalence in infants and to develop frequent relapse. Targeted therapy remains elusive for these patients due to a lack of targetable alterations as well as poor understanding of driver mutations. PBK/TOPK has previously been identified as a hub gene in medulloblastoma and we have recently demonstrated that the LIN28B-PBK axis may be playing a crucial role in Group 3 MB development. METHODS Here we utilize transcriptomic profiling to identify pathways regulated by PBK in Group 3 MB to help identify potential vulnerabilities, immunofluorescence and cell viability analysis to calculate drug synergy. RESULTS Our analysis demonstrates that PBK knockdown leads to significant down regulation of cell cycle pathway genes. We also demonstrate that combining PBK inhibitor HI-TOPK-032 with the CDK 4/6 inhibitor palbociclib is synergistic in Group 3 MB cells. CONCLUSION Our investigations suggest PBK inhibition alone or in combination with other targeted agents may be a useful addition to existing therapy for these hard to treat cancers.

Determination of the Prevalence of Ascaris lumbricoides in Children under the Age of Five Years Attending at Kongowe Health Centre, Kibaha District, Pwani Region.

The worldwide distribution and occurrence show that more than 1.8 billion people, accounting for 28% of the global population, are infected with A. lumbricoides infection due to poor hygiene. The World Health Organization aims to eliminate morbidity from A. lumbricoides infection in children by 2030 by at least 75%. Surveys in the Pwani Region of Tanzania have shown poor hygienic risk factors due to high population and lack of sufficient toilets/latrines, poor sewage waste disposal, and insufficient clean drinking water that encourages the reproduction, transmission, and reinfection of A. lumbricoides. No study has been conducted in Pwani Region to determine the extent of A. lumbricoides infection among the population. This research tends to explore more about the status of A. lumbricoides infection in Kibaha District in the Pwani Region, Tanzania. A cross-sectional study was done on 400 children (170 males and 230 females) who were under the age of 5 years old at Kongowe Health Centre. Collected data for A. lumbricoides infection measured were analyzed using Microsoft Excel, while data for sociodemographic findings and risk assessment were subjected to bivariate and multivariable analysis using Statistical Package for Social Sciences version 28.0.1.0 software (SPSS Inc., USA) at the level of significance of P < 0.05. Of the 400 children who participated in the laboratory testing of A. lumbricoides infection, 194 were found positive for A. lumbricoides infection. Amongst the 194 children who were found to be positive, 4.1%, 38.7%, and 57.2% were found to be in the age group of below 1 year old, 1 to 2, and 3 to 4 years old, respectively. The tabulated responses on the social demographic responses showed that 81.8% of the responses at P = 0.041 and 80.6% at P = 0.101 knew that A. lumbricoides infection is acquired from faeces and uncooked food, respectively, as 61.8% at P = 0.132 and 63.2% at P = 0.085 respondents did not accept that soil and dirty water, respectively, were not sources of A. lumbricoides infection. At P = 0.612 and P = 0.022, 64% and 91.2% of the respondents showed the importance of using latrines/toilets and washing fruits, respectively. Further results showed that 69.8% and 37.6% of the respondents reacted with no importance of washing hands with soap after using a toilet/latrine and no need to treat or boil water before drinking, respectively. A. lumbricoides infection has a high prevalence in infants of the Kibaha District of Tanzania, especially in Kongowe village. The infection is dominant in males compared to female children. The prevalence is due to risk factors such as inadequate sanitation, low level of education, knowledge, and awareness of prevention strategies.

A Comparative Study of the Breast Feeding Practice of Mothers between Rural Area and Urban Area in Bangladesh

The exclusive breast feeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months of life and the later age breastfeeding provides complete nutrition for infants and children. But it is not properly maintained in Bangladesh with limited resources, such as Sirajganj, where poverty and illiteracy are prevalent. Poor nutritional status during childhood can have long-lasting consequences in adulthood, including health, mortality, and human capital. It was a community based cross sectional comparative study which was conducted on 500 hundred mothers and their 500 hundred children in which 250 mothers and 250 children from each of Sirajganj and Dhaka City were selected. The target respondents were selecting randomly. χ 2 test, and Pearson’s correlation was performed as P&lt;0.05 level of significance. The study found that there was a higher number of female children and higher birth frequencies in Sirajganj and Dhaka City. The study assessed mothers' breast feeding practices, including knowledge of colostrums, first baby food feeding, initiation, and duration of exclusive breastfeeding. Sirajganj city mothers received more breastfeeding attention than Dhaka City mothers, with findings decreasing with child's birth order. Breast feeding privileges in Sirajganj City increase as mothers' education levels rise from low school to a bachelor's degree or higher. Breast-feeding prevalence in infants up to 12 months is influenced by factors like sex, maternal age, birth order, education, employment status, and mother's poverty income ratio. The sickness of children is also influence to stop breast-feeding. The child birth weight was found to comparatively lower in the Sirajganj city than Dhaka City.

PREVALENCE AND CHARACTERISTICS OF INFANTS WITH RESPIRATORY DISTRESS SYNDROME IN THE NEONATUS INTENSIVE CARE UNIT OF SANGLAH HOSPITAL IN 2020

Respiratory distress syndrome (RDS) is a cause of respiratory distress in baby that occurs several hours after newborns and can cause respiratory arrest and even death. This study aims to provide an overview of the prevalence and characteristics of infants with RDS in neonatal intensive care unit of Sanglah Hospital in 2020. This study used a cross-sectional descriptive approach with retrospective data. The study sample was infants aged 0-28 days with RDS in the neonatal intensive care unit of Sanglah Hospital who were recorded in complete medical records from January 1, 2020 to December 31, 2020. The prevalence of infants with RDS in the neonatal intensive care unit of Sanglah Hospital in 2020 was 10.9%. All of them were singleton pregnancies with a magnitude of 0 days (63.9%), female (52.8%), and second children (50%). Most of the mothers had done prenatal care (91.7%), without a history of disease (75%), primipara (50%), and ruptured membranes &lt;24 hours (75%). Babies born with very premature gestational age (61.1%), by cesarean section (55.6%), low birth weight (30.6%), and APGAR score 7-10 (75%). A total of 36.1% of infants used a breathing apparatus in CPAP and received first-line antibiotics (94.4%). Infants with RDS have a high variability of characteristics including the general characteristics of the history of pregnancy and childbirth. The recommendation for other researchers are expect to conduct further analytical studies in the future.

Genetic diversity and declining norovirus prevalence in infants and children during Japan's COVID-19 pandemic: a three-year molecular surveillance.

Noroviruses (NoVs) are a global concern, causing widespread outbreaks and sporadic acute gastroenteritis (AGE) cases across all age groups. Recent research has shed light on the emergence of novel recombinant strains of NoV in various countries. To delve deeper into this phenomenon, we extensively analyzed 1,175 stool samples collected from Japanese infants and children with AGE from six different prefectures in Japan over three years, from July 2018 to June 2021. Our investigation aimed to determine the prevalence and genetic characteristics of NoV associated with sporadic AGE while exploring the possibility of detecting NoV recombination events. Among the analyzed samples, we identified 355 cases positive for NoV, 11 cases attributed to GI genotypes, and 344 associated with GII genotypes. Notably, we discovered four distinct GI genotypes (GI.2, GI.3, GI.4, and GI.6) and seven diverse GII genotypes (GII.2, GII.3, GII.4, GII.6, GII.7, GII.14, and GII.17). The predominant genotypes were GII.4 (56.4%; 194 out of 344), followed by GII.2 and GII.3. Through dual genotyping based on sequencing of the ORF1/ORF2 junction region, we identified a total of 14 different RdRp/capsid genotypes. Of particular interest were the prevalent recombinant genotypes GII.4[P31] and GII.2[P16]. Notably, our study revealed a decrease in the number of children infected with NoV during and after the COVID-19 pandemic. These findings underscore the importance of continuous NoV surveillance efforts.

Evaluation of the effect of reduced-dose pneumococcal conjugate vaccine schedules on vaccine serotype carriage in children and their caretakers in a naïve population in Vietnam: Protocol for a cluster randomized non-inferiority trial.

Introduction: The WHO currently recommends giving pneumococcal conjugate vaccines (PCVs) as three doses - either three doses in infancy with Pentavalent vaccine (3p+0), or two doses in infancy followed by a booster around 12 months (2p+1). However, their high price is a barrier to introduction and sustainability in low and middle-income countries. We hypothesize that a schedule with a single priming and a booster dose (1p+1) may maintain similar levels of protection for the community by sustaining herd immunity, once circulation of vaccine types has been controlled. Methods and analysis: We will conduct a cluster randomized trial with four intervention arms (1p+1, 0p+1, 2p+1, 3p+0) and three unvaccinated clusters in the 27 communes of Nha Trang, central Vietnam. A PCV catch-up vaccination campaign to all children under three years of age will be performed at the start of the trial. The primary endpoint is non-inferiority of the1p+1 schedule if compared to the WHO standard 2p+1 and 3p+0 schedules in reducing vaccine serotype carriage prevalence in infants. We will also explore impact of 0p+1 schedule. A baseline and annual pneumococcal carriage surveys of 6480 participants per survey covering infants, toddlers and their mothers will be conducted. Ethics and dissemination: Ethical approvals were obtained from the ethical review committees of Institute of Tropical Medicine, Nagasaki University (151203149-2) and the Ministry of Health, Vietnam (1915/QD-BYT). The results, interpretation and conclusions will be presented at national and international conferences, and published in peer-reviewed open access journals. Trial registration number: NCT02961231.

Patterns of Breastfeeding Practices among Mothers in Two Urban Cities in Vietnam

INTRODUCTION: Breastfeeding is associated with lower risk of child morbidity and mortality and foster overall child development. However, suboptimal breastfeeding practices have been reported in many countries. This study aims to describe patterns of breastfeeding from birth to 24 months in Vietnam and examine factors associated with the maintenance of breastfeeding at 12 months. MATERIALS AND METHODS: 573 mothers whose infants aged from 12 to 24 months in a multi-centre cross-sectional study were recruited. RESULTS: The prevalence of initiation of breastfeeding within the first hour post-partum was 52.9%, between 1 to 24 hours was 21.9%, after the 24 hours was 25.2% and none not initiated by the 7th day after birth. The prevalence of delayed initiation of breastfeeding was significantly higher in caesarean section than in vaginal births (p=0.0001). Prevalence of infants ever breastfed was 100%; exclusively breastfed at 6 months was 19.7%, continued breastfeeding at 12 months was 92.5%, and continued breastfeeding at 20-24 months was 43.5%. There were 16.4% of mothers had breastfeeding problems. Correctly describing the recommended duration of exclusive breastfeeding and not using a bottle to give expressed milk to the infants were factors associated with the higher prevalence of breastfeeding maintenance for 12 months. CONCLUSION: Early initiation of breastfeeding and exclusive breastfeeding prevalence at 6 months in our study earn rating of “good” and “fair” respectively according to World Health Organization (WHO) recommendation. Improving mothers’ knowledge of exclusive breastfeeding recommendations and educating about breast milk expression may improve the prevalence of breastfeeding maintenance at 12 months.

Prevalence of low and high BMI during the first 3 years of life: using New Zealand national electronic health data.

Data on body mass index (BMI) in infants and toddlers worldwide are lacking, relative to older age groups. To describe the growth (weight, length/height, head circumference, and BMI z-score) of New Zealand children under the age of 3 years, and examine differences by sociodemographic characteristics (sex, ethnicity, and deprivation). Electronic health data were collected by Whānau Āwhina Plunket, who provide free 'Well Child' services for approximately 85% of newborn babies in New Zealand. Data from children under the age of 3, who had their weight and length/height measured between 2017 and 2019, were included. The prevalence of BMI (WHO child growth standards) ≤2nd, ≥85th, and ≥95th percentiles were determined. Between 12 weeks and 27 months of age, the percentage of infants ≥85th BMI percentile increased from 10.8% (95% CI, 10.4%-11.2%) to 35.0% (34.2%-35.9%). The percentage of infants with high BMI (≥95th percentile) also increased, particularly between 6months (6.4%; 95% CI, 6.0%-6.7%) and 27 months (16.4%; 15.8%-17.1%). By contrast, the percentage of infants with low BMI (≤2nd percentile) appeared steady between 6 weeks and 6months, and declined at older ages. The prevalence of infants with a high BMI appears to increase substantially from 6months across sociodemographic characteristics, with a widening prevalence gap by ethnicity occurring from 6months, mirroring that of infants with a low BMI. The number of children with high BMI increases rapidly between 6months and 27 months of age, suggesting this is an important timeframe for monitoring and preventive action. Future work should investigate the longitudinal growth trajectories of these children to determine if any particular patterns predict later obesity and what strategies could effectively change them.

Risk factors for early occurrence of malnutrition in infants with severe congenital heart disease.

To identify the risk factors of early occurrence of malnutrition in infants with severe congenital heart disease (CHD) during their first year of life. Retrospective longitudinal multicenter study carried out from January 2014 to December 2020 in two tertiary care CHD centers. Four CHD hemodynamic groups were identified. Malnutrition was defined by a Waterlow score under 80% and/or underweight under -2standard deviations. A total of 216 infants with a severe CHD, e.g., requiring cardiac surgery, cardiac catheterization, or hospitalization for heart failure during their first year of life, were included in the study. Malnutrition was observed among 43% of the cohort, with the highest prevalence in infants with increased pulmonary blood flow (71%) compared to the other hemodynamic groups (p < 0.001). In multivariate analysis, low birthweight (OR 0.62, 95% CI 0.44-0.89, p = 0.009), CHD with increased pulmonary blood flow (OR 4.80, 95% CI 1.42-16.20, p = 0.08), heart failure (OR 9.26, 95% CI 4.04-21.25, p < 0.001), and the number of hospitalizations (OR 1.35, 95% CI 1.08l-1.69, p = 0.009) during the first year of life were associated with malnutrition (AUC 0.85, 95% CI 0.79-0.90). Conclusions: In infants with a severe CHD, early occurrence of malnutrition during the first year of life affected a high proportion of subjects. CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations were risk factors for malnutrition. Further studies are required to identify optimal nutritional support in this population. What is Known: • Malnutrition is a known morbidity and mortality factor in children with severe congenital heart disease. What is New: • Early occurrence of malnutrition during the first year of life in infant severe congenital heart disease (CHD) was high (43%). • CHD with increased pulmonary blood flow, low birthweight, heart failure, and repeated hospitalizations during the first year of life were risk factors for malnutrition.

A case-control study comparing rates and diagnoses of hospital readmission in infants affected by neonatal abstinence syndrome

Objective Rates of neonatal abstinence syndrome/neonatal opioid withdrawal syndrome (NAS/NOWS), a withdrawal syndrome from opioids and other substances resulting from intrauterine exposure, have been increasing exponentially in the U.S. To improve health outcomes, it is important to understand population health risks, including rehospitalization and related diagnoses, using current data. This study will compare and describe the rates of rehospitalization, the demographic characteristics and the rehospitalization diagnoses and age at diagnosis between the infants affected by NAS/NOWS to those sampled who were unaffected. This study will also describe the frequency of NAS/NOWS births per year along with a yearly comparison of readmissions in those affected by NAS/NOWS to those who were not (2016–2020). Methods Health claims data were used to conduct a case/control study. Diagnosis codes for neonatal withdrawal syndrome/NAS/NOWS (P04.49 or P96.1 and P96.1 alone) from 1 October 2015 to 1 June 2021 were extracted, and controls were case-matched based on month/year of birth. Rehospitalizations following birth and the related diagnoses were described and grouped using the Agency of Healthcare Research Quality Clinical Classifications Software Refined Frequency distribution. The chi-square test of association and generalized estimating equation modeling were used for data analysis. Results Infants affected by NAS/NOWS are 2.7 times more likely to have a rehospitalization. White, non-Hispanic neonates (OR = 1.5; p = .007) and those infants residing in rural areas (OR = 1.9; p < .001) were disproportionately affected. We identified a host of admission diagnoses with increased prevalence in infants affected by NAS/NOWS when compared to those who were not affected (e.g. infectious diseases, feeding disorders). Conclusions Infants with NAS/NOWS are at increased risk of rehospitalization with a host of diagnoses, and specific demographic groups (White, rural) are more highly affected.

Complementary feeding methods and introduction of ultra-processed foods: A randomized clinical trial.

Complementary feeding (CF) is defined as a period when foods, other than milk, are introduced to the infant's diet. Unfortunately, frequent consumption of ultra-processed foods (UPF) has become highly prevalent early in an infant's life. The aim was to verify the association of CF methods with the introduction of UPF in early childhood. This randomized clinical trial involved pairs of mother-infants, allocated in groups receiving different CF interventions: strict Parent-Led Weaning (PLW); strict Baby-Led Introduction to SolidS (BLISS), or mixed-method. The intervention consisted of a counseling session on healthy eating at the child's 5.5 months of age. A structured questionnaire was created based on the NOVA classification for the definition of UPF and applied at 9 and 12 months. The effect of the CF method intervention was measured by a survival curve for UPF offered for the first time in early childhood between groups. Cox regression was used to estimate its magnitude. The primary analysis was done in three groups (PLW, BLISS, and Mixed) and the secondary analysis was done in two groups (PLW, and BLISS + Mixed). A total of 139 mother-infant pairs were eligible and 129 followed the study. The prevalence of infants who were exposed to UPF in early childhood was 58.9% (n = 76), being 71.4% in the PLW group, 53.3% in the BLISS group, and 52.4% in the Mixed group, without differences between them (p = 0.133). The PLW group intervention had a greater chance of exposure to ice cream or popsicles (p = 0.032) and sweet crackers (p = 0.009), compared with the other two CF groups. The Cox regression did not find significant differences between the three groups. However, the regression with two groups estimated a 38% reduction in the offer of UPF in the BLISS + Mixed group intervention (p = 0.049). The CF intervention promoting greater infant autonomy (BLISS and Mixed) was associated with a reduction in the offer of UPF in early childhood. This knowledge may contribute to supporting strategies aimed at reducing UPF consumption by the young infant. [https://ensaiosclinicos.gov.br/rg/RBR-229scm], identifier [RBR-229scm U1111-1226-9516].

Evaluation of the prescription pattern of ferrous sulfate as a therapy for preventing iron deficiency anemia in infants.

Iron deficiency prevalence in infants is high. Therefore, iron supplementation has been recommended and specified as a program. This study aimed to determine the characteristics of the prescription of ferrous sulfate as a preventive therapy for iron deficiency anemia in young infants. We conducted a descriptive cross-sectional study of clinical records of young infants with eight visits per year. We analyzed a total of 287 records. The prescription characteristics included five criteria prescription indication, age at prescription, dosage, periodicity, and time. These characteristics were scored as follows 1 point when it was considered adequate and 0 when it was considered inadequate; the minimum possible score was 0, and the maximum possible score was 5 points. Statistical analysis included percentages and 95% confidence intervals (CI). The prescription pattern of ferrous sulfate as preventive therapy in infants under one year of age was indicated in 100% of the records reviewed. All five criteria were met in 18.1% of the reviewed records (95%CI 13.6-22.6). The lowest compliance corresponded to adequate dosage (29.2%; 95%CI 23.9-34.5). Age at prescription was correct in 75.9% (95%CI 70.9-80.9); duration of prescription was correct in 44.2% (95%CI 38.4-50.0), and periodicity was proper in 31.1% (95%CI 25.9-36.7) of the files reviewed. Compliance with the prescription of ferrous sulfate as a preventive measure for anemia in infants was not as expected; interventions are needed to reverse this behavior.

Determinants of Behavior and Proportion of Exclusive Breastfeeding at Tapung Health Center, Kampar Regency

Breast milk is one of efforts to improve the mother and infant's health, one of which is reduce infant mortality rate (IMR). The prevalence of infants that receive the eclusive breastfeeding at The Tapung II public Health Center in 2020 was 57.1%. The purpose of this research is to know the determinant relationship of Exclusive Breastfeeding at The Tapung II Public health center in 2021. Type of this research is quantitative research observational with analytic cross sectional study. The population are Mothers who have babies aged 6-11 months. The sampling is non-probability sampling with consecutive sampling. The analysis used Chi Square and Multiple logistic regression with predictive model. The result of research is the proportion of infant who get exclusive breastfeeding is 43 people (45, grand mother's support and the early initiation of breast feeding) with exclusive breast feeding at The Tapung II Public Health Center. The recommending to health workers are increase the coverage of exclusive breast feeding through a health promotion strategy approach grand mother's support and the early initiation of breast feeding) with exclusive breast feeding at The Tapung II Public Health Center. The recommending to health workers are increase the coverage of exclusive breast feeding through a health promotion strategy approach

Effect of pneumococcal conjugate vaccine on prevalence of otitis media with effusion among children in Vietnam

PurposeOtitis media with effusion (OME) is common in young children and is associated with Streptococcus pneumoniae infection. We aimed to determine the impact of pneumococcal conjugate vaccine (PCV) introduction on the prevalence of OME and OME associated with vaccine-type (VT) or non-VT. MethodsPopulation-based cross-sectional surveys were conducted in pre- (2016) and post-PCV periods (2017, 2018, and 2019) at selected communes in Nha Trang, Vietnam. For each survey, we randomly selected 60 children aged 4–11 months and 60 aged 14–23 months from each commune. Nasopharyngeal sample collection and tympanic membrane examination by digital otoscope were performed. S. pneumoniae was detected and serotyped by lytA qPCR and microarray. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated using Firth’s logistic regression, stratified by age group. ResultsOver the four surveys, 2089 children had a bilateral ear examination. Compared to pre-PCV, the prevalence of OME reduced in 2018 (OR 0.51, 95 %CI 0.28–0.93) and in 2019 (OR 0.53, 95 %CI 0.29–0.97) among the <12-month-olds, but no significant reduction among the 12–23-month-olds. The prevalence of OME associated with VT pneumococcus decreased in 2018 and 2019 (2018: OR 0.14, 95 %CI 0.03–0.55; 2019: OR 0.20, 95 %CI 0.05–0.69 in the <12-months-olds, 2018: OR 0.05, 95 %CI 0.00–0.44, 2019: OR 0.41, 95 %CI 0.10–1.61 in the 12–23-months-olds). The prevalence of OME associated with non-VT pneumococcus increased in the 12–23-month-olds in 2017 (OR 3.09, 95 %CI 1.47–7.45) and returned to the pre-PCV level of prevalence in 2018 and 2019 (OR 0.94, 95 %CI 0.40–2.43 and 1.40, 95 %CI 0.63–3.49). ConclusionPCV10 introduction was associated with a reduction of OME prevalence in infants but not in older children.

Mutational and bioinformatics analysis of the NKX2.1 gene in a cohort of Iranian pediatric patients with congenital hypothyroidism (CH)

Congenital hypothyroidism (CH) occurs with a relatively alarming prevalence in infants, and if not diagnosed and treated in time, it can have devastating consequences for the development of the nervous system. CH is associated with genetic changes in several genes that encode transcription factors responsible for thyroid development, including mutations in the NK2 homeobox 1 (NKX2.1) gene, which encodes the thyroid transcription factor-1 (TTF-1). Although CH is frequently observed in pediatric populations, there is still a limited understanding of the genetic factors and molecular mechanisms contributing to this disease. The sequence of the NKX2.1 gene was investigated in 75 pediatric patients with CH by polymerase chain reaction (PCR), single-stranded conformation polymorphism (SSCP), and direct DNA sequencing. Four missense heterozygous variations were identified in exon 3 of the NKX2.1 gene, including three novel missense variations, namely c.708A>G, p.Gln202Arg; c.713T>G, p.Tyr204Asp; c.833T>G, p.Tyr244Asp, and a previously reported variant rs781133468 (c.772C>G, p.His223Gln). Importantly, these variations occur in highly conserved residues of the TTF-1 DNA-binding domain and were predicted by bioinformatics analysis to alter the protein structure, with a probable alteration in the protein function. These results indicate that nucleotide changes in the NKX2.1 gene may contribute to CH pathogenesis.

Prevalence, risk factors and parental perceptions of gastroesophageal reflux disease in Asian infants in Singapore

Infant gastroesophageal reflux disease (GERD) is a significant cause of concern to parents. This study seeks to describe GERD prevalence in infants, evaluate possible risk factors and assess common beliefs influencing management of GERD among Asian parents. Mother-infant dyads in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) cohort were prospectively followed from preconception to 12 months post-delivery. GERD diagnosis was ascertained through the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R) administered at 4 time points during infancy. Data on parental perceptions and lifestyle modifications were also collected. The prevalence of infant GERD peaked at 26.5% at age 6 weeks, decreasing to 1.1% by 12 months. Infants exclusively breastfed at 3 weeks of life had reduced odds of GERD by 1 year (adjusted odds ratio 0.43, 95% confidence interval 0.19-0.97, P=0.04). Elimination of "cold or heaty food" and "gas producing" vegetables, massaging the infant's abdomen and application of medicated oil to the infant's abdomen were quoted as major lifestyle modifications in response to GERD symptoms. Prevalence of GERD in infants is highest in the first 3 months of life, and the majority outgrow it by 1 year of age. Infants exclusively breastfed at 3 weeks had reduced odds of GERD. Cultural-based changes such as elimination of "heaty or cold" food influence parental perceptions in GERD, which are unique to the Asian population. Understanding the cultural basis for parental perceptions and health-seeking behaviours is crucial in tailoring patient education appropriately for optimal management of infant GERD.

Breastfeeding and its relationship with motor development of infants at 3–4 months of age

ABSTRACT This was a cross-sectional study that aimed to evaluate the association between breastfeeding and motor development of infants at 3–4 months of age in the city of Pelotas, Rio Grande do Sul. The outcome, infant motor development, was evaluated through the Bayley Scale of Infant Development (Bayley III). The prevalence of infants that stopped breastfeeding before reaching 3–4 months of age was 16.6%. The most prevalent reason for early weaning was ‘insufficient milk flow’ (50.4%). The general mean of motor development was 104.9 (±13.2) points, and the lowest means were attributed to babies who never breastfed (101.5; SD ±14.6), followed by those stopped breastfeeding (102.5; SD ±14.1). The results revealed that infants who never breastfed and those who had stopped at 3–4 months of age presented −1.9 (CI 95% −3.8;−0.2) points in the motor development scale means when compared with infants who were still breastfeeding.