Singaporean Children Research Articles

Recommending 1000 ppm fluoride toothpaste for caries prevention in children

The caries prevalence among Singapore children remains high, with almost 50% affected by the age of 6 years. Among oral hygiene homecare, toothpastes with a minimum fluoride concentration of 1000 ppm or greater have been shown to be more effective at preventing caries. Previous concerns with dental fluorosis have led to the marketing of non-fluoride and low-fluoride toothpastes specifically for children. In the local context, many parents start their children on these products due to ingestion concerns and recommendations of the product, rather than on sound advice from a healthcare professional. The latest recommendation is to use a smear size of 1000 ppm or greater fluoride toothpaste in children under 3 years of age with high caries risk. For children aged 3 years and older, a pea size of 1000 ppm or greater fluoride toothpaste should be used. As medical physicians are typically the first healthcare encounter for many children, they are well positioned to provide recommendations on the concentration and amount of fluoride toothpaste to be used in young children.

Promoting bilingualism and children’s co-participation in Singapore language classrooms: Preschool teacher strategies and children’s responses in Show-and-Tell

Show-and-Tell is one of many activities recommended for encouraging children’s oral language production in classrooms across the world, but there is little research on the topic. From existing studies, teacher facilitation is posited as key to shaping children’s oral language production. This paper explores teacher strategies for facilitating children’s oral language production during Show-and-Tell, in the case studies of four Singapore preschool language teachers (English, Chinese, Malay and Tamil) sampled from a larger nationwide longitudinal study, with 47 children observed across the four classrooms. Using a coding scheme with high reliability ( d = 0.80), a total of 1192 teacher utterances and 539 children’s utterances were coded to capture teacher strategies and types of children’s responses across the classrooms. Findings showed that the English teacher employed language modelling most frequently, while all other teachers most frequently facilitated through questioning. The potential of Show-and-Tell in encouraging children’s language output is observed in how self-initiated talk is among the most frequent form of child participation, especially in the English-language classroom, which was expected given the context of English-dominance among bilingual Singapore children. In response to teacher facilitation, children were more likely to respond with verbal responses and gestures, as compared to not responding. It was, however, noted that a lack of wait-time provided by teachers hampered children’s opportunities to express themselves during the activity. Our findings have implications on the need for different types of teacher strategies required to ensure the effectiveness of Show-and-Tell for promoting children’s oral language production.

Hearing and Neurodevelopmental Outcomes of Young Infants with Parechovirus-A and Enterovirus Meningitis: Cohort Study in Singapore Children and Literature Review

Abstract Parechovirus-A (PeV-A) and Enterovirus (EV) commonly cause childhood aseptic meningitis. Bacterial meningitis in children has been associated with devastating long-term sequelae. However, developmental outcomes are unclear in Parechovirus meningitis. This study aims to review the clinical findings and developmental outcomes of infants with PeV-A and EV meningitis. We performed a retrospective study of infants aged 90 days or younger being admitted to our hospital with PeV-A meningitis between November 2015 and July 2017, with positive cerebrospinal fluid (CSF) PeV-A PCR and negative blood and CSF bacterial cultures. Hearing and neurodevelopmental outcomes were compared with a previous cohort of infants aged 90 days or younger with EV meningitis admitted from January 2015 to December 2015. A total of 161 infants were included in our study, of which 68 infants (42.2%) had PeV-A meningitis and 93 infants (57.8%) had EV meningitis. We assessed their developmental outcome at 6 months, 1 year, and 2 years post-meningitis. At 2 years post-meningitis, three infants with PeV-A meningitis had developmental delay (5.5%), whereas none with EV meningitis had developmental delay. One patient had speech delay and autism spectrum disorder, while two had mild speech delay. When compared with our cohort of EV meningitis ≤90 days old, children with PeV-A meningitis ≤90 days old were more likely to have developmental delay 2 years post-meningitis (odds ratio 2.4, 95% confidence interval 2.0–3.0, p = 0.043). None of the patients with PeV-A or EV meningitis had sensorineural hearing loss or neurological sequelae, such as cortical blindness, oropharyngeal dysphagia, hydrocephalus, epilepsy, or cerebral palsy. Infants with PeV-A meningitis had a significant risk of developmental delay 2 years post-meningitis compared with those with EV meningitis. It is important to follow-up the developmental milestones of infants diagnosed with PeV-A meningitis for at least 2 years; and when they develop developmental delay, to ensure that they receive appropriate intervention.

Variations in longitudinal sleep duration trajectories from infancy to early childhood

ObjectiveThis study investigates variations in night, day, and total sleep trajectories across infancy and childhood in Asian children. ParticipantsParticipants consisted of a subset of 901 children, within the Growing Up in Singapore Towards healthy Outcomes cohort, which recruited 1247 pregnant women between June 2009 and September 2010. DesignWe used a novel conditional probabilistic trajectory model: a probabilistic model for mixture distribution, allowing different trajectory curves and model variances among groups to cluster longitudinal observations. Longitudinal sleep duration data for the trajectory analyses were collected from caregiver-reported questionnaires at 3, 6, 9, 12, 18, 24, and 54 months. ResultsWe found 3 patterns of night sleep trajectories (n = 356): long consistent (31%), moderate consistent (41%), and short variable (28%); and 4 patterns of day sleep trajectories (n = 347): long variable (21%), long consistent (20%), moderate consistent (34%), and short consistent (25%). We also identified 4 patterns of total sleep trajectories (n = 345): long variable (19%), long consistent (26%), moderate consistent (28%), and short variable (27%). Short, moderate, and long trajectories differed significantly in duration. Children with consistent trajectories also displayed sleep patterns that were significantly more representative of typical developmental sleep patterns than children with variable trajectories. ConclusionsThis is the first study to describe multiple sleep trajectories in Singaporean children and identify between-individual variability within the trajectory groups. Compared to predominantly Caucasian samples, night/total sleep trajectories were generally shorter, while day sleep trajectories were longer. Future studies should investigate how these variations are linked to different developmental outcomes.

The epidemiological risk factors of hand, foot, mouth disease among children in Singapore: A retrospective case-control study.

The incidence of hand, foot, and mouth disease (HFMD) is increasing over the years despite current prevention and control policies in Singapore. A retrospective case-control study was conducted among parents whose children attended childcare centres in Singapore to assess the epidemiological risk factors associated with HFMD among children below 7 years old. Parents of 363 children with HFMD (as cases) and 362 children without HFMD (as controls) were enrolled from 22 childcare centres. Data of potential risk factors were collected through a standardised self-administered questionnaire from parents which include demographics and hygiene practices. Multivariate analysis were adjusted for age group, parent's education level, mother's age, HFMD-infected siblings, and preschool admission period. Child's age between 1.5 and 4.9 years, child who had been in childcare for more than 1.9years, having HFMD-infected siblings, two or more children in a family, higher educated parents, parents who had HFMD episode previously, wash toys with soap once every two to three weeks, sanitise toys once every two to three weeks, out-sourced cleaner in childcare centre, no domestic helper at home and more than 22 children in a classroom were independent risk factors of HFMD. These evidence provide crucial implications to guide more effective prevention and control of HFMD in Singapore.

Student Version of the Teacher-Student Relationship Inventory (S-TSRI): Development, Validation and Invariance.

There is limited knowledge concerning children’s relationships with their teachers, and specifically, we lack a suitable, culturally appropriate measurement instrument for assessing the teacher-student relationship from the student’s perspective in Asia. This study used attachment theory as a theoretical framework to understand teacher-student relationships. Using a dataset from the Ministry of Education (MOE) of Singapore, the authors developed and validated a student version of the Teacher-Student Relationship Inventory (S-TSRI), with good psychometric properties for Singaporean children. The three-factor S-TSRI model comprising the factors satisfaction, instrumental help, and conflict was first established by exploratory factor analysis (EFA) and confirmed by confirmatory factor analysis (CFA). Through subsequent multigroup CFAs, we found that the factorial invariance was supported across gender, grade levels, and students of different academic levels, represented by the pass and fail groups. The structural model was tested in the total, pass, and fail groups. For the total and pass groups, the factors satisfaction and instrumental help showed significant positive relationships with a sense of school belonging, and negative or non-significant relationships with aggression. The conflict factor showed a weaker negative or non-significant relationship with a sense of school belonging, and a positive relationship with aggression. For the fail group, identical results were obtained with one exception; this was discussed in light of the fail group having a different needs profile. Findings from this study show that the 14-item S-TSRI measure has robust psychometric properties and yields scores that are reliable and valid in this large sample of primary school students from Singapore.

Comparison of myopic progression in Finnish and Singaporean children

To compare 3-year myopic progression between Finnish and Singaporean children. Myopic progression was compared between 9-year-old (mean age 9.7±0.4years, n=92) and 11-year-old (mean age 11.7±0.4years, n=144) Finnish (Finnish RCT) children and Singaporean children matched by age and refraction (SCORMMatched, n=403) and 7- to 8-year-old Singaporean children matched only by refraction (SCORM Young, n=186). Spherical equivalent (SE) was between -0.50 and -3.00 D. Refraction with cycloplegia was controlled annually for 3years. Information on parental myopia, mother's education, time spent on near-work and outdoor time was gathered by parental questionnaire. Three-year myopic progression was -2.08±0.96 D and -1.30±0.69 D in the Finnish RCT and Singaporean SCORM Matched 9-year-olds, respectively, and -1.34±0.78 D, and -0.52±0.44 D in the 11-year-olds, respectively (p<0.001 between all groups). Myopic progression was fastest (-2.69±0.89 D) in the SCORM 7-year-olds and similar between the SCORM Matched 9-year-olds and Finnish RCT 11-year-olds (p=0.55). The Finnish RCT and SCORM Matched children showed significant differences in both daily near-work time (1.8±1.0 versus 3.4±1.9hours per day, p<0.001) and outdoor time (2.6±0.9 versus 0.5±0.4hours per day, p<0.001). These differences did not, however, explain the differences in myopic progression between the groups. More time spent outdoors was associated with less myopic progression in the Finnish RCT (r=0.17, p=0.009) group only. In the whole materials, greater myopic progression was associated with younger age at baseline (p<0.001), younger age was associated with mother's higher education (p<0.001), and mothers higher education was associated with myopia in both parents (p<0.001). Age at baseline was the most significant factor associated with myopic progression. However, at the same age and with the same initial refraction, the Finnish and Singaporean children showed different myopic progression. This result remains unexplained. Thus, age of myopia onset should be considered when comparing myopic progression between different samples and conducting treatment trials. Parental myopia may be a weak indicator of heredity of myopia.

Burden and Cost of Hospitalization for Respiratory Syncytial Virus in Young Children, Singapore.

Respiratory syncytial virus (RSV) is the most common cause of pediatric acute lower respiratory tract infection worldwide. Detailed data on the health and economic burden of RSV disease are lacking from tropical settings with year-round RSV transmission. We developed a statistical and economic model to estimate the annual incidence and healthcare cost of medically attended RSV disease among young children in Singapore, using Monte Carlo simulation to account for uncertainty in model parameters. RSV accounted for 708 hospitalizations in children <6 months of age (33.5/1,000 child-years) and 1,096 in children 6–29 months of age (13.2/1,000 child-years). The cost of hospitalization was SGD 5.7 million (US $4.3 million) at 2014 prices; patients bore 60% of the cost. RSV-associated disease burden in tropical settings in Asia is high and comparable to other settings. Further work incorporating efficacy data from ongoing vaccine trials will help to determine the potential cost-effectiveness of different vaccination strategies.

A qualitative analysis of disclosure of parental incarceration to children in Singapore – Implications for best practice

Children are often the unintended victims of incarceration, and are frequently subjected to extreme hardship following the arrest of a parent, but their right to information is always compromised in the name of protection. Disclosure of incarceration can be equally challenging for both the family caregivers and the children. This paper presents the data from interviews about disclosure of incarceration, looking at how 10 caregiver–child dyadic pairs interacted and handled disclosure in the process. Disclosure is taken as a continuous process requiring the caregivers and the children to negotiate and make sense of it, rather than a static, one-off decision. Three dimensions of protection have been identified (i.e., protection from future blame, protection of the child, and protection of the inmate), together with the intent to use the disclosure for educational purposes. Although there was not a case where the children protested having limited or no information, they varied in their responses. A lack of interest in asking for essential information and intentional avoidance of the topic of parent’s incarceration have been observed in some children. Self-regulated submission by the child is a result of many factors, including a tacit demand to acknowledge parental authority and a caring intent not to add to the caregiver’s burdens. This article also highlights implications and recommendations for changing professional practice and policy guidelines to promote children’s rights and their healthy growth amidst the challenges of life.

Schooling (for) Japanese children in cosmopolitan Singapore: building bridges and erecting barriers

ABSTRACT The Japanese community in Singapore comprises mainly white-collar workers and their families. This article addresses issues concerning education, overseas living, and identity-related investments made visible by way of examining schooling and parenting practices. Framed within a critique which recognizes schooling and identity investment as being inherently ideological in nature, the discussion centers around a Japanese school in whose broader operations both parents and other Japanese institutions are involved. Subsequent analysis is directed towards deconstructing (1) institutionalized practices relating to ways in which Japanese overseas organize their lives and frame their life experiences; and (2) the means by which particular notions of Japanese cultural and national heritage are legitimated and fostered through schooling. The article concludes with the observation that the maintenance of an ideologized form of Japaneseness, and not the engenderment of cosmopolitan or globalized identities, constitutes the dominant driving force behind Japanese-medium schooling in Singapore.

High Myopes in Singapore: 19-Year Progression from Childhood to Adulthood

Highly myopic Singaporean children progress rapidly by adolescence to their adult spherical equivalent, with early onset and baseline myopia associated with pathologic findings of thinner choroid and tessellated fundus in young adulthood.

Epidemiology of Adenovirus Infections and Outcomes of Cidofovir Treatment in Severely Ill Children.

An increase in human adenovirus (HAdV) infections among hospitalized children in Singapore was observed since 2013. Young age (<2 years) and significant comorbidities have been associated with severe HAdV infections which can result in significant morbidity and mortality. Cidofovir (CDV) has been used to treat severe HAdV infections despite limited data and efficacy. This is a retrospective, observational review of infants and children 1 month to 17 years of age with laboratory-confirmed severe HAdV infection, admitted to a pediatric tertiary care hospital in Singapore between January 2013 and September 2017. Severe infection was defined as requiring intensive care unit or high dependency care at any point during hospital admission. Clinical characteristics, potential risk factors for mortality, as well as the outcome of cases treated with CDV were examined. A total of 1167 children were admitted for HAdV infection, of which 85 (7.3%) were severe. For severe infections, the median age was 1.5 years (interquartile range: 0.72-3.2 years). The majority had comorbidities (69.4%) and presented with pneumonia (32.9%). Genotypes HAdV-7 (29.4%) and HAdV-3 (27.0%) were the most common HAdV genotypes identified. Thirteen (15.3%) patients died. Patients who died had a higher proportion of existing neurologic comorbidity (46.2% vs. 13.9%; P = 0.014) and presentation with pneumonia (69.2% vs. 26.4%; P = 0.008) compared with survivors. Patients who presented with pneumonia had a higher risk of 30-day mortality (odds ratio 4.3, 95% confidence interval: 1.0-28.6; P < 0.05). CDV was administered to 17 (20%) children for mainly viremia (47.1%) and/or pneumonia (41.2%). Mortality rate was 41.2% for severe HAdV cases treated with CDV. A significant proportion of patients who died when compared with recovered patients presented with pneumonia (6 of 7, 85.7% vs 1 of 10, 10%; P = 0.004). All 8 patients who had viremia received CDV and survived. Mortality can be high in pediatric patients with severe HAdV infections. HAdV-7 and HAdV-3 were the most common genotypes identified in our cohort with severe HAdV infection. Pneumonia is a potential risk factor for mortality in severe HAdV infections in our cohort. Early CDV administration may be considered in patients with severe HAdV infection and existing comorbidities but more studies are required.

Understanding physical activity and sedentary behaviour among preschool-aged children in Singapore: a mixed-methods approach

ObjectivesThis study investigated physical activity (PA) and sedentary behaviour (SB) among preschool-aged children in Singapore and potential correlates at multiple levels of the socioecological model from in-school and out-of-school settings.DesignA...

Child, family, and school factors in bilingual preschoolers' vocabulary development in heritage languages.

Child characteristics, family factors, and preschool factors are all found to affect the rate of bilingual children's vocabulary development in heritage language (HL). However, what remains unknown is the relative importance of these three sets of factors in HL vocabulary growth. The current study explored the complex issue with 457 Singaporean preschool children who are speaking either Mandarin, Malay, or Tamil as their HL. A series of internal factors (e.g., non-verbal intelligence) and external factors (e.g., maternal educational level) were used to predict children's HL vocabulary growth over a year at preschool with linear mixed effects models.The results demonstrated that external factors (i.e., family and preschool factors) are relatively more important than child characteristics in enhancing bilingual children's HL vocabulary growth. Specifically, children's language input quantity (i.e., home language dominance), input quality (e.g., number of books in HL), and HL input quantity at school (i.e., the time between two waves of tests at preschool) predict the participants' HL vocabulary growth, with initial vocabulary controlled. The relative importance of external factors in bilingual children's HL vocabulary development is attributed to the general bilingual setting in Singapore, where HL is taken as a subject to learn at preschool and children have fairly limited exposure to HL in general. The limited amount of input might not suffice to trigger the full expression of internal resources. Our findings suggest the crucial roles that caregivers and preschools play in early HL education, and the necessity of more parental involvement in early HL learning in particular.

Using vignettes as a ‘safe space’ for low-income children to discuss sensitive topics in social work assessment

SummaryChildren’s voices are rarely heard in the social work assessment process, with their opinions often missing in decisions made about their lives, despite them being key contributors of their lives. As such, this paper aims to examine the usefulness of vignettes in eliciting and discussing sensitive issues, such as the lack of financial resource, with children to aid the social work assessment process. Vignettes are defined as short stories, embedded in a tangible context, about a fictional individual or situation that is relevant to a specific theme. MethodTen children aged seven to 12-years-old from economically disadvantaged families were invited to participate in this study. A two-pronged data collection method was used where (1) interviews incorporating vignettes was conducted with children followed by (2) small group discussions with social workers. Vignettes were crafted that placed the children in hypothetical dilemmas namely, (1) childcare responsibility versus desire for peer activities and (2) tight family finances versus personal wants. Preliminary findings from interview data with children guided small group discussions with social workers on the applicability of this method in the social work assessment process with children in Singapore. FindingsFindings of this research provide evidence that vignettes seem to enable access to children’s viewpoints regarding sensitive topics and provide insights on how they make meaning of and construct solutions to cope with their difficult circumstances in a relational context. It further provided insights into children’s ability to exercise agency in a relational context. ApplicationThis study proposes vignettes as a potentially useful tool that can enhance the social work assessment process, providing an avenue for children to be heard. Beyond being merely a research tool, vignettes can potentially be a useful social work assessment tool as it creates safe spaces to access children’s experiences, aiding social workers to engage in child-centered social work practice.

Timeliness of Childhood Vaccination Coverage: the Growing Up in Singapore Towards Healthy Outcomes Study.

Studies investigating timeliness for childhood vaccination are limited especially in Asia. We examined the timeliness of vaccine administration and associated factors among infant and young children in Singapore. A total of 782 children born between November 2009 and July 2011 from a prospective cohort in Singapore were studied. Vaccination records from birth to 24months of age were obtained from the National Immunization Registry of Singapore. Multivariable logistic regression models were performed. By 2years of age, 92.8% of children in our cohort experienced a delay in receiving 1 or more vaccine doses according to the recommended national immunization schedule. When vaccinations were reviewed by series for each vaccine, 15.6% received all vaccine series outside the recommended age ranges. Factors associated with receiving vaccination series outside the recommended ages included maternal aged ≤ 35years (OR 2.00; 95% CI 1.09, 3.66), Malay (1.71; 1.01, 2.89) or Indian ethnicity (2.06; 1.19, 3.59), low monthly household income (1.91; 1.14, 3.18), having at least four children (3.46; 1.62, 7.38) and private (3.42; 1.80, 6.48) and multiple vaccination providers (3.91; 1.23, 12.48). These findings show an unacceptably high proportion of children experienced a delay in the receipt of their vaccinations. The identification of several demographic, socioeconomic, health-seeking behavioural and vaccine provider factors provides opportunities for targeted interventions to enhance the timeliness of childhood vaccination in Singapore.

A 5-year retrospective review of children with peanut allergy in the largest paediatric hospital in Singapore.

BackgroundThe prevalence of peanut allergy (PA) among children has increased significantly over the past decade. Even though the prevalence of PA in Singapore is considered low, peanut is the top trigger for food-induced anaphylaxis in Singaporean children.ObjectiveTo describe the demographic characteristics and clinical features of children with PA.MethodsThis is a 5-year retrospective review of children diagnosed with PA based on clinical history coupled with a positive skin prick test to peanut or positive oral food challenge results.ResultsThere were 269 patients (53.9% males) with a clinical diagnosis of PA. The median age at first allergic presentation for the PA group was 24 months old, with interquartile range of 13–39 months. The most common form of peanut introduced was roasted peanut. The rate of peanut anaphylaxis was 7.1%. Concomitant tree nut sensitization was found in 32.3% of this cohort, predominantly to cashew nut. Majority of them have a personal history of atopy – 75.8% with eczema, 63.6% with allergic rhinitis, and 19.7% with asthma.ConclusionThis is the first large review of peanut-allergic children in Singapore. Prospective population-based studies are needed to establish the true prevalence and risk factors associated with the development of this potentially life-threatening condition.

FORMATION OF VALUE ORIENTATIONS OF PRESCHOOL AGE CHILDREN: SINGAPORE - UKRAINE, COMPARATIVE ASPECT

The article is devoted to a comparative analysis of the formation of values of preschool age children in Singapore and Ukraine. The authors note that, in line with social challenges in the world, Singapore has focused on the features of successful reform of the education system in general and the preschool sector in particular. The reasons of expediency of carrying out analytical comparative research in the field of reforming of preschool education of Singapore and Ukraine are covered. An analytical review of the content of reforming Singapore's educational system in the context of studying the issue of value orientations in preschool children of Ukraine and Singapore has been made by foreign and Ukrainian scholars. And also some aspects of educational changes that have taken place in Singapore at all educational levels, and in Ukraine only in secondary education institutions. The qualitative changes necessary for the formation of a holistic value approach to the organization of the educational process in the preschool education institutions of Ukraine are highlighted: the implementation of learning through play aimed at developing not only the intellectual but also the emotional sphere and laying the foundations for the formation of key skills of the 21st century through free play and teachers' democratic approach to personality formation. The problems of reforming Singapore's preschool education and the peculiarities of public policy in addressing them are revealed. The approach of preschool education of both countries to the free play of children with the purpose of forming social competences and values of communication is analyzed. The advantages of Ukrainian preschool education in social education of preschool children are identified and changes that need to be consolidated at the legislative level are necessary for the development of key values of children. The main ones are: the creation and implementation of national programs for preschool institutions and teacher training courses / institutes. The requirements for the formation of motivation of preschool teachers and training of pedagogical workers in Ukraine, capable to provide the process of development of critical and creative thinking of preschool children on the basis of the principle of lifelong learning and upbringing through the play of personality with holistic value orientation, are distinguished.

Attitudes & beliefs that influence healthy eating behaviours among mothers of young children in Singapore: A cross-sectional study

BackgroundMany countries recommend parental involvement to enhance the effectiveness of healthy lifestyle interventions focusing on behavioural modifications that encourage weight management in children. Our study investigates to what extent the different constructs of the Theory of Planned Behaviour (TPB) are influencing healthy eating behaviour among mothers of pre-school and primary school children in Singapore. MethodsA total of 716 mothers of pre-schoolers, 3–6 years old (N = 358) and primary school students, 7–12 years old (N = 358) were administered a survey to assess healthy eating behaviour using the TPB constructs. Bivariate correlations among TPB constructs were calculated and tested using Pearson's correlation. Multivariate generalized regression was performed to examine the associations between TPB constructs and healthy eating behaviour. ResultsMore than 80% of children consumed less than the daily recommended servings of at least 1 glass of dairy,2 servings of fruit and 2 servings of vegetables per day advised by the Singapore Health Board. More primary school children consumed less dairy per day compared to pre-school children (48.9% vs 26.3%; p < 0.001). Primary school children's healthy eating behaviours were correlated with mother's perceived behavioural control (PBC) such as adequate discipline (β = 0.40; p = 0.001), self-efficacy (β = 0.35; p = 0.01) and a lower barrier that healthy food does not satisfy hunger (β = −1.16; p < 0.001). Barriers that significantly reduced pre-school children's healthy food intake were lack of motivation among mothers (β = −1.13; p < 0.001) and children (β = −0.49; p = 0.02), lack of satiety (β = −1.06; p = 0.02), difficulty in changing child's eating habits (β = −0.58; p = 0.03), lack of family support (β = −0.62; p = 0.03). ConclusionsFindings from this study provides a formative foundation for future research and exploration of plausible interventions around improving mother's PBC, self-efficacy and reducing barriers, which could increase mother's engagement in improving their children's healthy eating behaviours in Singapore.

Seroprevalence of vaccine-preventable diseases among children and adolescents in Singapore: Results from the National Paediatric Seroprevalence Survey 2018

ObjectivesThe Ministry of Health (MOH), Singapore, conducted the National Paediatric Seroprevalence Survey 2018 (NPSS 2018) to estimate the latest immunity levels against measles, rubella, varicella, diphtheria, tetanus and hepatitis B, and the seroprevalence of chronic hepatitis B virus (HBV) carriage in children and adolescents in Singapore. MethodsThe survey involved prospective collection of residual sera from 1,200 children and adolescents aged 1–17 years in two public acute hospitals. Enzyme-linked immunosorbent assays (EIA) or plague reduction neutralisation tests (PRNT) were used to determine the seroprevalence of the vaccine-preventable diseases. ResultsOverall prevalence of measles and rubella antibodies among Singaporean children and adolescents aged 1–17 years were 98.2% (95% CI: 91.2–98.8%) and 94.8% (95% CI: 93.4–95.9%) respectively. 97.1% (95% CI: 96.0–97.9%) of subjects had at least basic protection against diphtheria, while 89.3% (95% CI: 87.5–91.0%) were protected against tetanus. The prevalence of chronic HBV carriage was 0.4% (95% CI: 0.2–1.0%), while 45.7% (95% CI: 42.9–48.5%) were immune against HBV. The seroprevalence for varicella antibodies was 52.9% (95% CI: 50.1–55.7%). Concordance between vaccination status and seroprevalence was observed for measles, rubella, diphtheria and tetanus. ConclusionSingapore’s children and adolescents are well-protected against measles, rubella, diphtheria and tetanus. Continual efforts in ensuring high vaccination coverage should be sustained.